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https://www.readbyqxmd.com/read/28445624/the-role-of-publicly-funded-family-planning-sites-in-health-insurance-enrollment
#1
Jennifer Yarger, Sara Daniel, M Antonia Biggs, Jan Malvin, Claire D Brindis
CONTEXT: Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. METHODS: In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance...
April 26, 2017: Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#2
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28444652/-establishment-of-specialized-pediatric-palliative-home-care-in-the-medical-valley-of-the-european-metropolitan-area-nuremberg
#3
Steven Hébert, Chara Gravou-Apostolatou, Wolfgang Rascher
Background As part of the 2007 health reform in Germany the structure of outpatient palliative care for children and adolescents was adopted for the first time and then implemented in Erlangen-Nuremberg in 2009. Methods The introduction of Pediatric Palliative Home Care (PPHC) at the Hospital for Children and Adolescents at the University of Erlangen-Nuremberg was retrospectively analyzed between the years 2009 to 2014. Referring medical records (paper-based and electronic) were evaluated systematically. Results Considering 69 patients within this study, 44 (63...
March 2017: Klinische Pädiatrie
https://www.readbyqxmd.com/read/28444383/optimizing-drug-dose-alerts-using-commercial-software-throughout-an-integrated-health-care-system
#4
Salim M Saiyed, Peter J Greco, Glenn Fernandes, David C Kaelber
All default electronic health record and drug reference database vendor drug-dose alerting recommendations (single dose, daily dose, dose frequency, and dose duration) were silently turned on in inpatient, outpatient, and emergency department areas for pediatric-only and nonpediatric-only populations. Drug-dose alerts were evaluated during a 3-month period. Drug-dose alerts fired on 12% of orders (104 098/834 911). System-level and drug-specific strategies to decrease drug-dose alerts were analyzed. System-level strategies included: (1) turning off all minimum drug-dosing alerts, (2) turning off all incomplete information drug-dosing alerts, (3) increasing the maximum single-dose drug-dose alert threshold to 125%, (4) increasing the daily dose maximum drug-dose alert threshold to 125%, and (5) increasing the dose frequency drug-dose alert threshold to more than 2 doses per day above initial threshold...
April 24, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28444213/representation-of-occupational-information-across-resources-and-validation-of-the-occupational-data-for-health-model
#5
Sripriya Rajamani, Elizabeth S Chen, Elizabeth Lindemann, Ranyah Aldekhyyel, Yan Wang, Genevieve B Melton
Reports by the National Academy of Medicine and leading public health organizations advocate including occupational information as part of an individual's social context. Given recent National Academy of Medicine recommendations on occupation-related data in the electronic health record, there is a critical need for improved representation. The National Institute for Occupational Safety and Health has developed an Occupational Data for Health (ODH) model, currently in draft format. This study aimed to validate the ODH model by mapping occupation-related elements from resources representing recommendations, standards, public health reports and surveys, and research measures, along with preliminary evaluation of associated value sets...
April 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28443275/integration-of-hiv-testing-into-maternal-newborn-and-child-health-weeks-for-improved-case-finding-and-linkage-to-prevention-of-mother-to-child-transmission-services-in-benue-state-nigeria
#6
Olusoji Akinleye, Gideon Dura, Arjan de Wagt, Abiola Davies, Dick Chamla
BACKGROUND: In Nigeria, maternal, newborn, and child health (MNCH) weeks are campaign-like events designed to accelerate progress toward Millennium Development Goals. The authors examined whether integrating HIV testing into MNCH weeks was feasible and could lead to increased case finding and linkage to prevention of mother-to-child transmission (PMTCT) services. METHODS: Pregnant women attending MNCH week during the first week of December 2014 in 13 local government areas in Benue State were provided with HIV tests and referrals to PMTCT services...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28442772/discriminative-and-distinct-phenotyping-by-constrained-tensor-factorization
#7
Yejin Kim, Robert El-Kareh, Jimeng Sun, Hwanjo Yu, Xiaoqian Jiang
Adoption of Electronic Health Record (EHR) systems has led to collection of massive healthcare data, which creates oppor- tunities and challenges to study them. Computational phenotyping offers a promising way to convert the sparse and complex data into meaningful concepts that are interpretable to healthcare givers to make use of them. We propose a novel su- pervised nonnegative tensor factorization methodology that derives discriminative and distinct phenotypes. We represented co-occurrence of diagnoses and prescriptions in EHRs as a third-order tensor, and decomposed it using the CP algorithm...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28442433/electronic-health-record-as-a-research-tool-frequency-of-exposure-to-targeted-clinical-problems-and-health-care-providers-clinical-proficiency
#8
Tim Wysocki, Maria Carmen G Diaz, James H Crutchfield, James P Franciosi, Lloyd N Werk
OBJECTIVES: The Electronic Health Record (EHR) could provide insight into possible decay in health care providers' (HCP) clinical knowledge and cognitive performance. Analyses of the contributions of variables such as frequency of exposure to targeted clinical problems could inform the development and testing of appropriate individualized interventions to mitigate these threats to quality and safety of care. MATERIALS/METHODS: Nine targeted clinical problems (TCP) were selected for further study, and de-identified, aggregated study data were obtained for one calendar year...
April 22, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28441696/declining-blood-pressure-and-intensification-of-blood-pressure-management-among-people-over-80-years-cohort-study-using-electronic-health-records
#9
Rathi Ravindrarajah, Alex Dregan, Nisha C Hazra, Shota Hamada, Stephen H D Jackson, Martin C Gulliford
BACKGROUND: Management of high blood pressure (BP) in people over 80 years is controversial, but there is limited information available concerning the uptake of hypertension treatment at this age. OBJECTIVE: To evaluate use of antihypertensive drugs and changes in SBP and DBP from 2001 to 2014 in men and women aged 80 years and over. METHODS: Cohort study using primary care electronic health records of 265 225 participants from the UK Clinical Practice Research Datalink...
June 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#10
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441234/validation-of-an-administrative-definition-of-icu-admission-using-revenue-center-codes
#11
Gary E Weissman, Rebecca A Hubbard, Rachel Kohn, George L Anesi, Scott Manaker, Meeta Prasad Kerlin, Scott D Halpern
OBJECTIVES: Describe the operating characteristics of a proposed set of revenue center codes to correctly identify ICU stays among hospitalized patients. DESIGN: Retrospective cohort study. We report the operating characteristics of all ICU-related revenue center codes for intensive and coronary care, excluding nursery, intermediate, and incremental care, to identify ICU stays. We use a classification and regression tree model to further refine identification of ICU stays using administrative data...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28440839/refugee-health-and-rehabilitation-challenges-and-response
#12
Fary Khan, Bhasker Amatya
BACKGROUND: The current global refugee crisis poses major challenges in providing effective healthcare to refugees, particularly for non-communicable diseases (NCDs) management and disability. This article provides an overview of refugee health and potential challenges from the rehabilitation perspective. METHODS: A literature search (both academic and grey literature) was conducted using medical and health science electronic databases and internet search engines (2001-2016)...
April 21, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28440047/mental-illness-in-bariatric-surgery-a-cohort-study-from-the-portal-network
#13
David Fisher, Karen J Coleman, David E Arterburn, Heidi Fischer, Ayae Yamamoto, Deborah R Young, Nancy E Sherwood, Connie Mah Trinacty, Kristina H Lewis
OBJECTIVE: To compare bariatric surgery outcomes according to preoperative mental illness category. METHODS: Electronic health record data from several US healthcare systems were used to compare outcomes of four groups of patients who underwent bariatric surgery in 2012 and 2013. These included the following: people with (1) no mental illness, (2) mild-to-moderate depression or anxiety, (3) severe depression or anxiety, and (4) bipolar, psychosis, or schizophrenia spectrum disorders...
May 2017: Obesity
https://www.readbyqxmd.com/read/28439179/big-data-science-opportunities-and-challenges-to-address-minority-health-and-health-disparities-in-the-21st-century
#14
Xinzhi Zhang, Eliseo J Pérez-Stable, Philip E Bourne, Emmanuel Peprah, O Kenrik Duru, Nancy Breen, David Berrigan, Fred Wood, James S Jackson, David W S Wong, Joshua Denny
Addressing minority health and health disparities has been a missing piece of the puzzle in Big Data science. This article focuses on three priority opportunities that Big Data science may offer to the reduction of health and health care disparities. One opportunity is to incorporate standardized information on demographic and social determinants in electronic health records in order to target ways to improve quality of care for the most disadvantaged populations over time. A second opportunity is to enhance public health surveillance by linking geographical variables and social determinants of health for geographically defined populations to clinical data and health outcomes...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28438733/use-and-customization-of-risk-scores-for-predicting-cardiovascular-events-using-electronic-health-record-data
#15
Julian Wolfson, David M Vock, Sunayan Bandyopadhyay, Thomas Kottke, Gabriela Vazquez-Benitez, Paul Johnson, Gediminas Adomavicius, Patrick J O'Connor
BACKGROUND: Clinicians who are using the Framingham Risk Score (FRS) or the American College of Cardiology/American Heart Association Pooled Cohort Equations (PCE) to estimate risk for their patients based on electronic health data (EHD) face 4 questions. (1) Do published risk scores applied to EHD yield accurate estimates of cardiovascular risk? (2) Are FRS risk estimates, which are based on data that are up to 45 years old, valid for a contemporary patient population seeking routine care? (3) Do the PCE make the FRS obsolete? (4) Does refitting the risk score using EHD improve the accuracy of risk estimates? METHODS AND RESULTS: Data were extracted from the EHD of 84 116 adults aged 40 to 79 years who received care at a large healthcare delivery and insurance organization between 2001 and 2011...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28438503/expanding-role-of-certified-electronic-health-records-technology-in-radiology-the-macra-mandate
#16
Gregory N Nicola, Andrew B Rosenkrantz, Joshua A Hirsch, Ezequiel Silva, Keith J Dreyer, Michael P Recht
Radiology has historically been at the forefront of innovation and the advancement of technology for the benefit of patient care. However, challenges to early implementation prevented most radiologists from adopting and integrating certified electronic health record technology (CEHRT) into their daily workflow despite the early and potential advantages it offered. This circumstance places radiology at a disadvantage in the two payment pathways of the Medicare Access and CHIP Reauthorization Act of 2015: the Merit-Based Incentive Payment System (MIPS) and advanced alternative payment models (APMs)...
April 19, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28438334/understanding-patterns-of-injury-in-kenya-analysis-of-a-trauma-registry-data-from-a-national-referral-hospital
#17
Isaac M Botchey, Yuen Wai Hung, Abdulgafoor M Bachani, Hassan Saidi, Fatima Paruk, Adnan A Hyder
BACKGROUND: Injuries contribute to a substantial proportion of the burden of disease in Kenya. Trauma registries can be a very useful source of data to understand patterns of injuries and serve to provide information about potential improvements in the care of injured patients. In Kenya, health facility-based injury data has been largely administrative. Our aim was to develop and implement a prospective trauma registry at the largest trauma hospital in Kenya, the Kenyatta National Hospital, and to understand the nature of injuries presenting to the hospital, their treatment and care, and their outcomes...
April 21, 2017: Surgery
https://www.readbyqxmd.com/read/28438048/the-impact-of-infant-well-child-care-compliance-and-social-risks-on-emergency-department-utilization
#18
Nikki R Lawson, Melissa D Klein, Nicholas J Ollberding, Victoria Wurster Ovalle, Andrew F Beck
Deployment of medical and social services at well-child visits promotes child health. A retrospective review of the electronic health record was conducted for infants presenting for their "newborn" visit over a 2-year period at an urban, academic primary care center. Primary outcomes were time to first emergency department (ED) visit, number of ED visits (emergent or nonemergent), and number of nonemergent ED visits by 2 years of life. Records from 212 consecutive newborns were evaluated-59.9% were black/African American and 84...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#19
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435342/patient-web-portals-disease-management-and-primary-prevention
#20
REVIEW
Steven S Coughlin, Judith J Prochaska, Lovoria B Williams, Gina M Besenyi, Vahé Heboyan, D Stephen Goggans, Wonsuk Yoo, Gianluca De Leo
BACKGROUND: Efforts aimed at health care reform and continued advances in information technologies have prompted interest among providers and researchers in patient web portals. Patient web portals are password-protected online websites that offer the patients 24-hour access to personal health information from anywhere with an Internet connection. METHODS: This article, which is based upon bibliographic searches in PubMed, reviews important developments in web portals for primary and secondary disease prevention, including patient web portals tethered to electronic medical records, disease-specific portals, health disparities, and health-related community web portals...
2017: Risk Management and Healthcare Policy
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