scholarly journals Identifying Multisite Chronic Pain with Electronic Health Records Data

Pain Medicine ◽  
2020 ◽  
Vol 21 (12) ◽  
pp. 3387-3392
Author(s):  
Michael Von Korff ◽  
Lynn L DeBar ◽  
Richard A Deyo ◽  
Meghan Mayhew ◽  
Robert D Kerns ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Electronic Health Records ◽  
Single Site ◽  
Self Report ◽  
Survey Questionnaire ◽  
Health Records ◽  
Health Care Data ◽  
Electronic Health ◽  
Weighted Prevalence

Abstract Background Multisite chronic pain (MSCP) is associated with increased chronic pain impact, but methods for identifying MSCP for epidemiological research have not been evaluated. Objective We assessed the validity of identifying MSCP using electronic health care data compared with survey questionnaires. Methods Stratified random samples of adults served by Kaiser Permanente Northwest and Washington (N = 2,059) were drawn for a survey, oversampling persons with frequent use of health care for pain. MSCP and single-site chronic pain were identified by two methods, with electronic health care data and with self-report of common chronic pain conditions by survey questionnaire. Analyses were weighted to adjust for stratified sampling. Results MSCP was somewhat less common when ascertained by electronic health records (14.7% weighted prevalence) than by survey questionnaire (25.9% weighted prevalence). Agreement of the two MSCP classifications was low (kappa agreement statistic of 0.21). Ascertainment of MSCP with electronic health records was 30.9% sensitive, 91.0% specific, and had a positive predictive value of 54.5% relative to MSCP identified by self-report as the standard. After adjusting for age and gender, patients with MSCP identified by either electronic health records or self-report showed higher levels of pain-related disability, pain severity, depressive symptoms, and long-term opioid use than persons with single-site chronic pain identified by the same method. Conclusions Identification of MSCP with electronic health care data was insufficiently accurate to be used as a surrogate or screener for MSCP identified by self-report, but both methods identified persons with heightened chronic pain impact.

scholarly journals Estimating the population health burden of musculoskeletal conditions using primary care electronic health records

Rheumatology ◽  
2021 ◽  
Author(s):  
Dahai Yu ◽  
George Peat ◽  
Kelvin P Jordan ◽  
James Bailey ◽  
Daniel Prieto-Alhambra ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Electronic Health Records ◽  
High Impact ◽  
Low Back ◽  
Musculoskeletal Health ◽  
Health Records ◽  
Electronic Health

Abstract Objectives Better indicators from affordable, sustainable data sources are needed to monitor population burden of musculoskeletal conditions. We propose five indicators of musculoskeletal health and assessed if routinely available primary care electronic health records (EHR) can estimate population levels in musculoskeletal consulters. Methods We collected validated patient-reported measures of pain experience, function and health status through a local survey of adults (≥35 years) presenting to English general practices over 12 months for low back pain, shoulder pain, osteoarthritis and other regional musculoskeletal disorders. Using EHR data we derived and validated models for estimating population levels of five self-reported indicators: prevalence of high impact chronic pain, overall musculoskeletal health (based on Musculoskeletal Health Questionnaire), quality of life (based on EuroQoL health utility measure), and prevalence of moderate-to-severe low back pain and moderate-to-severe shoulder pain. We applied models to a national EHR database (Clinical Practice Research Datalink) to obtain national estimates of each indicator for three successive years. Results The optimal models included recorded demographics, deprivation, consultation frequency, analgesic and antidepressant prescriptions, and multimorbidity. Applying models to national EHR, we estimated that 31.9% of adults (≥35 years) presenting with non-inflammatory musculoskeletal disorders in England in 2016/17 experienced high impact chronic pain. Estimated population health levels were worse in women, older aged and those in the most deprived neighbourhoods, and changed little over 3 years. Conclusion National and subnational estimates for a range of subjective indicators of non-inflammatory musculoskeletal health conditions can be obtained using information from routine electronic health records.

Negotiating stigma in health care: disclosure and the role of electronic health records

2015 ◽  
Vol 24 (3) ◽  
pp. 227-241 ◽  
Author(s):  
Timothy Stablein ◽  
Joseph Lorenzo Hall ◽  
Chauna Pervis ◽  
Denise L. Anthony
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health

Implementing Health Care Quality Measures in Electronic Health Records: A Conceptual Model

2021 ◽  
Author(s):  
Claire M. Campbell ◽  
Daniel R. Murphy ◽  
George E. Taffet ◽  
Anita B. Major ◽  
Christine S. Ritchie ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Conceptual Model ◽  
Health Care Quality ◽  
Quality Measures ◽  
Care Quality ◽  
Health Records ◽  
Electronic Health

scholarly journals Secure Exchange of Electronic Health Records

2012 ◽  
pp. 1403-1424
Author(s):  
Alejandro Enrique Flores ◽  
Khin Than Win ◽  
Willy Susilo
Keyword(s):  
Health Care ◽  
Access Control ◽  
Electronic Health Records ◽  
Shared Care ◽  
Health Records ◽  
Discretionary Access Control ◽  
Attribute Based Encryption ◽  
Electronic Health ◽  
Role Based ◽  
Traditional Approaches

Protecting the confidentiality of a patient’s information in a shared care environment could become a complex task. Correct identification of users, assigning of access permissions, and resolution of conflict rise as main points of interest in providing solutions for data exchange among health care providers. Traditional approaches such as Mandatory Access Control, Discretionary Access control and Role-Based Access Control policies do not always provide a suitable solution for health care settings, especially for shared care environments. The core of this contribution consists in the description of an approach which uses attribute-based encryption to protect the confidentiality of patients’ information during the exchange of electronic health records among healthcare providers. Attribute-based encryption allows the reinforcing of access policies and reduces the risk of unauthorized access to sensitive information; it also provides a set of functionalities which are described using a case study. Attribute-based encryption provides an answer to restrictions presented by traditional approaches and facilitate the reinforcing of existing security policies over the transmitted data.

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