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ARNOT HEALTH INCLUDES ARNOT OGDEN MEDICAL CENTER, AN INDEPENDent, not-for-profit, 256-bed tertiary medical facility, as well as an affiliated group of approximately 70 multi-specialty providers in 20-plus offices throughout the southern tier of New York and the northern tier of Pennsylvania. Located in Elmira, New York, the 250-bed Arnot Ogden Medical Center is very focused on using information technology throughout the medication dispensing and administration process, as evidenced by the implementation of our first clinical information system in 1982. Our strategy for implementing information technology is directly tied to how the technology in question can help support our mission or the organizational systems that support our mission. If technology does not address these fundamental requirements, it seldom--if ever--gets funding. So, when it came to looking for electronic health record solutions, the mandate given to the search and selection committee was based on the following goals: 1. Acquire a system that provides our end-users with demonstrable value, and that compliments and supports their work--rather than complicating it--thus encouraging them to be stakeholders in the system's success. 2. Acquire a system that offers a "closed-loop" medication-use process, with imbedded and integrated--not just interfaced--nursing and provider interaction, providing every care provider with instant, real-time access to pertinent information. We did not want to create silos of information that might not be in sync. 3. Acquire a flexible system with a tool set that would allow us to meet the needs of a dynamic environment and make changes relatively rapidly. 4. Work with a trusted vendor that shares our vision, acts as a partner in the process, and is committed to our success. tem. Deemed an essential strategy for supporting our objectives and gaining pharmacy and nursing enduser acceptance, this approach continues to pay dividends today, as the analysts continue to combine their clinical expertise and workflow knowledge with their newfound IS knowledge to help us meet ever-changing patient care requirements.
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1 Gibson PG, Henry RL, Coughlan JL. Gastro-esophageal reflux treatment for asthma in adults and children. Cochrane Database Syst Rev database online ; . Issue 2, 2002 2 Sontag SJ, O'Connell S, Khandelwal S, et al. Asthmatics with gastroesophageal reflux: long term results of a randomized trial of medical and surgical antireflux therapies. J Gastroenterol 2003; 98: 987999 Juniper EF, Buist S, Cox FM, et al. Validation of a standardized version of the asthma quality of life questionnaire. Chest 1999; 115: 12651270 DeVault KR, Castell DO. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease: the Practice Parameters Committee of the American College of Gastroenterology. J Gastroenterol 1999; 94: 1434 National Asthma Education and Prevention Program. Expert panel report II: guidelines for the diagnosis and management of asthma. Bethesda, MD: National Heart, Lung, and Blood Institute, April 1997; NIH Publication No. 97 4051 6 Crapo RO, Morris AH, Gardner RM. Reference spirometric values using techniques and equipment that meet ATS recommendations. Rev Respir Dis 1981; 123: 659 Ayres JG, Campbell LM. A controlled assessment of an asthma self-management plan involving a budesonide dose regimen: OPTIONS Research Group. Eur Respir J 1996; 9: 886, for example, exelpn powerlabs.
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Nature Lond. ; . 307: 273. 6. Chung, I.Y., J.G. Norris, and E.T. Benveniste. 1991. Differential TNF-c~ expressionby astrocytes from experimental allergic encephalomyelitis-susceptibleand -resistant rat strains Exl~ Med. 173: 801. 7. Frohman, E.M., T.C. Frohman, M.L. Dustin, B. Vayuvegula, B. Choi, A. Gupta, S. van den Noort, and S. Guputa. 1989. The induction of intercellular adhesion molecule 1 ICAM-1 ; expression on human fetal astrocytes by interferon-gamma, tumor necrosis factor-alpha, lymphotoxin, and interleukin-l: relevanceto intracerebralantigen presentation.J. Neuroimmunol. 23: 117. 8. Janeczko, K. 1991. The proliferative response of S-100 protein positive glial ceils to injury in the neonatal rat brain. Brain Res. 564: 86. 9. Petito, C.K., S. Morgello, J.C. Felix, and M.L. Lesser. 1990. The two patterns of reactive astrocytosis in postischemic rat brain, f Cerett Blood Flow Meta~t 10: 850. 10. Koga, S., S. Ogawa, K. Kuwabara, J. Brett J., L, A. Leavy, J. Ryan, Y. Koga, J. Plocinski, W. Benjamin, D.K. Burns, et al. 1992. Synthesis and release of interleukin 1 by reoxygenated human mononuclear phagocytes. J. Clin. Invest. 90: 1007. 11. Colletti, L., D.G. Remick, G. Burtch, S.L. Kunkel, R.M. Strieter, and D. Campbell, Jr. 1990. Role of tumor necrosis factor-c~in the pathophysiologic alterations after hepatic ischemia reperfusion injury in the rat. f Clin. Invest. 85: 1936. 12. Youker, K., C.W. Smith, D.C. Anderson, D. Miller, L.H. Michael, R.D. Rossen, and M.L. Entman. 1992. Neutrophil adherence to isolated adult cardiac monocytes. Induction by cardiac lymph collectedduring ischemia and ~erfusion.J. Clin. Invest. 89: 602. 13. Benveniste, E.T. 1992. Inflammatory cytokines within the central nervous system: sources, function, and mechanism of action. Am. J. Physiol. 263: C1. 14. McCarthy, K.D., and J. Vellis. 1980. Preparation of separate and astroglial and oligodendrogial cell cultures from rat cerebral tissue. J. Cell Biol. 85: 890. 15. Frei, K., C. Siepl, P. Groscurth, S. Bodmer, C. Schwerdel, and A. Fontana. 1987. Antigen presentation and tumor cytotoxicity by interferon-gamma-treated microglial cells. Eur. J. Immunol. 17: 1271. 16. Ogawa, S., G. Herwig, C. Esposito, A.P. Macaulay, J. Brett, and D. Stern. 1990. Hypoxia modulates the barrier and coagulant function of cultured bovine endothelium.J. Clin. Invest. 85: 1090. 17. Madri, J.A., B.M. Pratt, and A.M. Tucker. 1988. Phenotypic modulation of endothelialcellsby transforming growth factor-~ depends upon the composition and organization of the extracellular matrix, f Cell Biol. 106: 1375. 18. Ueda, H., T. Hashimoto, E. Furuya, K. Tagawa, K. Kitagawa, M. Matsumoto, S. Yoneda, K. Kimura, and T. Kamda. 1988. Changes in aerobic and anaerobic ATP-synthesizing activities in hypoxic mouse brain. J. Biochem. Tokyo ; . 104: 81. 19. Lowry, O.H., N.J. Rosenbrough, L.A. Farr, and R.J. Randull. 1951. Protein measurement with the Folin phenol reagent. J. Biol. Chem. 193: 265. 20. Nakai, S., K. Mizuno, M. Kenta, and Y. Hirai. 1988. A simple, sensitivebioassayfor the detection ofinterleukin-1 using human melanoma A375 cell line. Biochem. Biophys. Res. Commun. 154: 1189. 21. Kull, F.C., Jr., and J.M. Besterman. 1990. Drug-induced al2307 Maedaet al, because exelon employees.
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Giuseppe Cirino, * Carla Cicala, * Mariarosaria Bucci, * Ludovico Sorrentino, * Grazia Ambrosini, Gianfranco DeDominicis, and Dario C. Altieri * Departimento di Farmacologia Sperimentale, Universita' degli Studi di Napoli "Federico II", 80131 Napoli, Italy; Servizio di Anatomia Patologica, Ospedale Cardarelli 80131 Napoli, Italy; and Molecular Cardiobiology Program, The Boyer Center for Molecular Medicine, Department of Pathology, Yale University School of Medicine, New Haven, Connecticut 06536.
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Exelon energy introduces pilot program for emission-free energy product
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