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https://www.readbyqxmd.com/read/28619704/applying-stopp-guidelines-in-primary-care-through-electronic-medical-record-decision-support-randomized-control-trial-highlighting-the-importance-of-data-quality
#1
Morgan Price, Iryna Davies, Raymond Rusk, Mary Lesperance, Jens Weber
BACKGROUND: Potentially Inappropriate Prescriptions (PIPs) are a common cause of morbidity, particularly in the elderly. OBJECTIVE: We sought to understand how the Screening Tool of Older People's Prescriptions (STOPP) prescribing criteria, implemented in a routinely used primary care Electronic Medical Record (EMR), could impact PIP rates in community (non-academic) primary care practices. METHODS: We conducted a mixed-method, pragmatic, cluster, randomized control trial in research naïve primary care practices...
June 15, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28618862/probiotic-guidelines-and-physician-practice-a-cross-sectional-survey-and-overview-of-the-literature
#2
K Draper, C Ley, J Parsonnet
Probiotic use by patients and physicians has dramatically increased over the last decade, although definitive evidence is often lacking for their use. We examined probiotic-prescribing practices among health care providers (HCP) at a tertiary medical centre and compared these practices to clinical guidelines. HCP at the Stanford Medical Center received a survey on probiotic prescribing practices including choice of probiotic and primary indications. A broad overview of the literature was performed. Among 2,331 HCP surveyed, 632 responded...
June 16, 2017: Beneficial Microbes
https://www.readbyqxmd.com/read/28584837/hospital-managers-attitude-and-commitment-toward-electronic-medical-records-system-in-isfahan-hospitals-2014
#3
Maryam Jahanbakhsh, Saeed Karimi, Akbar Hassanzadeh, Maliheh Beigi
INTRODUCTION: Electronic medical record system (EMRS) is a valuable system for safe access to the patient's data and increases health care quality. Manpower is one of the requirements for EMRS, among which manager is the most important person in any hospital. Taking into account manager's positive attitude and good commitments, EMRS will be implemented successfully. As such, we decided to assess manager's attitude and commitment toward EMRS in Isfahan hospitals in the year of 2014. AIM: This article aimed to determine the hospital managers' attitude and commitment toward the implementation of EMRS...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28577543/implementation-of-emental-health-care-viewpoints-from-key-informants-from-organizations-and-agencies-with-ehealth-mandates
#4
Lori Wozney, Amanda S Newton, Nicole D Gehring, Kathryn Bennett, Anna Huguet, Lisa Hartling, Michele P Dyson, Patrick McGrath
BACKGROUND: The use of technology such as computers, tablets, and smartphones to improve access to and the delivery of mental health care (eMental Health care) is growing worldwide. However, despite the rapidly expanding evidence base demonstrating the efficacy of eMental Health care, its implementation in clinical practice and health care systems remains fragmented. To date, no peer-reviewed, key-informant studies have reported on the perspectives of decision-makers concerned with whether and how to implement eMental Health care...
June 2, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28575489/successful-implementation-of-a-bundle-strategy-to-prevent-ventilator-associated-pneumonia-in-a-neonatal-intensive-care-unit
#5
Ismail Kursad Gokce, Hayriye Gozde Kanmaz Kutman, Nurdan Uras, Fuat Emre Canpolat, Yasemin Dursun, Serife Suna Oguz
Background: We aimed to investigate the effectiveness of evidence-based bundle that we developed to reduce ventilator-associated pneumonia (VAP) rates and to assess the degree of compliance rates to this strategy in a tertiary neonatal intensive care unit. Methods: This before-after prospective cohort trial divided into two periods was conducted. All neonates requiring ventilation were enrolled in the study. VAP incidence, compliance rates to bundle components and the contribution of each bundle component to VAP rates were compared between the periods...
May 30, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28550979/status-of-blood-transfusion-in-world-health-organization-eastern-mediterranean-region-who-emr-successes-and-challenges
#6
REVIEW
Arezoo Darbandi, Pargol Mashati, Amir Yami, Arshia Gharehbaghian, Mehdi Tabrizi Namini, Ahmad Gharehbaghian
BACKGROUND: Blood products are used for patient treatment and survival in the cases of major surgery, hematological disorders or cancer therapy. Presently the main blood components are not yet replaceable by artificial products and all activities related to blood transfusion is highly dependent on the healthcare development of each country. The World Health Organization Eastern Mediterranean Region (WHO-EMR) comprises of 21 member states with variable socio-economic status effective on blood transfusion activities...
May 8, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28521714/development-and-implementation-of-the-dhapp-military-ehealth-information-network-system
#7
Mary Kratz, Anne Thomas, Ricardo Hora, Delphis Vera, Mickey Lutz, Mark D Johnson
As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards...
May 16, 2017: Current HIV Research
https://www.readbyqxmd.com/read/28515180/distribution-and-extent-of-electronic-medical-record-utilisation-in-eye-units-across-the-united-kingdom-a-cross-sectional-study-of-the-current-landscape
#8
Shin Bin Lim, Humma Shahid
OBJECTIVES: Ophthalmology units across the UK vary widely in their adoption of electronic medical records (EMR). There is a lack of evidence to show the extent and progress of EMR adoption. The aim of this study was to capture a snapshot of the current landscape of EMR use, as a baseline for comparison in future studies. SETTING: An electronic survey questionnaire was sent to all NHS ophthalmology Units in the UK. PARTICIPANTS: A total of 104 National Health Service (NHS) ophthalmology units participated in the survey, which was carried out over 6 months from December 2013 to June 2014...
May 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28514640/digital-disruption-syndromes
#9
Clair Sullivan, Andrew Staib
The digital transformation of hospitals in Australia is occurring rapidly in order to facilitate innovation and improve efficiency. Rapid transformation can cause temporary disruption of hospital workflows and staff as processes are adapted to the new digital workflows. The aim of this paper is to outline various types of digital disruption and some strategies for effective management. A large tertiary university hospital recently underwent a rapid, successful roll-out of an integrated electronic medical record (EMR)...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28486321/evaluation-tool-for-assessing-a-newly-implemented-massive-transfusion-protocol
#10
Shannon Broxton, Regina Medeiros, Autumn Schumacher
Exsanguination requires massive blood product replacement and termination of the bleeding source to prevent hemorrhagic shock and death. Massive transfusion protocols (MTPs) are algorithms that allow the health care team to quickly stabilize the bleeding patient and guide blood product administration. However, no national MTP guidelines or a standardized evaluation tool exist for collecting and reporting MTP-related data. The purpose of this article is to describe an original MTP evaluation tool, how it was used, barriers encountered, and a framework for reporting the MTP evaluation data...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28474729/utilizing-electronic-medical-records-to-discover-changing-trends-of-medical-behaviors-over-time
#11
Liangying Yin, Zhengxing Huang, Wei Dong, Chunhua He, Huilong Duan
OBJECTIVES: Medical behaviors are playing significant roles in the delivery of high quality and cost-effective health services. Timely discovery of changing frequencies of medical behaviors is beneficial for the improvement of health services. The main objective of this work is to discover the changing trends of medical behaviors over time. METHODS: This study proposes a two-steps approach to detect essential changing patterns of medical behaviors from Electronic Medical Records (EMRs)...
May 5, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28469901/use-of-electronic-clinical-decision-support-and-hard-stops-to-decrease-unnecessary-thyroid-function-testing
#12
Sonia Dalal, Siddharth Bhesania, Steven Silber, Parag Mehta
NewYork-Presbyterian Brooklyn Methodist Hospital embarked on a Zero Unnecessary Study (ZEUS) initiative, whereby all aspects of clinical care were evaluated and strategies were implemented to mitigate waste. An opportunity was found in regards to thyroid function testing. It has been shown that certain TFTs are ordered far more often than clinically indicated. Free T3 (fT3) and Free T4 (fT4) are only indicated when the TSH is abnormal in the inpatient setting, with rare exceptions. Thus, a clinical algorithm for Clinical Decision Support (CDS) and Hard Stops (HS) were incorporated into the Electronic Medical Record (EMR) to prevent fT3 or fT4 to be ordered without an abnormal TSH, with certain predefined exceptions...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28469889/a-quality-improvement-approach-to-standardization-and-sustainability-of-the-hand-off-process
#13
Craig Fryman, Carine Hamo, Siddharth Raghavan, Nirvani Goolsarran
There is mounting evidence that communication and hand-off failures are a root cause of two-thirds of sentinel events in hospitals. Several studies have shown that non-standardized hand-offs have yielded poor patient outcomes and adverse events. At Stony Brook University Hospital, there were numerous reported adverse events related to poor hand-off during the transfer of patient responsibility from one resident caregiver to the next. A resident-conducted root cause analysis identified lack of a standardized hand-off process and formal training on safe and efficient hand-off among caregivers as key contributing factors...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28446997/endoscopic-submucosal-dissection-and-endoscopic-mucosal-resection-for-early-stage-esophageal-cancer
#14
REVIEW
Bo Ning, Mohamed M Abdelfatah, Mohamed O Othman
Mortality from esophageal cancer remains high despite advances in medical therapy. Although the incidence of squamous cell carcinoma of the esophagus remains unchanged, the incidence of the esophageal adenocarcinoma has increased over time. Gastroesophageal reflux disease (GERD and obesity are contributing factors to the development of Barrett's esophagus and subsequent development of adenocarcinoma. Early recognition of the disease can lead to resection of esophageal cancer prior to the development of lymphovascular invasion...
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28427405/ceiling-effect-in-emr-system-assimilation-a-multiple-case-study-in-primary-care-family-practices
#15
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
#16
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
#17
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
#18
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...
October 1, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28395051/implementation-of-epic-beaker-clinical-pathology-at-stanford-university-medical-center
#19
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
#20
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
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