An audit of the use of laser Doppler imaging (LDI) in the assessment of burns of intermediate depth.

This is the first report of an evaluation of the use of a laser Doppler imager (LDI) scanner in the assessment of burn depth in patients. It is based on a 6-month, prospective audit of 76 burns of intermediate depth. Clinical and LDI assessments of burn wound depth were recorded at 48-72 h post-injury. Histological confirmation of depth was obtained from those burns requiring surgery. A healing time of less than 21 days was taken as confirmation of the injury being an superficial dermal burn. The accuracy of LDI in the assessment of burn depth was 97%, compared with 60-80% for established clinical methods. This audit confirms that LDI is a very accurate measurement tool for the assessment of burn wound depth. We recommend that all burns of intermediate depth should be analysed in this way in order to ensure appropriate management of the burn, to avoid unnecessary surgery and to reduce hospital stay and costs.

Health informatics in the context of user ownership.

Of fundamental importance to the successful implementation of health information systems is the public and professional acceptability of their inclusion in the healthcare process. Surprisingly, the health care sector is embracing the informatics revolution somewhat reluctantly. Even in the areas that progress can be seen and assessed, the rate of change is erratic and inconsistent when compared across the spectrum of health care informatics. The mystery intensifies if one considers the situation in global scale: despite the diversity in approaches and models used, the reluctance perseveres. One can only suspect that there is a common, underlying, reason which slows down the process and forces the whole sector in being reluctant to accept change.

Telematics in the northern United Kingdom.

The application, integration and development of methods and technology facilitating the seamless interchange of clinical, demographic and administrative information presented the medical and clinical community with unforeseen problems. Surprisingly, the wealth of existing solutions did not find the expected application and acceptance in hospital/General Practice environments. Even more surprising was the fact of the failure of many computer-based solutions to deliver the expected benefits. This paper outlines the Telematics project established in the Northern United Kingdom and its success in maintaining a working balance between technological needs and the clinical requirements. The result is a robust service linking five major Trusts and 12 General Practices in terms of clinical and administrative data, e-mail and other facilities.