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Journal of the American Medical Informatics Association: JAMIA

Chad M Hodge, Scott P Narus
Objective: Problem list data is a driving force for many beneficial clinical tools, yet these data remain underutilized. We performed a systematic literature review, pulling insights from previous research, aggregating insights into themes, and distilling themes into actionable advice. We sought to learn what changes we could make to existing applications, to the clinical workflow, and to clinicians' perceptions that would improve problem list utilization and increase the prevalence of problems data in the electronic medical record...
March 14, 2018: Journal of the American Medical Informatics Association: JAMIA
Richard C Waters, Jennifer M Toy, Adam Drechsler
Objective: Translating clinical evidence to daily practice remains a challenge and may improve with clinical pathways. We assessed interest in and usability of clinical pathways by primary care professionals. Methods: An online survey was created. Interest in pathways for patient care and learning was assessed at start and finish. Participants completed baseline questions then pathway-associated question sets related to management of 2 chronic diseases. Perceived pathway usability was assessed using the system usability scale...
February 26, 2018: Journal of the American Medical Informatics Association: JAMIA
You Chen, Mayur B Patel, Candace D McNaughton, Bradley A Malin
Background: Trauma-related hospitalizations drive a high percentage of health care expenditure and inpatient resource consumption, which is directly related to length of stay (LOS). Robust and reliable interactions among health care employees can reduce LOS. However, there is little known about whether certain patterns of interactions exist and how they relate to LOS and its variability. The objective of this study is to learn interaction patterns and quantify the relationship to LOS within a mature trauma system and long-standing electronic medical record (EMR)...
February 22, 2018: Journal of the American Medical Informatics Association: JAMIA
Angela Ai, Adrian Wong, Mary Amato, Adam Wright
Importance: Electronic prescribing promises to improve the safety and clarity of prescriptions. However, it also can introduce miscommunication between prescribers and pharmacists. There are situations where information that is meant to be sent to pharmacists is not sent to them, which has the potential for dangerous errors. Objective: To examine how frequently prescribers or administrative personnel put information intended for pharmacists in a field not sent to pharmacists, classify the type of information included, and assess the potential harm associated with these missed messages...
February 21, 2018: Journal of the American Medical Informatics Association: JAMIA
Dustin McEvoy, Michael L Barnett, Dean F Sittig, Skye Aaron, Ateev Mehrotra, Adam Wright
Objective: To assess the impact of electronic health record (EHR) implementation on hospital finances. Materials and Methods: We analyzed the impact of EHR implementation on bond ratings and net income from service to patients (NISP) at 32 hospitals that recently implemented a new EHR and a set of controls. Results: After implementing an EHR, 7 hospitals had a bond downgrade, 7 had a bond upgrade, and 18 had no changes. There was no difference in the likelihood of bond rating changes or in changes to NISP following EHR go-live when compared to control hospitals...
February 20, 2018: Journal of the American Medical Informatics Association: JAMIA
Harley Ramelson, Amanda Nederlof, Sam Karmiy, Pamela Neri, David Kiernan, Rajlakshmi Krishnamurthy, Adrienne Allen, David W Bates
Objective: To evaluate the impact of a referral manager tool on primary care practices. Materials and Methods: We evaluated a referral manager module in a locally developed electronic health record (EHR) that was enhanced to improve the referral management process in primary care practices. Baseline (n = 61) and follow-up (n = 35) provider and staff surveys focused on the ease of performing various steps in the referral process, confidence in completing those steps, and user satisfaction...
February 17, 2018: Journal of the American Medical Informatics Association: JAMIA
Meghan J Reading, Jacqueline A Merrill
Objective: This integrative review identifies convergent and divergent areas of need for collecting and using patient-generated health data (PGHD) identified by patients and providers (i.e., physicians, nurses, advanced practice nurses, physician assistants, and dietitians). Methods: A systematic search of 9 scholarly databases targeted peer-reviewed studies published after 2010 that reported patients' and/or providers' needs for incorporating PGHD in clinical care...
February 17, 2018: Journal of the American Medical Informatics Association: JAMIA
Xiruo Ding, Ziad F Gellad, Chad Mather, Pamela Barth, Eric G Poon, Mark Newman, Benjamin A Goldstein
Objective: As available data increases, so does the opportunity to develop risk scores on more refined patient populations. In this paper we assessed the ability to derive a risk score for a patient no-showing to a clinic visit. Methods: Using data from 2 264 235 outpatient appointments we assessed the performance of models built across 14 different specialties and 55 clinics. We used regularized logistic regression models to fit and assess models built on the health system, specialty, and clinic levels...
February 9, 2018: Journal of the American Medical Informatics Association: JAMIA
Eboni G Price-Haywood, Qingyang Luo, Dominique Monlezun
Objectives: Organizational strategies for implementing eHealth tools influence patient and provider use of portal technology. This study examines whether the intensity of bidirectional secure portal messaging is associated with improved clinical outcomes. Material and Methods: This is a retrospective cohort analysis of 101 019 patients with diabetes or hypertension (11 138 active portal users) who received primary care within the Ochsner Health System between 2012 and 2014...
February 9, 2018: Journal of the American Medical Informatics Association: JAMIA
Kathrin Blagec, Rudolf Koopmann, Mandy Crommentuijn-van Rhenen, Inge Holsappel, Cathelijne H van der Wouden, Lidija Konta, Hong Xu, Daniela Steinberger, Enrico Just, Jesse J Swen, Henk-Jan Guchelaar, Matthias Samwald
Clinical pharmacogenomics (PGx) has the potential to make pharmacotherapy safer and more effective by utilizing genetic patient data for drug dosing and selection. However, widespread adoption of PGx depends on its successful integration into routine clinical care through clinical decision support tools, which is often hampered by insufficient or fragmented infrastructures. This paper describes the setup and implementation of a unique multimodal, multilingual clinical decision support intervention consisting of digital, paper-, and mobile-based tools that are deployed across implementation sites in seven European countries participating in the Ubiquitous PGx (U-PGx) project...
February 9, 2018: Journal of the American Medical Informatics Association: JAMIA
Arianna Dagliati, Lucia Sacchi, Valentina Tibollo, Giulia Cogni, Marsida Teliti, Antonio Martinez-Millana, Vicente Traver, Daniele Segagni, Jorge Posada, Manuel Ottaviano, Giuseppe Fico, Maria Teresa Arredondo, Pasquale De Cata, Luca Chiovato, Riccardo Bellazzi
Objective: To describe the development, as part of the European Union MOSAIC (Models and Simulation Techniques for Discovering Diabetes Influence Factors) project, of a dashboard-based system for the management of type 2 diabetes and assess its impact on clinical practice. Methods: The MOSAIC dashboard system is based on predictive modeling, longitudinal data analytics, and the reuse and integration of data from hospitals and public health repositories. Data are merged into an i2b2 data warehouse, which feeds a set of advanced temporal analytic models, including temporal abstractions, care-flow mining, drug exposure pattern detection, and risk-prediction models for type 2 diabetes complications...
February 2, 2018: Journal of the American Medical Informatics Association: JAMIA
Seth Klapman, Emily Sher, Julia Adler-Milstein
Objective: Ensuring the ability to exchange patient information among disparate electronic health records systems is a top priority and a domain of substantial public investment across countries. However, we know little about the extent to which current capabilities meet the needs of frontline clinicians. Materials and Methods: We conducted in-person, semistructured interviews with emergency care physicians and nurses in select hospitals in Canada, Denmark, Finland, Germany, and the USA...
February 2, 2018: Journal of the American Medical Informatics Association: JAMIA
Carlos Baladrón, Alejandro Santos-Lozano, Javier M Aguiar, Alejandro Lucia, Juan Martín-Hernández
Objective: The most used search engine for scientific literature, PubMed, provides tools to filter results by several fields. When searching for reports on clinical trials, sample size can be among the most important factors to consider. However, PubMed does not currently provide any means of filtering search results by sample size. Such a filtering tool would be useful in a variety of situations, including meta-analyses or state-of-the-art analyses to support experimental therapies. In this work, a tool was developed to filter articles identified by PubMed based on their reported sample sizes...
February 1, 2018: Journal of the American Medical Informatics Association: JAMIA
Ravy K Vajravelu, Frank I Scott, Ronac Mamtani, Hongzhe Li, Jason H Moore, James D Lewis
Objective: Observational studies analyzing multiple exposures simultaneously have been limited by difficulty distinguishing relevant results from chance associations due to poor specificity. Set-based methods have been successfully used in genomics to improve signal-to-noise ratio. We present and demonstrate medication class enrichment analysis (MCEA), a signal-to-noise enhancement algorithm for observational data inspired by set-based methods. Materials and Methods: We used The Health Improvement Network database to study medications associated with Clostridium difficile infection (CDI)...
January 25, 2018: Journal of the American Medical Informatics Association: JAMIA
G Talley Holman, Steven E Waldren, John W Beasley, Deborah J Cohen, Lawrence D Dardick, Chester H Fox, Jenna Marquard, Ryan Mullins, Charles Q North, Matt Rafalski, A Joy Rivera, Tosha B Wetterneck
Objective: The federal meaningful use (MU) program was aimed at improving adoption and use of electronic health records, but practicing physicians have criticized it. This study was aimed at quantifying the benefits (ie, usefulness) and burdens (ie, workload) of the MU program for practicing family physicians. Materials and Methods: An interdisciplinary national panel of experts (physicians and engineers) identified the work associated with MU criteria during patient encounters...
January 23, 2018: Journal of the American Medical Informatics Association: JAMIA
Honghan Wu, Giulia Toti, Katherine I Morley, Zina M Ibrahim, Amos Folarin, Richard Jackson, Ismail Kartoglu, Asha Agrawal, Clive Stringer, Darren Gale, Genevieve Gorrell, Angus Roberts, Matthew Broadbent, Robert Stewart, Richard J B Dobson
Objective: Unlocking the data contained within both structured and unstructured components of electronic health records (EHRs) has the potential to provide a step change in data available for secondary research use, generation of actionable medical insights, hospital management, and trial recruitment. To achieve this, we implemented SemEHR, an open source semantic search and analytics tool for EHRs. Methods: SemEHR implements a generic information extraction (IE) and retrieval infrastructure by identifying contextualized mentions of a wide range of biomedical concepts within EHRs...
January 19, 2018: Journal of the American Medical Informatics Association: JAMIA
(no author information available yet)
No abstract text is available yet for this article.
January 19, 2018: Journal of the American Medical Informatics Association: JAMIA
Ron C Li, Trit Garg, Tony Cun, Lisa Shieh, Gomathi Krishnan, Daniel Fang, Jonathan H Chen
Objective: Problem-based charting (PBC) is a method for clinician documentation in commercially available electronic medical record systems that integrates note writing and problem list management. We report the effect of PBC on problem list utilization and accuracy at an academic intensive care unit (ICU). Materials and Methods: An interrupted time series design was used to assess the effect of PBC on problem list utilization, which is defined as the number of new problems added to the problem list by clinicians per patient encounter, and of problem list accuracy, which was determined by calculating the recall and precision of the problem list in capturing 5 common ICU diagnoses...
January 18, 2018: Journal of the American Medical Informatics Association: JAMIA
Xiaoling Chen, Anupama E Gururaj, Burak Ozyurt, Ruiling Liu, Ergin Soysal, Trevor Cohen, Firat Tiryaki, Yueling Li, Nansu Zong, Min Jiang, Deevakar Rogith, Mandana Salimi, Hyeon-Eui Kim, Philippe Rocca-Serra, Alejandra Gonzalez-Beltran, Claudiu Farcas, Todd Johnson, Ron Margolis, George Alter, Susanna-Assunta Sansone, Ian M Fore, Lucila Ohno-Machado, Jeffrey S Grethe, Hua Xu
Objective: Finding relevant datasets is important for promoting data reuse in the biomedical domain, but it is challenging given the volume and complexity of biomedical data. Here we describe the development of an open source biomedical data discovery system called DataMed, with the goal of promoting the building of additional data indexes in the biomedical domain. Materials and Methods: DataMed, which can efficiently index and search diverse types of biomedical datasets across repositories, is developed through the National Institutes of Health-funded biomedical and healthCAre Data Discovery Index Ecosystem (bioCADDIE) consortium...
January 13, 2018: Journal of the American Medical Informatics Association: JAMIA
Yizhao Ni, Todd Lingren, Eric S Hall, Matthew Leonard, Kristin Melton, Eric S Kirkendall
Background: Timely identification of medication administration errors (MAEs) promises great benefits for mitigating medication errors and associated harm. Despite previous efforts utilizing computerized methods to monitor medication errors, sustaining effective and accurate detection of MAEs remains challenging. In this study, we developed a real-time MAE detection system and evaluated its performance prior to system integration into institutional workflows. Methods: Our prospective observational study included automated MAE detection of 10 high-risk medications and fluids for patients admitted to the neonatal intensive care unit at Cincinnati Children's Hospital Medical Center during a 4-month period...
January 10, 2018: Journal of the American Medical Informatics Association: JAMIA
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