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Healthcare informatics and health IT

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256 papers 25 to 100 followers Healthcare information technology, analytics, big data, mHealth, EHRs/EMRs, meaningful use
By Jamie Jarmul Md / PhD student at UNC - Chapel Hill, PhD in Health Policy and Management
Satish M Mahajan, Prabir Burman, Ana Newton, Paul A Heidenreich
One of the goals of the Precision Medicine Initiative launched in the United States in 2016 is to use innovative tools and sources in data science. We realized this goal by implementing a use case that identified patients with heart failure at Veterans Health Administration using data from the Electronic Health Records from multiple health domains between 2005 and 2013. We applied a regularized logistic regression model and predicted 30-day readmission risk for 1210 unique patients. Our validation cohort resulted in a C-statistic of 0...
2017: Studies in Health Technology and Informatics
Danielle Mazza, Christopher Pearce, Lyle Robert Turner, Maria De Leon-Santiago, Adam McLeod, Jason Ferriggi, Marianne Shearer
The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET) research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices...
July 4, 2016: Journal of Innovation in Health Informatics
Jaishree Narayanan, Sofia Dobrin, Janet Choi, Susan Rubin, Anna Pham, Vimal Patel, Roberta Frigerio, Darryck Maurer, Payal Gupta, Lourdes Link, Shaun Walters, Chi Wang, Yuan Ji, Demetrius M Maraganore
OBJECTIVE: Using the electronic medical record (EMR) to capture structured clinical data at the point of care would be a practical way to support quality improvement and practice-based research in epilepsy. METHODS: We describe our stepwise process for building structured clinical documentation support tools in the EMR that define best practices in epilepsy, and we describe how we incorporated these toolkits into our clinical workflow. RESULTS: These tools write notes and capture hundreds of fields of data including several score tests: Generalized Anxiety Disorder-7 items, Neurological Disorders Depression Inventory for Epilepsy, Epworth Sleepiness Scale, Quality of Life in Epilepsy-10 items, Montreal Cognitive Assessment/Short Test of Mental Status, and Medical Research Council Prognostic Index...
January 2017: Epilepsia
Arjun K Venkatesh, Hao Mei, Keith E Kocher, Michael Granovsky, Ziad Obermeyer, Erica S Spatz, Craig Rothenberg, Harlan M Krumholz, Zhenqui Lin
OBJECTIVES: Administrative claims data sets are often used for emergency care research and policy investigations of healthcare resource utilization, acute care practices, and evaluation of quality improvement interventions. Despite the high profile of emergency department (ED) visits in analyses using administrative claims, little work has evaluated the degree to which existing definitions based on claims data accurately captures conventionally defined hospital-based ED services. We sought to construct an operational definition for ED visitation using a comprehensive Medicare data set and to compare this definition to existing operational definitions used by researchers and policymakers...
April 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Ferdynand Hebal, Elizabeth Nanney, Christine Stake, M L Miller, George Lales, Katherine A Barsness
BACKGROUND/PURPOSE: Although prohibitively labor intensive, manual data extraction (MDE) is the prevailing method used to obtain clinical research and quality improvement (QI) data. Automated data extraction (ADE) offers a powerful alternative. The purposes of this study were to 1) assess the feasibility of ADE from provider-authored outpatient documentation, and 2) evaluate the effectiveness of ADE compared to MDE. METHODS: A prospective collection of data was performed on 90 ADE-templated notes (N=71 patients) evaluated in our bowel management clinic...
January 2017: Journal of Pediatric Surgery
Clemens Scott Kruse, Rishi Goswamy, Yesha Raval, Sarah Marawi
BACKGROUND: Big data analytics offers promise in many business sectors, and health care is looking at big data to provide answers to many age-related issues, particularly dementia and chronic disease management. OBJECTIVE: The purpose of this review was to summarize the challenges faced by big data analytics and the opportunities that big data opens in health care. METHODS: A total of 3 searches were performed for publications between January 1, 2010 and January 1, 2016 (PubMed/MEDLINE, CINAHL, and Google Scholar), and an assessment was made on content germane to big data in health care...
November 21, 2016: JMIR Medical Informatics
Shirley V Wang, James R Rogers, Yinzhu Jin, David W Bates, Michael A Fischer
Background: Practice guidelines recommend anticoagulation therapy for patients with atrial fibrillation (AF) who have other risk factors putting them at an elevated risk of stroke. These patients remain undertreated, but, with increasing use of electronic healthcare records (EHRs), it may be possible to identify candidates for treatment. Objective: To test algorithms for identifying AF patients who also have known risk factors for stroke and major bleeding using EHR data...
March 1, 2017: Journal of the American Medical Informatics Association: JAMIA
Ramona Nelson, Heather D Carter-Templeton
The advent of computer based technology and the internet have not changed nurses' responsibility for patient education; but they are rapidly changing what we teach and how we teach. The challenge for nursing informaticians is to create innovative patient education models and applications with the goal of achieving literate, engaged, empowered and informed patients as well as preparing health professionals to maximize the advantages offered by digital media and other new technology based tools. This paper explores the interrelationship of basic literacy, health literacy and technology related literacies that provide the foundation for achieving these goals...
2016: Studies in Health Technology and Informatics
Sophie Marien, Bruno Krug, Anne Spinewine
OBJECTIVES: Medication reconciliation (MedRec) is essential for reducing patient harm caused by medication discrepancies across care transitions. Electronic support has been described as a promising approach to moving MedRec forward. We systematically reviewed the evidence about electronic tools that support MedRec, by (a) identifying tools; (b) summarizing their characteristics with regard to context, tool, implementation, and evaluation; and (c) summarizing key messages for successful development and implementation...
January 2017: Journal of the American Medical Informatics Association: JAMIA
Christopher M Shea, Kristin L Reiter, Mark A Weaver, Jordan Albritton
OBJECTIVE: This study assessed whether having an electronic health record (EHR) super-user, nurse champion for meaningful use (MU), and quality improvement (QI) team leading MU implementation is positively associated with MU Stage 1 demonstration. METHODS: Data on MU demonstration of 596 providers in 37 ambulatory care clinics came from the clinical data warehouse and administrative systems of UNC Health Care. We surveyed the 37 clinics about champions, super-users, and QI teams...
November 2016: Journal of the American Medical Informatics Association: JAMIA
Ok Min Cho, Hwasoon Kim, Young Whee Lee, Insook Cho
OBJECTIVES: The purpose of this descriptive study was to investigate the current situation of clinical alarms in intensive care unit (ICU), nurses' recognition of and fatigue in relation to clinical alarms, and obstacles in alarm management. METHODS: Subjects were ICU nurses and devices from 48 critically ill patient cases. Data were collected through direct observation of alarm occurrence and questionnaires that were completed by the ICU nurses. The observation time unit was one hour block...
January 2016: Healthcare Informatics Research
Lis Neubeck, Nicole Lowres, Emelia J Benjamin, S Ben Freedman, Genevieve Coorey, Julie Redfern
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. Mobile technology might enable increased access to effective prevention of CVDs. Given the high penetration of smartphones into groups with low socioeconomic status, health-related mobile applications might provide an opportunity to overcome traditional barriers to cardiac rehabilitation access. The huge increase in low-cost health-related apps that are not regulated by health-care policy makers raises three important areas of interest...
June 2015: Nature Reviews. Cardiology
Hanaa F Elkhenini, Kourtney J Davis, Norman D Stein, John P New, Mark R Delderfield, Martin Gibson, Jorgen Vestbo, Ashley Woodcock, Nawar Diar Bakerly
BACKGROUND: Real-world data on the benefit/risk profile of medicines is needed, particularly in patients who are ineligible for randomised controlled trials conducted for registration purposes. This paper describes the methodology and source data verification which enables the conduct of pre-licensing clinical trials of COPD and asthma in the community using the electronic medical record (EMR), NorthWest EHealth linked database (NWEH-LDB) and alert systems. METHODS: Dual verification of extracts into NWEH-LDB was performed using two independent data sources (Salford Integrated Record [SIR] and Apollo database) from one primary care practice in Salford (N = 3504)...
December 2015: BMC Medical Informatics and Decision Making
Matthew D Krasowski, Deborah Chudzik, Anna Dolezal, Bryan Steussy, Michael P Gailey, Benjamin Koch, Sara B Kilborn, Benjamin W Darbro, Carolyn D Rysgaard, Julia A Klesney-Tait
This case study over time describes five years of experience with interventions to improve laboratory test utilization at an academic medical center. The high-frequency laboratory tests showing the biggest declines in order volume post intervention were serum albumin (36%) and erythrocyte sedimentation rate (17%). Introduction of restrictions for 170 high-cost send-out tests resulted in a 23% decline in order volume. Targeted interventions reduced mis-orders involving several "look-alike" tests: 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D; manganese, magnesium; beta-2-glycoprotein, beta-2-microglobulin...
December 2015: BMC Medical Informatics and Decision Making
Gregory L Alexander
No abstract text is available yet for this article.
July 2015: Western Journal of Nursing Research
Paolo Fraccaro, Mercedes Arguello Casteleiro, John Ainsworth, Iain Buchan
BACKGROUND: Patients with multiple conditions have complex needs and are increasing in number as populations age. This multimorbidity is one of the greatest challenges facing health care. Having more than 1 condition generates (1) interactions between pathologies, (2) duplication of tests, (3) difficulties in adhering to often conflicting clinical practice guidelines, (4) obstacles in the continuity of care, (5) confusing self-management information, and (6) medication errors. In this context, clinical decision support (CDS) systems need to be able to handle realistic complexity and minimize iatrogenic risks...
January 7, 2015: JMIR Medical Informatics
Jonathan T Carter
Widespread adoption of electronic medical records (EMRs) in the United States is transforming the practice of medicine from a paper-based cottage industry into an integrated health care delivery system. Most physicians and institutions view the widespread use of EMRs to be inevitable. But the transformation has not been painless. Many have questioned whether the substantial investment in electronic health records has really been justified by improved patient outcomes or quality of care. This article describes historical and recent efforts to use EMRs to improve the quality of patient care, and provides a roadmap of EMR uses for the foreseeable future...
April 2015: Neurosurgery Clinics of North America
Lisa J Herrinton, Liyan Liu, Andrea Altschuler, Richard Dell, Violeta Rabrenovich, Amy L Compton-Phillips
The cost to build and to maintain traditional registries for many dire, complex, low-frequency conditions is prohibitive. The authors used accessible technology to develop a platform that would generate miniregistries (small, routinely updated datasets) for surveillance, to identify patients who were missing elected utilization and to influence clinicians to change practices to improve care. The platform, tested in 5 medical specialty departments, enabled the specialists to rapidly and effectively communicate clinical questions, knowledge of disease, clinical workflows, and improve opportunities...
2015: Permanente Journal
Marc-Oliver Wright, Ari Robicsek
Clinical decision support (CDS) systems are an increasingly used form of technology designed to guide health care providers toward established protocols and best practices with the intent of improving patient care. Utilization of CDS for infection prevention is not widespread and is particularly focused on antimicrobial stewardship. This article provides an overview of CDS systems and summarizes key attributes of successfully executed tools. A selection of published reports of CDS for infection prevention and antimicrobial stewardship are described...
June 2015: American Journal of Infection Control
Hege K Andreassen, Lars Erik Kjekshus, Aksel Tjora
From twenty years of information and communication technology (ICT) projects in the health sector, we have learned one thing: most projects remain projects. The problem of pilotism in e-health and telemedicine is a growing concern, both in medical literature and among policy makers, who now ask for large-scale implementation of ICT in routine health service delivery. In this article, we turn the question of failing projects upside down. Instead of investigating the obstacles to implementing ICT and realising permanent changes in health care routines, we ask what makes the temporary ICT project survive, despite an apparent lack of success...
May 2015: Social Science & Medicine
2015-03-27 03:00:04
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