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https://www.readbyqxmd.com/read/28817861/population-health-management-and-cancer-screening
#1
Bradley Kamstra, Mark K Huntington
Population health management (PHM) is a new health care model being implemented. It has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." This includes health outcomes and patterns of health determinants, and policies and interventions that link these two. Moving from a fee-for-service payment system to a quality- or value-based system, this model places on the clinician more responsibility for the costs of health care and its reimbursements...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28807836/development-and-evaluation-of-the-automated-risk-assessment-system-for-multidrug-resistant-organisms-autoras-mdro
#2
Eun-Young Hur, Yinji Jin, Taixian Jin, Sun-Mi Lee
BACKGROUND: A high proportion of infections acquired in hospitals are caused by multidrug-resistant organisms (MDROs). The priority in MDRO prevention is to detect high-risk patients and implement preventive intervention as soon as possible. AIM: To develop an automated risk assessment system for MDROs (autoRAS-MDRO) to screen for patients at MDRO infection risk and evaluate the predictive validity of the autoRAS-MDRO. METHODS: Data for 4,200 variables were extracted from the electronic health records (EHRs) for constructing the MDRO risk-scoring algorithm, which was based on a logistic regression model...
August 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28806953/a-fast-healthcare-interoperability-resources-fhir-layer-implemented-over-i2b2
#3
Abdelali Boussadi, Eric Zapletal
BACKGROUND: Standards and technical specifications have been developed to define how the information contained in Electronic Health Records (EHRs) should be structured, semantically described, and communicated. Current trends rely on differentiating the representation of data instances from the definition of clinical information models. The dual model approach, which combines a reference model (RM) and a clinical information model (CIM), sets in practice this software design pattern. The most recent initiative, proposed by HL7, is called Fast Health Interoperability Resources (FHIR)...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28805361/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the-long-term-care-hospital-prospective-payment-system-and-policy-changes-and-fiscal-year-2018-rates-quality-reporting-requirements-for-specific-providers-medicare
#4
(no author information available yet)
We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation...
August 14, 2017: Federal Register
https://www.readbyqxmd.com/read/28795061/a-multi-agent-based-approach-for-prehospital-emergency-management
#5
Reza Safdari, Jaleh Shoshtarian Malak, Niloofar Mohammadzadeh, Azimeh Danesh Shahraki
OBJECTIVE: To demonstrate an architecture to automate the prehospital emergency process to categorize the specialized care according to the situation at the right time for reducing the patient mortality and morbidity. METHODS: Prehospital emergency process were analyzed using existing prehospital management systems, frameworks and the extracted process were modeled using sequence diagram in Rational Rose software. System main agents were identified and modeled via component diagram, considering the main system actors and by logically dividing business functionalities, finally the conceptual architecture for prehospital emergency management was proposed...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28790075/implementation-of-a-pharmacist-managed-clinic-for-patients-with-chronic-nonmalignant-pain
#6
Jessica L Norman, Miranda E Kroehl, Huong Mindy Lam, Carmen L Lewis, Chelsea N Mitchell, Cindy L O'Bryant, Katy E Trinkley
PURPOSE: A pharmacist-managed chronic pain clinic (PMCPC) in a primary care setting is described. SUMMARY: As primary care providers (PCPs) may be unprepared or lack time to manage high-risk patients receiving opioids for chronic nonmalignant pain, alternative models of care are needed. The University of Colorado PMCPC is integrated into an internal medicine outpatient clinic. The PMCPC is staffed by 1 clinical pharmacist, with pharmacy students and residents also performing clinic duties...
August 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28776047/an-interoperable-similarity-based-cohort-identification-method-using-the-omop-common-data-model-version-5-0
#7
Shreya Chakrabarti, Anando Sen, Vojtech Huser, Gregory W Hruby, Alexander Rusanov, David J Albers, Chunhua Weng
Cohort identification for clinical studies tends to be laborious, time-consuming, and expensive. Developing automated or semi-automated methods for cohort identification is one of the "holy grails" in the field of biomedical informatics. We propose a high-throughput similarity-based cohort identification algorithm by applying numerical abstractions on Electronic Health Records (EHR) data. We implement this algorithm using the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM), which enables sites using this standardized EHR data representation to avail this algorithm with minimum effort for local implementation...
June 2017: J Healthc Inform Res
https://www.readbyqxmd.com/read/28766194/macra-and-the-changing-medicare-payment-landscape
#8
Steven L Chen, Matthew R Coffron
BACKGROUND: The Medicare Access and CHIP Reauthorization Act (MACRA) is being implemented in 2017 by the Centers for Medicare and Medicaid Services (CMS) as the Quality Payment Program (QPP) and will have important and far reaching effects on how physicians are reimbursed and on how they practice. The QPP modifies the Medicare physician payment system by eliminating the Sustainable Growth Rate formula and incorporating the existing Physician Quality Reporting System, EHR Incentive Program, and the Value Modifier into a single new Merit-based Incentive Payment System (MIPS)...
August 1, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28762577/assessing-barriers-to-adherence-in-routine-clinical-care-for-pediatric-kidney-transplant-patients
#9
Charles D Varnell, Kristin L Rich, Melissa Nichols, Devesh Dahale, Jens W Goebel, Ahna L H Pai, David K Hooper, Avani C Modi
Patient-identified barriers to immunosuppressive medications are associated with poor adherence and negative clinical outcomes in transplant patients. Assessment of adherence barriers is not part of routine post-transplant care, and studies regarding implementing such a process in a reliable way are lacking. Using the Model for Improvement and PDSA cycles, we implemented a system to identify adherence barriers, including patient-centered design of a barriers assessment tool, identification of eligible patients, clear roles for clinic staff, and creating a culture of non-judgmental discussion around adherence...
August 1, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28758100/appropriateness-of-tumor-marker-request-a-case-of-study
#10
Massimo Gion, Chiara Trevisiol, Aline S C Fabricio
Appropriateness is crucial to provide efficient and high-quality health services at affordable costs. Laboratory medicine is a sector of special interest for the investigation of inappropriateness, due to the high rate of technological innovation and its pivotal role in many diseases and clinical settings. Some subjective aspects related to either the patient or physician seem to have a major role on inappropriateness rates. Given the psychological impact of cancer on both patients and physicians, tumor markers represent a case of study for appropriateness...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28754523/development-and-classification-of-a-robust-inventory-of-near-real-time-outcome-measurements-for-assessing-information-technology-interventions-in-health-care
#11
Tiago K Colicchio, Guilherme Del Fiol, Debra L Scammon, Watson A Bowes, Julio C Facelli, Scott P Narus
OBJECTIVE: To develop and classify an inventory of near real-time outcome measures for assessing information technology (IT) interventions in health care and assess their relevance as perceived by experts in the field. MATERIALS AND METHODS: To verify the robustness and coverage of a previously published inventory of measures and taxonomy, we conducted semi-structured interviews with clinical and administrative leaders from a large care delivery system to collect suggestions of outcome measures that can be calculated with data available in electronic format for near real-time monitoring of EHR implementations...
July 25, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28752101/implementation-of-a-large-system-wide-hepatitis-c-virus-screening-and-linkage-to-care-program-for-baby-boomers
#12
Mariana Castrejón, Kara W Chew, Marjan Javanbakht, Romney Humphries, Sammy Saab, Jeffrey D Klausner
BACKGROUND: We implemented and evaluated a large health system-wide hepatitis C virus (HCV) screening and linkage to care program for persons born between 1945 and 1965 ("baby boomers"). METHODS: An electronic health record (EHR) clinical decision support (CDS) tool for HCV screening for baby boomers was introduced in August 2015 for patients seen in the outpatient University of California, Los Angeles healthcare system setting. An HCV care coordinator was introduced in January 2016 to facilitate linkage to HCV care...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28746069/barriers-to-medical-students-electronic-health-record-access-can-impede-their-preparedness-for-practice
#13
Catherine M Welcher, William Hersh, Blaine Takesue, Victoria Stagg Elliott, Richard E Hawkins
Medical students need hands-on experience documenting clinical encounters as well as entering orders to prepare for residency and become competent physicians. In the era of paper medical records, students consistently acquired experience writing notes and entering orders as part of their clinical experience. Over the past decade, however, patient records have transitioned from paper to electronic form. This change has had the unintended consequence of limiting medical students' access to patient records. This restriction has meant that many students leave medical school without the appropriate medical record skills for transitioning to residency...
July 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28743758/ashp-national-survey-of-pharmacy-practice-in-hospital-settings-prescribing-and-transcribing-2016
#14
Craig A Pedersen, Philip J Schneider, Douglas J Scheckelhoff
PURPOSE: The results of the 2016 ASHP national survey of pharmacy practice in hospital settings are presented. METHODS: A stratified random sample of pharmacy directors at 1,315 general and children's medical-surgical hospitals in the United States were surveyed using a mixed-mode method offering a choice of completing a paper survey or an online survey. IMS Health supplied data on hospital characteristics; the survey sample was drawn from IMS's hospital database...
July 25, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28729232/development-feasibility-and-small-scale-implementation-of-a-web-based-prognostic-tool-surveillance-epidemiology-and-end-results-cancer-survival-calculator
#15
Michelle Henton, Bridget Gaglio, Laurie Cynkin, Eric J Feuer, Borsika A Rabin
BACKGROUND: Population datasets and the Internet are playing an ever-growing role in the way cancer information is made available to providers, patients, and their caregivers. The Surveillance, Epidemiology, and End Results Cancer Survival Calculator (SEER*CSC) is a Web-based cancer prognostic tool that uses SEER data, a large population dataset, to provide physicians with highly valid, evidence-based prognostic estimates for increasing shared decision-making and improving patient-provider communication of complex health information...
July 20, 2017: JMIR Cancer
https://www.readbyqxmd.com/read/28724368/utilizing-patient-data-from-the-veterans-administration-electronic-health-record-to-support-web-based-clinical-decision-support-informatics-challenges-and-issues-from-three-clinical-domains
#16
Nallakkandi Rajeevan, Kristina M Niehoff, Peter Charpentier, Forrest L Levin, Amy Justice, Cynthia A Brandt, Terri R Fried, Perry L Miller
BACKGROUND: The US Veterans Administration (VA) has developed a robust and mature computational infrastructure in support of its electronic health record (EHR). Web technology offers a powerful set of tools for structuring clinical decision support (CDS) around clinical care. This paper describes informatics challenges and design issues that were confronted in the process of building three Web-based CDS systems in the context of the VA EHR. METHODS: Over the course of several years, we implemented three Web-based CDS systems that extract patient data from the VA EHR environment to provide patient-specific CDS...
July 19, 2017: BMC Medical Informatics and Decision Making
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
#17
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
#18
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
#19
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
#20
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
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