Ralph Korpman - Academia.edu (original) (raw)
Papers by Ralph Korpman
Springer eBooks, 1981
A physician ordering serial WBC differential counts on the typical hospital/clinic patient assume... more A physician ordering serial WBC differential counts on the typical hospital/clinic patient assumes that changes in the percentage representation of the various cell types will be due to disease.
The Journal of Thoracic and Cardiovascular Surgery, May 1, 1975
Five heparin protocols, representative of about 30 presently used throughout the country, were an... more Five heparin protocols, representative of about 30 presently used throughout the country, were analyzed. The adequacy of anticoagulation during and the precision of protamine neutralization at the conclusion of extracorporeal circulation were studied. In each of 50 patients, the half life of heparin and the sensitivity to heparin were measured. Knowledge of the patient's age, height, weight, or surface area was of no help in predicting heparin kinetics. The study group consisted of the 2 patients with the longest and the 2 patients with the shortest heparin half lives, as well as the 2 patients who showed the greatest sensitivity to heparin and the 2 who showed the least. By computer simulation, each was managed according to the five protocols and by a monitoring procedure. The protocols failed to provide safe anticoagulation or precise protamine neutralization, whereas the simplified monitoring approach was uniformly successful.
American Journal of Health-system Pharmacy, Mar 1, 1995
Interfaces between computer systems are reviewed. An interface establishes a physical connection ... more Interfaces between computer systems are reviewed. An interface establishes a physical connection between two computer systems, a conversational syntax, a format for logical messages passed between the systems, and a data-encoding structure understood by both systems. Interfaces are usually implemented as software modules and consist of three "layers." The physical layer contains the actual physical connection and the hardware, firmware, and software that make the connection work. The protocol layer ensures that the bits of data sent across the interface by the sending system are received intact and in the correct sequence. The logical layer organizes the data to be sent into a form that can be read by the other system. Interfaces can be described by whether they operate in batch or real time, whether they are unidirectional or bidirectional, and the medium used to establish the physical connection (e.g., the exchange of a floppy disk or with an RS-232 serial connection). The real challenge to producing an interface lies in ensuring that the transactions between the two systems are meaningful. An interface engine allows one computer system to interface with several others through a single connection. A good interface has invisibility, reliability, timeliness, flexibility, terseness, and utilities. In planning an interface, goals and the proposed exchanges of data should be clearly defined. The interface should be the simplest one that meets a pharmacy's needs. When the specifications for the interface are completed, the pharmacy should thoroughly test the interface.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed, Oct 1, 1991
Ralph Korpman has been thumping his "patient-centered computing" drum for some time now, and evid... more Ralph Korpman has been thumping his "patient-centered computing" drum for some time now, and evidently somebody out there is listening--if a recent 60million,11−hospitalcontractwithNewYorkCityHealthandHospitalCorporation,plusthreeinstallationcontractstotalinganadditional60 million, 11-hospital contract with New York City Health and Hospital Corporation, plus three installation contracts totaling an additional 60million,11−hospitalcontractwithNewYorkCityHealthandHospitalCorporation,plusthreeinstallationcontractstotalinganadditional10 million, are any indication. Korpman maintains that healthcare information systems should be designed around the true unit of information: the patient.
PubMed, Apr 9, 2001
The Health Insurance Portability and Accountability Act (HIPAA) is intended to simplify administr... more The Health Insurance Portability and Accountability Act (HIPAA) is intended to simplify administrative processes and improve health information security. There are a number of traditional ways to address the expense and complexities of simplification, but none of them are bargains or beauties to behold: (1) Do-it-yourself encryption; (2) new back-end system purchases; (3) legacy system re-programming; or (4) onerous paper documentation. The good news is that 'second generation' e-health solutions are emerging that act as internal "wrappers" for health plan or provider data systems. They provide both an interface for end-users and a layer of security for organizational information and allow detailed patient-related data to remain at the system owner's physical location. These second generation solutions don't just 'connect,' data, they actually 'understand' the information, and can use data elements to invoke necessary rules, processing pathways, or personalization for specific stakeholders as required by HIPAA.
PubMed, May 1, 1993
As the computer-based patient record, or CPR, moves closer to reality, patient identification iss... more As the computer-based patient record, or CPR, moves closer to reality, patient identification issues remain unresolved. A mechanism already in place would be the Social Security number, or SSN. But legal questions surround its use for specific identification purposes. And not everyone has one. Healthcare Informatics asked several people closely involved with computerizing patient records about alternatives to social security numbers. Their responses may prove enlightening.
PubMed, May 1, 1994
Over the last few years, health care providers have increasingly recognized that health care is a... more Over the last few years, health care providers have increasingly recognized that health care is an information business. In fact, the restructuring now being contemplated by many in the context of reform cannot be done without proper information management support. The unfortunate concentration of the health care industry over the last 20 years on administrative and financial data capture has obscured the fact that the important focus should be on patient care and health care operations information. Information on patient care has, unfortunately, largely been relegated to the paper chart and other ad hoc pieces of paper. New systems should focus on health care operations optimization, with specific design features to address failings in the paper system. To be successful, such systems must be integrated and patient centered. This is especially clear in the new enterprise-based world of health care delivery, where patients are the only common factor among venues. Health record professionals, the primary caretakers of patient care information, should be deeply involved in helping institutions move to this new world.
Springer eBooks, 1981
ABSTRACT
Springer eBooks, 1978
A recently published mathematical analysis allows the precise determination of the forces which a... more A recently published mathematical analysis allows the precise determination of the forces which acting on the red cell membrane cause any red cell to assume a particular shape. The effective use of this analysis in the study of membrane physiology and pathology, however, is dependent on the availability of large numbers of accurately measured RBC cross sections. Red cells under study must be suspended in physiologic solutions; this effectively limits the data gathering technique to light microscopy. The low resolving power of the light microscope causes a diffraction band to overlie the membrane and renders the determination of the actual membrane location difficult. This problem was first examined by Ponder in 1930, when he formulated a technique that has come to be known as ‘Ponder’s Rule’.
PubMed, 1986
The thickness of the red cell membrane skeleton was deduced from measurements of the isthmus zone... more The thickness of the red cell membrane skeleton was deduced from measurements of the isthmus zones of intact cells that were maximally narrowed by one of two independent methods. The first method involved application of viscous drag to red cells entrapped between spider web fibers. The second method utilized cellular dehydration followed by spectrin denaturation at 49.5 degrees C. Measurements on thin sections showed that the isthmus is narrowed to approximately 120 nm by either method, suggesting that the membrane skeleton occupies a zone beneath the lipid bilayer that is up to 60 nm in thickness. The tertiary and quarternary structure of band 3, a major integral membrane protein that anchors the membrane skeleton to the lipid bilayers may be a critical determinant of the location of the membrane skeleton within the red cell.
PubMed, Mar 1, 1991
In today's cost-constrained health care delivery environment, hospitals are recognizing the need ... more In today's cost-constrained health care delivery environment, hospitals are recognizing the need to optimize their care operations to improve the efficiency, efficacy, and service quality of primary health care providers, particularly the medical staff and nursing services, which comprise about 50% of the hospital's total personnel. Because health care institutions are in the business of caring for patients (not for accounts or departments), and because health care delivery largely is a personnel-intensive information industry, operations optimization is supported best by information systems that fully integrate all information concerning the patient. The goal of this is to simplify the job duties of direct care providers. The benefits of an integrated, patient-centered approach include demonstrable improvements in over-all patient care quality and staff satisfaction as well as a significant reduction in costs.
Journal of Theoretical Biology, Jul 1, 1976
Mathematical modeling was used to test two assumptions regarding red cell shape. The assumptions ... more Mathematical modeling was used to test two assumptions regarding red cell shape. The assumptions are that the elastic moduli of the red cell membrane are uniformly distributed throughout the membrane shell and that the biconcave shape results primarily from minlltion of strain energy when this uniform shell is partially deflated. This strain energy is assumed to arise from bending (involving surface area strain) and shear (involving superlicial tensile strain). The mathematical delineation demonstrated that it was impossible to produce a smooth symmetrical biconcave shape by minimizing shear energy in a partially deflated shell. It was possible to generate a symmetrical biconcave shape by minimizing bending energy; the shape was, however, thicker along the axis of symmetry than the measured red cell shape. A combination of bending and shear in the ratio of 6 to 1 produced a shape which matched the measured shape of a red cell to better than lx, a deviation of the order of the thickness of the red cell membrane. The success of the mathematical model provides very strong evidence for the uniform shell-minimum bending energy hypothesis as the primary determinant of the discoid red cell shape.
PubMed, May 1, 1975
Five heparin protocols, representative of about 30 presently used throughout the country, were an... more Five heparin protocols, representative of about 30 presently used throughout the country, were analyzed. The adequacy of anticoagulation during and the precision of protamine neutralization at the conclusion of extracorporeal circulation were studied. In each of 50 patient's age, height, weight, or surface area was of no help in predicting heparin kinetics. The study group consisted of the 2 patients with the longest and the 2 patients with the shortest heparin half lives, as well as the 2 patients who showed the greatest sensitivity to heparin and the 2 who showed the least. By computer simulation, each was managed according to the five protocols and by a monitoring procedure. The protocols failed to provide safe anticoagulation or precise protamine neutralization, whereas the simplified monitoring approach was uniformly successful.
Clinics in Laboratory Medicine, Mar 1, 1983
Clinica Chimica Acta, 1994
Springer eBooks, 1981
A physician ordering serial WBC differential counts on the typical hospital/clinic patient assume... more A physician ordering serial WBC differential counts on the typical hospital/clinic patient assumes that changes in the percentage representation of the various cell types will be due to disease.
The Journal of Thoracic and Cardiovascular Surgery, May 1, 1975
Five heparin protocols, representative of about 30 presently used throughout the country, were an... more Five heparin protocols, representative of about 30 presently used throughout the country, were analyzed. The adequacy of anticoagulation during and the precision of protamine neutralization at the conclusion of extracorporeal circulation were studied. In each of 50 patients, the half life of heparin and the sensitivity to heparin were measured. Knowledge of the patient's age, height, weight, or surface area was of no help in predicting heparin kinetics. The study group consisted of the 2 patients with the longest and the 2 patients with the shortest heparin half lives, as well as the 2 patients who showed the greatest sensitivity to heparin and the 2 who showed the least. By computer simulation, each was managed according to the five protocols and by a monitoring procedure. The protocols failed to provide safe anticoagulation or precise protamine neutralization, whereas the simplified monitoring approach was uniformly successful.
American Journal of Health-system Pharmacy, Mar 1, 1995
Interfaces between computer systems are reviewed. An interface establishes a physical connection ... more Interfaces between computer systems are reviewed. An interface establishes a physical connection between two computer systems, a conversational syntax, a format for logical messages passed between the systems, and a data-encoding structure understood by both systems. Interfaces are usually implemented as software modules and consist of three "layers." The physical layer contains the actual physical connection and the hardware, firmware, and software that make the connection work. The protocol layer ensures that the bits of data sent across the interface by the sending system are received intact and in the correct sequence. The logical layer organizes the data to be sent into a form that can be read by the other system. Interfaces can be described by whether they operate in batch or real time, whether they are unidirectional or bidirectional, and the medium used to establish the physical connection (e.g., the exchange of a floppy disk or with an RS-232 serial connection). The real challenge to producing an interface lies in ensuring that the transactions between the two systems are meaningful. An interface engine allows one computer system to interface with several others through a single connection. A good interface has invisibility, reliability, timeliness, flexibility, terseness, and utilities. In planning an interface, goals and the proposed exchanges of data should be clearly defined. The interface should be the simplest one that meets a pharmacy's needs. When the specifications for the interface are completed, the pharmacy should thoroughly test the interface.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed, Oct 1, 1991
Ralph Korpman has been thumping his "patient-centered computing" drum for some time now, and evid... more Ralph Korpman has been thumping his "patient-centered computing" drum for some time now, and evidently somebody out there is listening--if a recent 60million,11−hospitalcontractwithNewYorkCityHealthandHospitalCorporation,plusthreeinstallationcontractstotalinganadditional60 million, 11-hospital contract with New York City Health and Hospital Corporation, plus three installation contracts totaling an additional 60million,11−hospitalcontractwithNewYorkCityHealthandHospitalCorporation,plusthreeinstallationcontractstotalinganadditional10 million, are any indication. Korpman maintains that healthcare information systems should be designed around the true unit of information: the patient.
PubMed, Apr 9, 2001
The Health Insurance Portability and Accountability Act (HIPAA) is intended to simplify administr... more The Health Insurance Portability and Accountability Act (HIPAA) is intended to simplify administrative processes and improve health information security. There are a number of traditional ways to address the expense and complexities of simplification, but none of them are bargains or beauties to behold: (1) Do-it-yourself encryption; (2) new back-end system purchases; (3) legacy system re-programming; or (4) onerous paper documentation. The good news is that 'second generation' e-health solutions are emerging that act as internal "wrappers" for health plan or provider data systems. They provide both an interface for end-users and a layer of security for organizational information and allow detailed patient-related data to remain at the system owner's physical location. These second generation solutions don't just 'connect,' data, they actually 'understand' the information, and can use data elements to invoke necessary rules, processing pathways, or personalization for specific stakeholders as required by HIPAA.
PubMed, May 1, 1993
As the computer-based patient record, or CPR, moves closer to reality, patient identification iss... more As the computer-based patient record, or CPR, moves closer to reality, patient identification issues remain unresolved. A mechanism already in place would be the Social Security number, or SSN. But legal questions surround its use for specific identification purposes. And not everyone has one. Healthcare Informatics asked several people closely involved with computerizing patient records about alternatives to social security numbers. Their responses may prove enlightening.
PubMed, May 1, 1994
Over the last few years, health care providers have increasingly recognized that health care is a... more Over the last few years, health care providers have increasingly recognized that health care is an information business. In fact, the restructuring now being contemplated by many in the context of reform cannot be done without proper information management support. The unfortunate concentration of the health care industry over the last 20 years on administrative and financial data capture has obscured the fact that the important focus should be on patient care and health care operations information. Information on patient care has, unfortunately, largely been relegated to the paper chart and other ad hoc pieces of paper. New systems should focus on health care operations optimization, with specific design features to address failings in the paper system. To be successful, such systems must be integrated and patient centered. This is especially clear in the new enterprise-based world of health care delivery, where patients are the only common factor among venues. Health record professionals, the primary caretakers of patient care information, should be deeply involved in helping institutions move to this new world.
Springer eBooks, 1981
ABSTRACT
Springer eBooks, 1978
A recently published mathematical analysis allows the precise determination of the forces which a... more A recently published mathematical analysis allows the precise determination of the forces which acting on the red cell membrane cause any red cell to assume a particular shape. The effective use of this analysis in the study of membrane physiology and pathology, however, is dependent on the availability of large numbers of accurately measured RBC cross sections. Red cells under study must be suspended in physiologic solutions; this effectively limits the data gathering technique to light microscopy. The low resolving power of the light microscope causes a diffraction band to overlie the membrane and renders the determination of the actual membrane location difficult. This problem was first examined by Ponder in 1930, when he formulated a technique that has come to be known as ‘Ponder’s Rule’.
PubMed, 1986
The thickness of the red cell membrane skeleton was deduced from measurements of the isthmus zone... more The thickness of the red cell membrane skeleton was deduced from measurements of the isthmus zones of intact cells that were maximally narrowed by one of two independent methods. The first method involved application of viscous drag to red cells entrapped between spider web fibers. The second method utilized cellular dehydration followed by spectrin denaturation at 49.5 degrees C. Measurements on thin sections showed that the isthmus is narrowed to approximately 120 nm by either method, suggesting that the membrane skeleton occupies a zone beneath the lipid bilayer that is up to 60 nm in thickness. The tertiary and quarternary structure of band 3, a major integral membrane protein that anchors the membrane skeleton to the lipid bilayers may be a critical determinant of the location of the membrane skeleton within the red cell.
PubMed, Mar 1, 1991
In today's cost-constrained health care delivery environment, hospitals are recognizing the need ... more In today's cost-constrained health care delivery environment, hospitals are recognizing the need to optimize their care operations to improve the efficiency, efficacy, and service quality of primary health care providers, particularly the medical staff and nursing services, which comprise about 50% of the hospital's total personnel. Because health care institutions are in the business of caring for patients (not for accounts or departments), and because health care delivery largely is a personnel-intensive information industry, operations optimization is supported best by information systems that fully integrate all information concerning the patient. The goal of this is to simplify the job duties of direct care providers. The benefits of an integrated, patient-centered approach include demonstrable improvements in over-all patient care quality and staff satisfaction as well as a significant reduction in costs.
Journal of Theoretical Biology, Jul 1, 1976
Mathematical modeling was used to test two assumptions regarding red cell shape. The assumptions ... more Mathematical modeling was used to test two assumptions regarding red cell shape. The assumptions are that the elastic moduli of the red cell membrane are uniformly distributed throughout the membrane shell and that the biconcave shape results primarily from minlltion of strain energy when this uniform shell is partially deflated. This strain energy is assumed to arise from bending (involving surface area strain) and shear (involving superlicial tensile strain). The mathematical delineation demonstrated that it was impossible to produce a smooth symmetrical biconcave shape by minimizing shear energy in a partially deflated shell. It was possible to generate a symmetrical biconcave shape by minimizing bending energy; the shape was, however, thicker along the axis of symmetry than the measured red cell shape. A combination of bending and shear in the ratio of 6 to 1 produced a shape which matched the measured shape of a red cell to better than lx, a deviation of the order of the thickness of the red cell membrane. The success of the mathematical model provides very strong evidence for the uniform shell-minimum bending energy hypothesis as the primary determinant of the discoid red cell shape.
PubMed, May 1, 1975
Five heparin protocols, representative of about 30 presently used throughout the country, were an... more Five heparin protocols, representative of about 30 presently used throughout the country, were analyzed. The adequacy of anticoagulation during and the precision of protamine neutralization at the conclusion of extracorporeal circulation were studied. In each of 50 patient's age, height, weight, or surface area was of no help in predicting heparin kinetics. The study group consisted of the 2 patients with the longest and the 2 patients with the shortest heparin half lives, as well as the 2 patients who showed the greatest sensitivity to heparin and the 2 who showed the least. By computer simulation, each was managed according to the five protocols and by a monitoring procedure. The protocols failed to provide safe anticoagulation or precise protamine neutralization, whereas the simplified monitoring approach was uniformly successful.
Clinics in Laboratory Medicine, Mar 1, 1983
Clinica Chimica Acta, 1994