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https://www.readbyqxmd.com/read/28441696/declining-blood-pressure-and-intensification-of-blood-pressure-management-among-people-over-80-years-cohort-study-using-electronic-health-records
#1
Rathi Ravindrarajah, Alex Dregan, Nisha C Hazra, Shota Hamada, Stephen H D Jackson, Martin C Gulliford
BACKGROUND: Management of high blood pressure (BP) in people over 80 years is controversial, but there is limited information available concerning the uptake of hypertension treatment at this age. OBJECTIVE: To evaluate use of antihypertensive drugs and changes in SBP and DBP from 2001 to 2014 in men and women aged 80 years and over. METHODS: Cohort study using primary care electronic health records of 265 225 participants from the UK Clinical Practice Research Datalink...
June 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28439386/usefulness-of-clinical-prediction-rules-d-dimer-and-arterial-blood-gas-analysis-to-predict-pulmonary-embolism-in-cancer-patients
#2
Asifa Karamat, Shazia Awan, Muhammad Ghazanfar Hussain, Fahad Al Hameed, Faheem Butt, Ali Saeed Wahla
OBJECTIVES: Pulmonary embolism (PE) is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs) were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG) analysis and D-dimer in predicting PE in cancer patients. METHODS: Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs) were performed...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28438048/the-impact-of-infant-well-child-care-compliance-and-social-risks-on-emergency-department-utilization
#3
Nikki R Lawson, Melissa D Klein, Nicholas J Ollberding, Victoria Wurster Ovalle, Andrew F Beck
Deployment of medical and social services at well-child visits promotes child health. A retrospective review of the electronic health record was conducted for infants presenting for their "newborn" visit over a 2-year period at an urban, academic primary care center. Primary outcomes were time to first emergency department (ED) visit, number of ED visits (emergent or nonemergent), and number of nonemergent ED visits by 2 years of life. Records from 212 consecutive newborns were evaluated-59.9% were black/African American and 84...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28437203/using-the-surprise-question-to-identify-those-with-unmet-palliative-care-needs-in-emergency-and-inpatient-settings-what-do-clinicians-think
#4
Samir A Haydar, Lisa Almeder, Lauren Michalakes, Paul K J Han, Tania D Strout
BACKGROUND: The surprise question (SQ), "Would you be surprised if this patient died within the next year?" is effective in identifying end-stage renal disease and cancer patients at high risk of death and therefore potentially unmet palliative care needs. Following implementation of the SQ in our acute care setting, we sought to explore hospital-based providers' perceptions of the tool. OBJECTIVES: To evaluate (1) providers' perceptions regarding the feasibility of SQ use in emergency and inpatient settings, (2) clinician perceptions regarding the utility of the SQ, and (3) barriers to SQ use...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28435756/identifying-barriers-in-the-use-of-electronic-health-records-in-hawai-i
#5
Faith D Hamamura, Kelley Withy, Kira Hughes
Hawai'i faces unique challenges to Electronic Health Record (EHR) adoption due to physician shortages, a widespread distribution of Medically Underserved Areas and Populations (MUA/P), and a higher percentage of small independent practices. However, research on EHR adoption in Hawai'i is limited. To address this gap, this article examines the current state of EHR in Hawai'i, the barriers to adoption, and the future of Health Information Technology (HIT) initiatives to improve the health of Hawai'i's people...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28435497/improved-accuracy-and-quality-of-information-during-emergency-department-care-transitions
#6
Nnaemeka Okafor, Justin Mazzillo, Sara Miller, Kimberly A Chambers, Samar Yusuf, Vanessa Garza-Miranda, Yashwant Chathampally
INTRODUCTION: Suboptimal communication during emergency department (ED) care transitions has been shown to contribute to medical errors, sometimes resulting in patient injury and litigation. The study objective was to determine whether a standardized checkout process would decrease the number of relevant missed clinical items (MCI). METHODS: In this prospective pre- and post-intervention study conducted in an urban academic ED, we collected data on omitted or inaccurately conveyed medical information before and after the initiation of a standardized checkout process...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#7
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435484/outcomes-by-mode-of-transport-of-st-elevation-mi-patients-in-the-united-arab-emirates
#8
Edward L Callachan, Alawi A Alsheikh-Ali, Satish Chandrasekhar Nair, Stevan Bruijns, Lee A Wallis
INTRODUCTION: The purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities. METHODS: This multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435342/patient-web-portals-disease-management-and-primary-prevention
#9
REVIEW
Steven S Coughlin, Judith J Prochaska, Lovoria B Williams, Gina M Besenyi, Vahé Heboyan, D Stephen Goggans, Wonsuk Yoo, Gianluca De Leo
BACKGROUND: Efforts aimed at health care reform and continued advances in information technologies have prompted interest among providers and researchers in patient web portals. Patient web portals are password-protected online websites that offer the patients 24-hour access to personal health information from anywhere with an Internet connection. METHODS: This article, which is based upon bibliographic searches in PubMed, reviews important developments in web portals for primary and secondary disease prevention, including patient web portals tethered to electronic medical records, disease-specific portals, health disparities, and health-related community web portals...
2017: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/28435306/pediatric-acute-kidney-injury-prevalence-impact-and-management-challenges
#10
REVIEW
Eileen Ciccia, Prasad Devarajan
The incidence of pediatric acute kidney injury (AKI) is increasing globally, as are the associated morbidities and mortality. A recent standardization of the definition of AKI has allowed for a more accurate assessment of the epidemiology of pediatric AKI. Recent advances in leveraging electronic medical health record systems have allowed for real-time risk stratification and prevention of pediatric AKI in the hospital setting. Newly developed and validated clinical scores have improved our ability to predict AKI and provide a rational context for biomarker utilization in hospitalized children...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28435100/montreal-accord-on-patient-reported-outcomes-use-series-paper-5-patient-reported-outcomes-pro-can-be-linked-to-epidemiologic-measures-to-monitor-populations-and-inform-public-health-decisions
#11
Hiroshi Mamiya, Lisa M Lix, William Gardner, Susan J Bartlett, Sara Ahmed, David Buckeridge
BACKGROUND: Comprehensive picture of population health status can be captured by the incorporation of patient reported outcome measures into population health monitoring. OBJECTIVE: To identify current state, opportunities, and future research related to the utilization of patient reported outcome measures for population health monitoring in Canada. DISCUSSIONS: Patient reported outcome measures can help to identify community health needs in public health topics including injury, chronic disease, and communicable disease...
April 20, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28434847/mri-before-radiography-for-patients-with-new-shoulder-conditions
#12
Kirstin M Small, Frank J Rybicki, Lindsay R Miller, Stephen D Daniels, Laurence D Higgins
PURPOSE: To assess the patterns of Appropriate Criteria application among orthopedic specialists and other fields of medicine for use of MRI and radiography and the subsequent necessity for surgical intervention. METHODS: The hospital electronic medical record was used to identify all shoulder MRI studies at a single large urban teaching hospital between January 2, 2011, and June 30, 2011. For each study, variables collected included ordering department, patient age, patient gender, patient's self-reported race/ethnicity, whether the patient obtained surgery for an issue related to the MRI diagnosis, the type of MRI ordered, the date of pain onset, the date of x-ray (if any), and the date of the MRI...
April 20, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28434457/system-changes-to-implement-the-joint-commission-tobacco-treatment-tob-performance-measures-for-improving-the-treatment-of-tobacco-use-among-hospitalized-patients
#13
Donna Shelley, Keith S Goldfeld, Hannah Park, Ana Mola, Ryan Sullivan, Jonathan Austrian
BACKGROUND: In 2012 The Joint Commission implemented new Tobacco Treatment (TOB) performance measures for hospitals. A study evaluated the impact of a hospital-based electronic health record (EHR) intervention on adherence to the revised TOB measures. METHODS: The study was conducted in two acute care hospitals in New York City. Data abstracted from the EHR were analyzed retrospectively from 4,871 smokers discharged between December 2012 and March 2015 to evaluate the impact of two interventions: an order set to prompt clinicians to prescribe pharmacotherapy and a nurse-delivered counseling module that automatically populated the nursing care plan for all smokers...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434454/measuring-to-improve-medication-reconciliation-in-a-large-subspecialty-outpatient-practice
#14
Elizabeth Kern, Meg B Dingae, Esther L Langmack, Candace Juarez, Gary Cott, Sarah K Meadows
BACKGROUND: To assess performance in medication reconciliation (med rec)-the process of comparing and reconciling patients' medication lists at clinical transition points-and demonstrate improvement in an outpatient setting, sustainable and valid measures are needed. METHODS: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs), and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR)...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434279/extended-use-of-electronic-health-records-by-primary-care-physicians-does-the-electronic-health-record-artefact-matter
#15
Louis Raymond, Guy Paré, Marie Marchand
The deployment of electronic health record systems is deemed to play a decisive role in the transformations currently being implemented in primary care medical practices. This study aims to characterize electronic health record systems from the perspective of family physicians. To achieve this goal, we conducted a survey of physicians practising in private clinics located in Quebec, Canada. We used valid responses from 331 respondents who were found to be representative of the larger population. Data provided by the physicians using the top three electronic health record software products were analysed in order to obtain statistically adequate sub-sample sizes...
April 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28434269/electronic-adherence-monitoring-device-performance-and-patient-acceptability-a-randomized-control-trial
#16
Amy Hai Yan Chan, Alistair William Stewart, Jeff Harrison, Peter Nigel Black, Edwin Arthur Mitchell, Juliet Michelle Foster
BACKGROUND: To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population. METHODS: Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a device with reminder features enabled or disabled for use with their preventer. Device quality control tests were conducted...
April 24, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28434040/primary-ventral-or-groin-hernia-in-pregnancy-a-cohort-study-of-20-714-women
#17
E Oma, M Bay-Nielsen, K K Jensen, L N Jorgensen, A Pinborg, T Bisgaard
BACKGROUND: Prevalence, management, and risk of emergency operation for primary ventral or groin hernia in pregnancy are unknown. The objective of this study was to estimate the prevalences of primary ventral or groin hernia in pregnancy and the potential risks for elective and emergency repair. METHODS: This single-institutional retrospective study included all pregnant women attending one or more prenatal consultations at Hvidovre Hospital, Denmark, during a 3-year period...
April 22, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28434027/can-ultrasound-be-used-as-the-primary-imaging-in-children-with-suspected-crohn-disease
#18
Timothy L Tsai, Megan B Marine, Matthew R Wanner, Matthew L Cooper, Steven J Steiner, Fangqian Ouyang, S Gregory Jennings, Boaz Karmazyn
BACKGROUND: There is growing literature on the use of ultrasound (US) for evaluation of Crohn disease in adults, but few studies have been conducted on children. Several studies demonstrated high accuracy of US in the diagnosis of Crohn disease. Using US as the primary screening imaging modality for Crohn disease can reduce health care costs, the need for sedation and ionizing radiation exposure. OBJECTIVE: The aim of our study is to determine if US can be used for screening evaluation of pediatric Crohn disease...
April 22, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28433642/predicting-non-muscle-invasive-bladder-cancer-recurrence-and-progression-in-a-us-population
#19
Kourosh Ravvaz, Marcus E Walz, John A Weissert, Tracy M Downs
PURPOSE: To assess performance of The European Organization for Research and Treatment of Cancer (EORTC) and Club Urologico Español de Tratamiento Oncologico (CUETO) non-muscle invasive bladder cancer (NMIBC) predictive models compared to current US National Comprehensive Cancer Network (NCCN) treatment guidelines in a US population. MATERIALS AND METHODS: Retrospective analysis using electronic medical records of patients with NMIBC within a multicenter US patient population...
April 19, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#20
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
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