keyword
https://read.qxmd.com/read/38536235/decentralizing-health-care-history-and-opportunities-of-web3
#1
JOURNAL ARTICLE
Aditya Narayan, Kydo Weng, Nirav Shah
This paper explores the relationship between the development of the internet and health care, highlighting their parallel growth and mutual influence. It delves into the transition from the early, static days of Web 1.0, akin to siloed physician expertise in health care, to the more interactive and patient-centric era of Web 2.0, which was accompanied by advancements in medical technologies and patient engagement. This paper then focuses on the emerging era of Web3-the decentralized web-which promises a transformative shift in health care, particularly in how patient data are managed, accessed, and used...
March 27, 2024: JMIR Formative Research
https://read.qxmd.com/read/38533825/the-effect-of-an-electronic-medical-record-based-clinical-decision-support-system-on-adherence-to-clinical-protocols-in-inflammatory-bowel-disease-care-interrupted-time-series-study
#2
JOURNAL ARTICLE
Reed Taylor Sutton, Kaitlyn Delaney Chappell, David Pincock, Daniel Sadowski, Daniel C Baumgart, Karen Ivy Kroeker
BACKGROUND: Clinical decision support systems (CDSSs) embedded in electronic medical records (EMRs), also called electronic health records, have the potential to improve the adoption of clinical guidelines. The University of Alberta Inflammatory Bowel Disease (IBD) Group developed a CDSS for patients with IBD who might be experiencing disease flare and deployed it within a clinical information system in 2 continuous time periods. OBJECTIVE: This study aims to evaluate the impact of the IBD CDSS on the adherence of health care providers (ie, physicians and nurses) to institutionally agreed clinical management protocols...
March 22, 2024: JMIR Medical Informatics
https://read.qxmd.com/read/38531676/preparing-for-the-bedside-optimizing-a-postpartum-depression-risk-prediction-model-for-clinical-implementation-in-a-health-system
#3
JOURNAL ARTICLE
Yifan Liu, Rochelle Joly, Meghan Reading Turchioe, Natalie Benda, Alison Hermann, Ashley Beecy, Jyotishman Pathak, Yiye Zhang
OBJECTIVE: We developed and externally validated a machine-learning model to predict postpartum depression (PPD) using data from electronic health records (EHRs). Effort is under way to implement the PPD prediction model within the EHR system for clinical decision support. We describe the pre-implementation evaluation process that considered model performance, fairness, and clinical appropriateness. MATERIALS AND METHODS: We used EHR data from an academic medical center (AMC) and a clinical research network database from 2014 to 2020 to evaluate the predictive performance and net benefit of the PPD risk model...
March 26, 2024: Journal of the American Medical Informatics Association: JAMIA
https://read.qxmd.com/read/38530156/standardized-order-set-for-the-management-of-infective-endocarditis
#4
JOURNAL ARTICLE
Kerneisha Murphy, Emily Eiswirth
BACKGROUND: Infective endocarditis (IE) is a potentially life-threatening infection that affects the inner lining of the heart, particularly the heart valves. Patients with preexisting heart conditions, damaged heart valves, or a history of intravenous drug use are at a higher risk of acquiring IE. LOCAL PROBLEM: A rural acute care facility reported that 68.75% of patients who had a methicillin-resistant Staphylococcus aureus infection were diagnosed with IE. Review of medical records showed that 65% of patients with IE did not have antibiotic start/stop dates and 51% were discharged before the 6-week completion date...
March 26, 2024: Journal of the American Association of Nurse Practitioners
https://read.qxmd.com/read/38525197/patterns-and-gaps-in-guideline-directed-statin-use-for-atherosclerotic-cardiovascular-disease-by-race-and-ethnicity
#5
JOURNAL ARTICLE
Ashish Sarraju, Xiaowei Yan, Qiwen Huang, Ramzi Dudum, Latha Palaniappan, Fatima Rodriguez
OBJECTIVE: There remain disparities by race and ethnicity in atherosclerotic cardiovascular disease (ASCVD). Statins reduce low-density lipoprotein cholesterol (LDL-c) and improve ASCVD outcomes. ASCVD treatment patterns across disaggregated race and ethnicity groups are incompletely understood. We aimed to evaluate statin use and LDL-c control for ASCVD by race and ethnicity. METHODS: From an electronic health record (EHR)-based cohort from a multisite Northern California health system, we included adults with an ASCVD diagnosis from 2010 to 2021 and at least 2 primary care visits, stratified by race and ethnicity (Non-Hispanic White [NHW], Non-Hispanic Black [Black], Hispanic, and Asian)...
March 2024: American journal of preventive cardiology
https://read.qxmd.com/read/38525096/assessment-of-population-based-approach-to-direct-oral-anticoagulant-management
#6
JOURNAL ARTICLE
Nghi Ha, Erin Mouland, Elizabeth Renner, Denise Sutter-Long, Anisa Bici, Michael Lanham, Geoffrey D Barnes
Background: As preferences for oral anticoagulation shift from warfarin to direct oral anticoagulants (DOACs), a new care management model is needed. A population approach leveraging a DOAC Dashboard was implemented to track all patients on a DOAC followed by a physician at an academic medical center. The DOAC Dashboard is a real-time report within the electronic health record (EHR) that identifies patients who require evaluation for DOAC dose/therapy adjustment due to changing renal function, age, weight, indication, and/or significant drug-drug interaction (DDI)...
April 2024: Journal of Pharmacy Technology: JPT: Official Publication of the Association of Pharmacy Technicians
https://read.qxmd.com/read/38523930/strengths-weaknesses-opportunities-and-threats-swot-analysis-of-hemodialysis-electronic-health-record-implementation
#7
JOURNAL ARTICLE
Bassma Bennis, Ghita El Bardai, Basmat Amal Chouhani, Nadia Kabbali, Tarik Sqalli
BACKGROUND AND AIM: The Nephrology Department of Hassan II Hospital in Fez, Morocco, has implemented an Electronic Medical Record (EMR) system for managing patients undergoing acute hemodialysis. This initiative aims to digitize patient monitoring and enhance the management of acute dialysis within the department. Conducting strengths, weaknesses, opportunities, and threats (SWOT) analysis - assessing strengths, weaknesses, opportunities, and threats - was crucial to identifying and understanding the internal strengths and weaknesses, as well as the external opportunities and threats...
February 2024: Curēus
https://read.qxmd.com/read/38520907/healthcare-5-0-a-secure-and-distributed-network-for-system-informatics-in-medical-surgery
#8
JOURNAL ARTICLE
Chenggang Wu, Yuk Ming Tang, Wei Ting Kuo, Ho Tung Yip, Ka Yin Chau
INTRODUCTION: Health records serve not only as a database of a patient's health history and treatment process but also as a crucial tool for doctors to diagnose and treat patients. However, the storage and sharing of these records are sensitive issues as they involve maintaining patient privacy and ensuring data transparency, security, and interoperability between different parties. Challenges to achieving these goals in the current surgical process can impact the allocation of medical resources and surgical outcomes...
March 20, 2024: International Journal of Medical Informatics
https://read.qxmd.com/read/38511415/patient-perceptions-of-behavioral-flags-in-the-emergency-department-a-qualitative-analysis
#9
JOURNAL ARTICLE
Rachel E Gonzales, Emily F Seeburger, Ari B Friedman, Anish K Agarwal
BACKGROUND: To combat increasing levels of violence in the emergency department (ED), hospitals have implemented several safety measures, including behavioral flags. These electronic health record (EHR)-based notifications alert future clinicians of past incidents of potentially threatening patient behavior, but observed racial disparities in their placement may unintentionally introduce bias in patient care. Little is known about how patients perceive these flags and the disparities that have been found in their placement...
March 21, 2024: Academic Emergency Medicine
https://read.qxmd.com/read/38510692/wic-staff-and-healthcare-professional-perceptions-of-an-ehr-intervention-to-facilitate-referrals-to-and-improve-communication-and-coordination-with-wic-a-qualitative-study
#10
JOURNAL ARTICLE
Abigail McCall, Ashley E Strahley, Katy W Martin-Fernandez, Kristina H Lewis, Angelina Pack, Beatriz Ospino-Sanchez, Ivy Greene, Gabriela de la Vega, Alysha J Taxter, Sally G Eagleton, Kimberly G Montez
OBJECTIVES: Participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) has numerous benefits, yet many eligible children remain unenrolled. This qualitative study sought to explore perceptions of a novel electronic health record (EHR) intervention to facilitate referrals to WIC and improve communication/coordination between WIC staff and healthcare professionals. METHODS: WIC staff in three counties were provided EHR access and recruited to participate...
2024: Journal of Clinical and Translational Science
https://read.qxmd.com/read/38510279/smart-hospital-achieving-interoperability-and-raw-data-collection-from-medical-devices-in-clinical-routine
#11
JOURNAL ARTICLE
Eimo Martens, Hans-Ulrich Haase, Giulio Mastella, Andreas Henkel, Christoph Spinner, Franziska Hahn, Congyu Zou, Augusto Fava Sanches, Julia Allescher, Daniel Heid, Elena Strauss, Melanie-Maria Maier, Mark Lachmann, Georg Schmidt, Dominik Westphal, Tobias Haufe, David Federle, Daniel Rueckert, Martin Boeker, Matthias Becker, Karl-Ludwig Laugwitz, Alexander Steger, Alexander Müller
INTRODUCTION: Today, modern technology is used to diagnose and treat cardiovascular disease. These medical devices provide exact measures and raw data such as imaging data or biosignals. So far, the Broad Integration of These Health Data into Hospital Information Technology Structures-Especially in Germany-is Lacking, and if data integration takes place, only non-Evaluable Findings are Usually Integrated into the Hospital Information Technology Structures. A Comprehensive Integration of raw Data and Structured Medical Information has not yet Been Established...
2024: Frontiers in digital health
https://read.qxmd.com/read/38506482/communication-of-incidental-imaging-findings-on-inpatient-discharge-summaries-after-implementation-of-electronic-health-record-notification-system
#12
JOURNAL ARTICLE
Govind Mattay, Kushanth Mallikarjun, Paula Grow, Aaron Mintz, Thomas Ciesielski, Anthony Dao, Shivani Mattay, Geoffrey Cislo, Raghav Mattay, Vamsi Narra, Andrew Bierhals
OBJECTIVES: Inadequate follow-up of incidental imaging findings (IIFs) can result in poor patient outcomes, patient dissatisfaction, and provider malpractice. At our institution, radiologists flag IIFs during report dictation to trigger electronic health record (EHR) notifications to providers and patients. Nurse coordinators directly contact patients or their primary care physicians (PCPs) regarding IIFs if follow-up is not completed within the recommended time frame. Despite these interventions, many patients and their PCPs remain unaware of IIFs...
March 18, 2024: Journal of Patient Safety
https://read.qxmd.com/read/38502617/personalized-federated-graph-learning-on-non-iid-electronic-health-records
#13
JOURNAL ARTICLE
Tao Tang, Zhuoyang Han, Zhen Cai, Shuo Yu, Xiaokang Zhou, Taiwo Oseni, Sajal K Das
Understanding the latent disease patterns embedded in electronic health records (EHRs) is crucial for making precise and proactive healthcare decisions. Federated graph learning-based methods are commonly employed to extract complex disease patterns from the distributed EHRs without sharing the client-side raw data. However, the intrinsic characteristics of the distributed EHRs are typically non-independent and identically distributed (Non-IID), significantly bringing challenges related to data imbalance and leading to a notable decrease in the effectiveness of making healthcare decisions derived from the global model...
March 19, 2024: IEEE Transactions on Neural Networks and Learning Systems
https://read.qxmd.com/read/38499608/effect-of-clinical-decision-support-for-severe-hypercholesterolemia-on-low-density-lipoprotein-cholesterol-levels
#14
JOURNAL ARTICLE
Hana Bangash, Seyedmohammad Saadatagah, Mohammadreza Naderian, Marwan E Hamed, Lubna Alhalabi, Alborz Sherafati, Joseph Sutton, Omar Elsekaily, Ali Mir, Justin H Gundelach, Daniel Gibbons, Paul Johnsen, Christina M Wood-Wentz, Carin Y Smith, Pedro J Caraballo, Kent R Bailey, Iftikhar J Kullo
Severe hypercholesterolemia/possible familial hypercholesterolemia (FH) is relatively common but underdiagnosed and undertreated. We investigated whether implementing clinical decision support (CDS) was associated with lower low-density lipoprotein cholesterol (LDL-C) in patients with severe hypercholesterolemia/possible FH (LDL-C ≥ 190 mg/dL). As part of a pre-post implementation study, a CDS alert was deployed in the electronic health record (EHR) in a large health system comprising 3 main sites, 16 hospitals and 53 clinics...
March 18, 2024: NPJ Digital Medicine
https://read.qxmd.com/read/38493378/designing-an-implementable-clinical-prediction-model-for-near-term-mortality-and-long-term-survival-in-patients-on-maintenance-hemodialysis
#15
JOURNAL ARTICLE
Benjamin A Goldstein, Chun Xu, Jonathan Wilson, Ricardo Henao, Patti L Ephraim, Daniel E Weiner, Tariq Shafi, Julia J Scialla
RATIONALE & OBJECTIVE: The life expectancy of patients treated with maintenance hemodialysis (MHD) is heterogeneous. Knowledge of life-expectancy may focus care decisions on near-term versus long-term goals. The current tools are limited and focus on near-term mortality. Here, we develop and assess potential utility for predicting near-term mortality and long-term survival on MHD. STUDY DESIGN: Predictive modeling study. SETTING & PARTICIPANTS: 42,351 patients contributing 997,381 patient months over 11 years, abstracted from the electronic health record (EHR) system of midsize, nonprofit dialysis providers...
February 21, 2024: American Journal of Kidney Diseases
https://read.qxmd.com/read/38488173/an-age-friendly-approach-to-primary-care-in-an-academic-health-system
#16
JOURNAL ARTICLE
Andrea Wismann, Keith Kleszynski, Dawn Jelinek, Rachel Hand, Brian Lich, Elizabeth Wickersham, Lee A Jennings
BACKGROUND: Age-friendly care, addressing what matters most, medications, mentation, and mobility, is a successful model for improving older adult care. We describe the initial outcomes of age-friendly care implementation in five primary care clinics in an academic health system. METHODS: In partnership with a regional quality improvement (QI) organization, we used practice facilitation to implement age-friendly care from July 2020 to June 2023. Clinic workflows and electronic health record (EHR) templates were modified to capture six QI measures for patients ≥65 years: Documenting what matters most to patients Advance care planning (ACP) Annual cognitive screening Caregiver referral to dementia community resources Fall-risk screening Co-prescription of opioid and sedative-hypnotic drugs Providers were alerted if patients had positive screens and given support tools for clinical decision-making...
March 15, 2024: Journal of the American Geriatrics Society
https://read.qxmd.com/read/38486050/developing-an-individualized-treatment-rule-for-veterans-with-major-depressive-disorder-using-electronic-health-records
#17
JOURNAL ARTICLE
Nur Hani Zainal, Robert M Bossarte, Sarah M Gildea, Irving Hwang, Chris J Kennedy, Howard Liu, Alex Luedtke, Brian P Marx, Maria V Petukhova, Edward P Post, Eric L Ross, Nancy A Sampson, Erik Sverdrup, Brett Turner, Stefan Wager, Ronald C Kessler
Efforts to develop an individualized treatment rule (ITR) to optimize major depressive disorder (MDD) treatment with antidepressant medication (ADM), psychotherapy, or combined ADM-psychotherapy have been hampered by small samples, small predictor sets, and suboptimal analysis methods. Analyses of large administrative databases designed to approximate experiments followed iteratively by pragmatic trials hold promise for resolving these problems. The current report presents a proof-of-concept study using electronic health records (EHR) of n = 43,470 outpatients beginning MDD treatment in Veterans Health Administration Primary Care Mental Health Integration (PC-MHI) clinics, which offer access not only to ADMs but also psychotherapy and combined ADM-psychotherapy...
March 14, 2024: Molecular Psychiatry
https://read.qxmd.com/read/38482076/de-implementation-of-fecal-occult-blood-testing-in-the-emergency-department-and-hospital-units-a-quality-improvement-project
#18
JOURNAL ARTICLE
Adewale Ajumobi, Joline De Castro, Ammar Qureshi
BACKGROUND: Fecal occult blood tests (FOBT) are inappropriately used in patients with melena, hematochezia, coffee ground emesis, iron deficiency anemia, and diarrhea. The use of FOBT for reasons other than screening for colorectal cancer is considered low-value and unnecessary. METHODS: Quality Improvement Project that utilized education, Best Practice Advisory (BPA) and modification of order sets in the electronic health record (EHR). The interventions were done in a sequential order based on the Plan-Do-Study-Act (PDSA) method...
2024: Journal of Community Hospital Internal Medicine Perspectives
https://read.qxmd.com/read/38472006/implementation-of-a-geriatric-care-bundle-for-older-adults-with-acute-burns
#19
JOURNAL ARTICLE
Julia Oehlers, Carolyn Blayney, Jo Tate, Alexander Cheng, Andrew Tucker, May J Reed, Barclay T Stewart, Saman Arbabi, Kathleen O'Connell, Elisabeth Powelson, Tam N Pham
BACKGROUND: Frailty and comorbidities are important outcome determinants in older patients (age ≥65) with burns. A Geriatric Burn Bundle (Geri-B) was implemented in 2019 at a regional burn center to standardize care for older adults. Components included frailty screening and protocolized geriatric co-management, malnutrition screening with nutritional support, and geriatric-centered pain regimens. METHODS: This study aimed to qualitatively evaluate the implementation of Geri-B using the Proctor Framework...
February 29, 2024: Burns
https://read.qxmd.com/read/38470477/development-of-a-social-risk-score-in-the-electronic-health-record-to-identify-social-needs-among-underserved-populations-retrospective-study
#20
JOURNAL ARTICLE
Elham Hatef, Hsien-Yen Chang, Thomas M Richards, Christopher Kitchen, Janya Budaraju, Iman Foroughmand, Elyse C Lasser, Jonathan P Weiner
BACKGROUND: Patients with unmet social needs and social determinants of health (SDOH) challenges continue to face a disproportionate risk of increased prevalence of disease, health care use, higher health care costs, and worse outcomes. Some existing predictive models have used the available data on social needs and SDOH challenges to predict health-related social needs or the need for various social service referrals. Despite these one-off efforts, the work to date suggests that many technical and organizational challenges must be surmounted before SDOH-integrated solutions can be implemented on an ongoing, wide-scale basis within most US-based health care organizations...
March 12, 2024: JMIR Formative Research
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