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https://www.readbyqxmd.com/read/28714196/impact-of-an-electronic-health-record-alert-in-primary-care-on-increasing-hepatitis-c-screening-and-curative-treatment-for-baby-boomers
#1
Monica A Konerman, Mary Thomson, Kristen Gray, Meghan Moore, Hetal Choxi, Elizabeth Seif, Anna Sf Lok
Despite effective treatment for chronic hepatitis C (CHC), deficiencies in diagnosis and access preclude disease elimination. Screening of baby boomers remains low. The aims of this study were to assess the impact of an electronic health record (EHR) based prompt on HCV screening rates in baby boomers in primary care, and access to specialty care and treatment among those newly diagnosed. We implemented an EHR based "Best Practice Advisory" (BPA) that prompted primary care providers (PCPs) to perform HCV screening for patients seen in primary care clinic: 1) born between 1945-1965; 2) lacked a prior diagnosis of HCV infection; and 3) lacked prior documented anti-HCV testing...
July 17, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28711345/working-at-the-intersection-of-context-culture-and-technology-provider-perspectives-on-antimicrobial-stewardship-in-the-emergency-department-using-electronic-health-record-clinical-decision-support
#2
Phillip Chung, Jean Scandlyn, Peter S Dayan, Rakesh D Mistry
BACKGROUND: Antibiotic stewardship programs (ASPs) have not been fully developed for the emergency department (ED), in part the result of the barriers characteristic of this setting. Electronic health record-based clinical decision support (EHR CDS) represents a promising strategy to implement ASPs in the ED. We aimed to determine the cultural beliefs and structural barriers and facilitators to implementation of antimicrobial stewardship in the pediatric ED using EHR CDS. METHODS: Interviews and focus groups were conducted with hospital and ED leadership, attending ED physicians, nurse practitioners, physician assistants, and residents at a single health system in Colorado...
July 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28709453/validation-of-multisource-electronic-health-record-data-an-application-to-blood-transfusion-data
#3
Loan R van Hoeven, Martine C de Bruijne, Peter F Kemper, Maria M W Koopman, Jan M M Rondeel, Anja Leyte, Hendrik Koffijberg, Mart P Janssen, Kit C B Roes
BACKGROUND: Although data from electronic health records (EHR) are often used for research purposes, systematic validation of these data prior to their use is not standard practice. Existing validation frameworks discuss validity concepts without translating these into practical implementation steps or addressing the potential influence of linking multiple sources. Therefore we developed a practical approach for validating routinely collected data from multiple sources and to apply it to a blood transfusion data warehouse to evaluate the usability in practice...
July 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28708848/predicting-all-cause-risk-of-30-day-hospital-readmission-using-artificial-neural-networks
#4
Mehdi Jamei, Aleksandr Nisnevich, Everett Wetchler, Sylvia Sudat, Eric Liu
Avoidable hospital readmissions not only contribute to the high costs of healthcare in the US, but also have an impact on the quality of care for patients. Large scale adoption of Electronic Health Records (EHR) has created the opportunity to proactively identify patients with high risk of hospital readmission, and apply effective interventions to mitigate that risk. To that end, in the past, numerous machine-learning models have been employed to predict the risk of 30-day hospital readmission. However, the need for an accurate and real-time predictive model, suitable for hospital setting applications still exists...
2017: PloS One
https://www.readbyqxmd.com/read/28699944/improving-the-readability-of-pediatric-hospital-medicine-discharge-instructions
#5
Ndidi Unaka, Angela Statile, Karen Jerardi, Devesh Dahale, Joan Morris, Brianna Liberio, Ashley Jenkins, Blair Simpson, Randi Mullaney, Jodi Kelley, Michelle Durling, Jennifer Shafer, Patrick Brady
BACKGROUND: Readable discharge instructions may help caregivers understand and implement care plans following hospitalization. Many caregivers of hospitalized children, however, have limited literacy. We aimed to increase the percentage of discharge instructions written at 7th grade level or lower for hospital medicine patients from 13% to 80% in 6 months. METHODS: Quality improvement efforts targeted a 42-bed unit at the community satellite of our large, urban academic hospital...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28679879/assessing-dental-information-requirements-of-electronic-health-records-of-zahedan-dental-school
#6
Farahnaz Sadoughi, Aida Sarsarshahi, Leila Erfannia, Elnaz Yaghoubi
Due to the various beneficiaries of Electronic Health Records (EHR), the information requirements of each group should be taken into account while designing the EHR. In line with the priority of implementing electronic health records in the province of Sistan and Baluchestanin Iran, this study aims to assess the dental information requirements of EHR at Zahedan Dental School. This cross-sectional study was performed in 2014. The study population comprised 6565 faculty members, residents of dental school and staff in Health Information Management of Zahedan Hospitals...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28666044/electronic-health-record-implementation-is-associated-with-a-negligible-change-in-outpatient-volume-and-billing
#7
Matthew L Webb, Daniel D Bohl, Jennifer M Fischer, Andre M Samuel, Adam M Lukasiewicz, Bryce A Basques, Jonathan N Grauer
The Health Information Technology for Economic and Clinical Health (HITECH) Act mandated that hospitals begin using electronic health records (EHRs). To investigate potential up-coding, we reviewed billing data for changes in patient volumes and up-coding around the time of EHR implementation at our academic medical center. We identified all new, consultation, and return outpatient visits on a monthly basis in the general internal medicine and orthopedics departments at our center. We compared the volume of patient visits and the level of billing coding in these 2 departments before and after their transitions to ambulatory EHRs...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28657637/domain-modeling-and-application-development-of-an-archetype-and-xml-based-ehrs-practical-experiences-and-lessons-learnt
#8
Stefan Kropf, Claire Chalopin, Dirk Lindner, Kerstin Denecke
BACKGROUND: Access to patient data within the hospital or between hospitals is still problematic since a variety of information systems is in use applying different vendor specific terminologies and underlying knowledge models. Beyond, the development of electronic health record systems (EHRSs) is time and resource consuming. Thus, there is a substantial need for a development strategy of standardized EHRSs. We are applying a reuse-oriented process model and demonstrate its feasibility and realization on a practical medical use case, which is an EHRS holding all relevant data arising in the context of treatment of tumors of the sella region...
June 28, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28652227/reducing-parental-uncertainty-around-childhood-cancer-implementation-decisions-and-design-trade-offs-in-developing-an-electronic-health-record-linked-mobile-app
#9
Keith Marsolo, William Shuman, Jeremy Nix, Caroline F Morrison, Larry L Mullins, Ahna Lh Pai
BACKGROUND: Parents of children newly diagnosed with cancer are confronted with multiple stressors that place them at risk for significant psychological distress. One strategy that has been shown to help reduce uncertainty is the provision of basic information; however, families of newly diagnosed cancer patients are often bombarded with educational material. Technology has the potential to help families manage their informational needs and move towards normalization. OBJECTIVE: The aim of this study was to create a mobile app that pulls together data from both the electronic health record (EHR) and vetted external information resources to provide tailored information to parents of newly diagnosed children as one method to reduce the uncertainty around their child's illness...
June 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28648221/designing-and-implementing-an-electronic-patient-registry-to-improve-warfarin-monitoring-in-the-ambulatory-setting
#10
Shin-Yu Lee, Roy Cherian, Irene Ly, Claire Horton, Alaya Levi Salley, Urmimala Sarkar
BACKGROUND: Warfarin requires individualized dosing and monitoring in the ambulatory setting for protection against thromboembolic disease. Yet in multiple settings, patients spend upwards of 30% of time outside the therapeutic range, subjecting them to an increased risk of adverse events. At an urban, publicly funded clinic, the electronic health record (EHR) would not support integration with extant warfarin management software, which led to the creation and implementation of an electronic patient registry and a complementary team-based work flow to provide real-time health-system-level data for warfarin patients...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28624074/evaluating-quality-of-dental-care-among-patients-with-diabetes-adaptation-and-testing-of-a-dental-quality-measure-in-electronic-health-records
#11
Ana Neumann, Elsbeth Kalenderian, Rachel Ramoni, Alfa Yansane, Bunmi Tokede, Jini Etolue, Ram Vaderhobli, Kristen Simmons, Joshua Even, Joanna Mullins, Shwetha Kumar, Suhasini Bangar, Krishna Kookal, Joel White, Muhammad Walji
BACKGROUND: Patients with diabetes are at increased risk of developing oral complications, and annual dental examinations are an endorsed preventive strategy. The authors evaluated the feasibility and validity of implementing an automated electronic health record (EHR)-based dental quality measure to determine whether patients with diabetes received such evaluations. METHODS: The authors selected a Dental Quality Alliance measure developed for claims data and adapted the specifications for EHRs...
June 16, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28620094/an-interrupted-time-series-analysis-to-determine-the-effect-of-an-electronic-health-record-based-intervention-on-appropriate-screening-for-type-2-diabetes-in-urban-primary-care-clinics-in-new-york-city
#12
Jeanine B Albu, Nancy Sohler, Rui Li, Xuan Li, Edwin Young, Edward W Gregg, Dennis Ross-Degnan
OBJECTIVE: To determine the impact of a health system-wide primary care diabetes management system, which included targeted guidelines for type 2 diabetes (T2DM) and prediabetes (dysglycemia) screening, on detection of previously undiagnosed dysglycemia cases. RESEARCH DESIGN AND METHODS: Intervention included electronic health record (EHR)-based decision support and standardized providers and staff training for using the American Diabetes Association guidelines for dysglycemia screening...
June 15, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28614166/seven-years-after-meaningful-use-physicians-and-nurses-experiences-with-electronic-health-records
#13
Cheryl Rathert, Tracy H Porter, Jessica N Mittler, Michelle Fleig-Palmer
Although the federal government's Meaningful Use electronic health record (EHR) implementation program resulted in some successes, there have been many challenges. The purpose of this study was to obtain detailed empirical data to better understand physicians' and nurses' experiences with EHRs. We conducted in-depth interviews with 30 physicians and nurses from two large health systems that were focused on attaining Stage 3 Meaningful Use criteria. Thematic framework analysis identified themes related to perceived benefits and challenges with EHR use...
June 13, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28607678/choosing-wisely-a-quality-improvement-initiative-to-decrease-unnecessary-preoperative-testing
#14
John Matulis, Stephen Liu, John Mecchella, Frederick North, Alison Holmes
Dartmouth-Hitchcock Medical Center is a rural, academic medical center in the northeastern United States; its General Internal Medicine (GIM) division performs about 900 low and intermediate surgical risk preoperative evaluations annually. Routine preoperative testing in these evaluations is widely considered a low-value service. Our baseline data sample showed unnecessary testing rates of approximately 36%. A multi-disciplinary team used a micro-systems approach to analyze the existing process and formulate a rapid cycle improvement strategy...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28599812/making-electronic-health-records-support-quality-management-a-narrative-review
#15
REVIEW
Peter Triantafillou
BACKGROUND: Since the 1990s many hospitals in the OECD countries have introduced electronic health record (EHR) systems. A number of studies have examined the factors impinging on EHR implementation. Others have studied the clinical efficacy of EHR. However, only few studies have explored the (intermediary) factors that make EHR systems conducive to quality management (QM). OBJECTIVE: Undertake a narrative review of existing studies in order to identify and discuss the factors conducive to making EHR support three dimensions of QM: clinical outcomes, managerial monitoring and cost-effectiveness...
August 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28595766/improving-universal-pediatric-lipid-screening
#16
Kathleen DeSantes, Ann Dodge, Jens Eickhoff, Amy L Peterson
OBJECTIVE: To evaluate whether the release of national guidelines, electronic health record (EHR) modifications, and educational initiatives correlated with changes in pediatricians' universal lipid screening practices. STUDY DESIGN: Retrospective review of EHRs in an academic general pediatric practice was performed to measure the prevalence of order placement. A child was "screened" if an order was placed during a well-visit between 9 and 21 years of age. The prevalence of order placement for lipid screens on 22 374 patients from January 2010 to December 2015 was analyzed for date of order and patient age, then compared with timing of guidelines, local educational initiatives, and EHR modifications...
June 5, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28593116/bridging-the-gap-between-clinical-practice-and-public-health-using-ehr-data-to-assess-trends-in-the-seasonality-of-blood-pressure-control
#17
Aurora O Amoah, Sonia Y Angell, Hannah Byrnes-Enoch, Sam Amirfar, Phoenix Maa, Jason J Wang
Electronic health records (EHRs) provide timely access to millions of patient data records while limiting errors associated with manual data extraction. To demonstrate these advantages of EHRs to public health practice, we examine the ability of a EHR calculated blood-pressure (BP) measure to replicate seasonal variation as reported by prior studies that used manual data extraction. Our sample included 609 primary-care practices in New York City. BP control among hypertensives was defined as systolic blood pressure of 140 or less and diastolic blood pressure of 90 or less (BP < 140/90 mm Hg)...
June 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28589269/improving-std-screening-rates-on-a-university-campus
#18
Amanda Myers, Sherrie P McCaskill, Kathryn VanRavenstein
Gonorrhea and chlamydia infections have a high incidence among young adults. To increase screening rates among individuals aged 25 years of age and younger on a university campus, this quality improvement project was implemented to improve providers' knowledge of CDC guidelines through education. Education was provided to providers and staff members at a health clinic on a private residential university campus through informational sessions to increase knowledge of guideline-directed screening for gonorrhea and chlamydia...
June 6, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28587608/integrating-clinical-decision-support-systems-for-pharmacogenomic-testing-into-clinical-routine-a-scoping-review-of-designs-of-user-system-interactions-in-recent-system-development
#19
Marc Hinderer, Martin Boeker, Sebastian A Wagner, Martin Lablans, Stephanie Newe, Jan L Hülsemann, Michael Neumaier, Harald Binder, Harald Renz, Till Acker, Hans-Ulrich Prokosch, Martin Sedlmayr
BACKGROUND: Pharmacogenomic clinical decision support systems (CDSS) have the potential to help overcome some of the barriers for translating pharmacogenomic knowledge into clinical routine. Before developing a prototype it is crucial for developers to know which pharmacogenomic CDSS features and user-system interactions have yet been developed, implemented and tested in previous pharmacogenomic CDSS efforts and if they have been successfully applied. We address this issue by providing an overview of the designs of user-system interactions of recently developed pharmacogenomic CDSS...
June 6, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28566989/potential-effects-of-the-electronic-health-record-on-the-small-physician-practice-a-delphi-study
#20
Chad C Sines, Gerald R Griffin
The Health Information Technology for Economic and Clinical Health (HITECH) Act established the requirement of all medical practices to have certified electronic health records (EHRs). Some primary concerns that have been delaying implementation are issues of cost, revenue impact, and the effect on the patient encounter. Small physician practices (one to four physicians) account for 46 percent of all physicians. The purpose of this qualitative study using a modified Delphi research design was to examine the potential effect of the adoption of the EHR on revenue, unintended costs or savings, and changes in the patient encounter...
2017: Perspectives in Health Information Management
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