Automating the recording and improving the presentation of the anesthesia record

Although anesthesia records have been kept for over a hundred years, there is still discussion of their value and content. Two uses of the record are widely accepted: (1) review after the anesthetic event (as in medicolegal disputes), and (2) support of patient care during the delivery of an anesthetic. Although the anesthetic record is mandatory in much of the world, there is not a single standard for its format. Automating the generation and presentation of the record will enhance its value and help develop a consensus as to content. Merely automating the steps used to produce the manually generated record does not realize the full benefit of automation. For maximum benefit, the primary goal of automation should be to support the uses of the record. Specific techniques that are discussed include increasing time resolution, optimizing the type and location of input and display equipment, and tailoring the human interface. Particular attention is paid to the issue of how much detail is acceptable in the record, how to use visual cues to present detail properly, how to exclude extraneous detail, and how to avoid misleading presentations (erroneous interpretation of the data). Specific elements discussed include line width, the use of color, presentation of gradients, statistical summaries, contexts for reporting data, graphical techniques for increasing data content, and pictorial presentations. Current records are more often confusing because presented information is inconsistently displayed or irrelevant than because too much information is offered, and automation can ameliorate this problem.

[1]  H. Cushing I. On the Avoidance of Shock in Major Amputations by Cocainization of Large Nerve-Trunks Preliminary to their Division. With Observations on Blood-Pressure Changes in Surgical Cases. , 1902, Annals of surgery.

[2]  G. Smith,et al.  Harvey Cushing: His Contribution to Anesthesia , 1986, Anesthesia and analgesia.

[3]  J. S. Graenstein The Automated anesthesia record and alarm systems , 1987 .

[4]  A. J. Sarnat Do not fear computerized anesthesia records. , 1986, Anesthesiology.

[5]  J S Gravenstein The automated anesthesia record , 1991, Anaesthesiologie und Reanimation.

[6]  H T Davenport,et al.  The anaesthetic machine--a study of function and design. , 1980, British journal of anaesthesia.

[7]  R. Dirksen,et al.  The clinical use of the Ohmeda Automated Anesthesia Record Keeper integrated in the Modulus II Anesthesia System , 1987, International journal of clinical monitoring and computing.

[8]  H. Apple,et al.  Design and evaluation of a semiautomatic anesthesia record system. , 1982, Medical instrumentation.

[9]  J. Hipple,et al.  Electronic Problems Involved in the Practical Application of the Mass Spectrometer , 1945 .

[10]  Edward Tufte Attention to detail, or less is a bore , 1988 .

[11]  C. R. Chase,et al.  Computer Assisted Patient Evaluation (CAPE): a Multi‐Purpose Computer System for an Anesthesia Service , 1983, Anesthesia and analgesia.

[12]  Karen A. Frenkel The art and science of visualizing data , 1988, CACM.

[13]  A. S. Rosen,et al.  Computerized anesthesia record. , 1985, Anesthesiology.

[14]  F. J. Anscombe,et al.  Graphs in Statistical Analysis , 1973 .

[15]  P. Fayers,et al.  The Visual Display of Quantitative Information , 1990 .

[16]  J. Albers,et al.  Interaction of Color , 1971 .

[17]  Chandler Stolp,et al.  The Visual Display of Quantitative Information , 1983 .

[18]  R M Zollinger,et al.  Man-made versus computer-generated anesthesia records. , 1977, The Journal of surgical research.

[19]  William G. Bowen,et al.  Registration and Voting: Putting First Things First , 1967, American Political Science Review.

[20]  G Bashein,et al.  A Comprehensive Computer System for Anesthetic Record Retrieval , 1985, Anesthesia and analgesia.

[21]  M. Cousins,et al.  Computer-based Monitoring and Data Analysis in Anaesthesia and Intensive Care , 1982, Anaesthesia and intensive care.

[22]  P. G. Hugenholtz,et al.  A microcomputer based charting system for documentation of circulatory, respiratory and pharmacological data during anesthesia , 1984, International journal of clinical monitoring and computing.

[23]  E L Wiener,et al.  Analysis of Tasks and Human Factors in Anesthesia for Coronary‐Artery Bypass , 1976, Anesthesia and analgesia.

[24]  Donald P. Greenberg Coons Award Lecture , 1988, CACM.

[25]  T A Noel,et al.  Computerized anesthesia records may be dangerous. , 1986, Anesthesiology.

[26]  Martin S. Mok,et al.  KETAMINE ENHANCES VECURONIUM-INDUCED NEUROMUSCULAR BLOCK , 1986 .