scholarly journals COVID‐19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US

2021 ◽  
Author(s):  
QuanQiu Wang ◽  
Pamela B. Davis ◽  
Mark E. Gurney ◽  
Rong Xu
Keyword(s):  
Electronic Health Records ◽  
Health Records ◽  
The Us ◽  
Electronic Health

Professional fission in medical routines: medical scribes and physicians in two US hospital departments

2020 ◽  
Author(s):  
Ann L Bryan ◽  
John C Lammers
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Community Hospital ◽  
Health Record ◽  
Health Departments ◽  
Health Records ◽  
The Us ◽  
Electronic Health ◽  
Medical Scribes ◽  
Digestive Health

Abstract In this study we argue that professionalism imposed from above can result in a type of fission, leading to the ambiguous emergence of new occupations. Our case focuses on the US’ federally mandated use of electronic health records and the increased use of medical scribes. Data include observations of 571 patient encounters across 48 scribe shifts, and 12 interviews with medical scribes and physicians in the ophthalmology and digestive health departments of a community hospital. We found substantial differences in scribes’ roles based on the pre-existing routines within each department, and that scribes developed agency in the interface between the electronic health record and the physicians’ work. Our study contributes to work on occupations as negotiated orders by drawing attention to external influences, the importance of considering differences across professional task routines, and the personal interactions between professional and technical workers.

scholarly journals Quality and Certification of Electronic Health Records

2010 ◽  
Vol 01 (02) ◽  
pp. 149-164 ◽  
Author(s):  
E. Ammenwerth ◽  
A. Hoerbst
Keyword(s):  
Information Systems ◽  
Electronic Health Records ◽  
Qualitative Content Analysis ◽  
Real Life ◽  
Health Records ◽  
Selection Processes ◽  
Quality Certification ◽  
The Us ◽  
Service Oriented ◽  
Electronic Health

Summary Background: Numerous projects, initiatives, and programs are dedicated to the development of Electronic Health Records (EHR) worldwide. Increasingly more of these plans have recently been brought from a scientific environment to real life applications. In this context, quality is a crucial factor with regard to the acceptance and utility of Electronic Health Records. However, the dissemination of the existing quality approaches is often rather limited. Objectives: The present paper aims at the description and comparison of the current major quality certification approaches to EHRs. Methods: A literature analysis was carried out in order to identify the relevant publications with regard to EHR quality certification. PubMed, ACM Digital Library, IEEExplore, CiteSeer, and Google (Scholar) were used to collect relevant sources. The documents that were obtained were analyzed using techniques of qualitative content analysis. Results: The analysis discusses and compares the quality approaches of CCHIT, EuroRec, IHE, openEHR, and EN13606. These approaches differ with regard to their focus, support of service-oriented EHRs, process of (re-)certification and testing, number of systems certified and tested, supporting organizations, and regional relevance. Discussion: The analyzed approaches show differences with regard to their structure and processes. System vendors can exploit these approaches in order to improve and certify their information systems. Health care organizations can use these approaches to support selection processes or to assess the quality of their own information systems. Citation: Hoerbst A, Ammenwerth E. Quality and certification of electronic health records – An overview of current approaches from the US and Europe. Appl Clin Inf 2010; 1: 149–164 http://dx.doi.org/10.4338/ACI-2010-02-R-0009

scholarly journals Diabetes and hypertension among South Asians in New York and Atlanta leveraging hospital electronic health records

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jeannette M. Beasley ◽  
Joyce C. Ho ◽  
Sarah Conderino ◽  
Lorna E. Thorpe ◽  
Megha Shah ◽  
...  
Keyword(s):  
New York ◽  
Electronic Health Records ◽  
Health Systems ◽  
South Asian ◽  
South Asians ◽  
New York University ◽  
Health Records ◽  
Asian Patients ◽  
The Us ◽  
Electronic Health

Abstract Background Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. Methods Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2 + encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2 + abnormal A1C levels (≥ 6.5%) and 1 + encounter with a diagnosis of diabetes. Hypertension was defined as having 3 + BP readings of systolic BP ≥ 130 mmHg or diastolic BP ≥ 80 mmHg, 2 + encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. Results Among South Asian patients at these two large, private health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC. Conclusions These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.

Using Challenges Associated Meaningful-Use Criteria to Prioritize Needed Changes in Electronic Health Records

2016 ◽  
Vol 5 (1) ◽  
pp. 55-60 ◽  
Author(s):  
G. Talley Holman ◽  
Steven E. Waldren ◽  
A. Joy Rivera ◽  
Lawrence D. Dardick
Keyword(s):  
Electronic Health Records ◽  
Meaningful Use ◽  
Scientific Data ◽  
Comfort Level ◽  
Information Analysis ◽  
Health Records ◽  
Organizational Type ◽  
The Us ◽  
Electronic Health ◽  
Us Findings

To date, more than 30 billion dollars has been spent on the meaningful use (MU) program. While high adoption has been realized, there has been little improvement in usability of Electronic Health Records (EHRs), prompting continuous discussion. Further, very little scientific data has been provided regarding the type of challenges present for physicians when using an EHR. This study evaluates and prioritizes 6 of the most common challenges associated with EHR use by physicians during a patient encounter using meaningful use criteria as a basis. Data represents 430 physicians from across the US. Findings show all EHRs have significant challenges with organization and structure of information and the amount or method of documenting information. Analysis of the 31 MU criteria show only 1 criterion did not have any significant challenges. Alternately, 75% of criteria had 3 or more significant challenges with 9 criteria being significantly impacted by all reported challenges. Finally, individual groupings of physicians were found to have more challenges than others when considering physician’s age, computer comfort level, and the organizational type. Overall, findings show significant challenges exist for physicians when using EHRs, especially related to routine/basic patient care MU criteria. Specifically, challenges exist regarding how information is organized and the amount and/or method of EHR documentation, which must be a priority for improvement. If healthcare is to move forward and progress, EHRs must effectively support physicians in their work.

Diabetes and Hypertension Among South Asians in New York and Atlanta Leveraging Hospital Electronic Health Records

2021 ◽  
Author(s):  
Jeannette Beasley ◽  
Joyce C Ho ◽  
Sarah Conderino ◽  
Lorna E Thorpe ◽  
Megha Shah ◽  
...  
Keyword(s):  
New York ◽  
Electronic Health Records ◽  
Health Systems ◽  
South Asian ◽  
South Asians ◽  
New York University ◽  
Health Records ◽  
Asian Patients ◽  
The Us ◽  
Electronic Health

Abstract BACKGROUND: Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. METHODS: Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2+ encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2+ abnormal A1C levels (≥6.5%) and 1+ encounter with a diagnosis of diabetes. Hypertension was defined as having 3+ BP readings of systolic BP ≥130 mmHg or diastolic BP ≥80 mmHg, 2+ encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. RESULTS: Among South Asian patients at these two large health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC.CONCLUSIONS: These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.

scholarly journals User perspectives on barriers to and facilitators of the implementation of electronic health records in behavioral health hospitals: A qualitative study (Preprint)

2020 ◽  
Author(s):  
Se Young Jung ◽  
Hee Hwang ◽  
Keehyuck Lee ◽  
Donghyun Lee ◽  
Sooyoung Yoo ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Electronic Health Records ◽  
Behavioral Health ◽  
Successful Implementation ◽  
Health Records ◽  
Behavioral Healthcare ◽  
System P ◽  
Starting Point ◽  
The Us ◽  
Electronic Health

BACKGROUND Despite the rapid adoption of electronic health records (EHRs) thanks to the reimbursement program of the US government, the adoption of EHRs in behavioral health hospitals continues to lag behind that of other hospitals, and there remains a lack of evidence regarding barriers to and facilitators of the implementation of behavioral healthcare electronic health records (bhEHRs). OBJECTIVE The aim of this study was to analyze the experience of behavioral health professionals to explore the perceived barriers, facilitators, and critical ideas influencing the implementation and usability of bhEHRs. METHODS In this qualitative study, we interviewed physicians, nurses, pharmacists, behavioral health clinicians, and administrative professionals separately at 4 behavioral health hospitals in the US. We conducted semistructured interviews (N= 43) at behavioral health hospitals involved in the adoption of bhEHRs. We used purposeful sampling to maximize diversity. Transcripts were coded and analyzed for emergent domains. Exploratory data analysis was applied. RESULTS Content analyses revealed 4 barriers and 4 facilitators. The most important barriers to implementing bhEHRs were the low level of computer proficiency among nurses, the complexity of the system, alert fatigue, and resistance due to legacy systems. These barriers led to poor usability and acceptability and a distrust of the system. Among the major facilitators identified were well-executed training programs, improved productivity, better quality of care, and the good usability of the bhEHR system. CONCLUSIONS Healthcare professionals are keen to use bhEHRs, which may enhance their work productivity and interprofessional collaboration. Routine education for end users is the essential starting point to provide support for decision making and successful implementation of bhEHRs. When adopting bhEHRs, managers need to focus on common practices in behavioral health hospitals, such as documenting structured data in their organizations and adopting a seamless workflow of behavioral healthcare into the system.

Sign in / Sign up

Export Citation Format

Share Document