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Electronic personal health records

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https://www.readbyqxmd.com/read/28426439/high-mortality-among-patients-with-opioid-use-disorder-in-a-large-healthcare-system
#1
Yih-Ing Hser, Larissa J Mooney, Andrew J Saxon, Karen Miotto, Douglas S Bell, Yuhui Zhu, Di Liang, David Huang
OBJECTIVES: Elevated mortality has been observed among individuals with opioid use disorder (OUD) treated in addiction specialty clinics or programs. Information about OUD patients in general healthcare settings is needed in light of the current effort to integrate addiction services into primary healthcare systems. This study examined mortality rates, causes of death, and associated risk factors among patients with OUD in a large general healthcare system. METHODS: Mortality data were linked with electronic health records of 2576 OUD patients cared for in a large university health system from 2006 to 2014...
April 20, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28426302/innovations-in-population-health-surveillance-using-electronic-health-records-for-chronic-disease-surveillance
#2
Sharon E Perlman, Katharine H McVeigh, Lorna E Thorpe, Laura Jacobson, Carolyn M Greene, R Charon Gwynn
With 87% of providers using electronic health records (EHRs) in the United States, EHRs have the potential to contribute to population health surveillance efforts. However, little is known about using EHR data outside syndromic surveillance and quality improvement. We created an EHR-based population health surveillance system called the New York City (NYC) Macroscope and assessed the validity of diabetes, hyperlipidemia, hypertension, smoking, obesity, depression, and influenza vaccination indicators. The NYC Macroscope uses aggregate data from a network of outpatient practices...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28423809/use-of-a-nationwide-personally-controlled-electronic-health-record-by-healthcare-professionals-and-patients-a-case-study-with-the-french-dmp
#3
Brigitte Seroussi, Jacques Bouaud
If the wide adoption of electronic health records (EHRs) is necessary to address health information sharing and care coordination issues, it is not sufficient. In order to address health information sharing, some countries, among which, France, have implemented a centralized framework with "new" nationwide care records. The French DMP is a centralized, nationally shared, electronic medical record, created according to the opt-in model. More than five years after the launching of the DMP project, DMPs have been created for 1...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423796/personalized-guideline-based-treatment-recommendations-using-natural-language-processing-techniques
#4
Matthias Becker, Britta Böckmann
Clinical guidelines and clinical pathways are accepted and proven instruments for quality assurance and process optimization. Today, electronic representation of clinical guidelines exists as unstructured text, but is not well-integrated with patient-specific information from electronic health records. Consequently, generic content of the clinical guidelines is accessible, but it is not possible to visualize the position of the patient on the clinical pathway, decision support cannot be provided by personalized guidelines for the next treatment step...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423156/creation-of-an-internal-teledermatology-store-and-forward-system-in-an-existing-electronic-health-record-a-pilot-study-in-a-safety-net-public-health-and-hospital-system
#5
Zachary A Carter, Shauna Goldman, Kristen Anderson, Xiaxiao Li, Linda S Hynan, Benjamin F Chong, Arturo R Dominguez
Importance: External store-and-forward (SAF) teledermatology systems operate separately from the primary health record and have many limitations, including care fragmentation, inadequate communication among clinicians, and privacy and security concerns, among others. Development of internal SAF workflows within existing electronic health records (EHRs) should be the standard for large health care organizations for delivering high-quality dermatologic care, improving access, and capturing other telemedicine benchmark data...
April 19, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28420358/healthcare-utilization-in-older-patients-using-personal-emergency-response-systems-an-analysis-of-electronic-health-records-and-medical-alert-data-brief-description-a-longitudinal-retrospective-analyses-of-healthcare-utilization-rates-in-older-patients-using
#6
Stephen Agboola, Sara Golas, Nils Fischer, Mariana Nikolova-Simons, Jorn Op den Buijs, Linda Schertzer, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization...
April 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28410981/predicting-healthcare-trajectories-from-medical-records-a-deep-learning-approach
#7
Trang Pham, Truyen Tran, Dinh Phung, Svetha Venkatesh
Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, stored in electronic medical records are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors and models patient health state trajectories by the memory of historical records...
April 11, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28407197/autologous-hematopoietic-stem-cell-transplantation-following-high-dose-chemotherapy-for-nonrhabdomyosarcoma-soft-tissue-sarcomas
#8
REVIEW
Frank Peinemann, Heike Enk, Lesley A Smith
BACKGROUND: Soft tissue sarcomas (STS) are a highly heterogeneous group of rare malignant solid tumors. Nonrhabdomyosarcoma soft tissue sarcomas (NRSTS) comprise all STS except rhabdomyosarcoma. In people with advanced local or metastatic disease, autologous hematopoietic stem cell transplantation (HSCT) applied after high-dose chemotherapy (HDCT) is a planned rescue therapy for HDCT-related severe hematologic toxicity. The rationale for this update is to determine whether any randomized controlled trials (RCTs) have been conducted and to clarify whether HDCT followed by autologous HSCT has a survival advantage...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28406708/pack-year-cigarette-smoking-history-for-determination-of-lung-cancer-screening-eligibility-comparison-of-the-electronic-medical-record-versus-a-shared-decision-making-conversation
#9
Hannah E Modin, Joelle T Fathi, Christopher R Gilbert, Candice L Wilshire, Andrew K Wilson, Ralph W Aye, Alexander S Farivar, Brian E Louie, Eric Vallières, Jed A Gorden
RATIONALE: Implementation of lung cancer screening programs is occurring across the United States. Programs vary in approaches to patient identification and shared decision making. The eligibility of persons referred to screening programs, the outcomes of eligibility determination during shared decision making, and the potential for the electronic medical record to identify eligible individuals have not been well described. OBJECTIVES: Our objectives were to assess the eligibility of individuals referred for lung cancer screening, and compare information extracted from the electronic medical record to information derived from a shared decision making conversation for the determination of eligibility for lung cancer screening...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28401731/impact-of-early-personal-history-characteristics-on-the-pace-of-aging-implications-for-clinical-trials-of-therapies-to-slow-aging-and-extend-healthspan
#10
Daniel W Belsky, Avshalom Caspi, Harvey J Cohen, William E Kraus, Sandhya Ramrakha, Richie Poulton, Terrie E Moffitt
Therapies to extend healthspan are poised to move from laboratory animal models to human clinical trials. Translation from mouse to human will entail challenges, among them the multifactorial heterogeneity of human aging. To inform clinical trials about this heterogeneity, we report how humans' pace of biological aging relates to personal-history characteristics. Because geroprotective therapies must be delivered by midlife to prevent age-related disease onset, we studied young-adult members of the Dunedin Study 1972-73 birth cohort (n = 954)...
April 12, 2017: Aging Cell
https://www.readbyqxmd.com/read/28399844/implementation-of-a-pragmatic-randomized-trial-of-screening-for-chronic-kidney-disease-to-improve-care-among-non-diabetic-hypertensive-veterans
#11
Carmen A Peralta, Martin Frigaard, Anna D Rubinsky, Leticia Rolon, Lowell Lo, Santhi Voora, Karen Seal, Delphine Tuot, Shirley Chao, Kimberly Lui, Phillip Chiao, Neil Powe, Michael Shlipak
BACKGROUND: Whether screening for chronic kidney disease (CKD) can improve the care of persons at high risk for complications remains uncertain. We describe the design and early implementation experience of a pilot, cluster-randomized pragmatic trial to evaluate the feasibility, implementation, and effectiveness of a "triple marker" CKD screening program (creatinine, cystatin C and albumin to creatinine ratio) for improving care among hypertensive veterans seen in primary care at one Veterans Administration Hospital...
April 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28387314/analysis-of-free-text-in-electronic-health-records-for-identification-of-cancer-patient-trajectories
#12
Kasper Jensen, Cristina Soguero-Ruiz, Karl Oyvind Mikalsen, Rolv-Ole Lindsetmo, Irene Kouskoumvekaki, Mark Girolami, Stein Olav Skrovseth, Knut Magne Augestad
With an aging patient population and increasing complexity in patient disease trajectories, physicians are often met with complex patient histories from which clinical decisions must be made. Due to the increasing rate of adverse events and hospitals facing financial penalties for readmission, there has never been a greater need to enforce evidence-led medical decision-making using available health care data. In the present work, we studied a cohort of 7,741 patients, of whom 4,080 were diagnosed with cancer, surgically treated at a University Hospital in the years 2004-2012...
April 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28384314/patient-satisfaction-after-implementation-of-person-centred-handover-in-oncological-inpatient-care-a-cross-sectional-study
#13
Anna Kullberg, Lena Sharp, Hemming Johansson, Yvonne Brandberg, Mia Bergenmar
Effective nurse shift-to-shift handover is a prerequisite for high-quality inpatient care. Combining person-centeredness with the need for improved handover rituals, we introduced and evaluated person-centered handover (PCH) in an oncological inpatient setting. PCH is the shift-to-shift nursing report performed together with the patient according to a set structure focused on patient participation, relevant clinical information, and patient safety. Non-verbal handover, standard at the department, is conducted via the electronic health record, in absence of the patient, and without a set structure...
2017: PloS One
https://www.readbyqxmd.com/read/28375750/implementing-trauma-informed-partner-violence-assessment-in-family-planning-clinics
#14
Michele R Decker, Sarah Flessa, Ruchita V Pillai, Rebecca N Dick, Jamie Quam, Diana Cheng, Raegan McDonald-Mosley, Kamila A Alexander, Charvonne N Holliday, Elizabeth Miller
OBJECTIVE: Intimate partner violence (IPV) and reproductive coercion (RC) are associated with poor reproductive health. Little is known about how family planning clinics implement brief IPV/RC assessment interventions in practice. We describe the uptake and impact of a brief, trauma-informed, universal IPV/RC assessment and education intervention. METHODS: Intervention implementation was evaluated via a mixed methods study among women ages 18 and up receiving care at one of two family planning clinics in greater Baltimore, MD...
April 4, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28373173/prognosis-of-undiagnosed-chest-pain-linked-electronic-health-record-cohort-study
#15
MULTICENTER STUDY
Kelvin P Jordan, Adam Timmis, Peter Croft, Danielle A van der Windt, Spiros Denaxas, Arturo González-Izquierdo, Richard A Hayward, Pablo Perel, Harry Hemingway
Objective To ascertain long term cardiovascular outcomes in patients whose chest pain remained undiagnosed six months after first presentation.Design Cohort study.Setting UK electronic health record database (CALIBER) linking primary care, secondary care, coronary registry, and death registry information.Participants 172 180 adults aged ≥18 from 223 general practices presenting with a first episode of recorded chest pain, classified from medical records as diagnosed (non-coronary condition or angina) or undiagnosed (cause unattributed) at first consultation between 2002 and 2009 and with no previous record of cardiovascular disease...
April 3, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28370246/electronic-health-records-and-the-disappearing-patient
#16
Linda M Hunt, Hannah S Bell, Allison M Baker, Heather A Howard
With rapid consolidation of American medicine into large-scale corporations, corporate strategies are coming to the forefront in health care delivery, requiring a dramatic increase in the amount and detail of documentation, implemented through use of electronic health records (EHRs). EHRs are structured to prioritize the interests of a myriad of political and corporate stakeholders, resulting in a complex, multi-layered, and cumbersome health records system, largely not directly relevant to clinical care. Drawing on observations conducted in outpatient specialty clinics, we consider how EHRs prioritize institutional needs manifested as a long list of requisites that must be documented with each consultation...
March 31, 2017: Medical Anthropology Quarterly
https://www.readbyqxmd.com/read/28364355/population-health-management-for-diabetes-health-care-system-level-approaches-for-improving-quality-and-addressing-disparities
#17
REVIEW
Julie A Schmittdiel, Anjali Gopalan, Mark W Lin, Somalee Banerjee, Christopher V Chau, Alyce S Adams
PURPOSE OF REVIEW: Population care approaches for diabetes have the potential to improve the quality of care and decrease diabetes-related mortality and morbidity. Population care strategies are particularly relevant as accountable care organizations (ACOs), patient-centered medical homes (PCMH), and integrated delivery systems are increasingly focused on managing chronic disease care at the health system level. This review outlines the key elements of population care approaches for diabetes in the current health care environment...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28362596/a-method-of-signal-scrambling-to-secure-data-storage-for-healthcare-applications
#18
Shu-Di Bao, Meng Chen, Guang-Zhong Yang
Body sensor network that consists of wearable and/or implantable biosensors has been an important front-end for collecting personal health records. It is expected that the full integration of outside-hospital personal health records and hospital electronic health records will further promote preventative health services as well as global health. However, the integration and sharing of health information is bound to bring with it security and privacy issues. With the extensive development of healthcare applications, security and privacy issues will gradually become evident...
March 9, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28361731/health-information-technology-as-a-universal-donor-to-bioethics-education
#19
Kenneth W Goodman
Health information technology, sometimes called biomedical informatics, is the use of computers and networks in the health professions. This technology has become widespread, from electronic health records to decision support tools to patient access through personal health records. These computational and information-based tools have engendered their own ethics literature and now present an opportunity to shape the standard medical and nursing ethics curricula. It is suggested that each of four core components in the professional education of clinicians-privacy, end-of-life care, access to healthcare and valid consent, and clinician-patient communication-offers an opportunity to leverage health information technology for curricular improvement...
April 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28358972/nurse-patient-and-care-partner-perceptions-of-a-personalized-safety-plan-screensaver
#20
Megan Duckworth, Emily Leung, Theresa Fuller, Jenzel Espares, Brittany Couture, Frank Chang, Alexandra C Businger, Sarah Collins, Anuj Dalal, Anne Fladger, Jeffrey L Schnipper, Kumiko O Schnock, David W Bates, Patricia C Dykes
A patient safety plan dashboard was developed that captures disparate data from the electronic health record that is then displayed as a personalized bedside screensaver. The dashboard aligns all care team members, including patients and families, in the safety plan. The screensaver content includes icons that pertain to common geriatric syndromes. In two phases, interviews were conducted with nurses, nursing assistants, patients, and informal caregivers in a large, tertiary care center. End user perceptions of the content and interface of the personalized safety plan screensavers were identified and strategies to overcome the barriers to use for future iterations were defined...
April 1, 2017: Journal of Gerontological Nursing
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