Touchscreen clinical workstations at point of care: a paradigm shift in electronic medical record design for developing countries

2008 ◽  
Author(s):  
M.V. McKay ◽  
G.P. Douglas
Keyword(s):  
Developing Countries ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Paradigm Shift ◽  
Point Of Care

Electronic medical record systems for developing countries: Review

2009 ◽  
Author(s):  
N.A. Kalogriopoulos ◽  
J. Baran ◽  
A.J. Nimunkar ◽  
J.G. Webster
Keyword(s):  
Developing Countries ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Electronic Medical Record Systems

scholarly journals Examining the Prevalence and Patterns of Multimorbidity in Canadian Primary Healthcare: A Methodologic Protocol using a National Electronic Medical Record Database

2015 ◽  
Vol 5 (1) ◽  
pp. 150-161 ◽  
Author(s):  
Kathryn Nicholson ◽  
Amanda L. Terry ◽  
Martin Fortin ◽  
Tyler Williamson ◽  
Michael Bauer ◽  
...  
Keyword(s):  
Medical Record ◽  
Chronic Diseases ◽  
Electronic Medical Record ◽  
Primary Healthcare ◽  
Proportional Hazards ◽  
Point Of Care ◽  
Developed Countries ◽  
Cox Proportional Hazards ◽  
Surveillance Network ◽  
Geographical Variations

In many developed countries, the burden of disease has shifted from acute to long-term or chronic diseases – producing new and broader challenges for patients, healthcare providers, and healthcare systems. Multimorbidity, the coexistence of two or more chronic diseases within an individual, is recognized as a significant public health and research priority. This protocol aims to examine the prevalence, characteristics, and changing burden of multimorbidity among adult primary healthcare (PHC) patients using electronic medical record (EMR) data. The objectives are two-fold: (1) to measure the point prevalence and clusters of multimorbidity among adult PHC patients; and (2) to examine the natural history and changing burden of multimorbidity over time among adult PHC patients. Data will be derived from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The CPCSSN database contains longitudinal, point-of-care data from EMRs across Canada. To identify adult patients with multimorbidity, a list of 20 chronic disease categories (and corresponding ICD-9 codes) will be used. A computational cluster analysis will be conducted using a customized computer program written in JAVA. A Cox proportional hazards analysis will be used to model time-to-event data, while simultaneously adjusting for provider- and patient-level predictors. All analyses will be conducted using STATA SE 13.1. This research is the first of its kind using a pan-Canadian EMR database, which will provide an opportunity to contribute to the international evidence base. Future work should systematically compare international research using similar robust methodologies to determine international and geographical variations in the epidemiology of multimorbidity.

scholarly journals Developing a point-of-care electronic medical record system for TB/HIV co-infected patients: experiences from Lighthouse Trust, Lilongwe, Malawi

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Hannock Tweya ◽  
Caryl Feldacker ◽  
Oliver Jintha Gadabu ◽  
Wingston Ng’ambi ◽  
Soyapi L. Mumba ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Point Of Care ◽  
Electronic Medical Record System ◽  
Record System ◽  
Medical Record System

scholarly journals Integrating family planning services into HIV care: use of a point-of-care electronic medical record system in Lilongwe, Malawi

2017 ◽  
Vol 10 (1) ◽  
pp. 1383724 ◽  
Author(s):  
Hannock Tweya ◽  
Caryl Feldacker ◽  
Lisa B. Haddad ◽  
Chimango Munthali ◽  
Mwatha Bwanali ◽  
...  
Keyword(s):  
Family Planning ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Point Of Care ◽  
Electronic Medical Record System ◽  
Hiv Care ◽  
Family Planning Services ◽  
Record System ◽  
Medical Record System

scholarly journals A Case Study of a Point-of-Care Electronic Medical Record [SABER] in Totonicapán, Guatemala: Benefits, Challenges, and Future Directions

2020 ◽  
Vol 86 (1) ◽  
Author(s):  
Nicholas H. Aldredge ◽  
Dorian Rodriguez ◽  
Jessica González ◽  
David R. Burt
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Point Of Care ◽  
Future Directions

scholarly journals Transcription Errors of Blood Glucose Values and Insulin Errors in an Intensive Care Unit: Secondary Data Analysis Toward Electronic Medical Record-Glucometer Interoperability (Preprint)

2018 ◽  
Author(s):  
Azizeh Khaled Sowan ◽  
Ana Vera ◽  
Ashwin Malshe ◽  
Charles Reed
Keyword(s):  
Intensive Care ◽  
Blood Glucose ◽  
Medical Record ◽  
Intensive Care Units ◽  
Electronic Medical Record ◽  
Point Of Care ◽  
Vital Signs ◽  
Secondary Data ◽  
Flow Sheet ◽  
Glucose Testing

BACKGROUND Critically ill patients require constant point-of-care blood glucose testing to guide insulin-related decisions. Transcribing these values from glucometers into a paper log and the electronic medical record is very common yet error-prone in intensive care units, given the lack of connectivity between glucometers and the electronic medical record in many US hospitals. OBJECTIVE We examined (1) transcription errors of glucometer blood glucose values documented in the paper log and in the electronic medical record vital signs flow sheet in a surgical trauma intensive care unit, (2) insulin errors resulting from transcription errors, (3) lack of documenting these values in the paper log and the electronic medical record vital signs flow sheet, and (4) average time for docking the glucometer. METHODS This secondary data analysis examined 5049 point-of-care blood glucose tests. We obtained values of blood glucose tests from bidirectional interface software that transfers the meters’ data to the electronic medical record, the paper log, and the vital signs flow sheet. We obtained patient demographic and clinical-related information from the electronic medical record. RESULTS Of the 5049 blood glucose tests, which were pertinent to 234 patients, the total numbers of undocumented or untranscribed tests were 608 (12.04%) in the paper log, 2064 (40.88%) in the flow sheet, and 239 (4.73%) in both. The numbers of transcription errors for the documented tests were 98 (2.21% of 4441 documented tests) in the paper log, 242 (8.11% of 2985 tests) in the flow sheet, and 43 (1.64% of 2616 tests) in both. The numbers of transcription errors per patient were 0.4 (98 errors/234 patients) in the paper log, 1 (242 errors/234 patients) in the flow sheet, and 0.2 in both (43 errors/234 patients). Transcription errors in the paper log, the flow sheet, and in both resulted in 8, 24, and 2 insulin errors, respectively. As a consequence, patients were given a lower or higher insulin dose than the dose they should have received had there been no errors. Discrepancies in insulin doses were 2 to 8 U lower doses in paper log transcription errors, 10 U lower to 3 U higher doses in flow sheet transcription errors, and 2 U lower in transcription errors in both. Overall, 30 unique insulin errors affected 25 of 234 patients (10.7%). The average time from point-of-care testing to meter docking was 8 hours (median 5.5 hours), with some taking 56 hours (2.3 days) to be uploaded. CONCLUSIONS Given the high dependence on glucometers for point-of-care blood glucose testing in intensive care units, full electronic medical record-glucometer interoperability is required for complete, accurate, and timely documentation of blood glucose values and elimination of transcription errors and the subsequent insulin-related errors in intensive care units.

scholarly journals Design and implementation of pragmatic clinical trials using the electronic medical record and an adaptive design

JAMIA Open ◽  
2018 ◽  
Vol 1 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Kelly Claire Simon ◽  
Samuel Tideman ◽  
Laura Hillman ◽  
Rebekah Lai ◽  
Raman Jathar ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Adaptive Design ◽  
Point Of Care ◽  
Phase 1 ◽  
Clinical Practices ◽  
Pragmatic Trials ◽  
Clinical Workflow ◽  
Pragmatic Clinical Trials

AbstractObjectivesTo demonstrate the feasibility of pragmatic clinical trials comparing the effectiveness of treatments using the electronic medical record (EMR) and an adaptive assignment design.MethodsWe have designed and are implementing pragmatic trials at the point-of-care using custom-designed structured clinical documentation support and clinical decision support tools within our physician’s typical EMR workflow. We are applying a subgroup based adaptive design (SUBA) that enriches treatment assignments based on baseline characteristics and prior outcomes. SUBA uses information from a randomization phase (phase 1, equal randomization, 120 patients), to adaptively assign treatments to the remaining participants (at least 300 additional patients total) based on a Bayesian hierarchical model. Enrollment in phase 1 is underway in our neurology clinical practices for 2 separate trials using this method, for migraine and mild cognitive impairment (MCI).ResultsWe are successfully collecting structured data, in the context of the providers’ clinical workflow, necessary to conduct our trials. We are currently enrolling patients in 2 point-of-care trials of non-inferior treatments. As of March 1, 2018, we have enrolled 36% of eligible patients into our migraine study and 63% of eligible patients into our MCI study. Enrollment is ongoing and validation of outcomes has begun.DiscussionThis proof of concept article demonstrates the feasibility of conducting pragmatic trials using the EMR and an adaptive design.ConclusionThe demonstration of successful pragmatic clinical trials based on a customized EMR and adaptive design is an important next step in achieving personalized medicine and provides a framework for future studies of comparative effectiveness.

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