A Fully Collaborative, Noteless Electronic Medical Record Designed to Minimize Information Chaos: Software Design and Feasibility Study (Preprint)

BACKGROUND Clinicians spend large amounts of their workday using electronic medical records (EMRs). Poorly designed documentation systems contribute to the proliferation of out-of-date information, increased time spent on medical records, clinician burnout, and medical errors. Beyond software interfaces, examining the underlying paradigms and organizational structures for clinical information may provide insights into ways to improve documentation systems. In particular, our attachment to the <i>note</i> as the major organizational unit for storing unstructured medical data may be a cause of many of the problems with modern clinical documentation. Notes, as currently understood, systematically incentivize information duplication and information scattering, both within a single clinician’s notes over time and across multiple clinicians’ notes. Therefore, it is worthwhile to explore alternative paradigms for unstructured data organization. OBJECTIVE The aim of this study is to demonstrate the feasibility of building an EMR that does not use notes as the core organizational unit for unstructured data and which is designed specifically to disincentivize information duplication and information scattering. METHODS We used specific design principles to minimize the incentive for users to duplicate and scatter information. By default, the majority of a patient’s medical history remains the same over time, so users should not have to redocument that information. Clinicians on different teams or services mostly share the same medical information, so all data should be collaboratively shared across teams and services (while still allowing for disagreement and nuance). In all cases where a clinician must state that information has remained the same, they should be able to <i>attest</i> to the information without redocumenting it. We designed and built a web-based EMR based on these design principles. RESULTS We built a medical documentation system that does not use notes and instead treats the chart as a single, dynamically updating, and fully collaborative workspace. All information is organized by clinical topic or problem. Version history functionality is used to enable granular tracking of changes over time. Our system is highly customizable to individual workflows and enables each individual user to decide which data should be structured and which should be unstructured, enabling individuals to leverage the advantages of structured templating and clinical decision support as desired without requiring programming knowledge. The system is designed to facilitate real-time, fully collaborative documentation and communication among multiple clinicians. CONCLUSIONS We demonstrated the feasibility of building a non–note-based, fully collaborative EMR system. Our attachment to the <i>note</i> as the only possible atomic unit of unstructured medical data should be reevaluated, and alternative models should be considered.

A Novel Grid-Based Data Broadcasting Scheme for Wireless Sensor Networks

A run-of-the-mill remote sensor arrange comprises numerous vitality compelled sensor hubs that are arbitrarily sent is the sensor field. Vitality is one of the most significant parts of planning an information dispersal convention for applications, for example, war zone checking, living space observing, and so on. We present EGDD, an Energy-effective Grid-based Data Dissemination plot for arbitrarily conveyed remote sensor systems. The proposed conspire is vitality effective for dealing with both sink and source portability. EGDD depends on a virtual framework-based foundation for information scattering from various versatile sources to different portable sinks. The virtual lattice of square size is built by the main source showing up in the sensor field dependent on the remaining vitality of the sensor hubs. Moreover, we proposed an askew sending calculation for inquiry and information sending which guarantees that just a single spread hub advances the question and information at once. In EGDD, substitute scattering hubs are chosen ahead of time during the lattice development procedure and the least limit vitality level is characterized for spread hubs. When the vitality of a dispersal hub arrives at the base edge esteem, it is supplanted by another spread hub. The reenactment results show that the proposed EGDD conspire is more vitality proficient when contrasted with other information scattering conventions.

The Extensive Interpretation of Ethical Hacking

Dangerous development of the Internet has introduced diverse beneficial matters: digital enterprise, fundamental get admission to tremendous shops of reference fabric, community organized figuring, email, and new streets for advancing and information scattering, to provide some fashions. Moreover with maximum imaginative advances, there may be also a blurred aspect: crook builders. An moral software program engineer is a PC and framework ace who ambushes a safety structure to support its proprietors, searching for vulnerabilities that a threatening developer could abuse. Governments, associations, and private occupants round the world are irritating to be a some segment of this indignant, anyway they're on side about the likelihood that that some software engineer will destroy into their Web server and override their logo with sex diversion, read their email, take their charge card variety from an on line shopping internet site, or installation programming in an effort to stealthily transmit their affiliation's special bits of information to the open Internet. There are numerous techniques used to hack the records. This paper researches the ethics at the back of systems of appropriate hacking and whether there are issues that lie with this new area of labour.

Synchrotron Scattering Methods for Nanomaterials and Soft Matter Research

This article aims to provide an overview of broad range of applications of synchrotron scattering methods in the investigation of nanoscale materials. These scattering techniques allow the elucidation of the structure and dynamics of nanomaterials from sub-nm to micron size scales and down to sub-millisecond time ranges both in bulk and at interfaces. A major advantage of scattering methods is that they provide the ensemble averaged information under in situ and operando conditions. As a result, they are complementary to various imaging techniques which reveal more local information. Scattering methods are particularly suitable for probing buried structures that are difficult to image. Although, many qualitative features can be directly extracted from scattering data, derivation of detailed structural and dynamical information requires quantitative modeling. The fourth-generation synchrotron sources open new possibilities for investigating these complex systems by exploiting the enhanced brightness and coherence properties of X-rays.

The Building of Education Information System Based on Semantic Service

With the rapid development of distance continuing education in China, there is a need to integrate the education information systems in different regions to offer a unified information management to eliminate the problems of the information scattering, information isolation, and information isolated islands for distance education. A new information frame based on SOA technology in software engineering was proposed to fulfill the requirement of contemporary distance education.