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anesthesia informatics

Richard H Epstein, Franklin Dexter
For this special article, we reviewed the computer code, used to extract the data, and the text of all 47 studies published between January 2006 and August 2017 using anesthesia information management system (AIMS) data from Thomas Jefferson University Hospital (TJUH). Data from this institution were used in the largest number (P = .0007) of papers describing the use of AIMS published in this time frame. The AIMS was replaced in April 2017, making this finite sample finite. The objective of the current article was to identify factors that made TJUH successful in publishing anesthesia informatics studies...
March 27, 2018: Anesthesia and Analgesia
Dong Xu, Alexandrea G Ham, Rickey D Tivis, Matthew L Caylor, Aoxiang Tao, Steve T Flynn, Peter J Economen, Hung K Dang, Royal W Johnson, Vaughn L Culbertson
In 2009 the U.S. Food and Drug Administration (FDA) placed a black box warning on metoclopramide (MCP) due to the increased risks and prevalence of tardive dyskinesia (TD). In this study, we developed a multi-step biomedical informatics screening (MSBIS) approach leveraging publicly available bioactivity and drug safety data to identify concomitant drugs that mitigate the risks of MCP-induced TD. MSBIS includes (1) TargetSearch ( bioinformatics scoring for drug anticholinergic activity using CHEMBL bioactivity data; (2) unadjusted odds ratio (UOR) scoring for indications of TD-mitigating effects using the FDA Adverse Event Reporting System (FAERS); (3) adjusted odds ratio (AOR) re-scoring by removing the effect of cofounding factors (age, gender, reporting year); (4) logistic regression (LR) coefficient scoring for confirming the best TD-mitigating drug candidates...
December 2017: EBioMedicine
Robert E Freundlich, Jesse M Ehrenfeld
PURPOSE OF REVIEW: Perioperative informatics tools continue to be developed at a rapid pace and offer clinicians the potential to greatly enhance clinical decision making. The goal of this review is to bring the reader updates on perioperative information management and discuss future research directions in the field. RECENT FINDINGS: Clinical decision support tools become more timely, accurate, and, in some instances, have been shown to improve patient outcomes...
December 2017: Current Opinion in Anaesthesiology
Luis I Rodriquez, Todd J Smaka, Michael Mahla, Richard H Epstein
BACKGROUND: In the United States, anesthesia information management systems (AIMS) are well established, especially within academic practices. Many hospitals are replacing their stand-alone AIMS during migration to an enterprise-wide electronic health record. This presents an opportunity to review choices made during the original implementation, based on actual usage. One area amenable to this informatics approach is the configuration in the AIMS of quick buttons for typical drug doses...
July 2017: Anesthesia and Analgesia
Laura Phieffer, Jennifer L Hefner, Armin Rahmanian, Jason Swartz, Christopher E Ellison, Ronald Harter, Joshua Lumbley, Susan D Moffatt-Bruce
BACKGROUND: Operating rooms (ORs) are costly to run, and multiple factors influence efficiency. The first case on-time start (FCOS) of an OR is viewed as a harbinger of efficiency for the daily schedule. Across 26 ORs of a large, academic medical center, only 49% of cases started on time in October 2011. METHODS: The Perioperative Services Department engaged an interdisciplinary Operating Room Committee to apply Six Sigma tools to this problem. The steps of this project included (1) problem mapping, (2) process improvements to preoperative readiness, (3) informatics support improvements, and (4) continuous measurement and feedback...
September 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
George Silvay, Zdravka Zafirova
Admission on the day of surgery for elective cardiac and noncardiac surgery is the prevalent practice in North America and Canada. This approach realizes medical, psychological and logistical benefits, and its success is predicated on an effective outpatient preoperative evaluation. The establishment of a highly functional preoperative clinic with a comprehensive set up and efficient logistical pathways is invaluable. This notion in recent years has included the entire perioperative period, and the concept of a perioperative anesthesia/surgical home (PASH) is gaining popularity...
June 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Franklin Dexter, Ruth E Wachtel, Michael M Todd, Bradley J Hindman
Academic anesthesia departments have management responsibilities (e.g., coordinating sedation, directing the operating rooms [ORs], informatics, ongoing professional performance evaluation, staff scheduling, and workroom inventory management). For each of the 64 faculty, a survey sampled 10 weekdays and 4 weekend days of professional activity over N=56 days. Faculty time in managerial activities was 126% of time spent on education, 107% of time spent in research, and 112% of time spent on mandatory indirect clinical support (e...
December 1, 2015: A & A Case Reports
Seshadri C Mudumbai
Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS...
January 2016: Journal of Medical Systems
Olivier Joulin, Mathieu Jeanne, Philipe Mavoungou
No abstract text is available yet for this article.
April 2015: Anaesthesia, Critical Care & Pain Medicine
Jason J Saleem, William R Plew, Ross C Speir, Jennifer Herout, Nancy R Wilck, Dale Marie Ryan, Theresa A Cullen, Jean M Scott, Murielle S Beene, Toni Phillips
OBJECTIVE: This study evaluated the current use of commercial-off-the-shelf Clinical Information Systems (CIS) for intensive care units (ICUs) and Anesthesia Record Keeping (ARK) for operating rooms and post-anesthesia care recovery settings at three Veterans Affairs Medical Centers (VAMCs). Clinicians and administrative staff use these applications at bedside workstations, in operating rooms, at nursing stations, in physician's rooms, and in other various settings. The intention of a CIS or an ARK system is to facilitate creation of electronic records of data, assessments, and procedures from multiple medical devices...
July 2015: International Journal of Medical Informatics
Jessica J Peterson, Kathryn W White, Bonnie L Westra, Karen A Monsen
Informatics is a new science within healthcare and anesthesia that leverages computer technology to improve patient safety, the quality of care provided, and workload efficiency. In clinical anesthesia practice, appropriate application of informatics promotes data standardization and integrity, and supports clinical decision-making. This article describes current issues in anesthesia information management to support the critical need for Certified Registered Nurse Anesthetists (CRNAs) to influence functionality, adoption, and use of an anesthesia information management system...
October 2014: AANA Journal
Joseph R Starnes, Jonathan P Wanderer, Jesse M Ehrenfeld
The increasingly large databases available to researchers necessitate high-quality metadata that is not always available. We describe a method for generating this metadata independently. Cluster analysis and expectation-maximization were used to separate days into holidays/weekends and regular workdays using anesthesia data from Vanderbilt University Medical Center from 2004 to 2014. This classification was then used to describe differences between the two sets of days over time. We evaluated 3802 days and correctly categorized 3797 based on anesthesia case time (representing an error rate of 0...
May 2015: Journal of Medical Systems
Raymond J Malapero, Rodney A Gabriel, Robert Gimlich, Jesse M Ehrenfeld, Beverly K Philip, David W Bates, Richard D Urman
There is a growing emphasis on both cost containment and better quality health care. The creation of better methods for alerting providers and their departments to the costs associated with patient care is one tool for improving efficiency. Since anesthetic medications used in the OR setting are one easily monitored factor contributing to OR costs, anesthetic cost report cards can be used to assess the cost and, potentially the quality of care provided by each practitioner. An ongoing challenge is the identification of the most effective strategies to control costs, promote cost awareness and at the same time maximize quality...
May 2015: Journal of Medical Systems
A F Simpao, L M Ahumada, M A Rehman
Advances in computer technology, patient monitoring systems, and electronic health record systems have enabled rapid accumulation of patient data in electronic form (i.e. big data). Organizations such as the Anesthesia Quality Institute and Multicenter Perioperative Outcomes Group have spearheaded large-scale efforts to collect anaesthesia big data for outcomes research and quality improvement. Analytics--the systematic use of data combined with quantitative and qualitative analysis to make decisions--can be applied to big data for quality and performance improvements, such as predictive risk assessment, clinical decision support, and resource management...
September 2015: British Journal of Anaesthesia
Mette Terp Høybye, Martin Vesterby, Lene Bastrup Jørgensen
Visual approaches to health information reduce complexity and may bridge challenges in health literacy. But the mechanisms and meanings of using animated video in communication with patients undergoing surgery are not well described. By comparing two versions of a two-dimensional animated video on spinal anesthesia, this study tested the patient-avatar identification within two different narrative models. To explore the perspectives of total hip arthroplasty, we employed qualitative methods of interviews and ethnographic observation...
June 2016: Health Informatics Journal
Alberto Prats-Galino, Miguel A Reina, Marija Mavar Haramija, Anna Puigdellivol-Sánchez, Juan A Juanes Méndez, José A De Andrés
A 3D model of lumbar structures of anesthetic interest was reconstructed from human magnetic resonance (MR) images and embedded in a Portable Document Format (PDF) file, which can be opened by freely available software and used offline. The MR images were analyzed using a specific 3D software platform for biomedical data. Models generated from manually delimited volumes of interest and selected MR images were exported to Virtual Reality Modeling Language format and were presented in a PDF document containing JavaScript-based functions...
March 2015: Clinical Anatomy
Hannah King, Georgina E M Pipe, Sarah L Linford, Iain K Moppett, James A M Armstrong
BACKGROUND: Emergency pediatric situations are stressful for all involved. Variation in weight, physiology, and anatomy can be substantial and errors in calculating drugs and fluids can be catastrophic. OBJECTIVES: To evaluate the reliability of information resources that anesthetic trainees might use when faced with common pediatric emergencies. METHODS: Anesthetic trainees from a single UK deanery were recruited and timed while they identified 18 predetermined pieces of information from three Advanced Pediatric Life Support (APLS) scenarios...
March 2015: Paediatric Anaesthesia
Rodney A Gabriel, Robert Gimlich, Jesse M Ehrenfeld, Richard D Urman
The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback...
November 2014: Journal of Medical Systems
Andrew D Boyd, Young Min Yang, Jianrong Li, Colleen Kenost, Mike D Burton, Bryan Becker, Yves A Lussier
Reporting of hospital adverse events relies on Patient Safety Indicators (PSIs) using International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes. The US transition to ICD-10-CM in 2015 could result in erroneous comparisons of PSIs. Using the General Equivalent Mappings (GEMs), we compared the accuracy of ICD-9-CM coded PSIs against recommended ICD-10-CM codes from the Centers for Medicaid/Medicare Services (CMS). We further predict their impact in a cohort of 38,644 patients (1,446,581 visits and 399 hospitals)...
January 2015: Journal of the American Medical Informatics Association: JAMIA
Bryan A Wilbanks
An anesthesia information management system is a dynamic electronic documentation system that generates the legal records of patient care while the patient is receiving anesthesia. The generated documentation can be used to guide patient care, facilitate billing for services, and be used for clinical research. The purpose of this article was to synthesize the previous empirical and theoretical literature pertaining to the concept of accuracy in documentation in a wide range of disciplines in order to refine the concept and more effectively guide future research, clinical practice, and policy development in anesthesia informatics...
February 2014: Computers, Informatics, Nursing: CIN
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