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Applied Clinical Informatics

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https://www.readbyqxmd.com/read/28636063/solving-interoperability-in-translational-health-perspectives-of-students-from-the-international-partnership-in-health-informatics-education-iphie-2016-master-class
#1
Anne M Turner, Julio C Facelli, Monique Jaspers, Thomas Wetter, Daniel Pfeifer, Laël Cranmer Gatewood, Terry Adam, Yu-Chuan Li, Ming-Chin Lin, R Scott Evans, Anna Beukenhorst, Hugo Johan Theodoore van Mens, Esmee Tensen, Christian Bock, Laura Fendrich, Peter Seitz, Julian Suleder, Ranyah Aldelkhyyel, Kent Bridgeman, Zhen Hu, Aaron Sattler, Shin-Yi Guo, Islam Md Mohaimenul Mohaimenul, Dina Nur Anggraini Ningrum, Hsin-Ru Tung, Jiantano Bian, Joseph M Plasek, Casey Rommel, Juandalyn Burke, Harkirat Sohih
BACKGROUND: In the summer of 2016 an international group of biomedical and health informatics faculty and graduate students gathered for the 16th meeting of the International Partnership in Health Informatics Education (IPHIE) masterclass at the University of Utah campus in Salt Lake City, Utah. This international biomedical and health informatics workshop was created to share knowledge and explore issues in biomedical health informatics (BHI). OBJECTIVE: The goal of this paper is to summarize the discussions of biomedical and health informatics graduate students who were asked to define interoperability, and make critical observations to gather insight on how to improve biomedical education...
June 20, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28636060/developing-mobile-clinical-decision-support-for-nursing-home-staff-assessment-of-urinary-tract-infection-using-goal-directed-design
#2
Wallace Jones, Cynthia Drake, David Mack, Blaine Reeder, Barbara Trautner, Heidi Wald
BACKGROUND: Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. OBJECTIVES: We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff...
June 20, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28561130/the-effects-of-natural-language-processing-on-cross-institutional-portability-of-influenza-case-detection-for-disease-surveillance
#3
Jeffrey P Ferraro, Ye Ye, Per H Gesteland, Peter J Haug, Fuchiang Rich Tsui, Gregory F Cooper, Rudy Van Bree, Thomas Ginter, Andrew J Nowalk, Michael Wagner
OBJECTIVES: This study evaluates the accuracy and portability of a natural language processing (NLP) tool for extracting clinical findings of influenza from clinical notes across two large healthcare systems. Effectiveness is evaluated on how well NLP supports downstream influenza case-detection for disease surveillance. METHODS: We independently developed two NLP parsers, one at Intermountain Healthcare (IH) in Utah and the other at University of Pittsburgh Medical Center (UPMC) using local clinical notes from emergency department (ED) encounters of influenza...
May 31, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28536723/improving-medication-adherence-with-two-way-short-message-service-reminders-in-sickle-cell-disease-and-asthma-a-feasibility-randomized-controlled-trial
#4
B M Pernell, Michael R DeBaun, Kathleen Becker, Mark Rodeghier, Valencia Bryant, Robert M Cronin
INTRODUCTION: Sickle cell disease (SCD) is a childhood and adult disease that primarily affects African Americans, characterized by life threatening sequelae mitigated by medications. One-way and two-way short message service (SMS) medication reminders have differing efficacy in chronic diseases. There is limited literature about SMS medication reminders in SCD. OBJECTIVE: The goal of this study was to test the feasibility, defined by recruitment/acceptance, retention/attrition, and technology utilization, of two-way SMS medication reminders in individuals with SCD with and without asthma...
May 24, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28536719/insulin-bolus-calculator-in-a-pediatric-hospital-safety-and-user-perceptions
#5
Mohammad B Ateya, Ranjit Aiyagari, Colleen Moran, Kanakadurga Singer
BACKGROUND: Insulin dosing in hospitalized pediatric patients is challenging and requires dosing to be matched with the specific clinical and nutritional circumstances. We implemented a customized subcutaneous insulin bolus dose calculator tool integrated with the electronic health record to improve patient care. Here we describe this tool, its utilization and safety, and assess user satisfaction and perceptions of the tool. METHODS: Blood glucose results for all patients who received insulin with and without the calculator tool were compared to assess safety...
May 24, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28512663/advancing-the-integration-of-hospital-it-pitfalls-and-perspectives-when-replacing-specialized-software-for-high-risk-environments-with-enterprise-system-extensions
#6
Carsten Engelmann, Dzifa Ametowobla
BACKGROUND: Planning and controlling surgical operations hugely impacts upon productivity, patient safety, and surgeons' careers. Established, specialized software for this task is being increasingly replaced by "Operating Room (OR)-modules" appended to enterprise-wide resource planning (ERP) systems. As a result, usability problems are re-emerging and require developers' attention. OBJECTIVE: Systematic evaluation of the functionality and social repercussions of a global, market-leading IT business control system (SAP R3, Germany), adapted for real-time OR process steering...
May 17, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28512662/a-hospital-wide-transition-from-paper-to-digital-problem-oriented-clinical-notes-a-descriptive-history-and-cross-sectional-survey-of-use-usability-and-satisfaction
#7
Felix H J M Cillessen, Pieter F de Vries Robbé, Marion C J Biermans
OBJECTIVES: To evaluate the use, usability, and physician satisfaction of a locally developed problem-oriented clinical notes application that replaced paper-based records in a large Dutch university medical center. METHODS: Using a clinical notes database and an application event log file and a cross-sectional survey of usability, authors retrospectively analyzed system usage for medical specialties, users, and patients over 4 years. A standardized questionnaire measured usability...
May 17, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28487932/towards-usable-e-health-a-systematic-review-of-usability-questionnaires
#8
Vanessa E C Sousa, Karen Dunn Lopez
BACKGROUND: The use of e-health can lead to several positive outcomes. However, the potential for e-health to improve healthcare is partially dependent on its ease of use. In order to determine the usability for any technology, rigorously developed and appropriate measures must be chosen. OBJECTIVES: To identify psychometrically tested questionnaires that measure usability of e-health tools, and to appraise their generalizability, attributes coverage, and quality...
May 10, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28487931/advanced-3d-movement-analysis-algorithms-for-robust-functional-capacity-assessment
#9
Asma Hassani, Alexandre Kubicki, France Mourey, Fan Yang
OBJECTIVES: We developed a novel system for in home functional capacities assessment in frail older adults by analyzing the Timed Up and Go movements. This system aims to follow the older people evolution, potentially allowing a forward detection of motor decompensation in order to trigger the implementation of rehabilitation. However, the pre-experimentations conducted on the ground, in different environments, revealed some problems which were related to KinectTM operation. Hence, the aim of this actual study is to develop methods to resolve these problems...
May 10, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28487930/the-effects-of-medication-alerts-on-prescriber-response-in-a-pediatric-hospital
#10
Judith W Dexheimer, Eric S Kirkendall, Michal Kouril, Philip A Hagedorn, Thomas Minich, Leo L Duan, Monifa Mahdi, Rhonda Szczesniak, S Andrew Spooner
OBJECTIVE: More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider's response to any EHR alert. The primary goal was to evaluate the effects of alert burden on user response to the alerts. METHODS: We performed a retrospective study of medication alerts over a 24-month period (1/2013-12/2014) in a large pediatric academic medical center...
May 10, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28466088/combining-contrast-mining-with-logistic-regression-to-predict-healthcare-utilization-in-a-managed-care-population
#11
Lincoln Sheets, Gregory F Petroski, Yan Zhuang, Michael A Phinney, Bin Ge, Jerry C Parker, Chi-Ren Shyu
BACKGROUND: Because 5% of patients incur 50% of healthcare expenses, population health managers need to be able to focus preventive and longitudinal care on those patients who are at highest risk of increased utilization. Predictive analytics can be used to identify these patients and to better manage their care. Data mining permits the development of models that surpass the size restrictions of traditional statistical methods and take advantage of the rich data available in the electronic health record (EHR), without limiting predictions to specific chronic conditions...
May 3, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28466087/canary-an-nlp-platform-for-clinicians-and-researchers
#12
Shervin Malmasi, Nicolae L Sandor, Naoshi Hosomura, Matt Goldberg, Stephen Skentzos, Alexander Turchin
Information Extraction methods can help discover critical knowledge buried in the vast repositories of unstructured clinical data. However, these methods are underutilized in clinical research, potentially due to the absence of free software geared towards clinicians with little technical expertise. The skills required for developing/using such software constitute a major barrier for medical researchers wishing to employ these methods. To address this, we have developed Canary, a free and open-source solution designed for users without natural language processing (NLP) or software engineering experience...
May 3, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28447101/development-and-use-of-a-clinical-decision-support-tool-for-behavioral-health-screening-in-primary-care-clinics
#13
Timothy E Burdick, Rodger S Kessler
OBJECTIVE: Screening, brief intervention, and referral for treatment (SBIRT) for behavioral health (BH) is a key clinical process. SBIRT tools in electronic health records (EHR) are infrequent and rarely studied. Our goals were 1) to design and implement SBIRT using clinical decision support (CDS) in a commercial EHR; and 2) to conduct a pragmatic evaluation of the impact of the tools on clinical outcomes. METHODS: A multidisciplinary team designed SBIRT workflows and CDS tools...
April 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28447098/application-of-natural-language-processing-and-network-analysis-techniques-to-post-market-reports-for-the-evaluation-of-dose-related-anti-thymocyte-globulin-safety-patterns
#14
Taxiarchis Botsis, Matthew Foster, Nina Arya, Kory Kreimeyer, Abhishek Pandey, Deepa Arya
OBJECTIVE: To evaluate the feasibility of automated dose and adverse event information retrieval in supporting the identification of safety patterns. METHODS: We extracted all rabbit Anti-Thymocyte Globulin (rATG) reports submitted to the United States Food and Drug Administration Adverse Event Reporting System (FAERS) from the product's initial licensure in April 16, 1984 through February 8, 2016. We processed the narratives using the Medication Extraction (MedEx) and the Event-based Text-mining of Health Electronic Records (ETHER) systems and retrieved the appropriate medication, clinical, and temporal information...
April 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28421225/using-telephony-data-to-facilitate-discovery-of-clinical-workflows
#15
Donald W Rucker
BACKGROUND:  Discovery of clinical workflows to target for redesign using methods such as Lean and Six Sigma is difficult. VoIP telephone call pattern analysis may complement direct observation and EMR-based tools in understanding clinical workflows at the enterprise level by allowing visualization of institutional telecommunications activity. OBJECTIVE:  To build an analytic framework mapping repetitive and high-volume telephone call patterns in a large medical center to their associated clinical units using an enterprise unified communications server log file and to support visualization of specific call patterns using graphical networks...
April 19, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28401246/technology-mediated-interventions-and-quality-of-life-for-persons-living-with-hiv-aids-a-systematic-review
#16
Hwayoung Cho, Sarah Iribarren, Rebecca Schnall
BACKGROUND: As HIV/AIDS is considered a chronic disease; quality of life (QoL) has become an important focus for researchers and healthcare providers. Technology-mediated interventions have demonstrated improved clinical effectiveness in outcomes, such as viral suppression, for persons living with HIV/AIDS (PLWH). However, the evidence to support the impact of these interventions on QoL is lacking. OBJECTIVES: The aim of this paper was to assess the impact of technology-mediated interventions on QoL and to identify the instruments used to measure the QoL of PLWH...
April 12, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28401245/automating-clinical-score-calculation-within-the-electronic-health-record-a-feasibility-assessment
#17
Christopher Aakre, Mikhail Dziadzko, Mark T Keegan, Vitaly Herasevich
OBJECTIVES: Evidence-based clinical scores are used frequently in clinical practice, but data collection and data entry can be time consuming and hinder their use. We investigated the programmability of 168 common clinical calculators for automation within electronic health records. METHODS: We manually reviewed and categorized variables from 168 clinical calculators as being extractable from structured data, unstructured data, or both. Advanced data retrieval methods from unstructured data sources were tabulated for diagnoses, non-laboratory test results, clinical history, and examination findings...
April 12, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28378025/the-building-blocks-of-interoperability-a-multisite-analysis-of-patient-demographic-attributes-available-for-matching
#18
Adam Culbertson, Satyender Goel, Margaret B Madden, Niloufar Safaeinili, Kathryn L Jackson, Thomas Carton, Russ Waitman, Mei Liu, Ashok Krishnamurthy, Lauren Hall, Nickie Cappella, Shyam Visweswaran, Michael J Becich, Reuben Applegate, Elmer Bernstam, Russell Rothman, Michael Matheny, Gloria Lipori, Jiang Bian, William Hogan, Douglas Bell, Andrew Martin, Shaun Grannis, Jeff Klann, Rebecca Sutphen, Amy B O'Hara, Abel Kho
BACKGROUND: Patient matching is a key barrier to achieving interoperability. Patient demographic elements must be consistently collected over time and region to be valuable elements for patient matching. OBJECTIVES: We sought to determine what patient demographic attributes are collected at multiple institutions in the United States and see how their availability changes over time and across clinical sites. METHODS: We compiled a list of 36 demographic elements that stakeholders previously identified as essential patient demographic attributes that should be collected for the purpose of linking patient records...
April 5, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28378024/examining-perceptions-of-computerized-physician-order-entry-in-a-neonatal-intensive-care-unit
#19
Kristyn S Beam, Megan Cardoso, Megan Sweeney, Geoff Binney, Saul N Weingart
BACKGROUND: Computerized provider order entry (CPOE) is a technology with potential to transform care delivery. While CPOE systems have been studied in adult populations, less is known about the implementation of CPOE in the neonatal intensive care unit (NICU) and perceptions of nurses and physicians using the system. OBJECTIVE: To examine perceptions of clinicians before and after CPOE implementation in the NICU of a pediatric hospital. METHODS: A cross-sectional survey of clinicians working in a Level III NICU was conducted...
April 5, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28352926/the-effect-of-requesting-a-reason-for-non-adherence-to-a-guideline-in-a-long-running-automated-reminder-system-for-ponv-prophylaxis
#20
Fabian O Kooij, Toni Klok, Benedikt Preckel, Markus W Hollmann, Jasper E Kal
BACKGROUND: Automated reminders are employed frequently to improve guideline adherence, but limitations of automated reminders are becoming more apparent. We studied the reasons for non-adherence in the setting of automated reminders to test the hypothesis that a separate request for a reason in itself may further improve guideline adherence. METHODS: In a previously implemented automated reminder system on prophylaxis for postoperative nausea and vomiting (PONV), we included additional automated reminders requesting a reason for non-adherence...
March 29, 2017: Applied Clinical Informatics
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