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AMIA ... Annual Symposium Proceedings

Fabricio S P Kury, Seo H Baik, Clement J McDonald
The Medicare Shared Savings Program (MSSP) is the larger of the first two Accountable Care Organization (ACO) programs by the Centers for Medicare and Medicaid Services (CMS). In this study we assessed healthcare cost and utilization of 1.71 million Medicare beneficiaries assigned to the 333 MSSP ACOs in the calendar years of 2013 and 2014, in comparison to years 2010 and 2011, using the official CMS data. We employed doubly robust estimation (propensity score weighting followed by generalized linear regression) to adjust the analyses to beneficiary personal traits, history of chronic conditions, previous healthcare utilization, ACO administrative region, and ZIP code socioeconomic factors...
2016: AMIA ... Annual Symposium Proceedings
Wei Zhu, Lingyun Luo, Tarun Jain, Rebecca S Boxer, Licong Cui, Guo-Qiang Zhang
Heart disease is the leading cause of death in the United States. Heart failure disease management can improve health outcomes for elderly community dwelling patients with heart failure. This paper describes DCDS, a real-time data capture and personalized decision support system for a Randomized Controlled Trial Investigating the Effect of a Heart Failure Disease Management Program (HF-DMP) in Skilled Nursing Facilities (SNF). SNF is a study funded by the NIH National Heart, Lung, and Blood Institute (NHLBI)...
2016: AMIA ... Annual Symposium Proceedings
Shaodian Zhang, NoƩmie Elhadad
Dropping-out, which refers to when an individual abandons an intervention, is common in Internet-based studies as well as in online health communities. Community facilitators and health researchers are interested in this phenomenon because it usually indicates dissatisfaction towards the community and/or its failure to deliver expected benefits. In this study, we propose a method to identify dropout members from a large public online breast cancer community. We then study quantitatively what longitudinal factors of participation are correlated with dropping-out...
2016: AMIA ... Annual Symposium Proceedings
Zihao Yan, Ronilda Lacson, Ivan Ip, Vladimir Valtchinov, Ali Raja, David Osterbur, Ramin Khorasani
Purpose: Clinical decision support tools provide recommendations based on decision rules. A fundamental challenge regarding decision rule-sharing involves inadequate expression using standard terminology. We aimed to evaluate the coverage of three standard terminologies for mapping imaging-related decision rules. Methods: 50 decision rules, randomly selected from an existing library, were mapped to Systemized Nomenclature of Medicine (SNOMED CT), Radiology Lexicon (RadLex) and International Classification of Disease (ICD-10-CM)...
2016: AMIA ... Annual Symposium Proceedings
Tamara J Winden, Elizabeth S Chen, Genevieve B Melton
Social determinants of health play an important role in diagnosis, prevention, health outcomes, and quality of life. The objective of this study was to examine existing standards, vocabularies, and terminologies for items related to Residence, Living Situation, and Living Conditions and to synthesize them into model representations. Sources were identified through literature and keyword searches, and an examination of commonly used resources. Each source was systematically analyzed by two reviewers, mapped to topic area(s), and further mapped to a model representation...
2016: AMIA ... Annual Symposium Proceedings
Yue Wang, Kai Zheng, Hua Xu, Qiaozhu Mei
Resolving word ambiguity in clinical text is critical for many natural language processing applications. Effective word sense disambiguation (WSD) systems rely on training a machine learning based classifier with abundant clinical text that is accurately annotated, the creation of which can be costly and time-consuming. We describe a double-loop interactive machine learning process, named ReQ-ReC (ReQuery-ReClassify), and demonstrate its effectiveness on multiple evaluation corpora. Using ReQ-ReC, a human expert first uses her domain knowledge to include sense-specific contextual words into the ReQuery loops and searches for instances relevant to the senses...
2016: AMIA ... Annual Symposium Proceedings
Yefeng Wang, Terrence J Adam, Rui Zhang
As the clinical application and consumption of dietary supplements has grown, their side effects and possible interactions with prescribed medications has become a serious issue. Information extraction of dietary supplement related information is a critical need to support dietary supplement research. However, there currently is not an existing terminology for dietary supplements, placing a barrier for informatics research in this field. The terms related to dietary supplement ingredients should be collected and normalized before a terminology can be established to facilitate convenient search on safety information and control possible adverse effects of dietary supplements...
2016: AMIA ... Annual Symposium Proceedings
Yik-Ki J Wan, Catherine J Staes
Healthcare organizations use care pathways to standardize care, but once developed, adoption rates often remain low. One challenge for usage concerns clinicians' difficulty in accessing guidance when it is most needed. Although the HL7 'Infobutton Standard' allows clinicians easier access to external references, access to locally-developed resources often requires clinicians to deviate from their normal electronic health record (EHR) workflow to use another application. To address this gap between internal and external resources, we reviewed the literature and existing practices at the University of Utah Health Care...
2016: AMIA ... Annual Symposium Proceedings
Rohit Vashisht, Ken Jung, Nigam Shah
Treatment guidelines for management of type-2 diabetes mellitus (T2DM) are controversial because existing evidence from randomized clinical trials do not address many important clinical questions. Data from Electronic Medical Records (EMRs) has been used to profile first line therapy choices, but this work did not elucidate the factors underlying deviations from current treatment guidelines and the relative efficacy of different treatment options. We have used data from the Stanford Hospital to attempt to address these issues...
2016: AMIA ... Annual Symposium Proceedings
Prasad Unni, Catherine Staes, Howard Weeks, Heidi Kramer, Damion Borbolla, Stacey Slager, Teresa Taft, Valliammai Chidambaram, Charlene Weir
Introduction. Implementations of electronic health records (EHR) have been met with mixed outcome reviews. Complaints about these systems have led to many attempts to have useful measures of end-user satisfaction. However, most user satisfaction assessments do not focus on high-level reasoning, despite the complaints of many physicians. Our study attempts to identify some of these determinants. Method. We developed a user satisfaction survey instrument, based on pre-identified and important clinical and non-clinical clinician tasks...
2016: AMIA ... Annual Symposium Proceedings
Maxim Topaz, Charlene Ronquillo, Laura-Maria Peltonen, Lisiane Pruinelli, Raymond Francis Sarmiento, Martha K Badger, Samira Ali, Adrienne Lewis, Mattias Georgsson, Eunjoo Jeon, Jude L Tayaben, Chiu-Hsiang Kuo, Tasneem Islam, Janine Sommer, Hyunggu Jung, Gabrielle Jacklin Eler, Dari Alhuwail, Ying-Li Lee
This study presents a qualitative content analysis of nurses' satisfaction and issues with current electronic health record (EHR) systems, as reflected in one of the largest international surveys of nursing informatics. Study participants from 45 countries (n=469) ranked their satisfaction with the current state of nursing functionality in EHRs as relatively low. Two-thirds of the participants (n=283) provided disconcerting comments when explaining their low satisfaction rankings. More than one half of the comments identified issues at the system level (e...
2016: AMIA ... Annual Symposium Proceedings
Maurine Tong, William Hsu, Ricky K Taira
Contributions of clinical trials are captured in published reports that are unstructured and often require extensive manual review to gain a deeper understanding of the study itself. Our goal is to increase comprehension and decrease the time necessary to understand these reports through the use of visualization tools. In this paper, we specify and evaluate the visualization of a previously developed representation as well as gain insight from user input for further development. The usability experiment consisted of a two-arm study with users either having or not having access to the visualization...
2016: AMIA ... Annual Symposium Proceedings
Hyewon Suh, John R Porter, Robert Racadio, Yi-Chen Sung, Julie A Kientz
To help reach populations of children without consistent Internet access or medical care, we designed and implemented Baby Steps Text, an automated text message-based screening tool. We conducted preliminary user research via storyboarding and prototyping with target populations and then developed a fully functional system. In a one-month deployment study, we evaluated the feasibility of Baby Steps Text with fourteen families. During a one-month study, 13 out of 14 participants were able to learn and use the response structure (yielding 2...
2016: AMIA ... Annual Symposium Proceedings
Bryan D Steitz, Mia A Levy
Cancer treatment often consists of multiple therapeutic modalities delivered by specialists. As changing reimbursement paradigms move towards quality outcomes and bundled payments, extensive care coordination between healthcare providers is imperative. We developed an approach to quantify care coordination relationships among providers treating breast cancer patients at the Vanderbilt University Medical Center. Our cohort of 1285 providers treated 3924 breast cancer patients, and had 1758 unique provider-provider relationships...
2016: AMIA ... Annual Symposium Proceedings
Vishnupriya Sridharan, Trevor Cohen, Nathan Cobb, Sahiti Myneni
With online social platforms gaining popularity as venues of behavior change, it is important to understand the ways in which these platforms facilitate peer interactions. In this paper, we characterize temporal trends in user communication through mapping of theoretically-linked semantic content. We used qualitative coding and automated text analysis to assign theoretical techniques to peer interactions in an online community for smoking cessation, subsequently facilitating temporal visualization of the observed techniques...
2016: AMIA ... Annual Symposium Proceedings
Jamie R Robinson, Sharon E Davis, Robert M Cronin, Gretchen P Jackson
Patient portal research has focused on medical outpatient settings, with little known about portal use during hospitalizations or by surgical patients. We measured portal adoption among patients admitted to surgical services over two years. Surgical services managed 37,025 admissions of 31,310 unique patients. One-fourth of admissions (9,362, 25.3%) involved patients registered for the portal. Registration rates were highest for admissions to laparoscopic/gastrointestinal (55%) and oncology/endocrine (50%) services...
2016: AMIA ... Annual Symposium Proceedings
Frank Pandolfe, Bradley H Crotty, Charles Safran
Incompletely reconciled medication lists contribute to prescribing errors and adverse drug events. Providers expend time and effort at every point of patient contact attempting to curate a best possible medication list, and yet often the list is incomplete or inaccurate. We propose a framework that builds upon the existing infrastructure of a health information exchange (HIE), centralizes data and encourages patient activation. The solution is a constantly accessible, singular, patient-adjudicated medication list that incorporates useful information and features into the list itself...
2016: AMIA ... Annual Symposium Proceedings
Sunanda Mukherjee, Huanmei Wu, Josette Jones
Parkinson's Disease (PD), a prevalent problem, especially for the aged populations, is a progressive but non-fatal nervous system disorder. PD patients have special motor as well as non-motor symptoms over time. There are several limitations in the study of PD such as unavailability of data, proper diagnosis and treatment methods. These limitations significantly reduce the quality of PD patient life quality, either directly or indirectly. PD also imposes great financial burdens to PD patients and their family...
2016: AMIA ... Annual Symposium Proceedings
Justin Mower, Devika Subramanian, Ning Shang, Trevor Cohen
An important aspect of post-marketing drug surveillance involves identifying potential side-effects utilizing adverse drug event (ADE) reporting systems and/or Electronic Health Records. These data are noisy, necessitating identified drug/ADE associations be manually reviewed - a human-intensive process that scales poorly with large numbers of possibly dangerous associations and rapid growth of biomedical literature. Recent work has employed Literature Based Discovery methods that exploit implicit relationships between biomedical entities within the literature to estimate the plausibility of drug/ADE connections...
2016: AMIA ... Annual Symposium Proceedings
Mary Masterman, Robert M Cronin, Sharon E Davis, Jared A Shenson, Gretchen P Jackson
Few studies have explored adoption of patient portals for pediatric patients outside primary care or disease-specific applications. We examined use of patient-provider messaging in a patient portal across pediatric specialties during the three years after implementation of pediatric portal accounts at Vanderbilt University Medical Center. We determined the number of patient-initiated message threads and clinic visits for pediatric specialties and percentage of these outpatient interactions (i.e., message threads + clinic visits) done through messaging...
2016: AMIA ... Annual Symposium Proceedings
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