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Applied Clinical Informatics

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https://www.readbyqxmd.com/read/28326433/application-of-electronic-algorithms-to-improve-diagnostic-evaluation-for-bladder-cancer
#1
Daniel R Murphy, Ashley N D Meyer, Viralkumar Vaghani, Elise Russo, Dean F Sittig, Kyle A Richards, Li Wei, Louis Wu, Hardeep Singh
BACKGROUND: Strategies to ensure timely diagnostic evaluation of hematuria are needed to reduce delays in bladder cancer diagnosis. OBJECTIVE: To evaluate the performance of electronic trigger algorithms to detect delays in hematuria follow-up. METHODS: We developed a computerized trigger to detect delayed follow-up action on a urinalysis result with high-grade hematuria (>50 red blood cells/high powered field). The trigger scanned clinical data within a Department of Veterans Affairs (VA) national data repository to identify all patient records with hematuria, then excluded those where follow-up was unnecessary (e...
March 22, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28326432/harnessing-scientific-literature-reports-for-pharmacovigilance-prototype-software-analytical-tool-development-and-usability-testing
#2
Alfred Sorbello, Anna Ripple, Joseph Tonning, Monica Munoz, Rashedul Hasan, Thomas Ly, Henry Francis, Olivier Bodenreider
OBJECTIVES: We seek to develop a prototype software analytical tool to augment FDA regulatory reviewers' capacity to harness scientific literature reports in PubMed/MEDLINE for pharmacovigilance and adverse drug event (ADE) safety signal detection. We also aim to gather feedback through usability testing to assess design, performance, and user satisfaction with the tool. METHODS: A prototype, open source, web-based, software analytical tool generated statistical disproportionality data mining signal scores and dynamic visual analytics for ADE safety signal detection and management...
March 22, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28293685/healthcare-team-perceptions-of-a-portal-for-parents-of-hospitalized-children-before-and-after-implementation
#3
Michelle M Kelly, Shannon M Dean, Pascale Carayon, Tosha B Wetterneck, Peter L T Hoonakker
BACKGROUND: Patient electronic health record (EHR) portals can enhance patient and family engagement by providing information and a way to communicate with their healthcare team (HCT). However, portal implementation has been limited to ambulatory settings and met with resistance from HCTs. OBJECTIVE: We evaluated HCT perceptions before and 6-months after implementation of an inpatient EHR portal application on a tablet computer given to parents of hospitalized children...
March 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28293684/meaningful-use-of-an-electronic-personal-health-record-ephr-among-pediatric-cancer-survivors
#4
Rebecca S Williamson, Brooke O Cherven, Jordan Gilleland Marchak, Paula Edwards, Michael Palgon, Cam Escoffery, Lillian R Meacham, Ann C Mertens
Background and Objectivs: Survivors of pediatric and adolescent cancer are at an increased risk of chronic and debilitating health conditions and require life-long specialized care. Stand-alone electronic personal health records (ePHRs) may aid their self-management. This analysis characterizes young adult survivors and parents who meaningfully use an ePHR, Cancer SurvivorLink(TM), designed for survivors of pediatric and adolescent cancer. METHODS: This was a retrospective observational study of patients seen at a pediatric survivor clinic for annual survivor care...
March 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28271121/medication-use-among-veterans-across-health-care-systems
#5
Khoa A Nguyen, David A Haggstrom, Susan Ofner, Susan M Perkins, Dustin D French, Laura J Myers, Marc Rosenman, Michael Weiner, Brian E Dixon, Alan J Zillich
INTRODUCTION: Dual healthcare system use can create gaps and fragments of information for patient care. The Department of Veteran Affairs is implementing a health information exchange (HIE) program called the Virtual Lifetime Electronic Record (VLER), which allows providers to access and share information across healthcare systems. HIE has the potential to improve the safety of medication use. However, data regarding the pattern of outpatient medication use across systems of care is largely unknown...
March 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28271120/code-status-reconciliation-to-improve-identification-and-documentation-of-code-status-in-electronic-health-records
#6
Viral G Jain, Peter J Greco, David C Kaelber
BACKGROUND: Code status (CS) of a patient (part of their end-of-life wishes) can be critical information in healthcare delivery, which can change over time, especially at transitions of care. Although electronic health record (EHR) tools exist for medication reconciliation across transitions of care, much less attention is given to CS, and standard EHR tools have not been implemented for CS reconciliation (CSR). Lack of CSR creates significant potential patient safety and quality of life issues...
March 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28246673/satisfaction-and-improvements-in-peritoneal-dialysis-outcomes-associated-with-telehealth
#7
Manya Magnus, Neal Sikka, Teena Cherian, Susie Q Lew
BACKGROUND AND SIGNIFICANCE: End stage renal disease (ESRD) affects approximately 660,000 persons in the US each year, representing a significant financial burden to the health care system and affected individuals. Telehealth approaches to care offer an important means of reducing costs as well as increasing autonomy for patients. Understanding patient satisfaction with telehealth provides a key towards eventual scalability. MATERIALS AND METHODS: Quarterly surveys were conducted to characterize satisfaction with remote biometric monitoring (RBM) for blood pressure, weight, glucose and peritoneal dialysis (PD)-specific educational online videos for ESRD patients using PD...
March 1, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28246672/electronic-alerts-improve-immunization-rates-in-two-month-old-premature-infants-hospitalized-in-the-neonatal-intensive-care-unit
#8
Kimberly D Ernst
OBJECTIVE: To determine if an electronic alert improves 2 month immunization rates in infants remaining hospitalized in the neonatal intensive care unit. METHODS: Institutional Review Board-approved retrospective chart review of 261 infants with birth weights <2 kg and still hospitalized at ≥ 58 days. Charts were reviewed between 2009 and 2013, before and after the 2011 electronic alert was instituted in the electronic medical record from days 56 to 67 to remind providers that immunizations were due...
March 1, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28224163/getting-what-they-need-when-they-need-it-identifying-barriers-to-information-needs-of-family-caregivers-to-manage-dementia-related-behavioral-symptoms
#9
Nicole E Werner, Barbara Stanislawski, Katherine A Marx, Daphne C Watkins, Marissa Kobayashi, Helen Kales, Laura N Gitlin
BACKGROUND: Consumer health informatics (CHI) such as web-based applications may provide the platform for enabling the over 15 million family caregivers of patients with Alzheimer's Disease or related dementias the information they need when they need it to support behavioral symptom management. However, for CHI to be successful, it is necessary that it be designed to meet the specific information needs of family caregivers in the context in which caregiving occurs. A sociotechnical systems approach to CHI design can help to understand the contextual complexities of family caregiving and account for those complexities in the design of CHI for family caregivers...
February 22, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28197621/accelerating-the-benefits-of-the-problem-oriented-medical-record
#10
Joel Buchanan
No abstract text is available yet for this article.
February 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28197620/measuring-practicing-clinicians-information-literacy-an-exploratory-analysis-in-the-context-of-panel-management
#11
Brian E Dixon, Katherine Barboza, Ashley E Jensen, Katelyn J Bennett, Scott E Sherman, Mark D Schwartz
BACKGROUND: As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. OBJECTIVES: This study explored information literacy, a set of skills required to effectively navigate population health information systems, among primary care providers in one Veterans' Affairs (VA) medical center. METHODS: Information literacy was assessed during an 8-month randomized trial that tested a population health (panel) management intervention...
February 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28197619/evaluating-a-modular-decision-support-application-for-colorectal-cancer-screening
#12
Laura G Militello, Julie B Diiulio, Morgan R Borders, Christen E Sushereba, Jason J Saleem, Donald Haverkamp, Thomas F Imperiale
BACKGROUND: There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. OBJECTIVE: To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing...
February 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28174820/effect-of-a-novel-clinical-decision-support-tool-on-the-efficiency-and-accuracy-of-treatment-recommendations-for-cholesterol-management
#13
Marianne R Scheitel, Maya E Kessler, Jane L Shellum, Steve G Peters, Dawn S Milliner, Hongfang Liu, Ravikumar Komandur Elayavilli, Karl A Poterack, Timothy A Miksch, Jennifer Boysen, Ron A Hankey, Rajeev Chaudhry
BACKGROUND: The 2013 American College of Cardiology / American Heart Association Guidelines for the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk. But finding time in a primary care visit to manually calculate cardiovascular risk and prescribe treatment based on risk is challenging. We developed an informatics-based clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular risk scores and guideline-based treatment recommendations based on patient-specific data in the electronic heath record...
February 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28174819/screening-consolidated-clinical-document-architecture-ccda-documents-for-sensitive-data-using-a-rule-based-decision-support-system
#14
Beatriz H Rocha, Deepika Pabbathi, Molly Schaeffer, Howard S Goldberg
BACKGROUND: The Centers for Medicare & Medicaid Services' Stage 2 final rule requires that eligible hospitals provide a visit summary electronically at transitions of care in order to qualify for "meaningful use" incentive payments. However, Massachusetts state law and Federal law prohibit the transmission of documents containing "sensitive" data unless there is a new patient consent for each transmission. OBJECTIVES: To describe the implementation and evaluation of a rule-based decision support system used to screen transition of care documents for sensitive data...
February 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28144681/electronic-sentinel-surveillance-of-influenza-like-illness-experience-from-a-pilot-study-in-new-zealand
#15
Mehnaz Adnan, Donald Peterkin, Liza Lopez, Graham Mackereth
BACKGROUND: Electronic reporting of Influenza-like illness (eILI) from primary care was implemented and evaluated in three general medical practices in New Zealand during May to September 2015. OBJECTIVE: To measure the uptake of eILI and to identify the system's strength and limitations. METHODS: Analysis of transactional data from the eILI system; comparative study of influenza-like illness cases reported using manual methods and eILI; questionnaire administered to clinical and operational stakeholders...
February 1, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28144680/erratum-to-preprocessing-structured-clinical-data-for-predictive-modeling-and-decision-support-a-roadmap-to-tackle-the-challenges
#16
(no author information available yet)
No abstract text is available yet for this article.
February 1, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28144679/leveraging-the-value-of-human-relationships-to-improve-health-outcomes-lessons-learned-from-the-openmrs-electronic-health-record-system
#17
Suranga N Kasthurirathne, Burke W Mamlin, Theresa Cullen
OBJECTIVES: Despite significant awareness on the value of leveraging patient relationships across the healthcare continuum, there is no research on the potential of using Electronic Health Record (EHR) systems to store structured patient relationship data, or its impact on enabling better healthcare. We sought to identify which EHR systems supported effective patient relationship data collection, and for systems that do, what types of relationship data is collected, how this data is used, and the perceived value of doing so...
February 1, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28119992/development-and-feasibility-of-a-real-time-clinical-decision-support-system-for-traumatic-brain-injury-anesthesia-care
#18
Taniga Kiatchai, Ashley A Colletti, Vivian H Lyons, Rosemary M Grant, Monica S Vavilala, Bala G Nair
BACKGROUND: Real-time clinical decision support (CDS) integrated with anesthesia information management systems (AIMS) can generate point of care reminders to improve quality of care. OBJECTIVE: To develop, implement and evaluate a real-time clinical decision support system for anesthetic management of pediatric traumatic brain injury (TBI) patients undergoing urgent neurosurgery. METHODS: We iteratively developed a CDS system for pediatric TBI patients undergoing urgent neurosurgery...
January 25, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28119990/the-prevalence-of-obesity-documentation-in-primary-care-electronic-medical-records-are-we-acknowledging-the-problem
#19
Ahmed Mattar, David Carlston, Glen Sariol, Tongle Yu, Ahmad Almustafa, Genevieve B Melton, Adil Ahmed
BACKGROUND: Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient's problem list for patients with eligible body mass indexes (BMI) as contained in the patients' electronic medical record (EMR). Additionally, we examined the prevalence of selected chronic conditions across BMI levels. METHOD: This study is a retrospective study using EMR data for adult patients visiting an outpatient clinic between June 2012 and June 2015...
January 25, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28097288/secondary-analysis-of-an-electronic-surveillance-system-combined-with-multi-focal-interventions-for-early-detection-of-sepsis
#20
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. The effect of the sepsis intervention was evaluated for all patients, and High and Low Risk subgroups for illness severity...
January 18, 2017: Applied Clinical Informatics
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