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COMPUTERS IN MEDICINE: TREATMENT
Like HELP, which is used by L.D.S. Hospital in Utah, CARE is used by Wishard Memorial Hospital in Indianapolis to check a patient’s electronic medical record. As data from examinations, tests, and drug treatment pile up, the program may advise what treatment to try next, or it may warn against using the wrong treatment.
Another system now being tested, called ATTENDING, helps anesthesiologists find the optimal combination of drugs to use on a patient. The doctor enters the plan and the patient’s characteristics into the computer. The program then weighs the characteristics and critiques the doctor’s plan.
A program called ONCOCIN suggests possible cancer treatment plans. A cancer patient might be given as many as eight drugs, X-rays, surgery, or all of these. At Mount Sinai Medical Center in New York City, Dr. Larry Norton developed the Norton-Simon Model computer program to find the best way to give drug therapy to breast cancer patients. Since then, such patients’ survival rates have increased significantly.
The National Cancer Institute developed a program called Physician Data Query (PDQ) to put doctors everywhere in touch with the latest cancer treatments. With a computer, a physician can find the right therapy for a patient with any type of cancer. The computer also can list the names and addresses of cancer specialists and identify those who are doing the most advanced research on cancer treatment.
At L.D.S. Hospital, a HELP computer checked on the use of antibiotics before and after surgery had begun. These chemicals kill bacteria so they do not spread to other organs during surgery. The computer system revealed that patients who were given antibiotics before surgery developed infections only half as often as those given antibiotics after the start of surgery. As a result, the system now sends automatic “alerts” to doctors, reminding them to give antibiotics at least 2 hours before the patient gets to the operating room. Since the alerts, infections have decreased measurably.
At Canada’s Misericordia General Hospital in Winnipeg, Manitoba, doctors tested a desktop computer in the Drug Interactions Advisor system, which alerts doctors to drug conflicts. For example, if doctors simultaneously prescribe tetracycline, an antibiotic, and Coumadin, a blood thinner, the blood may get too thin and hemorrhaging could occur. Dozens of such possibilities exist.
In a test of 100 patients, the Canadian physicians found that 51 had potential drug conflicts, and the computer advised changing treatment in 26 cases.
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