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https://www.readbyqxmd.com/read/27924347/preprocessing-structured-clinical-data-for-predictive-modeling-and-decision-support-a-roadmap-to-tackle-the-challenges
#1
José Carlos Ferrão, Mónica Duarte Oliveira, Filipe Janela, Henrique M G Martins
BACKGROUND: EHR systems have high potential to improve healthcare delivery and management. Although structured EHR data generates information in machine-readable formats, their use for decision support still poses technical challenges for researchers due to the need to preprocess and convert data into a matrix format. During our research, we observed that clinical informatics literature does not provide guidance for researchers on how to build this matrix while avoiding potential pitfalls...
December 7, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27922661/fin-tiera-a-tool-for-assessing-technology-induced-errors
#2
Sari Palojoki, Tuuli Pajunen, Lasse Lehtonen, Kaija Saranto
BACKGROUND: Due to the complexity of healthcare processes, the potential for Health Information Systems (HIS) to cause technology-induced errors is a growing concern. Health Information Technology (HIT) errors nearly always threaten good patient care and can lead to patient harm. Instruments to allow hospitals to proactively identify areas of Electronic Health Records (EHR) safety, to set priorities and to intervene before incidents occur are currently underdeveloped. OBJECTIVES: The aim was to design a Finnish questionnaire to measure EHR users' perceptions of common EHR-related safety concerns in a specialized hospital district context through the lens of the theory of socio-technical dimensions...
December 6, 2016: Methods of Information in Medicine
https://www.readbyqxmd.com/read/27919400/a-novel-concept-for-integrating-and-delivering-health-information-using-a-comprehensive-digital-dashboard-an-analysis-of-healthcare-professionals-intention-to-adopt-a-new-system-and-the-trend-of-its-real-usage
#3
Keehyuck Lee, Se Young Jung, Hee Hwang, Sooyoung Yoo, Hyun Young Baek, Rong-Min Baek, Seok Kim
OBJECTIVE: To introduce a new concept of medical dashboard system called BESTBoard. Such a system was implemented in all wards in a tertiary academic hospital to explore the development process, core designs, functions, usability and feasibility. METHODS: The task-force team made user interface designs for 6 months based on a need analysis. Hardware configuration and software development was carried out for 3 months. We conducted a survey of 383 physicians and nurses to determine the usability and feasibility of the system...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919387/impacts-of-structuring-the-electronic-health-record-results-of-a-systematic-literature-review-from-the-perspective-of-secondary-use-of-patient-data
#4
REVIEW
Riikka Vuokko, Päivi Mäkelä-Bengs, Hannele Hyppönen, Minna Lindqvist, Persephone Doupi
PURPOSE: To explore the impacts that structuring of electronic health records (EHRs) has had from the perspective of secondary use of patient data as reflected in currently published literature. This paper presents the results of a systematic literature review aimed at answering the following questions; (1) what are the common methods of structuring patient data to serve secondary use purposes; (2) what are the common methods of evaluating patient data structuring in the secondary use context, and (3) what impacts or outcomes of EHR structuring have been reported from the secondary use perspective...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919385/usability-problems-do-not-heal-by-themselves-national-survey-on-physicians-experiences-with-ehrs-in-finland
#5
Johanna Kaipio, Tinja Lääveri, Hannele Hyppönen, Suvi Vainiomäki, Jarmo Reponen, Andre Kushniruk, Elizabeth Borycki, Jukka Vänskä
PURPOSE: Survey studies of health information systems use tend to focus on availability of functionalities, adoption and intensity of use. Usability surveys have not been systematically conducted by any healthcare professional groups on a national scale on a repeated basis. This paper presents results from two cross-sectional surveys of physicians' experiences with the usability of currently used EHR systems in Finland. The research questions were: To what extent has the overall situation improved between 2010 and 2014? What differences are there between healthcare sectors? METHODS: In the spring of 2014, a survey was conducted in Finland using a questionnaire that measures usability and respondents' user experiences with electronic health record (EHR) systems...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919371/a-machine-learning-based-framework-to-identify-type-2-diabetes-through-electronic-health-records
#6
Tao Zheng, Wei Xie, Liling Xu, Xiaoying He, Ya Zhang, Mingrong You, Gong Yang, You Chen
OBJECTIVE: To discover diverse genotype-phenotype associations affiliated with Type 2 Diabetes Mellitus (T2DM) via genome-wide association study (GWAS) and phenome-wide association study (PheWAS), more cases (T2DM subjects) and controls (subjects without T2DM) are required to be identified (e.g., via Electronic Health Records (EHR)). However, existing expert based identification algorithms often suffer in a low recall rate and could miss a large number of valuable samples under conservative filtering standards...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919368/clinical-reasoning-in-the-context-of-active-decision-support-during-medication-prescribing
#7
Jan Horsky, Jos Aarts, Leonie Verheul, Diane L Seger, Heleen van der Sijs, David W Bates
OBJECTIVE: Describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. Insights could be used to inform the design of decision-support interventions. METHODS: Thirty-two clinicians working with five EHRs in two countries completed sets of six medication orders each and responded to high- and low-severity drug-drug interaction alerts while verbalizing their thoughts in a standard think-aloud protocol...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27915122/effects-of-a-training-in-mental-imagery-on-worry-a-proof-of-principle-study
#8
Timo Skodzik, Alexandra Leopold, Thomas Ehring
Worry is characterized by a predominance of verbal thinking and relatively little mental imagery. This cognitive bias of verbal and abstract processing has been found to impair emotional processing of worry topics so that worrisome thoughts are maintained. On the other hand, engaging in mental imagery during the worry process fosters emotional processing of worry themes. In the present study, we examined whether training high worriers (n=71) to use more mental imagery in their everyday lives is an effective intervention to reduce pathological worry...
November 25, 2016: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/27913742/frailty-assessment-in-hospitalized-older-adults-using-the-electronic-health-record
#9
Deborah A Lekan, Debra C Wallace, Thomas P McCoy, Jie Hu, Susan G Silva, Heather E Whitson
INTRODUCTION: Frailty, a clinical syndrome of decreased physiologic reserve and dysregulation in multiple physiologic systems, is associated with increased risk for adverse outcomes. PURPOSE: The aim of this retrospective, cross-sectional, correlational study was to characterize frailty in older adults admitted to a tertiary-care hospital using a biopsychosocial frailty assessment and to determine associations between frailty and time to in-hospital mortality and 30-day rehospitalization...
December 2, 2016: Biological Research for Nursing
https://www.readbyqxmd.com/read/27908895/childhood-maltreatment-and-characteristics-of-adult-depression-meta-analysis
#10
REVIEW
Janna Nelson, Anne Klumparendt, Philipp Doebler, Thomas Ehring
BACKGROUND: Childhood maltreatment has been discussed as a risk factor for the development and maintenance of depression. AIMS: To examine the relationship between childhood maltreatment and adult depression with regard to depression incidence, severity, age at onset, course of illness and treatment response. METHOD: We conducted meta-analyses of original articles reporting an association between childhood maltreatment and depression outcomes in adult populations...
December 1, 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/27906530/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment-systems-and-quality-reporting-programs-organ-procurement-organization-reporting-and-communication-transplant-outcome-measures-and-documentation-requirements-electronic
#11
(no author information available yet)
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system...
November 14, 2016: Federal Register
https://www.readbyqxmd.com/read/27905815/medicare-program-merit-based-incentive-payment-system-mips-and-alternative-payment-model-apm-incentive-under-the-physician-fee-schedule-and-criteria-for-physician-focused-payment-models-final-rule-with-comment-period
#12
(no author information available yet)
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs)...
November 4, 2016: Federal Register
https://www.readbyqxmd.com/read/27903489/finding-important-terms-for-patients-in-their-electronic-health-records-a-learning-to-rank-approach-using-expert-annotations
#13
Jinying Chen, Jiaping Zheng, Hong Yu
BACKGROUND: Many health organizations allow patients to access their own electronic health record (EHR) notes through online patient portals as a way to enhance patient-centered care. However, EHR notes are typically long and contain abundant medical jargon that can be difficult for patients to understand. In addition, many medical terms in patients' notes are not directly related to their health care needs. One way to help patients better comprehend their own notes is to reduce information overload and help them focus on medical terms that matter most to them...
November 30, 2016: JMIR Medical Informatics
https://www.readbyqxmd.com/read/27902553/perspectives-and-uses-of-the-electronic-health-record-among-us-pediatricians-a-national-survey
#14
Julie W Doberne, Travis Redd, Daniel Lattin, Thomas R Yackel, Carl O Eriksson, Vishnu Mohan, Jeffrey A Gold, Joan S Ash, Michael F Chiang
Little is known about how existing electronic health records (EHRs) influence the practice of pediatric medicine. A total of 808 pediatricians participated in a survey about workflows using the EHR. The EHR was the most commonly used source of initial patient information. Seventy-two percent reported requiring between 2 and 10 minutes to complete an initial review of the EHR. Several moderately severe information barriers were reported regarding the display of information in the EHR. Pediatricians acquire information about new patients from EHRs more often than any other source...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27902552/factors-associated-with-electronic-health-record-use-among-nurse-practitioners-in-the-united-states
#15
Emily B Jones
Widespread use of electronic health records (EHRs) among all provider types is foundational to delivery system transformation. Three in 4 nurse practitioners used EHRs in 2012 (76.0%), and 60.3% of nonusers planned to adopt within 18 months. Practice setting, younger age, and colocation with physicians were associated with EHR use. In hospitals and in settings without on-site physicians, EHR use lagged in rural areas. Implementation assistance should be targeted to nonadopters, particularly those who never or infrequently work alongside physicians and those in rural hospitals...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27902551/do-years-of-experience-with-electronic-health-records-matter-for-productivity-in-community-health-centers
#16
Bianca K Frogner, Xiaoli Wu, Leighton Ku, Patricia Pittman, Leah E Masselink
This study investigated how years of experience with an electronic health record (EHR) related to productivity in community health centers (CHCs). Using data from the 2012 Uniform Data System, we regressed average annual medical visits, weighted for service intensity, as a function of full-time equivalent medical staff controlling for CHC size and location. Physician productivity significantly improved. Although the productivity of all other staff types was not significantly different by years of EHR experience, the trends showed lower productivity among nurses and other medical staff in CHCs with fewer years of EHR experience versus more years of experience...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27902550/-salt-in-the-wound-safety-net-clinician-perspectives-on-performance-feedback-derived-from-ehr-data
#17
Arwen E Bunce, Rachel Gold, James V Davis, MaryBeth Mercer, Victoria Jaworski, Celine Hollombe, Christine Nelson
Electronic health record (EHR) data can be extracted for calculating performance feedback, but users' perceptions of such feedback impact its effectiveness. Through qualitative analyses, we identified perspectives on barriers and facilitators to the perceived legitimacy of EHR-based performance feedback, in 11 community health centers (CHCs). Providers said such measures rarely accounted for CHC patients' complex lives or for providers' decisions as informed by this complexity, which diminished the measures' perceived validity...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27901561/onc-health-it-certification-program-enhanced-oversight-and-accountability-final-rule
#18
(no author information available yet)
This final rule finalizes modifications and new requirements under the ONC Health IT Certification Program ("Program"), including provisions related to the Office of the National Coordinator for Health Information Technology (ONC)'s role in the Program. The final rule creates a regulatory framework for ONC's direct review of health information technology (health IT) certified under the Program, including, when necessary, requiring the correction of non-conformities found in health IT certified under the Program and suspending and terminating certifications issued to Complete EHRs and Health IT Modules...
October 19, 2016: Federal Register
https://www.readbyqxmd.com/read/27897470/faculty-development-efforts-to-promote-screening-brief-intervention-and-referral-to-treatment-sbirt-in-an-internal-medicine-faculty-resident-practice
#19
Alanna Stone, Maria Wamsley, Patricia O'Sullivan, Jason Satterfield, Derek D Satre, Katherine Julian
BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is a practical means to address substance misuse in primary care. Important barriers to implementing SBIRT include adequacy of training and provider confidence as well as logistical hurdles and time constraints. A faculty development initiative aimed at increasing SBIRT knowledge and treatment of substance use disorders (SUDs) should lead to increased use of SBIRT by faculty and the residents they teach. This study examined how a faculty development program to promote SBIRT influenced faculty practice and resident teaching...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27897004/identifying-genetic-associations-with-variability-in-metabolic-health-and-blood-count-laboratory-values-diving-into-the-quantitative-traits-by-leveraging-longitudinal-data-from-an-ehr
#20
Shefali S Verma, Anastasia M Lucas, Daniel R Lavage, Joseph B Leader, Raghu Metpally, Sarathbabu Krishnamurthy, Frederick Dewey, Ingrid Borecki, Alexander Lopez, John Overton, John Penn, Jeffrey Reid, Sarah A Pendergrass, Gerda Breitwieser, Marylyn D Ritchie
A wide range of patient health data is recorded in Electronic Health Records (EHR). This data includes diagnosis, surgical procedures, clinical laboratory measurements, and medication information. Together this information reflects the patient's medical history. Many studies have efficiently used this data from the EHR to find associations that are clinically relevant, either by utilizing International Classification of Diseases, version 9 (ICD-9) codes or laboratory measurements, or by designing phenotype algorithms to extract case and control status with accuracy from the EHR...
2016: Pacific Symposium on Biocomputing
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