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JMIR Medical Informatics

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https://www.readbyqxmd.com/read/28931497/use-of-simulation-based-on-an-electronic-health-records-environment-to-evaluate-the-structure-and-accuracy-of-notes-generated-by-medical-scribes-proof-of-concept-study
#1
Robert Pranaat, Vishnu Mohan, Megan O'Reilly, Maxwell Hirsh, Karess McGrath, Gretchen Scholl, Deborah Woodcock, Jeffrey A Gold
BACKGROUND: The increasing adoption of electronic health records (EHRs) has been associated with a number of unintended negative consequences with provider efficiency and job satisfaction. To address this, there has been a dramatic increase in the use of medical scribes to perform many of the required EHR functions. Despite this rapid growth, little has been published on the training or assessment tools to appraise the safety and efficacy of scribe-related EHR activities. Given the number of reports documenting that other professional groups suffer from a number of performance errors in EHR interface and data gathering, scribes likely face similar challenges...
September 20, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28912115/system-wide-inpatient-portal%C3%A2-implementation-survey-of-health-care-team-perceptions
#2
Jennifer L Hefner, Cynthia J Sieck, Daniel M Walker, Timothy R Huerta, Ann Scheck McAlearney
BACKGROUND: Inpatient portals, a new type of patient portal tailored specifically to the hospital setting, can allow patients to access up-to-date health information and exchange secure communications with their care team. As such, inpatient portals present an opportunity for patients to increase engagement in their care during a time of acute crisis that emphasizes focus on a patient's health. While there is a large body of research on patient portals in the outpatient setting, questions are being raised specifically about inpatient portals, such as how they will be incorporated into the flow of patient care in hectic, stressed, team-based hospital settings...
September 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28903894/prototype-development-context-driven-dynamic-xml-ophthalmologic-data-capture-application
#3
Peggy Peissig, Kelsey M Schwei, Christopher Kadolph, Joseph Finamore, Efrain Cancel, Catherine A McCarty, Asha Okorie, Kate L Thomas, Jennifer Allen Pacheco, Jyotishman Pathak, Stephen B Ellis, Joshua C Denny, Luke V Rasmussen, Gerard Tromp, Marc S Williams, Tamara R Vrabec, Murray H Brilliant
BACKGROUND: The capture and integration of structured ophthalmologic data into electronic health records (EHRs) has historically been a challenge. However, the importance of this activity for patient care and research is critical. OBJECTIVE: The purpose of this study was to develop a prototype of a context-driven dynamic extensible markup language (XML) ophthalmologic data capture application for research and clinical care that could be easily integrated into an EHR system...
September 13, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28887294/impact-of-at-home-telemonitoring-on-health-services-expenditure-and-hospital-admissions-in-patients-with-chronic-conditions-before-and-after-control-intervention-analysis
#4
Branko Celler, Marlien Varnfield, Surya Nepal, Ross Sparks, Jane Li, Rajiv Jayasena
BACKGROUND: Telemonitoring is becoming increasingly important for the management of patients with chronic conditions, especially in countries with large distances such as Australia. However, despite large national investments in health information technology, little policy work has been undertaken in Australia in deploying telehealth in the home as a solution to the increasing demands and costs of managing chronic disease. OBJECTIVE: The objective of this trial was to evaluate the impact of introducing at-home telemonitoring to patients living with chronic conditions on health care expenditure, number of admissions to hospital, and length of stay (LOS)...
September 8, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28882812/health-information-technology-hit-adaptation-refocusing-on-the-journey-to-successful-hit-implementation
#5
Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta
In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines...
September 7, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28851681/is-there-evidence-of-cost-benefits-of-electronic-medical-records-standards-or-interoperability-in-hospital-information-systems-overview-of-systematic-reviews
#6
Zilma Silveira Nogueira Reis, Thais Abreu Maia, Milena Soriano Marcolino, Francisco Becerra-Posada, David Novillo-Ortiz, Antonio Luiz Pinho Ribeiro
BACKGROUND: Electronic health (eHealth) interventions may improve the quality of care by providing timely, accessible information about one patient or an entire population. Electronic patient care information forms the nucleus of computerized health information systems. However, interoperability among systems depends on the adoption of information standards. Additionally, investing in technology systems requires cost-effectiveness studies to ensure the sustainability of processes for stakeholders...
August 29, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28807893/optimizing-the-use-of-electronic-health-records-to-identify-high-risk-psychosocial-determinants-of-health
#7
Nicolas Michel Oreskovic, Jennifer Maniates, Jeffrey Weilburg, Garry Choy
BACKGROUND: Care coordination programs have traditionally focused on medically complex patients, identifying patients that qualify by analyzing formatted clinical data and claims data. However, not all clinically relevant data reside in claims and formatted data. Recently, there has been increasing interest in including patients with complex psychosocial determinants of health in care coordination programs. Psychosocial risk factors, including social determinants of health, mental health disorders, and substance abuse disorders, are less amenable to rapid and systematic data analyses, as these data are often not collected or stored as formatted data, and due to US Health Insurance Portability and Accountability Act (HIPAA) regulations are often not available as claims data...
August 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28790024/hierarchical-medical-system-based-on-big-data-and-mobile-internet-a-new-strategic-choice-in-health-care
#8
Yaogang Wang, Li Sun, Jie Hou
China is setting up a hierarchical medical system to solve the problems of biased resource allocation and high patient flows to large hospitals. The development of big data and mobile Internet technology provides a new perspective for the establishment of hierarchical medical system. This viewpoint discusses the challenges with the hierarchical medical system in China and how big data and mobile Internet can be used to mitigate these challenges.
August 8, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28778845/clinical-note-creation-binning-and-artificial-intelligence
#9
Rodrigo Octávio Deliberato, Leo Anthony Celi, David J Stone
The creation of medical notes in software applications poses an intrinsic problem in workflow as the technology inherently intervenes in the processes of collecting and assembling information, as well as the production of a data-driven note that meets both individual and healthcare system requirements. In addition, the note writing applications in currently available electronic health records (EHRs) do not function to support decision making to any substantial degree. We suggest that artificial intelligence (AI) could be utilized to facilitate the workflows of the data collection and assembly processes, as well as to support the development of personalized, yet data-driven assessments and plans...
August 3, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28760726/triaging-patient-complaints-monte-carlo-cross-validation-of-six-machine-learning-classifiers
#10
Adel Elmessiry, William O Cooper, Thomas F Catron, Jan Karrass, Zhe Zhang, Munindar P Singh
BACKGROUND: Unsolicited patient complaints can be a useful service recovery tool for health care organizations. Some patient complaints contain information that may necessitate further action on the part of the health care organization and/or the health care professional. Current approaches depend on the manual processing of patient complaints, which can be costly, slow, and challenging in terms of scalability. OBJECTIVE: The aim of this study was to evaluate automatic patient triage, which can potentially improve response time and provide much-needed scale, thereby enhancing opportunities to encourage physicians to self-regulate...
July 31, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28760725/what-patients-can-tell-us-topic-analysis-for-social-media-on-breast-cancer
#11
Mike Donald Tapi Nzali, Sandra Bringay, Christian Lavergne, Caroline Mollevi, Thomas Opitz
BACKGROUND: Social media dedicated to health are increasingly used by patients and health professionals. They are rich textual resources with content generated through free exchange between patients. We are proposing a method to tackle the problem of retrieving clinically relevant information from such social media in order to analyze the quality of life of patients with breast cancer. OBJECTIVE: Our aim was to detect the different topics discussed by patients on social media and to relate them to functional and symptomatic dimensions assessed in the internationally standardized self-administered questionnaires used in cancer clinical trials (European Organization for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire Core 30 [QLQ-C30] and breast cancer module [QLQ-BR23])...
July 31, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28747298/estimating-one-year-risk-of-incident-chronic-kidney-disease-retrospective-development-and-validation-study-using-electronic-medical-record-data-from-the-state-of-maine
#12
Shiying Hao, Tianyun Fu, Qian Wu, Bo Jin, Chunqing Zhu, Zhongkai Hu, Yanting Guo, Yan Zhang, Yunxian Yu, Terry Fouts, Phillip Ng, Devore S Culver, Shaun T Alfreds, Frank Stearns, Karl G Sylvester, Eric Widen, Doff B McElhinney, Xuefeng B Ling
BACKGROUND: Chronic kidney disease (CKD) is a major public health concern in the United States with high prevalence, growing incidence, and serious adverse outcomes. OBJECTIVE: We aimed to develop and validate a model to identify patients at risk of receiving a new diagnosis of CKD (incident CKD) during the next 1 year in a general population. METHODS: The study population consisted of patients who had visited any care facility in the Maine Health Information Exchange network any time between January 1, 2013, and December 31, 2015, and had no history of CKD diagnosis...
July 26, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28729233/dynamo-a-modular-platform-for-monitoring-process-outcome-and-algorithm-based-treatment-planning-in-psychotherapy
#13
Tim Kaiser, Anton Rupert Laireiter
BACKGROUND: In recent years, the assessment of mental disorders has become more and more personalized. Modern advancements such as Internet-enabled mobile phones and increased computing capacity make it possible to tap sources of information that have long been unavailable to mental health practitioners. OBJECTIVE: Software packages that combine algorithm-based treatment planning, process monitoring, and outcome monitoring are scarce. The objective of this study was to assess whether the DynAMo Web application can fill this gap by providing a software solution that can be used by both researchers to conduct state-of-the-art psychotherapy process research and clinicians to plan treatments and monitor psychotherapeutic processes...
July 20, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28679487/issues-associated-with-the-use-of-semantic-web-technology-in-knowledge-acquisition-for-clinical-decision-support-systems-systematic-review-of-the-literature
#14
Seyedjamal Zolhavarieh, David Parry, Quan Bai
BACKGROUND: Knowledge-based clinical decision support system (KB-CDSS) can be used to help practitioners make diagnostic decisions. KB-CDSS may use clinical knowledge obtained from a wide variety of sources to make decisions. However, knowledge acquisition is one of the well-known bottlenecks in KB-CDSSs, partly because of the enormous growth in health-related knowledge available and the difficulty in assessing the quality of this knowledge as well as identifying the "best" knowledge to use...
July 5, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28676467/the-rules-of-engagement-perspectives-on-secure-messaging-from-experienced-ambulatory-patient-portal-users
#15
Cynthia J Sieck, Jennifer L Hefner, Jeanette Schnierle, Hannah Florian, Aradhna Agarwal, Kristen Rundell, Ann Scheck McAlearney
BACKGROUND: Patient portals have shown promise in engaging individuals in self-management of chronic conditions by allowing patients to input and track health information and exchange secure electronic messages with their providers. Past studies have identified patient barriers to portal use including usability issues, low health literacy, and concerns about loss of personal contact as well as provider concerns such as increased time spent responding to messages. However, to date, studies of both patient and provider perspectives on portal use have focused on the pre-implementation or initial implementation phases and do not consider how these issues may change as patients and providers gain greater experience with portals...
July 4, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28663163/validation-of-an-improved-computer-assisted-technique-for-mining-free-text-electronic-medical-records
#16
Marco Duz, John F Marshall, Tim Parkin
BACKGROUND: The use of electronic medical records (EMRs) offers opportunity for clinical epidemiological research. With large EMR databases, automated analysis processes are necessary but require thorough validation before they can be routinely used. OBJECTIVE: The aim of this study was to validate a computer-assisted technique using commercially available content analysis software (SimStat-WordStat v.6 (SS/WS), Provalis Research) for mining free-text EMRs. METHODS: The dataset used for the validation process included life-long EMRs from 335 patients (17,563 rows of data), selected at random from a larger dataset (141,543 patients, ~2...
June 29, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28659257/telemedicine-services-for-the-arctic-a-systematic-review
#17
Ashenafi Zebene Woldaregay, Ståle Walderhaug, Gunnar Hartvigsen
BACKGROUND: Telemedicine services have been successfully used in areas where there are adequate infrastructures such as reliable power and communication lines. However, despite the increasing number of merchants and seafarers, maritime and Arctic telemedicine have had limited success. This might be linked with various factors such as lack of good infrastructure, lack of trained onboard personnel, lack of Arctic-enhanced telemedicine equipment, extreme weather conditions, remoteness, and other geographical challenges...
June 28, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28619704/applying-stopp-guidelines-in-primary-care-through-electronic-medical-record-decision-support-randomized-control-trial-highlighting-the-importance-of-data-quality
#18
Morgan Price, Iryna Davies, Raymond Rusk, Mary Lesperance, Jens Weber
BACKGROUND: Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly. OBJECTIVE: We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non-academic) primary care practices. METHODS: We conducted a mixed-method, pragmatic, cluster, randomized control trial in research naïve primary care practices...
June 15, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28619702/computerized-childbirth-monitoring-tools-for-health-care-providers-managing-labor-a-scoping-review
#19
Michael S Balikuddembe, Nazarius M Tumwesigye, Peter K Wakholi, Thorkild Tylleskär
BACKGROUND: Proper monitoring of labor and childbirth prevents many pregnancy-related complications. However, monitoring is still poor in many places partly due to the usability concerns of support tools such as the partograph. In 2011, the World Health Organization (WHO) called for the development and evaluation of context-adaptable electronic health solutions to health challenges. Computerized tools have penetrated many areas of health care, but their influence in supporting health staff with childbirth seems limited...
June 15, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28495661/virtual-reality-as-an-adjunct-home-therapy-in-chronic-pain-management-an-exploratory-study
#20
Bernie Garrett, Tarnia Taverner, Paul McDade
BACKGROUND: Virtual reality (VR) therapy has been successfully used as an adjunct therapy for the management of acute pain in adults and children, and evidence of potential efficacy in other health applications is growing. However, minimal research exists on the value of VR as an intervention for chronic pain. OBJECTIVE: This case series examined the value of VR to be used as an adjunctive therapy for chronic pain patients in their own homes. METHODS: An exploratory approach using a case series and personal interviews was used...
May 11, 2017: JMIR Medical Informatics
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