scholarly journals Characterizing Post-Acute Sequelae of SARS-CoV-2 Infection across Claims and Electronic Health Record Databases

2021 ◽  
Author(s):  
Matthew E Spotnitz ◽  
George Hripcsak ◽  
Patrick B Ryan ◽  
Karthik Natarajan
Keyword(s):  
Electronic Health Record ◽  
Large Scale ◽  
Medical Center ◽  
Respiratory Illness ◽  
Public Health Issue ◽  
Common Data Model ◽  
Health Record ◽  
Electronic Health

Structured Abstract Importance: Post-acute sequelae of SARS-CoV-2 infection (PASC) is emerging as a major public health issue. Objective: We characterized the incidence of PASC, or related symptoms and diagnoses, for COVID-19 and influenza patients. Design: Retrospective cohort study. Setting: Our data sources were the IBM MarketScan Commercial Claims and Encounters (CCAE), Optum Electronic Health Record (EHR) and Columbia University Irving Medical Center (CUIMC) databases that were transformed to the Observational Medical Outcome Partnership (OMOP) Common Data Model (CDM) and were part of the Observational Health Sciences and Informatics (OHDSI) network. Participants: The COVID-19 cohort consisted of patients with a diagnosis of COVID-19 or positive lab test of SARS-CoV-2 after January 1st 2020 with a follow up period of at least 30 days. The influenza cohort consisted of patients with a diagnosis of influenza between October 1, 2018 and May 1, 2019 with a follow up period of at least 30 days. Intervention: Infection with COVID-19 or influenza. Main Outcomes and Measures: Post-acute sequelae of SARS-CoV-2 infection (PASC), or related diagnoses, for COVID-19 and influenza patients. Results: In aggregate, we characterized the post-acute experience for over 440,000 patients who were diagnosed with COVID-19 or tested positive for SARS-COV-2. The long term sequelae that had a higher incidence in the COVID-19 compared to Influenza cohorts were altered smell or taste, myocarditis, acute kidney injury, dyspnea and alopecia. Additionally, the long term incidences of respiratory illness, musculoskeletal disease, and psychiatric disorders for the COVID-19 population were higher than expected. Conclusions and Relevance: The long term sequelae of COVID-19 and influenza may be different. Further characterization of PASC on large scale observational healthcare databases is warranted.

scholarly journals A long-term follow-up evaluation of electronic health record prescribing safety

2013 ◽  
Vol 20 (e1) ◽  
pp. e52-e58 ◽  
Author(s):  
E. L. Abramson ◽  
S. Malhotra ◽  
S. N. Osorio ◽  
A. Edwards ◽  
A. Cheriff ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Health Record ◽  
Long Term Follow Up ◽  
Electronic Health

scholarly journals Characterization and selection of Japanese electronic health record databases used as data sources for non-interventional observational studies

2021 ◽  
Author(s):  
Yumi Wakabayashi ◽  
Masamitsu Eitoku ◽  
Narufumi Suganuma
Keyword(s):  
Electronic Health Record ◽  
Observational Studies ◽  
Large Scale ◽  
Data Sources ◽  
Flow Diagram ◽  
Health Record ◽  
Medical Institutions ◽  
Data Source ◽  
Electronic Health ◽  
Using Data

Abstract Background Interventional studies are the fundamental method for obtaining answers to clinical question. However, these studies are sometimes difficult to conduct because of insufficient financial or human resources or the rarity of the disease in question. One means of addressing these issues is to conduct a non-interventional observational study using electronic health record (EHR) databases as the data source, although how best to evaluate the suitability of an EHR database when planning a study remains to be clarified. The aim of the present study is to identify and characterize the data sources that have been used for conducting non-interventional observational studies in Japan and propose a flow diagram to help researchers determine the most appropriate EHR database for their study goals. Methods We compiled a list of published articles reporting observational studies conducted in Japan by searching PubMed for relevant articles published in the last 3 years and by searching database providers’ publication lists related to studies using their databases. For each article, we reviewed the abstract and/or full text to obtain information about data source, target disease or therapeutic area, number of patients, and study design (prospective or retrospective). We then characterized the identified EHR databases. Results In Japan, non-interventional observational studies have been mostly conducted using data stored locally at individual medical institutions (713/1463) or collected from several collaborating medical institutions (351/1463). Whereas the studies conducted with large-scale integrated databases (195/1463) were mostly retrospective (68.2%), 27.2% of the single-center studies, 46.2% of the multi-center studies, and 74.4% of the post-marketing surveillance studies, identified in the present study, were conducted prospectively. Conclusions Our analysis revealed that the non-interventional observational studies were conducted using data stored local at individual medical institutions or collected from collaborating medical institutions in Japan. Disease registries, disease databases, and large-scale databases would enable researchers to conduct studies with large sample sizes to provide robust data from which strong inferences could be drawn. Using our flow diagram, researchers planning non-interventional observational studies should consider the strengths and limitations of each available database and choose the most appropriate one for their study goals. Trial registration Not applicable.

scholarly journals Electronic Health Record Adoption – Maybe It’s not about the Money

2011 ◽  
Vol 02 (04) ◽  
pp. 460-471 ◽  
Author(s):  
A. Skinner ◽  
J. Windle ◽  
L. Grabenbauer
Keyword(s):  
Electronic Health Record ◽  
Patient Care ◽  
Resistance To Change ◽  
Medical Center ◽  
Academic Medical Center ◽  
Care Physician ◽  
Health Record ◽  
Record System ◽  
Intuitive Interfaces ◽  
Electronic Health

SummaryObjective: The slow adoption of electronic health record (EHR) systems has been linked to physician resistance to change and the expense of EHR adoption. This qualitative study was conducted to evaluate benefits, and clarify limitations of two mature, robust, comprehensive EHR Systems by tech-savvy physicians where resistance and expense are not at issue.Methods: Two EHR systems were examined – the paperless VistA / Computerized Patient Record System used at the Veterans‘ Administration, and the General Electric Centricity Enterprise system used at an academic medical center. A series of interviews was conducted with 20 EHR-savvy multi-institutional internal medicine (IM) faculty and house staff. Grounded theory was used to analyze the transcribed data and build themes. The relevance and importance of themes were constructed by examining their frequency, convergence, and intensity.Results: Despite eliminating resistance to both adoption and technology as drivers of acceptance, these two robust EHR’s are still viewed as having an adverse impact on two aspects of patient care, physician workflow and team communication. Both EHR’s had perceived strengths but also significant limitations and neither were able to satisfactorily address all of the physicians’ needs.Conclusion: Difficulties related to physician acceptance reflect real concerns about EHR impact on patient care. Physicians are optimistic about the future benefits of EHR systems, but are frustrated with the non-intuitive interfaces and cumbersome data searches of existing EHRs.

scholarly journals Stratifying risk for dementia onset using large‐scale electronic health record data: A retrospective cohort study

2020 ◽  
Vol 16 (3) ◽  
pp. 531-540 ◽  
Author(s):  
Thomas H. McCoy ◽  
Larry Han ◽  
Amelia M. Pellegrini ◽  
Rudolph E. Tanzi ◽  
Sabina Berretta ◽  
...  
Keyword(s):  
Cohort Study ◽  
Electronic Health Record ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Large Scale ◽  
Health Record ◽  
Electronic Health Record Data ◽  
Record Data ◽  
Electronic Health ◽  
Dementia Onset

Hysterectomy utilization among newly diagnosed endometrial cancer patients by body mass index category: A real-world analysis using a claims and electronic health record database.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17112-e17112
Author(s):  
Debra E. Irwin ◽  
Ellen Thiel
Keyword(s):  
Endometrial Cancer ◽  
Electronic Health Record ◽  
Real World ◽  
Patient Population ◽  
Morbidly Obese ◽  
Health Record ◽  
Newly Diagnosed ◽  
Data Set ◽  
Electronic Health

e17112 Background: For endometrial cancer (EC), laparoscopic hysterectomy (LH) is an effective, minimally invasive surgical treatment; however, this approach may not be recommended for obese patients due to increased risk for complications. Methods: This retrospective study utilized insurance claims linked to electronic health record (EHR) data contained in the IBM MarketScan Explorys Claims-EHR Data Set. Newly diagnosed EC patients (1/1/2007 - 6/30/2017) with continuous enrollment during a 12-month baseline and 6-month follow-up period were selected. Patients were stratified into four BMI subgroups based on baseline BMI on the EHR: normal or underweight (BMI < 25), overweight (BMI 25- < 30), obese (BMI 30- < 40), morbidly obese (BMI > 40), and were required to have had a hysterectomy within the follow-up period. Emergency room visits and rehospitalization within 30 days of hysterectomy were measured. Results: A total of 1,090 newly-diagnosed EC patients met the selection criteria, of whom, 16% were normal/underweight, 19% were overweight, 39% were obese, and 26% were morbidly obese. The proportion of patients receiving LH increased as BMI category increased (Table 1). Among those with LH between 6% and 15% had an ER visit or rehospitalization in 30 days, and rates were higher among other hysterectomy modalities. Conclusions: This real-world analysis shows that LH is utilized in a high proportion of morbidly obese EC patients, despite that it is frequently deemed infeasible in this patient population. Although the rate of ER visits and rehospitalization is lower among LH patients than those undergoing traditional hysterectomy across all BMI strata, further research is needed to determine the optimal patient population to receive LH.[Table: see text]

scholarly journals Use of the Electronic Health Record to Track Continuity of Care in Neurological Surgery Residency

2014 ◽  
Vol 6 (3) ◽  
pp. 507-511 ◽  
Author(s):  
N. Scott Litofsky ◽  
Ali Farooqui ◽  
Tomoko Tanaka ◽  
Thor Norregaard
Keyword(s):  
Electronic Health Record ◽  
Continuity Of Care ◽  
Health Record ◽  
Electronic Health Record Data ◽  
Surgery Patient ◽  
Progress Notes ◽  
Electronic Health ◽  
Operative Notes ◽  
Neurological Surgery

Abstract Background Continuity of care in neurological surgery includes preoperative planning, technical and cognitive operative experience, and postoperative follow-up. Determining the extent of continuity of care with duty hour limits is problematic. Objective We used electronic health record data to track continuity of care in a neurological surgery program and to assess changes in rotation requirements. Methods The electronic health record was surveyed for all dictated resident–neurological surgery patient encounters (excluding progress notes), discharge summaries, and bedside procedures (July 2009–November 2011). Encounters were designated as preoperative, operative, or postoperative and were grouped by postgraduate year (PGY)–1 through PGY-6. Results A total of 6382 dictations were reviewed, with 5231 (82.0%) pertinent to neurological surgery. Of the 1469 operative notes, 303 (20.6%) had a record of an encounter with the operating resident in either a postoperative or preoperative setting. Preoperative encounters totaled 10.1% (148 of 1469); postoperative, 5.1% (75 of 1469); and encounters with both were 5.4% (80 of 1469). Continuity of care was as follows: PGY-1, 13.8% (4 of 29); PGY-2, 17.4% (26 of 149); PGY-3, 29.0% (36 of 124); PGY-4, 24.8% (73 of 294); PGY-5, 28.8% (109 of 379); and PGY-6, 11.1% (55 of 494). One of the highest continuity rates was observed in a rotation specifically constructed to enhance continuity of care. Conclusions The electronic health record can be used to track resident continuity of care in neurological surgery. The primary operating resident saw the patient in nonoperative settings, such as general admission, clinic visitation, or consultation in 20.6% (303 of 1469) of cases.

Using a Cloud-based Electronic Health Record During Disaster Response: A Case Study in Fukushima, March 2011

2013 ◽  
Vol 28 (4) ◽  
pp. 383-387 ◽  
Author(s):  
Takashi Nagata ◽  
John Halamka ◽  
Shinkichi Himeno ◽  
Akihiro Himeno ◽  
Hajime Kennochi ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Disaster Response ◽  
Nuclear Power ◽  
Large Scale ◽  
Health Record ◽  
Publication Type ◽  
Web Based ◽  
Electronic Health ◽  
Medical Teams

AbstractFollowing the Great East Japan Earthquake on March 11, 2011, the Japan Medical Association deployed medical disaster teams to Shinchi-town (population: approximately 8,000), which is located 50 km north of the Fukushima Daiichi nuclear power plant. The mission of the medical disaster teams sent from Fukuoka, 1,400 km south of Fukushima, was to provide medical services and staff a temporary clinic for six weeks. Fear of radiation exposure restricted the use of large medical teams and local infrastructure. Therefore, small volunteer groups and a cloud-hosted, web-based electronic health record were implemented. The mission was successfully completed by the end of May 2011. Cloud-based electronic health records deployed using a “software as a service” model worked well during the response to the large-scale disaster.NagataT, HalamkaJ, KennochiH, HimenoS, HimenoA, HashizumeM. Using a cloud-based electronic health record during disaster response: a case study in Fukushima, March 2011. Prehosp Disaster Med. 2013;28(4):1-5.

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