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Applied Clinical Informatics

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https://www.readbyqxmd.com/read/29669389/a-model-for-clinical-informatics-education-for-residents-addressing-an-unmet-need
#1
Mark V Mai, Brooke T Luo, Evan W Orenstein, Anthony A Luberti
Opportunities for education in clinical informatics exist throughout the spectrum of formal education extending from high school to postgraduate training. However, physicians in residency represent an underdeveloped source of potential informaticians. Despite the rapid growth of accredited fellowship programs since clinical informatics became a board-eligible subspecialty in 2011, few resident physicians are aware of their role at the intersection of clinical medicine and health information technology or associated opportunities...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29642247/examining-workflow-in-a-pediatric-emergency-department-to-develop-a-clinical-decision-support-for-an-antimicrobial-stewardship-program
#2
Mustafa Ozkaynak, Danny T Y Wu, Katia Hannah, Peter S Dayan, Rakesh D Mistry
BACKGROUND:  Clinical decision support (CDS) embedded into the electronic health record (EHR), is a potentially powerful tool for institution of antimicrobial stewardship programs (ASPs) in emergency departments (EDs). However, design and implementation of CDS systems should be informed by the existing workflow to ensure its congruence with ED practice, which is characterized by erratic workflow, intermittent computer interactions, and variable timing of antibiotic prescription. OBJECTIVE:  This article aims to characterize ED workflow for four provider types, to guide future design and implementation of an ED-based ASP using the EHR...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29618139/factors-affecting-acceptance-of-hospital-information-systems-based-on-extended-technology-acceptance-model-a-case-study-in-three-paraclinical-departments
#3
Hamed Nadri, Bahlol Rahimi, Hadi Lotfnezhad Afshar, Mahnaz Samadbeik, Ali Garavand
OBJECTIVE:  Regardless of the acceptance of users, information and communication systems can be considered as a health intervention designed to improve the care delivered to patients. This study aimed to determine the adoption and use of the extended Technology Acceptance Model (TAM2) by the users of hospital information system (HIS) in paraclinical departments including laboratory, radiology, and nutrition and to investigate the key factors of adoption and use of these systems. MATERIALS AND METHODS:  A standard questionnaire was used to collect the data from nearly 253 users of these systems in paraclinical departments of eight university hospitals in two different cities of Iran...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29590681/text-mining-and-automation-for-processing-of-patient-referrals
#4
James Todd, Brent Richards, Bruce James Vanstone, Adrian Gepp
BACKGROUND:  Various tasks within health care processes are repetitive and time-consuming, requiring personnel who could be better utilized elsewhere. The task of assigning clinical urgency categories to internal patient referrals is one such case of a time-consuming process, which may be amenable to automation through the application of text mining and natural language processing (NLP) techniques. OBJECTIVE:  This article aims to trial and evaluate a pilot study for the first component of the task-determining reasons for referrals...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29590680/nutrigenomic-information-in-the-openehr-data-set
#5
Priscila Alves Maranhão, Gustavo Marísio Bacelar-Silva, Duarte Nuno Gonçalves Ferreira, Conceição Calhau, Pedro Vieira-Marques, Ricardo João Cruz-Correia
BACKGROUND:  The traditional concept of personalized nutrition is based on adapting diets according to individual needs and preferences. Discussions about personalized nutrition have been on since the Human Genome Project, which has sequenced the human genome. Thenceforth, topics such as nutrigenomics have been assessed to help in better understanding the genetic variation influence on the dietary response and association between nutrients and gene expression. Hence, some challenges impaired the understanding about the nowadays important clinical data and about clinical data assumed to be important in the future...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29564850/consensus-statement-feature-and-function-recommendations-to-optimize-clinician-usability-of-direct-interoperability-to-enhance-patient-care
#6
Steven R Lane, Holly Miller, Elizabeth Ames, Lawrence Garber, David C Kibbe, Joseph H Schneider, Christoph U Lehmann
BACKGROUND: Secure clinical messaging and document exchange utilizing the Direct Protocol (Direct interoperability) has been widely implemented in health information technology (HIT) applications including electronic health records (EHRs) and by health care providers and organizations in the United States. While Direct interoperability has allowed clinicians and institutions to satisfy regulatory requirements and has facilitated communication and electronic data exchange as patients transition across care environments, feature and function enhancements to HIT implementations of the Direct Protocol are required to optimize the use of this technology...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29564849/collaborating-for-competency-a-model-for-single-electronic-health-record-onboarding-for-medical-students-rotating-among-separate-health-systems
#7
Anne G Pereira, Michael Kim, Marcus Seywerd, Brooke Nesbitt, Michael B Pitt
BACKGROUND: Use of the electronic health record (EHR) is widespread in academic medical centers, and hands-on EHR experience in medical school is essential for new residents to be able to meaningfully contribute to patient care. As system-specific EHR training is not portable across institutions-even when the same EHR platform is used-students rotating across health systems are often required to spend time away from clinical training to complete each system's, often duplicative, EHR training regardless of their competency within the EHR...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29539649/validation-and-refinement-of-a-pain-information-model-from-ehr-flowsheet-data
#8
Bonnie L Westra, Steven G Johnson, Samira Ali, Karen M Bavuso, Christopher A Cruz, Sarah Collins, Meg Furukawa, Mary L Hook, Anne LaFlamme, Kay Lytle, Lisiane Pruinelli, Tari Rajchel, Theresa Tess Settergren, Kathryn F Westman, Luann Whittenburg
BACKGROUND:  Secondary use of electronic health record (EHR) data can reduce costs of research and quality reporting. However, EHR data must be consistent within and across organizations. Flowsheet data provide a rich source of interprofessional data and represents a high volume of documentation; however, content is not standardized. Health care organizations design and implement customized content for different care areas creating duplicative data that is noncomparable. In a prior study, 10 information models (IMs) were derived from an EHR that included 2...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29539648/focus-section-health-it-usability-applying-a-task-technology-fit-model-to-adapt-an-electronic-patient-portal-for-patient-work
#9
Sana B Ali, Juana Romero, Kevin Morrison, Baria Hafeez, Jessica S Ancker
OBJECTIVES:  Although electronic patient portals are offered by most health care organizations, poor usability and poor fit to patient needs may pose barriers to adoption. We collaborated with an academic hospital to conduct iterative user evaluation of a newly deployed portal designed to deliver inpatient data upon hospital discharge. METHODS:  Three evaluators applied heuristic usability evaluation and conducted 23 individual user testing sessions with patients with chronic disease or managing the care of family members with chronic disease...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29514353/the-value-of-monitoring-clinical-decision-support-interventions
#10
Eileen Yoshida, Shirley Fei, Karen Bavuso, Charles Lagor, Saverio Maviglia
BACKGROUND: Well-functioning clinical decision support (CDS) can facilitate provider workflow, improve patient care, promote better outcomes, and reduce costs. However, poorly functioning CDS may lead to alert fatigue, cause providers to ignore important CDS interventions, and increase provider dissatisfaction. OBJECTIVE: The purpose of this article is to describe one institution's experience in implementing a program to create and maintain properly functioning CDS by systematically monitoring CDS firing rates and patterns...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29514352/the-reliability-of-electronic-health-record-data-used-for-obstetrical-research
#11
Molly R Altman, Karen Colorafi, Kenn B Daratha
BACKGROUND:  Hospital electronic health record (EHR) data are increasingly being called upon for research purposes, yet only recently has it been tested to examine its reliability. Studies that have examined reliability of EHR data for research purposes have varied widely in methods used and field of inquiry, with little reporting of the reliability of perinatal and obstetric variables in the current literature. OBJECTIVE:  To assess the reliability of data extracted from a commercially available inpatient EHR as compared with manually abstracted data for common attributes used in obstetrical research...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29490408/nonmodal-clinical-decision-support-and-antimicrobial-restriction-effects-on-rates-of-fluoroquinolone-use-in-uncomplicated-infections
#12
Lundy R Gunn, Robert Tunney, Kimberly Kelly
BACKGROUND:  Medication alert overrides remain persistently high over the past decade, influenced by factors such as "alert fatigue" and lack of provider acceptance. OBJECTIVE:  We compared the aggregate rate of fluoroquinolone (FQ) prescribing for the treatment of acute sinusitis, acute bronchitis, and uncomplicated urinary tract infections (UTIs) in adult inpatients prior to (historical control group) and after (prospective intervention group) implementation of a program requiring indication when ordering FQ antibiotics in combination with a nonmodal best-practice alert regarding the latest U...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29490407/best-practices-for-health-informatician-involvement-in-interprofessional-health-care-teams
#13
EDITORIAL
Richard J Holden, Samar Binkheder, Jay Patel, Sara Helene P Viernes
No abstract text is available yet for this article.
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29466819/feasibility-testing-of-a-wearable-behavioral-aid-for-social-learning-in-children-with-autism
#14
Jena Daniels, Nick Haber, Catalin Voss, Jessey Schwartz, Serena Tamura, Azar Fazel, Aaron Kline, Peter Washington, Jennifer Phillips, Terry Winograd, Carl Feinstein, Dennis P Wall
BACKGROUND:  Recent advances in computer vision and wearable technology have created an opportunity to introduce mobile therapy systems for autism spectrum disorders (ASD) that can respond to the increasing demand for therapeutic interventions; however, feasibility questions must be answered first. OBJECTIVE:  We studied the feasibility of a prototype therapeutic tool for children with ASD using Google Glass, examining whether children with ASD would wear such a device, if providing the emotion classification will improve emotion recognition, and how emotion recognition differs between ASD participants and neurotypical controls (NC)...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29466818/development-and-validation-of-a-natural-language-processing-tool-to-identify-patients-treated-for-pneumonia-across-va-emergency-departments
#15
B E Jones, B R South, Y Shao, C C Lu, J Leng, B C Sauer, A V Gundlapalli, M H Samore, Q Zeng
BACKGROUND:  Identifying pneumonia using diagnosis codes alone may be insufficient for research on clinical decision making. Natural language processing (NLP) may enable the inclusion of cases missed by diagnosis codes. OBJECTIVES:  This article (1) develops a NLP tool that identifies the clinical assertion of pneumonia from physician emergency department (ED) notes, and (2) compares classification methods using diagnosis codes versus NLP against a gold standard of manual chart review to identify patients initially treated for pneumonia...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29444537/a-novel-patient-recruitment-strategy-patient-selection-directly-from-the-community-through-linkage-to-clinical-data
#16
Lindsay P Zimmerman, Satyender Goel, Shazia Sathar, Charon E Gladfelter, Alejandra Onate, Lindsey L Kane, Shelly Sital, Jasmin Phua, Paris Davis, Helen Margellos-Anast, David O Meltzer, Tamar S Polonsky, Raj C Shah, William E Trick, Faraz S Ahmad, Abel N Kho
OBJECTIVE:  This article presents and describes our methods in developing a novel strategy for recruitment of underrepresented, community-based participants, for pragmatic research studies leveraging routinely collected electronic health record (EHR) data. METHODS:  We designed a new approach for recruiting eligible patients from the community, while also leveraging affiliated health systems to extract clinical data for community participants. The strategy involves methods for data collection, linkage, and tracking...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29444536/optimizing-the-user-experience-identifying-opportunities-to-improve-use-of-an-inpatient-portal
#17
Daniel M Walker, Terri Menser, Po-Yin Yen, Ann Scheck McAlearney
BACKGROUND:  Patient portals specifically designed for the inpatient setting have significant potential to improve patient care. However, little is known about how the users of this technology, the patients, may interact with the inpatient portals. As a result, hospitals have limited ability to design approaches that support patient use of the portal. OBJECTIVES:  This study aims to evaluate the user experience associated with an inpatient portal. METHODS:  We used a Think-Aloud protocol to study user interactions with a commercially available inpatient portal-MyChart Bedside (MCB)...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29415308/clinical-information-systems-integration-in-new-york-city-s-first-mobile-stroke-unit
#18
Benjamin R Kummer, Michael P Lerario, Babak B Navi, Adam C Ganzman, Daniel Ribaudo, Saad A Mir, Sammy Pishanidar, Tim Lekic, Olajide Williams, Hooman Kamel, Randolph S Marshall, George Hripcsak, Mitchell S V Elkind, Matthew E Fink
BACKGROUND:  Mobile stroke units (MSUs) reduce time to thrombolytic therapy in acute ischemic stroke. These units are widely used, but the clinical information systems underlying MSU operations are understudied. OBJECTIVE:  The first MSU on the East Coast of the United States was established at New York Presbyterian Hospital (NYP) in October 2016. We describe our program's 7-month pilot, focusing on the integration of our hospital's clinical information systems into our MSU to support patient care and research efforts...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29388181/using-ehr-data-to-detect-prescribing-errors-in-rapidly-discontinued-medication-orders
#19
Jonathan D Burlison, Robert B McDaniel, Donald K Baker, Murad Hasan, Jennifer J Robertson, Scott C Howard, James M Hoffman
BACKGROUND:  Previous research developed a new method for locating prescribing errors in rapidly discontinued electronic medication orders. Although effective, the prospective design of that research hinders its feasibility for regular use. OBJECTIVES:  Our objectives were to assess a method to retrospectively detect prescribing errors, to characterize the identified errors, and to identify potential improvement opportunities. METHODS:  Electronically submitted medication orders from 28 randomly selected days that were discontinued within 120 minutes of submission were reviewed and categorized as most likely errors, nonerrors, or not enough information to determine status...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29388180/exploring-data-quality-management-within-clinical-trials
#20
Lauren Houston, Yasmine Probst, Ping Yu, Allison Martin
BACKGROUND:  Clinical trials are an important research method for improving medical knowledge and patient care. Multiple international and national guidelines stipulate the need for data quality and assurance. Many strategies and interventions are developed to reduce error in trials, including standard operating procedures, personnel training, data monitoring, and design of case report forms. However, guidelines are nonspecific in the nature and extent of necessary methods. OBJECTIVE:  This article gathers information about current data quality tools and procedures used within Australian clinical trial sites, with the aim to develop standard data quality monitoring procedures to ensure data integrity...
January 2018: Applied Clinical Informatics
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