Measuring Outcomes and Effectiveness of the Nutrition Care Process - Electronic Health Record Applications for Nutrition Monitoring and Evaluation

Hospital malnutrition and pediatric nutrition care in Hasan Sadikin Hospital BandungBackground: Malnutrition during hospitalization delays the recovery of children with acute or chronic illnesses. The Pediatric Nutrition Care (PNC) can improve nutritional support and reduce the prevalence of hospital malnutrition.Objectives: This study was done to find evidence of hospital malnutrition and to evaluate the nutrition care in the pediatric ward of Dr. Hasan Sadikin Hospital, Bandung. Methods: We evaluated malnutrition by comparing body weight change between the first day of admission and at hospital discharge to the length of hospitalization. Screening for malnutrition risk was done using modified Pediatric Yorkhill Malnutrition Screening (mPYMS). Score≥2 was determined as high risk. The PNC process was evaluated by a focused group discussion with PNC-associated pediatric ward personnel.Results: From February-March 2016, 760 patients were admitted to the pediatric ward, of which 111(14.6%) were included in the study. An mPYMS score of ≥2 was found in 69(62.2%) of the patients. During hospitalization, body weight decreased in 23(20.7%) patients, 10(9.0%) of whom were defined as hospital malnutrition. Among these, seven had an mPYMS score≥2. PNC was performed in patients with an mPYMS score≥2 by dietitians who also provided a standardized nutrition care process following American Dietetic Association recommendation. However, a dedicated multidisciplinary PNC team was absent and the nutrition and metabolic disease division was consulted only in a few cases. Performing consistent monitoring and evaluation of PNC was also found to be difficult. Conclusions: Hospital malnutrition may be prevalent among pediatric patients in Dr. Hasan Sadikin Hospital, Bandung. Improving PNC services may reduce this prevalence.

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High-fidelity phenotyping: richness and freedom from bias

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocx110 ◽

2017 ◽

Vol 25 (3) ◽

pp. 289-294 ◽

Cited By ~ 13

Author(s):

George Hripcsak ◽

David J Albers

Keyword(s):

Electronic Health Record ◽

Care Process ◽

Mechanistic Models ◽

Health Record ◽

High Fidelity ◽

Electronic Health Record Data ◽

Record Data ◽

Electronic Health ◽

Substantial Bias ◽

Conceptual Relationships

Abstract Electronic health record phenotyping is the use of raw electronic health record data to assert characterizations about patients. Researchers have been doing it since the beginning of biomedical informatics, under different names. Phenotyping will benefit from an increasing focus on fidelity, both in the sense of increasing richness, such as measured levels, degree or severity, timing, probability, or conceptual relationships, and in the sense of reducing bias. Research agendas should shift from merely improving binary assignment to studying and improving richer representations. The field is actively researching new temporal directions and abstract representations, including deep learning. The field would benefit from research in nonlinear dynamics, in combining mechanistic models with empirical data, including data assimilation, and in topology. The health care process produces substantial bias, and studying that bias explicitly rather than treating it as merely another source of noise would facilitate addressing it.

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Implementing Electronic Health Records with Standardized Language for the Nutrition Care Process in Acute Care Hospital

Journal of the American Dietetic Association ◽

10.1016/j.jada.2009.06.035 ◽

2009 ◽

Vol 109 (9) ◽

pp. A18

Author(s):

L.F. Suen

Keyword(s):

Electronic Health Records ◽

Acute Care ◽

Acute Care Hospital ◽

Care Process ◽

Care Hospital ◽

Health Records ◽

Nutrition Care ◽

Electronic Health ◽

Nutrition Care Process

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Business: The Electronic Health Record: Front Line Experience

Perspectives on Administration and Supervision ◽

10.1044/aas21.1.18 ◽

2011 ◽

Vol 21 (1) ◽

pp. 18-22

Author(s):

Rosemary Griffin

Keyword(s):

Health Care ◽

Information Technology ◽

Electronic Health Record ◽

Financial Incentives ◽

Best Practice ◽

Health Care Systems ◽

The United States ◽

Health Record ◽

Health Trends ◽

Electronic Health

National legislation is in place to facilitate reform of the United States health care industry. The Health Care Information Technology and Clinical Health Act (HITECH) offers financial incentives to hospitals, physicians, and individual providers to establish an electronic health record that ultimately will link with the health information technology of other health care systems and providers. The information collected will facilitate patient safety, promote best practice, and track health trends such as smoking and childhood obesity.

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