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Applied Clinical Informatics

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https://www.readbyqxmd.com/read/30541153/health-information-exchange-in-emergency-medical-services
#1
Thomas J Martin, Megan L Ranney, James Dorroh, Nicholas Asselin, Indra Neil Sarkar
BACKGROUND:  The Office of the National Coordinator for Health Information Technology has outlined the benefits of health information exchange in emergency medical services (EMSs) according to the SAFR model- search , alert , file , and reconcile -developed in collaboration with the California Emergency Medical Services Authority. OBJECTIVE:  This scoping review aims to identify and characterize progress toward the adoption of prehospital health information exchange, as reported in the peer-reviewed literature...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30541152/communicating-with-vulnerable-patient-populations-a-randomized-intervention-to-teach-inpatients-to-use-the-electronic-patient-portal
#2
Jacob N Stein, Jared W Klein, Thomas H Payne, Sara L Jackson, Sue Peacock, Natalia V Oster, Trinell P Carpenter, Joann G Elmore
BACKGROUND:  Patient portals are expanding as a means to engage patients and have evidence for benefit in the outpatient setting. However, few studies have evaluated their use in the inpatient setting, or with vulnerable patient populations. OBJECTIVE:  This article assesses an intervention to teach hospitalized vulnerable patients to access their discharge summaries using electronic patient portals. METHODS:  Patients at a safety net hospital were randomly assigned to portal use education or usual care...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30517970/impact-of-electronic-physician-order-set-on-antibiotic-ordering-time-in-septic-patients-in-the-emergency-department
#3
Emily L Fargo, Frank D'Amico, Aaron Pickering, Kathleen Fowler, Ronald Campbell, Megan Baumgartner
BACKGROUND:  Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outcomes and reduce mortality. OBJECTIVE:  This article determines if the use of an electronic physician order-set decreases time to antibiotic ordering for patients with sepsis in the emergency department (ED)...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30517969/understanding-secure-messaging-in-the-inpatient-environment-a-new-avenue-for-communication-and-patient-engagement
#4
Cynthia J Sieck, Daniel M Walker, Jennifer L Hefner, Jaclyn Volney, Timothy R Huerta, Ann Scheck McAlearney
BACKGROUND:  Patient portals, and the secure messaging feature in particular, have been studied in the outpatient setting, but research in the inpatient setting is relatively less mature. OBJECTIVE:  To understand the topics discussed in secure messaging in the inpatient environment, we analyzed and categorized messages sent within an inpatient portal. MATERIALS AND METHODS:  This observational study examined the content of all secure messages sent from December 2013 to June 2017 within an inpatient portal at a large Midwestern academic medical center (AMC)...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30485880/social-media-in-health-care-time-for-transparent-privacy-policies-and-consent-for-data-use-and-disclosure
#5
Carolyn Petersen, Christoph U Lehmann
No abstract text is available yet for this article.
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30485879/evaluation-of-clinical-relevance-of-drug-drug-interaction-alerts-prior-to-implementation
#6
S M M Meslin, W Y Zheng, R O Day, E M Y Tay, M T Baysari
INTRODUCTION:  Drug-drug interaction (DDI) alerts are often implemented in the hospital computerized provider order entry (CPOE) systems with limited evaluation. This increases the risk of prescribers experiencing too many irrelevant alerts, resulting in alert fatigue. In this study, we aimed to evaluate clinical relevance of alerts prior to implementation in CPOE using two common approaches: compendia and expert panel review. METHODS:  After generating a list of hypothetical DDI alerts, that is, alerts that would have been triggered if DDI alerts were operational in the CPOE, we calculated the agreement between multiple drug interaction compendia with regards to the severity of these alerts...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30463095/the-impact-of-a-location-sensing-electronic-health-record-on-clinician-efficiency-and-accuracy-a-pilot-simulation-study
#7
Kevin King, John Quarles, Vaishnavi Ravi, Tanvir Irfan Chowdhury, Donia Friday, Craig Sisson, Yusheng Feng
BACKGROUND:  Through the Health Information Technology for Economic and Clinical Health Act of 2009, the federal government invested $26 billion in electronic health records (EHRs) to improve physician performance and patient safety; however, these systems have not met expectations. One of the cited issues with EHRs is the human-computer interaction, as exhibited by the excessive number of interactions with the interface, which reduces clinician efficiency. In contrast, real-time location systems (RTLS)-technologies that can track the location of people and objects-have been shown to increase clinician efficiency...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30463094/self-care-support-for-patients-with-gastrointestinal-cancer-icancerhealth
#8
Donna L Berry, Traci M Blonquist, Manan M Nayak, Nina Grenon, Thaer G Momani, Nadine J McCleary
BACKGROUND:  Patient-centered symptom assessment and management tools allow patients to perform self-assessments and engage in self-symptom management. Efficacious tools exist for reducing symptom distress; however, little is known about feature-specific use. OBJECTIVES:  This article evaluates the feasibility of the iCancerHealth app as an adjunct to usual patient education regarding cancer symptoms and medication management. METHODS:  We conducted a single-arm, pilot study grounded in the health outcomes model...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30428488/response-to-an-evidence-based-tool-for-safe-configuration-of-electronic-health-records-the-esafety-checklist
#9
LETTER
Ross Koppel
No abstract text is available yet for this article.
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30428487/an-evidence-based-tool-for-safe-configuration-of-electronic-health-records-the-esafety-checklist
#10
LETTER
Pritma Dhillon-Chattha, Ruth McCorkle, Elizabeth Borycki
BACKGROUND:  Electronic health records (EHRs) are transforming the way health care is delivered. They are central to improving the quality of patient care and have been attributed to making health care more accessible, reliable, and safe. However, in recent years, evidence suggests that specific features and functions of EHRs can introduce new, unanticipated patient safety concerns that can be mitigated by safe configuration practices. OBJECTIVE:  This article outlines the development of a detailed and comprehensive evidence-based checklist of safe configuration practices for use by clinical informatics professionals when configuring hospital-based EHRs...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30406625/an-electronic-medical-record-in-pediatric-medical-education-survey-of-medical-students-expectations-and-experiences
#11
Daryl R Cheng, Thomas Scodellaro, Wonie Uahwatanasakul, Mike South
OBJECTIVE:  This study sought to quantitatively characterize medical students' expectations and experiences of an electronic health record (EHR) system in a hospital setting, and to examine perceived and actual impacts on learning. METHODS:  Medical students from July to December 2016 at a tertiary pediatric institution completed pre- and postrotation surveys evaluating their expectations and experience of using an EHR during a pediatric medicine rotation. Survey data included past technology experience, EHR accessibility, use of learning resources, and effect on learning outcomes and patient-clinician communication...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30381818/automating-a-manual-sepsis-screening-tool-in-a-pediatric-emergency-department
#12
Julia K Lloyd, Erin A Ahrens, Donnie Clark, Terri Dachenhaus, Kathryn E Nuss
OBJECTIVE:  This article describes the method of integrating a manual pediatric emergency department sepsis screening process into the electronic health record that leverages existing clinical documentation and keeps providers in their current, routine clinical workflows. METHODS:  Criteria in the manual pediatric emergency department sepsis screening tool were mapped to standard documentation routinely entered in the electronic health record. Data elements were extracted and scored from the medical history, medication record, vital signs, and physical assessments...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30357777/user-testing-an-information-foraging-tool-for-ambulatory-surgical-site-infection-surveillance
#13
Dean J Karavite, Matthew W Miller, Mark J Ramos, Susan L Rettig, Rachael K Ross, Rui Xiao, Naveen Muthu, A Russell Localio, Jeffrey S Gerber, Susan E Coffin, Robert W Grundmeier
BACKGROUND:  Surveillance for surgical site infections (SSIs) after ambulatory surgery in children requires a detailed manual chart review to assess criteria defined by the National Health and Safety Network (NHSN). Electronic health records (EHRs) impose an inefficient search process where infection preventionists must manually review every postsurgical encounter (< 30 days). Using text mining and business intelligence software, we developed an information foraging application, the SSI Workbench, to visually present which postsurgical encounters included SSI-related terms and synonyms, antibiotic, and culture orders...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30332689/asynchronous-speech-recognition-affects-physician-editing-of-notes
#14
Kevin J Lybarger, Mari Ostendorf, Eve Riskin, Thomas H Payne, Andrew A White, Meliha Yetisgen
OBJECTIVE:  Clinician progress notes are an important record for care and communication, but there is a perception that electronic notes take too long to write and may not accurately reflect the patient encounter, threatening quality of care. Automatic speech recognition (ASR) has the potential to improve clinical documentation process; however, ASR inaccuracy and editing time are barriers to wider use. We hypothesized that automatic text processing technologies could decrease editing time and improve note quality...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30304745/factors-influencing-sustained-engagement-with-ecg-self-monitoring-perspectives-from-patients-and-health-care-providers
#15
Meghan Reading, Dawon Baik, Melissa Beauchemin, Kathleen T Hickey, Jacqueline A Merrill
BACKGROUND:  Patient-generated health data (PGHD) collected digitally with mobile health (mHealth) technology has garnered recent excitement for its potential to improve precision management of chronic conditions such as atrial fibrillation (AF), a common cardiac arrhythmia. However, sustained engagement is a major barrier to collection of PGHD. Little is known about barriers to sustained engagement or strategies to intervene upon engagement through application design. OBJECTIVE:  This article investigates individual patient differences in sustained engagement among individuals with a history of AF who are self-monitoring using mHealth technology...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30282094/the-use-of-health-information-exchange-to-augment-patient-handoff-in-long-term-care-a-systematic-review
#16
Clemens Scott Kruse, Gabriella Marquez, Daniel Nelson, Olivia Palomares
BACKGROUND:  Legislation aimed at increasing the use of a health information exchange (HIE) in healthcare has excluded long-term care facilities, resulting in a vulnerable patient population that can benefit from the improvement of communication and reduction of waste. OBJECTIVE:  The purpose of this review is to provide a framework for future research by identifying themes in the long-term care information technology sector that could function to enable the adoption and use of HIE mechanisms for patient handoff between long-term care facilities and other levels of care to increase communication between providers, shorten length of stay, reduce 60-day readmissions, and increase patient safety...
October 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30257260/automated-versus-manual-data-extraction-of-the-padua-prediction-score-for-venous-thromboembolism-risk-in-hospitalized-older-adults
#17
Juliessa M Pavon, Richard J Sloane, Carl F Pieper, Cathleen S Colón-Emeric, Harvey J Cohen, David Gallagher, Miriam C Morey, Midori McCarty, Thomas L Ortel, Susan N Hastings
OBJECTIVE:  Venous thromboembolism (VTE) prophylaxis is an important consideration for hospitalized older adults, and the Padua Prediction Score (PPS) is a risk prediction tool used to prioritize patient selection. We developed an automated PPS (APPS) algorithm using electronic health record (EHR) data. This study examines the accuracy of APPS and its individual components versus manual data extraction. METHODS:  This is a retrospective cohort study of hospitalized general internal medicine patients, aged 70 and over...
July 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30231259/integrated-electronic-discharge-summaries-experience-of-a-tertiary-pediatric-institution
#18
Daryl R Cheng, Merav L Katz, Mike South
OBJECTIVE:  Succinct and timely discharge summaries (DSs) facilitate ongoing care for patients discharged from acute care settings. Many institutions have introduced electronic DS (eDS) templates to improve quality and timeliness of clinical correspondence. However, significant intrahospital and intraunit variability and application exists. A review of the literature and guidelines revealed 13 key elements that should be included in a best practice DS. This was compared against our pediatric institution's eDS template-housed within an integrated electronic medical record (EMR) and used across most inpatient hospital units...
July 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30208497/emergency-physicians-perceived-influence-of-ehr-use-on-clinical-workflow-and-performance-metrics
#19
Courtney A Denton, Hiral C Soni, Thomas G Kannampallil, Anna Serrichio, Jason S Shapiro, Stephen J Traub, Vimla L Patel
OBJECTIVE:  Over the last decade, electronic health records (EHRs) have shaped clinical practice. In this article, we investigated the perceived effects of EHR use on clinical workflow and meaningful use (MU) performance metrics. MATERIALS AND METHODS:  Semistructured interviews were conducted with 20 ( n  = 20) physicians at two urban emergency departments. Interview questions focused on time spent on EHR use, changes in clinical practices with EHR use, and the effect of MU performance metrics on clinical workflow...
July 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/30208496/a-heuristic-evaluation-to-assess-use-of-after-visit-summaries-for-supporting-continuity-of-care
#20
Patrice Tremoulet, Ramya Krishnan, Dean Karavite, Naveen Muthu, Susan Harkness Regli, Amy Will, Jeremy Michel
BACKGROUND:  Outpatient providers often do not receive discharge summaries from acute care providers prior to follow-up visits. These outpatient providers may use the after-visit summaries (AVS) that are given to patients to obtain clinical information. It is unclear how effectively AVS support care coordination between clinicians. OBJECTIVES:  Goals for this effort include: (1) developing usability heuristics that may be applied both for assessment and to guide generation of medical documents in general, (2) conducting a heuristic evaluation to assess the use of AVS for communication between clinicians, and (3) providing recommendations for generating AVS that effectively support both patient/caregiver use and care coordination...
July 2018: Applied Clinical Informatics
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