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JMIR Medical Informatics

Denton Callander, Christopher Bourne, Handan Wand, Mark Stoové, Jane S Hocking, John de Wit, John M Kaldor, Basil Donovan, Catherine Pell, Robert Finlayson, David Baker, Bradley Forssman, B K Tee, Bill Kefalas, Tim Duck, Rebecca Guy
BACKGROUND: Gay and bisexual men are disproportionately affected by HIV and other sexually transmissible infections (STIs), yet opportunities for sexual health testing of this population are often missed or incomplete in general practice settings. Strategies are needed for improving the uptake and completeness of sexual health testing in this setting. OBJECTIVES: The goal of the research was to evaluate the impact of an intervention centered around integrated decision support software and routine data feedback on the collection of sexual orientation data and sexual health testing among gay and bisexual men attending general practice...
November 6, 2018: JMIR Medical Informatics
Gang Luo, Peter Tarczy-Hornoch, Adam B Wilcox, E Sally Lee
BACKGROUND: In the United States, health care is fragmented in numerous distinct health care systems including private, public, and federal organizations like private physician groups and academic medical centers. Many patients have their complete medical data scattered across these several health care systems, with no particular system having complete data on any of them. Several major data analysis tasks such as predictive modeling using historical data are considered impractical on incomplete data...
November 5, 2018: JMIR Medical Informatics
Gang Luo, Michael D Johnson, Flory L Nkoy, Shan He, Bryan L Stone
BACKGROUND: Bronchiolitis is the leading cause of hospitalization in children under 2 years of age. Each year in the United States, bronchiolitis results in 287,000 emergency department visits, 32%-40% of which end in hospitalization. Frequently, emergency department disposition decisions (to discharge or hospitalize) are made subjectively because of the lack of evidence and objective criteria for bronchiolitis management, leading to significant practice variation, wasted health care use, and suboptimal outcomes...
November 5, 2018: JMIR Medical Informatics
David Cw Wong, Julia Knight, Jacqueline Birks, Lionel Tarassenko, Peter J Watkinson
BACKGROUND: Electronic recording of vital sign observations (e-Obs) has become increasingly prevalent in hospital care. The evidence of clinical impact for these systems is mixed. OBJECTIVE: The objective of our study was to assess the effect of e-Obs versus paper documentation (paper) on length of stay (time between trauma unit admission and "fit to discharge") for trauma patients. METHODS: A single-center, randomized stepped-wedge study of e-Obs against paper was conducted in two 26-bed trauma wards at a medium-sized UK teaching hospital...
October 31, 2018: JMIR Medical Informatics
Sung Wook Kim, Jason Madan, Melina Dritsaki, Carol Bryce, Vera Forjaz, Joe Fraser, Frances Griffiths, Kathryn Hamilton, Caroline Huxley, Jackie Sturt
BACKGROUND: Since the introduction of digital health technologies in National Health Service (NHS), health professionals are starting to use email, text, and other digital methods to consult with their patients in a timely manner. There is lack of evidence regarding the economic impact of digital consulting in the United Kingdom (UK) NHS. OBJECTIVE: This study aimed to estimate the direct costs associated with digital consulting as an adjunct to routine care at 18 clinics serving young people aged 16-24 years with long-term conditions...
October 30, 2018: JMIR Medical Informatics
Safiya Richardson, Philip Solomon, Alexander O'Connell, Sundas Khan, Jonathan Gong, Alex Makhnevich, Guang Qiu, Meng Zhang, Thomas McGinn
BACKGROUND: Use of computed tomography pulmonary angiography (CTPA) in the assessment of pulmonary embolism (PE) has markedly increased over the past two decades. While this technology has improved the accuracy of radiological testing for PE, CTPA also carries the risk of substantial iatrogenic harm. Each CTPA carries a 14% risk of contrast-induced nephropathy and a lifetime malignancy risk that can be as high as 2.76%. The appropriate use of CTPA can be estimated by monitoring the CTPA yield, the percentage of tests positive for PE...
October 25, 2018: JMIR Medical Informatics
Jason Walonoski, Robert Scanlon, Conor Dowling, Mario Hyland, Richard Ettema, Steven Posnack
BACKGROUND: There is wide recognition that the lack of health data interoperability has significant impacts. Traditionally, health data standards are complex and test-driven methods played important roles in achieving interoperability. The Health Level Seven International (HL7) standard Fast Healthcare Interoperability Resources (FHIR) may be a technical solution that aligns with policy, but systems need to be validated and tested. OBJECTIVE: Our objective is to explore the question of whether or not the regular use of validation and testing tools improves server compliance with the HL7 FHIR specification...
October 23, 2018: JMIR Medical Informatics
Alexander R Lucas, Michael B Bass, Nan E Rothrock, Mary L O'Connor, Mia R Sorkin, Jason Nawyn, Fahd Albinali, Lynne I Wagner
BACKGROUND: Capturing and Analyzing Sensor and Self-Report Data for Clinicians and Researchers (COMPASS) is an electronic health (eHealth) platform designed to improve cancer care delivery through passive monitoring of patients' health status and delivering customizable reports to clinicians. Based on data from sensors and context-driven administration of patient-reported outcome (PRO) measures, key indices of patients' functional status can be collected between regular clinic visits, supporting clinicians in the delivery of patient care...
October 22, 2018: JMIR Medical Informatics
Brian J Wells, Kristin M Lenoir, Jose-Franck Diaz-Garelli, Wendell Futrell, Elizabeth Lockerman, Kevin M Pantalone, Michael W Kattan
BACKGROUND: Electronic, personalized clinical decision support tools to optimize glycated hemoglobin (HbA1c ) screening are lacking. Current screening guidelines are based on simple, categorical rules developed for populations of patients. Although personalized diabetes risk calculators have been created, none are designed to predict current glycemic status using structured data commonly available in electronic health records (EHRs). OBJECTIVE: The goal of this project was to create a mathematical equation for predicting the probability of current elevations in HbA1c (≥5...
October 22, 2018: JMIR Medical Informatics
Feichen Shen, Sijia Liu, Yanshan Wang, Andrew Wen, Liwei Wang, Hongfang Liu
BACKGROUND: In the United States, a rare disease is characterized as the one affecting no more than 200,000 patients at a certain period. Patients suffering from rare diseases are often either misdiagnosed or left undiagnosed, possibly due to insufficient knowledge or experience with the rare disease on the part of clinical practitioners. With an exponentially growing volume of electronically accessible medical data, a large volume of information on thousands of rare diseases and their potentially associated diagnostic information is buried in electronic medical records (EMRs) and medical literature...
October 10, 2018: JMIR Medical Informatics
Misa Usui, Eiji Aramaki, Tomohide Iwao, Shoko Wakamiya, Tohru Sakamoto, Mayumi Mochizuki
BACKGROUND: Despite the growing number of studies using natural language processing for pharmacovigilance, there are few reports on manipulating free text patient information in Japanese. OBJECTIVE: This study aimed to establish a method of extracting and standardizing patient complaints from electronic medication histories accumulated in a Japanese community pharmacy for the detection of possible adverse drug event (ADE) signals. METHODS: Subjective information included in electronic medication history data provided by a Japanese pharmacy operating in Hiroshima, Japan from September 1, 2015 to August 31, 2016, was used as patients' complaints...
September 27, 2018: JMIR Medical Informatics
Timothy Ad Graham, Mark Ballermann, Eddy Lang, Michael J Bullard, Denise Parsons, Gabriella Mercuur, Pat San Agustin, Samina Ali
BACKGROUND: The adoption and use of an electronic health record (EHR) can facilitate real-time access to key health information and support improved outcomes. Many Canadian provinces use interoperable EHRs (iEHRs) to facilitate health information exchange, but the clinical use and utility of iEHRs has not been well described. OBJECTIVE: The aim of this study was to describe the use of a provincial iEHR known as the Alberta Netcare Portal (ANP) in 4 urban Alberta emergency departments...
September 25, 2018: JMIR Medical Informatics
Tracie Risling, Juan Martinez, Jeremy Young, Nancy Thorp-Froslie
BACKGROUND: The increasing presence of technology in health care has created new opportunities for patient engagement and with this, an intensified exploration of patient empowerment within the digital health context. While the use of technology, such as patient portals, has been positively received, a clear linkage between digital health solutions, patient empowerment, and health outcomes remains elusive. OBJECTIVE: The primary objective of this research was to explore the views of participants enrolled in an electronic health record portal access trial regarding the resultant influence of this technology on their feelings of patient empowerment...
September 10, 2018: JMIR Medical Informatics
Sonja Brajovic, David A Blaser, Meaghan Zisk, Christine Caligtan, Sally Okun, Marni Hall, Carol A Pamer
BACKGROUND: The availability of and interest in patient-generated health data (PGHD) have grown steadily. Patients describe medical experiences differently compared with how clinicians or researchers would describe their observations of those same experiences. Patients may find nonserious, known adverse drug events (ADEs) to be an ongoing concern, which impacts the tolerability and adherence. Clinicians must be vigilant for medically serious, potentially fatal ADEs. Having both perspectives provides patients and clinicians with a complete picture of what to expect from drug therapies...
August 21, 2018: JMIR Medical Informatics
Axel Newe, Linda Becker
BACKGROUND: The Portable Document Format (PDF) is the standard file format for the communication of biomedical information via the internet and for electronic scholarly publishing. Although PDF allows for the embedding of three-dimensional (3D) objects and although this technology has great potential for the communication of such data, it is not broadly used by the scientific community or by clinicians. OBJECTIVE: The objective of this review was to provide an overview of existing publications that apply 3D PDF technology and the protocols and tools for the creation of model files and 3D PDFs for scholarly purposes to demonstrate the possibilities and the ways to use this technology...
August 7, 2018: JMIR Medical Informatics
Marcella McGovern, Maria Quinlan, Gerardine Doyle, Gemma Moore, Susi Geiger
BACKGROUND: Electronic referrals or e-referrals can be defined as the electronic transmission of patient data and clinical requests between health service providers. National electronic referral systems have proved challenging to implement due to problems of fit between the technical systems proposed and the existing sociotechnical systems. In seeming contradiction to a sociotechnical approach, the Irish Health Service Executive initiated an incremental implementation of a National Electronic Referral Programme (NERP), with step 1 including only the technical capability for general practitioners to submit electronic referral requests to hospital outpatient departments...
July 18, 2018: JMIR Medical Informatics
Kevon-Mark Jackman, Stefan David Baral, Lisa Hightow-Weidman, Tonia Poteat
BACKGROUND: Black youth continue to bear an overwhelming proportion of the United States sexually transmitted infection (STI) burden, including HIV. Several studies on web-based and mobile health (mHealth) STI interventions have focused on characterizing strategies to improve HIV-related prevention and treatment interventions, risk communication, and stigma among men who have sex with men (MSM), people who use substances, and adolescent populations. The Electronic Sexual Health Information Notification and Education (eSHINE) Study was an exploratory mixed-methods study among students at a historically black university exploring perceptions on facilitating STI testing conversations with partners using electronic personal health records (PHRs)...
July 12, 2018: JMIR Medical Informatics
Sabine Theis, Peter Wilhelm Victor Rasche, Christina Bröhl, Matthias Wille, Alexander Mertens
BACKGROUND: Increasingly, eHealth involves health data visualizations to enable users to better understand their health situation. Selecting efficient and ergonomic visualizations requires knowledge about the task that the user wants to carry out and the type of data to be displayed. Taxonomies of abstract tasks and data types bundle this knowledge in a general manner. Task-data taxonomies exist for visualization tasks and data. They also exist for eHealth tasks. However, there is currently no joint task taxonomy available for health data visualizations incorporating the perspective of the prospective users...
July 9, 2018: JMIR Medical Informatics
David Peddie, Serena S Small, Katherin Badke, Chantelle Bailey, Ellen Balka, Corinne M Hohl
BACKGROUND: Patients commonly transition between health care settings, requiring care providers to transfer medication utilization information. Yet, information sharing about adverse drug events (ADEs) remains nonstandardized. OBJECTIVE: The objective of our study was to describe a minimum required dataset for clinicians to document and communicate ADEs to support clinical decision making and improve patient safety. METHODS: We used mixed-methods analysis to design a minimum required dataset for ADE documentation and communication...
June 28, 2018: JMIR Medical Informatics
Inga M Zadvinskis, Jessica Garvey Smith, Po-Yin Yen
BACKGROUND: Nurses are the largest group of health information technology (HIT) users. As such, nurses' adaptations are critical for HIT implementation success. However, longitudinal approaches to understanding nurses' perceptions of HIT remain underexplored. Previous studies of nurses' perceptions demonstrate that the progress and timing for acceptance of and adaptation to HIT varies. OBJECTIVE: This study aimed to explore nurses' experience regarding implementation of HIT over time...
June 26, 2018: JMIR Medical Informatics
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