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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
#1
Ana Neumann, Elsbeth Kalenderian, Rachel Ramoni, Alfa Yansane, Bunmi Tokede, Jini Etoule, 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 14, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28566986/differences-in-sociocognitive-beliefs-between-involved-and-noninvolved-employees-during-the-implementation-of-an-electronic-health-record-system
#11
Nicola Esther Stanczyk, Rik Crutzen, Nikki Sewuster, Elwin Schotanus, Merijn Mulders, Henricus Paul Cremers
BACKGROUND: Electronic health records (EHRs) can improve quality and efficiency in patient care. However, the intention to work with such a new system is often relatively low among employees because the work processes of the healthcare organization may change. Involving employees in an EHR implementation may increase their beliefs and perceived capabilities concerning the new system. The current study aimed to assess the role of involvement and its effects on sociocognitive beliefs regarding the implementation of a new EHR system...
2017: Perspectives in Health Information Management
https://www.readbyqxmd.com/read/28557714/innovative-use-of-the-electronic-health-record-to-support-harm-reduction-efforts
#12
Daniel Hyman, Jenae Neiman, Michael Rannie, Renee Allen, Marguerite Swietlik, Andrea Balzer
BACKGROUND AND OBJECTIVES: Awareness of the impact of preventable harm on patients and families has resulted in extensive efforts to make our health care systems safer. We determined that, in our hospital, patients experienced 1 of 9 types of preventable harm approximately every other day. In an effort to expedite early identification of patients at risk and provide timely intervention, we used the electronic health record's (EHR) documentation to enable decision support, data capture, and auditing and implemented reporting tools to reduce rates of harm...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28553751/patient-centered-care-in-small-primary-care-practices-in-new-york-city-recognition-versus-reality
#13
Margaret M Paul, Stephanie L Albert, Tod Mijanovich, Sarah C Shih, Carolyn A Berry
BACKGROUND: The Primary Care Information Project (PCIP) is a program administered by the New York City Department of Health and Mental Hygiene to help primary care providers adopt a fully functional electronic health record (EHR) and focus on population health. PCIP also offers practices assistance with the National Committee for Quality Assurance (NCQA) patient-centered medical home (PCMH) recognition application. The objectives of this study were to assess the presence of key dimensions of PCMH among PCIP practices with 5 or fewer providers and to determine whether and to what extent NCQA recognition was related to the presence of these dimensions...
May 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28544048/use-of-electronic-health-record-clinical-decision-support-tool-for-hcv-birth-cohort-screening
#14
David N Fitch, Ajay Dharod, Claudia L Campos, Marina Núñez
The United States Preventive Services Task Force (USPSTF) recommended one-time HCV testing for all patients in the 1945-1965 birth cohort, given the high hepatitis C virus (HCV) prevalence in this group [1]. In response, various interventions differing in complexity and cost have been developed. Goel et al, evaluated a multifaceted intervention sequentially implemented and report poor response to the electronic health record (EHR) alert and a very successful HCV screening, increased by 137%, after adding other tools including physician education, data feedback, and patient navigation [2]...
May 24, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28532511/challenges-and-strategies-for-implementing-genomic-services-in-diverse-settings-experiences-from-the-implementing-genomics-in-practice-ignite-network
#15
Nina R Sperber, Janet S Carpenter, Larisa H Cavallari, Laura J Damschroder, Rhonda M Cooper-DeHoff, Joshua C Denny, Geoffrey S Ginsburg, Yue Guan, Carol R Horowitz, Kenneth D Levy, Mia A Levy, Ebony B Madden, Michael E Matheny, Toni I Pollin, Victoria M Pratt, Marc Rosenman, Corrine I Voils, Kristen W Weitzel, Russell A Wilke, R Ryanne Wu, Lori A Orlando
BACKGROUND: To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. METHODS: We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies...
May 22, 2017: BMC Medical Genomics
https://www.readbyqxmd.com/read/28527502/selection-and-implementation-of-an-electronic-health-record
#16
REVIEW
Grant S Fletcher, Thomas H Payne
Electronic health records (EHRs) are now the standard of practice in most communities, because of transition to reimbursement that increasingly focuses on risk sharing and quality measurement, and government EHR incentive programs. The selection and implementation of an EHR is one of the most important decisions a practice faces. Organizing the search for an EHR that fits a practice, negotiating a contract, planning and successfully implementing an EHR are best accomplished with a well-informed, strong, multidisciplinary team using project management techniques...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28527499/it-is-from-mars-and-physicians-from-venus-bridging-the-gap
#17
REVIEW
Mark E Huang
With increasing adoption of electronic health records (EHRs) and legislative mandates for its use within the United States, collaboration between physicians and information technology (IT) staff is essential. Current challenges that physicians face include addressing EHR usability, system performance, adequate training, issue resolution, regulatory compliance, and lack of awareness of IT roles. These challenges lead to gaps in communication between clinicians and IT staff. Strategies to improve collaboration between physicians and IT staff include increasing physician involvement with health information technology software development, involvement with legislative regulations and standards, IT project implementation, as well as system stabilization and optimization...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28527498/electronic-health-record-transition-considerations
#18
REVIEW
Louis E Penrod
After an initial phase of electronic health record (EHR) solutions for both independent practices and larger health care organizations, we are now entering a period in which transitioning between EHRs is becoming more common. Many of the decisions and implementation processes for an EHR transition are similar to those encountered during the transition from paper records to an EHR. Detailed project planning and management are essential to keep the effort on track and within budget to a successful conclusion...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28508786/implementation-of-nationwide-electronic-health-record-in-albania-a-case-study
#19
Olegas Niaksu, Paulin Kodra, Mariola Pina, Johannes Grabenweger
BACKGROUND: This paper presents a case study of the nationwide implementation of an Electronic Health Record system based on industry standards. OBJECTIVES: To critically review the finalized nationwide EHR implementation in Albania, pointing out the achievements and the shortcomings, gained knowledge and sharing lessons learned. METHODS: This paper reports on our analysis of the project's documentation, first-hand experience working with healthcare professionals during and after project implementation...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28495351/electronic-health-record-in-the-internal-medicine-clinic-of-a-brazilian-university-hospital-expectations-and-satisfaction-of-physicians-and-patients
#20
Jurandir Godoy Duarte, Raymundo Soares Azevedo
PURPOSE: To evaluate the satisfaction and expectations of patients and physicians before and after the implementation of an electronic health record (EHR) in the outpatient clinic of a university hospital. METHODS: We conducted 389 interviews with patients and 151 with physicians before and after the implementation of a commercial EHR at the internal medicine clinic of Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HC-FMUSP), Brazil...
June 2017: International Journal of Medical Informatics
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