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https://www.readbyqxmd.com/read/28915223/quality-measures-a-stakeholder-analysis
#1
Marianne Baernholdt, Nancy Dunton, Ronda G Hughes, Patricia W Stone, Kathleen M White
For quality measures, confusion and discontentment have increased, as availability of electronic data and data collection tools has expanded. We examined current issues with quality measures across 4 stakeholder groups: developers, regulators/endorsers, data collectors, and consumer advocates. There are missing quality measures, issues with data quality and purpose, questionable usability of electronic health records, and an increased measurement burden and cost. Policymakers, administrators, health care professionals, and consumers need to collaborate on measure development and selection...
September 14, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28914640/machine-learning-novel-bioinformatics-approaches-for-combating-antimicrobial-resistance
#2
Nenad Macesic, Fernanda Polubriaginof, Nicholas P Tatonetti
PURPOSE OF REVIEW: Antimicrobial resistance (AMR) is a threat to global health and new approaches to combating AMR are needed. Use of machine learning in addressing AMR is in its infancy but has made promising steps. We reviewed the current literature on the use of machine learning for studying bacterial AMR. RECENT FINDINGS: The advent of large-scale data sets provided by next-generation sequencing and electronic health records make applying machine learning to the study and treatment of AMR possible...
September 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28913416/using-focused-laboratory-management-and-quality-improvement-projects-to-enhance-resident-training-and-foster-scholarship
#3
Matthew D Krasowski, Bradley A Ford, J Stacey Klutts, Chris S Jensen, Angela S Briggs, Robert A Robinson, Leslie A Bruch, Nitin J Karandikar
Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28912836/methods-for-enhancing-the-reproducibility-of-biomedical-research-findings-using-electronic-health-records
#4
REVIEW
Spiros Denaxas, Kenan Direk, Arturo Gonzalez-Izquierdo, Maria Pikoula, Aylin Cakiroglu, Jason Moore, Harry Hemingway, Liam Smeeth
BACKGROUND: The ability of external investigators to reproduce published scientific findings is critical for the evaluation and validation of biomedical research by the wider community. However, a substantial proportion of health research using electronic health records (EHR), data collected and generated during clinical care, is potentially not reproducible mainly due to the fact that the implementation details of most data preprocessing, cleaning, phenotyping and analysis approaches are not systematically made available or shared...
2017: BioData Mining
https://www.readbyqxmd.com/read/28912203/can-electronic-health-records-make-quality-measurement-fast-and-easy
#5
EDITORIAL
Eric E Adelman, James F Burke
No abstract text is available yet for this article.
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28912200/development-and-validation-of-electronic-quality-measures-to-assess-care-for-patients-with-transient-ischemic-attack-and-minor-ischemic-stroke
#6
Dawn M Bravata, Laura J Myers, Eric Cheng, Mathew Reeves, Fitsum Baye, Zhangsheng Yu, Teresa Damush, Edward J Miech, Jason Sico, Michael Phipps, Alan Zillich, Jason Johanning, Seemant Chaturvedi, Curt Austin, Jared Ferguson, Bailey Maryfield, Kathy Snow, Susan Ofner, Glenn Graham, Rachel Rhude, Linda S Williams, Greg Arling
BACKGROUND: Despite interest in using electronic health record (EHR) data to assess quality of care, the accuracy of such data is largely unknown. We sought to develop and validate transient ischemic attack and minor ischemic stroke electronic quality measures (eQMs) using EHR data. METHODS AND RESULTS: A random sample of patients with transient ischemic attack or minor ischemic stroke, cared for in Veterans Health Administration facilities (fiscal year 2011), was identified...
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28911923/secondary-data-sources-for-health-services-research-in-urologic-oncology
#7
REVIEW
Alexander P Cole, David F Friedlander, Quoc-Dien Trinh
BACKGROUND: Though secondary data analyses of large datasets may reduce logistical and financial barriers required to perform significant and innovative work, such research requires specialized skills in data handling and statistical techniques as well as thorough and detailed knowledge of the data sources being used. OBJECTIVES: To provide an overview of several common types of secondary data, focusing on strengths, weaknesses and examples of how these data may be used for health services research...
September 11, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28911506/metabolically-healthy-obese-and-incident-cardiovascular-disease-events-among-3-5%C3%A2-million-men-and-women
#8
Rishi Caleyachetty, G Neil Thomas, Konstantinos A Toulis, Nuredin Mohammed, Krishna M Gokhale, Kumarendran Balachandran, Krishnarajah Nirantharakumar
BACKGROUND: Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals. OBJECTIVES: This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population. METHODS: We used linked electronic health records (1995 to 2015) in The Health Improvement Network (THIN) to assemble a cohort of 3...
September 19, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28910436/integrating-data-collection-into-office-work-flow-and-electronic-health-records-for-clinical-outcomes-research
#9
C Alessandra Colaianni, Patricia A Levesque, Robin W Lindsay
Meticulous collection of clinical outcomes metrics in patients undergoing elective surgery is important to ensure quality care; it is also increasing in importance as the Centers for Medicare & Medicaid Services moves to tie reimbursement to outcomes and insurance approval. This study assesses a systematic method for gathering preoperative and postoperative data on patients with nasal obstruction who undergo functional septorhinoplasty that was developed at the Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts...
September 14, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28906267/evidence-based-guidelines-for-interface-design-for-data-entry-in-electronic-health-records
#10
Bryan A Wilbanks, Jacqueline Moss
Electronic health records use a variety of data entry methods that are often customized to clinician needs. Data entry interfaces must be appropriately designed to maximize benefits and minimize unintended consequences. There was relatively little evidence in the literature to guide the selection of specific data entry methods according to the type of data documented. This literature review summarizes existing data entry design recommendations to guide data entry interface design. Structured data entry uses predefined charting elements to limit acceptable data entry to standard coded data and improve completeness and data reuse at the expense of correctness...
September 12, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28905658/decision-support-for-diabetes-in-scotland-implementation-and-evaluation-of-a-clinical-decision-support-system
#11
Nicholas Conway, Karen A Adamson, Scott G Cunningham, Alistair Emslie Smith, Peter Nyberg, Blair H Smith, Ann Wales, Deborah J Wake
BACKGROUND: Automated clinical decision support systems (CDSS) are associated with improvements in health care delivery to those with long-term conditions, including diabetes. A CDSS was introduced to two Scottish regions (combined diabetes population ~30 000) via a national diabetes electronic health record. This study aims to describe users' reactions to the CDSS and to quantify impact on clinical processes and outcomes over two improvement cycles: December 2013 to February 2014 and August 2014 to November 2014...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28903894/prototype-development-context-driven-dynamic-xml-ophthalmologic-data-capture-application
#12
Peggy Peissig, Kelsey M Schwei, Christopher Kadolph, Joseph Finamore, Efrain Cancel, Catherine A McCarty, Asha Okorie, Kate L Thomas, Jennifer Allen Pacheco, Jyotishman Pathak, Stephen B Ellis, Joshua C Denny, Luke V Rasmussen, Gerard Tromp, Marc S Williams, Tamara R Vrabec, Murray H Brilliant
BACKGROUND: The capture and integration of structured ophthalmologic data into electronic health records (EHRs) has historically been a challenge. However, the importance of this activity for patient care and research is critical. OBJECTIVE: The purpose of this study was to develop a prototype of a context-driven dynamic extensible markup language (XML) ophthalmologic data capture application for research and clinical care that could be easily integrated into an EHR system...
September 13, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28903729/dynamic-etl-a-hybrid-approach-for-health-data-extraction-transformation-and-loading
#13
Toan C Ong, Michael G Kahn, Bethany M Kwan, Traci Yamashita, Elias Brandt, Patrick Hosokawa, Chris Uhrich, Lisa M Schilling
BACKGROUND: Electronic health records (EHRs) contain detailed clinical data stored in proprietary formats with non-standard codes and structures. Participating in multi-site clinical research networks requires EHR data to be restructured and transformed into a common format and standard terminologies, and optimally linked to other data sources. The expertise and scalable solutions needed to transform data to conform to network requirements are beyond the scope of many health care organizations and there is a need for practical tools that lower the barriers of data contribution to clinical research networks...
September 13, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28903154/incidence-and-trends-of-sepsis-in-us-hospitals-using-clinical-vs-claims-data-2009-2014
#14
Chanu Rhee, Raymund Dantes, Lauren Epstein, David J Murphy, Christopher W Seymour, Theodore J Iwashyna, Sameer S Kadri, Derek C Angus, Robert L Danner, Anthony E Fiore, John A Jernigan, Greg S Martin, Edward Septimus, David K Warren, Anita Karcz, Christina Chan, John T Menchaca, Rui Wang, Susan Gruber, Michael Klompas
Importance: Estimates from claims-based analyses suggest that the incidence of sepsis is increasing and mortality rates from sepsis are decreasing. However, estimates from claims data may lack clinical fidelity and can be affected by changing diagnosis and coding practices over time. Objective: To estimate the US national incidence of sepsis and trends using detailed clinical data from the electronic health record (EHR) systems of diverse hospitals. Design, Setting, and Population: Retrospective cohort study of adult patients admitted to 409 academic, community, and federal hospitals from 2009-2014...
September 13, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28901698/online-training-introduces-a-novel-approach-to-the-dietetic-care-process-documentation
#15
Shelly Rachman-Elbaum, Aliza H Stark, Josefa Kachal, Teresa Johnson, Bat Sheva Porat-Katz
AIM: Nutrition professionals in Israel are developing a system to document the Dietetic Care Process (DCP) tailored for specific patient sectors and compliant with national health guidelines. The ultimate goal is to achieve uniform documentation and improve nutrition care. Israeli dietetic practitioners work in specific patient sectors; therefore, a patient population-specific reporting system is proposed instead of the typical singular format applied across all patient populations. The purpose of this project was to evaluate learning outcomes and attitudes among registered dietitians (RDs) after online training of a novel DCP documentation system...
September 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28899575/ehealth-in-integrated-care-programs-for-people-with-multimorbidity-in-europe-insights-from-the-icare4eu-project
#16
Maria Gabriella Melchiorre, Roberta Papa, Mieke Rijken, Ewout van Ginneken, Anneli Hujala, Francesco Barbabella
INTRODUCTION: Care for people with multimorbidity requires an integrated approach in order to adequately meet their complex needs. In this respect eHealth could be of help. This paper aims to describe the implementation, as well as benefits and barriers of eHealth applications in integrated care programs targeting people with multimorbidity in European countries, including insights on older people 65+. METHODS: Within the framework of the ICARE4EU project, in 2014, expert organizations in 24 European countries identified 101 integrated care programs based on selected inclusion criteria...
August 12, 2017: Health Policy
https://www.readbyqxmd.com/read/28898194/correlate-a-pacs-and-ehr-integrated-tool-leveraging-natural-language-processing-to-provide-automated-clinical-follow-up
#17
Mark D Kovacs, Joseph Mesterhazy, David Avrin, Thomas Urbania, John Mongan
A major challenge for radiologists is obtaining meaningful clinical follow-up information for even a small percentage of cases encountered and dictated. Traditional methods, such as keeping medical record number follow-up lists, discussing cases with rounding clinical teams, and discussing cases at tumor boards, are effective at keeping radiologists informed of clinical outcomes but are time intensive and provide follow-up for a small subset of cases. To this end, the authors developed a picture archiving and communication system-accessible electronic health record (EHR)-integrated program called Correlate, which allows the user to easily enter free-text search queries regarding desired clinical follow-up information, with minimal interruption to the workflow...
September 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28893815/risk-stratification-methods-and-provision-of-care-management-services-in-comprehensive-primary-care-initiative-practices
#18
Ashok Reddy, Laura Sessums, Reshma Gupta, Janel Jin, Tim Day, Bruce Finke, Asaf Bitton
PURPOSE: Risk-stratified care management is essential to improving population health in primary care settings, but evidence is limited on the type of risk stratification method and its association with care management services. METHODS: We describe risk stratification patterns and association with care management services for primary care practices in the Comprehensive Primary Care (CPC) initiative. We undertook a qualitative approach to categorize risk stratification methods being used by CPC practices and tested whether these stratification methods were associated with delivery of care management services...
September 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28893813/uninsured-primary-care-visit-disparities-under-the-affordable-care-act
#19
Heather Angier, Megan Hoopes, Miguel Marino, Nathalie Huguet, Elizabeth A Jacobs, John Heintzman, Heather Holderness, Carlyn M Hood, Jennifer E DeVoe
PURPOSE: Health insurance coverage affects a patient's ability to access optimal care, the percentage of insured patients on a clinic's panel has an impact on the clinic's ability to provide needed health care services, and there are racial and ethnic disparities in coverage in the United States. Thus, we aimed to assess changes in insurance coverage at community health center (CHC) visits after the Patient Protection and Affordable Care Act (ACA) Medicaid expansion by race and ethnicity...
September 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28893811/tethered-to-the-ehr-primary-care-physician-workload-assessment-using-ehr-event-log-data-and-time-motion-observations
#20
Brian G Arndt, John W Beasley, Michelle D Watkinson, Jonathan L Temte, Wen-Jan Tuan, Christine A Sinsky, Valerie J Gilchrist
PURPOSE: Primary care physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct patient care. Demand for non-face-to-face care, such as communication through a patient portal and administrative tasks, is increasing and contributing to burnout. The goal of this study was to assess time allocated by primary care physicians within the EHR as indicated by EHR user-event log data, both during clinic hours (defined as 8:00 am to 6:00 pm Monday through Friday) and outside clinic hours...
September 2017: Annals of Family Medicine
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