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https://www.readbyqxmd.com/read/27906530/medicare-program-hospital-outpatient-prospective-payment-and-ambulatory-surgical-center-payment-systems-and-quality-reporting-programs-organ-procurement-organization-reporting-and-communication-transplant-outcome-measures-and-documentation-requirements-electronic
#1
(no author information available yet)
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system...
November 14, 2016: Federal Register
https://www.readbyqxmd.com/read/27902552/factors-associated-with-electronic-health-record-use-among-nurse-practitioners-in-the-united-states
#2
Emily B Jones
Widespread use of electronic health records (EHRs) among all provider types is foundational to delivery system transformation. Three in 4 nurse practitioners used EHRs in 2012 (76.0%), and 60.3% of nonusers planned to adopt within 18 months. Practice setting, younger age, and colocation with physicians were associated with EHR use. In hospitals and in settings without on-site physicians, EHR use lagged in rural areas. Implementation assistance should be targeted to nonadopters, particularly those who never or infrequently work alongside physicians and those in rural hospitals...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27897470/faculty-development-efforts-to-promote-screening-brief-intervention-and-referral-to-treatment-sbirt-in-an-internal-medicine-faculty-resident-practice
#3
Alanna Stone, Maria Wamsley, Patricia O'Sullivan, Jason Satterfield, Derek D Satre, Katherine Julian
BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is a practical means to address substance misuse in primary care. Important barriers to implementing SBIRT include adequacy of training and provider confidence as well as logistical hurdles and time constraints. A faculty development initiative aimed at increasing SBIRT knowledge and treatment of substance use disorders (SUDs) should lead to increased use of SBIRT by faculty and the residents they teach. This study examined how a faculty development program to promote SBIRT influenced faculty practice and resident teaching...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27896989/opening-the-door-to-the-large-scale-use-of-clinical-lab-measures-for-association-testing-exploring-different-methods-for-defining-phenotypes
#4
Christopher R Bauer, Daniel Lavage, John Snyder, Joseph Leader, J Matthew Mahoney, Sarah A Pendergrass
The past decade has seen exponential growth in the numbers of sequenced and genotyped individuals and a corresponding increase in our ability of collect and catalogue phenotypic data for use in the clinic. We now face the challenge of integrating these diverse data in new ways new that can provide useful diagnostics and precise medical interventions for individual patients. One of the first steps in this process is to accurately map the phenotypic consequences of the genetic variation in human populations. The most common approach for this is the genome wide association study (GWAS)...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27891527/the-multimorbidity-index-a-tool-for-assessing-the-prognosis-of-patients-from-their-history-of-illness
#5
Farrokh Alemi, Cari R Levy, Raya E Kheirbek
BACKGROUND: The Multimorbidity (MM) Index predicts the prognosis of patients from their diagnostic history. In contrast to existing approaches with broad diagnostic categories, it treats each diagnosis as a separate independent variable using individual International Classification of Disease, Revision 9 (ICD-9) codes. OBJECTIVE: This paper describes the MM Index, reviews the published data on its accuracy, and provides procedures for implementing the Index within electronic health record (EHR) systems...
2016: EGEMS
https://www.readbyqxmd.com/read/27884165/implementing-an-evidence-based-computerized-decision-support-system-linked-to-electronic-health-records-to-improve-care-for-cancer-patients-the-onco-codes-study-protocol-for-a-randomized-controlled-trial
#6
Lorenzo Moja, Alessandro Passardi, Matteo Capobussi, Rita Banzi, Francesca Ruggiero, Koren Kwag, Elisa Giulia Liberati, Massimo Mangia, Ilkka Kunnamo, Michela Cinquini, Roberto Vespignani, Americo Colamartini, Valentina Di Iorio, Ilaria Massa, Marien González-Lorenzo, Lorenzo Bertizzolo, Peter Nyberg, Jeremy Grimshaw, Stefanos Bonovas, Oriana Nanni
BACKGROUND: Computerized decision support systems (CDSSs) are computer programs that provide doctors with person-specific, actionable recommendations, or management options that are intelligently filtered or presented at appropriate times to enhance health care. CDSSs might be integrated with patient electronic health records (EHRs) and evidence-based knowledge. METHODS/DESIGN: The Computerized DEcision Support in ONCOlogy (ONCO-CODES) trial is a pragmatic, parallel group, randomized controlled study with 1:1 allocation ratio...
November 25, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27870543/enhancing-patient-and-family-engagement-through-meaningful-use-stage-3-opportunities-and-barriers-to-implementation
#7
Jaclyn Rappaport, Sara Galantowicz, Andrea Hassol, Anisha Illa, Sid Thornton, Shan He, Jean Adams, Charlie Sawyer
OBJECTIVES: The proposed Patient and Family Engagement objectives for Meaningful Use Stage 3 (MU3) seek to provide patients with increased access to, and control over, the content and dissemination of their electronic health record (EHR) information. STUDY DESIGN: Implementation study conducted from 2013-2014. METHODS: In this study, 2 leading US health systems attempted to implement 4 draft MU3 objectives within their current EHR system. Senior staff provided qualitative feedback on their implementation experience; researchers used content analysis to identify major themes and implementation challenges...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27864204/integrating-pharmacogenomics-into-electronic-health-records-with-clinical-decision-support
#8
J Kevin Hicks, Henry M Dunnenberger, Karl F Gumpper, Cyrine E Haidar, James M Hoffman
PURPOSE: Existing pharmacogenomic informatics models, key implementation steps, and emerging resources to facilitate the development of pharmacogenomic clinical decision support (CDS) are described. SUMMARY: Pharmacogenomics is an important component of precision medicine. Informatics, especially CDS in the electronic health record (EHR), is a critical tool for the integration of pharmacogenomics into routine patient care. Effective integration of pharmacogenomic CDS into the EHR can address implementation challenges, including the increasing volume of pharmacogenomic clinical knowledge, the enduring nature of pharmacogenomic test results, and the complexity of interpreting results...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27847961/mind-the-gap-a-systematic-review-to-identify-usability-and-safety-challenges-and-practices-during-electronic-health-record-implementation
#9
Raj Ratwani, Terry Fairbanks, Erica Savage, Katie Adams, Michael Wittie, Edna Boone, Andrew Hayden, Janey Barnes, Zach Hettinger, Andrew Gettinger
OBJECTIVE: Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. MATERIALS AND METHODS: Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation...
November 16, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27843424/improving-the-collection-of-race-ethnicity-and-language-data-to-reduce-healthcare-disparities-a-case-study-from-an-academic-medical-center
#10
Wei-Chen Lee, Sreenivas P Veeranki, Hani Serag, Karl Eschbach, Kenneth D Smith
Well-designed electronic health records (EHRs) must integrate a variety of accurate information to support efforts to improve quality of care, particularly equity-in-care initiatives. This case study provides insight into the challenges those initiatives may face in collecting accurate race, ethnicity, and language (REAL) information in the EHR. We present the experience of an academic medical center strengthening its EHR for better collection of REAL data with funding from the EHR Incentive Programs for meaningful use of health information technology and the Texas Medicaid 1115 Waiver program...
2016: Perspectives in Health Information Management
https://www.readbyqxmd.com/read/27830226/new-unintended-adverse-consequences-of-electronic-health-records
#11
D F Sittig, A Wright, J Ash, H Singh
Although the health information technology industry has made considerable progress in the design, development, implementation, and use of electronic health records (EHRs), the lofty expectations of the early pioneers have not been met. In 2006, the Provider Order Entry Team at Oregon Health & Science University described a set of unintended adverse consequences (UACs), or unpredictable, emergent problems associated with computer-based provider order entry implementation, use, and maintenance. Many of these originally identified UACs have not been completely addressed or alleviated, some have evolved over time, and some new ones have emerged as EHRs became more widely available...
November 10, 2016: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/27802857/adoption-of-electronic-health-records-and-barriers
#12
REVIEW
Venkataraman Palabindala, Amaleswari Pamarthy, Nageshwar Reddy Jonnalagadda
Electronic health records (EHR) are not a new idea in the U.S. medical system, but surprisingly there has been very slow adoption of fully integrated EHR systems in practice in both primary care settings and within hospitals. For those who have invested in EHR, physicians report high levels of satisfaction and confidence in the reliability of their system. There is also consensus that EHR can improve patient care, promote safe practice, and enhance communication between patients and multiple providers, reducing the risk of error...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27800564/a-content-analysis-of-electronic-health-record-ehr-functionality-to-support-tobacco-treatment
#13
Jennifer M Schindler-Ruwisch, Lorien C Abroms, Steven L Bernstein, Christina L Heminger
Government regulations have created new incentives for health systems to implement changes in electronic health records (EHRs) to reduce tobacco use among patients. The purpose of this study is to conduct a content analysis of EHR modifications aimed at supporting tobacco cessation and to document these modifications using a 5 A's framework (i.e., Ask, Advise, Assess, Assist, Arrange). Fourteen trials were identified that met inclusion criteria. A content analysis of EHR functionality in these trials was conducted by two independent reviewers between February and June 2015...
October 31, 2016: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/27789783/emap-ckd-electronic-diagnosis-and-management-assistance-to-primary-care-in-chronic-kidney-disease
#14
Aspasia Pefanis, Roslin Botlero, Robyn G Langham, Craig L Nelson
BACKGROUND: The increasing burden of chronic kidney disease (CKD) underpins the importance for improved early detection and management programs in primary care to delay disease progression and reduce mortality rates. eMAP:CKD is a pilot program for primary care aimed at addressing the gap between current and best practice care for CKD. METHODS: Customized software programs were developed to integrate with primary care electronic health records (EHRs), allowing real-time prompting for CKD risk factor identification, testing, diagnosis and management according to Kidney Health Australia's (KHA) best practice recommendations...
October 26, 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27758162/rationale-and-design-of-the-registry-for-stones-of-the-kidney-and-ureter-resku-a-prospective-observational-registry-to-study-the-natural-history-of-urolithiasis-patients
#15
Helena C Chang, David T Tzou, Manint Usawachintachit, Brian D Duty, Ryan S Hsi, Jonathan D Harper, Mathew D Sorensen, Marshall L Stoller, Roger L Sur, Thomas Chi
OBJECTIVES: Registry-based clinical research in nephrolithiasis is critical to advancing quality in urinary stone disease management and ultimately reducing stone recurrence. A need exists to develop Health Insurance Portability and Accountability Act (HIPAA)-compliant registries that comprise integrated electronic health record (EHR) data using prospectively defined variables. An EHR-based standardized patient database-the Registry for Stones of the Kidney and Ureter (ReSKU™)-was developed, and herein we describe our implementation outcomes...
December 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27738129/medicaid-stage-1-meaningful-use-ehr-incentive-payments-are-associated-with-higher-quality-but-not-improvements-in-quality
#16
Zachary M Grinspan, Yuhua Bao, Alison Edwards, Phyllis Johnson, Rainu Kaushal, Lisa M Kern
This was a retrospective cohort study of ambulatory care quality by physicians who received payment for Medicaid Stage 1 Meaningful Use (MU) in 2012 using New York State Medicaid Claims (2010-2013). Eight quality measures were used to compare performance of physicians who received payments to Adopt, Implement, or Use (AIU) an electronic health record in 2011 but not for MU in 2012 (AIU-only group) and physicians who cared for Medicaid patients but received no payments (no-incentive group), using propensity score-weighted difference-in-difference logistic regression analyses, clustering by physician...
October 13, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27730248/a-two-year-longitudinal-assessment-of-ophthalmologists-perceptions-after-implementing-an-electronic-health-record-system
#17
Joshua R Ehrlich, Monica Michelotti, Taylor S Blachley, Kai Zheng, Mick P Couper, Grant M Greenberg, Sharon Kileny, Greta L Branford, David A Hanauer, Jennifer S Weizer
OBJECTIVES: To understand the attitudes and perceptions of ophthalmologists toward an electronic health record (EHR) system, before and after its clinical implementation. METHODS: Ophthalmologists at a single large academic ophthalmology department were surveyed longitudinally before and after implementation of a new EHR system. The survey measured ophthalmologists' attitudes toward implementation of a new EHR. Questions focused on satisfaction, efficiency, and documentation...
October 12, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27714560/barriers-to-electronic-health-record-adoption-a-systematic-literature-review
#18
Clemens Scott Kruse, Caitlin Kristof, Beau Jones, Erica Mitchell, Angelica Martinez
Federal efforts and local initiatives to increase adoption and use of electronic health records (EHRs) continue, particularly since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Roughly one in four hospitals not adopted even a basic EHR system. A review of the barriers may help in understanding the factors deterring certain healthcare organizations from implementation. We wanted to assemble an updated and comprehensive list of adoption barriers of EHR systems in the United States...
December 2016: Journal of Medical Systems
https://www.readbyqxmd.com/read/27713905/a-harmonized-data-quality-assessment-terminology-and-framework-for-the-secondary-use-of-electronic-health-record-data
#19
Michael G Kahn, Tiffany J Callahan, Juliana Barnard, Alan E Bauck, Jeff Brown, Bruce N Davidson, Hossein Estiri, Carsten Goerg, Erin Holve, Steven G Johnson, Siaw-Teng Liaw, Marianne Hamilton-Lopez, Daniella Meeker, Toan C Ong, Patrick Ryan, Ning Shang, Nicole G Weiskopf, Chunhua Weng, Meredith N Zozus, Lisa Schilling
OBJECTIVE: Harmonized data quality (DQ) assessment terms, methods, and reporting practices can establish a common understanding of the strengths and limitations of electronic health record (EHR) data for operational analytics, quality improvement, and research. Existing published DQ terms were harmonized to a comprehensive unified terminology with definitions and examples and organized into a conceptual framework to support a common approach to defining whether EHR data is 'fit' for specific uses...
2016: EGEMS
https://www.readbyqxmd.com/read/27697748/-i-want-to-keep-the-personal-relationship-with-my-doctor-understanding-barriers-to-portal-use-among-african-americans-and-latinos
#20
Courtney Rees Lyles, Jill Y Allen, Dolly Poole, Lina Tieu, Michael H Kanter, Terhilda Garrido
BACKGROUND: Despite the widespread implementation of electronic health records (EHRs), there is growing evidence that racial/ethnic minority patients do not use portals as frequently as non-Hispanic whites to access their EHR information online. This differential portal use could be problematic for health care disparities since early evidence links portal use to better outcomes. OBJECTIVE: We sought to understand specific barriers to portal use among African American and Latino patients at Kaiser Permanente, which has had a portal in place for over a decade, and broad uptake among the patient population at large...
October 3, 2016: Journal of Medical Internet Research
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