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Epic electronic record

Ferozkhan Jadhakhan, Tom Marshall, Ronan Ryan, Paramjit Gill
BACKGROUND: The risk of chronic kidney disease (CKD) is known to be elevated in patients with diabetes mellitus but the risk of young adults aged 18 to 40 years with impaired glucose tolerance/impaired fasting glucose (IGT/IFG) developing CKD is not well characterised. Furthermore, progression of IGT/IFG to diabetes and subsequent CKD development is not well understood. METHODS: A retrospective cohort study was undertaken using The Health Improvement Network (THIN) database, a large dataset of electronic patient records...
February 26, 2018: BMC Nephrology
Jeffery A Dusek, Kristen H Griffin, Michael D Finch, Rachael L Rivard, David Watson
OBJECTIVES: An important task facing hospitals is improving pain management without raising costs. Integrative medicine (IM), a promising nonpharmacologic pain management strategy, is yet to be examined for its cost implications in an inpatient setting. This institution has had an inpatient IM department for over a decade. The purpose was to examine the relationship between changes in patients' pain, as a result of receiving IM therapy, and total cost of care during an inpatient hospital admission...
February 23, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Judith C Lin, Janelle M Crutchfield, Dana K Zurawski, Courtney Stevens
OBJECTIVE: Using secured videoconferencing technologies, telemedicine may replace traditional clinic visits, save patients' time and travel, and improve use of limited surgeon and facility resources. We report our initial experience of the remote clinical encounter (RCE) by evaluating vascular surgery patients. METHODS: In this proof-of-concept pilot study, we conducted telemedicine evaluations of vascular patients at a tertiary care institution from October 2015 to August 2016...
February 1, 2018: Journal of Vascular Surgery
Anisha Chandiramani, Janet Gervasio, Michelle Johnson, Jessica Kolek, Steven Zibrat, Dana Edelson
BACKGROUND: Safe and efficient inpatient care depends on accurate identification of the licensed independent practitioner (LIP) primarily responsible for each admitted patient. The inability to do so has far-reaching consequences, including poor communication among care teams, delays in patient care (including critical result reporting), and significant threats to patient safety. METHODS: At the University of Chicago Medical Center, an 800-bed academic hospital, a new Epic feature, called First-Contact Provider (FCP), was developed to identify the responsible LIP for each inpatient...
February 2018: Joint Commission Journal on Quality and Patient Safety
James A Reagor
Enterprise electronic medical records (EMR) have largely become a standard since their use was mandated by The American Recovery and Reinvestment Act of 2009. However, perfusion departments have adopted true perfusion EMRs at various rates. In our efforts to integrate with the institutions EMR while enjoying the benefits of an EMR designed specifically for perfusion practice, we developed a discrete data integration solution between Epic and the Spectrum Medical VIPER Perfusion EMR. This report describes our perfusion EMR selection criteria, design challenges, and documentation process...
December 2017: Journal of Extra-corporeal Technology
Nadia Landex
In 2016 the first Danish hospitals adopted "Sundhedsplatformen", the Danish version of the Epic electronic health record. There has been much discussion about the perceived shortcomings of Sundhedsplatformen. This article reviews documents, that the introduction of electronic health records is associated with an increase in time spent on charting and an increase in errors. Even after several years of working with electronic health records physicians may consider themselves less than proficient in the use of the electronic health record...
December 11, 2017: Ugeskrift for Laeger
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
A Jay Holmgren, Julia Adler-Milstein, Jeffrey McCullough
Objective: The federal electronic health record (EHR) certification process was intended to ensure a baseline level of system quality and the ability to support meaningful use criteria. We sought to assess whether there was variation across EHR vendors in the degree to which hospitals using products from those vendors were able to achieve high levels of performance on meaningful use criteria. Materials and Methods: We created a cross-sectional national hospital sample from the Office of the National Coordinator for Health Information Technology EHR Products Used for Meaningful Use Attestation public use file and the Centers for Medicare & Medicaid Services Medicare EHR Incentive Program Eligible Hospitals public use file...
November 24, 2017: Journal of the American Medical Informatics Association: JAMIA
Kevin B Johnson, Jesse M Ehrenfeld
No abstract text is available yet for this article.
November 21, 2017: Journal of Medical Systems
Larissa Grigoryan, Roger Zoorob, Jesal Shah, Haijun Wang, Monisha Arya, Barbara W Trautner
Reducing inappropriate antibiotic prescribing is currently a global health priority. Current guidelines recommend against antibiotic treatment for acute uncomplicated bronchitis. We studied antibiotic prescribing patterns for uncomplicated acute bronchitis and identified predictors of inappropriate antibiotic prescribing. We used the Epic Clarity database (electronic medical record system) to identify all adult patients with acute bronchitis in family medicine clinics from 2011 to 2016. We excluded factors that could justify antibiotic use, such as suspected pneumonia, COPD or immunocompromising conditions...
October 27, 2017: Antibiotics
Ruth A Bush, Cynthia D Connelly, Alexa Pérez, Halsey Barlow, George J Chiang
BACKGROUND: Little is known about the health care utilization patterns of individuals with pediatric autism spectrum disorder (ASD). OBJECTIVES: Electronic health record (EHR) data provide an opportunity to study medical utilization and track outcomes among children with ASD.  Methods: Using a pediatric, tertiary, academic hospital's Epic EHR, search queries were built to identify individuals aged 2-18 with International Classification of Diseases, Ninth Revision (ICD-9) codes, 299...
July 19, 2017: Applied Clinical Informatics
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
Kenneth H Rand, Stacy G Beal, Gloria P Lipori
We studied the relationship between the time of day bacteriology reports were available in the electronic medical record (Epic, Verona, WI) and subsequent length of stay (LOS) following the last report before discharge. All patients ≥18years admitted to the UF Health Shands Hospital between 1/1/2014-2/29/2016 were included. We calculated the mean LOS following the report for each half-hour time period between 6AM and 1PM (N=14, 95.6% of all results) and tested the relationship to subsequent LOS. For patients whose total LOS was ≤168hours (N=13,830) there was a highly significant positive linear relationship between the report time and LOS following the last report (r=0...
November 2017: Diagnostic Microbiology and Infectious Disease
E Charles Osterberg, Nynikka R A Palmer, Catherine R Harris, Gregory P Murphy, Sarah D Blaschko, Carissa Chu, Isabel E Allen, Matthew R Cooperberg, Peter R Carroll, Benjamin N Breyer
PURPOSE: To characterize demographic, disease, and cancer outcomes of men on active surveillance (AS) at a safety-net hospital and characterize those who were lost to follow-up (LTFU). METHODS: From January 2004 to November 2014, 104 men with low-risk prostate cancer (PCa) were followed with AS at Zuckerberg San Francisco General Hospital (ZSFG). Criteria for AS have evolved over time; however, patients with diagnostic prostate-specific antigen (PSA) 10ng/mL or less, clinical stage T1/2, biopsy Gleason score 3 + 3 or 3 + 4, 33% or fewer positive cores, and 50% or less tumor in any single core were potentially eligible for AS...
November 2017: Urologic Oncology
K O Rove, J C Warncke, V M Vemulakonda
BACKGROUND: There is growing interest in the general activities of a pediatric urologist, whose specialty remains young in the spectrum of modern, organized medicine. Unplanned activities, which are more commonly referred to as consultations, can represent significant additional workload for the urologist seeing scheduled clinic patients or completing elective operative cases. OBJECTIVES: This study sought to better understand the practice patterns surrounding inpatient consultations of pediatric urology, and to describe patterns in reasons, timing, patient and service factors that may lead to patient intervention...
August 9, 2017: Journal of Pediatric Urology
Larissa Grigoryan, Roger Zoorob, Haijun Wang, Matthew Horsfield, Kalpana Gupta, Barbara W Trautner
AIMS: There is a lack of evidence on the optimal approach for treating acute cystitis in women with diabetes. We performed an outpatient database study to compare management of women with and without diabetes and to assess the effect of treatment duration on early and late recurrence. METHODS: We used the EPIC Clarity database (electronic medical record system) to identify all female patients aged ≥18years with acute cystitis in two family medicine clinics and a urology department...
July 2017: Diabetes Research and Clinical Practice
James R Martin, Peter Filip, Eric J Thorpe, John P Leonetti
PURPOSE: In this study we review our institution's experience and outcomes with temporal bone resection and parotidectomy in the treatment of advanced parotid malignancies. METHODS: Patients undergoing lateral temporal bone resection and parotidectomy from 2007-2013 were identified in the EPIC electronic medical record. Primary tumor location, staging, surgical procedure, and patient demographic and outcome data were collected retrospectively. RESULTS: Fifteen patients underwent combined temporal bone resection and parotidectomy for parotid malignancy...
July 2017: American Journal of Otolaryngology
Eilon Gabel, Ira S Hofer, Nancy Satou, Tristan Grogan, Richard Shemin, Aman Mahajan, Maxime Cannesson
BACKGROUND: In medical practice today, clinical data registries have become a powerful tool for measuring and driving quality improvement, especially among multicenter projects. Registries face the known problem of trying to create dependable and clear metrics from electronic medical records data, which are typically scattered and often based on unreliable data sources. The Society for Thoracic Surgery (STS) is one such example, and it supports manually collected data by trained clinical staff in an effort to obtain the highest-fidelity data possible...
May 2017: Anesthesia and Analgesia
Zachary A Carter, Shauna Goldman, Kristen Anderson, Xiaxiao Li, Linda S Hynan, Benjamin F Chong, Arturo R Dominguez
Importance: External store-and-forward (SAF) teledermatology systems operate separately from the primary health record and have many limitations, including care fragmentation, inadequate communication among clinicians, and privacy and security concerns, among others. Development of internal SAF workflows within existing electronic health records (EHRs) should be the standard for large health care organizations for delivering high-quality dermatologic care, improving access, and capturing other telemedicine benchmark data...
July 1, 2017: JAMA Dermatology
Brent T Tan, Jennifer Fralick, William Flores, Cary Schrandt, Vicki Davis, Tom Bruynell, Lisa Wilson, John Christopher, Shirley Weber, Neil Shah
Objectives: To provide an account of implementation of the Epic Beaker 2014 clinical pathology module at Stanford University Medical Center and highlight strengths and weaknesses of the system. Methods: Based on a formal selection process, Stanford selected Epic Beaker to replace Sunquest as the clinical laboratory information system (LIS). The rationale included integration between the LIS and already installed Epic electronic medical record (EMR), reduction in the number of systems and interfaces, and positive patient identification (PPID)...
March 1, 2017: American Journal of Clinical Pathology
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