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https://www.readbyqxmd.com/read/29791929/documenting-routinely-what-matters-to-people-standardized-headings-for-health-records-of-patients-with-chronic-health-conditions
#1
Birgit Prodinger, Paul Rastall, Dipak Kalra, Darren Wooldridge, Iain Carpenter
OBJECTIVE:  Specifying the content in electronic health records (EHRs) through standardized headings based on international reference classifications will facilitate their semantic interoperability. The objective of this study was to specify potential chapter headings for EHRs aligned with the World Health Organization's (WHO) International Classification of Functioning, Disability, and Health (ICF) based on the perspectives of people living with chronic health conditions, carers, and professionals...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29790073/effect-of-low-back-pain-risk-stratification-strategy-on-patient-outcomes-and-care-processes-the-match-randomized-trial-in-primary-care
#2
Dan Cherkin, Benjamin Balderson, Rob Wellman, Clarissa Hsu, Karen J Sherman, Sarah C Evers, Rene Hawkes, Andrea Cook, Martin D Levine, Diane Piekara, Pam Rock, Katherine Talbert Estlin, Georgie Brewer, Mark Jensen, Anne-Marie LaPorte, John Yeoman, Gail Sowden, Jonathan C Hill, Nadine E Foster
BACKGROUND: The STarT Back strategy for categorizing and treating patients with low back pain (LBP) improved patients' function while reducing costs in England. OBJECTIVE: This trial evaluated the effect of implementing an adaptation of this approach in a US setting. DESIGN: The Matching Appropriate Treatments to Consumer Healthcare needs (MATCH) trial was a pragmatic cluster randomized trial with a pre-intervention baseline period. Six primary care clinics were pair randomized, three to training in the STarT Back strategy and three to serve as controls...
May 22, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29788914/nutrition-care-practices-of-primary-care-providers-for-weight-management-in-multidisciplinary-primary-care-settings-in-ontario-canada-a-qualitative-study
#3
Stephanie Aboueid, Ivy Bourgeault, Isabelle Giroux
BACKGROUND: Despite the recommended guidelines on addressing diet for the management and prevention of obesity in primary care, the literature highlights that their implementation has been suboptimal. In this paper, we provide an in-depth understanding of current nutrition-related weight management practices of primary care providers (PCPs) working in relatively new multidisciplinary health care settings in Ontario. METHODS: Three types of multidisciplinary primary care settings were included (2 Family Health Teams, 3 Community Health Centres and 1 Nurse Practitioner-Led Clinic)...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788287/provider-and-patient-satisfaction-with-the-integration-of-ambulatory-and-hospital-ehr-systems
#4
Chad D Meyerhoefer, Susan A Sherer, Mary E Deily, Shin-Yi Chou, Xiaohui Guo, Jie Chen, Michael Sheinberg, Donald Levick
Objective: The installation of EHR systems can disrupt operations at clinical practice sites, but also lead to improvements in information availability. We examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. Methods: We collected data on provider satisfaction through 4 survey rounds during the phased implementation of the EHR...
May 16, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29787309/predicting-intensive-care-unit-readmission-with-machine-learning-using-electronic-health-record-data
#5
Juan C Rojas, Kyle A Carey, Dana P Edelson, Laura R Venable, Michael D Howell, Matthew M Churpek
RATIONALE: Patients transferred from the intensive care unit (ICU) to the wards who are later readmitted to the ICU have increased length of stay, healthcare expenditure, and mortality compared to those who are never readmitted. Improving risk-stratification for patients transferred to the wards could have important benefits for critically ill hospitalized patients. OBJECTIVE: We aimed to use a machine-learning technique to derive and validate an ICU readmission prediction model with variables available in the electronic health record (EHR) in real-time and compare it to previously published algorithms...
May 22, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29768633/evaluating-the-efficiency-and-safety-of-speech-recognition-within-a-commercial-electronic-health-record-system-a-replication-study
#6
Tobias Hodgson, Farah Magrabi, Enrico Coiera
OBJECTIVE:  To conduct a replication study to validate previously identified significant risks and inefficiencies associated with the use of speech recognition (SR) for documentation within an electronic health record (EHR) system. METHODS:  Thirty-five emergency department clinicians undertook randomly allocated clinical documentation tasks using keyboard and mouse (KBM) or SR using a commercial EHR system. The experiment design, setting, and tasks (E2) replicated an earlier study (E1), while technical integration issues that may have led to poorer SR performance were addressed...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29756524/chest-pain-atherosclerotic-cardiovascular-disease-risk-and-cardiology-referral-in-primary-care
#7
Vishaal Buch, Hayley Ralph, Joanne Salas, Paul J Hauptman, Dawn Davis, Jeffrey F Scherrer
BACKGROUND: The atherosclerotic cardiovascular disease (ASCVD) 10-year risk estimate is recommended by cardiologists for determining risk of a cardiac event. However, the majority of patients presenting to primary care with chest pain have noncardiac etiologies. Therefore, we determined if high versus low ASCVD risk was associated with primary care physicians' referral to cardiology in patients with and without chest pain. METHODS: Deidentified electronic health record (EHR) data was obtained from 5795 patients treated in academic primary care clinics from 2008 to 2015...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29753874/simulation-of-patient-flow-in-multiple-healthcare-units-using-process-and-data-mining-techniques-for-model-identification
#8
Sergey V Kovalchuk, Anastasia A Funkner, Oleg G Metsker, Aleksey N Yakovlev
INTRODUCTION: An approach to building a hybrid simulation of patient flow is introduced with a combination of data-driven methods for automation of model identification. The approach is described with a conceptual framework and basic methods for combination of different techniques. The implementation of the proposed approach for simulation of the acute coronary syndrome (ACS) was developed and used in an experimental study. METHODS: A combination of data, text, process mining techniques, and machine learning approaches for the analysis of electronic health records (EHRs) with discrete-event simulation (DES) and queueing theory for the simulation of patient flow was proposed...
May 10, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29751829/querying-archetype-based-ehrs-by-search-ontology-based-xpath-engineering
#9
Stefan Kropf, Alexandr Uciteli, Katrin Schierle, Peter Krücken, Kerstin Denecke, Heinrich Herre
BACKGROUND: Legacy data and new structured data can be stored in a standardized format as XML-based EHRs on XML databases. Querying documents on these databases is crucial for answering research questions. Instead of using free text searches, that lead to false positive results, the precision can be increased by constraining the search to certain parts of documents. METHODS: A search ontology-based specification of queries on XML documents defines search concepts and relates them to parts in the XML document structure...
May 11, 2018: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/29748851/a-platform-for-innovation-and-standards-evaluation-a-case-study-from-the-openmrs-open-source-radiology-information-system
#10
Judy W Gichoya, Marc Kohli, Larry Ivange, Teri S Schmidt, Saptarshi Purkayastha
Open-source development can provide a platform for innovation by seeking feedback from community members as well as providing tools and infrastructure to test new standards. Vendors of proprietary systems may delay adoption of new standards until there are sufficient incentives such as legal mandates or financial incentives to encourage/mandate adoption. Moreover, open-source systems in healthcare have been widely adopted in low- and middle-income countries and can be used to bridge gaps that exist in global health radiology...
May 10, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29747644/electronic-health-record-tools-to-assist-with-children-s-insurance-coverage-a-mixed-methods-study
#11
Jennifer E DeVoe, Megan Hoopes, Christine A Nelson, Deborah J Cohen, Aleksandra Sumic, Jennifer Hall, Heather Angier, Miguel Marino, Jean P O'Malley, Rachel Gold
BACKGROUND: Children with health insurance have increased access to healthcare and receive higher quality care. However, despite recent initiatives expanding children's coverage, many remain uninsured. New technologies present opportunities for helping clinics provide enrollment support for patients. We developed and tested electronic health record (EHR)-based tools to help clinics provide children's insurance assistance. METHODS: We used mixed methods to understand tool adoption, and to assess impact of tool use on insurance coverage, healthcare utilization, and receipt of recommended care...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29735477/finding-meaning-in-medication-reconciliation-using-electronic-health-records-qualitative-analysis-in-safety-net-primary-and-specialty-care
#12
George Yaccoub Matta, Elaine C Khoong, Courtney R Lyles, Dean Schillinger, Neda Ratanawongsa
BACKGROUND: Safety net health systems face barriers to effective ambulatory medication reconciliation for vulnerable populations. Although some electronic health record (EHR) systems offer safety advantages, EHR use may affect the quality of patient-provider communication. OBJECTIVE: This mixed-methods observational study aimed to develop a conceptual framework of how clinicians balance the demands and risks of EHR and communication tasks during medication reconciliation discussions in a safety net system...
May 7, 2018: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29732457/a-computable-definition-of-sepsis-facilitates-screening-and-performance-improvement-tracking
#13
Lauren J Alessi, Holly R Warmus, Erin K Schaffner, Sajel Kantawala, Joseph Carcillo, Johanna Rosen, Christopher M Horvat
Background: Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. Objectives: We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods: Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control...
March 2018: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29728348/the-acceptability-and-feasibility-of-implementing-a-bio-behavioral-enhanced-surveillance-tool-for-sexually-transmitted-infections-in-england-mixed-methods-study
#14
Sonali Wayal, David Reid, Paula B Blomquist, Peter Weatherburn, Catherine H Mercer, Gwenda Hughes
BACKGROUND: Sexually transmitted infection (STI) surveillance is vital for tracking the scale and pattern of epidemics; however, it often lacks data on the underlying drivers of STIs. OBJECTIVE: This study aimed to assess the acceptability and feasibility of implementing a bio-behavioral enhanced surveillance tool, comprising a self-administered Web-based survey among sexual health clinic attendees, as well as linking this to their electronic health records (EHR) held in England's national STI surveillance system...
May 4, 2018: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/29726447/feasibility-and-design-of-an-electronic-surgical-safety-checklist-in-a-teaching-hospital-a-user-based-approach
#15
Karin Kiefel, Klaus Donsa, Peter Tiefenbacher, Robert Mischak, Gernot Brunner, Gerald Sendlhofer, Thomas Pieber
BACKGROUND: The Surgical Safety Checklist (SSC) is routinely used in operating rooms (OR) but its acceptance is low. One promising way to improve acceptance of the SSC and thus quality of patient care is digitalization. OBJECTIVE: To investigate how a digitalization of the SSC could be implemented in a teaching hospital. Based on the identified user requirements we designed a first user interface (UI). METHOD: We performed a literature review, identified user perceptions and requirements during 12 interviews including a standardized questionnaire in surgical departments at the University Hospital Graz (Austria)...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29726422/effectiveness-of-anonymization-methods-in-preserving-patients-privacy-a-systematic-literature-review
#16
Mostafa Langarizadeh, Azam Orooji, Abbas Sheikhtaheri
BACKGROUND: An ever growing for application of electronic health records (EHRs) has improved healthcare providers' communications, access to data for secondary use and promoted the quality of services. Patient's privacy has been changed to a great issue today since there are large loads of critical information in EHRs. Therefore, many privacy preservation techniques have been proposed and anonymization is a common one. OBJECTIVES: This study aimed to investigate the effectiveness of anonymization in preserving patients' privacy...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29719309/capabilities-and-advantages-of-cloud-computing-in-the-implementation-of-electronic-health-record
#17
Maryam Ahmadi, Nasim Aslani
Background: With regard to the high cost of the Electronic Health Record (EHR), in recent years the use of new technologies, in particular cloud computing, has increased. The purpose of this study was to review systematically the studies conducted in the field of cloud computing. Methods: The present study was a systematic review conducted in 2017. Search was performed in the Scopus, Web of Sciences, IEEE, Pub Med and Google Scholar databases by combination keywords...
2018: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/29701854/adherence-to-recommended-electronic-health-record-safety-practices-across-eight-health-care-organizations
#18
Dean F Sittig, Mandana Salimi, Ranjit Aiyagari, Colin Banas, Brian Clay, Kathryn A Gibson, Ashutosh Goel, Robert Hines, Christopher A Longhurst, Vimal Mishra, Anwar M Sirajuddin, Tyler Satterly, Hardeep Singh
Objective: The Safety Assurance Factors for EHR Resilience (SAFER) guides were released in 2014 to help health systems conduct proactive risk assessment of electronic health record (EHR)- safety related policies, processes, procedures, and configurations. The extent to which SAFER recommendations are followed is unknown. Methods: We conducted risk assessments of 8 organizations of varying size, complexity, EHR, and EHR adoption maturity. Each organization self-assessed adherence to all 140 unique SAFER recommendations contained within 9 guides (range 10-29 recommendations per guide)...
April 26, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29697806/decreasing-triage-time-effects-of-implementing-a-step-wise-esi-algorithm-in-an-ehr
#19
Stephen Villa, Ellen J Weber, Steven Polevoi, Christopher Fee, Andrew Maruoka, Tina Quon
Objectives: To determine if adapting a widely-used triage scale into a computerized algorithm in an electronic health record (EHR) shortens emergency department (ED) triage time. Design: Before-and-after quasi-experimental study. Setting: Urban, tertiary care hospital ED. Participants: Consecutive adult patient visits between July 2011 and June 2013. Intervention: A step-wise algorithm, based on the Emergency Severity Index (ESI-5) was programmed into the triage module of a commercial EHR...
April 25, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29692945/challenges-in-communication-from-referring-clinicians-to-pathologists-in-the-electronic-health-record-era
#20
Andrea Lynne Barbieri, Oluwole Fadare, Linda Fan, Hardeep Singh, Vinita Parkash
We report on the role played by electronic health record inbox messages (EHRmsg) in a safety event involving pathology. Evolving socio-cultural norms led to the coopting of EHRmsg for alternate use and oversight of a clinician to pathologist request. We retrospectively examined EHR inbox messages to pathologists over a 3 month block. 36 messages from 22 pathologists were assessed. 26 pertained to patient care including requests for report corrections and additional testing. 88% of requests had gone unaddressed...
2018: Journal of Pathology Informatics
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