scholarly journals The Association Between Patient-Reported Asthma Morbidity and Electronic Health Record (EHR)-Identified Data Among Pediatric Asthma Patients Njeze O, Lee A, Singh A, Cosar E, Hsia B, Lin I, Jariwala SP. Division of Allergy/Immunology, Albert Einstein College of Medicine, Bronx, NY.

2020 ◽  
Vol 145 (2) ◽  
pp. AB212
Author(s):  
Obumneme Njeze ◽  
Audrey Lee ◽  
Anjani Singh ◽  
Emine Cosar ◽  
Brian Hsia ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Pediatric Asthma ◽  
Albert Einstein College ◽  
Albert Einstein ◽  
Health Record ◽  
Asthma Morbidity ◽  
Patient Reported ◽  
Asthma Patients ◽  
Electronic Health

What does social isolation have to do with my arthritis? Patient and provider views of the implementation of an electronic Social Determinants of Health risk assessment tool

2020 ◽  
Vol 64 (1) ◽  
pp. 707-710
Keyword(s):  
Electronic Health Record ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Assessment Tool ◽  
Determinants Of Health ◽  
Health Record ◽  
Institute Of Medicine ◽  
Patient Reported ◽  
Item Responses ◽  
Electronic Health

Social Determinants of Health (SDoH) are the conditions in which people are born, live, learn, work, and play that can affect health, functioning, and quality-of-life outcomes. The Institute of Medicine charged healthcare institutions with capturing and measuring patient SDoH risk factors through the electronic health record. Following the implementation of a social determinants of health electronic module across a major health institution, the response to institutional implementation was evaluated. To assess the response, a multidisciplinary team interviewed patients and providers, mapped the workflow, and performed simulated tests to trace the flow of SDoH data from survey item responses to visualization in EHR output for clinicians. Major results of this investigation were: 1) the lack of patient consensus about value of collecting SDOH data, and 2) the disjointed view of patient reported SDoH risks across patients, providers, and the electronic health record due to the way data was collected and visualized.

scholarly journals Temporal condition pattern mining in large, sparse electronic health record data: A case study in characterizing pediatric asthma

2020 ◽  
Vol 27 (4) ◽  
pp. 558-566
Author(s):  
Elizabeth A Campbell ◽  
Ellen J Bass ◽  
Aaron J Masino
Keyword(s):  
Electronic Health Record ◽  
Pattern Mining ◽  
Temporal Trends ◽  
Pediatric Asthma ◽  
Initial Diagnosis ◽  
Health Record ◽  
Electronic Health Record Data ◽  
Record Data ◽  
Electronic Health ◽  
Medical Concepts

Abstract Objective This study introduces a temporal condition pattern mining methodology to address the sparse nature of coded condition concept utilization in electronic health record data. As a validation study, we applied this method to reveal condition patterns surrounding an initial diagnosis of pediatric asthma. Materials and Methods The SPADE (Sequential PAttern Discovery using Equivalence classes) algorithm was used to identify common temporal condition patterns surrounding the initial diagnosis of pediatric asthma in a study population of 71 824 patients from the Children’s Hospital of Philadelphia. SPADE was applied to a dataset with diagnoses coded using International Classification of Diseases (ICD) concepts and separately to a dataset with the ICD codes mapped to their corresponding expanded diagnostic clusters (EDCs). Common temporal condition patterns surrounding the initial diagnosis of pediatric asthma ascertained by SPADE from both the ICD and EDC datasets were compared. Results SPADE identified 36 unique diagnoses in the mapped EDC dataset, whereas only 19 were recognized in the ICD dataset. Temporal trends in condition diagnoses ascertained from the EDC data were not discoverable in the ICD dataset. Discussion Mining frequent temporal condition patterns from large electronic health record datasets may reveal previously unknown associations between diagnoses that could inform future research into causation or other relationships. Mapping sparsely coded medical concepts into homogenous groups was essential to discovering potentially useful information from our dataset. Conclusions We expect that the presented methodology is applicable to the study of diagnostic trajectories for other clinical conditions and can be extended to study temporal patterns of other coded medical concepts such as medications and procedures.

scholarly journals Frequency and Types of Patient-Reported Errors in Electronic Health Record Ambulatory Care Notes

2020 ◽  
Vol 3 (6) ◽  
pp. e205867 ◽  
Author(s):  
Sigall K. Bell ◽  
Tom Delbanco ◽  
Joann G. Elmore ◽  
Patricia S. Fitzgerald ◽  
Alan Fossa ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Ambulatory Care ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health

Integrating patient-reported outcomes data into the electronic health record.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 186-186
Author(s):  
Brandon Bosch ◽  
Scott Hartman ◽  
Lauren Caldarello ◽  
Diane Denny, DBA
Keyword(s):  
Electronic Health Record ◽  
Population Analysis ◽  
Treatment Plan ◽  
Symptom Burden ◽  
Symptom Assessment ◽  
Patient Reported Outcome ◽  
Health Record ◽  
National Network ◽  
Patient Reported ◽  
Electronic Health

186 Background: As a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer, the network was an early adopter of using patient reported outcome (PRO) data as part of its routine patient assessment and treatment. Since 2012 an externally validated tool has been used to capture patients’ perceived symptom burden for real-time clinical intervention, from the point of first visit throughout the course of treatment, at intervals of 21 days or greater. Research has demonstrated the use of PRO data as a valuable component of a patient’s treatment plan, promoting improved quality and length of life. Methods: The use of this data across the network was expanded such that results once only accessible on paper and via electronically stored images, has now been fully integrated into the electronic health record (EHR). A multidisciplinary project team formulated the specifications for a successful integration of PRO data into the EHR. Results: The project achieved its goal and went beyond data integration to include implementation of a solution to facilitate documentation of intervention against patients’ symptoms. Provider workflow efficiency is greatly enhanced via single system access and visual notification, with critical values flagged, to focus providers’ attention on severe symptoms. Incorporation of a unified EHR flowsheet provides a paperless, one-stop symptom assessment approach and streamlined mechanism for intervention documentation. The documentation module leverages structured data fields and linkage of PRO data with interventions, such as specialist referrals or medication orders, to support enhanced patient care and quality improvement. Conclusions: The ability to easily view an array of patient reported concerns and document interventions against severe or significantly worsening symptoms provides clinicians an enhanced ability to address quality of life related needs. PRO data is now stored electronically in the enterprise warehouse, thus enabling aggregation with data from which to perform population analysis and eventually, pursue opportunities for predictive modeling.

scholarly journals Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report

2015 ◽  
Vol 23 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Christopher A Harle ◽  
Alyson Listhaus ◽  
Constanza M Covarrubias ◽  
Siegfried OF Schmidt ◽  
Sean Mackey ◽  
...  
Keyword(s):  
Case Report ◽  
Electronic Health Record ◽  
Patient Reported Outcomes ◽  
System Development ◽  
Lessons Learned ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health ◽  
Clinical Tools ◽  
The Right

Abstract In this case report, the authors describe the implementation of a system for collecting patient-reported outcomes and integrating results in an electronic health record. The objective was to identify lessons learned in overcoming barriers to collecting and integrating patient-reported outcomes in an electronic health record. The authors analyzed qualitative data in 42 documents collected from system development meetings, written feedback from users, and clinical observations with practice staff, providers, and patients. Guided by the Unified Theory on the Adoption and Use of Information Technology, 5 emergent themes were identified. Two barriers emerged: (i) uncertain clinical benefit and (ii) time, work flow, and effort constraints. Three facilitators emerged: (iii) process automation, (iv) usable system interfaces, and (v) collecting patient-reported outcomes for the right patient at the right time. For electronic health record-integrated patient-reported outcomes to succeed as useful clinical tools, system designers must ensure the clinical relevance of the information being collected while minimizing provider, staff, and patient burden.

scholarly journals Capturing a Patient-Reported Measure of Physical Function Through an Online Electronic Health Record Patient Portal in an Ambulatory Clinic: Implementation Study (Preprint)

2017 ◽  
Author(s):  
Jing Li ◽  
Jinoos Yazdany ◽  
Laura Trupin ◽  
Zara Izadi ◽  
Milena Gianfrancesco ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Physical Function ◽  
Patient Reported Outcomes ◽  
Health Record ◽  
Patient Portal ◽  
Rheumatology Clinic ◽  
Patient Reported ◽  
Physical Function Score ◽  
Electronic Health ◽  
White Patients

BACKGROUND Despite significant interest in the collection of patient-reported outcomes to make care more patient-centered, few studies have evaluated implementation efforts to collect patient-reported outcomes from diverse patient populations OBJECTIVE We assessed the collection of patient-reported outcomes from rheumatoid arthritis patients in an academic rheumatology clinic, using a paper and an online form through the electronic health record patient portal. METHODS We identified patients seen between 2012-2016 with ≥2 face-to-face encounters with a rheumatology provider and International Classification of Diseases codes for RA, ≥30 days apart. In 2013, our clinic implemented a paper version of the Patient Reported Outcome Measurement Information System (PROMIS) physical function form that was administered to patients upon their check-in at the clinic. In 2015, an online version of the form became available by way of the electronic health record patient portal to patients with active portal accounts. We compared the proportion of visits with documented PROMIS scores across age, race and ethnicity, and language and examined trends over time using a control chart. RESULTS We included 1078 patients with rheumatoid arthritis with 7049 in-person encounters at the rheumatology clinic over 4 years, with an average of 168 visits per month. Of the included patients, 80.4% of patients (867/1078) were female and the mean age was 58 (SD 16) years. The overall PROMIS physical function score documentation increased from 60.4% (1081/1791) of visits in 2013 to 74.4% (905/1217) of visits in 2016. Online score documentation increased from 10.0% (148/1473) in 2015 to 19.3% (235/1217) in 2016. African American patients were least likely to have a PROMIS physical function score recorded (55/88, 62.5% compared to 792/990, 80.0% for other racial or ethnic groups; P<.001). Compared with white patients, both African American and Hispanic patients were less likely to have active online electronic health record portal accounts (44/88, 50% and 90/157, 57.3% respectively, compared to 437/521, 83.9% of white patients; P<.001) and, once activated, less likely to use the online survey (6/44, 13.6% and 16/90, 17.8% respectively, compared to 135/437, 30.9% of white patients; P=.02). There was no significant difference in the proportion of any PROMIS physical function forms recorded between non-English vs English preferred patients. No significant differences were found across age or gender. CONCLUSIONS PROMIS physical function form completion improved overall from 2012-2016 but lagged among racial and ethnic minorities and non-English preferred patients. Future studies should address issues of portal access, enrollment, satisfaction, and persistence and focus on developing PRO implementation strategies that accommodate the needs and preferences of diverse populations.

Implementation and early adaptation of patient-reported outcome measures into an electronic health record: A technical report

2018 ◽  
Vol 26 (1) ◽  
pp. 129-140 ◽  
Author(s):  
Heather Taffet Gold ◽  
Raj J Karia ◽  
Alissa Link ◽  
Rachel Lebwohl ◽  
Joseph D Zuckerman ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Outcome Measures ◽  
Computerized Adaptive Testing ◽  
Clinical Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Measurement Information ◽  
Health Record ◽  
Patient Reported ◽  
Electronic Health

We integrated and optimized patient-reported outcome measures into the electronic health record to provide quantitative, objective data regarding patients’ health status, which is important for patient care, payer contracts, and research. With a multidisciplinary team from information technology, clinical informatics, population health, and physician champions, we used formal human–computer interaction techniques and user-centered design to integrate several technology platforms and computerized adaptive testing for the National Institutes of Health Patient-Reported Outcomes Measurement Information System. The patient-reported outcome measure system leverages software frequently used by health systems and provides data for research and clinical care via a mobile-responsive web application using Symfony, with REDCap for configuring assessments and de-identified data storage. The system incorporates Oracle databases and Epic flowsheets. Patients complete patient-reported outcome measures, with data viewable in MyChart and Epic Synopsis Reports. Researchers can access data portals. The highly usable, successful patient-reported outcome measures platform is acceptable to patients and clinicians and achieved 73 percent overall completion rates.

Implementation of Patient-Reported Outcomes in Routine Medical Care

2018 ◽  
pp. 122-134 ◽  
Author(s):  
Ethan Basch ◽  
Lisa Barbera ◽  
Carolyn L. Kerrigan ◽  
Galina Velikova
Keyword(s):  
Electronic Health Record ◽  
Patient Reported Outcomes ◽  
Clinical Care ◽  
Self Report ◽  
Routine Practice ◽  
Health Record ◽  
Patient Portals ◽  
Free Standing ◽  
Patient Reported ◽  
Electronic Health

There is increasing interest to integrate collection of patient-reported outcomes (PROs) in routine practice to enhance clinical care. Multiple studies show that systematic monitoring of patients using PROs improves patient-clinician communication, clinician awareness of symptoms, symptom management, patient satisfaction, quality of life, and overall survival. The general approach includes a brief electronic survey, administered via the Web or an app or an automated telephone system, with alerts to clinicians for concerning or worsening issues. Patients have generally been asked to self-report on a regular basis (remotely between visits and/or at visits), with reminders prompting patients to self-report that are sent via email, text, or automated phone message. More recently, care management pathways for patients and clinicians have been triggered by PRO system alerts. PRO systems may be free-standing, integrated into electronic health record systems or patient portals, or native functionality of an electronic health record. Despite potential benefits, there are challenges with integrating PROs into practice for monitoring patient status, as there are with any modifications to existing clinical processes. These challenges range from administrative to technical to workflow. A session at the 2018 ASCO Annual Meeting was dedicated to the implementation of PROs in clinical practice. The session focused on practical examples of PRO implementations, with honest reflections on barriers and strategies that may be generalizable to other systems looking to implement PROs. Panelists for that session are the authors of this paper, which describes their respective experiences implementing PROs in practice settings.

Sign in / Sign up

Export Citation Format

Share Document