scholarly journals Population-based identification and temporal trend of children with primary nephrotic syndrome: The Kaiser Permanente nephrotic syndrome study

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257674
Author(s):  
Rishi V. Parikh ◽  
Thida C. Tan ◽  
Dongjie Fan ◽  
David Law ◽  
Anne S. Salyer ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Electronic Health Records ◽  
Healthcare Delivery ◽  
Population Based ◽  
Healthcare Delivery System ◽  
Kaiser Permanente ◽  
Health Records ◽  
Primary Nephrotic Syndrome ◽  
Electronic Health ◽  
Asian Pacific

Introduction Limited population-based data exist about children with primary nephrotic syndrome (NS). Methods We identified a cohort of children with primary NS receiving care in Kaiser Permanente Northern California, an integrated healthcare delivery system caring for >750,000 children. We identified all children <18 years between 1996 and 2012 who had nephrotic range proteinuria (urine ACR>3500 mg/g, urine PCR>3.5 mg/mg, 24-hour urine protein>3500 mg or urine dipstick>300 mg/dL) in laboratory databases or a diagnosis of NS in electronic health records. Nephrologists reviewed health records for clinical presentation and laboratory and biopsy results to confirm primary NS. Results Among 365 cases of confirmed NS, 179 had confirmed primary NS attributed to presumed minimal change disease (MCD) (72%), focal segmental glomerulosclerosis (FSGS) (23%) or membranous nephropathy (MN) (5%). The overall incidence of primary NS was 1.47 (95% Confidence Interval:1.27–1.70) per 100,000 person-years. Biopsy data were available in 40% of cases. Median age for patients with primary NS was 6.9 (interquartile range:3.7 to 12.9) years, 43% were female and 26% were white, 13% black, 17% Asian/Pacific Islander, and 32% Hispanic. Conclusion This population-based identification of children with primary NS leveraging electronic health records can provide a unique approach and platform for describing the natural history of NS and identifying determinants of outcomes in children with primary NS.

scholarly journals Constructing data-derived family histories using electronic health records from a single healthcare delivery system

2019 ◽  
Vol 30 (2) ◽  
pp. 212-218
Author(s):  
Maya Leventer-Roberts ◽  
Ilan Gofer ◽  
Yuval Barak Corren ◽  
Ben Y Reis ◽  
Ran Balicer
Keyword(s):  
Family History ◽  
Electronic Health Records ◽  
Clinical Decision Making ◽  
Healthcare Delivery ◽  
Clinical Value ◽  
Healthcare Delivery System ◽  
Family History Information ◽  
Health Records ◽  
History Information ◽  
Electronic Health

Abstract Background In order to examine the potential clinical value of integrating family history information directly from the electronic health records of patients’ family members, the electronic health records of individuals in Clalit Health Services, the largest payer/provider in Israel, were linked with the records of their parents. Methods We describe the results of a novel approach for creating data-derived family history information for 2 599 575 individuals, focusing on three chronic diseases: asthma, cardiovascular disease (CVD) and diabetes. Results In our cohort, there were 256 598 patients with asthma, 55 309 patients with CVD and 66 324 patients with diabetes. Of the people with asthma, CVD or diabetes, the percentage that also had a family history of the same disease was 22.0%, 70.8% and 70.5%, respectively. Conclusions Linking individuals’ health records with their data-derived family history has untapped potential for supporting diagnostic and clinical decision-making.

scholarly journals Prevalence, incidence, and outcomes across cardiovascular diseases in homeless individuals using national linked electronic health records

2020 ◽  
Vol 41 (41) ◽  
pp. 4011-4020
Author(s):  
Atsunori Nanjo ◽  
Hannah Evans ◽  
Kenan Direk ◽  
Andrew C Hayward ◽  
Alistair Story ◽  
...  
Keyword(s):  
Risk Factors ◽  
Electronic Health Records ◽  
Mortality Risk ◽  
Homeless People ◽  
Arterial Disease ◽  
Population Based ◽  
Health Records ◽  
Coronary Death ◽  
Health And Social Care ◽  
Electronic Health

Abstract Aims The risk and burden of cardiovascular disease (CVD) are higher in homeless than in housed individuals but population-based analyses are lacking. The aim of this study was to investigate prevalence, incidence and outcomes across a range of specific CVDs among homeless individuals. Methods and results  Using linked UK primary care electronic health records (EHRs) and validated phenotypes, we identified homeless individuals aged ≥16 years between 1998 and 2019, and age- and sex-matched housed controls in a 1:5 ratio. For 12 CVDs (stable angina; unstable angina; myocardial infarction; sudden cardiac death or cardiac arrest; unheralded coronary death; heart failure; transient ischaemic attack; ischaemic stroke; subarachnoid haemorrhage; intracerebral haemorrhage; peripheral arterial disease; abdominal aortic aneurysm), we estimated prevalence, incidence, and 1-year mortality post-diagnosis, comparing homeless and housed groups. We identified 8492 homeless individuals (32 134 matched housed individuals). Comorbidities and risk factors were more prevalent in homeless people, e.g. smoking: 78.1% vs. 48.3% and atrial fibrillation: 9.9% vs. 8.6%, P &lt; 0.001. CVD prevalence (11.6% vs. 6.5%), incidence (14.7 vs. 8.1 per 1000 person-years), and 1-year mortality risk [adjusted hazard ratio 1.64, 95% confidence interval (CI) 1.29–2.08, P &lt; 0.001] were higher, and onset was earlier (difference 4.6, 95% CI 2.8–6.3 years, P &lt; 0.001), in homeless, compared with housed people. Homeless individuals had higher CVD incidence in all three arterial territories than housed people. Conclusion  CVD in homeless individuals has high prevalence, incidence, and 1-year mortality risk post-diagnosis with earlier onset, and high burden of risk factors. Inclusion health and social care strategies should reflect this high preventable and treatable burden, which is increasingly important in the current COVID-19 context.

Handoff Communication and Electronic Health Records

2014 ◽  
Vol 3 (1) ◽  
pp. 162-169 ◽  
Author(s):  
Julie Apker ◽  
Christopher Beach ◽  
Kevin O’Leary ◽  
Jennifer Ptacek ◽  
Dickson Cheung ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Patient Care ◽  
Healthcare Delivery ◽  
Communication Style ◽  
Health Records ◽  
Practical Applications ◽  
Sensemaking Theory ◽  
Making Sense ◽  
Study Results ◽  
Electronic Health

When transferring patient care responsibilities across the healthcare continuum, clinicians strive to communicate safely and effectively, but communication failures exist that threaten patient safety. Although researchers are making great strides in understanding and solving intraservice handoff problems, inter-service transition communication remains underexplored. Further, electronic health records (EHRs) figure prominently in healthcare delivery, but less is known about how EHRs contribute to inter-service handoffs. This descriptive, qualitative study uses Sensemaking Theory to explore EHR-facilitated, inter-service handoffs occurring between emergency medicine and internal/hospitalist medicine physicians. The researchers conducted six focus groups with 16 attending physicians and medical residents at a major Midwestern academic hospital. Findings suggest clinicians hold varied expectations for information content and relational communication/style. Their expectations contribute to making sense of uncertain handoff situations and communication best practices. Participants generally perceive EHRs as tools that, when used appropriately, can enhance handoffs and patient care continuity. Ideas for practical applications are offered based on study results.

scholarly journals Identifying social factors amongst older individuals in linked electronic health records: An assessment in a population based study

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0189038 ◽  
Author(s):  
Anu Jain ◽  
Albert J. van Hoek ◽  
Jemma L. Walker ◽  
Rohini Mathur ◽  
Liam Smeeth ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Social Factors ◽  
Population Based ◽  
Older Individuals ◽  
Population Based Study ◽  
Health Records ◽  
Electronic Health
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