Continuity of care is a cornerstone of primary care and is important for patients with chronic diseases such as diabetes. The study objective was to examine patient, provider and contextual factors associated with interpersonal continuity of care (ICoC) among Veterans Health Administration (VHA) primary care patients with diabetes. This patient-level cohort study (N = 656,368) used electronic health record data of adult, pharmaceutically treated patients (96.5% male) with diabetes at national VHA primary care clinics in 2012 and 2013. Each patient was assigned a
Paper Health Services Research Utilizing Electronic Health Record Data: A Grad Student How-To Paper Ashley W. Collinsworth, ScD, MPH, Baylor Scott & White Health and Tulane University School
TY - JOUR. T1 - Evaluating Delivery of Low Tidal Volume Ventilation in Six ICUs Using Electronic Health Record Data. AU - Sjoding, Michael W.. AU - Gong, Michelle N.. AU - Haas, Carl F.. AU - Iwashyna, Theodore J.. N1 - Funding Information: versions of this article on the journals website (http://journals.lww.com/tions appear in the printed text and are provided in the HTML and PDF Invasive mechanical ventilation with low tidal volumes is ccmjournal). the standard of care for patients with the acute respiratory Supported, in part, by grants to Dr. Sjoding from the National Heart, Lung, distress syndrome (ARDS) (1-3) and may be beneficial to and Blood Institute K01HL136687 and Dr. Iwashyna from the Department other patients receiving mechanical ventilation (4, 5). How-IIR 13-079. This work does not necessarily represent the views of the of Veterans Affairs Health Services Research & Development Services - ever, multiple recent studies have demonstrated that patients U.S. Government or Department ...
The U.S. Food and Drug Administration (FDA) is encouraging great use of electronic health record data to supplement the traditional randomized clinical trials. But you need to use care. Here is some guidance on what the FDA is recommending to industry.. ...
Electronic Health Record Data Show Concerns Continue Over Injury Claims - read this article along with other careers information, tips and advice on BioSpace
Building Evidence to Prevent Childhood Obesity | Use of Electronic Health Record Data to Study the Association of Sugary Drink Consumption With Child Weight Status
The Rise of Electronic Health Record Adoption Among Family Physicians. Imam M. Xierali , and colleagues Background Electronic health records (EHRs) are generally expected to improve the quality of health care, lower health care costs, and provide patients with more involvement in their own health care. Achieving these benefits, however, depends on clinicians use of the technology. This study estimates uptake of EHRs by US family physicians and other outpatient doctors, and looks at EHR adoption by state. What This Study Found Adoption of electronic health records by family physicians has doubled since 2005, reaching 68 percent nationally in 2011. Family physicians are adopting electronic health records at a higher rate than other office-based physicians and are likely to exceed 80 percent penetration by 2013 if the current trend continues. State-level analysis, however, indicates significant variation in EHR adoption, from a low of 44 percent in North Carolina to a high of 88 percent in Hawaii, ...
There is limited experience and methods for extractions of drug therapy data from electronic health records (EHR) in the hospital setting. We have therefore developed and evaluated completeness and consistency of an automatic versus a semi-automatic extraction procedure applied on prescribing and administration of the TNF inhibitor infliximab using a hospital EHR system in Karolinska University Hospital, Sweden. Using two different extraction methods (automatic and semi-automatic), all administered infusions of infliximab between 2007 and 2010 were extracted from a database linked to the EHR system. Extracted data included encrypted personal identity number (PIN), date of birth, sex, time of prescription/administration, healthcare units, prescribed/administered dose and time of admission/discharge. The primary diagnosis (ICD-10) for the treatment with infliximab was extracted by linking infliximab infusions to their corresponding treatment episode. A total of 13,590 infusions of infliximab were ...
The overall goal of this work was to identify data elements that are needed for site feasibility analysis in clinical studies and are at the same time commonly documented in European EHR systems. The heat map was created to determine the availability across the data provider sites. The coloring of each cell was considered a good means to give an overview of how frequently each element is documented and especially, highlight those which are generally not used. Widely available data elements are from data groups demographics, diagnosis, procedures and laboratory findings. Under-documented elements are those captured in the wish list which are from the groups scores and classifications and medical history. We chose to use own groups instead of using Weng et al./Luo et al.s [12, 13] semantic classes, because our focus was not only on clinical trials, but also on EHRs. With the data groups, we also wanted to indicate where data could be found in EHRs. For example, procedures are used in Europe for ...
The ASE definition was initially developed as part of a 2017 multicenter study of the burden of sepsis in the USA and applied across a nationally representative cohort of 409 diverse hospitals from seven datasets.19 This study yielded a sepsis prevalence rate of 6% in hospitalised adult patients and an in-hospital mortality rate of 15%; when extrapolated nationwide, this generated an estimated 1.7 million adult sepsis cases and 270 000 associated deaths. On medical record reviews, ASE criteria had reasonable sensitivity (69.7%) and good specificity (98.1%) compared with the clinical Sepsis-3 definition. Many of the false positives and false negatives, however, were due to intentional mismatches between the ASE organ dysfunction criteria and the SOFA score used by the Sepsis-3 definition, as the ASE criteria were designed to simplify the number of data elements to facilitate consistent implementation across different EHR systems (eg, by identifying respiratory failure by mechanical ventilation ...
The best algorithm for ascertainment of diabetes cases overall was billing data. The best type 1 algorithm was the ratio of the number of type 1 billing codes to the sum of type 1 and type 2 billing codes ≥0.5. A useful algorithm to ascertain type 2 youth with other race/ethnicity was identified. Considerable age and racial/ethnic differences were present in type-non-specific and type 2 algorithms ...
One of PCORIs goals is to improve the methods that researchers use for patient-centered outcomes research. PCORI funds methods projects like this one to better understand and advance the use of research methods that improve the strength and quality of comparative effectiveness research. This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
Health surveys (HS) are a well-established methodology for measuring the health status of a population. The relative merit of using information based on HS versus electronic health records (EHR) to measure multimorbidity has not been established. Our study had two objectives: 1) to measure and compare the prevalence and distribution of multimorbidity in HS and EHR data, and 2) to test specific hypotheses about potential differences between HS and EHR reporting of diseases with a symptoms-based diagnosis and those requiring diagnostic testing. Cross-sectional study using data from a periodic HS conducted by the Catalan government and from EHR covering 80% of the Catalan population aged 15 years and older. We determined the prevalence of 27 selected health conditions in both data sources, calculated the prevalence and distribution of multimorbidity (defined as the presence of ≥2 of the selected conditions), and determined multimorbidity patterns. We tested two hypotheses: a) health conditions requiring
Boston Strategic Partners, Inc. is utilizing its extensive experience with Health Economics and Outcomes Research (HEOR) and big data to provide in-depth analysis of hospital treated sepsis.. In 2014, US healthcare spending exceeded $3.0 trillion with nearly 1/3 spent on hospitalizations. BSPs real-world data report, Hospital Treated Sepsis, estimates 30% of all hospital discharges involve treatment of infectious organisms. Sepsis is responsible for an estimated 12% of all hospital stays. At an average cost of $15,500 per occurrence, we estimate that hospitalizations for severe infections account for $212 billion in annual spending or 7% of total healthcare expenditure. In this report, we conduct an in-depth analysis of sepsis patient characteristics, medication management, costs, and laboratory testing.. Gram-positive bacteria are the likely causative agents of most sepsis infections. Physicians treat the vast majority of these infections with vancomycin, piperacillin-tazobactam, ...
(PRWEB) September 14 2017 Boston Strategic Partners Inc. (BSP) a life-sciences and healthcare consulting firm is utilizing its extensive experience with Health Econ,Boston,Strategic,Partners,,Inc.,is,Utilizing,Electronic,Health,Record,Data,to,Analyze,Hospital,Treated,Pneumonia,biological,advanced biology technology,biology laboratory technology,biology device technology,latest biology technology
|jats:p|Background: The novel coronavirus disease 2019 (COVID-19) outbreak presents a significant threat to global health. A better understanding of patient clinical profiles is essential to drive efficient and timely health service strategies. In this study, we aimed to identify risk factors for a higher susceptibility to symptomatic presentation with COVID-19 and a transition to severe disease. Methods: We analysed data on 2756 patients admitted to Chelsea & Westminster Hospital NHS Foundation Trust between 1st January and 23rd April 2020. We compared differences in characteristics between patients designated positive for COVID-19 and patients designated negative on hospitalisation and derived a multivariable logistic regression model to identify risk factors for predicting risk of symptomatic COVID-19. For patients with COVID-19, we used univariable and multivariable logistic regression to identify risk factors associated with progression to severe disease defined by: 1) admission to the
PDF , Accepted Manuscript. This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication.. Download (306.4KB) ...
FORT WASHINGTON, PA--(Marketwired - September 07, 2016) - Although diffuse large B-cell lymphoma (DLBCL) is a curable disease in most patients aged 65 years or older, these patients are also at higher risk of chemotherapy-related death within the first 30 days of treatment.To quantify the risk of early fatality and...
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TY - GEN. T1 - Analysis of metrics for the usability evaluation of electronic health record systems. AU - Kopanitsa, Georgy. AU - Tsvetkova, Zhanna. AU - Veseli, Hasan. PY - 2012. Y1 - 2012. N2 - Electronic health records are gradually replacing conventional paper-based health records. For a doctor, it is a working instrument, which can significantly reduce the time spent on paper work. At the same time, patients can benefit from accessing the electronic health records even though they usually do not have a medical background. Therefore, when specifying a graphical user interface (GUI) it is necessary to take into account the requirements of the different users: e.g. the functionality for the doctors and the presentation of data in an understandable manner for the patients. The study aims to review and analyze metrics used to evaluate the usability of user interfaces in health information systems. A literature review was performed to identify existing metrics. The scope of the search included ...
Diagnostic codes from electronic health records are widely used to assess patterns of disease. Infective endocarditis is an uncommon but serious infection, with objective diagnostic criteria. Electronic health records have been used to explore the impact of changing guidance on antibiotic prophylaxis for dental procedures on incidence, but limited data on the accuracy of the diagnostic codes exists. Endocarditis was used as a clinically relevant case study to investigate the relationship between clinical cases and diagnostic codes, to understand discrepancies and to improve design of future studies. Electronic health record data from two UK tertiary care centres were linked with data from a prospectively collected clinical endocarditis service database (Leeds Teaching Hospital) or retrospective clinical audit and microbiology laboratory blood culture results (Oxford University Hospitals Trust). The relationship between diagnostic codes for endocarditis and confirmed clinical cases according to the
1.An 86-year-old male parishioner is on hospice care at home, and his daughter, who is a nurse, has been trying to meet all his physical needs around the clock. The pastor, who made a home visit, calls the faith community nurse to express his concern that the daughter is becoming burned out. How can the faith community nurse engage the faith community as a whole to provide volunteer support to this family?. 2.After reading the article,Transforming and Improving Health Care through Meaningful Use of Health Information Technology, discuss how meaningful use of data from electronic health records can be used to improve population health. Have you seen connections between data collection gathered from electronic health records and how you care for patients? Finally, reflect on your nursing experiences to an incidence where the electronic health record improved patient outcomes. How was the electronic health record used to improve outcomes? What negative impact have you seen using the electronic ...
Building a Software Pipeline for Developing and Evaluating Time-Series Machine Learning Models Using Electronic Health Record Data ...
The Department of Health & Human Services Office of the National Coordinator for Health Information Technology (ONC) released a data brief titled Electronic Health Record Adoption and Interoperability among U.S. Skilled Nursing Facilities in 2017. The brief examines the state of health IT use among home health agencies (HHAs) and skilled nursing facilities (SNFs) in 2017. Specifically, it presents key measures on electronic health record (EHR) adoption and interoperability from nationally representative surveys of SNFs and HHAs and describes variations in interoperability and the extent to which these facilities have information electronically available at the point of care.. High level findings include:. ...
TY - JOUR. T1 - Evidence for electronic health record systems in physical therapy. AU - Vreeman, Daniel J.. AU - Taggard, Samuel L.. AU - Rhine, Michael D.. AU - Worrell, Teddy W.. PY - 2006/3. Y1 - 2006/3. N2 - With increasing pressures to better manage clinical information, we investigated the role of electronic health record (EHR) systems in physical therapist practice through a critical review of the literature. We reviewed studies that met our predefined criteria after independent review by 3 authors. The investigators in all of the reviewed studies reported benefits, including improved reporting, operational efficiency, interdepartmental communication, data accuracy, and capability for future research. In 7 studies, the investigators reported barriers, including challenges with behavior modification, equipment inadequacy, and training. The investigators in all studies reported key success factors, including end-user participation, adequate training, workflow analysis, and data ...
HL7 is an organization that was founded in 1987 to set international standards for how health information is exchanged between information systems. It expanded its scope beyond data interchange to include specifications for EHR system functions through its Electronic Health Record Technical Committee. The Electronic Health Record Technical Committee, which was founded in 2001, published its first balloted standard for EHR system functions in 2004.34 This standard is being used as the basis for the EHR system certification process specified by the federal Office of the National Coordinator for Health Information Technology (created by Executive Order 13335, April 28, 2004, and authorized by Congress [FR Doc No. 05-16446, Filed August 18, 2005]). The purpose of certification is to set a minimum level of functionality that EHR systems will have to meet to qualify for special treatment, such as participation in pay-for-performance programs.35,36 By contract with the Office of the National ...
Design of a cluster-randomized trial of electronic health record-based tools to address overweight and obesity in primary care. Clin Trials. 2015 Aug; 12(4):374-83 ...
Allen-Ramey et al. Allergy, Asthma & Clinical Immunology 2013, 9:27 ALLERGY, ASTHMA & CLINICAL IMMUNOLOGY RESEARCH Open Access Electronic health record-based assessment of oral corticosteroid use in a
Principles of electronic health records and information systems theory and life cycle. Course work covers development, implementation, and management of electronic health records (EHR) systems, including the following topics: challenges to EHR adoption; EHR goal setting and impact on quality; strategic planning for the EHR migration path; health care process assessment; assessment of functional needs, data infrastructure, and information technology and systems infrastructure; analysis of return on investment for EHR expenditures; EHR selection and contract negotiation; EHR project management; EHR system implementation and ongoing maintenance; acute care EHR applications; and the growing momentum toward health information exchange. 3 Credits (3 Lecture) Prerequisite(s): HIT310. As needed.. ...
In order to achieve a learning health care system in which quality and effectiveness of health care are improved as costs are lowered, leveraging electronic health record data for purposes beyond treatment and payment will need to become easier and more widespread. This paper explores the current legal and policy challenges associated with secondary use of electronic clinical data, including those inherently relying on Institutional Review Board (IRB) review, and discusses a number of strategies that early health IT-adopters have employed to address them. The paper closes by noting potential changes to federal research rules that could ease restrictions on research in the future and by raising one additional policy challenge - support for health services research infrastructure - that, if unresolved, could create obstacles to further progress. ...
Training is a critical part of health information technology implementations, but little emphasis is placed on post-implementation training to support day-to-day activities. The goal of this study was to evaluate the impact of post-implementation training on key electronic health record activities. Based on feedback from providers and requests for technical support, we developed two classes designed to improve providers effectiveness with the electronic health record. Training took place at Kaiser Permanente, Mid-Atlantic States. The classes focused on managing patient-level information using problem lists and medication lists, as well as efficient documentation and chart review. Both classes used the blended learning method, integrating concrete scenarios, hands-on exercises and take-home materials to reinforce class concepts. To evaluate training effectiveness, we used a case-control study with a 1:4 match on pre-training performance. We measured the usage rate of two key electronic health record
The Principal Investigator (Efrain Riveros-Perez, [email protected]) was responsible for the conduct of this study, including overseeing participant confidentiality, executing the Data and Safety Monitoring (DSM) plan, and complying with all reporting requirements to local and federal authorities. Since this is a database study uses already existing electronic health record data and does not involve direct patient care, we believe that a DSM Board is not needed. The only patient rights issue is maintaining confidentiality of the data. The data was abstracted from each patients electronic health record using their name and medical record number (MRN). The patient name and MRN was replaced by a patient study number for use in the analysis file. A separate file was used to maintain linking patient name and MRN with the patient study number. The analysis file might contain limited PHI information, such as dates of hospitalization. ...
Health care data is a sensitive and highly personal collection of information that requires strong protection. However, in order to derive true value from electronic health records, this information needs to be readily available to providers, facilities, and even patients and their families to positively impact care quality, accuracy and cost. The Smart Card Alliance has released a report detailing the criteria for meaningful use of electronic health records and how health care providers can attain it. The report outlines various ways smart card-based systems can better position health care organizations and providers, while addressing many of the security and privacy challenges that come with electronic health records and health data exchange.. To view the full report click here.. ...
The Mohawk Valley Health System is moving toward a single electronic health record to replace the five it currently uses. A single electronic health record will let its health care providers see medical records and test results from other health care providers. At the moment, the clashing records can interfere with the goal of providing patients a seamless transition as they move between hospitals, primary care doctor offices, specialist practices and different medical testing services.
The Agency for Healthcare Research and Quality (AHRQ) has issued two new health care patient safety primers: 1) electronic health records; and 2) individual clinician performance. On electronic health records, AHRQ noted that the transition to this new way of recording and communicating health care information has also introduced new opportunities for error and other unanticipated consequences that can present safety risks. On individual clinician performance, AHRQ noted that individual clinician performance issues may relate to technical competence to perform specific tasks or procedures necessary to provide safe patient care. Alternatively, a clinician may be technically proficient-or even outstanding-but provide unsafe care for a variety of other reasons, including poor communication skills, lack of professionalism, or medical or mental health conditions. To read the AHRQ patient safety primer on electronic health records, use the first link below. To read the AHRQ patient safety primer on ...
Driven by major federal investments in health information technology over the last several years, hospitals, physicians and other providers have made significant strides in the adoption of Health Information Technology (HIT).
On June 5th, 2017 the VA Secretary at the time, Dr. David Shulkin, announced that the Veterans Affairs (VA) Health Care System would transition from Vista based electronic health record CPRS to Cerner Millennium by MHS GENESIS. This will be the largest implementation of an electronic health record system ever at 10 billion dollars over the next 10 years. The two primary reasons for the switch are that VistA is over 20 years old and there is a need for modernization and the Department of Defense (DOD) has already moved to the Cerner System. Having the VA and DOD on the same EHR would allow a Veterans complete and accurate health record in a single common EHR. From Dr. Shulkin While we have established interoperability between VA and DOD for key aspects of the health record, seamless care is fundamentally constrained by ever-changing information sharing standards, separate chains of command, complex governance, separate implementation schedules that must be coordinated to accommodate those ...
Electronic health record (EHR) data repositories contain large volumes of aggregated, longitudinal clinical data that could allow patient safety researchers to identify important safety issues and conduct comprehensive evaluations of health care delivery outcomes. However, few health systems have successfully converted this abundance of data into useful information or knowledge for safety improvement. In this paper, we use a case study involving a project on missed/delayed follow-up of test results to discuss real-world challenges in using EHR data for patient safety research. We identify three types of challenges that pose as barriers to advance patient safety improvement research: 1) gaining approval to access/review EHR data; 2) interpreting EHR data; 3) working with local IT/EHR personnel. We discuss the complexity of these challenges, all of which are unlikely to be unique to this project, and outline some key next steps that must be taken to support research that uses EHR data to improve safety.
The Health Information Technology for Economic and Clinical Health (HITECH) Act established Electronic Health Record (EHR) programs. These programs provide incentive payments for-and later are expected to apply penalties to-certain providers, such as hospitals and professionals, to encourage them to demonstrate meaningful use of certified EHR technology and meet other program requirements.. Based on the number of providers awarded incentive payments, participation in the Department of Health and Human Services (HHS) Medicare and Medicaid Electronic Health Record programs increased substantially from their first year in 2011 to 2012. This book assesses the extent of current and expected participation in the EHR programs; examines information reported by providers and others to measure meaningful use in the EHR programs; evaluates HHS efforts to ensure that EHR data can be reliably used to measure quality of care; and evaluates HHS efforts to assess the effect of the EHR programs on program goals ...
Find out how your medical practice or organization can benefit from the use of an electronic health record system. Stay organized and optimized with a EHR.
Compare electronic health records systems designed to meet the unique needs of cardiologists. Cardiology is one of the most demanding specializations in medicine..... ...
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Redpine Healthcare Technologies Inc. announced the availability of its iPad compatible cloud-based Practice Management and Electronic Health Record system for chiropractors.
Read on for evaluation data and see the quote below to compare electronic health record systems for ophthalmologists. Ophthalmology practices.... ...
Browse stories and reviews on Anobii of Implementing an Electronic Health Record System written by , published by Springer London Ltd in format Hardcover
EHR (Electronic Health Record) Adoption provides resources on adopting EHR programs. Learn more about EHR adoption from the AMA.
As president of the Mayo Clinic Platform, I lead a portfolio of new digital platform businesses focused on transforming health by leveraging artificial intelligence, the internet of things, and an ecosystem of partners for Mayo Clinic. This is made possible by an extraordinary team of people at Mayo and collaborators worldwide. This blog will document their story. ...
A collaborative studying including Dr. Brian Bossak at Georgia Southern University Jiann-Ping Hsu College of Public Health examines changes to the electronic health records market in light of health information technology certification and meaningful use. Health information technology (HIT) certification and meaningful use are interventions encouraging the adoption of electronic health records (EHRs) in the USA. However, these initiatives also constitute a significant intervention which will change the structure of the EHR market.. Researchers found that there was movement away from paper records, upward trends in the number of EHR vendors, and greater competition. However, changes differed according to hospital size and region of the country. Changes were greatest for small hospitals, whereas competition and the number of vendors did not change dramatically for large hospitals.. To read more click here.. ...
More than 100,000 health care providers are using electronic health records that meet federal standards and have benefitted from the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced.
The immediate purpose of this work is to identify electronic health record (EHR) data available today and in the near future at healthcare facilities participating in the NIDA Clinical Trials Network (CTN). The overarching goal is to address a critical barrier to progress in substance use disorder (SUD) research and support planning on the CTN for research infrastructure to leverage EHR data for research informing SUD screening, intervention, treatment, and referral efforts.
April 26, 2013) -- UTSA Student Health Services (SHS) will begin the transition from paper health records to a new electronic health record management system effective Monday, April 29. The new system is adapted from the student health platform Point n Click. Once the electronic health records system is fully implemented, the ease of appointment scheduling by students is expected to dramatically improve.. The UTSA Office of Information Technology and Student Health Services have collaborated over two years to adapt the program to the specific needs of the health service and its students, said Beth Wichman, M.D., director of Student Health Services. The staff has been actively involved in extensive training over the last year in preparation for the go-live date. It will enhance the delivery of patient care as well as offer extensive patient education resources.. Communication between UTSA SHS staff will be improved, resulting in enhanced prioritization of patients. The system will use a ...
ElectronicHealth Records: Adoption of New Technology Systems. Studentsname. ElectronicHealth Records: Adoption of New Technology Systems. Advancementin technology in the health sector has helped improve the waypatients are being handled and also in the management of diseases(Cresswell & Sheikh, 2009). Embracing the E.H.R will have apositive effect on the working efficiency in hospitals. Below arefive steps to be followed while trying to convince the nurses toadopt the new technology.. Thefirst step of approaching the nurses will be providing them withgeneral knowledge on the new technology that is to be adopted. Thiswill include giving a thorough explanation of how the system works tothe point that every nurse gets well acquainted (Murphy, 2011). Thiswill provide them with a sharp insight that the system is verycompatible with the existing values and practices in nursing. Theelectronic health record contains patient management section,clinical section, laboratory section and billing system ...
Project Summary:. An electronic personal health record (ePHR) could maximize patient/clinician collaboration and consequently improve patient self-management and related health outcomes. The purpose of the proposed project is to examine the feasibility, acceptability, and impact of an ePHR that has been modified using a patient- and family-centered approach and incorporates the experiences, perspectives, and insights of patients and family members actually using the system. Comparison of patients with the ePHR intervention to a group of care as usual patients will be performed. The investigators Specific Aims are: (1) To improve the application of patient- and family-centered care elements in an existing ePHR, based on feedback from a pilot study of patients and their families. The modified ePHR will be tested in a pilot group of patients with hypertension and their families. (2) To implement and test the effectiveness of the modified ePHR with patients being treated for hypertension by a team ...
More research must be done to prove that electronic personal health records are safe and effective, according to an article in this weeks BMJ.
TY - JOUR. T1 - Adoption of electronic health records and preparations for demonstrating meaningful use. T2 - An american academy of ophthalmology survey. AU - Boland, Michael V.. AU - Chiang, Michael F.. AU - Lim, Michele C.. AU - Wedemeyer, Linda. AU - Epley, K. David. AU - McCannel, Colin A.. AU - Silverstone, David E.. AU - Lum, Flora. PY - 2013/8/1. Y1 - 2013/8/1. N2 - Objective: To assess the current state of electronic health record (EHR) use by ophthalmologists, including adoption rate, user satisfaction, functionality, benefits, barriers, and knowledge of meaningful use criteria. Design: Population-based, cross-sectional study. Participants: A total of 492 members of the American Academy of Ophthalmology (AAO). Methods: A random sample of 1500 AAO members were selected on the basis of their practice location and solicited to participate in a study of EHR use, practice management, and image management system use. Participants completed the survey via the Internet, phone, or fax. The ...
AIM: To evaluate pretreatment hepatitis B virus (HBV) testing, vaccination, and antiviral treatment rates in Veterans Affairs patients receiving anti-CD20 Ab for quality improvement. METHODS: We performed a retrospective cohort study using a national repository of Veterans Health Administration (VHA) electronic health record data. We identified all patients receiving anti-CD20 Ab treatment (2002-2014). We ascertained patient demographics, laboratory results, HBV vaccination status (from vaccination records), pharmacy data, and vital status. The high risk period for HBV reactivation is during anti-CD20 Ab treatment and 12 mo follow up. Therefore, we analyzed those who were followed to death or for at least 12 mo after completing anti-CD20 Ab. Pretreatment serologic tests were used to categorize chronic HBV (hepatitis B surface antigen positive or HBsAg+), past HBV (HBsAg-, hepatitis B core antibody positive or HBcAb+), resolved HBV (HBsAg-, HBcAb+, hepatitis B surface antibody positive or ...
PURPOSE: The purpose of this paper is to describe the infrastructure of the total joint replacement registry of a large integrated healthcare systems and emphasize challenges associated with orthopedic device classification and evaluation.. METHODS: Using a large integrated healthcare system innovative infrastructure including electronic health record data, administrative data sources, and registry data collection, we evaluated device choice and outcomes of total hip arthroplasty (THA). Devices were classified into type of bearing surface (alternative versus traditional). Multiple imputation was used to accommodate missing data, and a logistic regression model was applied to assess the impact of patient and surgeon factors on choice of bearing surface. A Cox regression model was used to evaluate risk of aseptic revision while controlling for surgeon, site, and patient characteristics. Adjusted cumulative probability-of-event curves were created, comparing survival of alternative against ...
Abbey C. Sidebottom, Ph.D., M.P.H., from Allina Health in Minneapolis, and colleagues retrospectively reviewed electronic health record data (2014 to 2018) from two health systems (eight hospitals) to compare neonatal intensive care unit (NICU) or special care nursery admission for deliveries with water immersion versus matched deliveries without water immersion.. The researchers found that of the 583 women with water immersion, 34.1 percent experienced first-stage water immersion only, 65.9 percent experienced second-stage immersion, and 53.9 percent completed delivery in the water. Compared with control births, NICU or special care nursery admissions were lower for second-stage water immersion deliveries (odds ratio, 0.3), as were lacerations (odds ratio, 0.5). There were no differences seen for NICU or special care nursery admissions and lacerations between the first-stage immersion group and their matched comparisons. In second-stage water immersion births, cord avulsions occurred in 0.8 ...
TY - JOUR. T1 - Depression, its comorbidities and treatment, and childhood body mass index trajectories. AU - Schwartz, Brian S.. AU - Glass, Thomas A.. AU - Pollak, Jonathan. AU - Hirsch, Annemarie G.. AU - Bailey-Davis, Lisa. AU - Moran, Timothy H.. AU - Bandeen-Roche, Karen. N1 - Publisher Copyright: © 2016 The Obesity Society Copyright: Copyright 2017 Elsevier B.V., All rights reserved.. PY - 2016/12/1. Y1 - 2016/12/1. N2 - Objective: No prior studies have evaluated depression diagnoses and cumulative antidepressant use in relation to longitudinal body mass index (BMI) trajectories in a population-representative sample. Methods: Electronic health record data from 105,163 children ages 8 to 18 years with 314,648 BMI values were used. Depression diagnoses were evaluated as ever versus never, cumulative number of encounters with diagnoses, and total duration of diagnoses. Antidepressants were evaluated as months of use. Associations were evaluated with diagnoses alone, antidepressants alone, ...
Electronic health records (EHRs) hold the promise to improve primary health care for millions of patients. However, enhancing current EHR functionality is needed to better support primary care clinicians and patients, according to a recent article in the Journal of American Medical Informatics Association.. The adoption and use of electronic health records could greatly improve health care and lead to better patient outcomes, yet many clinicians are dissatisfied with current EHR systems, said Alex Krist, M.D., lead author of the article, member of the Cancer Prevention and Control research program at VCU Massey Cancer Center, and associate professor of family medicine and population health in the VCU School of Medicine. Enhancements to electronic record functionality are needed to better support care. Primary care needs EHRs to move beyond focusing on disease and instead focus on the whole person.. Objectives of EHRs remain focused on disease, ignoring the many factors that can play a role ...
Data stored in personally controlled health records (PCHRs) may hold value for clinicians and public health entities, if patients and their families will share them. We sought to characterize consumer willingness and unwillingness (reticence) to share PCHR data across health topics, and with different stakeholders, to advance understanding of this issue ...
TY - JOUR. T1 - Analyzing Medication Documentation in Electronic Health Records. T2 - Dental Students Self-Reported Behaviors and Charting Practices. AU - Burcham, Wesley K.. AU - Romito, Laura M.. AU - Moser, Elizabeth A.. AU - Gitter, Bruce D.. PY - 2019/6/1. Y1 - 2019/6/1. N2 - The aim of this two-part study was to assess third- and fourth-year dental students perceptions, self-reported behaviors, and actual charting practices regarding medication documentation in axiUm, the electronic health record (EHR) system. In part one of the study, in fall 2015, all 125 third- and 85 fourth-year dental students at one U.S. dental school were invited to complete a ten-item anonymous survey on medication history-taking. In part two of the study, the EHRs of 519 recent dental school patients were randomly chosen via axiUm query based on age ,21 years and the presence of at least one documented medication. Documentation completeness was assessed per EHR and each medication based on proper medication ...
New York, NY - April 17, 2013 - NTT DATA, Inc., a leading IT services provider, today announced that it has been selected by CareOne LTACH, New Jerseys first licensed Long-Term Acute Care Hospital (LTACH), for its Electronic Health Record solution. NTT DATA will host a full Optimum™ Acute Care Electronic Health Record (EHR) system in a Level 3 data center and support CareOnes two long-term acute care hospitals, CareOne at Raritan Bay Medical Center and CareOne at Trinitas Regional Medical Center. CareOnes selection of the Optimum EHR validates the need for sophisticated technologies designed specifically to meet the challenges of the post-acute care market. A new federal requirement for Quality Reporting that went into effect for LTACHs on October 1, 2012 mandated significant changes to paper-based clinical record keeping. This mandate, along with The American Recovery and Reinvestment Act (ARRA), drives CareOne and other healthcare organizations to upgrade their existing clinical ...
I spent the last few minutes of my doctors visit in early 2013 in silence, as my doctor clumsily typed away notes about my progress. He apologized before he started typing, complaining that he was being forced to transition from paper-based notes to a new computer-based system with which he was unfamiliar. This moment was awkward, but it represented an important trend in healthcare delivery improvement.. Electronic Health Records in the U.S.. In 2015, 84% of primary care physicians in the United States used electronic health records (EHRs). The U.S. trails countries like Australia and the United Kingdom in this respect, where EHR penetration levels among primary care physicians were 92% and 98%, respectively.[1] This discrepancy represents both a performance gap for the United States and an opportunity for continued innovation. The quality benefits of shifting to EHRs are well known; as a result, EHRs have been promoted by the Obama administration and a number of prestigious hospital systems, ...
The Singapore Ministry of Health has awarded Accenture a contract to implement the National Electronic Health Record (NEHR) system.
William Ozzie may be a fictional solider, but his electronic health record showed how Kaiser Permanente, the Department of Veterans Affairs and private sector providers can seamlessly share information over an interoperable health information exchange. In a critical step towards giving patients and doctors a health care Internet, Kaiser Permanente collaborated with the VA in a unique wounded warrior test demonstration of the Nationwide Health Information Network. The scenario showed how physicians could safely and securely share Ozzies sample medical history across multiple EHR systems, such as Kaiser Permanente HealthConnect and the VAs VistAWeb, to inform medical decisions and deliver high quality care regardless of location or where the health record originated.. Kaiser Permanente physician George Peredy, MD, showed how William Ozzies sample patient data could be obtained from five different health providers including the VA, the Department of Defense and the private sector. In the ...
We have written previously about the Meaningful Use electronic health record (EHR) initiative, which is run by the Centers for Medicare & Medicaid Services (CMS). We most recently noted that stakeholders are requesting delays in Meaningful Use Stage 2 requirements...
Semantic interoperability - the ability to send human readable and computable records from place to place. An electronic health record with vocabulary controlled, structured problem lists, medications, labs, and radiology studies sending this data into structured lists within a personal health record is an example of semantic interoperability. Semantic interoperability ensures that decision support software can interpret the transmitted data and perform quality and safety checks such as drug/drug or drug/allergy checking. Google Health supports semantic interoperability for problems, medications, allergies and laboratories. The Continuity of Care Document, the clinical summary which has been recognized by Secretary Leavitt and the American Health Information Community (AHIC) is semantically interoperable, as detailed below ...
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In the first real-world trial of the impact of patient-controlled access to electronic health records, almost half of the patients who participated withheld clinically sensitive information in their medical record from some or all of their health care providers.. Should patients control who can see specific information in their electronic medical records? How much control should they have? Can doctors and other clinicians provide safe, high-quality care when a patients preference may deny members of the medical team from seeing portions of the electronic medical record? What is the appropriate balance between individual privacy concerns and health care providers need for relevant data?. The Regenstrief Institute, Indiana University School of Medicine and Eskenazi Health (formerly Wishard Health Services) partnered to design and conduct the first real-world trial intended to help answer these and related questions. During the six-month trial, 105 patients in an Eskenazi Health primary care ...
Electronic Health Records (EHR) and Clinical Decision Support - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the Merck Manuals - Medical Professional Version.
Electronic Health Records (EHR) and Clinical Decision Support - Etiology, pathophysiology, symptoms, signs, diagnosis & prognosis from the MSD Manuals - Medical Professional Version.
New York, NY NYC Health + Hospitals, the nations largest public health care system, today announced that 19 additional patient care locations successfully went live with the new Epic electronic medical records (EMR) system earlier this month, bringing the total number of public hospitals and health centers using the advanced technology to 50 patient care locations with more than 19,000 users system-wide. The additional health care facilities that went live includes NYC Health + Hospitals/Harlem, NYC Health + Hospitals/Bellevue and 17 Gotham Health ambulatory care sites. The new technology, which has been named H2O (Health + Hospitals Online) by the health system, connects the hospitals, emergency rooms, primary and specialty outpatient services, and the health systems home care agency into one unified medical records and finance information system to help clinicians deliver safe, efficient care, and allows patients easy access to their records through a secure patient portal called MyChart. The new
The Centers for Medicare and Medicaid Services (CMS) grants an incentive payment to eligible health care professionals, eligible hospitals and critical access hospitals that can demonstrate efforts to adopt, implement or upgrade certified electronic health record technology. These incentives were established under the Health Information Technology for Economic and Clinical Health Act (HITECH).. To qualify for the EHR incentive payments, hospitals and eligible providers are required to meet at least one of these four public health-related objectives during Stage 1:. ...
With high-quality, well-designed, and carefully implemented systems, highly-reliable, safe health care will be achieved, stated Dean Sittig, Ph.D., commentary author, associate professor at the University of Texas School of Health Information Sciences at Houston and member of the University of Texas - Memorial Hermann Center for Healthcare Quality and Safety.. The American Recovery and Reinvestment Act of 2009 created approximately $20 billion in incentives for individuals and organisations to meaningfully use electronic health records beginning next year. Previous studies report that 4 percent of physicians in the outpatient setting and 1,5 percent of United States hospitals have a comprehensive electronic health record system.. This framework can help make sure that electronic health records are used safely and effectively as doctors continue to adopt them, stated Hardeep Singh, M.D., M.P.H. co-author and assistant professor of medicine and health services research at the VA Health ...
Purpose - Little is known about the comparative effects of common oral antidiabetic drugs ([OADs] metformin, sulfonylureas, or thiazolidinediones [THZs]) on chronic kidney disease (CKD) outcomes in patients newly diagnosed with type 2 diabetes (T2DM) and followed in community primary care practices. Electronic health records (EHRs) were used to evaluate the relationships
On 28 February 2016, the Journal of the American Medical Association and IEEE Pulse hosted a one-day symposium in Las Vegas, Nevada, concurrent with the Healthcare Information and Management Systems Societys 2016 annual meeting. The event, which was the first in a series of technical talks dubbed IEEE Pulse On Stage, focused on the struggle of the U.S. health care system to have a scalable adoption of efficient and interoperable electronic health record (EHR) systems. Keynote speakers from both the medical and technical communities shared their insights on usability roadblocks as well as possibilities for reimagining the future of the EHR. The event was attended by a mixed audience of clinicians, informaticians, and health IT researchers ...
This data brief from the Office of National Coordinator for Health IT reports on health information exchange activities among U.S. hospitals based on data from the 2014 American Hospital Association Annual Survey Information Technology Supplement. All non-federal acute care general medical and surgical, general childrens, and cancer hospitals owned by private/not-for-profit, investor-owned/for-profit, or state/local government and located…
The Pew Charitable Trusts sent a letter Nov. 12 to congressional leaders in the House and Senate highlighting the importance of standardizing addresses in electronic health records (EHRs) to better match patient records accurately. The letter noted that standardizing addresses using the U.S. Postal Services format could improve contact tracing to slow the COVID-19 pandemic and support the administration of a future vaccine. The letter comes as Congress considers legislation that would require EHRs to format addresses using the Postal Services standard, which research shows could increase the number of accurate record matches by tens of thousands per day.. ...
At Childrens of Mississippi, we see a large number of children insured by Medicaid, said Barr, the Suzan B. Thames Endowed Professor and senior associate dean for graduate medical education. Delivery of high quality medical care is very dependent on having a comprehensive medical record that includes information well beyond our own electronic health record. . The impact of the data exchange goes far beyond easy access to patient medical records, Dzielak said.. This is a beginning for population health, and for the design of something that will improve the health of our beneficiaries, he said. We want to start driving health policy so that were not just paying claims and being happy with that. We want to improve the health of our beneficiaries long term. Then we can figure out how to incentivize providers and to educate beneficiaries on how to improve their own health.. MedeAnalytics expects to receive about 3,500 clinical inquiries per day from UMMC and in response will send the ...
Study Shows Increased Use of EHRs by Physicians. The Center for Public Integrity (CPI) conducted its own study, which it called the Cracking the Codes investigation. CPIs study determined that more than half of physicians billing for patient visits in 2011 used electronic health records. The Center said that its study of questionable Medicare billings found that doctors and other medical professionals steadily billed higher rates for treating elderly patients over the last decade, adding $11 billion to their fees.. Indications of electronic billing abuse provoked Attorney General Eric Holder and HHS Secretary Kathleen Sebellius to send a sternly-worded letter to five major hospital trade organizations. They are:. • American Hospital Association. • Federation of American Hospitals. • Association of Academic Health Centers. • Association of American Medical Colleges. • National Association of Public Hospitals and Health Systems. In its story, The New York Times explained how the ...
The 2009 American Recovery and Reinvestment Act spurred adoption of electronic health records (EHRs) in the United States, through such measures as financial incentives to providers through Medicare and Medicaid and regional extension centers, which provide ongoing technical assistance to practices.
Allscripts is an industry leader in EHR and EMR software. Learn more about St. Vincent Health Selects Allscripts for Electronic Health Record; Indiana Healthcare System to Provide Physicians Real-Time Access to Patient Data
BACKGROUND: Limited information is available on whether antipsychotics prescribed in pregnancy are associated with increased risks of adverse outcomes. METHODS: We used electronic health records from pregnant women and their children to examine risks of adverse maternal and child outcomes in three cohorts of women who: (A) received antipsychotic treatment in pregnancy (n=416) (B) discontinued antipsychotic treatment before pregnancy (n=670), and (C) had no records of antipsychotic treatment before or during pregnancy (n=318,434). Absolute and risk ratios were estimated and adjusted for health and lifestyle and concomitant medications. RESULTS: Caesarean section was more common in cohort A (25%) than C (18%), but non-significant after adjustment for health and lifestyle factors (Risk Ratio (adj.) 1.09 (95% CI: 0.92, 1.30). Proportion of gestational diabetes was similar in cohort A (2.6%) and B (2.7%), but lower in A than B after adjustments (RRadj: 0.43 (0.20, 0.93). Premature birth/low birthweight were
CONTEXT: The relationship between rising body mass index (BMI) and prospective risk of nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) is virtually absent. OBJECTIVE: Determine the extent of the association between BMI and risk of future NAFLD diagnosis, stratifying by sex and diabetes. DESIGN: Two prospective studies using Humedica and Health Improvement Network (THIN) with 1.54 and 4.96 years of follow-up, respectively. SETTING: Electronic health record databases. PARTICIPANTS: Patients with a recorded BMI measurement between 15 and 60 kg/m(2), and smoking status, and 1 year of active status before baseline BMI. Patients with a diagnosis or history of chronic diseases were excluded. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Recorded diagnosis of NAFLD/NASH during follow-up (Humedica International Classification of Diseases, Ninth Revision code 571.8, and read codes for NAFLD and NASH in THIN). RESULTS: Hazard ratios (HRs) were calculated across BMI categories using BMI of
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Availability of electronic health records among advanced practice nurses and physicians in California is concentrated among large practices with fewer Medicaid patients.
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JOHN MCCONNELL: So Gopal assigned this topic, and originally, I said, what the heck is this? But I actually am very grateful that I got a chance review this. Turns out theres a literature on this subject of how patients perceive the value of electronic health records. I think our concern as providers, going back in the early days of HR, depicted in this cartoon, is that we would all be focused on our computer screen, and not on the patient, OK? As Ill show you in a little while, the data dont actually support this perception, and I think one of my conclusions from this review is, I think providers are actually more worried about this scenario on the screen than patients are. So as I mentioned, there is actually some reasonable literature on this. I wouldnt call it high-quality, in terms of level-one evidence, but its nevertheless helpful information. Ill try to get through this, and if we have time, Stewart, maybe see if people want to comment on their own personal experiences with this. ...
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In honor of the first ever National Health IT Week, heres a gem of a story that seems to voraciously support the need for more integration of electronic health records, and technology in general, to find their way into more medical practices.. According to an article published by Referral MD, in a report issued by Health and Human Services (HHS), despite all of the attention surrounding the security of electronic health records, in actuality, between May 17 and June 17, there were 45 security breaches involving paper health records - 42 more than with EHRs.. I shouldnt be surprised by this, but I guess I am. Perhaps Im programmed to think about EHRs exclusively, but paper records are still the majority of records kept, at least in the smaller ambulatory practices where EHRs havent been implemented, so security breaches in environments like this are quite likely.. According to the report, the following fit the definition of a breach, including theft, unauthorized access, improper disposal ...
Preparing, selecting and fully implementing an electronic health record require time and money at a time when theres not a lot of either. Six easy steps can prepare staff to meet the core sets of objectives and measures.
Physician adoption of electronic health record (EHR) systems has increased substantially over the last decade, even among physicians not participating in EHR Incentive Programs, according to a September data brief from the Office of the National Coordinator for Health Information Technology (ONC).. The data revealed that more than 8 in 10 physicians have adopted an EHR; of those, almost three-quarters have adopted a certified EHR, while 51 percent of physicians were using all basic EHR functionalities. However, only 6 in 10 physicians electronically viewed imaging results. The computerized function reported by the most physicians was the ability to record patient demographic information (86 percent).. Whats more, regardless of if they are participating in the EHR Incentive Program, the majority of physicians are using certified EHR. The data found that almost two-thirds of physicians applied, or planned to apply, to the Medicare and Medicaid EHR Incentive Programs, while 38 percent of ...
Provider organizations have been able to develop, test, and implement quality-of-care indicators based on data collected from their EHR systems, according to findings from a Commonwealth Fund report.. The report, Performance Measures Using Electronic Health Records: Five Case Studies, looks at how HealthPartners (Minneapolis) utilized its EHR system to compile blood pressure measurements; Park Nicollet Health Services (Minneapolis) developed a composite measure for care of patients with diabetes; Billings Clinic (Billings, Mont.) tested an automatic alert on potential interactions between antibiotics and the anticoagulant warfarin; Kaiser Permanente of the Northwest (Portland, Ore.) used a natural language processing tool for counseling about tobacco use; and Geisinger Health System (Danville, Pa.) explored ways of reconciling problem lists and provider-visit notes in the case of high-impact chronic-disease diagnoses.. The Commonwealth Fund is a private foundation based in New York that aims ...