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https://www.readbyqxmd.com/read/29156900/implementation-of-an-advance-directive-focus-in-a-chronic-multi-organ-rare-disease-clinic
#1
Nancy Elorreaga, Deanna Allred, Gloria Ortiz, Constance McNeill, Mary Beth Scholand, Tracy M Frech
BACKGROUND: Education about an advance directive is frequently not addressed in the outpatient, ambulatory care setting. The objective of this study was to identify patients that do not have an advance directive in a Chronic Multi-Organ Rare Disease Clinic model, and define the role of a social worker in providing advance care planning (ACP). METHODS: The Chronic Multi-Organ Rare Disease Clinic in-corporates a multi-disciplinary team to provide outpatient care to over 600 patients...
August 31, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29153922/e-health-in-switzerland-the-laborious-adoption-of-the-federal-law-on-electronic-health-records-ehr-and-health-information-exchange-hie-networks
#2
Carlo De Pietro, Igor Francetic
Within the framework of a broader e-health strategy launched a decade ago, in 2015 Switzerland passed a new federal law on patients' electronic health records (EHR). The reform requires hospitals to adopt interoperable EHRs to facilitate data sharing and cooperation among healthcare providers, ultimately contributing to improvements in quality of care and efficiency in the health system. Adoption is voluntary for ambulatories and private practices, that may however be pushed towards EHRs by patients. The latter have complete discretion in the choice of the health information to share...
November 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29133283/open-source-electronic-health-record-systems-for-low-resource-settings-systematic-review
#3
REVIEW
Assel Syzdykova, André Malta, Maria Zolfo, Ermias Diro, José Luis Oliveira
BACKGROUND: Despite the great impact of information and communication technologies on clinical practice and on the quality of health services, this trend has been almost exclusive to developed countries, whereas countries with poor resources suffer from many economic and social issues that have hindered the real benefits of electronic health (eHealth) tools. As a component of eHealth systems, electronic health records (EHRs) play a fundamental role in patient management and effective medical care services...
November 13, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29132447/clinical-documentation-in-an-era-of-increasing-transparency-the-impact-of-electronic-portals-on-care
#4
Joanne Maxwell, Keith Adamson, Amir Karmali, Lee Verweel
Electronic health records (EHRs) and consumer health portals have implications for improving the quality and cost-effectiveness of healthcare and make it much easier for patients and families to access health information in a timely and convenient manner. However, the accessibility of information afforded by EHRs and health portals changes the dynamic of control over health information in very significant ways. Institutions and their clinicians have typically been the caretakers of these documents; therefore, the introduction of portals represents a major cultural shift in healthcare...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29113934/validating-ehr-clinical-models-using-ontology-patterns
#5
Catalina Martínez-Costa, Stefan Schulz
Clinical models are artefacts that specify how information is structured in electronic health records (EHRs). However, the makeup of clinical models is not guided by any formal constraint beyond a semantically vague information model. We address this gap by advocating ontology design patterns as a mechanism that makes the semantics of clinical models explicit. This paper demonstrates how ontology design patterns can validate existing clinical models using SHACL. Based on the Clinical Information Modelling Initiative (CIMI), we show how ontology patterns detect both modeling and terminology binding errors in CIMI models...
November 4, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29099060/clinical-pharmacogenetics-of-cytochrome-p450-associated-drugs-in-children
#6
Ida Aka, Christiana J Bernal, Robert Carroll, Angela Maxwell-Horn, Kazeem A Oshikoya, Sara L Van Driest
Cytochrome P450 (CYP) enzymes are commonly involved in drug metabolism, and genetic variation in the genes encoding CYPs are associated with variable drug response. While genotype-guided therapy has been clinically implemented in adults, these associations are less well established for pediatric patients. In order to understand the frequency of pediatric exposures to drugs with known CYP interactions, we compiled all actionable drug-CYP interactions with a high level of evidence using Clinical Pharmacogenomic Implementation Consortium (CPIC) data and surveyed 10 years of electronic health records (EHR) data for the number of children exposed to CYP-associated drugs...
November 2, 2017: Journal of Personalized Medicine
https://www.readbyqxmd.com/read/29095377/automated-pressure-injury-risk-assessment-system-incorporated-into-an-electronic-health-record-system
#7
Yinji Jin, Taixian Jin, Sun-Mi Lee
BACKGROUND: Pressure injury risk assessment is the first step toward preventing pressure injuries, but traditional assessment tools are time-consuming, resulting in work overload and fatigue for nurses. OBJECTIVES: The objectives of the study were to build an automated pressure injury risk assessment system (Auto-PIRAS) that can assess pressure injury risk using data, without requiring nurses to collect or input additional data, and to evaluate the validity of this assessment tool...
November 2017: Nursing Research
https://www.readbyqxmd.com/read/29089403/cost-effectiveness-of-a-clinical-childhood-obesity-intervention
#8
RANDOMIZED CONTROLLED TRIAL
Mona Sharifi, Calvin Franz, Christine M Horan, Catherine M Giles, Michael W Long, Zachary J Ward, Stephen C Resch, Richard Marshall, Steven L Gortmaker, Elsie M Taveras
OBJECTIVES: To estimate the cost-effectiveness and population impact of the national implementation of the Study of Technology to Accelerate Research (STAR) intervention for childhood obesity. METHODS: In the STAR cluster-randomized trial, 6- to 12-year-old children with obesity seen at pediatric practices with electronic health record (EHR)-based decision support for primary care providers and self-guided behavior-change support for parents had significantly smaller increases in BMI than children who received usual care...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29069394/exploring-completeness-in-clinical-data-research-networks-with-dqe-c
#9
Hossein Estiri, Kari A Stephens, Jeffrey G Klann, Shawn N Murphy
Objective: To provide an open source, interoperable, and scalable data quality assessment tool for evaluation and visualization of completeness and conformance in electronic health record (EHR) data repositories. Materials and Methods: This article describes the tool's design and architecture and gives an overview of its outputs using a sample dataset of 200 000 randomly selected patient records with an encounter since January 1, 2010, extracted from the Research Patient Data Registry (RPDR) at Partners HealthCare...
October 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29063568/capturing-the-patient-s-perspective-a-review-of-advances-in-natural-language-processing-of-health-related-text
#10
G Gonzalez-Hernandez, A Sarker, K O'Connor, G Savova
Background: Natural Language Processing (NLP) methods are increasingly being utilized to mine knowledge from unstructured health-related texts. Recent advances in noisy text processing techniques are enabling researchers and medical domain experts to go beyond the information encapsulated in published texts (e.g., clinical trials and systematic reviews) and structured questionnaires, and obtain perspectives from other unstructured sources such as Electronic Health Records (EHRs) and social media posts. Objectives: To review the recently published literature discussing the application of NLP techniques for mining health-related information from EHRs and social media posts...
August 2017: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/29063542/are-we-there-yet-human-factors-knowledge-and-health-information-technology-the-challenges-of-implementation-and-impact
#11
P Turner, A Kushniruk, C Nohr
Objective: To review the developments in human factors (HF) research on the challenges of health information technology (HIT) implementation and impact given the continuing incidence of usability problems and unintended consequences from HIT development and use. Methods: A search of PubMed/Medline and Web of Science® identified HF research published in 2015 and 2016. Electronic health records (EHRs) and patient-centred HIT emerged as significant foci of recent HF research. The authors selected prominent papers highlighting ongoing HF and usability challenges in these areas...
August 2017: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/29059372/disparities-in-the-receipt-of-tobacco-treatment-counseling-within-the-us-context-of-the-affordable-care-act-and-meaningful-use-implementation
#12
Andy S L Tan, Kelly C Young-Wolff, Lisa Carter-Harris, Ramzi G Salloum, Smita C Banerjee
Introduction: Disparities in receiving advice to quit smoking and other tobacco use from health professionals may contribute to the continuing gap in smoking prevalence among priority populations. Under the Affordable Care Act (ACA), beginning in 2010, tobacco cessation services are currently covered in private and public health insurance plans. Providers and hospitals are also incentivized through the Meaningful Use of Electronic Health Records (EHRs) to screen and document patients' tobacco use and deliver brief cessation counseling...
October 20, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/29054261/development-and-validation-of-various-phenotyping-algorithms-for-diabetes-mellitus-using-data-from-electronic-health-records
#13
Santiago Esteban, Manuel Rodríguez Tablado, Francisco E Peper, Yamila S Mahumud, Ricardo I Ricci, Karin S Kopitowski, Sergio A Terrasa
BACKGROUND AND OBJECTIVE: Recent progression towards precision medicine has encouraged the use of electronic health records (EHRs) as a source for large amounts of data, which is required for studying the effect of treatments or risk factors in more specific subpopulations. Phenotyping algorithms allow to automatically classify patients according to their particular electronic phenotype thus facilitating the setup of retrospective cohorts. Our objective is to compare the performance of different classification strategies (only using standardized problems, rule-based algorithms, statistical learning algorithms (six learners) and stacked generalization (five versions)), for the categorization of patients according to their diabetic status (diabetics, not diabetics and inconclusive; Diabetes of any type) using information extracted from EHRs...
December 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29039366/a-socio-technical-analysis-of-patient-accessible-electronic-health-records
#14
Maria Hägglund, Isabella Scandurra
In Sweden, and internationally, there is a movement towards increased transparency in healthcare including giving patients online access to their electronic health records (EHR). The purpose of this paper is to analyze the Swedish patient accessible EHR (PAEHR) service using a socio-technical framework, to increase the understanding of factors that influence the design, implementation, adoption and use of the service. Using the Sitting and Singh socio-technical framework as a basis for analyzing the Swedish PAEHR system and its context indicated that there are many stakeholders engaged in these types of services, with different driving forces and incentives that may influence the adoption and usefulness of PAEHR services...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29036503/implementing-electronic-health-records-ehrs-health-care-provider-perceptions-before-and-after-transition-from-a-local-basic-ehr-to-a-commercial-comprehensive-ehr
#15
Marie Krousel-Wood, Allison B McCoy, Chad Ahia, Elizabeth W Holt, Donnalee N Trapani, Qingyang Luo, Eboni G Price-Haywood, Eric J Thomas, Dean F Sittig, Richard V Milani
Objective: We assessed changes in the percentage of providers with positive perceptions of electronic health record (EHR) benefit before and after transition from a local basic to a commercial comprehensive EHR. Methods: Changes in the percentage of providers with positive perceptions of EHR benefit were captured via a survey of academic health care providers before (baseline) and at 6-12 months (short term) and 12-24 months (long term) after the transition. We analyzed 32 items for the overall group and by practice setting, provider age, and specialty using separate multivariable-adjusted random effects logistic regression models...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29035732/development-and-validation-of-an-automated-delirium-risk-assessment-system-auto-delras-implemented-in-the-electronic-health-record-system
#16
Kyoung-Ja Moon, Yinji Jin, Taixian Jin, Sun-Mi Lee
BACKGROUND: A key component of the delirium management is prevention and early detection. OBJECTIVE: To develop an automated delirium risk assessment system (Auto-DelRAS) that automatically alerts health care providers of an intensive care unit (ICU) patient's delirium risk based only on data collected in an electronic health record (EHR) system, and to evaluate the clinical validity of this system. DESIGN: Cohort and system development designs were used...
September 23, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29029696/perceived-critical-success-factors-of-electronic-health-record-system-implementation-in-a-dental-clinic-context-an-organisational-management-perspective
#17
Yusof Haji Sidek, Jorge Tiago Martins
BACKGROUND: Electronic health records (EHR) make health care more efficient. They improve the quality of care by making patients' medical history more accessible. However, little is known about the factors contributing to the successful EHR implementation in dental clinics. OBJECTIVES: This article aims to identify the perceived critical success factors of EHR system implementation in a dental clinic context. METHODS: We used Grounded Theory to analyse data collected in the context of Brunei's national EHR - the Healthcare Information and Management System (Bru-HIMS)...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29025847/exploring-the-role-of-the-nurse-manager-in-supporting-point-of-care-nurses-adoption-of-electronic-health-records-protocol-for-a-qualitative-research-study
#18
Gillian Strudwick, Richard G Booth, Ragnhildur I Bjarnadottir, Sarah Collins, Rani Srivastava
INTRODUCTION: An increasing number of electronic health record (EHR) systems have been implemented in clinical practice environments where nurses work. Findings from previous studies have found that a number of intended benefits of the technology have not yet been realised to date, partially due to poor system adoption among health professionals such as nurses. Previous studies have suggested that nurse managers can support the effective adoption and use of the technology by nurses. However, no known studies have identified what role nurse managers have in supporting technology adoption, nor the specific strategies that managers can employ to support their staff...
October 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29016971/efficiency-and-safety-of-speech-recognition-for-documentation-in-the-electronic-health-record
#19
Tobias Hodgson, Farah Magrabi, Enrico Coiera
Objective: To compare the efficiency and safety of using speech recognition (SR) assisted clinical documentation within an electronic health record (EHR) system with use of keyboard and mouse (KBM). Methods: Thirty-five emergency department clinicians undertook randomly allocated clinical documentation tasks using KBM or SR on a commercial EHR system. Tasks were simple or complex, and with or without interruption. Outcome measures included task completion times and observed errors...
November 1, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29016969/implementation-of-a-scalable-web-based-automated-clinical-decision-support-risk-prediction-tool-for-chronic-kidney-disease-using-c-cda-and-application-programming-interfaces
#20
Lipika Samal, John D D'Amore, David W Bates, Adam Wright
Background and Objective: Clinical decision support tools for risk prediction are readily available, but typically require workflow interruptions and manual data entry so are rarely used. Due to new data interoperability standards for electronic health records (EHRs), other options are available. As a clinical case study, we sought to build a scalable, web-based system that would automate calculation of kidney failure risk and display clinical decision support to users in primary care practices...
November 1, 2017: Journal of the American Medical Informatics Association: JAMIA
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