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https://www.readbyqxmd.com/read/28811769/significance-of-electronic-health-records-a-comparative-study-of-vaccination-rates-in-patients-with-sickle-cell-disease
#1
Asli Korur, Süheyl Asma, Cigdem Gereklioglu, Soner Solmaz, Can Boga, Akatlı Kürsat Ozsahin, Altug Kut
OBJECTIVE: In this study, we investigated the influence of electronic health records (EHR) and electronic vaccination schedule applications on the vaccination status of patients who were admitted to our Center for the treatment of sickle cell disease (SCD). METHODS: The vaccination status against influenza and pneumococcus infection was determined in 93 patients who were admitted to the hematology outpatient clinic, Baskent University Adana Hospital from April 2004 to March 2009...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28809201/secondary-use-of-ehr-interpreting-clinician-inter-rater-reliability-through-qualitative-assessment
#2
Sarah Mullin, Edwin Anand, Shyamashree Sinha, Buer Song, Jane Zhao, Peter L Elkin
In a retrospective secondary-use EHR study identifying a cohort of Non-Valvular Atrial Fibrillation (NVAF) patients, chart abstraction was done by two sets of clinicians to create a gold standard for risk measures CHA2DS2-VASc and HAS-BLED. Inter-rater reliability between each set of clinicians for NVAF and the outcomes of interest were variable, ranging from extremely low agreement to high agreement. To assess the chart abstraction process, a focus group and a survey was conducted. Survey findings revealed patterns of difficulty in assessing certain items dealing with temporality and social data...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28808942/primary-care-providers-opening-of-time-sensitive-alerts-sent-to-commercial-electronic-health-record-inbaskets
#3
Sarah L Cutrona, Hassan Fouayzi, Laura Burns, Rajani S Sadasivam, Kathleen M Mazor, Jerry H Gurwitz, Lawrence Garber, Devi Sundaresan, Thomas K Houston, Terry S Field
BACKGROUND: Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. OBJECTIVE: To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. DESIGN AND PARTICIPANTS: We analyzed data for 799 automated alerts...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28808359/electronic-health-records-and-improved-patient-care-opportunities-for-applied-psychology
#4
Raj Ratwani
Healthcare is undergoing an unprecedented technology transition from paper medical records to electronic health records (EHRs). While the adoption of EHRs holds tremendous promise for improving efficiency, quality and safety, there have been numerous challenges that have been largely centered on the technology not meeting the cognitive needs of the clinical end-users. Clinicians are experiencing increased stress and frustration, and new safety hazards have been introduced. There is a significant opportunity for applied psychologists to address many of these challenges...
August 2017: Current Directions in Psychological Science
https://www.readbyqxmd.com/read/28807893/optimizing-the-use-of-electronic-health-records-to-identify-high-risk-psychosocial-determinants-of-health
#5
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/28807836/development-and-evaluation-of-the-automated-risk-assessment-system-for-multidrug-resistant-organisms-autoras-mdro
#6
Eun-Young Hur, Yinji Jin, Taixian Jin, Sun-Mi Lee
BACKGROUND: A high proportion of infections acquired in hospitals are caused by multidrug-resistant organisms (MDROs). The priority in MDRO prevention is to detect high-risk patients and implement preventive intervention as soon as possible. AIM: To develop an automated risk assessment system for MDROs (autoRAS-MDRO) to screen for patients at MDRO infection risk and evaluate the predictive validity of the autoRAS-MDRO. METHODS: Data for 4,200 variables were extracted from the electronic health records (EHRs) for constructing the MDRO risk-scoring algorithm, which was based on a logistic regression model...
August 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28806953/a-fast-healthcare-interoperability-resources-fhir-layer-implemented-over-i2b2
#7
Abdelali Boussadi, Eric Zapletal
BACKGROUND: Standards and technical specifications have been developed to define how the information contained in Electronic Health Records (EHRs) should be structured, semantically described, and communicated. Current trends rely on differentiating the representation of data instances from the definition of clinical information models. The dual model approach, which combines a reference model (RM) and a clinical information model (CIM), sets in practice this software design pattern. The most recent initiative, proposed by HL7, is called Fast Health Interoperability Resources (FHIR)...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28805361/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the-long-term-care-hospital-prospective-payment-system-and-policy-changes-and-fiscal-year-2018-rates-quality-reporting-requirements-for-specific-providers-medicare
#8
(no author information available yet)
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation...
August 14, 2017: Federal Register
https://www.readbyqxmd.com/read/28804870/effect-of-the-tool-to-reduce-inappropriate-medications-on-medication-communication-and-deprescribing
#9
Terri R Fried, Kristina M Niehoff, Richard L Street, Peter A Charpentier, Nallakkandi Rajeevan, Perry L Miller, Mary K Goldstein, John R O'Leary, Brenda T Fenton
OBJECTIVES: To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN: Randomized clinical trial. SETTING: Primary care clinics at a Veterans Affairs Medical Center. PARTICIPANTS: Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128)...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28804791/intelligent-mortality-reporting-with-fhir
#10
Ryan A Hoffman, Hang Wu, Janani Venugopalan, Paula Braun, May D Wang
One pressing need in the area of public health is timely, accurate, and complete reporting of deaths and the conditions leading up to them. Fast Healthcare Interoperability Resources (FHIR) is a new HL7 interoperability standard for electronic health record (EHR), while Sustainable Medical Applications and Reusable Technologies (SMART)-on-FHIR enables third-party app development that can work "out of the box". This research demonstrates the feasibility of developing SMART-on-FHIR applications to enable medical professionals to perform timely and accurate death reporting within multiple different jurisdictions of US...
February 2017: IEEE-EMBS International Conference on Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28800599/extracting-information-from-free-text-electronic-patient-records-to-identify-practice-based-evidence-of-the-performance-of-coronary-stents
#11
Yoon Seob Kim, Dukyong Yoon, JungHyun Byun, Hojun Park, Ahram Lee, Il Hyun Kim, Sukhoon Lee, Hong-Seok Lim, Rae Woong Park
BACKGROUND AND OBJECTIVE: Percutaneous coronary intervention (PCI) using drug-eluting stents (DES) is an indispensable treatment for coronary artery disease. However, to evaluate the performance of various types of stents for PCI, numerous resources are required. We extracted clinical information from free-text records and, using practice-based evidence, compared the efficacy of various DES. MATERIALS AND METHODS: We developed a text mining tool based on regular expression and applied it to PCI reports stored in the electronic health records (EHRs) of Ajou University Hospital from 2010-2014...
2017: PloS One
https://www.readbyqxmd.com/read/28800265/use-of-snomed-ct%C3%A2-and-loinc%C3%A2-to-standardize-terminology-for-primary-care-asthma-electronic-health-records
#12
M Diane Lougheed, Nicola J Thomas, Nastasia V Wasilewski, Alison H Morra, Janice P Minard
OBJECTIVES: The burden of asthma ranks among the highest for chronic diseases. Interoperable EHRs can improve the management of chronic diseases such as asthma by facilitating sharing of data between health care settings along the continuum of care. Terminology such as SNOMED CT® (Systematized Nomenclature of Medicine-Clinical Terms) and LOINC® (Logistical Observation Identifier Names and Codes) are prerequisites for interoperability of electronic health records (EHRs). We sought to determine the extent to which data elements in a validated asthma care map (ACM) are congruent with these terminologies...
August 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28798013/an-electronic-health-record-based-strategy-to-systematically-assess-medication-use-among-primary-care-patients-with-multidrug-regimens-feasibility-study
#13
Stacy Cooper Bailey, Christine U Oramasionwu, Alexandra C Infanzon, Emily R Pfaff, Izabela E Annis, Daniel S Reuland
BACKGROUND: Medication nonadherence and misuse are public health and patient safety concerns. With the increased adoption of electronic health records (EHRs), greater opportunities exist to communicate directly with, and collect data from, patients through secure portals linked to EHRs. OBJECTIVE: The study objectives were to develop and pilot test a method of monitoring patient medication use in outpatient settings and determine the feasibility and acceptability of this approach...
August 10, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28796625/collaborative-ehealth-meets-security-privacy-enhancing-patient-profile-management
#14
Rosa Sanchez-Guerrero, Florina Almenarez, Daniel Diaz-Sanchez, Patricia Arias, Andres Marin
Collaborative healthcare environments offer potential benefits, including enhancing the healthcare quality delivered to patients and reducing costs. As a direct consequence, sharing of Electronic Health Records (EHRs) among healthcare providers has experienced a noteworthy growth in the last years, since it enables physicians to remotely monitor patients' health and enables individuals to manage their own health data more easily. However, these scenarios face significant challenges regarding security and privacy of the extremely sensitive information contained in EHRs...
August 7, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28795061/a-multi-agent-based-approach-for-prehospital-emergency-management
#15
Reza Safdari, Jaleh Shoshtarian Malak, Niloofar Mohammadzadeh, Azimeh Danesh Shahraki
OBJECTIVE: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. METHODS: Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28790075/implementation-of-a-pharmacist-managed-clinic-for-patients-with-chronic-nonmalignant-pain
#16
Jessica L Norman, Miranda E Kroehl, Huong Mindy Lam, Carmen L Lewis, Chelsea N Mitchell, Cindy L O'Bryant, Katy E Trinkley
PURPOSE: A pharmacist-managed chronic pain clinic (PMCPC) in a primary care setting is described. SUMMARY: As primary care providers (PCPs) may be unprepared or lack time to manage high-risk patients receiving opioids for chronic nonmalignant pain, alternative models of care are needed. The University of Colorado PMCPC is integrated into an internal medicine outpatient clinic. The PMCPC is staffed by 1 clinical pharmacist, with pharmacy students and residents also performing clinic duties...
August 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28776047/an-interoperable-similarity-based-cohort-identification-method-using-the-omop-common-data-model-version-5-0
#17
Shreya Chakrabarti, Anando Sen, Vojtech Huser, Gregory W Hruby, Alexander Rusanov, David J Albers, Chunhua Weng
Cohort identification for clinical studies tends to be laborious, time-consuming, and expensive. Developing automated or semi-automated methods for cohort identification is one of the "holy grails" in the field of biomedical informatics. We propose a high-throughput similarity-based cohort identification algorithm by applying numerical abstractions on Electronic Health Records (EHR) data. We implement this algorithm using the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM), which enables sites using this standardized EHR data representation to avail this algorithm with minimum effort for local implementation...
June 2017: J Healthc Inform Res
https://www.readbyqxmd.com/read/28769599/identification-of-people-with-acquired-hemophilia-in-a-large-electronic-health-record-database
#18
Michael Wang, Anissa Cyhaniuk, David L Cooper, Neeraj N Iyer
BACKGROUND: Electronic health records (EHRs) can provide insights into diagnoses, treatment patterns, and clinical outcomes. Acquired hemophilia (AH) is an ultrarare bleeding disorder characterized by factor VIII inhibiting autoantibodies. AIM: To identify patients with AH using an EHR database. METHODS: Records were accessed from a large EHR database (Humedica) between January 1, 2007 and July 31, 2013. Broad selection criteria were applied using the International Classification of Diseases, Ninth Revision, clinical modification (ICD-9-CM) code for intrinsic circulating anticoagulants (286...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/28766194/macra-and-the-changing-medicare-payment-landscape
#19
Steven L Chen, Matthew R Coffron
BACKGROUND: The Medicare Access and CHIP Reauthorization Act (MACRA) is being implemented in 2017 by the Centers for Medicare and Medicaid Services (CMS) as the Quality Payment Program (QPP) and will have important and far reaching effects on how physicians are reimbursed and on how they practice. The QPP modifies the Medicare physician payment system by eliminating the Sustainable Growth Rate formula and incorporating the existing Physician Quality Reporting System, EHR Incentive Program, and the Value Modifier into a single new Merit-based Incentive Payment System (MIPS)...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28765864/comparison-of-ehr-based-diagnosis-documentation-locations-to-a-gold-standard-for-risk-stratification-in-patients-with-multiple-chronic-conditions
#20
Shelby Martin, Jesse Wagner, Nicoleta Lupulescu-Mann, Katrina Ramsey, Aaron Cohen, Peter Graven, Nicole G Weiskopf, David A Dorr
OBJECTIVE: To measure variation among four different Electronic Health Record (EHR) system documentation locations versus 'gold standard' manual chart review for risk stratification in patients with multiple chronic illnesses. METHODS: Adults seen in primary care with EHR evidence of at least one of 13 conditions were included. EHRs were manually reviewed to determine presence of active diagnoses, and risk scores were calculated using three different methodologies and five EHR documentation locations...
August 2, 2017: Applied Clinical Informatics
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