scholarly journals Interactive, on-line visualization tools to measure and drive equity in COVID-19 vaccine administrations

2021 ◽  
Author(s):  
Amy W Shaheen ◽  
Eileen Ciesco ◽  
Kevin Johnson ◽  
Greg Kuhnen ◽  
Christopher Paolini ◽  
...  
Keyword(s):  
Data Warehouse ◽  
Social Vulnerability ◽  
Large Hospital ◽  
Equitable Distribution ◽  
Hospital System ◽  
Online Tools ◽  
On Line ◽  
Visualization Tools ◽  
Race Ethnicity ◽  
Data Elements

Abstract Equitable distribution of vaccines is necessary to ensure those at highest risk of illness are protected from COVID-19 (coronavirus disease 2019). Unfortunately, there is significant evidence that vaccines have not been reaching the most vulnerable. At our large hospital system, we created interactive online tools to measure and visualize equitability of vaccine administrations and to help stakeholders identify populations at highest risk within state-designated eligible vaccine groups. Using race, ethnicity, gender, and social vulnerability, we are able to measure and reflect our vaccine administration performance against the communities that we serve. With our visualization tools, stakeholders have been able to target interventions to improve equity in vaccine administrations, including improvements in race, ethnicity, and social vulnerability. We plan to use the data elements incorporated in our electronic health record and data warehouse due to the COVID-19 pandemic to guide further population health efforts at decreasing disparities.

Evolutionary Intelligent Data Warehousing Approach to Knowledge Discovery Systems: Dynamic Cubing

2019 ◽  
Vol 13 ◽  
Author(s):  
Harkiran Kaur ◽  
Kawaljeet Singh ◽  
Tejinder Kaur
Keyword(s):  
Knowledge Discovery ◽  
Data Warehouse ◽  
Business Intelligence ◽  
End Users ◽  
Processing Stage ◽  
Information Update ◽  
On Line ◽  
Analytical Processing ◽  
Warehouse Operations ◽  
Made In

Background: Numerous E – Migrants databases assist the migrants to locate their peers in various countries; hence contributing largely in communication of migrants, staying overseas. Presently, these traditional E – Migrants databases face the issues of non – scalability, difficult search mechanisms and burdensome information update routines. Furthermore, analysis of migrants’ profiles in these databases has remained unhandled till date and hence do not generate any knowledge. Objective: To design and develop an efficient and multidimensional knowledge discovery framework for E - Migrants databases. Method: In the proposed technique, results of complex calculations related to most probable On-Line Analytical Processing operations required by end users, are stored in the form of Decision Trees, at the pre- processing stage of data analysis. While browsing the Cube, these pre-computed results are called; thus offering Dynamic Cubing feature to end users at runtime. This data-tuning step reduces the query processing time and increases efficiency of required data warehouse operations. Results: Experiments conducted with Data Warehouse of around 1000 migrants’ profiles confirm the knowledge discovery power of this proposal. Using the proposed methodology, authors have designed a framework efficient enough to incorporate the amendments made in the E – Migrants Data Warehouse systems on regular intervals, which was totally missing in the traditional E – Migrants databases. Conclusion: The proposed methodology facilitate migrants to generate dynamic knowledge and visualize it in the form of dynamic cubes. Applying Business Intelligence mechanisms, blending it with tuned OLAP operations, the authors have managed to transform traditional datasets into intelligent migrants Data Warehouse.

scholarly journals Assessment of vitamin B12 deficiency and B12 screening trends for patients on metformin: a retrospective cohort case review

2021 ◽  
pp. bmjnph-2020-000193
Author(s):  
Darby Martin ◽  
Jeet Thaker ◽  
Maria Shreve ◽  
Lois Lamerato ◽  
Kartazyna Budzynska
Keyword(s):  
Retrospective Cohort ◽  
Protective Factor ◽  
Vitamin B12 Deficiency ◽  
Older Age ◽  
Secondary Outcome ◽  
Vitamin B ◽  
Case Review ◽  
Large Hospital ◽  
Hospital System ◽  
B12 Deficiency

ObjectivesOur study investigated the use of vitamin B12 testing in a large cohort of patients on metformin and assesses appropriateness and benefits of screening recommendations for vitamin B12 deficiency.DesignThis retrospective cohort study included insured adult patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin to establish compliance. The comparison group was not exposed to metformin. Primary outcome was incidence of B12 deficiency diagnosed in patients on metformin. Secondary outcome was occurrence of B12 testing in the patient population on metformin. Records dated through 31 December 2018 were analysed.SettingLarge hospital system consisting of inpatient and outpatient data base.ParticipantsA diverse, adult, insured population of patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin.ResultsOf 13 489 patients on metformin, 6051 (44.9%) were tested for vitamin B12 deficiency, of which 202 (3.3%) tested positive (vs 2.2% of comparisons). Average time to test was 990 days. Average time to test positive for deficiency was 1926 days. Factors associated with testing were linked to sex (female, 47.8%), older age (62.79% in patients over 80 years old), race (48.98% white) and causes of malabsorption (7.11%). Multivariable logistic regression showed older age as the only factor associated with vitamin B12 deficiency, whereas African-American ethnicity approached significance as a protective factor.ConclusionsBased on our study’s findings of vitamin B12 deficiency in patients on metformin who are greater than 65 years old and have been using it for over 5 years, we recommend that physicians consider screening in these populations.

scholarly journals Leveraging Real-World Data for the Selection of Relevant Eligibility Criteria for the Implementation of Electronic Recruitment Support in Clinical Trials

2021 ◽  
Vol 12 (01) ◽  
pp. 017-026
Author(s):  
Georg Melzer ◽  
Tim Maiwald ◽  
Hans-Ulrich Prokosch ◽  
Thomas Ganslandt
Keyword(s):  
Data Warehouse ◽  
Real World ◽  
Chart Review ◽  
Patient Recruitment ◽  
Real World Data ◽  
Eligibility Criteria ◽  
Health Records ◽  
World Data ◽  
Paper Chart ◽  
Data Elements

Abstract Background Even though clinical trials are indispensable for medical research, they are frequently impaired by delayed or incomplete patient recruitment, resulting in cost overruns or aborted studies. Study protocols based on real-world data with precisely expressed eligibility criteria and realistic cohort estimations are crucial for successful study execution. The increasing availability of routine clinical data in electronic health records (EHRs) provides the opportunity to also support patient recruitment during the prescreening phase. While solutions for electronic recruitment support have been published, to our knowledge, no method for the prioritization of eligibility criteria in this context has been explored. Methods In the context of the Electronic Health Records for Clinical Research (EHR4CR) project, we examined the eligibility criteria of the KATHERINE trial. Criteria were extracted from the study protocol, deduplicated, and decomposed. A paper chart review and data warehouse query were executed to retrieve clinical data for the resulting set of simplified criteria separately from both sources. Criteria were scored according to disease specificity, data availability, and discriminatory power based on their content and the clinical dataset. Results The study protocol contained 35 eligibility criteria, which after simplification yielded 70 atomic criteria. For a cohort of 106 patients with breast cancer and neoadjuvant treatment, 47.9% of data elements were captured through paper chart review, with the data warehouse query yielding 26.9% of data elements. Score application resulted in a prioritized subset of 17 criteria, which yielded a sensitivity of 1.00 and specificity 0.57 on EHR data (paper charts, 1.00 and 0.80) compared with actual recruitment in the trial. Conclusion It is possible to prioritize clinical trial eligibility criteria based on real-world data to optimize prescreening of patients on a selected subset of relevant and available criteria and reduce implementation efforts for recruitment support. The performance could be further improved by increasing EHR data coverage.

Abstract TP374: Data Linkage is Effective for Improving the Available Data for Stroke: An Example from the Australian Stroke Clinical Registry.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Monique F Kilkenny ◽  
Helen M Dewey ◽  
Natasha A Lannin ◽  
Vijaya Sundararajan ◽  
Joyce Lim ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Hospital Discharge Data ◽  
Hospital Data ◽  
High Quality ◽  
Clinical Registry ◽  
Large Hospital ◽  
Common Data Elements ◽  
Discharge Data ◽  
Data Elements ◽  
Data Collections

Introduction: Multiple data collections can be a burden for clinicians. In 2009, the Australian Stroke Clinical Registry (AuSCR) was established by non-government and research organizations to provide quality of care data unavailable for acute stroke admissions. We show here the reliability of linking complimentary registry data with routinely collected hospital discharge data submitted to governmental bodies. Hypothesis: A high quality linkage with a > 90% rate is possible, but requires multiple personal identifiers common to each dataset. Methods: AuSCR identifying variables included date of birth (DoB), Medicare number, first name, surname, postcode, gender, hospital record number, hospital name and admission date. The Victorian Department of Health emergency department (ED) and hospital discharge linked dataset has most of these, with first name truncated to the first 3 digits, but no surname. Common data elements of AuSCR patients registered at a large hospital in Melbourne, Victoria (Australia) between 15 June 2009 and 31 December 2010 were submitted to undergo stepwise deterministic linkage. Results: The Victorian AuSCR sample had 818 records from 788 individuals. Three steps with 1) Medicare number, postcode, gender and DoB (80% matched); 2) hospital number/admit date; and 3) ED number/visit date were required to link AuSCR data with the ED and hospital discharge data. These led to an overall high quality linkage of >99% (782/788) of AuSCR patients, including 731/788 for ED records and 736/788 for hospital records. Conclusion: Multiple personal identifiers from registries are required to achieve reliable linkage to routinely collected hospital data. Benefits of these linked data include the ability to investigate a broader range of research questions than with a single dataset. Characters with spaces= 1941 (limit is 1950)

Resourcing Popular Music for Relevant Themes in Music Therapy with Perinatal Loss

2021 ◽  
Author(s):  
John Mondanaro
Keyword(s):  
Music Therapy ◽  
Popular Music ◽  
Belief Systems ◽  
Perinatal Loss ◽  
Anticipatory Grief ◽  
Large Hospital ◽  
Hospital System ◽  
Perinatal Bereavement ◽  
Art Form ◽  
Grief Responses

Abstract Perinatal loss poses unique challenges to grief work because of the complexity of dynamics it carries. Historically shrouded in socially and culturally based belief systems often impeding normal grief responses, the barriers to healthy processing have been surmounted in recent decades. The emergence of music therapy in partnership with social work is one such approach to addressing both anticipatory grief and bereavement of parents enduring the death of their infant prenatally. This retrospective article highlights the resourcing of popular music within a clinical music therapy approach to the curation of a perinatal bereavement event within a large hospital system in a metropolitan area. Popular music as a ubiquitous art form lends tangibility and relevance to the complicated themes of perinatal loss in a manner that invites bereft parents into a forum of acceptance and acknowledgment of a loss that for too long has remained in the shadows.

Abstract WP455: Memorial Hermann Hospital System Stroke Coordinators: Working as One

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sandi G Shaw ◽  
Isabel Gonzales ◽  
Hari Indupuru ◽  
Nicole Harrison ◽  
Sean Savitz ◽  
...  
Keyword(s):  
Best Practice ◽  
Quality Care ◽  
High Volume ◽  
Work Load ◽  
Joint Commission ◽  
Large Hospital ◽  
Hospital System ◽  
Primary Stroke Center ◽  
Stroke Center ◽  
The Joint Commission

Background: Many hospital stroke programs fail to meet or maintain the certification requirements of The Joint Commission (TJC) as a Primary Stroke Center (PSC) or Comprehensive Stroke Center (CSC). The most common reason is the absence of a dedicated stroke program coordinator. There are opportunities for improvement to promote stroke coordinator growth and retention. Purpose: We created The Memorial Hermann Hospital System Stroke Coordinator Alliance to combine resources, reduce workload, and support stroke coordinators in order to promote adherence to best practice and maintain TJC stroke certification. Methods: The Memorial Hermann Hospital System Stroke Coordinator Alliance was developed in 2015. It includes 14 nurses who represent 11 acute care hospitals within a large hospital system in Houston (Figure1). Four of the hospitals are CSCs, five are PSCs, and two are not certified. Monthly meetings are conducted to create standardized access to resources, stroke coordinator orientation, education, medical power plans, process improvement, and data development. Coordinator work groups, a central email and shared drive, biweekly data meetings, and a buddy system were created to reduce work load, improve electronic communication, and streamline data review procedures. A partnership was created to onboard new coordinators and to prepare for mock and real time survey visits. In 2018 data abstraction was standardized across hospitals with use of a homegrown database Stroke Program Registry (REGIS). Results: Of the 14 Stroke Coordinators in place during fiscal years 2015 - 2019, retention was 100%. A total of 19 stroke surveys were completed and recognized as successful by The Joint Commission. A total of 17,148 stroke patients were received with PSC measures averaging greater than 95% and CSC measures above 90%. Conclusion: Implementing program development support for stroke coordinators improves retention and quality care in a high volume stroke system.

Analysis of On-Line Clinical Laboratory Manuals and Practical Recommendations

2004 ◽  
Vol 128 (4) ◽  
pp. 476-479
Author(s):  
Bruce Beckwith ◽  
Robert Schwartz ◽  
Liron Pantanowitz
Keyword(s):  
Reference Range ◽  
Clinical Laboratory ◽  
Critical Values ◽  
Supplementary Information ◽  
Reference Ranges ◽  
Individual Test ◽  
Test Methodology ◽  
Laboratory Manuals ◽  
On Line ◽  
Data Elements

Abstract Context.—On-line clinical laboratory manuals are a valuable resource for medical professionals. To our knowledge, no recommendations currently exist for their content or design. Objective.—To analyze publicly accessible on-line clinical laboratory manuals and to propose guidelines for their content. Design.—We conducted an Internet search for clinical laboratory manuals written in English with individual test listings. Four individual test listings in each manual were evaluated for 16 data elements, including sample requirements, test methodology, units of measure, reference range, and critical values. Web sites were also evaluated for supplementary information and search functions. Results.—We identified 48 on-line laboratory manuals, including 24 academic or community hospital laboratories and 24 commercial or reference laboratories. All manuals had search engines and/or test indices. No single manual contained all 16 data elements evaluated. An average of 8.9 (56%) elements were present (range, 4–14). Basic sample requirements (specimen and volume needed) were the elements most commonly present (98% of manuals). The frequency of the remaining data elements varied from 10% to 90%. Conclusions.—On-line clinical laboratory manuals originate from both hospital and commercial laboratories. While most manuals were user-friendly and contained adequate specimen-collection information, other important elements, such as reference ranges, were frequently absent. To ensure that clinical laboratory manuals are of maximal utility, we propose the following 13 data elements be included in individual test listings: test name, synonyms, test description, test methodology, sample requirements, volume requirements, collection guidelines, transport guidelines, units of measure, reference range, critical values, test availability, and date of latest revision.

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