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https://www.readbyqxmd.com/read/28435842/is-individual-smoking-behaviour-influenced-by-area-level-ethnic-density-a-cross-sectional-electronic-health-database-study-of-inner-south-east-london
#1
Rohini Mathur, Peter Schofield, Dianna Smith, Alexander Gilkes, Patrick White, Sally Hull
Tobacco smoking remains one of the greatest public health problems facing the UK today. It varies significantly by ethnic group. This study aimed to determine whether ethnic differences in smoking behaviour are related to neighbourhood-level, own-group ethnic density across south and east London. The association between ethnic density and individual smoking behaviour was assessed by multilevel logistic regression using the electronic health records of 688 397 general practitioner-registered patients. Restricted cubic splines were created to explore whether the effect of ethnic density on smoking behaviour was nonlinear...
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28435756/identifying-barriers-in-the-use-of-electronic-health-records-in-hawai-i
#2
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/28435501/impact-of-clinical-decision-support-on-radiography-for-acute-ankle-injuries-a-randomized-trial
#3
Shahein Tajmir, Ali S Raja, Ivan K Ip, James Andruchow, Patricia Silveira, Stacy Smith, Ramin Khorasani
INTRODUCTION: While only 15-20% of patients with foot and ankle injuries presenting to urgent care centers have clinically significant fractures, most undergo radiography. We examined the impact of electronic point-of-care clinical decision support (CDS) on adherence to the Ottawa Ankle Rules (OAR), as well as use and yield of foot and ankle radiographs in patients with acute ankle injury. METHODS: We obtained institutional review board approval for this randomized controlled study performed April 18, 2012-December 15, 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435184/mining-electronic-health-records-data-domestic-violence-and-adverse-health-effects
#4
Gunnur Karakurt, Vishal Patel, Kathleen Whiting, Mehmet Koyutürk
Intimate partner violence (IPV) often culminates in acute physical injury, sexual assault, and mental health issues. It is crucial to understand the healthcare habits of victims to develop interventions that can drastically improve a victim's quality of life and prevent future abuse. The objective of this study is to mine de-identified and aggregated Electronic Health Record data to identify women's health issues that are potentially associated with IPV. In this study we compared health issues of female domestic abuse victims to female non-domestic abuse victims...
January 2017: Journal of Family Violence
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
#5
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
#6
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
#7
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/28434278/electronic-health-record-use-among-cancer-patients-insights-from-the-health-information-national-trends-survey
#8
Yulia A Strekalova
Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute's Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access...
April 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28433675/montreal-accord-on-patient-reported-outcomes-use-series-paper-8-patient-reported-outcomes-pro-in-electronic-health-records-can-inform-clinical-and-policy-decisions
#9
S Ahmed, P Ware, W Gardner, J Witter, C O Bingham, D Khairy, S J Bartlett
BACKGROUND: Given that the goal of healthcare systems is to improve and maintain the health of the populations they serve, the indicators of performance must include outcomes that are meaningful to patients. The growth of health technologies provides an unprecedented opportunity to integrate the patient voice into clinical care by linking electronic health records (EHR) to patient-reported outcome (PRO) data collection. However, PRO data must be relevant, meaningful, and actionable for those who will have to invest the time and effort to collect it...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28433591/-artificial-intelligence-applied-to-radiation-oncology
#10
J-E Bibault, A Burgun, P Giraud
Performing randomised comparative clinical trials in radiation oncology remains a challenge when new treatment modalities become available. One of the most recent examples is the lack of phase III trials demonstrating the superiority of intensity-modulated radiation therapy in most of its current indications. A new paradigm is developing that consists in the mining of large databases to answer clinical or translational issues. Beyond national databases (such as SEER or NCDB), that often lack the necessary level of details on the population studied or the treatments performed, electronic health records can be used to create detailed phenotypic profiles of any patients...
April 19, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#11
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
https://www.readbyqxmd.com/read/28432662/targeting-ldl-cholesterol-beyond-absolute-goals-toward-personalized-risk
#12
REVIEW
Morton Leibowitz, Chandra Cohen-Stavi, Sanjay Basu, Ran D Balicer
PURPOSE OF REVIEW: The aim of this study was to review and assess the evidence for low-density lipoprotein cholesterol (LDL-C) treatment goals as presented in current guidelines for primary and secondary prevention of cardiovascular disease. RECENT FINDINGS: Different sets of guidelines and clinical studies for secondary prevention have centered on lower absolute LDL-C targets [<70 mg/dL (<1.8 mmol/L)], greater percent reductions of LDL-C (≥50%), or more intense treatment to achieve greater reductions in cardiovascular risk...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28432148/systolic-blood-pressure-trajectory-frailty-and-all-cause-mortality-over-80-years-of-age-cohort-study-using-electronic-health-records
#13
Rathi Ravindrarajah, Nisha C Hazra, Shota Hamada, Judith Charlton, Stephen H D Jackson, Alex Dregan, Martin C Gulliford
Background -Clinical trials show benefit from lowering systolic blood pressure in people aged ≥80 years but non-randomised epidemiological studies suggest lower systolic blood pressure may be associated with higher mortality. This study aimed to evaluate associations of SBP with all-cause mortality by frailty category over 80 years of age and to evaluate SBP trajectories before death. Methods -A population-based cohort study was conducted using electronic health records of 144,403 participants aged 80 and older registered with family practices in the United Kingdom from 2001 to 2014...
April 21, 2017: Circulation
https://www.readbyqxmd.com/read/28430829/effect-of-a-price-transparency-intervention-in-the-electronic-health-record-on-clinician-ordering-of-inpatient-laboratory-tests-the-price-randomized-clinical-trial
#14
Mina S Sedrak, Jennifer S Myers, Dylan S Small, Irving Nachamkin, Justin B Ziemba, Dana Murray, Gregory W Kurtzman, Jingsan Zhu, Wenli Wang, Deborah Mincarelli, Daniel Danoski, Brian P Wells, Jeffrey S Berns, Patrick J Brennan, C William Hanson, C Jessica Dine, Mitesh S Patel
Importance: Many health systems are considering increasing price transparency at the time of order entry. However, evidence of its impact on clinician ordering behavior is inconsistent and limited to single-site evaluations of shorter duration. Objective: To test the effect of displaying Medicare allowable fees for inpatient laboratory tests on clinician ordering behavior over 1 year. Design, Setting, and Participants: The Pragmatic Randomized Introduction of Cost data through the electronic health record (PRICE) trial was a randomized clinical trial comparing a 1-year intervention to a 1-year preintervention period, and adjusting for time trends and patient characteristics...
April 21, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28430572/lessons-about-so-called-difficult-patients-from-the-uk-controversy-over-patient-access-to-electronic-health-records
#15
Federica Lucivero
Increasing numbers of patients have direct access to their electronic health records (EHRs). Proponents of direct access argue that it empowers patients by making them more informed and offering them more control over their health and care. According to some proponents of patients' access to EHRs, clinicians' concerns about potential negative implications are grounded in a form of paternalism that protects clinicians' authority. This paper draws upon narratives from patients in the United Kingdom (UK) who have access to their EHRs and suggests strategies for moving beyond these controversies between proponents and critics of the system...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28428750/applying-an-archetype-based-approach-to-electroencephalography-event-related-potential-experiments-in-the-eegbase-resource
#16
Václav Papež, Roman Mouček
PURPOSE: The purpose of this study is to investigate the feasibility of applying openEHR (an archetype-based approach for electronic health records representation) to modeling data stored in EEGBase, a portal for experimental electroencephalography/event-related potential (EEG/ERP) data management. The study evaluates re-usage of existing openEHR archetypes and proposes a set of new archetypes together with the openEHR templates covering the domain. The main goals of the study are to (i) link existing EEGBase data/metadata and openEHR archetype structures and (ii) propose a new openEHR archetype set describing the EEG/ERP domain since this set of archetypes currently does not exist in public repositories...
2017: Frontiers in Neuroinformatics
https://www.readbyqxmd.com/read/28428130/development-and-validation-of-an-algorithm-to-accurately-identify-atopic-eczema-patients-in-primary-care-electronic-health-records-from-the-uk
#17
K Abuabara, A M Magyari, O Hoffstad, Z K Jabbar-Lopez, L Smeeth, H C Williams, J M Gelfand, D J Margolis, S M Langan
Electronic health records hold great promise for clinical and epidemiologic research. Undertaking atopic eczema (AE) research using such data is challenging due to its episodic and heterogeneous nature. We sought to develop and validate a diagnostic algorithm that identifies AE cases based on codes used for electronic records used in the UK Health Improvement Network (THIN). We found that at least one of 5 diagnosis codes plus two treatment codes for any skin-directed therapy were likely to accurately identify patients with AE...
April 18, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28428097/care-coordination-and-comprehensive-electronic-health-records-are-associated-with-increased-transition-planning-activities
#18
Niraj Sharma, Kitty O'Hare, Karen G O'Connor, Umbereen Nehal, Megumi J Okumura
OBJECTIVE: Youth with Special Health Care Needs (YSHCN) require assistance from their pediatricians to transition to adult care. There is little data on what transition resources pediatricians have. This paper studies if care coordination and/or comprehensive electronic health record (CEHR) implementation are associated with improved transition processes. METHODS: Using AAP Periodic Survey #79, we report whether practices generated written transition plans, assisted in finding adult providers, and discussed confidentiality issues...
April 18, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28427727/implementation-of-human-trafficking-education-and-treatment-algorithm-in-the-emergency-department
#19
Amber Egyud, Kimberly Stephens, Brenda Swanson-Bierman, Marge DiCuccio, Kimberly Whiteman
PROBLEM: Health care professionals have not been successful in recognizing or rescuing victims of human trafficking. The purpose of this project was to implement a screening system and treatment algorithm in the emergency department to improve the identification and rescue of victims of human trafficking. The lack of recognition by health care professionals is related to inadequate education and training tools and confusion with other forms of violence such as trauma and sexual assault...
April 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28427407/constructive-ehealth-evaluation-lessons-from-evaluation-of-ehr-development-in-4-danish-hospitals
#20
Anna Marie Balling Høstgaard, Pernille Bertelsen, Christian Nøhr
BACKGROUND: Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development...
April 20, 2017: BMC Medical Informatics and Decision Making
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