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pediatric electronic health records

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https://www.readbyqxmd.com/read/27902553/perspectives-and-uses-of-the-electronic-health-record-among-us-pediatricians-a-national-survey
#1
Julie W Doberne, Travis Redd, Daniel Lattin, Thomas R Yackel, Carl O Eriksson, Vishnu Mohan, Jeffrey A Gold, Joan S Ash, Michael F Chiang
Little is known about how existing electronic health records (EHRs) influence the practice of pediatric medicine. A total of 808 pediatricians participated in a survey about workflows using the EHR. The EHR was the most commonly used source of initial patient information. Seventy-two percent reported requiring between 2 and 10 minutes to complete an initial review of the EHR. Several moderately severe information barriers were reported regarding the display of information in the EHR. Pediatricians acquire information about new patients from EHRs more often than any other source...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27899166/pain-management-of-acute-appendicitis-in-canadian-pediatric-emergency-departments
#2
Andrea L Robb, Samina Ali, Naveen Poonai, Graham C Thompson
OBJECTIVES: Children with suspected appendicitis are at risk for suboptimal pain management. We sought to describe pain management patterns for suspected appendicitis across Canadian pediatric emergency departments (PEDs). METHODS: A retrospective medical record review was undertaken at 12 Canadian PEDs. Children ages 3 to 17 years who were admitted to the hospital in February or October 2010 with suspected appendicitis were included. Patients were excluded if partially assessed or treated at another hospital...
November 30, 2016: CJEM
https://www.readbyqxmd.com/read/27875603/emr-based-intervention-improves-lead-screening-at-an-urban-family-medicine-practice
#3
Kathryn McGrath, Krys Foster, Patrick Doggett, Marc Altshuler, Jewel Osborne-Wu, Christine Castellan, Kelly Lopez, Pheobe Askie, Daniel Chung, Laura Parente, Yury Parra
BACKGROUND AND OBJECTIVES: Elevated blood lead levels have well-described detrimental effects to growth and development in children, yet screening rates remain low. We sought to determine if a reminder within the electronic health record (EHR) could change provider behavior and improve blood lead level (BLL) screening test ordering rates in an urban academic family medicine practice. METHODS: Baseline BLL test ordering rates were calculated for children ages 9-72 months...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27856010/increased-capture-of-pediatric-surgical-complications-utilizing-a-novel-case-log-web-application-to-enhance-quality-improvement
#4
Jason C Fisher, Keith A Kuenzler, Sandra S Tomita, Prashant Sinha, Paresh Shah, Howard B Ginsburg
PURPOSE: Documenting surgical complications is limited by multiple barriers and is not fostered in the electronic health record. Tracking complications is essential for quality improvement (QI) and required for board certification. Current registry platforms do not facilitate meaningful complication reporting. We developed a novel web application that improves accuracy and reduces barriers to documenting complications. METHODS: We deployed a custom web application that allows pediatric surgeons to maintain case logs...
October 28, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27846070/implementation-and-operational-research-an-integrated-and-comprehensive-service-delivery-model-to-improve-pediatric-and-maternal-hiv-care-in-rural-africa
#5
Anna Gamell, Tracy R Glass, Lameck B Luwanda, Herry Mapesi, Leila Samson, Tom Mtoi, Angelo Nyamtema, Lukas Muri, Alex Ntamatungiro, Marcel Tanner, Christoph Hatz, Manuel Battegay, Emilio Letang
BACKGROUND: Strategies to improve HIV diagnosis and linkage into care, antiretroviral treatment coverage, and treatment outcomes of mothers and children are urgently needed in sub-Saharan Africa. METHODS: From December 2012, we implemented an intervention package to improve prevention of mother-to-child transmission (PMTCT) and pediatric HIV care in our rural Tanzanian clinic, consisting of: (1) creation of a PMTCT and pediatric unit integrated within the reproductive and child health clinic; (2) implementation of electronic medical records; (3) provider-initiated HIV testing and counseling in the hospital wards; and (4) early infant diagnosis test performed locally...
December 15, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27845473/preliminary-analysis-of-the-respiratory-disease-based-on-hospital-discharge-records-in-the-province-of-l-aquila-abruzzo-italy
#6
L Fabiani, L Mammarella, P Vittorini, F Zazzara, F Di Orio
BACKGROUND: The hospital discharge records (HDRs), integrated by other electronic health archives, besides some contra, can be a valuable and low-cost tool for monitoring public health. METHODS: Throughout a retrospective cohort study, we analyzed all hospitalizations in ordinary regime from the HDRs database of the residents in the province of L'Aquila, with the exception of day hospital, rehabilitation and long-hospital stay between 2008 and 2013, with a principal diagnosis of respiratory disease of 460 to 519, according to the ICD-9-CM...
November 2016: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/27832032/accuracy-and-efficiency-of-recording-pediatric-early-warning-scores-using-an-electronic-physiological-surveillance-system-compared-with-traditional-paper-based-documentation
#7
Gerri Sefton, Steven Lane, Roger Killen, Stuart Black, Max Lyon, Pearl Ampah, Cathryn Sproule, Dominic Loren-Gosling, Caitlin Richards, Jean Spinty, Colette Holloway, Coral Davies, April Wilson, Chung Shen Chean, Bernie Carter, E D Carrol
Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score...
November 9, 2016: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/27811586/verbal-communication-during-airway-management-and-emergent-endotracheal-intubation-observations-of-team-behavior-among-multi-institutional-pediatric-intensive-care-unit-in-situ-simulations
#8
Ranna A Rozenfeld, Anna P Nannicelli, Alexandra R Brown, Walter J Eppich, Donna M Woods, Steven O Lestrud, Zehava L Noah, Jane L Holl
OBJECTIVE: To assess health-care teams' verbal communication, an observable teamwork behavior, during simulations involving pediatric emergency airway management and intubation. METHODS: We conducted video-recorded, risk-informed in situ simulations at 5 hospitals with pediatric intensive care units in the Chicago, Illinois, area. Clinicians participated in their clinical roles (eg, attending physician, bedside nurse) and had access to hospital operational systems (eg, electronic health record, medical imaging, laboratory services)...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27757472/evaluation-of-a-pilot-asthma-care-program-for-electronic-communication-between-school-health-and-a-healthcare-system-s-electronic-medical-record
#9
Kelly W Reeves, Yhenneko Taylor, Hazel Tapp, Thomas Ludden, Lindsay E Shade, Beth Burton, Cheryl Courtlandt, Michael Dulin
OBJECTIVE: Asthma is a common childhood chronic lung disease affecting greater than 10% of children in the United States. School nurses are in a unique position to close gaps in care. Indeed, effective asthma management is more likely to result when providers, family, and schools work together to optimize the patient's treatment plan. Currently, effective communication between schools and healthcare systems through electronic medical record (EMR) systems remains a challenge. The goal of this feasibility pilot was to link the school-based care team with primary care providers in the healthcare system network via electronic communication through the EMR, on behalf of pediatric asthma patients who had been hospitalized for an asthma exacerbation...
October 19, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27747794/implication-of-socio-demographics-on-cognitive-related-symptoms-in-sports-concussion-among-children
#10
Laurens Holmes, Joshua Tworig, Joseph Casini, Isabel Morgan, Kathleen O'Brien, Patricia Oceanic, Kirk Dabney
BACKGROUND: Sports-related concussion remains a public health challenge due to its morbidity and mortality. One of the consequences of concussion is cognitive impairment (CI) and cognitive-related symptoms (CRS) which determine, to some extent, physical and behavioral functioning of children who sustain concussion. Despite the high prevalence of CI and CRS associated with concussion, the risk factors are not fully understood. We aimed to characterize CRS and to examine its relationship with race, ethnicity, age, insurance, and sex in a pediatric population...
December 2016: Sports Medicine—Open
https://www.readbyqxmd.com/read/27743336/improving-adherence-to-care-recommendations-using-a-community-health-worker-chw-intervention-with-the-pediatric-medical-home
#11
Sarah P Justvig, Justine Li, Giuseppina Caravella, Minqin Chen, Hua Wang, Lisa A Benz Scott, Susmita Pati
While CHW interventions improve health outcomes, evidence identifying specific domains of CHW-delivered support resulting in positive outcomes is limited. Our goals were to identify domains of CHW-delivered support that assist families with adhering to recommended pediatric care; and, to identify predictors of successful completion of an enriched medical home intervention (EMHI) using trained CHWs making home visits to provide health education and support positive health behaviors. We performed a prospective descriptive study of 88 families participating in a protocol-based EMHI...
October 14, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/27718346/prevalence-of-auditory-processing-disorder-in-school-aged-children-in-the-mid-atlantic-region
#12
Kyoko Nagao, Tammy Riegner, Jennifer Padilla, L Ashleigh Greenwood, Jessica Loson, Sarah Zavala, Thierry Morlet
BACKGROUND: Although auditory processing disorder (APD) is a widely recognized impairment, its prevalence and demographic characteristics are not precisely known in the pediatric population. PURPOSE: To examine the demographic characteristics of children diagnosed with APD at a tertiary health-care facility and the prevalence of pediatric APD. RESEARCH DESIGN: A cross-sectional study. STUDY SAMPLE: A total of 243 children (149 boys and 94 girls) who were referred to the Nemours Audiology Clinics in the Delaware Valley for an APD evaluation...
October 2016: Journal of the American Academy of Audiology
https://www.readbyqxmd.com/read/27708494/teleconsultation-and-clinical-decision-making-a-systematic-review
#13
Kolsoum Deldar, Kambiz Bahaadinbeigy, Seyed Mahmood Tara
BACKGROUND: The goal of teleconsultation is to omit geographical and functional distance between two or more geographically separated health care providers. The purpose of present study is to review and analyze physician-physician teleconsultations. METHOD: The PubMed electronic database was searched. The primary search was done on January 2015 and was updated on December 2015. A fetch and tag plan was designed by the researchers using an online Zotero library. RESULTS: 174 full-text articles of 1702 records met inclusion criteria...
July 16, 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/27698673/suboptimal-clinical-documentation-in-young-children-with-severe-obesity-at-tertiary-care-centers
#14
Cassandra C Brady, Vidhu V Thaker, Todd Lingren, Jessica G Woo, Stephanie S Kennebeck, Bahram Namjou-Khales, Ashton Roach, Jonathan P Bickel, Nandan Patibandla, Guergana K Savova, Imre Solti, Ingrid A Holm, John B Harley, Isaac S Kohane, Nancy A Crimmins
Background and Objectives. The prevalence of severe obesity in children has doubled in the past decade. The objective of this study is to identify the clinical documentation of obesity in young children with a BMI ≥ 99th percentile at two large tertiary care pediatric hospitals. Methods. We used a standardized algorithm utilizing data from electronic health records to identify children with severe early onset obesity (BMI ≥ 99th percentile at age <6 years). We extracted descriptive terms and ICD-9 codes to evaluate documentation of obesity at Boston Children's Hospital and Cincinnati Children's Hospital and Medical Center between 2007 and 2014...
2016: International Journal of Pediatrics
https://www.readbyqxmd.com/read/27697749/enhance-electronic-hydroxyurea-adherence-a-protocol-to-increase-hydroxyurea-adherence-in-patients-with-sickle-cell-disease
#15
Susan Creary, Deena J Chisolm, Sarah H O'Brien
BACKGROUND: Hydroxyurea (HU) is the only disease-modifying medication for patients with sickle cell disease (SCD). HU can reduce SCD-related complications but only 35% to 50% of pediatric patients adhere to HU at the rates achieved in clinical trials and this limits its clinical effectiveness. Mobile Directly Observed Therapy (Mobile DOT) is a pilot-tested, electronic, multidimensional, HU adherence intervention that targets many components of the Health Behavior Model. OBJECTIVE: The aim of this study is to evaluate the impact of Mobile DOT on HU adherence in children with SCD...
October 3, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27688362/predicting-severe-pneumonia-outcomes-in-children
#16
Derek J Williams, Yuwei Zhu, Carlos G Grijalva, Wesley H Self, Frank E Harrell, Carrie Reed, Chris Stockmann, Sandra R Arnold, Krow K Ampofo, Evan J Anderson, Anna M Bramley, Richard G Wunderink, Jonathan A McCullers, Andrew T Pavia, Seema Jain, Kathryn M Edwards
BACKGROUND: Substantial morbidity and excessive care variation are seen with pediatric pneumonia. Accurate risk-stratification tools to guide clinical decision-making are needed. METHODS: We developed risk models to predict severe pneumonia outcomes in children (<18 years) by using data from the Etiology of Pneumonia in the Community Study, a prospective study of community-acquired pneumonia hospitalizations conducted in 3 US cities from January 2010 to June 2012...
September 29, 2016: Pediatrics
https://www.readbyqxmd.com/read/27664505/building-interpretable-predictive-models-for-pediatric-hospital-readmission-using-tree-lasso-logistic-regression
#17
Milos Jovanovic, Sandro Radovanovic, Milan Vukicevic, Sven Van Poucke, Boris Delibasic
OBJECTIVES: Quantification and early identification of unplanned readmission risk have the potential to improve the quality of care during hospitalization and after discharge. However, high dimensionality, sparsity, and class imbalance of electronic health data and the complexity of risk quantification, challenge the development of accurate predictive models. Predictive models require a certain level of interpretability in order to be applicable in real settings and create actionable insights...
September 2016: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/27638908/national-trends-in-safety-performance-of-electronic-health-record-systems-in-children-s-hospitals
#18
Juan D Chaparro, David C Classen, Melissa Danforth, David C Stockwell, Christopher A Longhurst
OBJECTIVE: To evaluate the safety of computerized physician order entry (CPOE) and associated clinical decision support (CDS) systems in electronic health record (EHR) systems at pediatric inpatient facilities in the US using the Leapfrog Group's pediatric CPOE evaluation tool. METHODS: The Leapfrog pediatric CPOE evaluation tool, a previously validated tool to assess the ability of a CPOE system to identify orders that could potentially lead to patient harm, was used to evaluate 41 pediatric hospitals over a 2-year period...
September 16, 2016: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/27599004/an-integrated-and-comprehensive-service-delivery-model-to-improve-pediatric-and-maternal-hiv-care-in-rural-africa
#19
Anna Gamell, Tracy R Glass, Lameck B Luwanda, Herry Mapesi, Leila Samson, Tom Mtoi, Angelo Nyamtema, Lukas Muri, Alex Ntamatungiro, Marcel Tanner, Christoph Hatz, Manuel Battegay, Emilio Letang
BACKGROUND: Strategies to improve HIV diagnosis and linkage into care, antiretroviral treatment coverage and treatment outcomes of mothers and children are urgently needed in sub-Saharan Africa. METHODS: From 12/2012, we implemented an intervention package to improve Prevention of Mother-To-Child Transmission (PMTCT) and pediatric HIV care in our rural Tanzanian clinic, consisting of: a) creation of a PMTCT and pediatric unit integrated within the reproductive and child health clinic; b) implementation of electronic medical records; c) provider-initiated HIV testing and counseling in the hospital wards; and d) early infant diagnosis test performed locally...
September 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27582288/outpatient-evaluation-recognition-and-initial-management-of-pediatric-overweight-and-obesity-in-u-s-military-medical-treatment-facilities
#20
Wayne Dickey, David R Arday, Joseph Kelly, Col David Carnahan
BACKGROUND AND PURPOSE: As childhood obesity is a concern in many communities, this study investigated outpatient evaluation and initial management of overweight and obese pediatric patients in U.S. military medical treatment facilities (MTFs). METHODS: Samples of 579 overweight and 341 obese patients (as determined by body mass index [BMI]) aged 3-17 years were drawn from MTFs. All available FY2011 outpatient records were searched for documentation of BMI assessment, overweight/obesity diagnosis, and counseling...
September 1, 2016: Journal of the American Association of Nurse Practitioners
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