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Applied Clinical Informatics

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https://www.readbyqxmd.com/read/28097288/secondary-analysis-of-an-electronic-surveillance-system-combined-with-multi-focal-interventions-for-early-detection-of-sepsis
#1
Bonnie L Westra, Sean Landman, Pranjul Yadav, Michael Steinbach
: To conduct an independent secondary analysis of a multi-focal intervention for early detection of sepsis that included implementation of change management strategies, electronic surveillance for sepsis, and evidence based point of care alerting using the POC AdvisorTM application. METHODS: Propensity score matching was used to select subsets of the cohorts with balanced covariates. Bootstrapping was performed to build distributions of the measured difference in rates/means...
18, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28097287/using-active-learning-to-identify-health-information-technology-related-patient-safety-events
#2
Allan Fong, Jessica L Howe, Katharine T Adams, Raj M Ratwani
The widespread adoption of health information technology (HIT) has led to new patient safety hazards that are often difficult to identify. Patient safety event reports, which are self-reported descriptions of safety hazards, provide one view of potential HIT-related safety events. However, identifying HIT-related reports can be challenging as they are often categorized under other more predominate clinical categories. This challenge of identifying HIT-related reports is exacerbated by the increasing number and complexity of reports which pose challenges to human annotators that must manually review reports...
January 18, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28074211/safe-practices-for-copy-and-paste-in-the-ehr-systematic-review-recommendations-and-novel-model-for-health%C3%A2-it-collaboration
#3
Amy Y Tsou, Christoph U Lehmann, Jeremy Michel, Ronni Solomon, Lorraine Possanza, Tejal Gandhi
BACKGROUND: Copy and paste functionality can support efficiency during clinical documentation, but may promote inaccurate documentation with risks for patient safety. The Partnership for Health IT Patient Safety was formed to gather data, conduct analysis, educate, and disseminate safe practices for safer care using health information technology (IT). OBJECTIVE: To characterize copy and paste events in clinical care, identify safety risks, describe existing evidence, and develop implementable practice recommendations for safe reuse of information via copy and paste...
January 11, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28066851/analysis-of-smartphone-interruptions-on-academic-general-internal-medicine-wards-frequent-interruptions-may-cause-a-crisis-mode-work-climate
#4
Alon Vaisman, Robert C Wu
INTRODUCTION: Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a 'crisis mode' climate. METHODS: We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014...
January 4, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27999841/a-novel-survey-to-examine-the-relationship-between-health-it-adoption-and-nurse-physician-communication
#5
A Jay Holmgren, Eric Pfeifer, Milisa Manojlovich, Julia Adler-Milstein
BACKGROUND: As EHR adoption in US hospitals becomes ubiquitous, a wide range of IT options are theoretically available to facilitate physician-nurse communication, but we know little about the adoption rate of specific technologies or the impact of their use. OBJECTIVES: To measure adoption of hardware, software, and telephony relevant to nurse-physician communication in US hospitals. To assess the relationship between non-IT communication practices and hardware, software, and telephony adoption...
December 21, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27999840/identification-and-characterization-of-inter-organizational-information-flows-in-the-portuguese-national-health-service
#6
Eduardo Pinto, António Carvalho Brito, Ricardo João Cruz-Correia
OBJECTIVES: To understand and build a collective vision of all existing institutions in the Portuguese National Health Service as well as to perceive how and how far the interaction between those multiple institutions is supported by Information Systems (IS). METHODS: Upon identification of the institutions involved in the healthcare process, a set of interviews with experienced people from those institutions was conducted, which produced about five hours of tape...
December 21, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27966006/medical-record-keeping-in-the-summer-camp-setting
#7
Laura Kaufman, Jaycelyn Holland, Stuart Weinberg, S Trent Rosenbloom
BACKGROUND: Approximately one fifth of school-aged children spend a significant portion of their year at residential summer camp, and a growing number have chronic medical conditions. Camp health records are essential for safe, efficient care and for transitions between camp and home providers, yet little research exists regarding these systems. OBJECTIVE: To survey residential summer camps for children to determine how camps create, store, and use camper health records...
December 14, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27966005/eprescribing-reducing-costs-through-in-class-therapeutic-interchange
#8
Shane P Stenner, Rohini Chakravarthy, Kevin B Johnson, William L Miller, Julie Olson, Marleen Wickizer, Nate N Johnson, Rick Ohmer, David R Uskavitch, Gordon R Bernard, Erin B Neal, Christoph U Lehmann
INTRODUCTION: Spending on pharmaceuticals in the US reached $373.9 billion in 2014. Therapeutic interchange offers potential medication cost savings by replacing a prescribed drug for an equally efficacious therapeutic alternative. METHODS: Hard-stop therapeutic interchange recommendation alerts were developed for four medication classes (HMG-CoA reductase inhibitors, serotonin receptor agonists, intranasal steroid sprays, and proton-pump inhibitors) in an electronic prescription-writing tool for outpatient prescriptions...
December 14, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27924347/preprocessing-structured-clinical-data-for-predictive-modeling-and-decision-support-a-roadmap-to-tackle-the-challenges
#9
José Carlos Ferrão, Mónica Duarte Oliveira, Filipe Janela, Henrique M G Martins
BACKGROUND: EHR systems have high potential to improve healthcare delivery and management. Although structured EHR data generates information in machine-readable formats, their use for decision support still poses technical challenges for researchers due to the need to preprocess and convert data into a matrix format. During our research, we observed that clinical informatics literature does not provide guidance for researchers on how to build this matrix while avoiding potential pitfalls...
December 7, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27924346/bpcontrol-a-mobile-app-to-monitor-hypertensive-patients
#10
Adrian Carrera, Marc Pifarré, Jordi Vilaplana, Josep Cuadrado, Sara Solsona, Jordi Mateo, Francesc Solsona
BACKGROUND: Hypertension or high blood pressure is on the rise. Not only does it affect the elderly but is also increasingly spreading to younger sectors of the population. Treating this condition involves exhaustive monitoring of patients. The current mobile health services can be improved to perform this task more effectively. OBJECTIVE: To develop a useful, user-friendly, robust and efficient app, to monitor hypertensive patients and adapted to the particular requirements of hypertension...
December 7, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27901174/metrics-for-electronic-nursing-record-based-narratives-cross-sectional-analysis
#11
Kidong Kim, Suyeon Jeong, Kyogu Lee, Hyeoun-Ae Park, Yul Ha Min, Joo Yun Lee, Yekyung Kim, Sooyoung Yoo, Gippeum Doh, Soyeon Ahn
OBJECTIVES: We aimed to determine the characteristics of quantitative metrics for nursing narratives documented in electronic nursing records and their association with hospital admission traits and diagnoses in a large data set not limited to specific patient events or hypotheses. METHODS: We collected 135,406,873 electronic, structured coded nursing narratives from 231,494 hospital admissions of patients discharged between 2008 and 2012 at a tertiary teaching institution that routinely uses an electronic health records system...
November 30, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27878205/iterative-development-and-evaluation-of-a-pharmacogenomic-guided-clinical-decision-support-system-for-warfarin-dosing
#12
Brittany L Melton, Alan J Zillich, Jason Saleem, Alissa L Russ, James E Tisdale, Brian R Overholser
OBJECTIVE: Pharmacogenomic-guided dosing has the potential to improve patient outcomes but its implementation has been met with clinical challenges. Our objective was to develop and evaluate a clinical decision support system (CDSS) for pharmacogenomic-guided warfarin dosing designed for physicians and pharmacists. METHODS: Twelve physicians and pharmacists completed 6 prescribing tasks using simulated patient scenarios in two iterations (development and validation phases) of a newly developed pharmacogenomic-driven CDSS prototype...
November 23, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27847961/mind-the-gap-a-systematic-review-to-identify-usability-and-safety-challenges-and-practices-during-electronic-health-record-implementation
#13
Raj Ratwani, Terry Fairbanks, Erica Savage, Katie Adams, Michael Wittie, Edna Boone, Andrew Hayden, Janey Barnes, Zach Hettinger, Andrew Gettinger
OBJECTIVE: Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. MATERIALS AND METHODS: Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation...
November 16, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27826610/identification-of-long-bone-fractures-in-radiology-reports-using-natural-language-processing-to-support-healthcare-quality-improvement
#14
Robert W Grundmeier, Aaron J Masino, T Charles Casper, Jonathan M Dean, Jamie Bell, Rene Enriquez, Sara Deakyne, James M Chamberlain, Elizabeth R Alpern
BACKGROUND: Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were developed. OBJECTIVE: To implement and validate NLP tools to identify long bone fractures for pediatric emergency medicine quality improvement. METHODS: Using freely available statistical software packages, we implemented NLP methods to identify long bone fractures from radiology reports...
November 9, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27803949/usability-and-workflow-evaluation-of-rheumatic-disease-activity-ready-a-mobile-application-for-rheumatology-patients-and-providers
#15
Po-Yin Yen, Barbara Lara, Marcelo Lopetegui, Aseem Bharat, Stacy Ardoin, Bernadette Johnson, Puneet Mathur, Peter J Embi, Jeffrey R Curtis
BACKGROUND: RhEumAtic Disease activitY (READY) is a mobile health (mHealth) application that aims to create a shared platform integrating data from both patients and physicians, with a particular emphasis on arthritis disease activity. METHODS: We made READY available on an iPad and pilot implemented it at a rheumatology outpatient clinic. We conducted 1) a usability evaluation study to explore patients' and physicians' interactions with READY, and 2) a time motion study (TMS) to observe the clinical workflow before and after the implementation...
November 2, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27803948/telemedicine-for-developing-countries-a-survey-and-some-design-issues
#16
Carlo Combi, Gabriele Pozzani, Giuseppe Pozzi
BACKGROUND: Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries...
November 2, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27786335/how-physician-perspectives-on-e-prescribing-evolve-over-time-a-case-study-following-the-transition-between-ehrs-in-an-outpatient-clinic
#17
Erika L Abramson, Vaishali Patel, Elizabeth R Pfoh, Rainu Kaushal
BACKGROUND: Physicians are expending tremendous resources transitioning to new electronic health records (EHRs), with electronic prescribing as a key functionality of most systems. Physician dissatisfaction post-transition can be quite marked, especially initially. However, little is known about how physicians' experiences using new EHRs for e-prescribing evolve over time. We previously published a qualitative case study about the early physician experience transitioning from an older to a newer, more robust EHR, in the outpatient setting, focusing on their perceptions of the electronic prescribing functionality...
October 26, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27781238/improving-individual-acceptance-of-health-clouds-through-confidentiality-assurance
#18
Tatiana Ermakova, Benjamin Fabian, Rüdiger Zarnekow
BACKGROUND: Cloud computing promises to essentially improve healthcare delivery performance. However, shifting sensitive medical records to third-party cloud providers could create an adoption hurdle because of security and privacy concerns. OBJECTIVES: This study examines the effect of confidentiality assurance in a cloud-computing environment on individuals' willingness to accept the infrastructure for inter-organizational sharing of medical data. METHODS: We empirically investigate our research question by a survey with over 260 full responses...
October 26, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27757472/evaluation-of-a-pilot-asthma-care-program-for-electronic-communication-between-school-health-and-a-healthcare-system-s-electronic-medical-record
#19
Kelly W Reeves, Yhenneko Taylor, Hazel Tapp, Thomas Ludden, Lindsay E Shade, Beth Burton, Cheryl Courtlandt, Michael Dulin
OBJECTIVE: Asthma is a common childhood chronic lung disease affecting greater than 10% of children in the United States. School nurses are in a unique position to close gaps in care. Indeed, effective asthma management is more likely to result when providers, family, and schools work together to optimize the patient's treatment plan. Currently, effective communication between schools and healthcare systems through electronic medical record (EMR) systems remains a challenge. The goal of this feasibility pilot was to link the school-based care team with primary care providers in the healthcare system network via electronic communication through the EMR, on behalf of pediatric asthma patients who had been hospitalized for an asthma exacerbation...
October 19, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27757471/appointment-lead-time-policy-development-to-improve-patient-access-to-care
#20
Yu-Li Huang, Sarah M Bach
BACKGROUND: Patient access to care has been a known and continuing struggle for many health care providers. In spite of appointment lead time policies set by government or clinics, the problem persists. Justification for how lead time policies are determined is lacking. OBJECTIVES: This paper proposed a data-driven approach for how to best set feasible appointment target lead times given a clinic's capacity and appointment requests. METHODS: The proposed approach reallocates patient visits to minimize the deviation between actual appointment lead time and a feasible target lead time...
October 19, 2016: Applied Clinical Informatics
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