Electronic personal health records

This review paper analyzes the ethical implications of billing patients for electronic communication with physicians through electronic health records, a practice already adopted by medical institutions such as the Cleveland Clinic. The analysis assesses how billing aligns with pillars of medical ethics which include beneficence, respect for persons, and justice. Although billing may enhance communication, improve patient care, and alleviate physician burnout, concerns arise over potential consequences on patient autonomy, trust, and health care disparities...

Recent advancements in science and technology, coupled with the proliferation of data, have also urged laboratory medicine to integrate with the era of artificial intelligence (AI) and machine learning (ML). In the current practices of evidence-based medicine, the laboratory tests analysing disease patterns through the association rule mining (ARM) have emerged as a modern tool for the risk assessment and the disease stratification, with the potential to reduce cardio-vascular disease (CVD) mortality. CVDs are the well recognised leading global cause of mortality with the higher fatality rates in the Indian population due to associated factors like hypertension, diabetes, and lifestyle choices...

BACKGROUND: Numerous prior opinion papers, administrative electronic health record data studies, and cross-sectional surveys of telehealth during the pandemic have been published, but none have combined assessments of video visit success monitoring with longitudinal assessments of perceived challenges to the rapid adoption of video visits during the pandemic. OBJECTIVE: This study aims to quantify (1) the use of video visits (compared with in-person and telephone visits) over time during the pandemic, (2) video visit successful connection rates, and (3) changes in perceived video visit challenges...

BACKGROUND: The Environmental Justice Index is a tool released by the Centers for Disease Control and Prevention that quantifies and ranks the environmental burden and social vulnerability of each census tract. Racial and ethnic disparities in adverse pregnancy outcomes are well established. The relative contributions of individual (person-level) and environmental (neighborhood-level) risk factors to disease prevalence remain poorly understood. OBJECTIVE: This study aimed to determine whether the Environmental Justice Index is associated with adverse pregnancy outcomes after adjustment for individual clinical and sociodemographic risk factors...

BACKGROUND: COVID-19 vaccination and shielding targeted hypertensive patients in low and middle income countries. We describe the COVID-19 experiences of hypertensive patients in Colombia and Jamaica and discuss factors associated with vaccine acceptance. METHODS: A cross-sectional study was conducted between December 2021 and February 2022 in 4 randomly selected primary care clinics in Colombia and 10 primary care clinics in Jamaica. Participants in Colombia were randomly selected from an electronic medical record...

PURPOSE: Screening guidelines for breast cancer (BC) in transgender male (TM) patients are not well defined. This study describes referral patterns and compliance with referral for BC screening among TM patients receiving care at a tertiary care center. METHODS: This was a retrospective cohort study of TM patients, 40-74 years of age, presenting for care between 2017 and 2020. The electronic medical record was queried for medical history and cancer screening data...

BACKGROUND: Communication failures are among the most common causes of harmful medical errors. At one Comprehensive Cancer Center, patient handoffs varied among services. The authors describe the implementation and results of an Organization-wide project to improve handoffs and implement an evidence-based handoff tool across all inpatient services. METHODS: The research team created a task force composed of members from 22 hospital services-advanced practice providers (APPs), trainees, some faculty members, electronic health record (EHR) staff, education and training specialists, and nocturnal providers...

OBJECTIVES: The field of oncology has been revolutionized by precision medicine, driven by advancements in molecular and genomic profiling. High-throughput genomic sequencing and non-invasive diagnostic methods have deepened our understanding of cancer biology, leading to personalized treatment approaches. Precision health expands on precision medicine, emphasizing holistic healthcare, integrating molecular profiling and genomics, physiology, behavioral, and social and environmental factors...

BACKGROUND: Patient registries and databases are essential tools for advancing clinical research in the area of rare diseases, as well as for enhancing patient care and healthcare planning. The primary aim of this study is a landscape analysis of available European data sources amenable to machine learning (ML) and their usability for Rare Diseases screening, in terms of findable, accessible, interoperable, reusable(FAIR), legal, and business considerations. Second, recommendations will be proposed to provide a better understanding of the health data ecosystem...

OBJECTIVE: To create a data-driven definition of post-COVID conditions (PCC) by directly measure changes in symptomatology before and after a first COVID episode. MATERIALS AND METHODS: Retrospective cohort study using Optum® de-identified Electronic Health Record (EHR) dataset from the United States of persons of any age April 2020-September 2021. For each person with COVID (ICD-10-CM U07.1 "COVID-19" or positive test result), we selected up to 3 comparators...

BACKGROUND: We aimed to compare the risk of herpes zoster (HZ) in adults with and without laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: This retrospective dynamic cohort study analyzed data from a public healthcare database in Spain between November 2020 and October 2021. The main outcome was incident cases of HZ in individuals ≥ 18-year-old. Relative risk (RR) of HZ in SARS-CoV-2-confirmed versus SARS-CoV-2-free individuals was estimated by a multivariable negative binomial regression adjusted by age, sex, and comorbidities...

In the past 2 decades, health care has witnessed technological and pharmacological advancements leading to innovations in diabetes management. Despite these advances, published guidelines, and treatment algorithms, most people with diabetes remain above glycemic targets. Thus, the authors designed a novel care model aimed at improving several causative factors, including therapeutic inertia, limited access to endocrinology and cardiovascular specialists, time constraints, and complexity in incorporating clinical practice guidelines...

INTRODUCTION: Social risk factors such as food insecurity and lack of transportation can negatively affect health outcomes, yet implementation of screening and referral for social risk factors is limited in medical settings, particularly in cancer survivorship. METHODS: We conducted 18 qualitative, semistructured interviews among oncology teams in 3 health systems in Washington, DC, during February and March 2022. We applied the Exploration, Preparation, Implementation, Sustainment Framework to develop a deductive codebook, performed thematic analysis on the interview transcripts, and summarized our results descriptively...

BACKGROUND: Persistent low-level viraemia (PLLV) is a risk factor for virologic failure among people receiving antiretroviral therapy (ART). OBJECTIVES: We assessed the prevalence and predictors of PLLV among individuals receiving Dolutegravir-based ART in southern Nigeria. DESIGN: This retrospective cohort study used routine program data from electronic medical records of persons receiving Dolutegravir-based first-line ART in 154 PEPFAR/USAID-supported health facilities in Akwa Ibom and Cross Rivers states, Nigeria...

PURPOSE: Adult day services (ADS) are a valuable resource for people living with Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD) and serve a large population of late-life immigrants, often with limited English proficiency (LEP). This secondary data analysis examined potential disparities in diagnosis, dementia severity, medical complexity, and dementia-related behavioral problems in persons with AD/ADRD with LEP within the ADS setting. METHOD: The current study used data from TurboTAR, the electronic health record for ADS in California...

BACKGROUND: The rehabilitation of a patient who had a stroke requires precise, personalized treatment plans. Natural language processing (NLP) offers the potential to extract valuable exercise information from clinical notes, aiding in the development of more effective rehabilitation strategies. OBJECTIVE: This study aims to develop and evaluate a variety of NLP algorithms to extract and categorize physical rehabilitation exercise information from the clinical notes of patients who had a stroke treated at the University of Pittsburgh Medical Center...

Objective: The purpose of this integrative review is to assess the existing evidence regarding the effects of a person's lactation history on later-life development of Alzheimer's disease. Methods: The authors searched the electronic databases PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Excerpta Medica dataBASE, and performed backward reference searches using search terms such as, "Alzheimer's disease, dementia," and "breastfeeding, lactation." Authors selected relevant records through the application of inclusion and exclusion criteria and reading the titles, abstracts, or records in full...

BACKGROUND: The US Department of Veterans Affairs (VA) Community Nursing Home (CNH) program provides in-person oversight monitoring the quality of care of veterans in VA-contracted community-based skilled nursing homes. The number of veterans receiving CNH care is projected to increase by 80% by 2037. METHODS: Retrospective observational data describing the distance between contracted facilities and VA medical centers (VAMCs) were linked to Centers for Medicare and Medicaid monthly Nursing Home Compare and Brown University Long Term Care: Facts on Care in the US data...

BACKGROUND: Efforts to reduce the heterogeneity of major depressive disorder (MDD) by identifying subtypes have not yet facilitated treatment personalization or investigation of biology, so novel approaches merit consideration. METHODS: We utilized electronic health records drawn from 2 academic medical centers and affiliated health systems in Massachusetts to identify data-driven subtypes of MDD, characterizing sociodemographic features, comorbid diagnoses, and treatment patterns...

BACKGROUND: There is limited data on risk of new-onset anxiety disorders in hidradenitis suppurativa (HS) patients. OBJECTIVES: To compare the risk of new-onset anxiety disorder in patients with HS and controls, and to describe risk factors for development of anxiety among HS patients. METHODS: Retrospective cohort analysis of a US electronic health records database between 2011-2020. Adults newly diagnosed with HS at a dermatology or primary care visit and controls were included...