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https://www.readbyqxmd.com/read/28435842/is-individual-smoking-behaviour-influenced-by-area-level-ethnic-density-a-cross-sectional-electronic-health-database-study-of-inner-south-east-london
#1
Rohini Mathur, Peter Schofield, Dianna Smith, Alexander Gilkes, Patrick White, Sally Hull
Tobacco smoking remains one of the greatest public health problems facing the UK today. It varies significantly by ethnic group. This study aimed to determine whether ethnic differences in smoking behaviour are related to neighbourhood-level, own-group ethnic density across south and east London. The association between ethnic density and individual smoking behaviour was assessed by multilevel logistic regression using the electronic health records of 688 397 general practitioner-registered patients. Restricted cubic splines were created to explore whether the effect of ethnic density on smoking behaviour was nonlinear...
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28435756/identifying-barriers-in-the-use-of-electronic-health-records-in-hawai-i
#2
Faith D Hamamura, Kelley Withy, Kira Hughes
Hawai'i faces unique challenges to Electronic Health Record (EHR) adoption due to physician shortages, a widespread distribution of Medically Underserved Areas and Populations (MUA/P), and a higher percentage of small independent practices. However, research on EHR adoption in Hawai'i is limited. To address this gap, this article examines the current state of EHR in Hawai'i, the barriers to adoption, and the future of Health Information Technology (HIT) initiatives to improve the health of Hawai'i's people...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#3
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/28435484/outcomes-by-mode-of-transport-of-st-elevation-mi-patients-in-the-united-arab-emirates
#4
Edward L Callachan, Alawi A Alsheikh-Ali, Satish Chandrasekhar Nair, Stevan Bruijns, Lee A Wallis
INTRODUCTION: The purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities. METHODS: This multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435342/patient-web-portals-disease-management-and-primary-prevention
#5
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
https://www.readbyqxmd.com/read/28435306/pediatric-acute-kidney-injury-prevalence-impact-and-management-challenges
#6
REVIEW
Eileen Ciccia, Prasad Devarajan
The incidence of pediatric acute kidney injury (AKI) is increasing globally, as are the associated morbidities and mortality. A recent standardization of the definition of AKI has allowed for a more accurate assessment of the epidemiology of pediatric AKI. Recent advances in leveraging electronic medical health record systems have allowed for real-time risk stratification and prevention of pediatric AKI in the hospital setting. Newly developed and validated clinical scores have improved our ability to predict AKI and provide a rational context for biomarker utilization in hospitalized children...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28435184/mining-electronic-health-records-data-domestic-violence-and-adverse-health-effects
#7
Gunnur Karakurt, Vishal Patel, Kathleen Whiting, Mehmet Koyutürk
Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim's quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women's health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims...
January 2017: Journal of Family Violence
https://www.readbyqxmd.com/read/28435100/montreal-accord-on-patient-reported-outcomes-use-series-paper-5-patient-reported-outcomes-pro-can-be-linked-to-epidemiologic-measures-to-monitor-populations-and-inform-public-health-decisions
#8
Hiroshi Mamiya, Lisa M Lix, William Gardner, Susan J Bartlett, Sara Ahmed, David Buckeridge
BACKGROUND: Comprehensive picture of population health status can be captured by the incorporation of patient reported outcome measures into population health monitoring. OBJECTIVE: To identify current state, opportunities, and future research related to the utilization of patient reported outcome measures for population health monitoring in Canada. DISCUSSIONS: Patient reported outcome measures can help to identify community health needs in public health topics including injury, chronic disease, and communicable disease...
April 20, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28434457/system-changes-to-implement-the-joint-commission-tobacco-treatment-tob-performance-measures-for-improving-the-treatment-of-tobacco-use-among-hospitalized-patients
#9
Donna Shelley, Keith S Goldfeld, Hannah Park, Ana Mola, Ryan Sullivan, Jonathan Austrian
BACKGROUND: In 2012 The Joint Commission implemented new Tobacco Treatment (TOB) performance measures for hospitals. A study evaluated the impact of a hospital-based electronic health record (EHR) intervention on adherence to the revised TOB measures. METHODS: The study was conducted in two acute care hospitals in New York City. Data abstracted from the EHR were analyzed retrospectively from 4,871 smokers discharged between December 2012 and March 2015 to evaluate the impact of two interventions: an order set to prompt clinicians to prescribe pharmacotherapy and a nurse-delivered counseling module that automatically populated the nursing care plan for all smokers...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434454/measuring-to-improve-medication-reconciliation-in-a-large-subspecialty-outpatient-practice
#10
Elizabeth Kern, Meg B Dingae, Esther L Langmack, Candace Juarez, Gary Cott, Sarah K Meadows
BACKGROUND: To assess performance in medication reconciliation (med rec)-the process of comparing and reconciling patients' medication lists at clinical transition points-and demonstrate improvement in an outpatient setting, sustainable and valid measures are needed. METHODS: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs), and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR)...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434279/extended-use-of-electronic-health-records-by-primary-care-physicians-does-the-electronic-health-record-artefact-matter
#11
Louis Raymond, Guy Paré, Marie Marchand
The deployment of electronic health record systems is deemed to play a decisive role in the transformations currently being implemented in primary care medical practices. This study aims to characterize electronic health record systems from the perspective of family physicians. To achieve this goal, we conducted a survey of physicians practising in private clinics located in Quebec, Canada. We used valid responses from 331 respondents who were found to be representative of the larger population. Data provided by the physicians using the top three electronic health record software products were analysed in order to obtain statistically adequate sub-sample sizes...
April 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28434278/electronic-health-record-use-among-cancer-patients-insights-from-the-health-information-national-trends-survey
#12
Yulia A Strekalova
Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute's Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access...
April 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28434027/can-ultrasound-be-used-as-the-primary-imaging-in-children-with-suspected-crohn-disease
#13
Timothy L Tsai, Megan B Marine, Matthew R Wanner, Matthew L Cooper, Steven J Steiner, Fangqian Ouyang, S Gregory Jennings, Boaz Karmazyn
BACKGROUND: There is growing literature on the use of ultrasound (US) for evaluation of Crohn disease in adults, but few studies have been conducted on children. Several studies demonstrated high accuracy of US in the diagnosis of Crohn disease. Using US as the primary screening imaging modality for Crohn disease can reduce health care costs, the need for sedation and ionizing radiation exposure. OBJECTIVE: The aim of our study is to determine if US can be used for screening evaluation of pediatric Crohn disease...
April 22, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28433675/montreal-accord-on-patient-reported-outcomes-use-series-paper-8-patient-reported-outcomes-pro-in-electronic-health-records-can-inform-clinical-and-policy-decisions
#14
S Ahmed, P Ware, W Gardner, J Witter, C O Bingham, D Khairy, S J Bartlett
BACKGROUND: Given that the goal of healthcare systems is to improve and maintain the health of the populations they serve, the indicators of performance must include outcomes that are meaningful to patients. The growth of health technologies provides an unprecedented opportunity to integrate the patient voice into clinical care by linking electronic health records (EHR) to patient-reported outcome (PRO) data collection. However, PRO data must be relevant, meaningful, and actionable for those who will have to invest the time and effort to collect it...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28433591/-artificial-intelligence-applied-to-radiation-oncology
#15
J-E Bibault, A Burgun, P Giraud
Performing randomised comparative clinical trials in radiation oncology remains a challenge when new treatment modalities become available. One of the most recent examples is the lack of phase III trials demonstrating the superiority of intensity-modulated radiation therapy in most of its current indications. A new paradigm is developing that consists in the mining of large databases to answer clinical or translational issues. Beyond national databases (such as SEER or NCDB), that often lack the necessary level of details on the population studied or the treatments performed, electronic health records can be used to create detailed phenotypic profiles of any patients...
April 19, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#16
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28432662/targeting-ldl-cholesterol-beyond-absolute-goals-toward-personalized-risk
#17
REVIEW
Morton Leibowitz, Chandra Cohen-Stavi, Sanjay Basu, Ran D Balicer
PURPOSE OF REVIEW: The aim of this study was to review and assess the evidence for low-density lipoprotein cholesterol (LDL-C) treatment goals as presented in current guidelines for primary and secondary prevention of cardiovascular disease. RECENT FINDINGS: Different sets of guidelines and clinical studies for secondary prevention have centered on lower absolute LDL-C targets [<70 mg/dL (<1.8 mmol/L)], greater percent reductions of LDL-C (≥50%), or more intense treatment to achieve greater reductions in cardiovascular risk...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28432148/systolic-blood-pressure-trajectory-frailty-and-all-cause-mortality-over-80-years-of-age-cohort-study-using-electronic-health-records
#18
Rathi Ravindrarajah, Nisha C Hazra, Shota Hamada, Judith Charlton, Stephen H D Jackson, Alex Dregan, Martin C Gulliford
Background -Clinical trials show benefit from lowering systolic blood pressure in people aged ≥80 years but non-randomised epidemiological studies suggest lower systolic blood pressure may be associated with higher mortality. This study aimed to evaluate associations of SBP with all-cause mortality by frailty category over 80 years of age and to evaluate SBP trajectories before death. Methods -A population-based cohort study was conducted using electronic health records of 144,403 participants aged 80 and older registered with family practices in the United Kingdom from 2001 to 2014...
April 21, 2017: Circulation
https://www.readbyqxmd.com/read/28430829/effect-of-a-price-transparency-intervention-in-the-electronic-health-record-on-clinician-ordering-of-inpatient-laboratory-tests-the-price-randomized-clinical-trial
#19
Mina S Sedrak, Jennifer S Myers, Dylan S Small, Irving Nachamkin, Justin B Ziemba, Dana Murray, Gregory W Kurtzman, Jingsan Zhu, Wenli Wang, Deborah Mincarelli, Daniel Danoski, Brian P Wells, Jeffrey S Berns, Patrick J Brennan, C William Hanson, C Jessica Dine, Mitesh S Patel
Importance: Many health systems are considering increasing price transparency at the time of order entry. However, evidence of its impact on clinician ordering behavior is inconsistent and limited to single-site evaluations of shorter duration. Objective: To test the effect of displaying Medicare allowable fees for inpatient laboratory tests on clinician ordering behavior over 1 year. Design, Setting, and Participants: The Pragmatic Randomized Introduction of Cost data through the electronic health record (PRICE) trial was a randomized clinical trial comparing a 1-year intervention to a 1-year preintervention period, and adjusting for time trends and patient characteristics...
April 21, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28430572/lessons-about-so-called-difficult-patients-from-the-uk-controversy-over-patient-access-to-electronic-health-records
#20
Federica Lucivero
Increasing numbers of patients have direct access to their electronic health records (EHRs). Proponents of direct access argue that it empowers patients by making them more informed and offering them more control over their health and care. According to some proponents of patients' access to EHRs, clinicians' concerns about potential negative implications are grounded in a form of paternalism that protects clinicians' authority. This paper draws upon narratives from patients in the United Kingdom (UK) who have access to their EHRs and suggests strategies for moving beyond these controversies between proponents and critics of the system...
April 1, 2017: AMA Journal of Ethics
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