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pediatric electronic health records

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https://www.readbyqxmd.com/read/29226008/variation-in-results-release-and-patient-portal-access-to-diagnostic-test-results-at-an-academic-medical-center
#1
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/29183146/improving-rates-of-screening-for-anemia-in-infancy
#2
Barbara Ha, Deirdre L O'Sullivan, Carol A Diamond, Amy J Plumb, Jeffrey S Sleeth, Frank R Greer, Pamela J Kling
In 2010, the American Academy of Pediatrics recommended universal screening for anemia at approximately 1 year of age. This quality improvement study sought to improve anemia screening in an ambulatory setting. In a large university-based setting, a best practice alert (BPA) was placed within the electronic health record. The primary outcome was overall screening rate in ambulatory family medicine (DFM) and pediatrics (PEDS) clinics. From 2545 pre-BPA clinic visits over a 12-month period, the screening rate was 48...
November 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/29167089/predicting-unplanned-transfers-to-the-intensive-care-unit-a-machine-learning-approach-leveraging-diverse-clinical-elements
#3
Ben Wellner, Joan Grand, Elizabeth Canzone, Matt Coarr, Patrick W Brady, Jeffrey Simmons, Eric Kirkendall, Nathan Dean, Monica Kleinman, Peter Sylvester
BACKGROUND: Early warning scores aid in the detection of pediatric clinical deteriorations but include limited data inputs, rarely include data trends over time, and have limited validation. OBJECTIVE: Machine learning methods that make use of large numbers of predictor variables are now commonplace. This work examines how different types of predictor variables derived from the electronic health record affect the performance of predicting unplanned transfers to the intensive care unit (ICU) at three large children's hospitals...
November 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29147468/use-of-dictation-as-a-tool-to-decrease-documentation-errors-in-electronic-health-records
#4
Samer Al Hadidi, Sunil Upadhaya, Rupal Shastri, Zain Alamarat
Background: Use of Electronic Health Records is increasing. Copy-and-paste function is frequently used with higher rates of documentation errors. Studies to determine the nature of such errors are needed.Objectives: Determination of the effect of implementing a dictation system for completing notes on the quality of clinical documentation. We hypothesized that implementation of the dictation system for note writing would decrease the rate of errors in the progress notes as well as decrease the rate of copying and pasting...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29135900/ondansetron-prescription-for-home-use-in-a-pediatric-emergency-department
#5
James M Gray, Jaya D Maewal, Scott A Lunos, Ronald A Furnival, Marissa A Hendrickson
OBJECTIVES: Ondansetron has been shown to decrease admission rates and the need for intravenous fluids among pediatric emergency department (ED) patients with acute gastroenteritis, but there is limited evidence regarding its use after ED discharge. This study describes prescribing patterns for ondansetron and assesses the effects of ondansetron home prescription on rate of return. METHODS: Data were gathered from the electronic health record on 2 separate but overlapping groups of patients seen in a pediatric ED from 2012 to 2014...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29121953/risk-of-tuberculosis-among-alabama-children-and-adolescents-treated-with-tumor-necrosis-factor-inhibitors-a-retrospective-study
#6
Matthew L Stoll, James Aaron Grubbs, Timothy Beukelman, Melissa L Mannion, Traci W Jester, Randy Q Cron, Marilyn J Crain
BACKGROUND: Tumor Necrosis Factor inhibitors (TNFi) have dramatically improved the outlook for patients with inflammatory arthritides and bowel disease (IBD), but are associated with increased infection risks, including tuberculosis (TB). Pediatric inflammatory diseases are uncommon, and the risk of TB in children taking TNFi remains unclear. The objective of this study was to report the incidence of TB disease among TNFi recipients at a single pediatric medical center serving most of Alabama compared to that of the general population of Alabama children...
November 9, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29117934/uses-of-mobile-device-digital-photography-of-dermatologic-conditions-in-primary-care
#7
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
#8
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/29102458/an-electronic-health-record-based-strategy-to-address-child-tobacco-smoke-exposure
#9
E Melinda Mahabee-Gittens, Judith W Dexheimer, Meredith Tabangin, Jane C Khoury, Ashley L Merianos, Lara Stone, Gabe T Meyers, Judith S Gordon
INTRODUCTION: A high proportion of children presenting to pediatric urgent cares are exposed to tobacco smoke. An electronic health record-based clinical decision support system for nurses to facilitate guideline-based tobacco smoke exposure screening and counseling for caregivers who smoke was designed and evaluated. DESIGN: A mixed-methods, 3-month, prospective study that began in November 2015, data were analyzed in June 2016. SETTING/PARTICIPANTS: Five urgent cares that were part of a large children's hospital in Cincinnati, OH...
November 1, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29099060/clinical-pharmacogenetics-of-cytochrome-p450-associated-drugs-in-children
#10
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/29095809/progress-in-childhood-vaccination-data-in-immunization-information-systems-united-states-2013-2016
#11
Neil Murthy, Loren Rodgers, Laura Pabst, Amy Parker Fiebelkorn, Terence Ng
In 2016, 55 jurisdictions in 49 states and six cities in the United States* used immunization information systems (IISs) to collect and manage immunization data and support vaccination providers and immunization programs. To monitor progress toward achieving IIS program goals, CDC surveys jurisdictions through an annual self-administered IIS Annual Report (IISAR). Data from the 2013-2016 IISARs were analyzed to assess progress made in four priority areas: 1) data completeness, 2) bidirectional exchange of data with electronic health record systems, 3) clinical decision support for immunizations, and 4) ability to generate childhood vaccination coverage estimates...
November 3, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29089403/cost-effectiveness-of-a-clinical-childhood-obesity-intervention
#12
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
https://www.readbyqxmd.com/read/29089191/a-multi-site-feasibility-study-to-assess-fever-and-wheezing-in-children-after-influenza-vaccines-using-text-messaging
#13
Melissa S Stockwell, Colin D Marchant, A Patrica Wodi, Elizabeth D Barnett, Karen R Broder, Kathleen Jakob, Paige Lewis, Meyer Kattan, Anne Marie Rezendes, Angela Barrett, Devindra Sharma, Nadira Fernandez, Philip LaRussa
BACKGROUND: Using text messaging for vaccine safety monitoring, particularly for non-medically attended events, would be valuable for pandemic influenza and emergency vaccination program preparedness. We assessed the feasibility and acceptability of text messaging to evaluate fever and wheezing post-influenza vaccination in a prospective, observational, multi-site pediatric study. METHODS: Children aged 2-11 years old, with an emphasis on children with asthma, were recruited during the 2014-2015 influenza season from three community-based clinics in New York City, and during the 2014-2015 and 2015-2016 seasons from a private practice in Fall River, Massachusetts...
October 28, 2017: Vaccine
https://www.readbyqxmd.com/read/29079043/pediatric-appropriate-use-criteria-for-outpatient-echocardiography-practice-variations-among-pediatric-cardiologists-noncardiologist-subspecialists-and-primary-care-providers
#14
Soultana Kourtidou, Patrick D Evers, Neal W Jorgensen, Richard A Kronmal, Mark B Lewin, Amy H Schultz
BACKGROUND: The first pediatric appropriate use criteria (AUC) address the use of initial transthoracic echocardiography in outpatients by all ordering providers. The aim of this study was to appraise the performance of the AUC across pediatric cardiologists, noncardiologist subspecialists, and primary care providers (PCPs). A further aim was to describe the variations in ordering patterns of different groups of practitioners, which could serve as the basis for targeted quality improvement activities...
October 24, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29075864/the-use-of-electronic-health-records-to-identify-children-with-elevated-blood-pressure-and-hypertension
#15
REVIEW
Michael G Semanik
Elevated blood pressures often go unrecognized in pediatric patients, potentially putting children and adolescents at risk for the sequelae of untreated hypertension. This may be partially due to the complexity involved in diagnosing elevated pediatric blood pressures, which demands a high cognitive workload from providers. Tools built into electronic health records have the potential to alleviate this workload, and studies investigating these tools confirm they show promise in improving elevated blood pressure recognition...
October 26, 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/29063541/best-paper-selection
#16
(no author information available yet)
Bahous MC, Shadmi E. Health information exchange and information gaps in referrals to a pediatric emergency department. Int J Med Inform 2016;87:68-74 https://linkinghub.elsevier.com/retrieve/pii/S1386-5056(15)30078-2 Esmaeilzadeh P, Sambasivan M. Health Information Exchange (HIE): A literature review, assimilation pattern and a proposed classification for a new policy approach. J Biomed Inform 2016;64:74-86 http://www.sciencedirect.com/science/article/pii/S1532046416301241?via%3Dihub Massoudi BL, Marcial LH, Tant E, Adler-Milstein J, West SL...
August 2017: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/29038132/provider-perspectives-of-high-quality-pediatric-hospital-to-home-transitions-for-children-and-youth-with-chronic-disease
#17
Carolyn C Foster, Elizabeth Jacob-Files, Kimberly C Arthur, Stephanie A Hillman, Todd C Edwards, Rita Mangione-Smith
OBJECTIVE: The objective of this study was to describe health care providers' and hospital administrators' perspectives on how to improve pediatric hospital-to-home transitions for children and youth with chronic disease (CYCD). METHODS: Focus groups and key informant interviews of inpatient attending physicians, primary care physicians, pediatric residents, nurses, care coordinators, and social workers were conducted at a tertiary care children's hospital. Key informant interviews were performed with hospital administrators...
November 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29027824/a-computable-phenotype-for-asthma-case-identification-in-adult-and-pediatric-patients-external-validation-in-the-chicago-area-patient-outcomes-research-network-capricorn
#18
Majid Afshar, Valerie G Press, Rachel G Robison, Abel N Kho, Sindhura Bandi, Ashvini Biswas, Pedro C Avila, Harsha Vardhan Madan Kumar, Byung Yu, Edward T Naureckas, Sharmilee M Nyenhuis, Christopher D Codispoti
OBJECTIVE: Comprehensive, rapid, and accurate identification of patients with asthma for clinical care and engagement in research efforts is needed. The original development and validation of a computable phenotype for asthma case identification occurred at a single institution in Chicago and demonstrated excellent test characteristics. However, its application in a diverse payer mix, across different health systems and multiple electronic health record vendors, and in both children and adults was not examined...
October 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29021115/specialty-addiction-and-psychiatry-treatment-initiation-and-engagement-results-from-an-sbirt-randomized-trial-in-pediatrics
#19
Stacy Sterling, Andrea H Kline-Simon, Ashley Jones, Derek D Satre, Sujaya Parthasarathy, Constance Weisner
OBJECTIVE: Many adolescents needing specialty addiction or psychiatry treatment never access care. We examined initiation and engagement with addiction and/or psychiatry treatment among adolescents referred to treatment from a trial comparing two different modalities of delivering Screening, Brief Intervention and Referral to Treatment (SBIRT) to Usual Care in pediatric primary care. We hypothesized that both intervention arms would have higher initiation and engagement rates than usual care...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28992828/differences-in-sleep-patterns-and-problems-by-race-in-a-clinical-sample-of-black-and-white-preschoolers
#20
Ariel A Williamson, Sonia L Rubens, Kristina E Patrick, Melisa Moore, Jodi A Mindell
STUDY OBJECTIVES: Community-based research indicates that Black preschoolers tend to have more bedtime difficulties and are at higher risk for obstructive sleep apnea (OSA) compared to White preschoolers. This study examined differences in sleep patterns and problems by race among a clinical sample of Black and White preschoolers at an outpatient sleep clinic. METHODS: Data were collected from electronic medical records for 125 children ages 2-5 years (mean = 3...
November 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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