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https://www.readbyqxmd.com/read/28428097/care-coordination-and-comprehensive-electronic-health-records-are-associated-with-increased-transition-planning-activities
#1
Niraj Sharma, Kitty O'Hare, Karen G O'Connor, Umbereen Nehal, Megumi J Okumura
OBJECTIVE: Youth with Special Health Care Needs (YSHCN) require assistance from their pediatricians to transition to adult care. There is little data on what transition resources pediatricians have. This paper studies if care coordination and/or comprehensive electronic health record (CEHR) implementation are associated with improved transition processes. METHODS: Using AAP Periodic Survey #79, we report whether practices generated written transition plans, assisted in finding adult providers, and discussed confidentiality issues...
April 18, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28423843/an-approach-for-the-support-of-semantic-workflows-in-electronic-health-records
#2
Marco Schweitzer, Alexander Hoerbst
With the unprecedented increase of healthcare data, technologies need to be both, highly efficient for the meaningful utilization of accessible data and flexible to adapt to future challenges and individual preferences. The OntoHealth system makes use of semantic technologies to enable flexible and individual interaction with Electronic Health Records (EHR) for physicians. This is achieved by the execution of formally modelled clinical workflows and the composition of Semantic Web Services (SWS). Several seamless components provide a service-oriented structure defined by individual designed EHR-workflows...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423824/querying-archetype-based-electronic-health-records-using-hadoop-and-dewey-encoding-of-openehr-models
#3
Erik Sundvall, Fang Wei-Kleiner, Sergio M Freire, Patrick Lambrix
Archetype-based Electronic Health Record (EHR) systems using generic reference models from e.g. openEHR, ISO 13606 or CIMI should be easy to update and reconfigure with new types (or versions) of data models or entries, ideally with very limited programming or manual database tweaking. Exploratory research (e.g. epidemiology) leading to ad-hoc querying on a population-wide scale can be a challenge in such environments. This publication describes implementation and test of an archetype-aware Dewey encoding optimization that can be used to produce such systems in environments supporting relational operations, e...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423809/use-of-a-nationwide-personally-controlled-electronic-health-record-by-healthcare-professionals-and-patients-a-case-study-with-the-french-dmp
#4
Brigitte Seroussi, Jacques Bouaud
If the wide adoption of electronic health records (EHRs) is necessary to address health information sharing and care coordination issues, it is not sufficient. In order to address health information sharing, some countries, among which, France, have implemented a centralized framework with "new" nationwide care records. The French DMP is a centralized, nationally shared, electronic medical record, created according to the opt-in model. More than five years after the launching of the DMP project, DMPs have been created for 1...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423773/introducing-a-method-for-transformation-of-paper-based-research-data-into-concept-based-representation-with-openehr
#5
Birgit Saalfeld, Erik Tute, Klaus-Hendrik Wolf, Michael Marschollek
Combining research data and clinical routine data is a chance for medical research. We present our method for the transformation of paper-based research data into a concept-based representation. With this representation the study data from research projects can be combined with data from clinical tools with less integration effort. We applied and verified our method using data from a current research study. In this paper we also show our main challenges and lessons learned. Clinical assessment data and study diaries from a long term study (n=24, 3 months observation time each, 17 different clinical assessments) stored on paper were used as the data set...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423767/querying-ehrs-with-a-semantic-and-entity-oriented-query-language
#6
Romain Lelong, Lina Soualmia, Badisse Dahamna, Nicolas Griffon, Stéfan J Darmoni
While the digitization of medical documents has greatly expanded during the past decade, health information retrieval has become a great challenge to address many issues in medical research. Information retrieval in electronic health records (EHR) should also reduce the difficult tasks of manual information retrieval from records in paper format or computer. The aim of this article was to present the features of a semantic search engine implemented in EHRs. A flexible, scalable and entity-oriented query language tool is proposed...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423747/establishment-of-requirements-and-methodology-for-the-development-and-implementation-of-greymatters-a-memory-clinic-information-system
#7
Archana Tapuria, Matt Evans, Vasa Curcin, Tony Austin, Nathan Lea, Dipak Kalra
INTRODUCTION: The aim of the paper is to establish the requirements and methodology for the development process of GreyMatters, a memory clinic system, outlining the conceptual, practical, technical and ethical challenges, and the experiences of capturing clinical and research oriented data along with the implementation of the system. METHODS: The methodology for development of the information system involved phases of requirements gathering, modeling and prototype creation, and 'bench testing' the prototype with experts...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28405062/pre-and-post-hoc-analysis-of-electronic-health-record-implementation-on-emergency-department-metrics
#8
Kyle J Rupp, Nathan J Ham, Dennis E Blankenship, Mark E Payton, Kelly A Murray
Longitudinal time-based emergency department (ED) performance measures were quantified 12 months before and 12 months after (March 2012-February 2014) implementation of a Meditech 6.0® electronic health record (EHR) at a single urban academic ED. Data assessed were length of stay from door to door, door to admission, door to bed, bed to provider, provider to disposition, and disposition to admission, as well as number of patients leaving against medical advice and number of patients leaving without being seen...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28399844/implementation-of-a-pragmatic-randomized-trial-of-screening-for-chronic-kidney-disease-to-improve-care-among-non-diabetic-hypertensive-veterans
#9
Carmen A Peralta, Martin Frigaard, Anna D Rubinsky, Leticia Rolon, Lowell Lo, Santhi Voora, Karen Seal, Delphine Tuot, Shirley Chao, Kimberly Lui, Phillip Chiao, Neil Powe, Michael Shlipak
BACKGROUND: Whether screening for chronic kidney disease (CKD) can improve the care of persons at high risk for complications remains uncertain. We describe the design and early implementation experience of a pilot, cluster-randomized pragmatic trial to evaluate the feasibility, implementation, and effectiveness of a "triple marker" CKD screening program (creatinine, cystatin C and albumin to creatinine ratio) for improving care among hypertensive veterans seen in primary care at one Veterans Administration Hospital...
April 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28370246/electronic-health-records-and-the-disappearing-patient
#10
Linda M Hunt, Hannah S Bell, Allison M Baker, Heather A Howard
With rapid consolidation of American medicine into large-scale corporations, corporate strategies are coming to the forefront in health care delivery, requiring a dramatic increase in the amount and detail of documentation, implemented through use of electronic health records (EHRs). EHRs are structured to prioritize the interests of a myriad of political and corporate stakeholders, resulting in a complex, multi-layered, and cumbersome health records system, largely not directly relevant to clinical care. Drawing on observations conducted in outpatient specialty clinics, we consider how EHRs prioritize institutional needs manifested as a long list of requisites that must be documented with each consultation...
March 31, 2017: Medical Anthropology Quarterly
https://www.readbyqxmd.com/read/28365090/smoking-cessation-assistance-before-and-after-stage-1-meaningful-use-implementation
#11
Steffani R Bailey, John D Heintzman, Miguel Marino, R Lorie Jacob, Jon E Puro, Jennifer E DeVoe, Tim E Burdick, Brian L Hazlehurst, Deborah J Cohen, Stephen P Fortmann
INTRODUCTION: Brief smoking-cessation interventions in primary care settings are effective, but delivery of these services remains low. The Centers for Medicare and Medicaid Services' Meaningful Use (MU) of Electronic Health Record (EHR) Incentive Program could increase rates of smoking assessment and cessation assistance among vulnerable populations. This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 MU implementation...
March 29, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28364948/adoption-of-dental-innovations-the-case-of-a-standardized-dental-diagnostic-terminology
#12
Rachel B Ramoni, Jini Etolue, Oluwabunmi Tokede, Lyle McClellan, Kristen Simmons, Alfa Yansane, Joel M White, Muhammad F Walji, Elsbeth Kalenderian
BACKGROUND: Standardized dental diagnostic terminologies (SDDxTs) were introduced decades ago. Their use has been on the rise, accompanying the adoption of electronic health records (EHRs). One of the most broadly used terminologies is the Dental Diagnostic System (DDS). Our aim was to assess the adoption of SDDxTs by US dental schools by using the Rogers diffusion of innovations framework, focusing on the DDS. METHODS: The authors electronically surveyed clinic deans in all US dental schools (n = 61) to determine use of an EHR and SDDxT, perceived barriers to adoption of an SDDxT, and the effect of implementing an SDDxT on clinical productivity...
March 30, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28361730/safeguarding-confidentiality-in-electronic-health-records
#13
Akhil Shenoy, Jacob M Appel
Electronic health records (EHRs) offer significant advantages over paper charts, such as ease of portability, facilitated communication, and a decreased risk of medical errors; however, important ethical concerns related to patient confidentiality remain. Although legal protections have been implemented, in practice, EHRs may be still prone to breaches that threaten patient privacy. Potential safeguards are essential, and have been implemented especially in sensitive areas such as mental illness, substance abuse, and sexual health...
April 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28361157/integration-of-hospital-information-and-clinical-decision-support-systems-to-enable-the-reuse-of-electronic-health-record-data
#14
Georgy Kopanitsa
BACKGROUND: The efficiency and acceptance of clinical decision support systems (CDSS) can increase if they reuse medical data captured during health care delivery. High heterogeneity of the existing legacy data formats has become the main barrier for the reuse of data. Thus, we need to apply data modeling mechanisms that provide standardization, transformation, accumulation and querying medical data to allow its reuse. OBJECTIVES: In this paper, we focus on the interoperability issues of the hospital information systems (HIS) and CDSS data integration...
March 31, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28347442/clinical-impact-and-value-of-workstation-single-sign-on
#15
George A Gellert, John F Crouch, Lynn A Gibson, George S Conklin, S Luke Webster, John A Gillean
BACKGROUND: CHRISTUS Health began implementation of computer workstation single sign-on (SSO) in 2015. SSO technology utilizes a badge reader placed at each workstation where clinicians swipe or "tap" their identification badges. OBJECTIVE: To assess the impact of SSO implementation in reducing clinician time logging in to various clinical software programs, and in financial savings from migrating to a thin client that enabled replacement of traditional hard drive computer workstations...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28346620/varied-rates-of-implementation-of-patient-centered-medical-home-features-and-residents-perceptions-of-their-importance-based-on-practice-experience
#16
M Patrice Eiff, Larry A Green, Geoff Jones, Alex Verdieck Devlaeminck, Elaine Waller, Eve Dexter, Miguel Marino, Patricia A Carney
BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28339692/decrease-in-unnecessary-vitamin-d-testing-using-clinical-decision-support-tools-making-it-harder-to-do-the-wrong-thing
#17
Andrew H Felcher, Rachel Gold, David M Mosen, Ashley B Stoneburner
Objective: To evaluate the impact of clinical decision support (CDS) tools on rates of vitamin D testing. Screening for vitamin D deficiency has increased in recent years, spurred by studies suggesting vitamin D's clinical benefits. Such screening, however, is often unsupported by evidence and can incur unnecessary costs. Materials and Methods: We evaluated how rates of vitamin D screening changed after we implemented 3 CDS tools in the electronic health record (EHR) of a large health plan: (1) a new vitamin D screening guideline, (2) an alert that requires clinician acknowledgement of current guidelines to continue ordering the test (a "hard stop"), and (3) a modification of laboratory ordering preference lists that eliminates shortcuts...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339559/using-a-stakeholder-engaged-approach-to-develop-and-validate-electronic-clinical-quality-measures
#18
Jill Boylston Herndon, Krishna Aravamudhan, Ronald L Stephenson, Ryan Brandon, Jesley Ruff, Frank Catalanotto, Huong Le
Objective: To describe the stakeholder-engaged processes used to develop, specify, and validate 2 oral health care electronic clinical quality measures. Materials and Methods: A broad range of stakeholders were engaged from conception through testing to develop measures and test feasibility, reliability, and validity following National Quality Forum guidance. We assessed data element feasibility through semistructured interviews with key stakeholders using a National Quality Forum-recommended scorecard...
May 1, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28334590/a-prospective-emergency-department-quality-improvement-project-to-improve-the-treatment-of-vaso-occlusive-crisis-in-sickle-cell-disease-lessons-learned
#19
Paula Tanabe, Caroline E Freiermuth, David M Cline, Susan Silva
BACKGROUND: Guidelines recommend rapid, aggressive management of vaso-occlusive crisis (VOC) for patients with sickle cell disease (SCD). A large prospective research and quality improvement (QI) project was conducted to measure changes in clinical outcomes in two EDs-academic medical centers with emergency medicine residency programs and Level 1 trauma centers-during a 2.5-year time period (October 2011-March 2014). METHODS: A QI team used a Plan-Do-Study-Act approach to modify and implement changes to opioid analgesic protocols for the emergency department (ED) treatment of VOC...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334559/design-and-hospitalwide-implementation-of-a-standardized-discharge-summary-in-an-electronic-health-record
#20
Shannon M Dean, Andrea Gilmore-Bykovskyi, Joel Buchanan, Brad Ehlenfeldt, Amy J H Kind
BACKGROUND: The hospital discharge summary is the primary method used to communicate a patient's plan of care to the next provider(s). Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to posthospital care, incomplete discharge summaries remain a common problem that may contribute to poor posthospital outcomes. Electronic health records (EHRs) are regularly used as a platform on which standardization of content and format can be implemented...
December 2016: Joint Commission Journal on Quality and Patient Safety
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