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https://www.readbyqxmd.com/read/29696479/natural-language-processing-accurately-calculates-adenoma-and-sessile-serrated-polyp-detection-rates
#1
Jennifer Nayor, Lawrence F Borges, Sergey Goryachev, Vivian S Gainer, John R Saltzman
BACKGROUND: ADR is a widely used colonoscopy quality indicator. Calculation of ADR is labor-intensive and cumbersome using current electronic medical databases. Natural language processing (NLP) is a method used to extract meaning from unstructured or free text data. AIMS: (1) To develop and validate an accurate automated process for calculation of adenoma detection rate (ADR) and serrated polyp detection rate (SDR) on data stored in widely used electronic health record systems, specifically Epic electronic health record system, Provation® endoscopy reporting system, and Sunquest PowerPath pathology reporting system...
April 26, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29688461/transition-to-a-new-electronic-health-record-and-pediatric-medication-safety-lessons-learned-in-pediatrics-within-a-large-academic-health-system
#2
Kimberly Whalen, Emily Lynch, Iman Moawad, Tanya John, Denise Lozowski, Brian M Cummings
Objective: While the electronic health record (EHR) has become a standard of care, pediatric patients pose a unique set of risks in adult-oriented systems. We describe medication safety and implementation challenges and solutions in the pediatric population of a large academic center transitioning its EHR to Epic. Methods: Examination of the roll-out of a new EHR in a mixed neonatal, pediatric and adult tertiary care center with staggered implementation. We followed the voluntarily reported medication error rate for the neonatal and pediatric subsets and specifically monitored the first 3 months after the roll-out of the new EHR...
April 23, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29610734/extracting-and-utilizing-electronic-health-data-from-epic-for-research
#3
Alex Milinovich, Michael W Kattan
Many institutions would like to harness their electronic health record (EHR) data for research. However, with many EHR systems, this process is remarkably difficult. We have been using our vast EHR system for research very effectively, with substantial research support and many publications. Herein we share our process and provide recommendations for others wanting to utilize their EHR data for research.
February 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29605025/fewer-thromboembolic-events-after-implementation-of-a-venous-thromboembolism-risk-stratification-tool
#4
Florence E Turrentine, Min-Woong Sohn, Susan L Wilson, Crockett Stanley, Wendy Novicoff, Robert G Sawyer, Michael D Williams
BACKGROUND: Deep venous thrombosis and pulmonary embolus are leading preventable causes of death after surgery. Venous thromboembolism (VTE) prophylaxis management guidelines, with evidenced-based recommendations, are available in the literature. However, over 40% of "at-risk" surgical patients fail to receive appropriate VTE prophylaxis. Decision support-based interventions to reduce venous thromboembolic events were explored. METHODS: A venous thromboembolic risk stratification tool embedded in the electronic medical record, Epic, linking risk category to venous thromboembolic prophylaxis order sets was created, implemented, and analyzed for general surgery patients...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29565797/meaningful-use-of-electronic-health-records-for-quality-assessment-and-review-of-clinical-ethics-consultation
#5
Susan Sanelli-Russo, Kelly McBride Folkers, William Sakolsky, Joseph J Fins, Nancy Neveloff Dubler
Evolving practice requires peer review of clinical ethics (CE) consultation for quality assessment and improvement. Many institutions have identified the chart note as the basis for this process, but to our knowledge, electronic health record (EHR) systems are not necessarily designed to easily include CE consultation notes. This article provides a framework for the inclusion of CE consultation notes into the formal EHR, describing a developed system in the Epic EHR that allows for the elaborated electronic notation of the CE chart note...
2018: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/29564849/collaborating-for-competency-a-model-for-single-electronic-health-record-onboarding-for-medical-students-rotating-among-separate-health-systems
#6
Anne G Pereira, Michael Kim, Marcus Seywerd, Brooke Nesbitt, Michael B Pitt
BACKGROUND: Use of the electronic health record (EHR) is widespread in academic medical centers, and hands-on EHR experience in medical school is essential for new residents to be able to meaningfully contribute to patient care. As system-specific EHR training is not portable across institutions-even when the same EHR platform is used-students rotating across health systems are often required to spend time away from clinical training to complete each system's, often duplicative, EHR training regardless of their competency within the EHR...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29482513/risk-of-chronic-kidney-disease-in-young-adults-with-impaired-glucose-tolerance-impaired-fasting-glucose-a-retrospective-cohort-study-using-electronic-primary-care-records
#7
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
https://www.readbyqxmd.com/read/29474095/cost-savings-from-reducing-pain-through-the-delivery-of-integrative-medicine-program-to-hospitalized-patients
#8
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
https://www.readbyqxmd.com/read/29398312/implementation-of-a-virtual-vascular-clinic-with-point-of-care-ultrasound-in-an-integrated-health-care-system
#9
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
https://www.readbyqxmd.com/read/29389459/-who-s-covering-this-patient-developing-a-first-contact-provider-fcp-designation-in-an-electronic-health-record
#10
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
https://www.readbyqxmd.com/read/29302120/a-dedicated-perfusion-electronic-medical-record-with-discrete-epic-integration
#11
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
https://www.readbyqxmd.com/read/29260708/-the-epic-healthcare-system-in-denmark
#12
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
https://www.readbyqxmd.com/read/29226008/variation-in-results-release-and-patient-portal-access-to-diagnostic-test-results-at-an-academic-medical-center
#13
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/29186508/are-all-certified-ehrs-created-equal-assessing-the-relationship-between-ehr-vendor-and-hospital-meaningful-use-performance
#14
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...
June 1, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29164347/an-epic-switch-preparing-for-an-electronic-health-record-transition-at-vanderbilt-university-medical-center
#15
EDITORIAL
Kevin B Johnson, Jesse M Ehrenfeld
No abstract text is available yet for this article.
November 21, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29077003/antibiotic-prescribing-for-uncomplicated-acute-bronchitis-is-highest-in-younger-adults
#16
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
https://www.readbyqxmd.com/read/28925416/extracting-autism-spectrum-disorder-data-from-the-electronic-health-record
#17
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
https://www.readbyqxmd.com/read/28893811/tethered-to-the-ehr-primary-care-physician-workload-assessment-using-ehr-event-log-data-and-time-motion-observations
#18
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
https://www.readbyqxmd.com/read/28888673/relationship-between-bacteriology-report-time-in-the-morning-and-length-of-stay-in-hospital-after-the-report
#19
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
https://www.readbyqxmd.com/read/28826701/outcomes-of-men-on-active-surveillance-for-low-risk-prostate-cancer-at-a-safety-net-hospital
#20
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
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