Article Content


Electronic Documentation Comes of Age was the theme of the sixth annual Perinatal Information Systems User Group (PISUG) conference held October 17-19, 2001, in (Viva!) Las Vegas, Nev. The conference included 11 presenters, along with expert panelists and 6 vendors who handled fundamental topics and displayed various electronic documentation systems to the close to 100 attendees.


"Coming of Age" was an appropriate theme for the year because the conference covered timely updates and recommendations for startup obstetric computer documentation systems.


The keynote speaker, Toni Hendel, RN, JD, spoke on the Legal Issues of Electronic Documentation, with emphasis on how electronic records can lower risk. She discussed the benefits of having electronic documentation as a readable diary of patient care events as well as an easier way to gather statistics, analyze data, and improve outcomes. Billing and reimbursement can improve by using the record for procedure and equipment tracking.


One of the highest factors resulting in settlement of malpractice claims is the lack of documentation in the medical record. Because the record is used to prove breach of duty, the plaintiff's attorney first decides if documentation supports that the standard of care was met. Electronic documentation systems that offer rules support and remind users to chart missing information are most helpful in this area. In addition, storing the fetal monitor strip electronically allows for timely retrieval and minimizes risk of data loss caused by misplaced paper strips.


Attorney Hendel pointed out that along with using standard note sets and dialogues, users must remember to add specific details to these quotations. Additionally, anyone who has ever had to interpret "doctor's" handwriting can easily appreciate the benefits of having a clear legible record.


There are also drawbacks to the electronic chart. The fear of virus infection and system malfunction resulting in data loss were noted, along with possible fixes for these problems such as antivirus programs and data backups.


Attorney Hendel identified "the person most knowledgeable" as the one who will most likely be asked to testify on system operations if there is litigation. This individual probably will be the systems administrator or the clinical analyst responsible for day-to-day system operations. She went on to discuss that all charting should be done in a timely manner, which adheres to hospital set standards as well as Joint Commission on Accreditation of Health Care Organizations (JCAHO) and Centers for Medicare & Medicaid Services (CMS) (formerly the Health Care Financing Administration [HCFA]) regulations.


For the novice electronic patient record crowd, there were presentations on preparing a case for financial consideration, system evaluation tips, implementation, and training as well as an ergonomic lecture presented by PISUG president Daniel Sheldon. Another timely discussion updated us on Health Insurance Portability and Accountability Act (HIPAA) regulations, although definitive information is not yet available regarding this complicated act.


Debby Aiton, MA, RN, and Valerie Heaslip, RN, information systems analysts from Eisenhower Medical Center, Rancho Mirage, Calif, detailed their experiences with a product that has been implemented and upgraded.


British physician Dr Nicholas Pairaudeau, who currently practices in Canada, gave an interesting talk concerning difficulties surrounding physician compliance with charting in the electronic record. Dr Pairaudeau offered specific strategies and emphasized that the patient-clinician relationship should continue to hold a higher stead than the documentation piece.


Six vendors were represented at the conference: E&C Medical Intelligence, Philips Medical Systems, Clinical Computer Systems, LMS Medical Systems, and GE Medical Systems Information Technologies. This is a smaller number from previous years, which is a strange phenomenon because conference attendees are a group of rich prospects, ranging from nurses to administrators to information systems analysts. Attendees were shopping for a new system, upgrading a current one, or starting new units expressing an interest to combine a new system with the current hospital information system. Others were there to enjoy the updates from the various speakers and, perhaps, take in a show or two. However, the vendors didn't use a strong market strategy in this forum as in others such as American College of Obstetricians and Gynecologists (ACOG) or Association of Women's Health, Obstetric, and Neonatal Nursing (AWHONN) conventions where vendor presence is at a much higher and more aggressive level. The September 11 attacks may have added to the decreased vendor participation this year as well.


Always a highlight of the annual PISUG conference, Molly Gray, RN, MSN, and Patrick O'Grady, MD, of Baystate Medical Center, Springfield, Mass, surprised the audience with a witty parody of a Shakespearean play in their presentation on Evidence-based Cost Containment. Using tenuous connections, Ms Gray and Dr O'Grady drew on their experiences with Baystate's implemented rules-based computerized record to enhance the hospital's Misoprostol protocol adherence, improve the management of shoulder dystocia through a Web-based educational program, and reduce specific costs by tracking data and responding to the evidence-based outcome for patients with preterm labor and overuse of intravenous fluids. Peppering their talk with various quotations from Groucho Marx, Phyllis Diller, and Mae West, Dr O'Grady and Ms Gray entertained and educated the attendees. Interspersed throughout their presentation were "famous" charting errors, to which everyone could relate. Dr O'Grady ended the conference with an original Shakespearean epilogue, which put quite a unique seal on a successful conference.


The annual PISUG conference is one at which all obstetric units and electronic computerized record vendors should be represented. If you do not have a system in place, you will gain much knowledge from those who have "been there, done that." If you have an already established system, the opportunity to network and grow your product can be found here. Vendors must be aware that the PISUG attendees are the ones who will bring back positive feedback to the financial decision makers of their institutions. By keeping low profiles or not being represented, the vendors don't give much weight to this organization's ability to develop.


As the membership of the fledgling PISUG grows and computerized documentation is the norm, I hope there will be a variety of progressive topics that will continue to follow federal regulations such as HIPAA and future system expansion options. As this group builds membership and more revenue is generated, PISUG will be able to provide other nationally known speakers and a greater variety of topics.


Contact for information regarding membership and future conferences. The PISUG Web site is currently under construction and will soon be available at The 2002 conference is tentatively scheduled for New Orleans-see you there!


Contributed by Nancy Fagan, RN



Secretary of Commerce Don Evans announced approval of a new information technology encryption standard for the federal government at a meeting with members of the Business Software Alliance, a group made up of information technology (IT) industry chief executive officers. The Advanced Encryption Standard (AES) also is expected to be used widely in the private sector to protect sensitive computerized information and financial transactions, benefiting millions of consumers and businesses.


The new standard is based on a mathematical formula known as an algorithm. Algorithms are at the heart of computerized encryption systems, which can be used to encode all kinds of digital information, from electronic mail to the secret personal identification numbers (PINs) that people use with bank teller machines.


Today's announcement marks the culmination of a 4-year effort by computer scientists at the Commerce Department's National Institute of Standards and Technology (NIST) to achieve a highly secure algorithm for the AES. This was done through an international competition, starting in September 1997, in which researchers from 12 different countries submitted encryption algorithms. Fifteen candidate formulas chosen by NIST in August 1998 were "attacked" for vulnerabilities and intensely evaluated by the worldwide cryptographic community to ensure that they met the AES criteria. After the field was narrowed to 5 in April 1999, NIST asked for intensified attacks and scrutiny on the finalists. Evaluations of the encoding formulas examined factors such as security, speed, and versatility.


The algorithm selected for the AES in October 2000 incorporates the Rijndael encryption formula. Belgian cryptographers Joan Daemen of Proton World International and Vincent Rijmen of Katholieke Universiteit Leuven developed Rijndael. Both men are highly regarded experts within the international cryptographic community. They have agreed that their algorithm may be used without royalty fees.


Each of the algorithms submitted for the AES competition was required to support key sizes of 128, 192, and 256 bits. For a 128-bit key size, there are approximately 340 undecillion (340 followed by 36 zeros) possible keys.


NIST and leading cryptographers from around the world found that all 5 finalist algorithms had a very high degree of security. Rijndael was selected because it had the best combination of security, performance, efficiency, and flexibility. The specifications for the Rijndael algorithm have now been formally incorporated into Federal Information Processing Standard 197.


The AES has been designed to protect sensitive government information well into the 21st century. It will replace the aging Data Encryption Standard (DES), which NIST adopted in 1977 as a Federal Information Processing Standard used by federal agencies to protect sensitive unclassified information. DES and a variant called Triple DES are used widely in the private sector as well, especially in the financial services industry.


The effort to establish the AES reflects the dramatic transformation that cryptography has undergone in recent years. Just a few decades ago, the science of cryptography was an esoteric endeavor employed primarily by governments to protect state and military secrets. Today, hundreds of encryption products currently employ DES or Triple DES, and such systems have become almost ubiquitous in the financial services industry.


The secretary's formal approval action announced today follows a 2001 request for public comments on the draft AES. Products implementing the AES are expected to be available shortly in the marketplace. NIST also is completing arrangements so that vendors can have their implementations of AES validated under the Cryptographic Module Validation Program (CMVP), jointly led by NIST and the Government of Canada's Communications Security Establishment. The CMVP provides security testing against the specifications of FIPS 140-2, Security Requirements for Cryptographic Modules, and individual federally recognized algorithms. Validation helps ensure that the complex AES algorithm has been implemented correctly. Private-sector accredited laboratories conduct this testing, which then is validated by NIST and CSE. For more details see


Detailed information about the development of the AES and the standard itself is available at NIST's Web site at





FireLogic, Inc, today announced the release of the second generation of its HealthEngage Asthma software, making the possibility of vital health management anywhere at any time a reality. The software replaces paper diaries, which are the traditional method currently used for asthma management. It is available for PCs, Macs, Palm OS, and Pocket PC devices (including wireless devices) and on the Web.


HealthEngage Asthma version 2.0's new features include advanced symptom and peak flow graphing and advanced medication management to full reports for patients and physicians. It also includes a Web version that is designed to work seamlessly with the desktop and handheld versions.


Asthma sufferers, including children, can use version 2.0 to enter health information at any time from anywhere to manage their healthcare. Physicians and healthcare providers can review patient information in simple charts and records and through online access. A recent study showed that with proper management, the number of asthma-related deaths could fall to almost zero; FireLogic believes that it has found that management tool.


This new release will allow the 17 million people with asthma in the United States to better manage their conditions. The concept for the software came as a result of President Michael Slage's work at NASA on the International Space Station and Planning for Human Missions to Mars. The telemedicine program, as it is called at NASA, was too expensive and bulky to be practical for use on Earth. FireLogic's advisors, including the chief medical officer of NASA, and the other founders of the firm decided to use new telecommunication and handheld computer technology.


A free trial version of the Health-Engage Asthma software can be downloaded at The solution is immediately available to current and new individual users as well as healthcare and disease management organizations.


FireLogic, founded in 1999, is a provider of software, services, and expertise for the collection and visualization of complex data for handheld, wireless, and desktop computing devices in industries, including healthcare, the environment, and employee/sales force automation.





Three versions of drug databases optimized for handheld devices have been released in recent months. Pharma Lexicon has just launched a Palm Pilot version of the Medical/ Pharma Abbreviations Database, claiming to be the world's largest database of medical, pharma, biotech, agrochem, and healthcare abbreviations (and their meanings), with 46,000 entries contributed by hundreds of people and organizations worldwide. Details about it can be found at


Gold Standard Multimedia has announced Clinical Pharmacology OnHand, which offers complete dosing information based on indication and patient population, multiple search options, and need-to-have clinical checking utilities. This pocket resource includes two modules to provide fast accurate answers.


Drug Information, which allows users to review drug descriptions, as well as a complete list of indications, interactions, precautions/contraindications, classifications, and adverse reactions; check adult, pediatric, renal, and hepatic dosing and dosage limits specific to indication, including off-label uses; look up drugs by generic or brand name, indication, classification, precaution, or adverse reaction; and get maximum results using partial word search feature (ideal for uncertain spellings).


Clinical Reports, featuring the Drug Interactions Report, which allows users to screen combinations of prescription drugs, over-the-counter medications, and herbal and nutritional products for interactions and the intravenous compatibility report to check the compatibility of two or more intravenous products when mixed in solution, syringe, or via Y-site administration.


Clinical Pharmacology OnHand is updated quarterly to ensure the most recent information. For Clinical Pharmacology OnHand pricing, system requirements, and details, please visit


Unbound Medicine and Facts and Comparisons have partnered to launch A to Z Drug Facts on CogniQ, a platform for personal knowledge management on mobile electronic devices. CogniQ's Web integration and communications technology also enables clinicians to capture the questions that arise daily at the point of care and to answer these with in-depth resources on the World Wide Web.


Unbound Medicine will distribute A to Z Drug Facts as a new channel on the CogniQ platform, providing current accurate information, including dosage and interaction data.


For more information about Unbound Medicine, Inc, please visit the company's Web site at


For more information about Facts and Comparisons, please visit the company's Web site at





The Simputer, a device designed to bring portable computing and the information age to developing countries, is being developed by the Simputer Trust, a group of individuals from the Indian Institute of Science, and Encore Software. The machine is expected to arrive in the second quarter of 2002.


The finished product will run the Linux operating system and will be slightly larger than a personal digital assistant but will use 32 MB of flash memory and 32 MB of RAM to function as a simple portable computer with a built-in modem, infrared port, and USB (Universal Serial Bus) port for connecting to other devices.


The Simputer's interface, designed to overcome language barriers and illiteracy, primarily uses icons and graphics on a 240-by-320-pixel touch screen, aiming at truly simple and natural user interfaces based on sight, touch, and audio. The Simputer meets these demands through a browser for the Information Markup Language (IML). IML has been created to provide a uniform experience to users and to allow rapid development of solutions on any platform. The device also supports text-to-speech capability and will be able to provide voice feedback in local languages, according to specifications provided by Encore Software.


The Simputer will be available initially for government organizations and released for businesses and consumers at a later date, according to the Simputer Trust. India will be one of the first countries in which the product will be made available. The project began two years ago as a way of getting rural areas in India networked and connected to the Internet. The Simputer will be shared by small communities for various uses such as sending and receiving e-mail and carrying out banking transactions. To use the Simputer, individuals will need to purchase a smart card to store personal information. Once inserted into the device, the card will provide access to private information, such as bank accounts.


Expected to cost about $200, the Simputer will be powered by three AAA batteries that offer 6 to 8 hours of continuous use.





As part of the $50 million patient safety research initiative announced by Health and Human Services Secretary Tommy G. Thompson on October 11, the Agency for Healthcare Research and Quality (AHRQ) is funding 22 projects that will develop and test the use of information and communication technology to reduce medical errors, improve patient safety, and improve quality of care.


A $255,289 project at the University of Alabama at Birmingham and another $345,286 project at Creighton University in Omaha will test whether the use of handheld computers with decision support systems can reduce medical errors in primary care clinics.


A $486,805 project at Montefiore Medical Center in New York City will use state-of-the-art computer simulation tools to train surgery residents and to identify, quantify, and analyze errors as well as "near misses."


A $275,179 project at the University of Chicago will identify factors that lead to errors in the use of infusion pumps that are used to give patient intravenous fluids and medicine.


For more information on AHRQ and these projects, please visit





Although it might seem as though genetics researchers would top the list of new patents for 2001, computer giant IBM was actually awarded the most US patents last year for the ninth year in a row. IBM holds a record 3,411 patents, representing nearly a 20% increase over its previous record of 2,886 set in 2000. This makes IBM the first patent holder in history to be granted more than 3,000 US patents in a single year.


IBM topped the next closest company by 75%, a margin of more than 1,450 patents, with more than 1,500 patents for infrastructure technologies (including software, servers, and storage systems) and 1,200 patents for core component technologies (microelectronics, storage devices, and displays).


More than one third of the technologies IBM patented last year are already being applied to IBM product and service offerings. For example, Patent 6280813, Magnetic Recording Media with Antiferromagnetically Coupled (AFC) Ferromagnetic Films as the Recording Layer, is IBM's "pixie dust" patent. Pixie dust is a new type of magnetic coating that is expected to quadruple the data density of current hard disk drive products. In 2001, IBM shipped more than 5.3 million disk drives manufactured with AFC media.


Among the US patents issued for IBM inventions in 2001:


* Mirror image improves chip performance: An alternate type of transistor, the basic building block of semiconductors or microchips, is the dual or double gate transistor. Double gate transistors improve on existing devices by effectively doubling the electrical current that can be sent through a transistor or, alternatively, lowering the amount of electricity running through a given gate for better power management. This makes these new transistors suitable for both high-performance processors or very low power uses.


* Instant recovery: With this invention, an early example of self-healing capabilities, computer users can revert within minutes to a back-up copy of applications and operating system software stored in a separate area of the hard drive, without having to download or install a new copy from an outside computer. Called "Rapid Restore PC," this technology is available now on IBM ThinkPad notebooks and NetVista desktop PCs.


* Linking data made easier: Computers store data in diverse and often incompatible forms: structured, unstructured, relational, or hierarchical databases, in flat files or as multimedia objects. This patent allows users to access all types of data using a "single-query" search and makes it possible for businesses to integrate the management and retrieval of traditional coded information with newer digitized data and is used by IBM's Discovery-Link software, which is aimed at the Life Sciences industry.


* New way to analyze fingerprints: This patent helps to accurately identify and analyze fingerprints, which can be distorted due to skin elasticity and the varying amount of pressure applied when providing a fingerprint. By counting the number of ridges between features in the print, different images of the same fingerprint can be identified as identical.


* Drivers' friend: artificial passenger. An automatic in-car dialog system carries on a conversation with the driver on various topics in an effort to keep drivers awake. The system also analyzes the driver's answers and voice patterns to determine if the driver is alert and will warn the driver or change the topic of conversation if it determines that the driver is about to fall asleep. The system also can be used for voice-activated operation of audio equipment, such as in-car CD/DVD players, radios, and telephones.



For more information on IBM, visit the company's Web site at





Xybernaut Corporation, maker of wearable computing devices such as the Mobile Assistant V (MA V), has launched the Personal Optical Mobile Assistant (POMA). Intended as a "wearable Internet device," users can surf the Internet, play games, listen to music, and access e-mail with a 1.8-ounce optical pointing device that can be used in the air, in any orientation. Weighing 10.9 ounces (including battery), the POMA features a 128 MHz, 32-bit RISC (Reduced Instruction Set Computer) processor, with 32 MB of RAM, a 32 MB ROM flash card slot, built-in charger, and USB (Universal Serial Bus) port, and can accept an optional 1 GB external microdrive. The POMA's Liquid Crystal on Silicon Display viewer is mounted on a forehead band and rides over one eye but does not interfere with wearing glasses. A 4-foot cable connects the display to the CPU. A variety of Microsoft Windows software is included, such as Windows CE, Media Player, Pocket Word, and Internet Explorer for CE. The unit retails for $1499, and a limited number are expected to be shipped during the first quarter of 2002.


A number of industry analysts have stated that the potential market for wearable and mobile computing technologies is expected to grow rapidly in the coming decade. The Gartner Group recently forecast that wearable computing is 1 of 4 key emerging technology trends for the next 10 years, predicting that by 2007, more than 60% of the European Union and US populations aged 15 to 50 will carry or wear a wireless computing and communications device at least 6 hours a day.


In addition, Key3Media, which sponsors COMDEX, announced it would replace several registration kiosks using desktop computers with the MA V, to enable "roving registrations," a way to capture attendee data and eliminate long registration queues at the COMDEX held in Chicago in early March 2002.


Xybernaut Corporation provides wearable/mobile computing hardware, software and services, communications, and full-function computing power in a hands-free design. For more information on the company and to see its products, visit its Web site at





Lifeline Senior Living Systems, provider of Personal Response Services for elders and the disabled, has unveiled an innovative "Cut the Cord" campaign aimed at helping assisted living facilities adopt the company's technologically advanced system. As part of its campaign, which has been continued thanks to enthusiastic response, Lifeline is offering facilities with dated pull-cord emergency systems a $25 rebate for each apartment fitted with the wireless alternative.


Lifeline's automated emergency call system includes full-featured telephones tailored to elders and wearable personal help buttons that residents press to summon help. The wireless device, worn around the wrist or neck, connects a resident via the nearest Lifeline speakerphone to a staff person, enabling communication even if the resident is immobile. Because the system is fully automated through a supplied computer, a staff monitor who moves away from the response center is summoned through a page-forwarding feature.


The system requires no additional wiring and provides concrete benefits to residents and staff not currently delivered through a fixed-position pull-cord system. A patented closed-loop protocol alerts the on-site response center when help has arrived or when further assistance is required, voice communicators quickly link with staff, and call activity is archived for required reporting and service verifications. The latest component, CarePartner Telephone with Reminders, helps residents remember everything from medications to social events.


More than 2,500 hospital systems have successfully integrated the Lifeline service into care management for elderly patients to bridge the gap between costs and care. The "Cut the Cord" campaign targets assisted living facilities of 50 beds or more in the United States.


Lifeline's Response Center, phone, and push-button system offer benefits beyond its emergency call capability. An inactivity alarm automatically signals staff when residents are inactive for an extended period of time. Large high-contrast buttons, Voice Assist voice prompts, high-volume controls and enunciated dialing for the visually impaired, and a hearing-aid-compatible handset on the CarePartner Telephone are a comprehensive system for the special needs of elders. A personal reminder service allows residents or caregivers to program the Lifeline phone, on site or from remote locations, with up to 6 recorded messages reminding the resident to take medications, remember medical appointments, or keep track of birthdays and other social engagements.


Lifeline's wireless smoke detectors send an alarm to facility staff in case of a fire. Residents are warned audibly and visually. A rechargeable battery back-up power supply provides 24 hours of power in case of a power failure. A low battery warning alerts staff when the unit's back-up battery needs to be replaced. Lithium batteries for Lifeline pendant or wristwatch provide reliable service for up to 5 years before a replacement is needed.


Lifeline has been supplying Personal Response Services for nearly 30 years. In 2001, Lifeline won the American Society on Aging's (ASA) Business of the Year Award for "exemplary programs that meet the needs of older people and their families, expand public awareness of the private sector's increasing involvement with older people, and create performance models for other companies to emulate."


For more information, please visit Lifeline's Web site at





The Kaiser Family Foundation has changed its Web site (, segregating press releases and survey results into separate areas for easy access and unveiling a new area that compiles health data by state for profiles and comparisons.


Among recent surveys are Generation, which found that more young people (aged 15-24 years) go online for health information than to shop, check sports scores, or chat. Two out of 3 young people (68%) have used the Internet to search for health information from diabetes to AIDS, and 1 in 4 says he or she gets "a lot" of health information online. The survey also suggests that a significant proportion of youth are acting on what they find: 4 out of 10 (39%) online health seekers say they have changed their own behavior because of information they found on the Web.


The majority (55%) of those who have surfed the Web for health information do so just a few times a year, but nearly 4 in 10 (39%) do so at least once a month.


Half (50%) of all online youth have searched the Web for information on specific diseases such as cancer or diabetes. Almost all (94%) who have looked for health information on the Internet say that what they find is useful, but they remain skeptical about the quality of online health information in general. When asked about a variety of sources, 17% say they trust health information from the Internet "a lot," as compared with 85% for doctors, 68% for parents, and 30% for the television news-but only 29% of those who looked up health information online checked the source the last time they conducted a search.


Another survey found that nearly 1 in 3 adults has talked to a doctor, 1 in 8 adults has received a prescription in response to a drug advertisement, and that most Food and Drug Administration (FDA)-required information doesn't register. The nationally representative survey gauged the public's response to drug ads in general, as well as to ads for 3 specific medications shown to some respondents before the survey-Lipitor (to lower cholesterol), Nexium (for heartburn or acid reflux), and Singulair (for asthma). Key findings included:


* Nearly a third (30%) of adults have talked to their doctor about a drug they saw advertised, and 44% of those who talked to their doctor received a prescription for the medication they inquired about.


* After viewing specific prescription drug ads, about 4 in 10 said they were very or somewhat likely to talk to their doctor about the drug they saw advertised (37%) and/or to talk to their doctor about the health condition mentioned in the advertisement (40%).


* When asked for a self-assessment of how much they learned from viewing a specific advertisement, most (70%) said they had learned little or nothing more about the health condition, and a majority (59%) said they knew little or nothing more about the drug. However, when asked questions about medical information featured in advertisements for the drugs Lipitor, Nexium, and Singulair, people who just viewed a particular advertisement are in some cases much more likely than nonviewers to give correct answers.



Last year alone, the pharmaceutical industry spent $2.5 billion on all forms of "direct-to-consumer" (DTC) ads. The FDA requires DTC advertisements to include information about possible side effects and where consumers can go to learn more about the drug. Although people who had just viewed an advertisement were not always able to remember the specific side effects it mentioned, they were more likely than people asked about advertisements in general to view the side effects as serious.


Finally, the Kaiser Family Foundation site has unveiled a new area, "State Health Facts Online," featuring a graphic user interface (a map of the 50 states) and compiling demographic and health data by state for individual state profiles or comparisons among the states by category, which include demographics and the economy, health status, health coverage and uninsured, managed care and health insurance, women's health, minority health, and HIV/AIDS. The data can also be searched by entering a keyword.





The Clinical Evidence Web site's official domain name has changed to (previously the suffix was .org). To continue accessing the Web site, please use and update your bookmark.



The paper is published alongside helpful commentary by Cynthia Baur and Mary Jo Deering of the US Department of Health and an editorial by Gunther Eysenbach, MD, editor in chief of JMIR, on the Semantic Web, and the role of the World Health Organization in that respect.


Visit the web site at




Your contributions to Top Drawer (news, calendar items, products for review) are welcome. Send them to:


CIN: Computers, Informatics, Nursing


Editorial Office


10 Beach St, Suite 2


Portland, ME 04101


Fax: 207-553-7751