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Lipika Samal, John D D'Amore, David W Bates, Adam Wright
Background and Objective: Clinical decision support tools for risk prediction are readily available, but typically require workflow interruptions and manual data entry so are rarely used. Due to new data interoperability standards for electronic health records (EHRs), other options are available. As a clinical case study, we sought to build a scalable, web-based system that would automate calculation of kidney failure risk and display clinical decision support to users in primary care practices...
November 1, 2017: Journal of the American Medical Informatics Association: JAMIA
Dominik Brammen, Heike Dewenter, Volker Thiemann, Raphael W Majeed, Tingyan Xu, Kai U Heitmann, Felix Walcher, Sylvia Thun, Rainer Röhrig
A standardized medical record for the emergency department (GEDMR) was released in Germany, but only sparsely and randomly implemented by emergency department (ED) electronic health record (EHR) vendors. A reason for this may be a lacking common language between the medical and the Health Information Technology (HIT) domain. HL7 clinical document architecture (CDA) may leverage this communication gap. This paper reports on the effects of a professional medical association record standard on EHR vendors and the German ED-EHR market...
2017: Studies in Health Technology and Informatics
Steve Bonney
No abstract text is available yet for this article.
November 2015: Journal of AHIMA
M Topaz, D L Seger, F Goss, K Lai, S P Slight, J J Lau, H Nandigam, L Zhou
BACKGROUND: Adverse sensitivity (e.g., allergy and intolerance) information is a critical component of any electronic health record system. While several standards exist for structured entry of adverse sensitivity information, many clinicians record this data as free text. OBJECTIVES: This study aimed to 1) identify and compare the existing common adverse sensitivity information models, and 2) to evaluate the coverage of the adverse sensitivity information models for representing allergy information on a subset of inpatient and outpatient adverse sensitivity clinical notes...
2016: Methods of Information in Medicine
Susan A Matney, Gay Dolin, Lindy Buhl, Amy Sheide
A care plan provides a patient, family, or community picture and outlines the care to be provided. The Health Level Seven Consolidated Clinical Document Architecture (C-CDA) Release 2 Care Plan Document is used to structure care plan data when sharing the care plan between systems and/or settings. The American Nurses Association has recommended the use of two terminologies, Logical Observation Identifiers Names and Codes (LOINC) for assessments and outcomes and Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) for problems, procedures (interventions), outcomes, and observation findings within the C-CDA...
March 2016: Computers, Informatics, Nursing: CIN
Jeremy L Warner, Suzanne E Maddux, Kevin S Hughes, John C Krauss, Peter Paul Yu, Lawrence N Shulman, Deborah K Mayer, Mike Hogarth, Mark Shafarman, Allison Stover Fiscalini, Laura Esserman, Liora Alschuler, George Augustine Koromia, Zabrina Gonzaga, Edward P Ambinder
OBJECTIVE: Develop and evaluate a foundational oncology-specific standard for the communication and coordination of care throughout the cancer journey, with early-stage breast cancer as the use case. MATERIALS AND METHODS: Owing to broad uptake of the Health Level Seven (HL7) Consolidated Clinical Document Architecture (C-CDA) by health information exchanges and large provider organizations, we developed an implementation guide in congruence with C-CDA. The resultant product was balloted through the HL7 process and subsequently implemented by two groups: the Health Story Project (Health Story) and the Athena Breast Health Network (Athena)...
May 2015: Journal of the American Medical Informatics Association: JAMIA
Matthew D Alvin, Thomas E Mroz
BACKGROUND: Cervical disc arthroplasty (CDA) is a novel motion-preserving procedure that is an alternative to fusion. The Mobi-C disc prosthesis, one of many Food and Drug Administration (FDA)-approved devices for CDA, is the only FDA-approved prosthesis for two-level CDA. Hence, it may allow for improved outcomes compared with multilevel fusion procedures. PURPOSE: To critically assess the available literature on CDA with the Mobi-C prosthesis, with a focus on two-level CDA...
2014: Medical Devices: Evidence and Research
Jeffrey G Klann, Michael Mendis, Lori C Phillips, Alyssa P Goodson, Beatriz H Rocha, Howard S Goldberg, Nich Wattanasin, Shawn N Murphy
OBJECTIVE: Clinical data warehouses have accelerated clinical research, but even with available open source tools, there is a high barrier to entry due to the complexity of normalizing and importing data. The Office of the National Coordinator for Health Information Technology's Meaningful Use Incentive Program now requires that electronic health record systems produce standardized consolidated clinical document architecture (C-CDA) documents. Here, we leverage this data source to create a low volume standards based import pipeline for the Informatics for Integrating Biology and the Bedside (i2b2) clinical research platform...
March 2015: Journal of the American Medical Informatics Association: JAMIA
Guilherme Del Fiol, Barbara Insley Crouch, Mollie R Cummins
OBJECTIVE: Poison control centers (PCCs) routinely collaborate with emergency departments (EDs) to provide care for poison-exposed patients. During this process, a significant amount of information is exchanged between EDs and PCCs via telephone, leading to important inefficiencies and safety vulnerabilities. In the present work, we identified and assessed a set of data standards to enable a standards-based health information exchange process between EDs and PCCs. MATERIALS AND METHODS: Based on a reference model for PCC-ED health information exchange, we (1) mapped PCC-ED information exchange events to clinical documents specified in the Health Level Seven (HL7) Consolidated Clinical Document Architecture (C-CDA) Standard, and (2) mapped information types routinely exchanged in PCC-ED telephone conversations to C-CDA sections...
May 2015: Journal of the American Medical Informatics Association: JAMIA
Catherine Chronaki, Ana Estelrich, Giorgio Cangioli, Marcello Melgara, Dipak Kalra, Zabrina Gonzaga, Larry Garber, Elaine Blechman, Jamie Ferguson, Stephen Kay
In an increasingly mobile world, many citizens and professionals are frequent travellers. Access during unplanned care to their patient summary, their most essential health information in a form physicians in another country can understand can impact not only their safety, but also the quality and effectiveness of care. International health information technology (HIT) standards such as HL7 CDA have been developed to advance interoperability. Implementation guides (IG) and IHE profiles constrain standards and make them fit for the purpose of specific use cases...
2014: Studies in Health Technology and Informatics
Robert James Campbell
No abstract text is available yet for this article.
July 2014: Journal of AHIMA
John D D'Amore, Joshua C Mandel, David A Kreda, Ashley Swain, George A Koromia, Sumesh Sundareswaran, Liora Alschuler, Robert H Dolin, Kenneth D Mandl, Isaac S Kohane, Rachel B Ramoni
BACKGROUND AND OBJECTIVE: Upgrades to electronic health record (EHR) systems scheduled to be introduced in the USA in 2014 will advance document interoperability between care providers. Specifically, the second stage of the federal incentive program for EHR adoption, known as Meaningful Use, requires use of the Consolidated Clinical Document Architecture (C-CDA) for document exchange. In an effort to examine and improve C-CDA based exchange, the SMART (Substitutable Medical Applications and Reusable Technology) C-CDA Collaborative brought together a group of certified EHR and other health information technology vendors...
November 2014: Journal of the American Medical Informatics Association: JAMIA
Vienna Ludovini, Irene Floriani, Lorenza Pistola, Vincenzo Minotti, Marialuisa Meacci, Rita Chiari, Daniela Garavaglia, Francesca Romana Tofanetti, Antonella Flacco, Annamaria Siggillino, Elisa Baldelli, Maurizio Tonato, Lucio Crinò
BACKGROUND: Selecting patients according to key genetic characteristics may help to tailor chemotherapy and optimize the treatment in non-small cell lung cancer (NSCLC). Genetic variations in drug metabolism may affect the clinical response, toxicity, and prognosis of NSCLC patients treated with cisplatin/gemcitabine-based therapy. PATIENTS AND METHODS: We evaluated seven single-nucleotide polymorphisms of six genes CDA Lys27Gln (A/C); CDA C435T; ERCC1 C118T; XRCC3 Thr241Met (C/T); XPD Lys751Gln (A/C); P53 Arg72Pro (G/C), and RRM1 C524T in 192 chemotherapy-naive patients with advanced NSCLC treated with cisplatin/gemcitabine-based regimen by TaqMan probe-based assays with 7300 Real-Time PCR System, using genomic DNA extracted from blood samples...
December 2011: Journal of Thoracic Oncology
M Joerger, J A Burgers, P Baas, V D Doodeman, P H M Smits, R S Jansen, L D Vainchtein, H Rosing, A D R Huitema, J H Beijnen, J H M Schellens
BACKGROUND: This study quantified the impact of drug pathway-associated genetic variants on the pharmacokinetics (PK) of gemcitabine and cisplatin in patients with advanced non-small-cell lung cancer (NSCLC). METHODS: Thirty-seven patients with advanced NSCLC were sampled for plasma concentrations of gemcitabine, difluoro-deoxy uridine (dFdU), intracellular gemcitabine triphosphates (dFdCTP), and unbound platinum concentrations after gemcitabine 1,250 mg/m(2) i...
January 2012: Cancer Chemotherapy and Pharmacology
C Grünauer-Kloevekorn, S Bräutigam, M Wolter-Roessler, F Tost, E Weidle, U Froster, G I W Duncker
BACKGROUND: Mutations of the BIGH3 gene were delineated as the underlying gene defect for corneal dystrophy Lattice Type I (CDL1) and corneal dystrophy Avellino type (CDA) in families with different regional provenance. Missense mutations in exon 4 with single base pair substitution which result in amino acid alterations Arg124Cys (CDL1) and ARG124His are described as hot spots. We report on histopathological and molecular genetic investigations in 2 German families and a single patient with CDL1 and CDA...
December 2005: Klinische Monatsblätter Für Augenheilkunde
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