scholarly journals Improving infant sleep safety via electronic health record communication: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ethan A. Canty ◽  
Benjamin N. Fogel ◽  
Erich K. Batra ◽  
Eric W. Schaefer ◽  
Jessica S. Beiler ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Controlled Trial ◽  
Intervention Group ◽  
Health Record ◽  
Patient Portal ◽  
Infant Sleep ◽  
Patient Portals ◽  
Safe Sleep ◽  
Electronic Health ◽  
Sleep Safety

Abstract Background With increased use of telehealth, interventions to improve infant sleep environments have not been explored. This study sought to assess the feasibility and efficacy of using electronic health record patient portals to transmit photographs of infant sleep between mothers and healthcare professionals as part of an intervention to promote sleep environments consistent with AAP guidelines. Methods One hundred eighty-four mother-newborn dyads consented to participate in a randomized trial requiring patient portal registration within 1 month of delivery. We first assessed feasibility as measured by a) the proportion of consented mothers enrolling in the portal and b) maternal adherence to prompts to submit photographs of their infant sleeping to the research team through the patient portal. Intervention group mothers were prompted at 1 and 2 months; controls were prompted only at 2 months. Efficacy was determined via research assistant review of submitted photographs. These assistants were trained to detect sudden unexplained infant death risk factors utilizing AAP guidelines. Standardized feedback was returned to mothers through the patient portal. We used Fisher’s Exact test to assess group differences in guideline adherence at 2 months. Results One hundred nine mothers (59%) enrolled in the patient portal and were randomized to intervention (N = 55) and control (N = 54) groups. 21 (38, 95% CI 25–52%) intervention group participants sent photographs at 1 month and received personalized feedback. Across both groups at 2 months, 40 (37, 95% CI 28–46%) sent photographs; 56% of intervention group participants who submitted photographs met all safe sleep criteria compared with 46% of controls (difference 0.10, 95% CI − 0.26 to 0.46, p = .75). Common reasons for guideline non-adherence were sleeping in a room without a caregiver (43%), loose bedding (15%) and objects (8%) on the sleep surface. Conclusions Utilizing the patient portal to individualize safe infant sleep is possible, however, we encountered numerous barriers in this trial to assess its effects on promoting safe infant sleep. Photographs of infants sleeping showed substantial non-adherence to AAP guidelines, suggesting further needs for improvement to promote safe infant sleep practices. Trial registration Name: Improving Infant Sleep Safety With the Electronic Health Record; Clinicaltrials.gov: NCT03662048; Date of Registration: September 7, 2018; Data Sharing Statement: None

scholarly journals Correction to: Improving infant sleep safety via electronic health record communication: a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ethan A. Canty ◽  
Benjamin N. Fogel ◽  
Erich K. Batra ◽  
Eric W. Schaefer ◽  
Jessica S. Beiler ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Electronic Health Record ◽  
Controlled Trial ◽  
Health Record ◽  
Infant Sleep ◽  
Randomized Controlled ◽  
Electronic Health ◽  
Sleep Safety

An amendment to this paper has been published and can be accessed via the original article.

Interventions to Increase Physician Efficiency and Comfort with an Electronic Health Record System

2015 ◽  
Vol 54 (01) ◽  
pp. 103-109 ◽  
Author(s):  
L. Jalota ◽  
M. R. Aryal ◽  
M. Mahmood ◽  
T. Wasser ◽  
A. Donato
Keyword(s):  
Electronic Health Record ◽  
Group Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Clinical Work ◽  
Educational Interventions ◽  
Health Record ◽  
Record System ◽  
Progress Note ◽  
Electronic Health

SummaryObjective: To determine comfort when using the Electronic Health Record (EHR) and increase in documentation efficiency after an educational intervention for physicians to improve their transition to a new EHR.Methods: This study was a single-center randomized, parallel, non-blinded controlled trial of real-time, focused educational interventions by physician peers in addition to usual training in the intervention arm compared with usual training in the control arm. Participants were 44 internal medicine physi cians and residents stratified to groups using a survey of comfort with electronic media during rollout of a system-wide EHR and order entry system. Outcomes were median time to complete a progress note, notes completed after shift, and comfort with EHR at 20 and 40 shifts.Results: In the intervention group, 73 education sessions averaging 14.4 (SD: 7.7) minutes were completed with intervention group participants, who received an average of 3.47 (SD: 2.1) interventions. Intervention group participants decreased their time to complete a progress note more quickly than controls over 30 shifts (p < 0.001) and recorded significantly fewer progress notes after scheduled duty hours (77 versus 292, p < 0.001). Comfort with EHRs increased significantly in both groups from baseline but did not differ significantly by group. Intervention group participants felt that the intervention was more helpful than their standard training (3.47 versus 1.95 on 4-point scale).Conclusion: Physicians teaching physicians during clinical work improved physician efficiency but not comfort with EHRs. More study is needed to determine best methods to assist those most challenged with new EHR rollouts.

scholarly journals Analysis of Employee Patient Portal Use and Electronic Health Record Access at an Academic Medical Center

2020 ◽  
Vol 11 (03) ◽  
pp. 433-441 ◽  
Author(s):  
Lina Sulieman ◽  
Bryan Steitz ◽  
S. Trent Rosenbloom
Keyword(s):  
Electronic Health Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Data ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Clinical Notes ◽  
Usage Patterns ◽  
Electronic Health

Abstract Background Patient portals provide patients and their caregivers online access to limited health results. Health care employees with electronic health record (EHR) access may be able to view their health information not available in the patient portal by looking in the EHR. Objective In this study, we examine how employees use the patient portal when they also have access to the tethered EHR. Methods We obtained patient portal and EHR usage logs corresponding to all employees who viewed their health data at our institution between January 1, 2013 and November 1, 2017. We formed three cohorts based on the systems that employees used to view their health data: employees who used the patient portal only, employees who viewed health data in the EHR only, and employees who used both systems. We compared system accesses and usage patterns for each employee cohort. Results During the study period, 35,172 employees accessed the EHR as part of patients' treatment and 28,631 employees accessed their health data: 25,193 of them used the patient portal and 13,318 accessed their clinical data in EHR. All employees who accessed their records in the EHR viewed their clinical notes at least once. Among EHR accesses, clinical note accesses comprised more than 42% of all EHR accesses. Provider messaging and appointment scheduling were the most commonly used functions in the patient portal. Employees who had access to their health data in both systems were more likely to engage with providers through portal messages. Conclusion Employees at a large medical center accessed clinical notes in the EHR to obtain information about their health. Employees also viewed other health data not readily available in the patient portal.

scholarly journals Validation of a Novel Electronic Health Record Patient Portal Advance Care Planning Delivery System

2018 ◽  
Vol 20 (6) ◽  
pp. e208 ◽  
Author(s):  
Seuli Bose-Brill ◽  
Michelle Feeney ◽  
Laura Prater ◽  
Laura Miles ◽  
Angela Corbett ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Delivery System ◽  
Advance Care Planning ◽  
Health Record ◽  
Patient Portal ◽  
Care Planning ◽  
Advance Care ◽  
Electronic Health

Electronic Health Record Patient Portals and the Blockchain Technology

2021 ◽  
pp. 218-227
Author(s):  
Jorge Tavares
Keyword(s):  
Medical Information ◽  
Healthcare Providers ◽  
Appointment Scheduling ◽  
Health Record ◽  
Patient Portal ◽  
Patient Portals ◽  
Blockchain Technology ◽  
Electronic Health ◽  
Implementation Of Ehr ◽  
E Mail

The electronic health records (EHR) patient portals are an integrated eHealth technology that combines an EHR system and a patient portal, giving patients access to their medical records, exam results, and services, such as appointment scheduling, notification systems, and e-mail access to their physician. EHR patient portals empower patients to carry out self-management activities and facilitate communication with healthcare providers, enabling the patient and healthcare provider to access the medical information quickly. Worldwide governmental initiatives have aimed to promote the use of EHR patient portals. The implementation of EHR patient portals encompasses several challenges, including security, confidentiality concerns, and interoperability between systems. New technological approaches like blockchain could address these issues and enable a successful worldwide implementation of EHR patient portals.

scholarly journals Development of a Cancer Care Summary Through the Electronic Health Record

2016 ◽  
Vol 12 (2) ◽  
pp. e231-e240 ◽  
Author(s):  
Laurie L. Carr ◽  
Pearlanne Zelarney ◽  
Sarah Meadows ◽  
Jeffrey A. Kern ◽  
M. Bronwyn Long ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Cancer Care ◽  
Query Language ◽  
Primary Care Providers ◽  
Urgent Care ◽  
Health Record ◽  
Patient Portal ◽  
Care Providers ◽  
Improvement Project ◽  
Electronic Health

Introduction: Our objective was to improve communication concerning lung cancer patients by developing and distributing a Cancer Care Summary that would provide clinically useful information about the patient’s diagnosis and care to providers in diverse settings. Methods: We designed structured, electronic forms for the electronic health record (EHR), detailing tumor staging, classification, and treatment. To ensure completeness and accuracy of the information, we implemented a data quality cycle, composed of reports that are reviewed by oncology clinicians. The data from the EHR forms are extracted into a structured query language database system on a daily basis, from which the Summaries are derived. We conducted focus groups regarding the utility, format, and content of the Summary. Cancer Care Summaries are automatically generated 4 months after a patient’s date of diagnosis, then every 6 months for those receiving treatment, and on an as-needed basis for urgent care or hospital admission. Results: The product of our improvement project is the Cancer Care Summary. To date, 102 individual patient Summaries have been generated. These documents are automatically entered into the National Jewish Health (NJH) EHR, attached to correspondence to primary care providers, available to patients as electronic documents on the NJH patient portal, and faxed to emergency departments and admitting physicians on patient evaluation. Conclusion: We developed a sustainable tool to improve cancer care communication. The Cancer Care Summary integrates information from the EHR in a timely manner and distributes the information through multiple avenues.

scholarly journals Electronic Health Record Goes Personal World-wide

2009 ◽  
Vol 18 (01) ◽  
pp. 40-43 ◽  
Author(s):  
PS Lee ◽  
WS Jian ◽  
CH Kuo ◽  
YC Li
Keyword(s):  
Electronic Health Record ◽  
Content Standards ◽  
Health Record ◽  
Patient Portal ◽  
Consumer Empowerment ◽  
Privacy And Security ◽  
Healthcare Data ◽  
The World ◽  
Personal Use ◽  
Electronic Health

Summary Objective Increasing patient demand for convenient access to their own healthcare data has led to more personal use of the Electronic Health Record (EHR). With “consumer empowerment” being an important issue of EHR, we are seeing a more “patient-centric” approach of EHR from countries around the world. Researchers have reported on issues in EHR sharing including concerns on privacy and security, consumer empowerment, competition among providers, and content standards. This study attempts to analyze prior research and to synthesize comprehensive, empirically-based conceptual models of EHR for personal use. Methods We use “B2C(2B)” to represent this new behavior of EHR sharing and exchange, with “consumer” in the center stage. ResultsBased on different information sharing mechanisms, we summarized the “B2C(2B)” behavior into three models, namely, the Inexpensive data media model, the Internet patient portal model and the Personal portable device model. Models each have their own strengths and weaknesses in their ways to share patient data and to address privacy and security concerns. Conclusion Personal use of EHR under the B2C(2B) model does look promising based on our study. We started to observe a trend that governments around the world are embarking on related projects. With multiple stake-holders involved, we are only beginning to understand the complexity of such undertakings.

scholarly journals Potential of an Electronic Health Record-Integrated Patient Portal for Improving Care Plan Concordance during Acute Care

2019 ◽  
Vol 10 (03) ◽  
pp. 358-366 ◽  
Author(s):  
Anuj K. Dalal ◽  
Patricia Dykes ◽  
Lipika Samal ◽  
Kelly McNally ◽  
Eli Mlaver ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Acute Care ◽  
Transitions Of Care ◽  
Care Plan ◽  
Health Record ◽  
Patient Portal ◽  
Intention To Treat ◽  
Electronic Health ◽  
The Impact ◽  
Treat Analysis

Background Care plan concordance among patients and clinicians during hospitalization is suboptimal. Objective This article determines whether an electronic health record (EHR)-integrated patient portal was associated with increased understanding of the care plan, including the key recovery goal, among patients and clinicians in acute care setting. Methods The intervention included (1) a patient portal configured to solicit a single patient-designated recovery goal and display the care plan from the EHR for participating patients; and (2) an electronic care plan for all unit-based nurses that displays patient-inputted information, accessible to all clinicians via the EHR. Patients admitted to an oncology unit, including their nurses and physicians, were enrolled before and after implementation. Main outcomes included mean concordance scores for the overall care plan and individual care plan elements. Results Of 457 and 283 eligible patients approached during pre- and postintervention periods, 55 and 46 participated in interviews, respectively, including their clinicians. Of 46 postintervention patients, 27 (58.7%) enrolled in the patient portal. The intention-to-treat analysis demonstrated a nonsignificant increase in the mean concordance score for the overall care plan (62.0–67.1, adjusted p = 0.13), and significant increases in mean concordance scores for the recovery goal (30.3–57.7, adjusted p < 0.01) and main reason for hospitalization (58.6–79.2, adjusted p < 0.01). The on-treatment analysis of patient portal enrollees demonstrated significant increases in mean concordance scores for the overall care plan (61.9–70.0, adjusted p < 0.01), the recovery goal (30.4–66.8, adjusted p < 0.01), and main reason for hospitalization (58.3–81.7, adjusted p < 0.01), comparable to the intention-to-treat analysis. Conclusion Implementation of an EHR-integrated patient portal was associated with increased concordance for key care plan components. Future efforts should be directed at improving concordance for other care plan components and conducting larger, randomized studies to evaluate the impact on key outcomes during transitions of care. Clinical Trials Identifier NCT02258594.

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