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https://www.readbyqxmd.com/read/28427405/ceiling-effect-in-emr-system-assimilation-a-multiple-case-study-in-primary-care-family-practices
#1
Marie-Claude Trudel, Josianne Marsan, Guy Paré, Louis Raymond, Ana Ortiz de Guinea, Éric Maillet, Thomas Micheneau
BACKGROUND: There has been indisputable growth in adoption of electronic medical record (EMR) systems in the recent years. However, physicians' progress in using these systems has stagnated when measured with maturity scales. While this so-called ceiling effect has been observed and its consequences described in previous studies, there is a paucity of research on the elements that could explain such an outcome. We first suggest that in the context of EMR systems we are in presence of a "tiered ceiling effect" and then we show why such phenomenon occurs...
April 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28421546/electronic-medical-record-interventions-and-recurrent-perioperative-antibiotic-administration-a-before-and-after-study
#2
Alexander Hincker, Arbi Ben Abdallah, Michael Avidan, Penka Candelario, Daniel Helsten
PURPOSE: Perioperative antibiotics decrease rates of surgical-site infections. Numerous interventions have improved administration of the first antibiotic dose; however, failures in the administration of subsequent doses frequently occur. We hypothesized that modifications to the electronic medical record (EMR) would improve the administration of the second antibiotic dose and that such improvements would be sustained over time. METHODS: This historical cohort before-and-after study of multipronged alerts in the EMR analyzed 1,348 operations on adult patients...
April 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28412052/-the-relationship-between-preoperative-anxiety-levels-and-vasovagal-incidents-during-the-administration-of-spinal-anesthesia
#3
Mürsel Ekinci, Birzat Emre Gölboyu, Onur Dülgeroğlu, Murat Aksun, Pınar Karaca Baysal, Erkan Cem Çelik, Ayşe Nur Yeksan
BACKGROUND: It was aimed to investigate the relationship between preoperative anxiety and vasovagal symptoms observed during the administration of spinal anesthesia in patients undergoing surgery in the perianal and inguinal regions. METHODS: The study included patients with planned surgery for inguinal hernia repair, anal fissure, hemorrhoid and pilonidal sinus excision. The study included a total of 210 patients of ASA I-II, aged 18-65 years. Patients were evaluated in respect of demographic characteristics, smoking and alcohol consumption, ASA grade and educational level...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28395258/a-pollution-fate-and-transport-model-application-in-a-semi-arid-region-is-some-number-better-than-no-number
#4
Zeynep Özcan, Oğuz Başkan, H Şebnem Düzgün, Elçin Kentel, Emre Alp
Fate and transport models are powerful tools that aid authorities in making unbiased decisions for developing sustainable management strategies. Application of pollution fate and transport models in semi-arid regions has been challenging because of unique hydrological characteristics and limited data availability. Significant temporal and spatial variability in rainfall events, complex interactions between soil, vegetation and topography, and limited water quality and hydrological data due to insufficient monitoring network make it a difficult task to develop reliable models in semi-arid regions...
April 7, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28395051/implementation-of-epic-beaker-clinical-pathology-at-stanford-university-medical-center
#5
Brent T Tan, Jennifer Fralick, William Flores, Cary Schrandt, Vicki Davis, Tom Bruynell, Lisa Wilson, John Christopher, Shirley Weber, Neil Shah
Objectives: To provide an account of implementation of the Epic Beaker 2014 clinical pathology module at Stanford University Medical Center and highlight strengths and weaknesses of the system. Methods: Based on a formal selection process, Stanford selected Epic Beaker to replace Sunquest as the clinical laboratory information system (LIS). The rationale included integration between the LIS and already installed Epic electronic medical record (EMR), reduction in the number of systems and interfaces, and positive patient identification (PPID)...
March 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28391811/a-study-of-emr-based-medical-knowledge-network-and-its-applications
#6
Chao Zhao, Jingchi Jiang, Zhiming Xu, Yi Guan
BACKGROUND AND OBJECTIVE: Electronic medical records (EMRs) contain an amount of medical knowledge which can be used for clinical decision support. We attempt to integrate this medical knowledge into a complex network, and then implement a diagnosis model based on this network. METHODS: The dataset of our study contains 992 records which are uniformly sampled from different departments of the hospital. In order to integrate the knowledge of these records, an EMR-based medical knowledge network (EMKN) is constructed...
May 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28372788/utilizing-technology-to-improve-intraoperative-family-communication
#7
M M Wieck, B Blake, C Sellick, D Kenron, D DeVries, S Terry, S Krishnaswami
PURPOSE: To create and assess satisfaction with an electronic-medical-record (EMR) integrated communication system designed to optimize perioperative communication with families. METHODS: We built a tool in the EMR's intraoperative nursing navigation screen for sending customized or standardized text pages to families in English or Spanish. Preoperatively, families were given text pagers with instructions and a hospital map to facilitate leaving the waiting area...
March 27, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28365240/using-electronic-health-records-to-build-an-ophthalmological-data-warehouse-and-visualize-patients-data
#8
Karsten U Kortüm, Michael Müller, Christoph Kern, Alexander Babenko, Wolfgang J Mayer, Anselm Kampik, Thomas C Kreutzer, Siegfried Priglinger, Christoph Hirneiss
PURPOSE: To develop a near real-time data warehouse (DW) in an academic ophthalmological center to gain scientific use of increasing digital data from electronic medical records (EMR) and diagnostic devices. Design; Database development METHODS: Specific macular clinic user interfaces within the institutional hospital information system were created. Orders for imaging modalities were sent by an EMR -linked picture-archiving and communications system to the respective devices. All data of 325,767 patients since 2002 were gathered in a DW running on a SQL database...
March 29, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28360503/the-role-of-copy-and-paste-function-in-orthopedic-trauma-progress-notes
#9
Wesley Winn, Irshad A Shakir, Heidi Israel, Lisa K Cannada
INTRODUCTION: The electronic medical record (EMR) is standard in institutions. While there is not concern for legibility of notes and access to charts, there is an ease of copy and paste for daily notes. This may not lead to accurate portrayal of patient's status. Our purpose was to evaluate the use of copy and paste functions in daily notes of patients with injuries at high risk for complications. METHODS: IRB approval was obtained for a retrospective review. Inclusion criteria included patients aged 18 and older treated at our Level 1 Trauma Center after implementation of Epic Systems Corporation, Verona, WI, USA...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28274382/legal-priorities-for-prevention-of-non-communicable-diseases-innovations-from-who-s-eastern-mediterranean-region
#10
REVIEW
L O Gostin, H Abou-Taleb, S A Roache, A Alwan
OBJECTIVES: Non-communicable diseases (NCDs) are the leading cause of death globally and in the World Health Organization's (WHO) Eastern Mediterranean region (EMR). This paper reports on a research collaboration between the WHO's Eastern Mediterranean Office (EMRO) and the O'Neill Institute for National and Global Health Law at Georgetown University that aims to identify (1) regionally relevant, cost-effective and affordable legal interventions to prevent NCDs, and (2) methods to strengthen implementation and enforcement...
March 2017: Public Health
https://www.readbyqxmd.com/read/28268937/csdc-a-nationwide-screening-platform-for-stroke-control-and-prevention-in-china
#11
Jinghui Yu, Huajian Mao, Mei Li, Dan Ye, Dongsheng Zhao
As a leading cause of severe disability and death, stroke places an enormous burden on Chinese society. A nationwide stroke screening platform called CSDC (China Stoke Data Center) has been built to support the national stroke prevention program and stroke clinical research since 2011. This platform is composed of a data integration system and a big data analysis system. The data integration system is used to collect information on risk factors, diagnosis history, treatment, and sociodemographic characteristics and stroke patients' EMR...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28256114/development-of-clinical-data-mart-of-hmg-coa-reductase-inhibitor-for-varied-clinical-research
#12
Hun Sung Kim, Hyunah Kim, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Sun Jung Baik, Seung Hwan Lee, Jae Hyoung Cho, In Young Choi, Kun Ho Yoon
BACKGROUND: The increasing use of electronic medical record (EMR) systems for documenting clinical medical data has led to EMR data being increasingly accessed for clinical trials. In this study, a database of patients who were prescribed statins for the first time was developed using EMR data. A clinical data mart (CDM) was developed for cohort study researchers. METHODS: Seoul St. Mary's Hospital implemented a clinical data warehouse (CDW) of data for ~2.8 million patients, 47 million prescription events, and laboratory results for 150 million cases...
March 2017: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28247320/nutrient-deficiency-10%C3%A2-years-following-roux-en-y-gastric-bypass-who-s-responsible
#13
J Hunter Mehaffey, Rachel L Mehaffey, Mathew G Mullen, Florence E Turrentine, Steven K Malin, Bruce Schirmer, Andrew M Wolf, Peter T Hallowell
OBJECTIVE(S): Monitoring and prevention of long-term nutrient deficiency after laparoscopic Roux-en-Y gastric bypass (LRYGB) remains ill defined due to limited surgical follow-up after bariatric surgery. This study compared nutrient supplementation as well as surgeon and primary care physician (PCP) follow-up between patients with short-term versus long-term follow-up. METHODS: All patients undergoing LRYGB at a single institution in 2004 (long-term group, n = 281) and 2012-2013 (short-term group, n = 149) were evaluated...
February 28, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28228372/progress-in-the-enhanced-use-of-electronic-medical-records-data-from-the-ontario-experience
#14
Mavis Jones, Chad Koziel, Darren Larsen, Plumaletta Berry, Elena Kubatka-Willms
BACKGROUND: This paper describes a change management strategy, including a self-assessment survey tool and electronic medical record (EMR) maturity model (EMM), developed to support the adoption and implementation of EMRs among community-based physicians in the province of Ontario, Canada. OBJECTIVE: The aim of our study was to present an analysis of progress in EMR use in the province of Ontario based on data from surveys completed by over 4000 EMR users. METHODS: The EMM and the EMR progress report (EPR) survey tool clarify levels of capability and expected benefits of improved use...
February 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28227143/csdc-a-nationwide-screening-platform-for-stroke-control-and-prevention-in-china
#15
Jinghui Yu, Huajian Mao, Mei Li, Dan Ye, Dongsheng Zhao, Jinghui Yu, Huajian Mao, Mei Li, Dan Ye, Dongsheng Zhao, Dan Ye, Huajian Mao, Mei Li, Dongsheng Zhao, Jinghui Yu
As a leading cause of severe disability and death, stroke places an enormous burden on Chinese society. A nationwide stroke screening platform called CSDC (China Stoke Data Center) has been built to support the national stroke prevention program and stroke clinical research since 2011. This platform is composed of a data integration system and a big data analysis system. The data integration system is used to collect information on risk factors, diagnosis history, treatment, and sociodemographic characteristics and stroke patients' EMR...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224246/comparison-of-veterinary-drug-residue-results-in-animal-tissues-by-ultrahigh-performance-liquid-chromatography-coupled-to-triple-quadrupole-or-quadrupole-time-of-flight-tandem-mass-spectrometry-after-different-sample-preparation-methods-including-use-of-a-commercial
#16
Tarun Anumol, Steven J Lehotay, Joan Stevens, Jerry Zweigenbaum
Veterinary drug residues in animal-derived foods must be monitored to ensure food safety, verify proper veterinary practices, enforce legal limits in domestic and imported foods, and for other purposes. A common goal in drug residue analysis in foods is to achieve acceptable monitoring results for as many analytes as possible, with higher priority given to the drugs of most concern, in an efficient and robust manner. The U.S. Department of Agriculture has implemented a multiclass, multi-residue method based on sample preparation using dispersive solid phase extraction (d-SPE) for cleanup and ultrahigh-performance liquid chromatography-tandem quadrupole mass spectrometry (UHPLC-QQQ) for analysis of >120 drugs at regulatory levels of concern in animal tissues...
February 21, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28210363/using-the-electronic-medical-record-to-reduce-unnecessary-ordering-of-coagulation-studies-for-patients-with-chest-pain
#17
Jeremiah S Hinson, Binoy Mistry, Yu-Hsiang Hsieh, Nicholas Risko, David Scordino, Karolina Paziana, Susan Peterson, Rodney Omron
INTRODUCTION: Our goal was to reduce ordering of coagulation studies in the emergency department (ED) that have no added value for patients presenting with chest pain. We hypothesized this could be achieved via implementation of a stopgap measure in the electronic medical record (EMR). METHODS: We used a pre and post quasi-experimental study design to evaluate the impact of an EMR-based intervention on coagulation study ordering for patients with chest pain. A simple interactive prompt was incorporated into the EMR of our ED that required clinicians to indicate whether patients were on anticoagulation therapy prior to completion of orders for coagulation studies...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28210351/cross-continuum-tool-is-associated-with-reduced-utilization-and-cost-for-frequent-high-need-users
#18
Lauran Hardin, Adam Kilian, Leslie Muller, Kevin Callison, Michael Olgren
INTRODUCTION: High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28192551/effectiveness-of-computer-automation-for-the-diagnosis-and-management-of-childhood-type-2-diabetes-a-randomized-clinical-trial
#19
Tamara S Hannon, Tamara M Dugan, Chandan K Saha, Steven J McKee, Stephen M Downs, Aaron E Carroll
Importance: Type 2 diabetes (T2D) is increasingly common in young individuals. Primary prevention and screening among children and adolescents who are at substantial risk for T2D are recommended, but implementation of T2D screening practices in the pediatric primary care setting is uncommon. Objective: To determine the feasibility and effectiveness of a computerized clinical decision support system to identify pediatric patients at high risk for T2D and to coordinate screening for and diagnosis of prediabetes and T2D...
April 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28187729/use-of-electronic-medical-records-and-quality-of-patient-data-different-reaction-patterns-of-doctors-and-nurses-to-the-hospital-organization
#20
Mattijs S Lambooij, Hanneke W Drewes, Ferry Koster
BACKGROUND: As the implementation of Electronic Medical Records (EMRs) in hospitals may be challenged by different responses of different user groups, this paper examines the differences between doctors and nurses in their response to the implementation and use of EMRs in their hospital and how this affects the perceived quality of the data in EMRs. METHODS: Questionnaire data of 402 doctors and 512 nurses who had experience with the implementation and the use of EMRs in hospitals was analysed with Multi group Structural equation modelling (SEM)...
February 10, 2017: BMC Medical Informatics and Decision Making
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