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https://www.readbyqxmd.com/read/29792312/identification-of-patients-with-hemoglobin-ss-s%C3%AE-0-thalassemia-disease-and-pain-crises-within-electronic-health-records
#1
Ashima Singh, Javier Mora, Julie A Panepinto
Electronic health records (EHRs) are a source of big data that provide opportunities for conducting population-based studies and creating learning health systems, especially for rare conditions such as sickle cell disease (SCD). The objective of our study is to validate algorithms for accurate identification of patients with hemoglobin (Hb) SS/Sβ0 thalassemia and acute care encounters for pain among SCD patients within EHR warehouse. We used data for children receiving care at Children's Hospital of Wisconsin from 2013 to 2016 to test the accuracy of the 2 algorithms...
June 12, 2018: Blood Advances
https://www.readbyqxmd.com/read/29792259/going-digital-a-checklist-in-preparing-for-hospital-wide-electronic-medical-record-implementation-and-digital-transformation
#2
Ian A Scott, Clair Sullivan, Andrew Staib
Objective In an era of rapid digitisation of Australian hospitals, practical guidance is needed in how to successfully implement electronic medical records (EMRs) as both a technical innovation and a major transformative change in clinical care. The aim of the present study was to develop a checklist that clearly and comprehensively defines the steps that best prepare hospitals for EMR implementation and digital transformation. Methods The checklist was developed using a formal methodological framework comprised of: literature reviews of relevant issues; an interactive workshop involving a multidisciplinary group of digital leads from Queensland hospitals; a draft document based on literature and workshop proceedings; and a review and feedback from senior clinical leads...
May 24, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29792051/predicting-suicide-attempts-and-suicide-deaths-following-outpatient-visits-using-electronic-health-records
#3
Gregory E Simon, Eric Johnson, Jean M Lawrence, Rebecca C Rossom, Brian Ahmedani, Frances L Lynch, Arne Beck, Beth Waitzfelder, Rebecca Ziebell, Robert B Penfold, Susan M Shortreed
OBJECTIVE: The authors sought to develop and validate models using electronic health records to predict suicide attempt and suicide death following an outpatient visit. METHOD: Across seven health systems, 2,960,929 patients age 13 or older (mean age, 46 years; 62% female) made 10,275,853 specialty mental health visits and 9,685,206 primary care visits with mental health diagnoses between Jan. 1, 2009, and June 30, 2015. Health system records and state death certificate data identified suicide attempts (N=24,133) and suicide deaths (N=1,240) over 90 days following each visit...
May 24, 2018: American Journal of Psychiatry
https://www.readbyqxmd.com/read/29790815/maternal-psychosocial-stress-and-children-s-adhd-diagnosis-a-prospective-birth-cohort-study
#4
Lauren Okano, Yuelong Ji, Anne W Riley, Xiaobin Wang
OBJECTIVE: Examine the association of mothers' psychosocial stressors before and during pregnancy with their children's diagnosis of attention deficit hyperactivity disorder (ADHD). METHODS: This study included 2140 mother-child pairs who had at least one postnatal pediatric visit at the Boston Medical Center between 2003 and 2015. Child ADHD was determined via International Classification of Diseases, Ninth Revision (ICD-9) codes documented in electronic medical records...
May 23, 2018: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29790625/managing-paediatric-bleeding-disorder-patients-undergoing-surgical-procedures-leveraging-the-electronic-medical-record
#5
C Tarango, D Dahale, N Dodson, A Otte, P J Schoettker
INTRODUCTION: Individuals with bleeding disorders have a high risk of bleeding complications with surgical procedures. Careful planning and management of peri-operative treatment is vital for their safety. Yet, inter-provider communication and communication between patients/families and providers is not reliable. AIM: Our haemophilia treatment centre (HTC) created a care gap report that used the electronic medical record to inform our team when patients with bleeding disorders were scheduled for procedures...
May 23, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29790177/mri-based-emvi-positivity-predicts-systemic-recurrence-in-rectal-cancer-patients-with-a-good-tumor-response-to-chemoradiotherapy-followed-by-surgery
#6
Min Soo Cho, Youn Young Park, Jiho Yoon, Seung Yoon Yang, Seung Hyuk Baik, Kang Young Lee, Ik Yong Kim, Nam Kyu Kim
BACKGROUND: This study aimed to determine the prognostic value of baseline magnetic resonance imaging-based extramural vascular invasion status (EMVI) among rectal cancer patients with a good tumor response to standard chemoradiotherapy followed by surgery. METHODS: A total of 359 patients with ypT0-2/N0 disease from The Yonsei Multicenter Colorectal Cancer Electronic Database were retrospectively included between January 2000 and December 2014. Magnetic resonance images and medical records were reviewed to investigate risk factors for tumor recurrence...
May 22, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29790040/building-behavioral-health-homes-clinician-and-staff-perspectives-on-creating-integrated-care-teams
#7
Tracy Anastas, Elizabeth Needham Waddell, Sonya Howk, Mark Remiker, Gretchen Horton-Dunbar, L J Fagnan
Adults with serious mental illness and substance use disorders have elevated risk of mortality and higher healthcare costs compared to the general population. As these disparities have been linked to poor management of co-occurring chronic conditions in primary care, the behavioral health setting may be a preferred setting for routine medical screening and treatment. This qualitative study describes early stages of integrating care teams in emerging medical homes based in mental health and addiction treatment settings...
May 22, 2018: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29789607/point-of-care-microspirometry-to-facilitate-the-copd-diagnostic-process-in-primary-care-a-clustered-randomised-trial
#8
Tjard R Schermer, Maria Vatsolaki, Robbert Behr, Joke Grootens, Riet Cretier, Reinier Akkermans, Joke Denis, Patrick Poels, Lisette van den Bemt
We studied if pre-bronchodilator FEV1 /FEV6 determinations with microspirometers by GPs improve the diagnostic process for COPD in a 6-8 month clustered randomised controlled trial in Dutch general practices ( http://www.trialregister.nl : NTR4041). GPs allocated to microspirometry (MI) used COPD-6® microspirometers in patients ≥50 years old with a smoking history and respiratory complaints that could indicate undiagnosed COPD and ask to refer patients for full spirometry if MI was positive (FEV1 /FEV6 <0...
May 22, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29788914/nutrition-care-practices-of-primary-care-providers-for-weight-management-in-multidisciplinary-primary-care-settings-in-ontario-canada-a-qualitative-study
#9
Stephanie Aboueid, Ivy Bourgeault, Isabelle Giroux
BACKGROUND: Despite the recommended guidelines on addressing diet for the management and prevention of obesity in primary care, the literature highlights that their implementation has been suboptimal. In this paper, we provide an in-depth understanding of current nutrition-related weight management practices of primary care providers (PCPs) working in relatively new multidisciplinary health care settings in Ontario. METHODS: Three types of multidisciplinary primary care settings were included (2 Family Health Teams, 3 Community Health Centres and 1 Nurse Practitioner-Led Clinic)...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788842/veno-arterio-venous-ecmo-for-septic-cardiomyopathy-a-single-centre-experience
#10
Dominik J Vogel, Josie Murray, Adam Z Czapran, Luigi Camporota, Nicholas Ioannou, Chris I S Meadows, Peter B Sherren, Kathleen Daly, Nigel Gooby, Nicholas Barrett
INTRODUCTION: The role of extracorporeal support for patients with septic shock remains unclear. METHODS: We conducted a retrospective analysis of our single-centre experience with veno-arterio-venous extracorporeal membrane oxygenation (VAV ECMO) in adult patients with severe respiratory failure and septic cardiomyopathy. Clinical data was extracted from electronic medical records including a dedicated ECMO referral and follow-up database. RESULTS: Twelve patients were commenced on VAV ECMO for septic cardiomyopathy for a median of four days (IQR 3...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29787411/perianesthetic-and-anesthesia-related-mortality-in-a-southeastern-united-states-population-a-longitudinal-review-of-a-prospectively-collected-quality-assurance-data-base
#11
Richard J Pollard, Thomas Hopkins, C Tyler Smith, Bryan V May, James Doyle, C Labron Chambers, Reese Clark, William Buhrman
BACKGROUND: Perianesthetic mortality (death occurring within 48 hours of an anesthetic) continues to vary widely depending on the study population examined. The authors study in a private practice physician group that covers multiple anesthetizing locations in the Southeastern United States. This group has in place a robust quality assurance (QA) database to follow all patients undergoing anesthesia. With this study, we estimate the incidence of anesthesia-related and perianesthetic mortality in this QA database...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787406/effect-of-patient-and-provider-education-on-antibiotic-overuse-for-respiratory-tract-infections
#12
Erin Chiswell, Debra Hampton, Chizimuzo T C Okoli
Antibiotic overuse for respiratory tract infections (RTIs) in primary care (PC) is a known important contributor to the serious health threat of antibiotic resistance, yet remains a difficult problem to improve. The purpose of the study was to assess the effects of a combination patient and provider education program on antibiotic prescribing in RTIs in a rural primary care clinic. Utilizing a quasi-experimental pretest-posttest design, a retrospective electronic medical record review was conducted to determine if a patient and provider education program changed the rates of antibiotics being prescribed (immediate or delayed) during a visit for RTI for 207 randomly selected patients during the established evaluation time periods...
May 18, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29787405/introducing-a-clinical-documentation-specialist-to-improve-coding-and-collectability-on-a-surgical-service
#13
Maria Castaldi, John McNelis
INTRODUCTION: Inadequate electronic medical record (EMR) documentation remains a significant source of revenue loss. The Department of Surgery in a trauma and tertiary care teaching hospital developed a revenue optimization initiative for inpatients on general, vascular, and trauma surgery and surgical intensive care unit services to enhance clinical documentation and increase revenue capture. METHODS: Clinical documentation management program included six trained clinical documentation specialists (CDSs), five physician assistants (PAs), directors of health information management (HIM), and two surgical champions...
May 18, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29787309/predicting-intensive-care-unit-readmission-with-machine-learning-using-electronic-health-record-data
#14
Juan C Rojas, Kyle A Carey, Dana P Edelson, Laura R Venable, Michael D Howell, Matthew M Churpek
RATIONALE: Patients transferred from the intensive care unit (ICU) to the wards who are later readmitted to the ICU have increased length of stay, healthcare expenditure, and mortality compared to those who are never readmitted. Improving risk-stratification for patients transferred to the wards could have important benefits for critically ill hospitalized patients. OBJECTIVE: We aimed to use a machine-learning technique to derive and validate an ICU readmission prediction model with variables available in the electronic health record (EHR) in real-time and compare it to previously published algorithms...
May 22, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29786937/the-effect-of-the-weekend-upon-admissions-to-general-medicine
#15
Tessa Potezny, Chris Horwood, Paul Hakendorf, Campbell Thompson
RATIONALE, AIMS, AND OBJECTIVES: A reduction in the provision of hospital services on the weekend probably explains higher mortality for patients who are either admitted to hospital or undergo procedures on the weekend. The aim was to examine the effect of the day of the week of admission (DOWOA) upon the efficiency and quality of care for a cohort of General Medical inpatients. METHODS: Electronic records were selected for unplanned adult admissions to 2 large public hospitals in Adelaide, South Australia, July 2012 to June 2017...
May 22, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29786928/evaluation-of-medication-dose-omissions-amongst-inpatients-in-a-hospital-using-an-electronic-medication-management-system
#16
Katherine V Hunt, Andrew M Harding, Simone E Taylor, Colin Curtain
RATIONALE, AIMS, AND OBJECTIVES: Whilst many dose omissions cause no patient harm, inappropriate dose omissions have been associated with increased length of hospital stay, risk of sepsis, and mortality. This study aimed to comprehensively describe the prevalence and nature of omitted doses overall and of high risk medication dose omissions in an organization using an electronic Medication Management System. METHODS: A retrospective cross-sectional study was undertaken in an Australian tertiary referral health service...
May 22, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29785721/heeding-humanity-in-an-age-of-electronic-health-records-heidegger-levinas-and-healthcare
#17
Casey Rentmeester
The American Recovery and Reinvestment Act of 2009 (ARRA) required healthcare providers in the United States to adopt and demonstrate meaningful use of electronic health records (EHRs) by January 1, 2014. In many ways, EHRs mark a notable improvement over paper medical records as they are more easily accessible and allow for electronic searching and sharing of medical history. However, as EHRs have become mandated by ARRA, many nurses now rely upon computers far more heavily during nurse-patient interactions, thereby decreasing the level of direct interpersonal communication between the two...
May 21, 2018: Nursing Philosophy: An International Journal for Healthcare Professionals
https://www.readbyqxmd.com/read/29785625/exploring-the-association-between-electronic-health-record-use-and-burnout-among-psychiatry-residents-and-faculty-a-pilot-survey-study
#18
Nicholas M Domaney, John Torous, William E Greenberg
OBJECTIVE: Burnout is a phenomenon with profound negative effects on the US healthcare system. Little is known about the relationship between time spent working on electronic health record (EHR) and burnout among psychiatry residents. The purpose of this study is to generate preliminary data on EHR use and burnout among psychiatry residents and faculty. METHODS: In August 2017, psychiatry residents and faculty at an academic medical center were given the Maslach Burnout Inventory (MBI), a standardized measurement tool for burnout, and a survey of factors related to EHR use and potential risk factors for burnout...
May 21, 2018: Academic Psychiatry
https://www.readbyqxmd.com/read/29785094/association-of-health-literacy-and-medication-self-efficacy-with-medication-adherence-and-diabetes-control
#19
Yen-Ming Huang, Olayinka O Shiyanbola, Paul D Smith
Introduction: The exact pathway linking health literacy, self-efficacy, medication adherence, and glycemic control for type 2 diabetes remains unclear. Understanding the relationship between patient factors, medication adherence, and lower glycated hemoglobin (HbA1c) may help patients better manage their disease. This study examined the association of health literacy and medication self-efficacy with self-reported diabetes medication adherence, and the association of health literacy, medication self-efficacy, and self-reported diabetes medication adherence with HbA1c of patients with type 2 diabetes...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29784512/epidemiology-and-etiology-of-invasive-bacterial-infection-in-infants-%C3%A2-60-days-old-treated-in-emergency-departments
#20
Christopher Woll, Mark I Neuman, Christopher M Pruitt, Marie E Wang, Eugene D Shapiro, Samir S Shah, Russell J McCulloh, Lise E Nigrovic, Sanyukta Desai, Adrienne G DePorre, Rianna C Leazer, Richard D Marble, Fran Balamuth, Elana A Feldman, Laura F Sartori, Whitney L Browning, Paul L Aronson
OBJECTIVES: To help guide empiric treatment of infants ≤60 days old with suspected invasive bacterial infection by describing pathogens and their antimicrobial susceptibilities. STUDY DESIGN: Cross-sectional study of infants ≤60 days old with invasive bacterial infection (bacteremia and/or bacterial meningitis) evaluated in the emergency departments of 11 children's hospitals between July 1, 2011 and June 30, 2016. Each site's microbiology laboratory database or electronic medical record system was queried to identify infants from whom a bacterial pathogen was isolated from either blood or cerebrospinal fluid...
May 18, 2018: Journal of Pediatrics
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