Sincerity in bulk.

This paper is concerned with situations in which a speaker issues many speech acts at the same time. A common example is the publication of a large text such as a book containing many distinct assertions. It is argued that these cases present a challenge for speech act theory related to how we are to understand sincerity.

Sincerely, Anonymous.

This paper provides an account of anonymous speech treated as anonymized speech. It is argued that anonymous speech acts are best defined by reference to intentional acts of blocking a speaker's identification as opposed to the various epistemic effects that imperfectly correlate with these actions. The account is used to examine two important subclasses of anonymized speech: speech using pseudonyms, and speech anonymized in a specifically communicative manner.

Synoptic operative reports for spinal cord injury patients as a tool for data quality.

The advent of synoptic operative reports has revolutionized how clinical data are captured at the time of care. In this article, an electronic synoptic operative report for spinal cord injury was implemented using interoperable standards, HL7 and Systematized Nomenclature of Medicine-Clinical Terms. Subjects (N = 10) recruited for a pilot study completed recruitment and feedback questionnaires, and produced both an electronic synoptic operative report for spinal cord injury report and a dictated narrative operative report for an actual patient case.

Design and implementation of synoptic operative report template using interoperable standards.

The increasing use of synoptic operative reports in clinical settings represents a major milestone in the advancement of health information technology. Synoptic operative report templates enable clinicians to capture and display succinct clinical information in a standardized and logical manner. Synoptic operative report templates also provide the optimum goal of enriching personalized health information of a given patient at the point of care so as to support the exchange of clinical information across the continuum of multiple healthcare providers.

Systematized nomenclature of medicine clinical terms (SNOMED CT) to represent computed tomography procedures.

Objective: To evaluate the ability of systematized nomenclature of medicine clinical terms (SNOMED CT) to represent computed tomography procedures in computed tomography dictionaries used in the Canadian province of Newfoundland and Labrador.

Methods: This study was conducted in two stages. In the first stage computed tomography dictionaries were collected and consolidated to one master list.

The evolution and uptake of a drug information system: the case of a small Canadian province.

In 2008 the province of PEI, Canada implemented a province-wide, web-based drug information system for the purpose of improving patient safety. An evaluation study using grounded theory examined the human and workflow impact. Results indicated a need for great attention to the details of change management during implementation, including: ensuring application quality of all informational and technical elements, just-in-time training and technical support, on-site preparation for changed workflow processes, and collaboration among all stakeholders throughout.

A conceptual framework for analyzing how Canadian physicians are using electronic medical records in clinical care.

Our electronic medical record (EMR) case study research pursued a set of questions to provide Canadian physicians with practical information on best practices and lessons learned regarding implementation and use of EMRs in ambulatory clinical care. The study's conceptual framework included an EMR System and Use Assessment Survey, interview guide, transcription codes, observation guide and case study report template. The common message that emerged was that no clinic would return to paper-based charts after experiencing the benefits of EMR.

Topic maps for exploring nosological, lexical, semantic and HL7 structures for clinical data.

A topic map is implemented for learning about clinical data associated with a hospital stay for patients diagnosed with chronic kidney disease, diabetes and hypertension. The question posed is: how might a topic map help bridge perspectival differences among communities of practice and help make commensurable the different classifications they use? The knowledge layer of the topic map was generated from existing ontological relationships in nosological, lexical, semantic and HL7 boundary objects. Discharge summaries, patient charts and clinical data warehouse entries rectified the clinical knowledge used in practice.

HealthInfoCDA: Case Composition Using Electronic Health Record Data Sources.

HealthInfoCDA denotes a health informatics educational intervention for learning about the clinical process through use of the Clinical Document Architecture (CDA). We hypothesize those common standards for an electronic health record can provide content for a case base for learning how to make decisions. The medical record provides a shared context to coordinate delivery of healthcare and is a boundary object that satisfies the informational requirement of multiple communities of practice.

Undocumented patient information: an impediment to quality of care.

Purpose: Poor documentation in medical records might reduce the quality of care and undermine analyses based on retrospective chart reviews. We assessed the documentation of cardiac risk factors and cardiac history in the records of patients hospitalized with myocardial infarction or heart failure.

Methods: We performed a retrospective cohort study involving direct chart audit of all consecutive hospitalizations for myocardial infarction (n = 2,109) or heart failure (n = 3,392) in Nova Scotia, Canada, from October 15, 1997, to October 14, 1998.