\'olume 16 .. l\ umber I, Part ~

165 OMNIScan™:A CUSTOMIZED ULTRASOUND DATABASE MANAGEMENT SYSTEM FOR THE PERINATAL ACADEMIC ENVIRONMENT McLean D Nardi D.x Vlntzlleos A.M. University of Connecticut Health Center Farmington, CT.

The goal was to develop a DBMS for ultrasound reporting that would fulfill the service requirements of a regional referral center as well as provide the capability to carry out clinical research studies OMNIScan™ is a customized application based on a commercially available data base program, OMNIS 5™ by Blyth Software. The application was written by a single author(DM) The system IS designed to offer the following features:1) It utilizes the graphical user Interface of the Macintosh™ environment so that Inexperienced computer users can function as data entry personnel with minimal training, 2) The file structure allows for the single entry of patient demographic data, It also allows for the storing of data involving multiple pregnancies, each having multiple sonograms, 3) Multiple gestations with no limit on the number of fetuses are allowed, 4) All biometric measurements are calculated for gestational age uSing published standards, 5) Calculations that may be utilized as part of a fully targeted obstetrical sonogram are performed eg ThoracIc circumference, 6) Antenatal testing results including NST, BPP score and SID ratio values are valid data entry fields and are reported, 7) Procedures including CVS, PUBS and amniocentesis can also be entered, 8) Standard data options are stored in "lists" and are entered uSing a "point and click" technique. This ensures uniformity of data entry and optimal search criteria for an investigator performing a retrospective reView, 9) Each exam generates a text based report that allows for the full Interpretation of the exam findings and recommendations for further management. This is In keeping with the consultative nature of our Antenatal Fetal Testing Unit, 10) Customizable data entry fields are available for prospective studies that may be undertaken In the future, 11) The Inherent properties of the program allows for the easy export of data into other statistical and graphical software programs for data analysIs and display.

166 AUTOMATED OBSTETRICAL DATA MANAGEMENT C. Nadolski·, C. VOGT·, B. RAPALJE*, E. CAPELESS University of Vermont College of Medicine, Burlington, Vermont 05405.

There is continuing need for accurate and consistent documentation of labor and delivery events in obstetrical records as well as an increasing requirement for the compilation of statistical data It is difficult to reliably obtain this information without resorting to multiple forms which often need the same information. Our purpose was to design an automated system combining easy data entry by caregivers with compilation of the data and output into various formats. A unique computer generated dialogue allows each birth record to be completed through data entry modules corresponding to the normal order of obstetrical events: antepartum, intrapartum, delivery and immediate postpartum, baby and placenta, postpartum, and demographics. Many answers are defaulted to a common value. The caregiver either accepts the defaulted value, changes it with a mouse interface, or uses keyboard entry to a text field. Direct keyboard input represents less than 10% of the average record. Immediate output of data into predefined formats for delivery notes, operative notes, labor and delivery summaries, and birth certificates are generated for physician verification and signature. The application is PC-based utilizing a local area network to link a central file server with separate devices located in labor and delivery, postpartum, and medical records. Data records are stored and exchanged via this file server which also acts as a long term repository. Simple translations allow the porting of user-selected fields to other application software. Gateway to MCHV's IBM 4381 is provided for higher level data support. Automatic echo of stored information has kept caregiver data entry time to less than five minutes both following delivery and prior to discharge. We have designed a system which is easy to use, ensures a database on each patient, and generates required reports. It replaces multiple forms therefore decreasing caregiver paperwork. It has been well accepted by students, residents and attending staff.

SPO Abstracts 293

167 A DISTRIBUTED CARE "LIFE CYCLE" MODEL FOR A MULTI-FUNCTIONAL PERINATAL INFORMATION SYSTEM. J E. Deaver>', K. Johnsonx, C.J. Hobel, I.R Merkatz. Albert Einstein College of Medicine, Bronx, NY and UCLA, Cedars-Sinai Medical Center, Los Angeles, CA

We hypothesized that the utility of a perinatal information system would be enhanced by replacing the traditional medical record or forms-based data model with one which explicitly represents interactions of patients with the medical care system. A traditional forms-based data system is a repository constrained in utility by its two­dimensional patient information perspective. An alternative model creates linkages supporting nonredundant storage and conveyance of information, not only between distributed care sites, but also between phases of the perinatal life cycle, i.e. preconceptional, prenatal, intrapartum, neonatal, postpartum, and interconceptional Such a system can meet diverse requirements including: service and practice management, concurrent clinical quality assurance, risk management, medical record generation, birth certificate and other external reporting, and clinical research. It will be demonstrated that, based on our model, a perinatal information system has been created and implemented using client-server system architecture, a relational database system, and Structured Ouery Language (SOL). Clinical rules and formulae to automatically validate data, detect inconsistencies and missing items, and generate clinical views of data are incorporated

168 L"IITIAL f\ '.\1.\ 'XnON OF :\1\1 INTELLIGDIT,

I;-.ITER.. \CTIVE DELI\ 'fRY BOOK . .)'Qhn ]',.BI'-illl;m,,_;'.lOx JJepartment at Ohstetncs and Gynecology. Long Island

College HOSPlt:,], Brooklyn, New York. "\ccurate and det.llied record" of the a.:ttvities oj a Labor

and Deltvery unit are a necessity in efforts to evaluate or improve functiorung. Cntd rec"ntly nearly all uruli> relied upon a large hound book, in which entnes were manually I.,ompktcd for eat.:h deliverv. C0nlpuLCriled pennatll r!atabase<; have heen developed which rely upon hatch entry of mallUallv compkted d...ltl.1 I~Jrm1). \\'~ have d~'Yelup..:d ~ cnmputer haser! delivery hook WhICh alh",<; Immediate Intt;r~tJVL dJ.w Cn~iy b) Jcl!",Cfy per.)Ollfb'::. lh~ tJUiru~C vI' this study \l'a, to comnarc the accuracy and comrletencss of ()bj~dlV~ ~crJnat~~l ddta ~vlle.;tcd by <.l vJ.nd:~ 1.)1 mdhoJ3. hoth manual and computenzed. rhese mcluded: 1. ~16.nu~1 entr) into J. GeL· .... LiY bovk. 2. t-.!anuaJ comnletlon of a delivery summ:lry sheet 3. Dat~ entry C(lrJi1 mdn~tall) (:onljJkL.:J 1'01 b~:d~ cn:n .:I [ntelligent mteractlve delivery hook. Ill .... ,.h.ClLra.::y and (:()mp~denc-:,.) u1' ,)\"lc.::kd \,...vI11ulUvU.'! '-tlKi

categorIC'al rennatal vanahle<; Wcrr comrared to the f)enI1~ncnt n~~dl~~.tl rel..'urd. \\' e -":0ndud~ th0.t Jlil!1... t ';.l1Lr:.,

hrldges the 'lap ix,tween old-<;tvle manual entry logs ,wei ull':dlc bakh 4 1.-ntry vy.)klll;:;, ullprU\Ul5 th..: yU\.lilt~~ \)f cL.l .. 1.

c.lpl11rcd. The intelligent. mteractlve del1vcrv hook "iii he d ... 'ilwlt:,tratl'1..1 dt llk SPO.