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'''Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System'''
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'''Welcome to the OHSU Clinfowiki'''
  
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The OHSU Clinical Informatics Wiki (aka ClinfoWiki) is the implementation of a  [http://en.wikipedia.org/wiki/Wiki wiki] website devoted to topics in [[Biomedical Informatics]].
  
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Based upon the report by Institute of Medicine and safety initiatives promoted by Leapfrog group, the Department of Critical care Medicine, University of Pittsburg School Of Medicine, Pittsburg, PA implemented a commercially sold computerized physician order entry (CPOE) systems. Accordingly, the attempt was an effort to reduce medical errors and mortality rate. The idea behind the implementation was to test the hypothesis that CPOE results in the reduction of mortality rate among children who are transported for specialized care. The method employed was, gathering demographic, clinical, and mortality of all children that were admitted via interfacility transport to the authors’ children’s hospital for a period of 18 months. According to the authors, a commercially purchased CPOE was used during the time frame in general and medical-surgical operations. The implementation of the software was completed in six days. Retrospective analysis of pre-CPOE (15 months) and post-CPOE implementation was done on 1942 children.
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The Department of Medical Informatics & Clinical Epidemiology (DMICE) is one of 27 academic departments in the School of Medicine at Oregon Health & Science University (OHSU). The mission of DMICE is to provide leadership, discovery and dissemination of knowledge in clinical informatics, clinical epidemiology, and bioinformatics / computation biology. This mission is fulfilled through programs of research, education, and service. DMICE programs are recognized internationally for their accomplishment and innovation. The OHSU Biomedical Informatics program is one of the largest of its kind in the world.  
  
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The authors claimed that 75 children, among the 1942 who were referred for specialized care during the study period, which result in 3.86%. Analysis revealed that the mortality rate increased significantly from 2.80 % (39 of 1394) before the CPOE implementation to 6.57% (36 of 548) after CPOE. With respect to the observations of the authors, they conclude that there the unexpected increase in mortality and the implementation of the CPOE seem to be coincidental. Accordingly, while the CPOE holds great promise, the authors advise that, when implementing CPOE, systems, institutions should continue to evaluate mortality effects, in addition to medical error rates for “children who are dependent on time-sensitive therapies.”
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Clinfowiki is edited by [https://www.ohsu.edu/people/vishnu-mohan/2BD88C7AE00A4A21861DFB0964974984 Vishnu Mohan, M.D., M.B.I.], and was created in 2005 by [https://en.wikipedia.org/wiki/Dean_F._Sittig Dean F. Sittig, Ph.D.].
  
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''Comment:  The authors did not totally disagree with the findings of those who were promoting the efficacy of CPOE in clinical settings. It appears that their observations could be prone to errors as well. Moreover, the environment in which the examination was made could not be representatives of the total environment in which CPOE systems have been implemented. The unexpected increase in the mortality rate of the patients could also be attributed to the time of the sickness or the degree of illness of the patients involved. Moreover, the authors did not indicate any demonstrable bias against or for the use of CPOE by the clinicians. And this could also be a factor in not using the systems efficiently, which could have had impact on the clinicians’ job performances. Are all these clinicians computer literate? That question was not answered. Therefore, further studies are needed to justify the efficacy of CPOE. –GB Abimbola''
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The site can be browsed by anyone. To begin a new article, or edit an existing article, you must first create an account and login to the ClinfoWiki. The easiest way to create a new page is to edit an existing page where you want your article to link from, and then place your page's name within double square brackets, like so: <nowiki> [[Your page name here]] </nowiki> If you then save the page and click on that link, you will be taken to a screen with a box where you can begin to write your content.
  
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Young Y. Han, Joseph A. Carcillo, Shekhar T. Venkataraman, Robert S.B. Clark, R. Scott Watson, Trung C. Nguyen, Hulya Bayir and Richard A.Orr
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[[Special:ActiveUsers|We]] are currently working on [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles, and we '''[[Clinfowiki To Do|need your help]]''' to complete this study of Informatics. See [[Special:Statistics]] for more complete information on the site.
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Pediatrics 2005;116;1506-1512
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DOI: 10.1542/peds.2005-1287
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The Clinfowiki has recently been reorganized into the <u>20</u> categories below. When adding (or editing) content, please try to ensure the content traces back to one of these categories.
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=[[:Category:Technologies | Technologies]]=
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==[[:Category: EHR | Electronic Medical Record (EMR)]]==
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* [[EHR | What is the Electronic Medical Record]]
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* [[EMR v. EHR]]
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* [[Interface Design of the EHR]]
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* [[EHR-enabled Research]]
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* [[Security of the distributed electronic patient record: a case-based approach to identifying policy issues]]
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* [[Purpose of EMRs]]
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* [[Registries]]
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==[[:Category: CPOE | Computerized Physician Order Entry (CPOE)]]==
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* [[CPOE | Computerized Physician Order Entry]]
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* [[Barcode medication administration]]
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* [[E-prescribing | Electronic Prescribing (E-prescribing)]]
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* [[Medication Errors]]
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==[[:Category: CDS | Clinical Decision Support (CDS)]]==
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* [[CDS | Clinical Decision Support]]
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* [[Timeline of the Development of Clinical Decision Support]]
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* [[The Evolution of Clinical Decision Support]]
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* [[Decision Support Service]]
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* [[Effect of Computerized Clinical Decision Support on the Use and Yield of CT Pulmonary Angiography in the Emergency Department]]
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* [[Automated Clinical Decision Support (CDS) using Pattern Recognition/Temporal Relationships]]
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==[[:Category: PHR | Personal Health Record (PHR)]]==
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* [[PHR | Personal Health Records]]
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* [[PHA | Personal Health Applications]]
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==[[:Category: Reviews | Reviews of scientific papers]]==
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==[[:Category:Integrated Data Repositories (IDR) | Integrated Data Repositories (IDR)]]==
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* [[CIDR | Clinical Integrated Data Repositories (CIDR)]]
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==[[:Category:Ancillary Systems | Ancillary Systems]]==
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* [[Ancillary Clinical Information Systems]]
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* [[BioBanking | Biobanking -- a.k.a. Biorepositories or Tissue Bank]]
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* [[Anesthesia Information Management Systems (AIMS)]]
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==[[:Category:Medical Devices | Medical Devices]]==
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<DynamicPageList>
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category = Medical Devices
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</DynamicPageList>
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*  [[mHealth]]
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==[[:Information Retrieval]]==
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* [[Semantic MEDLINE]]
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==[[:Category:Other Technologies | Other Technologies]]==
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* [[:Category:New_Technology| New CIS-related Technologies]]
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* [[FOSSM | Free and Open Source Software (FOSS) licensing in medicine]]
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* [[Unintended Consequences of HIT]]
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* [[i2b2 Informatics for Integrating Biology and the Bedside]]
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*  [[The Cloud and it's impact on Health IT]]
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* [[Teleconcussion - An Emerging Sports Concussion Management Model]]
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* [[The Blockchain in Healthcare]]
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* [[Robot Anesthesia]]
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* [[American College of Emergency Physicians:  InnovatED]]
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* [[Software-Guided insulin therapy]]
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* [[L1000 assay and the Connectivity Map dataset]]
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* [[5G and Healthcare]]
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=[[:Category:Applications | Applications]]=
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==[[:Category:Evidence Based Medicine (EBM) | Evidence Based Medicine (EBM)]]==
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* [[EBM | Evidence Based Medicine]]
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* [[Hierarchy of Evidence]]
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*  Rationale, design,and implementation protocol of an electronic health record integrated clinical prediction rule (iCPR) randomized trial in primary care
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* [[Efficacy of an Evidence-Based Clinical Decision Support in Primary Care Practices A Randomized Clinical Trial]]
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==[[:Category:Methodologies and Frameworks | Methodologies and Frameworks]]==
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* [[Evaluation and Design Methodologies]]
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* [[EHR Data Quality]]
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* [[The Journey through Grief: Insights from a Qualitative Study of Electronic Health Record Implementation]]
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* [[Sociotechnical systems]]
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* [[Data Center Planning and Design Overview for Healthcare Organizations]]
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* [[EHR Participatory Deployment Vs Black box Deployment methods]]
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* [[Real-time automatic polyp detection system for colonoscopy using artificial intelligence]]
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==[[:Category:Government, Public and Private Initiatives | Government, Public and Private Initiatives]]==
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* [[HITREC | Health Information Technology Regional Extension Centers (HITREC)]]
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* [[RHIO | Regional Health Information Organization (RHIO)]]
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* [[NHIN | Nationwide Health Information Network (NwHIN)]]
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* [[Assistant Secretary for Planning & Evaluation]]
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* [[Office of the National Coordinator for Health Information Technology (ONC)]]
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* [[Trusted Exchange Framework and Common Agreement (TEFCA)]]
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* [[Council on the Application of Health Information Technology (CAHIT)]]
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* [[Agency for Healthcare Research and Quality (AHRQ)]]
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* [[Centers for Medicare and Medicaid Services (CMS)]]
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* [[U.S. Food and Drug Administration (FDA)]]
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* [[National Institutes of Health (NIH)]]
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* [[Big Data to Knowledge (BD2K)]]
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* [[Indian Health Service (IHS)]]
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* [[Health Services and Resource Administration (HRSA)]]
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* [[Centers for Disease Control and Prevention (CDC)]]
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* [[U.S. Department of Commerce]]
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* [[Combined U.S. Department of Defense / Veterans Affairs Initiatives]]
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* [[U.S. Department of Defense (DoD) Initiatives]]
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* [[Department of Veterans Affairs Initiatives]]
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* [[U.S. Department of Homeland Security]]
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* [[Healthcare Information Technology Standards Panel (HITSP)]]
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* [[Purpose and overview | International perspectives]]
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* [[UK]]
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* [[National Electronic Health Record Program in United Kingdom]]
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* [[:Category:Blogposium|All articles resulting from the Blogposium collaboration]]
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* [[Maternal and Perinatal Quality Care Collaboratives]]
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* [[EHealth Initiative]]
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* [[Meaningful use]]
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* [[Electronic Laboratory Reporting]]
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* [[Department of Education]]
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* [[PMI | Precision Medicine Initiative (PMI)]]
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* [[Health Information and Management Systems Society (HIMSS)]]
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* [[Society for Participatory Medicine]]
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* [[Veteran’s Affairs Switch from VistA based Electronic Health Record to Cerner Millennium]]
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* [[Singapore NEHR]]
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* [[ORCATECH | Oregon Center for Aging and Technology (ORCATECH)]]
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==[[:Category:Training and User Support | Training and User Support]]==
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* [[Learning Health Systems (LHS)]]
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==[[:Category:Terminology and Coding | Terminology and Coding]]==
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*  [[Glossary of acronyms]]
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*  [[Definition and Use of Interface Terminologies]]
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*  [[Common Terminology Services | Common Terminology Services (CTS)]]
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*  [[Distributed Cognition and Knowledge-based Controlled Medical Terminologies]]
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*  [[Ontology]]
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*  [[International Statistical Classification of Diseases | International Statistical Classification of Diseases (ICD)]]
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*  [[Systematized Nomenclature Of Medicine | Systematized Nomenclature Of Medicine (SNOMED)]]
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*  [[International Dietetics and Nutrition Terminology | International Dietetics and Nutrition Terminology (IDNT)]]
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*  [[International Classification of Primary Care | International Classification of Primary Care (ICPC)]]
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*  [[Unified Medical Language System | Unified Medical Language System (UMLS)]]
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*  [[Aggregated data]]
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==[[:Category:Workflow | Workflow]]==
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* [[Methods to capture workflow]]
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* [[Measurement]]
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* [[Importance of Workflow Analysis During Physician Office EMR Implementation]]
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* [[Workflow Management System]]
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* [[Process Mining]]
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* [[Using Evidence-Based Layout Design to Enhance Workflow in the Clinical Laboratory]]
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* [[Planning for Radiology CDS Technology]]
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==[[:Category:Interface, Usability and Accessibility | Interface, Usability and Accessibility]]==
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*  [[Usability]]
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* [[Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA]]
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*  [[Software Test Documentation]]
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* [[Data Model to Enhance the Security and Privacy of Healthcare Data]]
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==[[:Category:Data Visualization | Data Visualization]]==
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* [[Clinically Relevant Data Visualization]]
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=[[:Category:Reference | Reference]]=
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==[[:Category:Academics and Education | Academics and Education]]==
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* [[Informatics Students' Contributions|Contributions from OHSU students]]
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* [[List of Informatics Departments]]
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* [[Endowed Professorships | Endowed Professorships and Chairs in Health / Medical / Nursing / Biomedical Informatics]]
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* [[Graduate Medical Education Milestones]]
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* [[List of Clinical Informatics Conferences]]
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==[[:Category:Specialties and Disciplines | Specialties and Disciplines]]==
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* [[Bioinformatics]]
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* [[Chief Nursing Informatics Officer]]
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* [[Clinical Informatics Fellowship]]
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* [[Clinical research informatics]]
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* [[Clinical Social Work Informatics]]
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* [[Cognitive Informatics]]
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* [[Consumer health informatics]]
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* [[Dental informatics]]
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* [[Health informatics]]
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* [[Imaging informatics]]
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* [[Medical laboratory informatics]]
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* [[Medical Subspecialty Board of Clinical Informatics]]
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* [[Mental health informatics]]
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* [[Neuroinformatics]]
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* [[Nursing informatics]]
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* [[Pediatric Informatics]]
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* [[Pharmacy Informatics]]
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* [[Public Health Informatics]]
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* [[Quality Informatics]]
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* [[Traditional Chinese Medicine (TCM) informatics]]
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* [[Translational Bioinformatics]]
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* [[Ethics in Informatics]]
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==[[:Category:Research Groups | Research Groups]]==
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* [[CIRCLE: Clinical Informatics Research Collaborative]]
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* [[Biomedical Informatics Research Network (BIRN)]]
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 +
==[[:Category:Literature | Literature]]==
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* [[Books | Books on Topics in Clinical Informatics]]
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* [[Leading Health Informatics and Medical Informatics Journals]]
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==[[:Category:External Links | External Links]]==
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* [http://www.ohsu.edu/xd/ Oregon Health & Science University]
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* [http://www.ohsu.edu/xd/education/schools/school-of-medicine/departments/clinical-departments/dmice/ The Department of Medical Informatics and Clinical Epidemiology at OHSU]
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* [http://www.cpoe.org Website of the Provider Order Entry Team from Oregon Health]
 +
* [http://hittransition.com/tools.htm Links to online tools for HIT/RHIO development]
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* [http://www.hitdashboard.com/unitedStates.aspx Health Information Technology Dashboard]
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* [http://wellness.wikispaces.com/Tactic+-+Use+Evolving+Health+Information+Technology+Tools Wellness Wiki: Use Evolving Health Information Technology Tools]
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* [http://www.emedicine.com/ eMedicine] Physician contributed medical articles and CME
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* [http://www.kmle.com KMLE Medical Dictionary] Medical dictionary and medical related links
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* [http://www.merckmedicus.com Merck Medicus] Contains a significant number of textbook resources (requires free registration
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* [http://www.nlm.nih.gov NLM] (US National Library of Medicine)
 +
* [http://www.webmd.com WebMD] General comprehensive online health information
 +
* [http://www.open.medicdrive.org Medicine 2.0] Comprehensive online Personal health record information.
 +
* [http://www.searchmedica.com SearchMedica.com] Searches medical literature for health care professionals
 +
* [http://www.ahima.org AHIMA] American Health Information Management Association
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* [http://www.amia.org AMIA] American Medical Informatics Association
 +
* [http://www.ania-caring.org ANIA-CARING] American Nursing Informatics Association and the Capital Area Roundtable on Informatics in NursinG
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* [http://www.himss.org HIMSS] Healthcare Information and Management Systems
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* [http://www.imia-medinfo.org IMIA] International Medical Informatics Association
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* [http://wellness.wikispaces.com/Tactic+-+Use+Evolving+Health+Information+Technology+Tools Use Evolving Health Information Technology Tools]
 +
* [http://wellness.wikispaces.com/Blueprint+for+an+Integrated+HIT+system+-+The+Patient+Life-Cycle+Wellness+System Blueprint for an Integrated HIT system - The Patient Life-Cycle Wellness System]
 +
* [http://circleinformatics.org CIRCLE: Clinical Informatics Research Collaborative]

Latest revision as of 13:46, 26 April 2022

Welcome to the OHSU Clinfowiki

The OHSU Clinical Informatics Wiki (aka ClinfoWiki) is the implementation of a wiki website devoted to topics in Biomedical Informatics.

The Department of Medical Informatics & Clinical Epidemiology (DMICE) is one of 27 academic departments in the School of Medicine at Oregon Health & Science University (OHSU). The mission of DMICE is to provide leadership, discovery and dissemination of knowledge in clinical informatics, clinical epidemiology, and bioinformatics / computation biology. This mission is fulfilled through programs of research, education, and service. DMICE programs are recognized internationally for their accomplishment and innovation. The OHSU Biomedical Informatics program is one of the largest of its kind in the world.

Clinfowiki is edited by Vishnu Mohan, M.D., M.B.I., and was created in 2005 by Dean F. Sittig, Ph.D..

The site can be browsed by anyone. To begin a new article, or edit an existing article, you must first create an account and login to the ClinfoWiki. The easiest way to create a new page is to edit an existing page where you want your article to link from, and then place your page's name within double square brackets, like so: [[Your page name here]] If you then save the page and click on that link, you will be taken to a screen with a box where you can begin to write your content.

We are currently working on 1,583 articles, and we need your help to complete this study of Informatics. See Special:Statistics for more complete information on the site.

The Clinfowiki has recently been reorganized into the 20 categories below. When adding (or editing) content, please try to ensure the content traces back to one of these categories.


Technologies

Electronic Medical Record (EMR)

Computerized Physician Order Entry (CPOE)

Clinical Decision Support (CDS)

Personal Health Record (PHR)

Reviews of scientific papers

Integrated Data Repositories (IDR)

Ancillary Systems

Medical Devices

Information Retrieval

Other Technologies

Applications

Evidence Based Medicine (EBM)

Methodologies and Frameworks

Government, Public and Private Initiatives

Training and User Support

Terminology and Coding

Workflow

Interface, Usability and Accessibility

Data Visualization

Reference

Academics and Education

Specialties and Disciplines

Research Groups

Literature

External Links

Retrieved from "https://clinfowiki.org/wiki/index.php?title=Main_Page&oldid=33213"