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Healthcare informatics and health IT

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263 papers 100 to 500 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
https://www.readbyqxmd.com/read/30141213/the-impact-of-clinical-vs-administrative-claims-coding-on-hospital-risk-adjusted-outcomes
#1
Emily C O'Brien, Shuang Li, Laine Thomas, Tracy Y Wang, Matthew T Roe, Eric D Peterson
BACKGROUND: Comorbid condition and hospital risk-adjusted outcomes prevalence were compared based on clinical registry vs administrative claims data. HYPOTHESIS: Risk-adjusted outcomes will vary depending on the source of comorbidity data used. METHODS: Clinical data from hospitalized Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association (ACC/AHA) Guidelines (CRUSADE) non-ST-segment elevation myocardial infarction (NSTEMI) patients ≥65 years was linked to Medicare claims...
September 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29468944/estimating-cost-effectiveness-from-claims-and-registry-data-with-measured-and-unmeasured-confounders
#2
Elizabeth A Handorf, Daniel F Heitjan, Justin E Bekelman, Nandita Mitra
The analysis of observational data to determine the cost-effectiveness of medical treatments is complicated by the need to account for skewness, censoring, and the effects of measured and unmeasured confounders. We quantify cost-effectiveness as the Net Monetary Benefit (NMB), a linear combination of the treatment effects on cost and effectiveness that denominates utility in monetary terms. We propose a parametric estimation approach that describes cost with a Gamma generalized linear model and survival time (the canonical effectiveness variable) with a Weibull accelerated failure time model...
January 1, 2018: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/27189013/opportunities-and-challenges-in-developing-risk-prediction-models-with-electronic-health-records-data-a-systematic-review
#3
REVIEW
Benjamin A Goldstein, Ann Marie Navar, Michael J Pencina, John P A Ioannidis
OBJECTIVE: Electronic health records (EHRs) are an increasingly common data source for clinical risk prediction, presenting both unique analytic opportunities and challenges. We sought to evaluate the current state of EHR based risk prediction modeling through a systematic review of clinical prediction studies using EHR data. METHODS: We searched PubMed for articles that reported on the use of an EHR to develop a risk prediction model from 2009 to 2014. Articles were extracted by two reviewers, and we abstracted information on study design, use of EHR data, model building, and performance from each publication and supplementary documentation...
January 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/27436868/moving-beyond-regression-techniques-in-cardiovascular-risk-prediction-applying-machine-learning-to-address-analytic-challenges
#4
REVIEW
Benjamin A Goldstein, Ann Marie Navar, Rickey E Carter
Risk prediction plays an important role in clinical cardiology research. Traditionally, most risk models have been based on regression models. While useful and robust, these statistical methods are limited to using a small number of predictors which operate in the same way on everyone, and uniformly throughout their range. The purpose of this review is to illustrate the use of machine-learning methods for development of risk prediction models. Typically presented as black box approaches, most machine-learning methods are aimed at solving particular challenges that arise in data analysis that are not well addressed by typical regression approaches...
June 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/27732706/risk-prediction-with-electronic-health-records-the-importance-of-model-validation-and-clinical-context
#5
Benjamin A Goldstein, Ann Marie Navar, Michael J Pencina
No abstract text is available yet for this article.
December 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/28687707/validity-of-cardiovascular-data-from-electronic-sources-the-multi-ethnic-study-of-atherosclerosis-and-healthlnk
#6
Faraz S Ahmad, Cheeling Chan, Marc B Rosenman, Wendy S Post, Daniel G Fort, Philip Greenland, Kiang J Liu, Abel N Kho, Norrina B Allen
BACKGROUND: Understanding the validity of data from electronic data research networks is critical to national research initiatives and learning healthcare systems for cardiovascular care. Our goal was to evaluate the degree of agreement of electronic data research networks in comparison with data collected by standardized research approaches in a cohort study. METHODS: We linked individual-level data from MESA (Multi-Ethnic Study of Atherosclerosis), a community-based cohort, with HealthLNK, a 2006 to 2012 database of electronic health records from 6 Chicago health systems...
September 26, 2017: Circulation
https://www.readbyqxmd.com/read/29324567/electronic-health-record-implementation-findings-at-a-large-suburban-health-and-human-services-department
#7
Kenyon Crowley, Anubhuti Mishra, Raul Cruz-Cano, Robert Gold, Dushanka Kleinman, Ritu Agarwal
OBJECTIVE: Evaluate an electronic health record (EHR) implementation across a large public health department to better understand and improve implementation effectiveness of EHRs in public health departments. DESIGN: A survey based on Consolidated Framework for Implementation Research constructs was administered to staff before and after implementation of an EHR. SETTING: Large suburban county department of health and human services that provides clinical, behavioral, social, and oral health services...
January 10, 2018: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/29295146/a-validated-risk-model-for-30-day-readmission-for-heart-failure
#8
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
https://www.readbyqxmd.com/read/27869584/the-melbourne-east-monash-general-practice-database-magnet-using-data-from-computerised-medical-records-to-create-a-platform-for-primary-care-and-health-services-research
#9
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
https://www.readbyqxmd.com/read/27864833/structured-clinical-documentation-in-the-electronic-medical-record-to-improve-quality-and-to-support-practice-based-research-in-epilepsy
#10
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
https://www.readbyqxmd.com/read/27864915/identification-of-emergency-department-visits-in-medicare-administrative-claims-approaches-and-implications
#11
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
https://www.readbyqxmd.com/read/27865473/automated-data-extraction-merging-clinical-care-with-real-time-cohort-specific-research-and-quality-improvement-data
#12
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
https://www.readbyqxmd.com/read/27872036/challenges-and-opportunities-of-big-data-in-health-care-a-systematic-review
#13
REVIEW
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
https://www.readbyqxmd.com/read/27375290/use-of-electronic-healthcare-records-to-identify-complex-patients-with-atrial-fibrillation-for-targeted-intervention
#14
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
https://www.readbyqxmd.com/read/27332198/the-nursing-informatician-s-role-in-mediating-technology-related-health-literacies
#15
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
https://www.readbyqxmd.com/read/27301747/electronic-tools-to-support-medication-reconciliation-a-systematic-review
#16
REVIEW
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
https://www.readbyqxmd.com/read/27107442/quality-improvement-teams-super-users-and-nurse-champions-a-recipe-for-meaningful-use
#17
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
https://www.readbyqxmd.com/read/26893950/clinical-alarms-in-intensive-care-units-perceived-obstacles-of-alarm-management-and-alarm-fatigue-in-nurses
#18
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
https://www.readbyqxmd.com/read/25801714/the-mobile-revolution-using-smartphone-apps-to-prevent-cardiovascular-disease
#19
REVIEW
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
https://www.readbyqxmd.com/read/25784238/using-an-electronic-medical-record-emr-to-conduct-clinical-trials-salford-lung-study-feasibility
#20
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
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