Site offers tools for busy clinicians
At the Web site of the National Center for Emergency Medicine Informatics, (www.ncemi.org) users can be updated on cutting-edge research, subscribe to an emergency medicine listserv, or determine if a patient is a candidate for thrombolytics.
NCEMI was founded as a not-for-profit institute in 1995 by Craig F. Feied, MD, FACEP, FAAEM, the organization’s director, and Mark Smith, MD, FACEP.
"It was created as a way to use informatics to deliver the kinds of tools and information needed by practicing clinicians in a busy clinical environment," says Feied, director of informatics for the department of emergency medicine at Washington (DC) Hospital Center.
The Web site is a real-time resource to meet the daily needs of ED managers, physicians, and nurses, Feied explains. "Because of the immediate usefulness of its content, www.ncemi.org has become the default home page for Web browsers in many EDs around the world," he says.
Here are some of the items on the site:
• Clinical decision-making tools. Many of the tools deliver practical answers to specific questions, says Feied. "For example, if you need to calculate the Alveolar-arterial oxygen gradient for a patient who is intubated and breathing 60% oxygen at an elevation well above sea level, you may not have that formula at your fingertips," he notes. "But you can find a simple calculator at the NCEMI site that will give you the answer in seconds."
To decide whether a stroke patient is eligible to receive thrombolytics, you need to calculate the National Institutes of Health stroke scale score for the patient, but there are 47 distinct choices to be made in calculating that score, and the printed documentation may not be readily available, says Feied.
"NCEMI can ask you 16 questions and can calculate that score for you in two seconds," he says.
The site contains 72 clinical tools: six algorithms, 25 clinical calculators, five decision rules, nine diagrams, 18 scoring systems, and nine reference tables, Feied reports.
• Journal update system. The site includes a daily selection of recent articles in the emergency medicine literature that helps clinicians and administrators stay current. The Journal Abstracts Delivered Electronically tool, accessible from a link on the page, allows visitors to sign up for a weekly e-mail that will send them links to every abstract published in the Medline-indexed literature on any topic (such as "emergency department and administration" or "observation unit") during that week. It can do the same for the articles published in any Medline-indexed journal in the past week.
Want a customized Medline search?
The journal update system, says Feied, "performs your customized Medline search every week. The results are automatically e-mailed to subscribers in a very brief format. That makes it extremely easy to stay current on a particular topic or to keep up with everything from a selected medical journal."
Links to abstracts of interest can be saved in a personal on-line "filing cabinet" for future reference whenever and wherever needed, notes Feied.
• A free staff scheduling program. This program is used by many EDs to handle shift scheduling needs, Feied reports. Special memo and project tracking systems provide administrative support, he says.
• Access to Web search engines. The site provides access to multiple Web search engines, so users can obtain medical information with a single click, says Feied. "For example, a search for clinical images of patients with a dermatologic problem or for X-rays of a particular type of fracture turns up dozens of high-quality images located at many different sites," he notes.
Other search functions permit identification of an unknown pill, delivery of drug dosing information, a Medline search, the discovery of practice guidelines, and several other commonly needed information.
• Information on medical topics. The site provides access to the most extensive set of medical textbooks in the world, located at emedicine.com, says Feied. "Nearly 10,000 medical authors and 1,500 editors work to write and maintain these textbooks, and all of the results are available free on-line," he explains.
In addition, more than 150 clinically useful medical topics are addressed directly on the site, including the most common simple emergencies seen in the ED, he says.
• "Question-a-day." The site delivers a brief daily question, answer, and citation taken from the core material of emergency medicine, says Feied. "The daily question shows up on the Web page and is also used as the basis for an on-line quiz system. But most users sign up to receive each day’s question via e-mail."
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