Are Patients Electronically Accessing Their Medical Records? Evidence From National Hospital Data

2019 ◽  
Vol 38 (11) ◽  
pp. 1850-1857 ◽  
Author(s):  
Sunny C. Lin ◽  
Courtney R. Lyles ◽  
Urmimala Sarkar ◽  
Julia Adler-Milstein
Keyword(s):  
Medical Records ◽  
Hospital Data ◽  
National Hospital

scholarly journals Prehospital triage of patients with acute cardiac complaints: study protocol of HART-c, a multicentre prospective study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041553
Author(s):  
Enrico de Koning ◽  
Tom E Biersteker ◽  
Saskia Beeres ◽  
Jan Bosch ◽  
Barbra E Backus ◽  
...  
Keyword(s):  
Real Time ◽  
Patient Outcomes ◽  
Medical Records ◽  
Vital Signs ◽  
Hospital Data ◽  
Ed Overcrowding ◽  
Prehospital Triage ◽  
Ed Visits ◽  
Multicentre Prospective Study ◽  
At Home

IntroductionEmergency department (ED) overcrowding is a major healthcare problem associated with worse patient outcomes and increased costs. Attempts to reduce ED overcrowding of patients with cardiac complaints have so far focused on in-hospital triage and rapid risk stratification of patients with chest pain at the ED. The Hollands-Midden Acute Regional Triage—Cardiology (HART-c) study aimed to assess the amount of patients left at home in usual ambulance care as compared with the new prehospital triage method. This method combines paramedic assessment and expert cardiologist consultation using live monitoring, hospital data and real-time admission capacity.Methods and analysisPatients visited by the emergency medical services (EMS) for cardiac complaints are included. EMS consultation consists of medical history, physical examination and vital signs, and ECG measurements. All data are transferred to a newly developed platform for the triage cardiologist. Prehospital data, in-hospital medical records and real-time admission capacity are evaluated. Then a shared decision is made whether admission is necessary and, if so, which hospital is most appropriate. To evaluate safety, all patients left at home and their general practitioners (GPs) are contacted for 30-day adverse events.Ethics and disseminationThe study is approved by the LUMC’s Medical Ethics Committee. Patients are asked for consent for contacting their GPs. The main results of this trial will be disseminated in one paper.DiscussionThe HART-c study evaluates the efficacy and feasibility of a prehospital triage method that combines prehospital patient assessment and direct consultation of a cardiologist who has access to live-monitored data, hospital data and real-time hospital admission capacity. We expect this triage method to substantially reduce unnecessary ED visits.

scholarly journals A Novel Deep Learning–Based System for Triage in the Emergency Department Using Electronic Medical Records: Retrospective Cohort Study

10.2196/27008 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e27008
Author(s):  
Li-Hung Yao ◽  
Ka-Chun Leung ◽  
Chu-Lin Tsai ◽  
Chien-Hua Huang ◽  
Li-Chen Fu
Keyword(s):  
Deep Learning ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Severity Index ◽  
University Hospital ◽  
Emergency Severity Index ◽  
National Hospital ◽  
Data Set ◽  
Care Survey ◽  
Ambulatory Medical Care

Background Emergency department (ED) crowding has resulted in delayed patient treatment and has become a universal health care problem. Although a triage system, such as the 5-level emergency severity index, somewhat improves the process of ED treatment, it still heavily relies on the nurse’s subjective judgment and triages too many patients to emergency severity index level 3 in current practice. Hence, a system that can help clinicians accurately triage a patient’s condition is imperative. Objective This study aims to develop a deep learning–based triage system using patients’ ED electronic medical records to predict clinical outcomes after ED treatments. Methods We conducted a retrospective study using data from an open data set from the National Hospital Ambulatory Medical Care Survey from 2012 to 2016 and data from a local data set from the National Taiwan University Hospital from 2009 to 2015. In this study, we transformed structured data into text form and used convolutional neural networks combined with recurrent neural networks and attention mechanisms to accomplish the classification task. We evaluated our performance using area under the receiver operating characteristic curve (AUROC). Results A total of 118,602 patients from the National Hospital Ambulatory Medical Care Survey were included in this study for predicting hospitalization, and the accuracy and AUROC were 0.83 and 0.87, respectively. On the other hand, an external experiment was to use our own data set from the National Taiwan University Hospital that included 745,441 patients, where the accuracy and AUROC were similar, that is, 0.83 and 0.88, respectively. Moreover, to effectively evaluate the prediction quality of our proposed system, we also applied the model to other clinical outcomes, including mortality and admission to the intensive care unit, and the results showed that our proposed method was approximately 3% to 5% higher in accuracy than other conventional methods. Conclusions Our proposed method achieved better performance than the traditional method, and its implementation is relatively easy, it includes commonly used variables, and it is better suited for real-world clinical settings. It is our future work to validate our novel deep learning–based triage algorithm with prospective clinical trials, and we hope to use it to guide resource allocation in a busy ED once the validation succeeds.

scholarly journals Completeness of informed consent in supporting national standard accreditation of patient and family rights 5 hospitals at Ropanasuri surgical special hospital in Padang

2019 ◽  
Vol 6 (11) ◽  
pp. 4639
Author(s):  
Yastori .
Keyword(s):  
Informed Consent ◽  
Medical Record ◽  
Medical Records ◽  
National Standards ◽  
National Standard ◽  
National Hospital ◽  
Microsoft Excel ◽  
Patient Medical Record ◽  
Special Hospital ◽  
Descriptive Method

Background: Completeness of informed consent is one indicator in supporting the accreditation of national hospital standards through the assessment of patient and family rights (PFR) assessment standards 5. In the health service process, informed consent can also be used as evidence and has a strong legal value in the form of a sheet of paper containing the doctor’s explanation about the diagnosis of the disease and the actions that will be performed on the patient.Methods: This research uses descriptive method with a qualitative approach. The population used was the entire patient medical record file in 2018, which was 3.093 medical record files. Sampling was done by random sampling using a formula according to Notoatmodjo for the calculation of the number of samples and obtained 355 files of medical records. Data processing using Microsoft Excel computer programs. For observing the completeness of the standard rights of patients and families using national standards for hospital accreditation.Results: Based on the analysis of 355 medical record files at Ropanasuri specialty hospital it is known that 296 pieces of informed consent were filled in with a percentage of 83.38%, 59 sheets of informed consent were incomplete with a percentage of 16.62%. The results showed the greatest incompleteness found in filling the informed consent items of witness signatures of 2.81%, providing information on the completeness of filling the doctor's identity by 2.54% and the name of the witness 1.70% on filling the authentication.Conclusions: 296 pieces of informed consent were filled in with a percentage of 83.38%, 59 sheets of informed consent were incomplete with a percentage of 16.62%.

scholarly journals EVALUASI PENGGUNAAN OBAT GASTRITIS PADA PASIEN RAWAT INAP DI RS GRANDMED LUBUK PAKAM TAHUN 2020

2021 ◽  
Vol 4 (1) ◽  
pp. 1-6
Author(s):  
Dini Mayasari ◽  
Delfi Mutiara Hutahean ◽  
Debi Dinha Octora
Keyword(s):  
Data Collection ◽  
Medical Records ◽  
Sampling Technique ◽  
Hospital Data ◽  
Duration Of Treatment ◽  
Data Collection Sheet ◽  
Treatment Data ◽  
Retrospective Data Collection ◽  
Care Outcomes ◽  
The Right

Gastritis is a disease caused by the bacterium Helicobacter phylory, this first gastritis drug, namely Antacids, Omeprazole, and Ranitidine. The increasing number of Gastritis patients from 2019 to 2020 at Grandmed Lubuk Pakam Hospital is encouraging researchers to conduct this study. The purpose of this study was to determine the description of the use of Gastritis drugs and the rationality of the use of Gastritis medications in Gastritis patients at Grandmed Lubuk Pakam Hospital in 2019. This study was a descriptive (non-experimental) study with retrospective data collection taken from patient medical records. Gastritis at Grandmed Lubuk Pakam Hospital. Data were collected using a purposive sampling technique in accordance with the inclusion criteria and exclusion criteria using the Data Collection Sheet. The number of samples used in this study were 64 medical records of patients diagnosed with gastritis. Data analysis was performed using Univariat with the help of SPSS. Results of distribution of duration of treatment data for which most patients undergo treatment. And the number of Chronic Diseases suffered by Diarrhea patients is 20 patients (31.2%). All three have a significant relationship with patient care outcomes. While in the age range 31-60 years, 45 people (70.3%) affected by gastritis. and The results of evaluating the rationality of treatment for gastritis are the right indications (96.9%), (62 patients), 100% correct patients (64 patients), the right medication by (96.9%) (62 patients), and the correct dosage 100% correct (64).

scholarly journals P.106 Intravenous lacosamide use in pre-school children

2021 ◽  
Vol 48 (s3) ◽  
pp. S49-S49
Author(s):  
G Laflamme ◽  
C Héroux ◽  
M Thibeault-Eybalin
Keyword(s):  
Medical Records ◽  
Pediatric Patients ◽  
Refractory Status Epilepticus ◽  
Hospital Data ◽  
Refractory Status ◽  
Seizure Relapse ◽  
Suboptimal Dose ◽  
Medical Indications ◽  
Order Of Administration ◽  
Time Of Administration

Background: Data on intravenous lacosamide use in young pediatric patients is scarce, especially of pre-school age. Methods: We retrospectively reviewed the medical records of all patients less than 6 years old who received intravenous lacosamide at our tertiary pediatric hospital. Data on dose, timing and order of administration was collected. Clinical and electrographic response was independently assessed with EEG interpretation blinded to time of administration. For adverse effects surveillance, heart rate was noted before and 1 hour after dose. Results: Eleven patients (8 boys), received lacosamide between 2013 and 2018. Mean age was 2 years (11 days – 5,3 years). Medical indications were: refractory status epilepticus (n=6), repetitive seizures (n=4), and inability to take oral lacosamide (n=1). On average, lacosamide was the fifth (1st-8th) IV antiepileptic drug administered 78 hours (SD 11 hours) after presentation. The most frequent dose was 5 mg/kg. Clinical response was confirmed in 7 patients, while electrographic response was proven in 3 patients. Seizure relapse at 24 hours was noted in 6 patients. No bradycardia occurred post-lacosamide. Conclusions: Although very safe, therapeutic response to lacosamide in young pediatric patients was inconclusive, mostly due to delay in administration, suboptimal dose, and high number of other IV antiepileptic drugs previously given.

scholarly journals Patients' Interest in Shared Medical Records

1970 ◽  
Vol 39 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Minati Adhikary ◽  
A Wazed ◽  
Md Sharfuddin Ahmed
Keyword(s):  
Medical Records ◽  
Medical Condition ◽  
Personal Characteristics ◽  
Cross Sectional Study ◽  
Hospital Data ◽  
College Hospital ◽  
Cross Sectional ◽  
Face To Face ◽  
Medical College ◽  
Trust In Physicians

To determine the proportion of patients who are interested in examining their medical records, the personal characteristics related to their interest, and the reasons for their interest. This descriptive cross sectional study was conducted among randomly selected 110 inpatients in a tertiary level hospital. Data were collected through face- to- face interview using one pretested semistructured questionnaire as the research instrument. Collected data were processed, and analyzed by using the SPSS software Version 11.0. The study was conducted in inpatients departments of Comilla Medical College Hospital during May- June2007. Male patients were more interested (85 out of 90) than female (7 out of 20) patients to anticipate the benefits of shared medical records and they were also somewhat more likely to anticipate problems with shared records. Significant predictors of sharing medical records by the patients were anticipation of improving the patient's adherence to their doctor's recommendations (90%) , improving understanding of own medical condition (88%), anticipation of increasing patient's trust in physicians(95%) and anticipation of being reassuring (85%). Shared medical records are almost universally endorsed across a broad range of socioeconomic groups. Patients' interest in reading their medical record is better predicted by their consumer approach to health care. A group of patients were also interested in Internet-accessible records. Key words: Shared medical records; patient access; physician-patient relation DOI: 10.3329/bmj.v39i1.6225 Bangladesh Medical Journal 2010; 39(1): 3-6

scholarly journals ASSOCIATION BETWEEN NEUTROPHIL-TO-LYMPHOCYTE RATIO AND PLATELET-TO-LYMPHOCYTE RATIO WITH 1-YEAR MORTALITY IN HEMODIALYSIS PATIENT IN WANGAYA REGIONAL GENERAL HOSPITAL

2019 ◽  
pp. 50-52
Author(s):  
I PUTU YOGI SASTRAWAN ◽  
CHRISTINA PERMATA SHALIM
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
General Hospital ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Hemodialysis Patient ◽  
Neutrophil To Lymphocyte Ratio ◽  
Hospital Data ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio

Objective: The aim of this study was to determine whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with mortality risk in patients with hemodialysis (HD). Methods: We conducted a retrospective cohort study among regular HD patients at Wangaya Regional General Hospital. Data were collected from patients’ medical records in June 2018 and followed up until May 2019. Results: NLR and PLR were significantly associated with 1-year mortality (p=0.047 and p=0.009), with higher NLR (NLR>2.84) and higher PLR (PLR>10) associated with higher risk of 1-year mortality (relative risk [RR]=3.36 and RR=5.19). Conclusion: NLR and PLR were significantly associated with 1-year mortality in patients with HD.

A retrospective analysis of eye disorders induced by chemotherapy including S-1 for gastrointestinal cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 20-20
Author(s):  
Masataka Yagisawa ◽  
Michio Nakamura ◽  
Chika Matsuda ◽  
Taichi Murai ◽  
Kazufumi Itaya ◽  
...  
Keyword(s):  
Cohort Study ◽  
Gastrointestinal Cancer ◽  
Medical Records ◽  
Cancer Site ◽  
Clinicopathological Factors ◽  
Hospital Data ◽  
Chi Square ◽  
Exact Test ◽  
Eye Disorders ◽  
Chi Square Test

20 Background: Eye disorders (EDs) are common adverse events in patients received S-1 chemotherapy. Although there are some retrospective reports about EDs induced by S-1 mono therapy (mono) as adjuvant chemotherapy (Adj) in gastric cancer (GC), there are few reports about S-1 induced EDs in other gastrointestinal cancer (GIC). So we conducted this retrospective cohort study to investigate the incidence of S-1 induced EDs in GIC and the association with several clinicopathological factors, such as primary site, treatment setting, regimen, and duration. Methods: All the patients received S-1 chemotherapy for GIC in our institution from January 2008 to May 2016 were identified through medical records review extracted by our hospital data warehouse. We analyzed the incidence of S-1 induced EDs by reviewing all the medical records and the association between ED incidence and several clinicopathological factors using a chi-square test or a Fisher's exact test and logistic regression. Results: Two hundred eighty three GIC patients were analyzed on this study. Patients characteristics were as follows; male/female 170/113, GC/colorectal cancer (CRC)/pancreatic cancer (PC)/biliary cancer (BC) 119/67/57/32, non-Adj/Adj 263/20, S-1 mono/S-1 combination therapy (combo) 130/153. The overall incidence rate with EDs such as epiphora, gum, photophobia, nephelopsia was 15.2% (n = 43). The median time to onset of EDs was 109 days (range 5-1100). The each of ED incidence was 16.5% (n = 28) and 13.3% (n = 15) in male and female (p = 0.503), 14.8% (n = 39) and 20.0% (n = 4) in non-Adj and Adj setting (p = 0.520), 13.8% (n = 18) and 16.3% (n = 25) in S-1 mono and combo (p = 0.619), respectively. The incidence of EDs in GC, CRC, PC, and BC were 15.1% (n = 18), 17.9% (n = 12), 17.5% (n = 10), and 9.4% (n = 3) (p = 0.635), respectively. Conclusions: We found that the incidence of EDs induced by S-1 chemotherapy for GIC was relatively high regardless of cancer site, treatment regimen, setting and duration. Further accumulation of data as prospective cohort study is necessary to confirm the incidence of S-1 induced EDs. Clinical trial information: UMIN000024160.

Nursing Documentation: Culture Perception, Motivation, and Commitment(Study in Paru Batu Hospital Malang East Java Indonesia)

2014 ◽  
Vol 2 (2) ◽  
pp. 110-117
Author(s):  
Agni H. Pratiwi ◽  
Armanu Armanu ◽  
Dewi K. Ningsih
Keyword(s):  
Organizational Culture ◽  
Data Analysis ◽  
Medical Records ◽  
Legal Aspects ◽  
Hospital Data ◽  
Nursing Documentation ◽  
A Value ◽  
The Subject ◽  
Culture Motivation

Objective - Nursing documentation is a part of the medical records. Which have important values such as administrative and legal aspects, etc. Therefore, the hospital manager should design an organizational culture that increases nurse commitment and motivation to complete medical records. The objective of this study was to find out the effect of direct and indirect perception of organizational culture toward nurse's commitment with motivation as a mediating variable. Methodology - The data were collected using questionnaires. The sample was 44 nurses of inpatient unit inthe Paru Batu Hospital. Data analysis used in this research was path analysis. Findings - The result of data analysis showed that there was an influence of organizational culture on nurse commitment at a value of 0,592. Moreover, there was an influence of organizational culture on the commitment with motivation as a mediating variable at value of 0,307. Novelty - Nowadays, only few studies have investigated the influence of organizational culture toward commitment with motivation as a mediating variable. In addition, studies examining the effect of it with nurses as the subject and nursing documentation as the object are very limited. Type of Paper - Case study Keywords: Culture, Motivation, Commitment, Nursing Documentation

Assessment of adverse events among cervical cancer patients at Kenyatta National Hospital

2021 ◽  
pp. 107815522110681
Author(s):  
Muthoni Kibaara ◽  
Amsalu Degu
Keyword(s):  
Cervical Cancer ◽  
Adverse Event ◽  
Adverse Events ◽  
Cancer Patients ◽  
Medical Records ◽  
Cross Sectional Study ◽  
National Hospital ◽  
Cross Sectional ◽  
Kenyatta National Hospital ◽  
Loss Of Appetite

Introduction Due to their cytotoxic nature, anticancer drugs and radiotherapy have the potential to cause toxic adverse events. As a result, they can increase the risk of morbidity and mortality. However, there was a lack of data among cervical cancer patients in our setting. Hence, this study was aimed to assess the prevalence of adverse events among cervical cancer patients at Kenyatta National Hospital. Methods A cross-sectional study design was employed among a consecutive sample of 151 adult cervical cancer patients. The data were collected by reviewing the medical records and interviewing the patients. The data were entered and analyzed using SPSS 27.0 software. The results were presented with frequency tables and graphs. Results A total of 214 adverse events (prevalence of 100%) were identified from 151 patients. The most common adverse events identified were ulcerated sores (52.8%), dysuria (7.5%), thrombocytopenia (5.6%), and loss of appetite (5.6%). The majority of the patients (80.8%) who had adverse events were on radiotherapy. As per the Naranjo causality assessment scale, the predominant (80.1%) proportion of the adverse event was a probable adverse event with a total score of 5–8. Besides, 15.9% of the adverse events had a possible causality. The present study also reported that 61.6% of patients with a probable adverse event were treated with radiotherapy. Conclusion The prevalence of adverse events among cervical patients was high in our setting. The predominant proportion of the adverse event was a probable adverse event and most of them were treated with radiotherapy.

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