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https://www.readbyqxmd.com/read/28324321/structured-data-entry-in-the-electronic-medical-record-perspectives-of-pediatric-specialty-physicians-and-surgeons
#1
Ruth A Bush, Cynthia Kuelbs, Julie Ryu, Wen Jiang, George Chiang
The Epic electronic health record (EHR) platform supports structured data entry systems (SDES), which allow developers, with input from users, to create highly customized patient-record templates in order to maximize data completeness and to standardize structure. There are many potential advantages of using discrete data fields in the EHR to capture data for secondary analysis and epidemiological research, but direct data acquisition from clinicians remains one of the largest obstacles to leveraging the EHR for secondary use...
May 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28293684/meaningful-use-of-an-electronic-personal-health-record-ephr-among-pediatric-cancer-survivors
#2
Rebecca S Williamson, Brooke O Cherven, Jordan Gilleland Marchak, Paula Edwards, Michael Palgon, Cam Escoffery, Lillian R Meacham, Ann C Mertens
Background and Objectivs: Survivors of pediatric and adolescent cancer are at an increased risk of chronic and debilitating health conditions and require life-long specialized care. Stand-alone electronic personal health records (ePHRs) may aid their self-management. This analysis characterizes young adult survivors and parents who meaningfully use an ePHR, Cancer SurvivorLink(TM), designed for survivors of pediatric and adolescent cancer. METHODS: This was a retrospective observational study of patients seen at a pediatric survivor clinic for annual survivor care...
March 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28291152/medical-student-documentation-in-the-emergency-department-in-the-electronic-health-record-era-a-national-survey
#3
Ryan A Virden, F Meridith Sonnett, Abu N G A Khan
OBJECTIVES: Implementation of electronic health record (EHR) has generated a new challenge in the practice of medical student documentation in the emergency department (ED). This study discerns both the current practices and consensus opinions of pediatric ED directors and Association of American Medical Colleges (AAMC) student representatives regarding best practices for documentation by medical students in the ED EHR nationwide. METHODS: The authors conducted a cross-sectional Web-based survey of the directors of academic pediatric EDs and AAMC student representatives using Qualtric survey engine...
March 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28291130/making-the-pediatric-perioperative-surgical-home-come-to-life-by-leveraging-existing-health-information-technology
#4
Izabela C Leahy, Rachel Borczuk, Lynne R Ferrari
PURPOSE OF REVIEW: To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. RECENT FINDINGS: By using 360 Technology, patient data was automatically pulled from all available Electronic Health Record sources from 2005 to the present. The PPSH dashboard described in this report provides a guide for implementation of PPSH Clinical Care Pathways...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28277414/implementation-of-an-electronic-clinical-decision-support-tool-for-pediatric-appendicitis-within-a-hospital-network
#5
Marissa A Hendrickson, Andrew R Wey, Philippe R Gaillard, Anupam B Kharbanda
OBJECTIVES: Computed tomography (CT) has been widely used in the evaluation of children with suspected appendicitis, but concerns about ionizing radiation have increased interest in ultrasound for these patients. We sought to assess the effectiveness of an appendicitis electronic clinical decision support (E-CDS) system in increasing ultrasound and decreasing CT use in children evaluated in emergency departments (EDs) for suspected appendicitis. METHODS: This was a preintervention and postintervention analysis of an E-CDS implemented into an electronic health record system shared by an academic, tertiary-care children's hospital and a community hospital...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28202769/project-impact-pilot-report-feasibility-of-implementing-a-hospital-to-home-transition-bundle
#6
Leah A Mallory, Snezana Nena Osorio, B Stephen Prato, Jennifer DiPace, Lisa Schmutter, Paula Soung, Amanda Rogers, William J Woodall, Kayla Burley, Sandra Gage, David Cooperberg
BACKGROUND AND OBJECTIVES: To improve hospital to home transitions, a 4-element pediatric patient-centered transition bundle was developed, including: a transition readiness checklist; predischarge teach-back education; timely and complete written handoff to the primary care provider; and a postdischarge phone call. The objective of this study was to demonstrate the feasibility of bundle implementation and report initial outcomes at 4 pilot sites. Outcome measures included postdischarge caregiver ability to teach-back key home management information and 30-day reuse rates...
February 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28196931/minimally-important-differences-in-patient-or-proxy-reported-outcome-studies-relevant-to-children-a-systematic-review
#7
REVIEW
Shanil Ebrahim, Kelsey Vercammen, Arunima Sivanand, Gordon H Guyatt, Alonso Carrasco-Labra, Ricardo M Fernandes, Mark W Crawford, Gihad Nesrallah, Bradley C Johnston
CONTEXT: No study has characterized and appraised all anchor-based minimally important differences (MIDs) associated with patient-reported outcome (PRO) instruments in pediatric studies. OBJECTIVE: To complete a comprehensive systematic survey and appraisal of published anchor-based MIDs associated with PRO instruments used in children. DATA SOURCES: Medline, Embase, and PsycINFO (1989 to February 11, 2015). STUDY SELECTION: Studies reporting empirical ascertainment of anchor-based MIDs among PROs used in pediatric care...
February 14, 2017: Pediatrics
https://www.readbyqxmd.com/read/28169982/effect-of-an-asthma-guideline-in-2-pediatric-emergency-departments-and-an-urgent-care-center
#8
Jennifer J Dilts, Sharon G Humiston, Brian R Lee, Nancy H Allen, Jeffrey G Michael
OBJECTIVES: The objective of this study was to evaluate ordering of albuterol via metered-dose inhaler with spacer (MDI-spacer), length of stay (LOS), and 72-hour return rates before and after publication of an internally developed pediatric asthma clinical practice guideline (CPG). METHODS: The internally developed CPG reflected national recommendations. It was explained at faculty meetings by a respected clinician and published on the intranet on February 6, 2012...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28161526/low-fertility-preservation-utilization-among-transgender-youth
#9
Leena Nahata, Amy C Tishelman, Nicole M Caltabellotta, Gwendolyn P Quinn
PURPOSE: Research demonstrates a negative psychosocial impact of infertility among otherwise healthy adults, and distress among adolescents facing the prospect of future infertility due to various medical conditions and treatments that impair reproductive health. Guidelines state that providers should counsel transgender youth about potential infertility and fertility preservation (FP) options prior to initiation of hormone therapy. The purpose of this study was to examine the rates of fertility counseling and utilization of FP among a cohort of adolescents with gender dysphoria seen at a large gender clinic...
February 1, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28161199/use-of-a-digital-modified-checklist-for-autism-in-toddlers-revised-with-follow-up-to-improve-quality-of-screening-for-autism
#10
Kathleen Campbell, Kimberly L H Carpenter, Steven Espinosa, Jordan Hashemi, Qiang Qiu, Mariano Tepper, Robert Calderbank, Guillermo Sapiro, Helen L Egger, Jeffrey P Baker, Geraldine Dawson
OBJECTIVES: To assess changes in quality of care for children at risk for autism spectrum disorders (ASD) due to process improvement and implementation of a digital screening form. STUDY DESIGN: The process of screening for ASD was studied in an academic primary care pediatrics clinic before and after implementation of a digital version of the Modified Checklist for Autism in Toddlers - Revised with Follow-up with automated risk assessment. Quality metrics included accuracy of documentation of screening results and appropriate action for positive screens (secondary screening or referral)...
February 1, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28135880/electronic-heath-record-prompts-may-increase-screening-for-secondhand-smoke-exposure
#11
Katharine E H Thomas, Steve Kisely, Fernando Urrego
INTRODUCTION: The American Academy of Pediatrics recommends that pediatricians promote smoking cessation among caregivers at every visit. Currently, there are inconsistencies between recommendations and clinical practice. This study aims to compare results generated from 3 intervention methods on the rate at which pediatricians screen for secondhand smoke exposure (SHSe). METHODS: Pediatricians were randomly assigned to 1 of 3 intervention groups: no lecture, changes in electronic health record (EHR) (G1); lecture, no changes in the EHR (G2); or a lecture and EHR changes (G3)...
January 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28121467/modifying-provider-practice-to-improve-assessment-of-unhealthy-weight-and-lifestyle-in-young-children-translating-evidence-in-a-quality-improvement-initiative-for-at-risk-children
#12
Nadine L Camp, Rebecca C Robert, Jessica E Nash, Cara B Lichtenstein, Candice S Dawes, Katherine Patterson Kelly
BACKGROUND: We designed a quality improvement (QI) project to address the high prevalence of childhood overweight and obesity (OW/OB) in our patient population and the inconsistencies among primary care providers in recognizing and addressing OW/OB. METHODS: We used mixed methods data collection approach to evaluate a QI project, the Childhood Healthy Behaviors Intervention (CHBI), to improve provider obesity prevention practice in two low-income, predominantly African American pediatric primary care clinics...
January 25, 2017: Childhood Obesity
https://www.readbyqxmd.com/read/28118128/an-adult-health-care-based-pediatric-to-adult-transition-program-for-emerging-adults-with-type-1-diabetes
#13
Shivani Agarwal, Jennifer K Raymond, Mark H Schutta, Serena Cardillo, Victoria A Miller, Judith A Long
Purpose The purpose of the study was to evaluate an adult health care program model for emerging adults with type 1 diabetes transitioning from pediatric to adult care. Methods Evaluation of the Pediatric to Adult Diabetes Transition Clinic at the University of Pennsylvania included a cohort of 72 emerging adults with type 1 diabetes, ages 18 to 25 years. Data were extracted from transfer summaries and the electronic medical record, including sociodemographic, clinical, and follow-up characteristics. Pre- and postprogram assessment at 6 months included mean daily blood glucose monitoring frequency (BGMF) and glycemic control (A1C)...
February 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28115033/development-of-an-evacuation-tool-to-facilitate-disaster-preparedness-use-in-a-planned-evacuation-to-support-a-hospital-move
#14
Ranna A Rozenfeld, Sally L Reynolds, Sherri Ewing, Mary Margaret Crulcich, Michelle Stephenson
OBJECTIVES: Our institution relocated to a new facility 3.5 miles from our original location in Chicago on June 9, 2012. We describe the tools we developed to prepare, execute, and manage our evacuation and relocation. METHODS: Tools developed for the planned evacuation included the following: level of acuity and team composition classification, patient departure checklist, evacuation handoff tool, and a patient tracking system within the electronic health record...
January 24, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28112025/validation-of-the-use-of-electronic-health-records-for-classification-of-adhd-status
#15
Siobhan M Gruschow, Benjamin E Yerys, Thomas J Power, Dennis R Durbin, Allison E Curry
OBJECTIVE: To validate an electronic health record (EHR)-based algorithm to classify ADHD status of pediatric patients. METHOD: As part of an applied study, we identified all primary care patients of The Children's Hospital of Philadelphia [CHOP] health care network who were born 1987-1995 and residents of New Jersey. Patients were classified with ADHD if their EHR indicated an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code of "314...
October 1, 2016: Journal of Attention Disorders
https://www.readbyqxmd.com/read/28087684/the-effect-of-price-information-on-the-ordering-of-images-and-procedures
#16
Alyna T Chien, Smitha Ganeshan, Mark A Schuster, Lisa Soleymani Lehmann, Laura A Hatfield, Kate E Koplan, Carter R Petty, Anna D Sinaiko, Thomas D Sequist, Meredith B Rosenthal
BACKGROUND AND OBJECTIVES: Ordering rates for imaging studies and procedures may change if clinicians are shown the prices of those tests while they are ordering. We studied the effect of 2 forms of paid price information, single median price and paired internal/external median prices, on how often pediatric-focused and adult-oriented clinicians (most frequently general pediatricians and adult specialists caring for pediatric-aged patients, respectively) order imaging studies and procedures for 0- to 21-year-olds...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28078809/three-year-analysis-of-repeated-laboratory-tests-for-the-markers-total-cholesterol-ferritin-vitamin-d-vitamin-b12-and-folate-in-a-large-research-and-teaching-hospital-in-italy
#17
Monica Lanzoni, Marco Fornili, Irene Felicetta, Rita Maiavacca, Elia Biganzoli, Silvana Castaldi
RATIONALE, AIMS AND OBJECTIVES: The increasing number of diagnostic tests requests all over the world is a problem that can partially be explained by inappropriate testing. Impact on the total costs of health systems becomes relevant when tests are performed in a large amount. In this paper, retesting of total cholesterol, ferritin, vitamin B12 , vitamin D, and folate is assessed. METHODS: The Quality Unit of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano (Fondazione) decided to perform a first assessment of the appropriate use of the laboratory tests cholesterol, ferritin, vitamin B12 , vitamin D, and folate focusing on the retesting interval for the same patient in the time period January 1, 2012, to December 31, 2014, in every care setting...
January 12, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28025240/safety-of-quadrivalent-meningococcal-conjugate-vaccine-in-11-to-21-year-olds
#18
Hung-Fu Tseng, Lina S Sy, Bradley K Ackerson, Rulin C Hechter, Sara Y Tartof, Mendel Haag, Jeffrey M Slezak, Yi Luo, Christine A Fischetti, Harp S Takhar, Yan Miao, Marianne Cunnington, Zendi Solano, Steven J Jacobsen
BACKGROUND: Meningococcal conjugate vaccination is recommended in the United States. This study evaluates the safety of quadrivalent meningococcal conjugate vaccine in a cohort aged 11 to 21 years. METHODS: This cohort study with self-controlled case-series analysis was conducted at Kaiser Permanente Southern California. Individuals receiving MenACWY-CRM, a quadrivalent meningococcal conjugate vaccine, during September 30, 2011 to June 30, 2013, were included. Twenty-six prespecified events of interest (EOIs), including neurologic, rheumatologic, hematologic, endocrine, renal, pediatric, and pediatric infectious disease EOIs, were identified through electronic health records 1 year after vaccination...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27966006/medical-record-keeping-in-the-summer-camp-setting
#19
Laura Kaufman, Jaycelyn Holland, Stuart Weinberg, S Trent Rosenbloom
BACKGROUND: Approximately one fifth of school-aged children spend a significant portion of their year at residential summer camp, and a growing number have chronic medical conditions. Camp health records are essential for safe, efficient care and for transitions between camp and home providers, yet little research exists regarding these systems. OBJECTIVE: To survey residential summer camps for children to determine how camps create, store, and use camper health records...
December 14, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27965068/pda-based-self-work-sampling-study-of-pediatric-interns-quantifies-workday-and-educational-value
#20
Joyce K Campbell, Michael V Ortiz, Mary C Ottolini, Sarah Birch, Dewesh Agrawal
OBJECTIVE: Optimizing clinical proficiency and education of residents has become more important with restricted residency duty hours. Our objective was to investigate how interns spend their time on inpatient rotations and the perceived educational value of workday activities. METHODS: A descriptive, self-work sampling study using a personal digital assistant (PDA) to randomly query interns on inpatient rotations in real time as to their activity and the perceived educational value of that activity on a 4-point Likert scale...
December 10, 2016: Academic Pediatrics
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