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Applied Medical Informatics for the Chest Physician: Time Commitment
How much do EMRs cost? The firm First Consulting Group, based in California, said it would cost $210 million in one-time start-up expenditures for the 46 Massachusetts hospitals to install them or to update existing technology to a minimum agreed-on standard. However, the consultant predicted the hospitals would save $275 million annually because the systems […]
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Applied Medical Informatics for the Chest Physician: Technology
It is intuitive that the introduction of an EMR into a large academic health system will differ in many ways from its introduction into a small, community, private practice office. However, what may not be as evident is that the characteristics of these different clinical environments may have more to do with success than simply […]
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Applied Medical Informatics for the Chest Physician: Complexity of the EMR
The elements of achieving success in an EMR selection, configuration, and implementation are complex. The three major categories are “Winning Hearts and Minds,” “Technology,” and “Place and Time” (Fig 1). Credible leadership is essential, and, as has been demonstrated repeatedly, implementing any change in medical practice usually revolves around a group leadership model. The change […]
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Applied Medical Informatics for the Chest Physician
In the first installment in this series on applied medical informatics (AMI) for the chest physician, we reviewed the structure and basic function of the electronic medical record (EMR). Even to the casual observer of the technology of the EMR in American medicine, the following two realities are manifest: (1) recently, there has been a […]
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Pulmonary Mycobacterium kansasii Infection in Israel, 1999-2004: Conclusion
The present report supports M kansasii susceptibility to clarithromycin and ofloxacin.2′ Ofloxacin was also superior to ciprofloxacin (Table 2). We believed that some isolates are susceptible to slightly higher ciprofloxacin concentrations; therefore, when clinically indicated, ciprofloxacin should be used regardless of the in vitro susceptibility results. M kansasii infection affects middle-aged men more than women. […]
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Pulmonary Mycobacterium kansasii Infection in Israel, 1999-2004: Discussion
We noted several clinically significant findings. Series from the United States’ and Spain suggested a higher-than-normal rate of isolation of M kansasii from HIV-positive patients, and a study done between 1981 and 1987 reported a 200-fold higher incidence of disseminated M kansasii infection in people with AIDS (138 per 100,000) than in the general population […]
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Pulmonary Mycobacterium kansasii Infection in Israel, 1999-2004: Molecular Characterizations
Twenty M kansasii isolates underwent molecular characterization. Eighteen isolates were found to be M kansasii type I, and 2 isolates were M kansasii type II. Table 2 summarizes the drug sensitivity of the M kansasii isolates. All isolates were sensitive to rifam-picin, all but one isolate (borderline) were sensitive to ethambutol and ofloxacin, and all […]