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https://www.readbyqxmd.com/read/29155848/an-electronic-health-record-based-model-predicts-statin-adherence-ldl-cholesterol-and-cardiovascular-disease-in-the-united-states-military-health-system
#1
Joseph E Lucas, Taylor C Bazemore, Celan Alo, Patrick B Monahan, Deepak Voora
HMG-CoA reductase inhibitors (or "statins") are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk...
2017: PloS One
https://www.readbyqxmd.com/read/29153922/e-health-in-switzerland-the-laborious-adoption-of-the-federal-law-on-electronic-health-records-ehr-and-health-information-exchange-hie-networks
#2
Carlo De Pietro, Igor Francetic
Within the framework of a broader e-health strategy launched a decade ago, in 2015 Switzerland passed a new federal law on patients' electronic health records (EHR). The reform requires hospitals to adopt interoperable EHRs to facilitate data sharing and cooperation among healthcare providers, ultimately contributing to improvements in quality of care and efficiency in the health system. Adoption is voluntary for ambulatories and private practices, that may however be pushed towards EHRs by patients. The latter have complete discretion in the choice of the health information to share...
November 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29147880/targeted-physician-education-and-standardizing-documentation-improves-documented-reporting-with-inflammatory-bowel-disease-quality-measures-in-a-large-academic-and-private-practice
#3
Joseph D Feuerstein, Konstantinos Papamichael, Sara Popejoy, Adam Nadelson, Jeffrey J Lewandowski, Kathy Geissler, Manuel Martinez-Vazquez, Daniel A Leffler, Kim Ariyabuddhiphongs, Chandrashekhar Thukral, Adam S Cheifetz
BACKGROUND: Prior studies have shown poor compliance with quality measures for IBD at academic and private practices. We sought to provide focused interventions to improve compliance and documentation with the IBD measures. METHODS: Two centers, academic practice (AP) and private practice (PP), initially reviewed their compliance with eight established IBD quality measures in consecutive charts. A multi-faceted intervention was developed to improve awareness and documentation of these measures...
November 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29138126/promoting-secondary-analysis-of-electronic-medical-records-in-china-summary-of-the-plagh-mit-critical-data-conference-and-health-datathon
#4
Peiyao Li, Chen Xie, Tom Pollard, Alistair Edward William Johnson, Desen Cao, Hongjun Kang, Hong Liang, Yuezhou Zhang, Xiaoli Liu, Yong Fan, Yuan Zhang, Wanguo Xue, Lixin Xie, Leo Anthony Celi, Zhengbo Zhang
Electronic health records (EHRs) have been widely adopted among modern hospitals to collect and track clinical data. Secondary analysis of EHRs could complement the traditional randomized control trial (RCT) research model. However, most researchers in China lack either the technical expertise or the resources needed to utilize EHRs as a resource. In addition, a climate of cross-disciplinary collaboration to gain insights from EHRs, a crucial component of a learning healthcare system, is not prevalent. To address these issues, members from the Massachusetts Institute of Technology (MIT) and the People's Liberation Army General Hospital (PLAGH) organized the first clinical data conference and health datathon in China, which provided a platform for clinicians, statisticians, and data scientists to team up and address information gaps in the intensive care unit (ICU)...
November 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29133283/open-source-electronic-health-record-systems-for-low-resource-settings-systematic-review
#5
REVIEW
Assel Syzdykova, André Malta, Maria Zolfo, Ermias Diro, José Luis Oliveira
BACKGROUND: Despite the great impact of information and communication technologies on clinical practice and on the quality of health services, this trend has been almost exclusive to developed countries, whereas countries with poor resources suffer from many economic and social issues that have hindered the real benefits of electronic health (eHealth) tools. As a component of eHealth systems, electronic health records (EHRs) play a fundamental role in patient management and effective medical care services...
November 13, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29132625/variation-in-interoperability-across-clinical-laboratories-nationwide
#6
Vaishali Patel, Lauren McNamara, Prashila Dullabh, Megan E Sawchuk, Matthew Swain
OBJECTIVE: To characterize nationwide variation and factors associated with clinical laboratories': (1) capabilities to send structured test results electronically to ordering practitioners' EHR systems; and (2) their levels of exchange activity, as measured by whether they sent more than three-quarters of their test results as structured data to ordering practitioners' EHR systems. MATERIALS AND METHODS: A national survey of all independent and hospital laboratories was conducted in 2013...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132624/the-value-of-ehr-based-assessment-of-physician-competency-an-investigative-effort-with-internal-medicine-physicians
#7
Kimberly Venta, Erin Baker, Cali Fidopiastis, Kay Stanney
OBJECTIVE: The purpose of this study was to investigate the potential of developing an EHR-based model of physician competency, named the Skill Deficiency Evaluation Toolkit for Eliminating Competency-loss Trends (Skill-DETECT), which presents the opportunity to use EHR-based models to inform selection of Continued Medical Education (CME) opportunities specifically targeted at maintaining proficiency. METHODS: The IBM Explorys platform provided outpatient Electronic Health Records (EHRs) representing 76 physicians with over 5000 patients combined...
December 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29132447/clinical-documentation-in-an-era-of-increasing-transparency-the-impact-of-electronic-portals-on-care
#8
Joanne Maxwell, Keith Adamson, Amir Karmali, Lee Verweel
Electronic health records (EHRs) and consumer health portals have implications for improving the quality and cost-effectiveness of healthcare and make it much easier for patients and families to access health information in a timely and convenient manner. However, the accessibility of information afforded by EHRs and health portals changes the dynamic of control over health information in very significant ways. Institutions and their clinicians have typically been the caretakers of these documents; therefore, the introduction of portals represents a major cultural shift in healthcare...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29132446/a-model-for-developing-clinical-analytics-capacity-closing-the-loops-on-outcomes-to-optimize-quality
#9
Corinne Eggert, Kenneth Moselle, Denis Protti, Dale Sanders
Closed Loop Analytics© is receiving growing interest in healthcare as a term referring to information technology, local data and clinical analytics working together to generate evidence for improvement. The Closed Loop Analytics model consists of three loops corresponding to the decision-making levels of an organization and the associated data within each loop - Patients, Protocols, and Populations. The authors propose that each of these levels should utilize the same ecosystem of electronic health record (EHR) and enterprise data warehouse (EDW) enabled data, in a closed-loop fashion, with that data being repackaged and delivered to suit the analytic and decision support needs of each level, in support of better outcomes...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29127903/causes-of-ehr-projects-stalling-or-failing-a-study-of-ehr-projects-in-saudi-arabia
#10
Bakheet Aldosari
BACKGROUND: Electronic Medical Records (EMRs) are designed to automatically collect, store, and retrieve patients' information from healthcare providers within an organization. They assist clinicians in deciding the future course of treatment. The primary objective of this study is to investigate the practices of Electronic Health Record (EHR) project managers regarding the causes of EHR projects getting stalled or failing in Saudi Arabia. METHODS: Three focus groups were identified across three main cities of Saudi Arabia, namely Riyadh, Jeddah, and Dammam during the years 2013 and 2014...
November 3, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29126253/enabling-phenotypic-big-data-with-phenorm
#11
Sheng Yu, Yumeng Ma, Jessica Gronsbell, Tianrun Cai, Ashwin N Ananthakrishnan, Vivian S Gainer, Susanne E Churchill, Peter Szolovits, Shawn N Murphy, Isaac S Kohane, Katherine P Liao, Tianxi Cai
Objective: Electronic health record (EHR)-based phenotyping infers whether a patient has a disease based on the information in his or her EHR. A human-annotated training set with gold-standard disease status labels is usually required to build an algorithm for phenotyping based on a set of predictive features. The time intensiveness of annotation and feature curation severely limits the ability to achieve high-throughput phenotyping. While previous studies have successfully automated feature curation, annotation remains a major bottleneck...
November 3, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29123330/markov-logic-networks-for-adverse-drug-event-extraction-from-text
#12
Sriraam Natarajan, Vishal Bangera, Tushar Khot, Jose Picado, Anurag Wazalwar, Vitor Santos Costa, David Page, Michael Caldwell
Adverse drug events (ADEs) are a major concern and point of emphasis for the medical profession, government, and society. A diverse set of techniques from epidemiology, statistics, and computer science are being proposed and studied for ADE discovery from observational health data (e.g., EHR and claims data), social network data (e.g., Google and Twitter posts), and other information sources. Methodologies are needed for evaluating, quantitatively measuring, and comparing the ability of these various approaches to accurately discover ADEs...
May 2017: Knowledge and Information Systems
https://www.readbyqxmd.com/read/29121852/an-informatics-approach-to-interprofessional-management-of-low-back-pain-a-feasibility-study-using-the-omaha-system
#13
Robin R Austin, Karen A Monsen, Craig Schulz
BACKGROUND: Low back pain (LBP) is a complex health care issue that often involves multiple providers across various care settings. Health information technology (HIT) holds promise to improve care delivery by providing infrastructure for communication, clinical documentation, and management of patient data. Standardized terminology is essential for interoperability and enables evaluation of clinical data generated by documentation in an electronic health record (EHR). OBJECTIVE: The purpose of this study was to demonstrate the feasibility of mapping evidence-based practice for conservative management of low back pain to the Omaha System and foster inter-professional communication and collaboration among diverse practitioners and patients...
October 6, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29121480/palliative-care-planner-pcplanner-a-pilot-study-to-evaluate-acceptability-and-usability-of-an-electronic-health-records-system-integrated-needs-targeted-app-platform
#14
Christopher E Cox, Derek M Jones, Wen Reagan, Mary D Key, Vinca Chow, Jessica McFarlin, David Casarett, Claire J Creutzfeldt, Sharron L Docherty
RATIONALE: The quality and patient-centeredness of intensive care unit (ICU)-based palliative care delivery is highly variable. OBJECTIVE: To develop and pilot an app platform for clinicians, ICU patients, and their family members that enhances the delivery of needs-targeted palliative care. METHODS: In the Development Phase of the study, we developed an electronic health record (EHR) system-integrated mobile web app system prototype, PCplanner (Palliative Care Planner)...
November 9, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29121197/higher-accuracy-of-complex-medication-reconciliation-through-improved-design-of-electronic-tools
#15
Jan Horsky, Elizabeth A Drucker, Harley Z Ramelson
Objective: Investigate the accuracy of 2 different medication reconciliation tools integrated into electronic health record systems (EHRs) using a cognitively demanding scenario and complex medication history. Materials and Methods: Seventeen physicians reconciled medication lists for a polypharmacy patient using 2 EHRs in a simulation study. The lists contained 3 types of discrepancy and were transmitted between the systems via a Continuity of Care Document. Participants updated each EHR and their interactions were recorded and analyzed for the number and type of errors...
November 7, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29121175/association-of-the-presence-of-trainees-with-outpatient-appointment-times-in-an-ophthalmology-clinic
#16
Isaac H Goldstein, Michelle R Hribar, Sarah Read-Brown, Michael F Chiang
Importance: Physicians face pressure to improve clinical efficiency, particularly with electronic health record (EHR) adoption and gradual shifts toward value-based reimbursement models. These pressures are especially pronounced in academic medical centers, where delivery of care must be balanced with medical education. However, the association of the presence of trainees with clinical efficiency in outpatient ophthalmology clinics is not known. Objective: To quantify the association of the presence of trainees (residents and fellows) and efficiency in an outpatient ophthalmology clinic...
November 9, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29121053/adept-a-semantically-enriched-pipeline-for-extracting-adverse-drug-events-from-free-text-electronic-health-records
#17
Ehtesham Iqbal, Robbie Mallah, Daniel Rhodes, Honghan Wu, Alvin Romero, Nynn Chang, Olubanke Dzahini, Chandra Pandey, Matthew Broadbent, Robert Stewart, Richard J B Dobson, Zina M Ibrahim
Adverse drug events (ADEs) are unintended responses to medical treatment. They can greatly affect a patient's quality of life and present a substantial burden on healthcare. Although Electronic health records (EHRs) document a wealth of information relating to ADEs, they are frequently stored in the unstructured or semi-structured free-text narrative requiring Natural Language Processing (NLP) techniques to mine the relevant information. Here we present a rule-based ADE detection and classification pipeline built and tested on a large Psychiatric corpus comprising 264k patients using the de-identified EHRs of four UK-based psychiatric hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/29118045/measurement-of-selected-preventable-adverse-drug-events-in-electronic-health-records-toward-developing-a-complexity-score
#18
Nakyung Jeon, Magarita Sorokina, Carl Henriksen, Ben Staley, Gloria Pflugfelder Lipori, Almut G Winterstein
PURPOSE: The defining of a select number of high-priority preventable adverse drug events (pADEs) for measurement in the electronic health record (EHR) and the estimation of pADE incidences in two tertiary care facilities are described. METHODS: This study was part of a larger effort aimed at developing an automated electronic health record (EHR)-based complexity-score (C-score) that ranks hospitalized patients according to their risk for pADEs for clinical intervention...
November 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29117934/uses-of-mobile-device-digital-photography-of-dermatologic-conditions-in-primary-care
#19
Jennifer L Pecina, Kirk D Wyatt, Nneka I Comfere, Matthew E Bernard, Frederick North
BACKGROUND: PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)-based mobile devices. OBJECTIVE: The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. METHODS: Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant)...
November 8, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29114434/usability-evaluation-of-laboratory-information-systems
#20
Althea Mathews, David Marc
Background: Numerous studies have revealed widespread clinician frustration with the usability of electronic health records (EHRs) that is counterproductive to adoption of EHR systems to meet the aims of health-care reform. With poor system usability comes increased risk of negative unintended consequences. Usability issues could lead to user error and workarounds that have the potential to compromise patient safety and negatively impact the quality of care.[1] While there is ample research on EHR usability, there is little information on the usability of laboratory information systems (LISs)...
2017: Journal of Pathology Informatics
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