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Applied Clinical Informatics

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https://www.readbyqxmd.com/read/28956888/the-9-item-physician-documentation-quality-instrument-pdqi-9-score-is-not-useful-in-evaluating-emr-scribe-note-quality-in-emergency-medicine
#1
Katherine J Walker, Andrew Wang, William Dunlop, Hamish Rodda, Michael Ben-Meir, Margaret Staples
BACKGROUND: Scribes are assisting Emergency Physicians by writing their electronic clinical notes at the bedside during consultations. They increase physician productivity and improve their working conditions. The quality of Emergency scribe notes is unevaluated and important to determine. OBJECTIVE: The primary objective of the study was to determine if the quality of Emergency Department scribe notes was equivalent to physician only notes, using the Physician Documentation Quality Instrument, Nine-item tool (PDQI-9)...
September 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28933506/the-international-classification-of-functioning-disability-and-health-icf-in-electronic-health-records-a-systematic-literature-review
#2
Roxanne Maritz, Dominik Aronsky, Birgit Prodinger
BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) is the World Health Organization's standard for describing health and health-related states. Examples of how the ICF has been used in Electronic Health Records (EHRs) have not been systematically summarized and described yet. OBJECTIVES: To provide a systematic review of peer-reviewed literature about the ICF's use in EHRs, including related challenges and benefits. METHODS: Peer-reviewed literature, published between January 2001 and July 2015 was retrieved from Medline(®), CINAHL(®), Scopus(®), and ProQuest(®) Social Sciences using search terms related to ICF and EHR concepts...
September 20, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28905980/response-to-lapkoff-and-sittig-who-watches-the-watchers-working-towards-safety-for-clinical-decision-support-knowledge-resources
#3
John Poikonen, Edward Fotsch, Christoph U Lehmann
No abstract text is available yet for this article.
September 13, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28905978/redesign-of-computerized-decision-support-to-improve-antimicrobial-prescribing-a-controlled-before-and-after-study
#4
Melissa T Baysari, Jessica Del Gigante, Maria Moran, Indy Sandaradura, Ling Li, Katrina L Richardson, Anmol Sandhu, Elin C Lehnbom, Johanna I Westbrook, Richard O Day
OBJECTIVE: To determine the impact of the introduction of new pre-written orders for antimicrobials in a computerized provider order entry (CPOE) system on 1) accuracy of documented indications for antimicrobials in the CPOE system, 2) appropriateness of antimicrobial prescribing, and 3) compliance with the hospital's antimicrobial policy. Prescriber opinions of the new decision support were also explored to determine why the redesign was effective or ineffective in altering prescribing practices...
September 13, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28880046/clinical-decisions-support-malfunctions-in-a-commercial-electronic-health-record
#5
Steven Z Kassakian, Thomas R Yackel, Paul N Gorman, David A Dorr
OBJECTIVES: Determine if clinical decision support (CDS) malfunctions occur in a commercial electronic health record (EHR) system, characterize their pathways and describe methods of detection. METHODS: We retrospectively examined the firing rate for 226 alert type CDS rules for detection of anomalies using both expert visualization and statistical process control (SPC) methods over a five year period. Candidate anomalies were investigated and validated. RESULTS: Twenty-one candidate CDS anomalies were identified from 8,300 alert-months...
September 6, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28853766/enhancing-patient-safety-event-reporting-a-systematic-review-of-system-design-features
#6
Yang Gong, Hong Kang, Xinshuo Wu, Lei Hua
OBJECTIVES: Electronic patient safety event reporting (e-reporting) is an effective mechanism to learn from errors and enhance patient safety. Unfortunately, the value of e-reporting system (a software or web server based platform) in patient safety research is greatly overshadowed by low quality reporting. This paper aims at revealing the current status of system features, detecting potential gaps in system design, and accordingly proposing suggestions for future design and implementation of the system...
August 30, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28853764/exploring-vital-sign-data-quality-in-electronic-health-records-with-focus-on-emergency-care-warning-scores
#7
Niclas Skyttberg, Rong Chen, Hans Blomqvist, Sabine Koch
BACKGROUND: Computerized clinical decision support and automation of warnings have been advocated to assist clinicians in detecting patients at risk of physiological instability. To provide reliable support such systems are dependent on high-quality vital sign data. Data quality depends on how, when and why the data is captured and/or documented. OBJECTIVES: This study aims to describe the effects on data quality of vital signs by three different types of documentation practices in five Swedish emergency hospitals, and to assess data fitness for calculating warning and triage scores...
August 30, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28832069/comment-topic-evolution-on-a-cancer-institution-s-facebook-page
#8
Chunlei Tang, Li Zhou, Joseph Plasek, Ronen Rozenblum, David Bates
OBJECTIVES: Our goal was to identify and track the evolution of the topics discussed in free-text comments on a cancer institution's social media page. METHODS: We utilized the Latent Dirichlet Allocation model to extract ten topics from free-text comments on a cancer research institution's Facebook™ page between January 1, 2009, and June 30, 2014. We calculated Pearson correlation coefficients between the comment categories to demonstrate topic intensity evolution...
August 23, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28832067/comparison-of-overridden-medication-related-clinical-decision-support-in-the-intensive-care-unit-between-a-commercial-system-and-a-legacy-system
#9
Adrian Wong, Adam Wright, Diane L Seger, Mary G Amato, Julie M Fiskio, David Bates
BACKGROUND: Electronic health records (EHRs) with clinical decision support (CDS) have shown to be effective at improving patient safety. Despite this, alerts delivered as part of CDS are overridden frequently, which is of concern in the critical care population as this group may have an increased risk of harm. Our organization recently transitioned from an internally-developed EHR to a commercial system. Data comparing various EHR systems, especially after transitions between EHRs, are needed to identify areas for improvement...
August 23, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28885637/-is-there-an-app-for-that-orthopaedic-patient-preferences-for-a-smartphone-application
#10
Jonathan R Datillo, Daniel J Gittings, Matthew Sloan, William M Hardaker, Matthew J Deasey, Neil P Sheth
BACKGROUND: Patients are seeking out medical information on the Internet and utilizing smartphone health applications ("apps"). Smartphone use has exponentially increased among orthopaedic surgeons and patients. Despite this increase, patients are rarely directed to specific apps by physicians. No study exists querying patient preferences for a patient-centered, orthopaedic smartphone application. OBJECTIVES: The purpose of this study is to 1) determine Internet use patterns amongst orthopaedic patients; 2) ascertain access to and use of smartphones; and 3) elucidate what features orthopaedic patients find most important in a smartphone application...
August 16, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28832068/the-emerging-role-of-the-chief-research-informatics-officer-in-academic-health-centers
#11
L Nelson Sanchez-Pinto, Abu S M Mosa, Kate Fultz-Hollis, Umberto Tachinardi, William K Barnett, Peter J Embi
BACKGROUND: The role of the Chief Research Informatics Officer (CRIO) is emerging in academic health centers to address the challenges clinical researchers face in the increasingly digitalized, data-intensive healthcare system. Most current CRIOs are the first officers in their institutions to hold that role. To date there is very little published information about this role and the individuals who serve it. OBJECTIVE: To increase our understanding of the CRIO role, the leaders who serve it, and the factors associated with their success in their organizations...
August 16, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28837212/barriers-to-achieving-economies-of-scale-in-analysis-of-ehr-data-a-cautionary-tale
#12
Mark P Sendak, Suresh Balu, Kevin A Schulman
Signed in 2009, the Health Information Technology for Economic and Clinical Health Act infused $28 billion of federal funds to accelerate adoption of electronic health records (EHRs). Yet, EHRs have produced mixed results and have even raised concern that the current technology ecosystem stifles innovation. We describe the development process and report initial outcomes of a chronic kidney disease analytics application that identifies high-risk patients for nephrology referral. The cost to validate and integrate the analytics application into clinical workflow was $217,138...
August 9, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28837211/special-topic-interoperability-and-ehr-combining-openehr-snomed-ihe-and-continua-as-approaches-to-interoperability-on-national-ehealth
#13
Mate Beštek, Dalibor Stanimirović
OBJECTIVES: The main aims of the paper comprise the characterization and examination of the potential approaches regarding interoperability. This includes openEHR, SNOMED, IHE, and Continua as combined interoperability approaches, possibilities for their incorporation into the eHealth environment, and identification of the main success factors in the field, which are necessary for achieving required interoperability, and consequently, for the successful implementation of eHealth projects in general...
August 9, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28765865/long-term-patterns-of-patient-portal-use-for-pediatric-patients-at-an-academic-medical-center
#14
Bryan Steitz, Robert M Cronin, Sharon E Davis, Ellen Yan, Gretchen P Jackson
BACKGROUND: Patient portal adoption has increased over the last two decades. Most research about patient portals has focused on adult populations in the primary care and medical specialty settings. OBJECTIVE: We describe initial and long-term portal use by pediatric patients and their caregivers in a broadly deployed patient portal at an academic medical center. METHODS: We analyzed portal usage for pediatric patients and their caregivers from 2008 to 2014...
August 2, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28765864/comparison-of-ehr-based-diagnosis-documentation-locations-to-a-gold-standard-for-risk-stratification-in-patients-with-multiple-chronic-conditions
#15
Shelby Martin, Jesse Wagner, Nicoleta Lupulescu-Mann, Katrina Ramsey, Aaron Cohen, Peter Graven, Nicole G Weiskopf, David A Dorr
OBJECTIVE: To measure variation among four different Electronic Health Record (EHR) system documentation locations versus 'gold standard' manual chart review for risk stratification in patients with multiple chronic illnesses. METHODS: Adults seen in primary care with EHR evidence of at least one of 13 conditions were included. EHRs were manually reviewed to determine presence of active diagnoses, and risk scores were calculated using three different methodologies and five EHR documentation locations...
August 2, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28745778/conversion-of-provider-emr-training-from-instructor-led-training-to-elearning-at-an-academic-medical-center
#16
Karen Sharp, Michele Williams, Alison Aldrich, Adrienne Bogacz, Sighle Denier, Ann S McAlearney
This case study overviews the conversion of provider training of the electronic medical record (EMR) from an instructor-led training (ILT) program to eLearning at an Academic Medical Center (AMC). This conversion provided us with both a useful training tool and the opportunity to maximize efficiency within both our training and optimization team and organization. eLearning Development Principles were created and served as a guide to assist us with designing an eLearning curriculum using a five step process...
July 26, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28925416/extracting-autism-spectrum-disorder-data-from-the-electronic-health-record
#17
Ruth A Bush, Cynthia D Connelly, Alexa Pérez, Halsey Barlow, George J Chiang
BACKGROUND: Little is known about the health care utilization patterns of individuals with pediatric autism spectrum disorder (ASD). OBJECTIVES: Electronic health record (EHR) data provide an opportunity to study medical utilization and track outcomes among children with ASD.  Methods: Using a pediatric, tertiary, academic hospital's Epic EHR, search queries were built to identify individuals aged 2-18 with International Classification of Diseases, Ninth Revision (ICD-9) codes, 299...
July 19, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28880047/comparison-of-secure-messaging-application-whatsapp-and-standard-telephone-usage-for-consultations-on-length-of-stay-in-the-ed-a-prospective-randomized-controlled-study
#18
Umut Gulacti, Ugur Lok
OBJECTIVE: Consultation, the process of an Emergency Physician seeking an opinion from other specialties, occurs frequently in the Emergency Department (ED). The aim of this study was to determine the effect of secure messaging application (WhatsApp) usage for medical consultations on Emergency Department Length of Stay (ED LOS) and consult time. METHODS: We conducted a prospective, randomized controlled trial in the ED using allocation concealment over three months...
July 19, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28696480/a-picture-is-worth-1-000-words-the-use-of-clinical-images-in-electronic-medical-records
#19
Angela C Ai, Francine L Maloney, Thu-Trang Hickman, Allison R Wilcox, Harley Ramelson, Adam Wright
OBJECTIVE: To understand how clinicians utilize image uploading tools in a home grown electronic health records (EHR) system. METHODS: A content analysis of patient notes containing non-radiological images from the EHR was conducted. Images from 4,000 random notes from July 1, 2009 - June 30, 2010 were reviewed and manually coded. Codes were assigned to four properties of the image: (1) image type, (2) role of image uploader (e.g. MD, NP, PA, RN), (3) practice type (e...
July 12, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28696479/a-web-based-game-for-teaching-facial-expressions-to-schizophrenic-patients
#20
Kemal Hakan Gülkesen, Filiz Isleyen, Buket Cinemre, Mehmet Kemal Samur, Semiha Sen Kaya, Nese Zayim
BACKGROUND: Recognizing facial expressions is an important social skill. In some psychological disorders such as schizophrenia, loss of this skill may complicate the patient's daily life. Prior research has shown that information technology may help to develop facial expression recognition skills through educational software and games. OBJECTIVES: To examine if a computer game designed for teaching facial expressions would improve facial expression recognition skills of patients with schizophrenia...
July 12, 2017: Applied Clinical Informatics
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