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https://www.readbyqxmd.com/read/28716477/2017-aha-acc-key-data-elements-and-definitions-for-ambulatory-electronic-health-records-in-pediatric%C3%A2-and-congenital-cardiology-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-data-standards
#1
Jeffrey R Boris, Marie J Béland, Lisa J Bergensen, Steven D Colan, Joanna Dangel, Curtis J Daniels, Christopher Davis, Allen D Everett, Rodney Franklin, J William Gaynor, Darryl T Gray, Jennifer C Hirsch-Romano, Jeffrey P Jacobs, Marshall Jacobs, Howard Jeffries, Otto Nils Krogmann, Edwin A Lomotan, Leo Lopez, Ariane Marelli, Gerard R Martin, G Paul Matherne, Constantine Mavroudis, Ken McCardle, Gail D Pearson, Geoffrey Rosenthal, John S Scott, Gerald A Serwer, Stephen S Seslar, Robert Shaddy, Timothy Slesnick, David F Vener, Henry L Walters, Paul M Weinberg
No abstract text is available yet for this article.
July 10, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28711345/working-at-the-intersection-of-context-culture-and-technology-provider-perspectives-on-antimicrobial-stewardship-in-the-emergency-department-using-electronic-health-record-clinical-decision-support
#2
Phillip Chung, Jean Scandlyn, Peter S Dayan, Rakesh D Mistry
BACKGROUND: Antibiotic stewardship programs (ASPs) have not been fully developed for the emergency department (ED), in part the result of the barriers characteristic of this setting. Electronic health record-based clinical decision support (EHR CDS) represents a promising strategy to implement ASPs in the ED. We aimed to determine the cultural beliefs and structural barriers and facilitators to implementation of antimicrobial stewardship in the pediatric ED using EHR CDS. METHODS: Interviews and focus groups were conducted with hospital and ED leadership, attending ED physicians, nurse practitioners, physician assistants, and residents at a single health system in Colorado...
July 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28710700/enhancing-state-medical-home-capacity-through-a-care-coordination-technical-assistance-model
#3
Susan Berry, Patti Barovechio, Emily Mabile, Tri Tran
Introduction A practice-based care coordination (CC) model was developed by Louisiana's Title V Children's Special Health Services (CSHS) program to meet the overwhelming needs of the New Orleans post-Katrina population. The pilot clinic demonstrated an improvement in medical home (MH) capacity over the course of 3 months. The purpose of the current study is to evaluate the replicability of the model and sustainability of MH improvement over at least 2 years, while identifying factors that may modify the effect of the intervention...
July 14, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28710153/2017-aha-acc-key-data-elements-and-definitions-for-ambulatory-electronic-health-records-in-pediatric-and-congenital-cardiology-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-data-standards
#4
REVIEW
Jeffrey R Boris, Marie J Béland, Lisa J Bergensen, Steven D Colan, Joanna Dangel, Curtis J Daniels, Christopher Davis, Allen D Everett, Rodney Franklin, J William Gaynor, Darryl T Gray, Jennifer C Hirsch-Romano, Jeffrey P Jacobs, Marshall Jacobs, Howard Jeffries, Otto Nils Krogmann, Edwin A Lomotan, Leo Lopez, Ariane Marelli, Gerard R Martin, G Paul Matherne, Constantine Mavroudis, Ken McCardle, Gail D Pearson, Geoffrey Rosenthal, John S Scott, Gerald A Serwer, Stephen S Seslar, Robert Shaddy, Timothy Slesnick, David F Vener, Henry L Walters, Paul M Weinberg
No abstract text is available yet for this article.
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28701350/effectiveness-of-interventions-to-improve-medication-use-during-rapid-sequence-intubation-in-a-pediatric-emergency-department
#5
Michelle C Caruso, Jenna R Dyas, Matthew R Mittiga, Andrea S Rinderknecht, Benjamin T Kerrey
PURPOSE: Results of a study to determine whether checklist-based interventions improved the selection and administration of rapid-sequence intubation (RSI) medications in a pediatric emergency department (ED) are reported. METHODS: A retrospective study of data collected during a quality-improvement project was conducted. Data sources included the electronic health record and video review. The central intervention was use of a 21-item RSI checklist, which included guidance for the physician team leader on medication selection and timing...
July 12, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28699944/improving-the-readability-of-pediatric-hospital-medicine-discharge-instructions
#6
Ndidi Unaka, Angela Statile, Karen Jerardi, Devesh Dahale, Joan Morris, Brianna Liberio, Ashley Jenkins, Blair Simpson, Randi Mullaney, Jodi Kelley, Michelle Durling, Jennifer Shafer, Patrick Brady
BACKGROUND: Readable discharge instructions may help caregivers understand and implement care plans following hospitalization. Many caregivers of hospitalized children, however, have limited literacy. We aimed to increase the percentage of discharge instructions written at 7th grade level or lower for hospital medicine patients from 13% to 80% in 6 months. METHODS: Quality improvement efforts targeted a 42-bed unit at the community satellite of our large, urban academic hospital...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28699564/detecting-clinically-relevant-new-information-in-clinical-notes-across-specialties-and-settings
#7
Rui Zhang, Serguei V S Pakhomov, Elliot G Arsoniadis, Janet T Lee, Yan Wang, Genevieve B Melton
BACKGROUND: Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. METHODS: Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient...
July 5, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28653504/clinical-effectiveness-of-the-massachusetts-childhood-obesity-research-demonstration-initiative-among-low-income-children
#8
Elsie M Taveras, Meghan Perkins, Shikha Anand, Jennifer A Woo Baidal, Candace C Nelson, Neil Kamdar, Jo-Ann Kwass, Steven L Gortmaker, Jessica L Barrett, Kirsten K Davison, Thomas Land
OBJECTIVE: To examine the extent to which a clinical intervention resulted in reduced BMI z scores among 2- to 12-year-old children compared to routine practice (treatment as usual [TAU]). METHODS: The Massachusetts Childhood Obesity Research Demonstration (MA-CORD) project is a multifaceted initiative to prevent childhood obesity among low-income children. At the federally qualified community health centers (FQHCs) of two communities (Intervention Site #1 and #2), the following were implemented: (1) pediatric weight management training, (2) electronic decision supports for clinicians, (3) on-site Healthy Weight Clinics, (4) community health worker integration, and (5) healthful clinical environment changes...
July 2017: Obesity
https://www.readbyqxmd.com/read/28644180/mucosal-healing-in-clinical-practice-a-single-center-pediatric-ibd-experience
#9
Savini L Santha, Prabhu R Shankar, Anqi Pan, Bess Schoen, Subra Kugathasan, Cary G Sauer
BACKGROUND: Mucosal healing (MH) is associated with improved clinical outcomes in patients with Crohn's disease (CD) and ulcerative colitis (UC). MH as a target for treatment has been suggested, although there is little pediatric data. The goal of this study was to evaluate MH in clinical practice in pediatric patients with inflammatory bowel disease in clinical remission. METHODS: A retrospective review of electronic health record data was performed on all patients with CD or UC who underwent at least 2 colonoscopies from 2010 through 2016...
August 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28638518/automated-reporting-of-trainee-metrics-using-electronic-clinical-systems
#10
Jonathan C Levin, Jonathan Hron
BACKGROUND: The Accreditation Council for Graduate Medical Education has called for increased emphasis on reporting objective performance measures to trainees and programs. However, reporting of objective measures, including clinical volume, is largely omitted from training programs. OBJECTIVE: To use automated electronic medical systems at a tertiary pediatric care hospital to create a dashboard that reports objective trainee and program metrics, including clinical volume and diagnoses in a pediatrics residency...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28634427/leveraging-food-and-drug-administration-adverse-event-reports-for-the-automated-monitoring-of-electronic-health-records-in-a-pediatric-hospital
#11
Huaxiu Tang, Imre Solti, Eric Kirkendall, Haijun Zhai, Todd Lingren, Jaroslaw Meller, Yizhao Ni
The objective of this study was to determine whether the Food and Drug Administration's Adverse Event Reporting System (FAERS) data set could serve as the basis of automated electronic health record (EHR) monitoring for the adverse drug reaction (ADR) subset of adverse drug events. We retrospectively collected EHR entries for 71 909 pediatric inpatient visits at Cincinnati Children's Hospital Medical Center. Natural language processing (NLP) techniques were used to identify positive diseases/disorders and signs/symptoms (DDSSs) from the patients' clinical narratives...
2017: Biomedical Informatics Insights
https://www.readbyqxmd.com/read/28632576/understanding-the-constipation-conundrum-predictors-of-obtaining-an-abdominal-radiograph-during-the-emergency-department-evaluation-of-pediatric-constipation
#12
Claire A MacGeorge, Daniel C Williams, Natalie Vajta, Kristen Morella, Paul G Thacker, Scott Russell, William T Basco, David G Bundy
OBJECTIVES: Many children with constipation who are evaluated in emergency departments (EDs) receive an abdominal radiograph (AR) despite evidence-based guidelines discouraging imaging. The objectives of this study were to identify predictors associated with obtaining an AR and to determine if ARs were associated with a longer length of stay (LOS) among children with constipation evaluated in the ED. METHODS: A review of billing and electronic health records was conducted in an academic pediatric ED for children ages 0 to 17 years who had a primary discharge diagnosis of constipation from July 2013 to June 2014...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28629687/sensitivity-and-specificity-of-empiric-treatment-for-sexually-transmitted-infections-in-a-pediatric-emergency-department
#13
Kristen Breslin, Lisa Tuchman, Katie L Hayes, Gia Badolato, Monika K Goyal
OBJECTIVE: To determine test characteristics of provider judgment for empiric antibiotic provision to patients undergoing testing for a sexually transmitted infection. STUDY DESIGN: We conducted a retrospective cross-sectional electronic health record review of all patients aged 13-19 years who had Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) testing sent from an urban, academic pediatric emergency department in 2012. We abstracted data, including patient demographics, chief complaint, sexually transmitted infection test results, and treatment...
June 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28625502/a-computable-phenotype-improves-cohort-ascertainment-in-a-pediatric-pulmonary-hypertension-registry
#14
Alon Geva, Jessica L Gronsbell, Tianxi Cai, Tianrun Cai, Shawn N Murphy, Jessica C Lyons, Michelle M Heinz, Marc D Natter, Nandan Patibandla, Jonathan Bickel, Mary P Mullen, Kenneth D Mandl
OBJECTIVES: To compare registry and electronic health record (EHR) data mining approaches for cohort ascertainment in patients with pediatric pulmonary hypertension (PH) in an effort to overcome some of the limitations of registry enrollment alone in identifying patients with particular disease phenotypes. STUDY DESIGN: This study was a single-center retrospective analysis of EHR and registry data at Boston Children's Hospital. The local Informatics for Integrating Biology and the Bedside (i2b2) data warehouse was queried for billing codes, prescriptions, and narrative data related to pediatric PH...
June 15, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28604931/motor-vehicle-crash-risk-among-adolescents-and-young-adults-with-attention-deficit-hyperactivity-disorder
#15
Allison E Curry, Kristina B Metzger, Melissa R Pfeiffer, Michael R Elliott, Flaura K Winston, Thomas J Power
Importance: Attention-deficit/hyperactivity disorder (ADHD) often persists into adolescence, when motor vehicle crash risk peaks. We know little about when adolescents with ADHD get licensed and, once they do, the extent to which they have increased crash risk compared with adolescents without ADHD. Objectives: To examine the association between ADHD and both driver licensing and crash involvement and whether it varies by sex, licensing age, and/or being prescribed ADHD medication at licensure...
June 12, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28603057/prevalence-of-eosinophilic-gastroenteritis-and-colitis-in-a-population-based-study-from-2012-to-2017
#16
Emad Mansoor, Mohannad Abou Saleh, Gregory S Cooper
BACKGROUND & AIMS: Although eosinophilic esophagitis (EoE) has been extensively studied, there have been few epidemiology studies of other eosinophilic gastrointestinal disorders (EGIDs). Using a large, population-based database, we investigated epidemiologic features of eosinophilic gastroenteritis (EoGE), and colitis (EoC) in the United States (US). METHODS: We collected data from a commercial database (Explorys Inc, Cleveland, OH) that provided electronic health records from 26 major integrated US healthcare systems from 1999 to March 2017...
June 8, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28595766/improving-universal-pediatric-lipid-screening
#17
Kathleen DeSantes, Ann Dodge, Jens Eickhoff, Amy L Peterson
OBJECTIVE: To evaluate whether the release of national guidelines, electronic health record (EHR) modifications, and educational initiatives correlated with changes in pediatricians' universal lipid screening practices. STUDY DESIGN: Retrospective review of EHRs in an academic general pediatric practice was performed to measure the prevalence of order placement. A child was "screened" if an order was placed during a well-visit between 9 and 21 years of age. The prevalence of order placement for lipid screens on 22 374 patients from January 2010 to December 2015 was analyzed for date of order and patient age, then compared with timing of guidelines, local educational initiatives, and EHR modifications...
June 5, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28557748/the-next-7-great-achievements-in-pediatric-research
#18
Tina L Cheng, Clifford W Bogue, George J Dover
The "7 Great Achievements in Pediatric Research" campaign noted discoveries in the past 40 years that have improved child and adult health in the United States and around the globe. This article predicts the next 7 great pediatric research advancements, including new immunizations, cancer immunotherapy, genomic discoveries, identification of early antecedents of adult health, impact of specific social-environmental influences on biology and health, quality improvement science, and implementation and dissemination research to reduce global poverty...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28549669/the-iscreen-electronic-diabetes-dashboard-a-tool-to-improve-knowledge-and-implementation-of-clinical-practice-guidelines
#19
Stacy Zahanova, Alexandra Tsouka, Mark R Palmert, Farid H Mahmud
OBJECTIVES: Clinical practice guidelines (CPG) provide evidence-based recommendations for patient care but may not be optimally applied in clinical settings. As a pilot study, we evaluated the impact of a computerized, point-of-care decision support system (CDSS) on guideline knowledge and adherence in our diabetes clinic. METHODS: iSCREEN, a CDSS, integrated with a province-wide electronic health record, was designed based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada...
May 23, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28536719/insulin-bolus-calculator-in-a-pediatric-hospital-safety-and-user-perceptions
#20
Mohammad B Ateya, Ranjit Aiyagari, Colleen Moran, Kanakadurga Singer
BACKGROUND: Insulin dosing in hospitalized pediatric patients is challenging and requires dosing to be matched with the specific clinical and nutritional circumstances. We implemented a customized subcutaneous insulin bolus dose calculator tool integrated with the electronic health record to improve patient care. Here we describe this tool, its utilization and safety, and assess user satisfaction and perceptions of the tool. METHODS: Blood glucose results for all patients who received insulin with and without the calculator tool were compared to assess safety...
May 24, 2017: Applied Clinical Informatics
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