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https://www.readbyqxmd.com/read/29747644/electronic-health-record-tools-to-assist-with-children-s-insurance-coverage-a-mixed-methods-study
#1
Jennifer E DeVoe, Megan Hoopes, Christine A Nelson, Deborah J Cohen, Aleksandra Sumic, Jennifer Hall, Heather Angier, Miguel Marino, Jean P O'Malley, Rachel Gold
BACKGROUND: Children with health insurance have increased access to healthcare and receive higher quality care. However, despite recent initiatives expanding children's coverage, many remain uninsured. New technologies present opportunities for helping clinics provide enrollment support for patients. We developed and tested electronic health record (EHR)-based tools to help clinics provide children's insurance assistance. METHODS: We used mixed methods to understand tool adoption, and to assess impact of tool use on insurance coverage, healthcare utilization, and receipt of recommended care...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29732457/a-computable-definition-of-sepsis-facilitates-screening-and-performance-improvement-tracking
#2
Lauren J Alessi, Holly R Warmus, Erin K Schaffner, Sajel Kantawala, Joseph Carcillo, Johanna Rosen, Christopher M Horvat
Background: Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. Objectives: We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods: Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control...
March 2018: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29691919/impact-of-different-assumptions-on-estimates-of-childhood-diseases-obtained-from-health-care-data-a-retrospective-cohort-study
#3
Osemeke U Osokogu, Alexandra Pacurariu, Mees Mosseveld, Peter Rijnbeek, Daniel Weibel, Katia Verhamme, Miriam C J M Sturkenboom
PURPOSE: Accurate estimates of disease incidence in children are required to support pediatric drug development. Analysis of electronic health care records (EHR) may yield such estimates but pediatric-specific methods are lacking. We aimed to understand the impact of assumptions regarding duration of disease episode and length of run-in period on incidence estimates from EHRs. METHODS: Children aged 0 to 17 years (5-17 years for asthma) registered in the Integrated Primary Care Information database between 2002 and 2014 were studied...
April 24, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29688461/transition-to-a-new-electronic-health-record-and-pediatric-medication-safety-lessons-learned-in-pediatrics-within-a-large-academic-health-system
#4
Kimberly Whalen, Emily Lynch, Iman Moawad, Tanya John, Denise Lozowski, Brian M Cummings
Objective: While the electronic health record (EHR) has become a standard of care, pediatric patients pose a unique set of risks in adult-oriented systems. We describe medication safety and implementation challenges and solutions in the pediatric population of a large academic center transitioning its EHR to Epic. Methods: Examination of the roll-out of a new EHR in a mixed neonatal, pediatric and adult tertiary care center with staggered implementation. We followed the voluntarily reported medication error rate for the neonatal and pediatric subsets and specifically monitored the first 3 months after the roll-out of the new EHR...
April 23, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29672356/improving-documentation-of-inpatient-problem-list-in-electronic-health-record-a-quality-improvement-project
#5
Prabi Rajbhandari, Moises Auron, Sarah Worley, Michelle Marks
BACKGROUND: The problem list is critical in electronic documentation. It is a powerful tool for clinical decision-making because it provides a concise view of all patient problems in one place and is also a criterion for the Medicare meaningful use incentive program. OBJECTIVE: To measure the rate of utilization of problem list in electronic health records (EHR) in a pediatric hospital medicine unit and implement sequential interventions to increase the rate of use of problem list to more than 80% by the end of 2015, as measured by at least one documented hospital problem at discharge...
April 19, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29661609/assessing-the-effect-of-an-educational-intervention-on-nurses-and-patient-care-assistants-comprehension-and-documentation-of-functional-ability-in-pediatric-patients-with-sickle-cell-disease
#6
Katherine M Bernier, Megan Strobel, Ruth Lucas
PURPOSE: In 2014, the Youth Acute Pain Functional Ability Questionnaire (YAPFAQ) was developed to investigate patient's self-rated functional ability during times of acute pain in the inpatient clinical setting. Although it has great potential, the application of this tool has not been made a standard of care. The purpose of this multiple methods study was to determine if, through an educational intervention, hospital staff could consistently document the YAPFAQ in children with sickle cell disease (SCD) during a vaso-occlusive episode...
April 13, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29650310/electronic-health-record-with-computerized-decision-support-tools-for-the-purposes-of-a-pediatric-cardiovascular-heart-disease-screening-program-in-crete
#7
Ilias Chatzakis, Kostas Vassilakis, Christos Lionis, Ioannis Germanakis
BACKGROUND AND OBJECTIVE: Early detection of cardiovascular (CV) disease or associated risk factors during childhood is of paramount importance, allowing for early treatment or lifestyle modifications, respectively. The objective of this study was to describe the development of an electronic health record (EHR), with integrated computerized decision support system (CDSS), specifically designed for supporting the needs of a pilot pediatric CV disease screening program applied on primary school students of a Mediterranean island...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29519956/enhancing-health-it-functionality-for-children-the-2015-children-s-ehr-format
#8
Jonathan S Wald, Saira N Haque, Stephanie Rizk, Jennifer R Webb, Stephen Brown, Shellery Ebron, Christoph U Lehmann, Mark Frisse, Vanessa A Shorte, Edwin A Lomotan, Barbara A Dailey, Kevin B Johnson
Electronic health record (EHR) use throughout the United States has advanced considerably, but functionality to support the optimal care of children has been slower to develop and deploy. A previous team of experts systematically identified gaps in EHR functionality during collaborative work from 2010 to 2013 that produced the Children's EHR Format (Format), funded under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3. After that, a team of practitioners, software developers, health policy leaders, and other stakeholders examined the Format's exhaustive list of 547 EHR functional requirements in 26 topic areas and found them to be valuable but in need of further refinement and prioritization...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29436391/associations-between-pediatric-palliative-care-consultation-and-end-of-life-preparation-at-an-academic-medical-center-a-retrospective-ehr-analysis
#9
Matthew Stutz, Roy L Kao, Leanna Huard, Jonathan Grotts, Javier Sanz, Mindy K Ross
OBJECTIVES: Our aim in this study was to understand usage patterns of pediatric palliative care (PPC) consultation and associations with end-of-life preparation among pediatric patients who are deceased. METHODS: We reviewed 233 pediatric mortalities. Data extraction from the electronic health record included determination of PPC consultation by using Current Procedural Terminology codes. Diagnoses were identified by International Classification of Disease codes and were classified into categories of life-threatening complex chronic conditions (LT-CCCs)...
March 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29422435/the-catch-to-confidentiality-the-use-of-electronic-health-records-in-adolescent-health-care
#10
Timothy Stablein, Keith J Loud, Christopher DiCapua, Denise L Anthony
PURPOSE: This study aims to understand pediatric health-care providers' expectations and the practices they employ to protect confidentiality in electronic health records (EHRs) and subsequently how EHRs affect the documentation and dissemination of information in the course of health-care delivery to adolescent minors. METHODS: Twenty-six pediatric health-care providers participated in in-depth interviews about their experiences using EHRs to understand a broad spectrum of expectations and practices guiding the documentation and dissemination of information in the EHR...
May 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29342478/design-and-implementation-of-a-visual-analytics-electronic-antibiogram-within-an-electronic-health-record-system-at-a-tertiary-pediatric-hospital
#11
Allan F Simpao, Luis M Ahumada, Beatriz Larru Martinez, Ana M Cardenas, Talene A Metjian, Kaede V Sullivan, Jorge A Gálvez, Bimal R Desai, Mohamed A Rehman, Jeffrey S Gerber
BACKGROUND: Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. OBJECTIVE: We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29325519/providers-preferences-for-pediatric-oral-health-information-in-the-electronic-health-record-a-cross-sectional-survey
#12
Christopher M Shea, Kea Turner, B Alex White, Ye Zhu, R Gary Rozier
BACKGROUND: The majority of primary care physicians support integration of children's oral health promotion and disease prevention into their practices but can experience challenges integrating oral health services into their workflow. Most electronic health records (EHRs) in primary care settings do not include oral health information for pediatric patients. Therefore, it is important to understand providers' preferences for oral health information within the EHR. The objectives of this study are to assess (1) the relative importance of various elements of pediatric oral health information for primary care providers to have in the EHR and (2) the extent to which practice and provider characteristics are associated with these information preferences...
January 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29301735/integrating-patient-centered-electronic-health-record-communication-training-into-resident-onboarding-curriculum-development-and-post-implementation-survey-among-housestaff
#13
Maria Alcocer Alkureishi, Wei Wei Lee, Sandra Webb, Vineet Arora
BACKGROUND: Electronic health record (EHR) use can enhance or undermine the ability of providers to deliver effective, humanistic patient-centered care. Given patient-centered care has been found to positively impact patient health outcomes, it is critical to provide formal education on patient-centered EHR communication skills. Unfortunately, despite increasing worldwide EHR adoption, few institutions educate trainees on EHR communication best practices. OBJECTIVE: The goal of this research was to develop and deliver mandatory patient-centered EHR training to all incoming housestaff at the University of Chicago...
January 4, 2018: JMIR Medical Education
https://www.readbyqxmd.com/read/29244735/development-of-the-precision-link-biobank-at-boston-children-s-hospital-challenges-and-opportunities
#14
REVIEW
Florence T Bourgeois, Paul Avillach, Sek Won Kong, Michelle M Heinz, Tram A Tran, Ramkrishna Chakrabarty, Jonathan Bickel, Piotr Sliz, Erin M Borglund, Susan Kornetsky, Kenneth D Mandl
Increasingly, biobanks are being developed to support organized collections of biological specimens and associated clinical information on broadly consented, diverse patient populations. We describe the implementation of a pediatric biobank, comprised of a fully-informed patient cohort linking specimens to phenotypic data derived from electronic health records (EHR). The Biobank was launched after multiple stakeholders' input and implemented initially in a pilot phase before hospital-wide expansion in 2016...
December 15, 2017: Journal of Personalized Medicine
https://www.readbyqxmd.com/read/29241239/a-new-ehr-training-curriculum-and-assessment-for-pediatric-residents
#15
Kathryn Stroup, Benjamin Sanders, Bruce Bernstein, Leah Scherzer, Lee M Pachter
Background Conventional classroom Electronic Health Record (EHR) training is often insufficient for new EHR users. Studies suggest that enhanced training with a hands-on approach and closely supported clinical use is beneficial. Objectives Our goals were to develop an enhanced EHR learning curriculum for Post Graduate Year 1 (PGY1) residents and measure changes in EHR skill proficiency, efficiency, and self-efficacy. Methods A novel three-phase, multimodal enhanced EHR curriculum was designed for a cohort of PGY1 residents...
October 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29226008/variation-in-results-release-and-patient-portal-access-to-diagnostic-test-results-at-an-academic-medical-center
#16
Matthew D Krasowski, Caleb V Grieme, Brian Cassady, Nicholas R Dreyer, Karolyn A Wanat, Maia Hightower, Kenneth G Nepple
Background: Electronic health records (EHRs) are commonplace in industrialized countries. Many hospitals are granting their patients access to their medical information through online patient portals. In this report, we describe a retrospective analysis of patient access to diagnostic test results released through the patient portal (MyChart; Epic, Inc.) at a state academic medical center. Methods: We analyzed 6 months of data for anatomic pathology, clinical laboratory, and radiology test results to evaluate variations in results release (automated vs...
2017: Journal of Pathology Informatics
https://www.readbyqxmd.com/read/29117934/uses-of-mobile-device-digital-photography-of-dermatologic-conditions-in-primary-care
#17
Jennifer L Pecina, Kirk D Wyatt, Nneka I Comfere, Matthew E Bernard, Frederick North
BACKGROUND: PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)-based mobile devices. OBJECTIVE: The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. METHODS: Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant)...
November 8, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29106306/assessing-the-value-of-the-meaningful-use-clinical-summary-for-patients-and-families-with-pediatric-asthma
#18
Karen Colorafi, Lee Moua, Michele Shaw, David Ricker, Julie Postma
Electronic clinical summaries are innovations supported by the Electronic Health Record Incentive Program, known as "Meaningful Use" (MU). The MU clinical summary documents the shared understanding of the plan of care for patients and assists families in managing asthma-related health care. The purpose of this analysis was to identify the communicative value of the summaries to patients and families. Readability measurements, content analysis, and descriptive statistics were employed in a review of twenty clinical summaries and compared with provider encounter notes...
November 6, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29099060/clinical-pharmacogenetics-of-cytochrome-p450-associated-drugs-in-children
#19
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/29089403/cost-effectiveness-of-a-clinical-childhood-obesity-intervention
#20
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
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