scholarly journals Small interface changes have dramatic impacts: how mandatory fields in electronic medical records increased pertussis vaccination rates in Australian obstetric patients

2019 ◽  
Vol 26 (1) ◽  
pp. e000013
Author(s):  
Roberto Orefice ◽  
Julie A Quinlivan
Keyword(s):  
Clinical Practice ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Quality Outcomes ◽  
Health Records ◽  
Vaccination Rates ◽  
Time Points ◽  
Improve Compliance ◽  
Single Difference ◽  
Women And Children

IntroductionElectronic health records have been widely introduced into clinical practice. The aim of this study was to determine whether a small interface change could improve compliance with a key quality indicator, namely antenatal pertussis vaccination.MethodsAudits were performed between 1–31 July 2015 and 1–31 July 2017 of all deliveries at the Centenary Hospital for Women and Children to determine compliance with antenatal pertussis vaccination. The single difference between time points was changing the interface so the antenatal pertussis vaccination field became compulsory.Results275 and 299 women delivered in the audit periods. Vaccination rates almost doubled (52.7% vs 91.4%, p<0.0001).ConclusionSmall interface changes increase compliance. Interface change could be considered for key quality outcomes in patient care.

scholarly journals Electronic Health Record–Based Registries: Clinical Research Using Registries in Colon and Rectal Surgery

2019 ◽  
Vol 32 (01) ◽  
pp. 082-090
Author(s):  
Jacob Carlson ◽  
Jonathan Laryea
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Rectal Surgery ◽  
Building Blocks ◽  
Colon And Rectal Surgery ◽  
Data Standards ◽  
Health Records ◽  
Coding Systems ◽  
Disease Registries ◽  
Electronic Health

AbstractElectronic health records (EHRs) or electronic medical records (EMRs) contain a vast amount of clinical data that can be useful for multiple purposes including research. Disease registries are collections of data in predefined formats for population management, research, and other purposes. There are differences between EHRs and registries in the data structure, data standards, and protocols. Proprietary EHR systems use different coding systems and data standards, which are usually kept secret. For EHR data to flow seamlessly into registries, there is the need for interoperability between EHR systems and between EHRs and registries. The levels of interoperability required include functional, structural, and semantic interoperability. EHR data can be manually mapped to registry data, but that is a tedious, resource-intensive endeavor. The development of data standards that can be used as building blocks for both EHRs and registries will help overcome the problem of interoperability.

scholarly journals Trends in antiepileptic drug treatment and effectiveness in clinical practice in England from 2003 to 2016: a retrospective cohort study using electronic medical records

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032551 ◽  
Author(s):  
Graham Powell ◽  
John Logan ◽  
Victor Kiri ◽  
Simon Borghs
Keyword(s):  
Cohort Study ◽  
Clinical Practice ◽  
Electronic Medical Records ◽  
Retrospective Cohort Study ◽  
Medical Records ◽  
Retrospective Cohort ◽  
First Line ◽  
Nice Guideline ◽  
Treatment Trends ◽  
Over Time

ObjectiveTo assess the evolution of antiepileptic drug (AED) treatment patterns and seizure outcomes in England from 2003 to 2016.Design, setting and participantsRetrospective cohort study of electronic medical records from Clinical Practice Research Datalink and National Health Service Digital Hospital Episode Statistics databases. Patients newly diagnosed with epilepsy were identified and followed until end of data availability. Three eras were defined starting 1 April 2003 (first National Institute for Health and Care Excellence (NICE) guideline); 1 September 2007 (Standard and New Antiepileptic Drugs publication); and 1 January 2012 (second NICE guideline).Outcome measuresTime from diagnosis to first AED; AED sequence; time from first AED to first 1-year remission period (no new AED attempts and no seizure-related healthcare events); time from first AED to refractoriness (third AED attempt regardless of reason); Kaplan-Meier analysis of time-to-event variables.Results4388 patients were included (mean follow-up: 6.8, 4.2 and 1.7 years by era). 84.6% of adults (≥16 years), 75.5% of children (<16) and 89.1% of elderly subgroup (65+) received treatment within 1 year; rates were generally stable over time. Treatment trends included reduced use of carbamazepine (adult first line, era 1: 34.9%; era 3: 10.7%) and phenytoin, earlier line and increased use of levetiracetam (adult first line, era 1: 2.6%; era 3: 26.2%) and lamotrigine (particularly in adults and elderly subgroup), and a larger number of different AEDs used. Valproate use shifted somewhat to later lines. Rates of 1-year remission within 2 years of starting treatment increased in adults (era 1: 71.9%; era 3: 81.4%) and elderly (era 1: 76.1%; era 3: 81.7%). Overall, 55.5% of patients relapsed after achieving 1-year remission. Refractoriness rates remained stable over time (~26% of adults within 5 years).ConclusionTreatment trends often were not aligned with era-relevant guidance. However, our results suggest a slight improvement in epilepsy treatment outcomes over the 13-year period.

scholarly journals Best Paper Selection

2017 ◽  
Vol 26 (01) ◽  
pp. 70-71
Keyword(s):  
Public Health ◽  
Data Mining ◽  
Quality Control ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Systematic Approach ◽  
Biomedical Data ◽  
Control Methods ◽  
Data Quality Control ◽  
Health Records

Chen J, Podchiyska T, Altman R. OrderRex: clinical order decision support and outcome predictions by data-mining electronic medical records. J Am Med Inform Assoc 2016;23:339-48 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5009921/ Miotto R, Li L, Kidd BA, Dudley JT. Deep Patient: An Unsupervised Representation to Predict the Future of Patients from the Electronic Health Records. Sci Rep 2016;6:26094 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4869115/ Prasser F, Kohlmayer F, Kuhn KA. The Importance of Context: Risk-based De-identification of Biomedical Data. Methods Inf Med 2016;55:347-55 https://methods.schattauer.de/en/contents/archivestandard/issue/2382/manuscript/25994.ht Saez C, Zurriaga O, Perez-Panades J, Melchor I, Robles M, Garcia-Gomez JM. Applying probabilistic temporal and multisite data quality control methods to a public health mortality registry in Spain: a systematic approach to quality control of repositories. J Am Med Inform Assoc 2016;23:1085-95 https://academic.oup.com/jamia/article-lookup/doi/10.1093/jamia/ocw010

scholarly journals An Assessment of Globe Position Dynamics following Transcranial Lateral and Superior Orbital Wall Resections without Rigid Reconstruction: A Case Series of 55 Patients

2019 ◽  
Vol 81 (03) ◽  
pp. 244-250
Author(s):  
Randall G. Krug ◽  
Elizabeth A. Bradley ◽  
Jamie J. Van Gompel
Keyword(s):  
Skull Base ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Significant Risk ◽  
Case Series ◽  
Time Points ◽  
Orbital Wall ◽  
Skull Base Approach ◽  
Over Time

Background There is no consensus exists regarding which reconstructive approach, if any, should be used after performing transcranial lateral orbital wall resections. Rigid reconstruction is often done to prevent enophthalmos; however, it is not clear if this is a risk with extensive orbital wall resections for transcranial surgery. Objective To assess globe position dynamics in patients that underwent transcranial lateral and superior orbital wall resections without rigid reconstruction to determine if enophthalmos is a significant risk. Methods Preoperative (PO) and postoperative data were retrospectively collected from the electronic medical records of 55 adult patients undergoing lateral and superior orbital wall resections as part of a skull base approach. The globe positions were assessed radiologically at all available time points and used to track relative globe displacements over time. Results An evaluation of PO variables identified a relationship between maximum lesion diameters and globe positions dynamics. The composition of globe position presentations in the population remained relatively stable over time, with only 1 out of 55 patients (1.81%) developing postoperative enophthalmos. An assessment of mean globe displacements revealed improvements in the patients presenting with PO exophthalmos, and stability in the patients presenting with normal PO globe positions. Conclusions Excellent results in long-term postoperative globe position dynamics can be achieved without the use of rigid reconstruction after transcranial lateral and superior orbital wall resections, regardless of the PO globe positioning.

ANALYZING THE SCOPE OF INTEGRATING ELECTRONIC MEDICAL RECORDS (EMR) AND ELECTRONIC HEALTH RECORDS (EHR) WITH MULTIMODAL HUMAN COMPUTER INTERACTION (MMHCI)

2016 ◽  
Vol 78 (6) ◽  
Author(s):  
Vairamuthu S. ◽  
Margret Anouncia
Keyword(s):  
Electronic Health Records ◽  
Human Computer Interaction ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Complex Data ◽  
Medical Systems ◽  
Health Records ◽  
History Of ◽  
Electronic Health ◽  
Computer Interaction

Developing applications using Multi Modal Human Computer Interaction (MMHCI) remains a great challenge due to the advancement of technologies. Enhanced interaction applications and tools employed in medical records will help to improve the quality of patients’ healthcare and it opens a variety of research challenges. Replacing a difficult system to store complex data related to medical history of patients through Electronic Medical Records (EMR)/Electronic Health Records (EHR) would offer several advantages that include confidentiality and patient details reliability along with the mechanisms for quick and flexible retrieval of data/information. The task of designing MMHCI applications for real time environment for EMR/EHR is thus complex. As the inputs to medical systems are heterogeneous, the associated issues grow up with the need for new system since the existing frameworks have many gaps and drawbacks. This paper attempts to discuss the possible guidelines, standards, tools and techniques involved in integrating MMHCI with EMR/EHR.

Closing the Loop between Clinical Practice, Research, and Education: The Potential of Electronic Patient Records

2002 ◽  
Vol 41 (01) ◽  
pp. 51-54 ◽  
Author(s):  
J. van der Lei
Keyword(s):  
Clinical Practice ◽  
Electronic Medical Records ◽  
Medical Practice ◽  
Medical Records ◽  
Electronic Record ◽  
Practice Research ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Closing The Loop ◽  
Research And Education

Summary Objective: To discuss the possible contribution of electronic patient records in closing the loop among clinical practice, research and education. Results and conclusions: Applying Information and Communication Technology (ICT) to a given medical domain is not merely adding a new technique. When introduced into an environment, ICT will initially often emulate or resemble the already existing processes. When workers and researchers in that domain begin to appreciate the potential of ICT, this initial stage is followed by more fundamental changes in that domain that take advantage of the potential of ICT. To understand the scope of the potential changes enabled by electronic records, three principle changes need to be understood. First, data recorded in computer memories can be readily retrieved and re-used for a variety of purposes. Second, once data are available in computer memories, the data can be transported easily. Third, as physicians (and patients) are using computers to record medical data, the same electronic record can be used to introduce other computer programs that interact with the user. New usage of data, however, generates additional requirements. Thus the experience in developing decision support systems and analyzing observational databases feeds back into the requirements for electronic medical records.Each patient-physician encounter, each investigation, each laboratory test, and each treatment in medical practice constitutes, in principle, an experiment. Ideally, we learn from each experiment. Electronic medical records will facilitate research that relies on data recorded in routine medical practice. The potential and challenge, however, of Medical Informatics lies in its ability to close the loop among clinical practice, research, and education.

Electronic Medical Records and Electronic Health Records: Overview for Nurse Practitioners

2014 ◽  
Vol 10 (9) ◽  
pp. 660-665 ◽  
Author(s):  
Patricia C. McMullen ◽  
William O. Howie ◽  
Nayna Philipsen ◽  
Virletta C. Bryant ◽  
Patricia D. Setlow ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Electronic Medical Records ◽  
Nurse Practitioners ◽  
Medical Records ◽  
Health Records ◽  
Electronic Health

scholarly journals Impact of the Introduction of a Vaccination Status Checkbox in Electronic Medical Records on Pneumococcal Vaccination Rates

2019 ◽  
Vol 65 (1) ◽  
pp. 92-94
Author(s):  
SHINICHI FUKUSHIMA ◽  
MAI SUZUKI ◽  
NOBUJIRO ABE ◽  
YOSUKE SHIMADA ◽  
MINORU OHNO ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Pneumococcal Vaccination ◽  
Vaccination Status ◽  
Vaccination Rates

scholarly journals On-the-job training of health professionals for electronic health record and electronic medical record use: A scoping review

2015 ◽  
pp. 436-469
Keyword(s):  
Electronic Medical Records ◽  
Health Professionals ◽  
Medical Records ◽  
Health Informatics ◽  
Clinical Care ◽  
Training Methods ◽  
Health Records ◽  
Ovid Medline ◽  
Electronic Health ◽  
Orientation Training

The implementation of electronic health records (EHRs) or electronic medical records (EMRs) is well documented in health informatics literature yet, very few studies focus primarily on how health professionals in direct clinical care are trained for EHR or EMR use. Purpose: To investigate how health professionals in direct clinical care are trained to prepare them for EHR or EMR use. Methods: Systematic searches were conducted in CINAHL, EMBASE, Ovid MEDLINE, PsycINFO, PubMed and ISI WoS and, the Arksey and O’Malley scoping methodological framework was used to collect the data and analyze the results. Results: Training was done at implementation, orientation and post-implementation. Implementation and orientation training had a broader scope while post-implementation training focused on proficiency, efficiency and improvement. The multiplicity of training methods, types and levels of training identified appear to suggest that training is more effective when a combination of training methods are used.

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