scholarly journals Computer-facilitated Review of Electronic Medical Records Reliably Identifies Emergency Department Interventions in Older Adults

2013 ◽  
Vol 20 (6) ◽  
pp. 621-628 ◽  
Author(s):  
Kevin J. Biese ◽  
Cory R. Forbach ◽  
Richard P. Medlin ◽  
Timothy F. Platts-Mills ◽  
Matthew J. Scholer ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Electronic Medical Records ◽  
Medical Records

scholarly journals Orthostatic Hypotension and Falls in Hospitalized Older Adults

2021 ◽  
pp. 105477382098668
Author(s):  
Kathleen Schell ◽  
Denise Lyons ◽  
Barry Bodt
Keyword(s):  
Older Adults ◽  
Orthostatic Hypotension ◽  
Electronic Medical Records ◽  
Fall Prevention ◽  
Medical Records ◽  
The Elderly ◽  
Chi Square ◽  
Convenience Sample ◽  
Chi Square Test ◽  
Hospitalized Older Adults

The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings ( n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance ( p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.

scholarly journals Prevalence of chronic disease in older adults in multitier eye-care facilities in South India: Electronic medical records-driven big data analytics report

2021 ◽  
Vol 69 (12) ◽  
pp. 3618
Author(s):  
UmeshChandra Behera ◽  
Brooke Salzman ◽  
AnthonyVipin Das ◽  
GumpiliSai Prashanthi ◽  
Parth Lalakia ◽  
...  
Keyword(s):  
Older Adults ◽  
Big Data ◽  
Chronic Disease ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Data Analytics ◽  
South India ◽  
Big Data Analytics ◽  
Eye Care ◽  
Care Facilities

scholarly journals ELECTRONIC MEDICAL RECORD ALGORITHM TO IDENTIFY UNDIAGNOSED (PRE)DIABETES: A CASE STUDY FROM HAWAIʻI

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S934-S934
Author(s):  
David Stupplebeen ◽  
Tetine L Sentell ◽  
Lance Ching ◽  
Blythe Nett ◽  
Hermina Taylor ◽  
...  
Keyword(s):  
Older Adults ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Laboratory ◽  
Older Men ◽  
State Health ◽  
Missed Opportunities ◽  
The Past ◽  
Department Of Health

Abstract An estimated one-quarter of United States’ older adults (≥65 years) have diabetes (DM) while half have prediabetes (PreDM). Timely diagnosis can prevent disease progression, but significant proportions of PreDM/DM are undiagnosed. Among Hawai‘i adults, one-third of diabetes and two-thirds of prediabetes cases are undiagnosed; rates for older adults are unknown. Algorithms integrated into Electronic Medical Records (EMR) may improve care by identifying probable undiagnosed cases in patient panels using clinical/laboratory measures. We assessed one algorithm developed by the Hawai‘i Department of Health that identified individuals overdue for screening or with Pre/DM using the records of 20,362 adult patients (51.33% were >65) from a major state health system. 6,371 (31.3%) patients were excluded from analysis; they had no HbA1c screening in the past year or were overdue for screening (70%) based on standard guidelines. Of the remaining 13,991 patients, 7317 were older adults; 6130 (84%) had a PreDM (50.6%) or DM (33.2%) HbA1c value; the rest were controlled or false-positive. Of those older adults with probable PreDM/DM, 38.6% were undiagnosed. Adults >65 were significantly more likely to be flagged with undiagnosed PreDM compared to their younger counterparts (58 versus 54%, p<.001). Notably, 61% of older men flagged with PreDM were undiagnosed. Of the 5,737 patients identified with DM, 22% of those 65 were undiagnosed. Given the recognized high burden of diabetes among older adults, results indicate substantial missed opportunities for the prevention and early treatment of this condition as identified by an EMR algorithm.

scholarly journals Not All Patients with Hemiplegia Need Alteplase: A Case of Hemiplegic Migraine

2020 ◽  
Author(s):  
Sumeet Yadav ◽  
Michelle Talukder ◽  
Jacky Duong
Keyword(s):  
Emergency Department ◽  
Early Diagnosis ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Cerebrovascular Accident ◽  
Sensory Impairment ◽  
Hemiplegic Migraine ◽  
Rare Type ◽  
Head Ct ◽  
Work Up

Hemiplegic migraine (HM) is a rare type of migraine which presents with motor and sensory impairment like a cerebrovascular accident (CVA). We present a case of a 36-year-old female, with a prior CVA treated with alteplase, who presented to the emergency department with stroke-like symptoms with a duration of 1 hour. The NIH Stroke Scale score was 22 at presentation. The patient received alteplase under the supervision of a neurologist after head CT confirmed no bleed. Further work-up revealed no acute or remote ischaemia or infarction. This case demonstrates the importance of a thorough history, intercommunication between health systems and integrated Electronic Medical Records (EMR) for early diagnosis and management of HM.

scholarly journals Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

10.2196/14487 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14487 ◽  
Author(s):  
Kwang Yul Jung ◽  
SuJin Kim ◽  
Kihyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Care Providers ◽  
Significant Inverse Relationship ◽  
The Relationship

Background Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. Objective For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. Methods This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mobile EMR, and we merged data using doctors’ deidentification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests. Results A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=–0.19; 95% CI –0.32 to –0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests (coefficient=–0.18; 95% CI –0.30 to –0.04; P=.009). Conclusions Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

Methods Employed to Assess Weight Loss in Older Adults by Means of Electronic Medical Records: A Systematic Review

2017 ◽  
Vol 36 (1) ◽  
pp. 18-30 ◽  
Author(s):  
Sunny Chen ◽  
William A. Banks ◽  
Julie Silverman ◽  
Meera Sheffrin ◽  
Stephen M. Thielke
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Weight Loss ◽  
Electronic Medical Records ◽  
Medical Records

scholarly journals Acute care in glioblastoma: the burden and the consequences

2017 ◽  
Vol 4 (4) ◽  
pp. 248-254 ◽  
Author(s):  
Andrea Wasilewski ◽  
Jennifer Serventi ◽  
Lily Kamalyan ◽  
Thomas Wychowski ◽  
Nimish Mohile
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Electronic Medical Records ◽  
Acute Care ◽  
Medical Records ◽  
Emergency Department Visits ◽  
Nursing Facility ◽  
Neurosurgical Procedure ◽  
Care Visit ◽  
The University

Abstract Background The utilization of inpatient medical services by patients with glioblastoma (GBM) is not well studied. We sought to describe causes, frequency, and outcomes of acute care visits in GBM. Methods We conducted a retrospective study of 158 GBM patients at the University of Rochester over 5 years. Electronic medical records were reviewed to identify all local and outside acute care visits. Acute care visits were defined as any encounter resulting in an emergency department visit or inpatient admission. Results Seventy-one percent (112/158) of GBM patients had 235 acute care visits corresponding to 163 hospitalizations (69%) and 72 emergency department visits (31%). Sixty-three percent of patients had multiple visits. Admission diagnoses were seizure (33%), neurosurgical procedure (15%), infection (12%), focal neurologic symptoms (9%), and venous thromboembolism (VTE, 9%). Forty-six patients had 1 or more visits for seizures. Median time to first acute care visit was 65.6 days and 22% of patients had an acute care visit within 30 days of diagnosis. Median length of stay was 5 days. Thirty-five percent of admitted patients were discharged home; 62% required a higher level of care than prior to admission (23% were discharged home with services, 17% to a nursing facility, 16% to hospice, 6% to acute rehab) and 3% died. Thirty-eight percent of patients had ACV within 30 days of death. Median survival was 14 months for patients who had acute care visits and 22.2 months for patients who did not. Conclusion The majority of GBM patients utilize acute care, most commonly for seizures. The high number of emergency department visits, short length of stay, and many patients discharged home suggest that some acute care visits may be avoidable.

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