collection
https://read.qxmd.com/read/25784241/promoting-improved-utilization-of-laboratory-testing-through-changes-in-an-electronic-medical-record-experience-at-an-academic-medical-center
#21
JOURNAL ARTICLE
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
https://read.qxmd.com/read/25784685/building-evidence-in-health-informatics
#22
EDITORIAL
Gregory L Alexander
No abstract text is available yet for this article.
July 2015: Western Journal of Nursing Research
https://read.qxmd.com/read/25785897/adoption-of-clinical-decision-support-in-multimorbidity-a-systematic-review
#23
REVIEW
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
https://read.qxmd.com/read/25771280/electronic-medical-records-and-quality-improvement
#24
REVIEW
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
https://read.qxmd.com/read/25785640/big-data-miniregistries-a-rapid-turnaround-solution-to-get-quality-improvement-data-into-the-hands-of-medical-specialists
#25
JOURNAL ARTICLE
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
https://read.qxmd.com/read/25798779/clinical-decision-support-systems-and-infection-prevention-to-know-is-not-enough
#26
REVIEW
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
https://read.qxmd.com/read/25795426/survival-of-the-project-a-case-study-of-ict-innovation-in-health-care
#27
JOURNAL ARTICLE
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
https://read.qxmd.com/read/25793339/building-a-mobile-medical-app-and-understanding-fda-regulatory-requirements
#28
JOURNAL ARTICLE
Jason King
No abstract text is available yet for this article.
March 2015: Biomedical Instrumentation & Technology
https://read.qxmd.com/read/25710808/navigating-the-digital-divide-a-systematic-review-of-ehealth-literacy-in-underserved-populations-in-the-united-states
#29
REVIEW
Amy Chesser, Anne Burke, Jared Reyes, Tessa Rohrberg
eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria...
2016: Informatics for Health & Social Care
https://read.qxmd.com/read/25405067/technology-acceptance-and-adoption-of-innovative-smartphone-uses-among-hospital-employees
#30
JOURNAL ARTICLE
Byung Chan Moon, Hyejung Chang
OBJECTIVES: The number of healthcare institutions adopting smartphones continues to increase, implying that their utilization is undoubtedly gaining attention. Understanding the needs of smartphone users will provide a greater opportunity for successful information technology acceptance by expanding the scope of its utilization. This study focuses on how smartphones are accepted and utilized in hospitals and analyzes the factors influencing users' attitude, social influence, and intention of use...
October 2014: Healthcare Informatics Research
https://read.qxmd.com/read/25705552/big-data-analysis-framework-for-healthcare-and-social-sectors-in-korea
#31
REVIEW
Tae-Min Song, Seewon Ryu
OBJECTIVES: We reviewed applications of big data analysis of healthcare and social services in developed countries, and subsequently devised a framework for such an analysis in Korea. METHODS: We reviewed the status of implementing big data analysis of health care and social services in developed countries, and strategies used by the Ministry of Health and Welfare of Korea (Government 3.0). We formulated a conceptual framework of big data in the healthcare and social service sectors at the national level...
January 2015: Healthcare Informatics Research
https://read.qxmd.com/read/25705553/development-of-a-smartphone-application-for-clinical-guideline-based-obesity-management
#32
JOURNAL ARTICLE
Eunjoo Jeon, Hyeoun-Ae Park
OBJECTIVES: The purpose of the study was to develop and evaluate a clinical-guideline-based smartphone application ('app') for obesity management. METHODS: Obesity-related knowledge and functional requirements were extracted from clinical practice guidelines, a literature review, and consultations with experts. The extracted knowledge was used to design obesity-management algorithms, and the functions of the developed app are presented through a use case diagram and activity diagrams...
January 2015: Healthcare Informatics Research
https://read.qxmd.com/read/25705559/smart-careplan-system-for-continuum-of-care
#33
JOURNAL ARTICLE
Young Ah Kim, Seon Young Jang, Meejung Ahn, Kyung Duck Kim, Sung Soo Kim
OBJECTIVES: This paper describes the integrated Careplan system, designed to manage and utilize the existing Electronic Medical Record (EMR) system; the system also defines key items for interdisciplinary communication and continuity of patient care. METHODS: We structured the Careplan system to provide effective interdisciplinary communication for healthcare services. The design of the Careplan system architecture proceeded in four steps-defining target datasets; construction of conceptual framework and architecture; screen layout and storyboard creation; screen user interface (UI) design and development, and pilot test and step-by-step deployment...
January 2015: Healthcare Informatics Research
https://read.qxmd.com/read/25765963/a-health-record-integrated-clinical-decision-support-system-to-support-prescriptions-of-pharmaceutical-drugs-in-patients-with-reduced-renal-function-design-development-and-proof-of-concept
#34
JOURNAL ARTICLE
Tero Shemeikka, Pia Bastholm-Rahmner, Carl-Gustaf Elinder, Anikó Vég, Elisabeth Törnqvist, Birgitta Cornelius, Seher Korkmaz
OBJECTIVES: To develop and verify proof of concept for a clinical decision support system (CDSS) to support prescriptions of pharmaceutical drugs in patients with reduced renal function, integrated in an electronic health record system (EHR) used in both hospitals and primary care. METHODS: A pilot study in one geriatric clinic, one internal medicine admission ward and two outpatient healthcare centers was evaluated with a questionnaire focusing on the usefulness of the CDSS...
June 2015: International Journal of Medical Informatics
https://read.qxmd.com/read/25770311/interventions-to-increase-the-use-of-electronic-health-information-by-healthcare-practitioners-to-improve-clinical-practice-and-patient-outcomes
#35
REVIEW
Michelle Fiander, Jessie McGowan, Roland Grad, Pierre Pluye, Karin Hannes, Michel Labrecque, Nia W Roberts, Douglas M Salzwedel, Vivian Welch, Peter Tugwell
BACKGROUND: There is a large volume of health information available, and, if applied in clinical practice, may contribute to effective patient care. Despite an abundance of information, sub-optimal care is common. Many factors influence practitioners' use of health information, and format (electronic or other) may be one such factor. OBJECTIVES: To assess the effects of interventions aimed at improving or increasing healthcare practitioners' use of electronic health information (EHI) on professional practice and patient outcomes...
March 14, 2015: Cochrane Database of Systematic Reviews
https://read.qxmd.com/read/25726568/technology-mediated-interventions-for-enhancing-medication-adherence
#36
REVIEW
Niraj Mistry, Arun Keepanasseril, Nancy L Wilczynski, Robby Nieuwlaat, Manthan Ravall, R Brian Haynes
BACKGROUND: Despite effective therapies for many conditions, patients find it difficult to adhere to prescribed treatments. Technology-mediated interventions (TMIs) are increasingly being used with the hope of improving adherence. OBJECTIVE: To assess the effects of TMI, intended to enhance patient adherence to prescribed medications, on both medication adherence and clinical outcomes. METHODS: A secondary in-depth analysis was conducted of the subset of studies that utilized technology in at least one component of the intervention from an updated Cochrane review on all interventions for enhancing medication adherence...
April 2015: Journal of the American Medical Informatics Association: JAMIA
https://read.qxmd.com/read/25731758/embedding-electronic-decision-support-tools-for-suspected-cancer-in-primary-care-a-qualitative-study-of-gps-experiences
#37
JOURNAL ARTICLE
Lisa Dikomitis, Trish Green, Una Macleod
AIM: The purpose of this evaluation was to obtain views from general practitioners (GPs) who piloted the electronic risk assessment tools (eRATs) for suspected lung or colorectal cancer. We wanted to find out whether GPs were able to integrate these tools into their everyday practice. We were also keen to identify facilitators and barriers to their more widespread use. BACKGROUND: Cancer remains one of UK's biggest health problems, in terms of morbidity and mortality...
November 2015: Primary Health Care Research & Development
https://read.qxmd.com/read/25734604/an-empirically-based-model-for-knowledge-management-in-health-care-organizations
#38
JOURNAL ARTICLE
Shannon L Sibbald, C Nadine Wathen, Anita Kothari
BACKGROUND: Knowledge management (KM) encompasses strategies, processes, and practices that allow an organization to capture, share, store, access, and use knowledge. Ideal KM combines different sources of knowledge to support innovation and improve performance. PURPOSES: Despite the importance of KM in health care organizations (HCOs), there has been very little empirical research to describe KM in this context. This study explores KM in HCOs, focusing on the status of current intraorganizational KM...
January 2016: Health Care Management Review
https://read.qxmd.com/read/25756221/commentary-epidemiology-in-the-era-of-big-data
#39
JOURNAL ARTICLE
Stephen J Mooney, Daniel J Westreich, Abdulrahman M El-Sayed
Big Data has increasingly been promoted as a revolutionary development in the future of science, including epidemiology. However, the definition and implications of Big Data for epidemiology remain unclear. We here provide a working definition of Big Data predicated on the so-called "three V's": variety, volume, and velocity. From this definition, we argue that Big Data has evolutionary and revolutionary implications for identifying and intervening on the determinants of population health. We suggest that as more sources of diverse data become publicly available, the ability to combine and refine these data to yield valid answers to epidemiologic questions will be invaluable...
May 2015: Epidemiology
https://read.qxmd.com/read/25755064/telemedicine-for-cardiovascular-disease-continuum-a-position-paper-from-the-italian-society-of-cardiology-working-group-on-telecardiology-and-informatics
#40
REVIEW
Natale Daniele Brunetti, Simonetta Scalvini, Flavio Acquistapace, Gianfranco Parati, Maurizio Volterrani, Francesco Fedele, Giuseppe Molinari
Telemedicine is the provision of health care services, through the use of information and communication technology, in situations where the health care professional and the patient, or 2 health care professionals, are not in the same location. It involves the secure transmission of medical data and information, through text, sound, images, or other forms needed for the prevention, diagnosis, treatment, and follow-up of a patient. First data on implementation of telemedicine for the diagnosis and treatment of acute myocardial infarction date from more than 10 years ago...
April 1, 2015: International Journal of Cardiology
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