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Hospital informatic

Timothy E Sweeney, Tej D Azad, Michele Donato, Winston A Haynes, Thanneer M Perumal, Ricardo Henao, Jesús F Bermejo-Martin, Raquel Almansa, Eduardo Tamayo, Judith A Howrylak, Augustine Choi, Grant P Parnell, Benjamin Tang, Marshall Nichols, Christopher W Woods, Geoffrey S Ginsburg, Stephen F Kingsmore, Larsson Omberg, Lara M Mangravite, Hector R Wong, Ephraim L Tsalik, Raymond J Langley, Purvesh Khatri
OBJECTIVES: To find and validate generalizable sepsis subtypes using data-driven clustering. DESIGN: We used advanced informatics techniques to pool data from 14 bacterial sepsis transcriptomic datasets from eight different countries (n = 700). SETTING: Retrospective analysis. SUBJECTS: Persons admitted to the hospital with bacterial sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A unified clustering analysis across 14 discovery datasets revealed three subtypes, which, based on functional analysis, we termed "Inflammopathic, Adaptive, and Coagulopathic...
March 13, 2018: Critical Care Medicine
Matthieu Ollivier, Sébastien Parratte, Ludovic Lino, Xavier Flecher, Sébastien Pesenti, Jean-Noël Argenson
BACKGROUND: Previously published studies reported benefits of computer-assisted surgery (CAS) in terms of radiographic implant position in TKA, but whether these improvements result in clinically important survival differences or functional differences that a patient might perceive at a minimum 10-year followup remains largely unknown. QUESTIONS/PURPOSES: We performed a prospective randomized trial and asked whether CAS (1) improved survival free from aseptic loosening; and (2) demonstrated any clear difference in patient-reported outcomes at latest followup using validated outcome measures at minimum 10-year followup...
January 2018: Clinical Orthopaedics and related Research
Sajidah Al-Hawamdih, Muayyad M Ahmad
The purpose of this study was to examine nursing informatics competency and the quality of information processing among nurses in Jordan. The study was conducted in a large hospital with 380 registered nurses. The hospital introduced the electronic health record in 2010. The measures used in this study were personal and job characteristics, self-efficacy, Self-Assessment Nursing Informatics Competencies, and Health Information System Monitoring Questionnaire. The convenience sample consisted of 99 nurses who used the electronic health record for at least 3 months...
March 2018: Computers, Informatics, Nursing: CIN
Steve Harris, Sinan Shi, David Brealey, Niall S MacCallum, Spiros Denaxas, David Perez-Suarez, Ari Ercole, Peter Watkinson, Andrew Jones, Simon Ashworth, Richard Beale, Duncan Young, Stephen Brett, Mervyn Singer
OBJECTIVE: To build and curate a linkable multi-centre database of high resolution longitudinal electronic health records (EHR) from adult Intensive Care Units (ICU). To develop a set of open-source tools to make these data 'research ready' while protecting patient's privacy with a particular focus on anonymisation. MATERIALS AND METHODS: We developed a scalable EHR processing pipeline for extracting, linking, normalising and curating and anonymising EHR data. Patient and public involvement was sought from the outset, and approval to hold these data was granted by the NHS Health Research Authority's Confidentiality Advisory Group (CAG)...
April 2018: International Journal of Medical Informatics
Saad Khan
With the recent passage of the National Defense Authorization Act for Fiscal Year 2017, Congress has triggered groundbreaking Military Health System organizational restructuring with the Defense Health Agency assuming responsibility for managing all hospitals and clinics owned by the Army, Navy, and Air Force. This is a major shift toward a modern value-based managed care system, which will require much greater military-civilian health care delivery integration to be in place by October 2018. Just before the National Defense Authorization Act for Fiscal Year 2017 passage, the Department of Defense had already begun a seismic shift and awarded a contract for the new Military Health System-wide electronic health record system...
February 6, 2018: Military Medicine
Roberta Fernanda da Paz de Souza Paiva, Marcela Fernanda da Paz de Souza
The current study aimed to assess the association between socioeconomic conditions, basic sanitation, and coverage by family health teams and hospitalizations for waterborne diseases. The analysis of socioeconomic conditions and sanitation was based on an ecological study with data from the Brazilian National Household Sample Survey (PNAD) and the Brazilian Health Informatics Departament (DATASUS) database (observations for the States and Federal District) for the year 2013. Associations between family health teams and hospitalization were assessed by simple regressions, with data from DATASUS and the Department of Primary Care of Ministry of Health from 1998 to 2014...
February 5, 2018: Cadernos de Saúde Pública
Scott M Sutherland, Stuart L Goldstein, Sean M Bagshaw
The recognition of a standardized, consensus definition for acute kidney injury (AKI) has been an important milestone in critical care nephrology, which has facilitated innovation in prevention, quality of care, and outcomes research among the growing population of hospitalized patients susceptible to AKI. Concomitantly, there have been substantial advances in "big data" technologies in medicine, including electronic health records (EHR), data registries and repositories, and data management and analytic methodologies...
2018: Contributions to Nephrology
Muhammad Faisal, Andy Scally, Donald Richardson, Kevin Beatson, Robin Howes, Kevin Speed, Mohammed A Mohammed
OBJECTIVES: To develop a logistic regression model to predict the risk of sepsis following emergency medical admission using the patient's first, routinely collected, electronically recorded vital signs and blood test results and to validate this novel computer-aided risk of sepsis model, using data from another hospital. DESIGN: Cross-sectional model development and external validation study reporting the C-statistic based on a validated optimized algorithm to identify sepsis and severe sepsis (including septic shock) from administrative hospital databases using International Classification of Diseases, 10th Edition, codes...
April 2018: Critical Care Medicine
C Maier, L Lang, H Storf, P Vormstein, R Bieber, J Bernarding, T Herrmann, C Haverkamp, P Horki, J Laufer, F Berger, G Höning, H W Fritsch, J Schüttler, T Ganslandt, H U Prokosch, M Sedlmayr
BACKGROUND:  In 2015, the German Federal Ministry of Education and Research initiated a large data integration and data sharing research initiative to improve the reuse of data from patient care and translational research. The Observational Medical Outcomes Partnership (OMOP) common data model and the Observational Health Data Sciences and Informatics (OHDSI) tools could be used as a core element in this initiative for harmonizing the terminologies used as well as facilitating the federation of research analyses across institutions...
January 2018: Applied Clinical Informatics
Robin de Putter, Karen Geboes, Marc De Man, Simon Van Belle
Background Anemia is frequent in patients with cancer and is often multifactorial. Treatment depends on etiology and can consist of transfusions, intravenous iron (IV Fe), and/or erythropoiesis-stimulating agents (ESA). Several studies have shown that cancer-related anemia is undertreated. The aim of this study is to compare usual practice in a university hospital with the international guidelines. Methods Using the hospital and pharmacy informatics all adults (≥18 years), who received a treatment for anemia (transfusion, IV Fe, ESA) from February to August 2016 during palliative chemotherapy, were identified...
January 16, 2018: Acta Clinica Belgica
Christian Haverkamp, Thomas Ganslandt, Petar Horki, Martin Boeker, Arnd Dörfler, Stefan Schwab, Joachim Berkefeld, Waltraud Pfeilschifter, Wolf-Dirk Niesen, Karl Egger, Manfred Kaps, Marc A Brockmann, Eva Neumaier-Probst, Kristina Szabo, Martin Skalej, Siegfried Bien, Christoph Best, Hans-Ulrich Prokosch, Horst Urbach
BACKGROUND AND PURPOSE: Mechanical thrombectomy, in addition to intravenous (i.v.) thrombolysis is recommended for treatment of acute stroke in patients with large vessel occlusions (LVO) in the anterior circulation up to 6 h after symptom onset. We compared thrombectomy rates of eight university hospitals of the MIRACUM consortium to analyze the implementation of this guideline in clinical routine. METHODS: Anonymized billing data in a standardized format were loaded into a local i2b2 data warehouse by applying already existing extract, transform and load (ETL) routines...
January 8, 2018: Clinical Neuroradiology
Roy B Jones, Charles Martinez, Navneet S Majhail, Matthew Prestegaard, Martin Maiers, Mitchell Horwitz, Krishna Komanduri
Informatics strategies and applications available to stem cell transplant (SCT) programs are diverse and changing rapidly. While most hospitals have electronic medical records (EMR), few are equipped with specialized SCT applications. Most EMR do not contain critical elements to support SCT practice and research. Strategies to optimize IT resources to support SCT programs are reviewed, and technical and workflow support are discussed. Guidance and rationale for the use of both SCT applications and EMR are emphasized...
December 27, 2017: Biology of Blood and Marrow Transplantation
Olive Fast, Janet Rankin
In this paper, we examine the practicalities of nurse managers' work. We expose how managers' commitments to transformational leadership are undermined by the rationing practices and informatics of hospital reform underpinned by the ideas of new public management. Using institutional ethnography, we gathered data in a Canadian hospital. We began by interviewing and observing frontline leaders, nurse managers, and expanded our inquiry to include interviews with other nurses, staffing clerks, and administrators whose work intersected with that of nurse managers...
December 25, 2017: Nursing Inquiry
Anthony Blash, Connie L Saltsman, Condit Steil
BACKGROUND AND PURPOSE: Upon completion of their post-graduate training, pharmacy informatics residents need to be prepared to interact with clinical and technology experts in the new healthcare environment. This study describes pharmacy informatics residency programs within the United States. EDUCATIONAL ACTIVITY AND SETTING: Preliminary information for all pharmacy informatics residency programs was accessed from program webpages. An email was sent out to programs asking them to respond to a six-item questionnaire...
November 2017: Currents in Pharmacy Teaching & Learning
Kelly R Reveles, Kenneth A Lawson, Eric M Mortensen, Mary Jo V Pugh, Jim M Koeller, Jacqueline R Argamany, Christopher R Frei
INTRODUCTION: Prior studies demonstrated marked increases in Clostridium difficile infection (CDI) in the United States (U.S.) in recent years. The objective of this study was to describe the epidemiology of initial and recurrent CDI in a national Veterans Health Administration (VHA) cohort over a 12-year period. METHODS: This was a retrospective cohort study of all adult VHA beneficiaries with CDI (ICD-9-CM code 008.45) plus a positive CDI stool test between October 1, 2002 and September 30, 2014...
2017: PloS One
Ming Y Lim, Joyce Foster, Angela Rourk, Charles S Greenberg
Many medical centers are faced with a major challenge in making an accurate diagnosis of heparin-induced thrombocytopenia (HIT) and ensuring appropriate changes in management strategy in line with guideline recommendations. We report the initial and long-term impact and challenges of institution-wide changes in the diagnosis and management of HIT in the inpatient setting at an academic medical center. We established a HIT Task Force, consisting of a multidisciplinary team of non-malignant hematologists, nursing, pharmacist, pathology, blood bank and clinical lab informatics...
January 2018: Journal of Thrombosis and Thrombolysis
Sai Wai Yan Myint Thu, Boonchai Kijsanayotin, Jaranit Kaewkungwal, Ngamphol Soonthornworasiri, Wirichada Pan-Ngum
Objectives: To overcome challenges in the implementation of electronic dental record systems in a low-resource setting, it is crucial to know the level of users' satisfaction with the existing system of paper-based dental records and their perceptions of electronic dental records. Methods: A cross-sectional paper-based questionnaire survey was conducted among Myanmar dental professionals who worked in one of two teaching hospitals or in private dental clinics. Descriptive data were analyzed and regression analysis was carried out to identify factors influencing perceptions of electronic dental records...
October 2017: Healthcare Informatics Research
Francisco Winter Dos Santos Figueiredo, Tábata Cristina do Carmo Almeida, Débora Terra Cardial, Érika da Silva Maciel, Fernando Luiz Affonso Fonseca, Fernando Adami
BACKGROUND: Breast cancer affects millions of women worldwide, particularly in Brazil, where public healthcare system is an important model in health organization and the cost of chronic disease has affected the economy in the first decade of the twenty-first century. The aim was to evaluate the role of health policy in the burden of breast cancer in Brazil between 2004 and 2014. METHODS: Secondary analysis was performed in 2017 with Brazilian Health Ministry official data, extracted from the Department of Informatics of the National Health System...
November 28, 2017: BMC Women's Health
Baraa M Hammoudi, Samantha Ismaile, Omar Abu Yahya
BACKGROUND: Patient safety is a significant challenge facing healthcare systems. The administration of medication is pivotal to patient safety, and errors in drug administration are associated with mortality and morbidity. In this study, we assessed the factors contributing to the occurrence and reporting of medication errors from the nurse's perspective. METHODS: In this descriptive cross-sectional study, we distributed a validated questionnaire to 367 nurses at a large public hospital and obtained a response rate of 73...
November 22, 2017: Scandinavian Journal of Caring Sciences
Cynthia S Selleck, Matthew Fifolt, Heidi Burkart, Jennifer Sandson Frank, William A Curry, Lisle S Hites
This article details a nurse-led, interprofessional collaborative practice (IPCP) model that was developed to provide primary care to a medically indigent population in Birmingham, Alabama. Funding to develop and implement this project came from a federal Nurse Education, Practice, Quality and Retention award to the University of Alabama at Birmingham (UAB) School of Nursing, with additional support coming from the UAB Hospital and Health System. The clinic is housed within a local community-based, non-profit organization and all services, including supplies and pharmaceuticals, are provided free of charge to this vulnerable population...
November 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
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