OBJECTIVES: Improvements in electronic health record (EHR) system development will require an understanding of psychiatric clinicians' views on EHR system acceptability, including effects on psychotherapy communications, data-recording behaviors, data accessibility versus security and privacy, data quality and clarity, communications with medical colleagues, and stigma. DESIGN: Multidisciplinary development of a survey instrument targeting psychiatric clinicians who recently switched to EHR system use, focus group testing, data analysis, and data reliability testing. MEASUREMENTS: Survey of 120 university-based, outpatient mental health clinicians, with 56 (47%) responding, conducted 18 months after transition from a paper to an EHR system. RESULTS: Factor analysis gave nine item groupings that overlapped strongly with five a priori domains. Respondents both praised and criticized the EHR system. A strong majority (81%) felt that open therapeutic communications were preserved. Regarding data quality, content, and privacy, clinicians (63%) were less willing to record highly confidential information and disagreed (83%) with including their own psychiatric records among routinely accessed EHR systems. LIMITATIONS: single time point; single academic medical center clinic setting; modest sample size; lack of prior instrument validation; survey conducted in 2005. CONCLUSIONS: In an academic medical center clinic, the presence of electronic records was not seen as a dramatic impediment to therapeutic communications. Concerns regarding privacy and data security were significant, and may contribute to reluctances to adopt electronic records in other settings. Further study of clinicians' views and use patterns may be helpful in guiding development and deployment of electronic records systems.

The problems of heterogeneous, distinct computer integrated manufacturing (CIM) databases and alternative methods to approach these problems are discussed. The literature in three related areas-natural language (NL) interface for database access, database integration, and CIM data requirements-is reviewed. The architecture of the total system is presented. The detailed design of the NL user interface, which is composed of the DCG (definite clause grammar) parser, the semantic interpreter and the query generator, is described. An experimental prototype of the NL user interface and a demonstration of how the system handles a global NL query are presented. Future issues in the integration of CIM databases are discussed.>

The authors propose a framework for using knowledge-based systems to integrate the heterogeneous multidatabases of computer integrated manufacturing (CIM). For each database, a corresponding knowledge-based system is designed for directing knowledge-processing of shared information. This one-to-one method reduces the complexity of the problem. Specifically, the structure, features, and knowledge representation for a knowledge-based system are presented. Then, a prototype of an interface between manufacturing planning and computer-aided design is described. Due to the potential for rapid changes in the manufacturing environment, the linkages among CIM databases are designed to be dynamic, flexible, and adaptive to a wide variety of situations.>