scholarly journals Patterns of referral in a Canadian primary care electronic health record database: retrospective cross-sectional analysis

2011 ◽  
Vol 19 (4) ◽  
pp. 217-223
Author(s):  
Joshua Shadd ◽  
Bridget Ryan ◽  
Heather Maddocks ◽  
Amardeep Thind
Keyword(s):  
Primary Care ◽  
Electronic Health Record ◽  
Health Record ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Electronic Health ◽  
Sectional Analysis

scholarly journals Lifetime risk assessment in cholesterol management among hypertensive patients: Observational cross-sectional study based on electronic health record data.

2020 ◽  
Author(s):  
Aapo Tahkola ◽  
Päivi Korhonen ◽  
Hannu Kautiainen ◽  
Teemu Niiranen ◽  
Pekka Mäntyselkä
Keyword(s):  
Primary Care ◽  
Electronic Health Record ◽  
Cross Sectional Study ◽  
Lifetime Risk ◽  
Health Record ◽  
Sectional Study ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Electronic Health

Abstract Background In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains generally insufficient, also in patients with hypertension. We analyzed Electronic Health Record (EHR) data of 7117 hypertensive patients to find the most potential age and sex subgroups in greatest need for improvement in real life dyslipidemia treatment. Taking into account the current discussion on lifetime CVD risk, we focused on the age dependence in LDL-C control. Methods In this observational cross-sectional study, based on routine electronic health record (EHR) data, we investigated LDL-C control of hypertensive, non-diabetic patients without renal dysfunction or CVD, aged 30 years or more in Finnish primary care setting. Results More than half (54% of women and 53 % of men) of untreated patients did not meet the LDL-C target of <3 mmol/l and one third (35% of women and 33 % of men) of patients did not reach the target even with the lipid-lowering medication (LLM). Furthermore, higher age was strongly associated with better LDL-C control (p<0.001) and lower LDL-C level (p<0.001) in individuals with and without LLM. Higher age was also strongly associated with LLM prescription (p<0.001). In total, about half of the patients were on LLM (53% of women and 51 % of men). Conclusions Our findings indicate that dyslipidemia treatment among Finnish primary care hypertensive patients is generally insufficient, particularly in younger age groups who might benefit the most from CVD risk reduction over time. Clinicians should probably rely more on the lifetime risk of CVD, especially when treating working age hypertensive patients.

scholarly journals Lifetime risk assessment in cholesterol management among hypertensive patients: Observational cross-sectional study based on electronic health record data.

2019 ◽  
Author(s):  
Aapo Tahkola ◽  
Päivi Korhonen ◽  
Hannu Kautiainen ◽  
Teemu Niiranen ◽  
Pekka Mäntyselkä
Keyword(s):  
Primary Care ◽  
Electronic Health Record ◽  
Cross Sectional Study ◽  
Lifetime Risk ◽  
Health Record ◽  
Sectional Study ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Electronic Health

Abstract Background In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains generally insufficient, also in patients with hypertension. We analyzed Electronic Health Record (EHR) data of 7117 hypertensive patients to find the most potential subgroups in greatest need for improvement in real life dyslipidemia treatment. Taking into account the current discussion on lifetime CVD risk, we focused on the age dependence in LDL-C control. Methods In this observational cross-sectional study, based on routine electronic health record (EHR) data, we investigated LDL-C control of hypertensive, non-diabetic patients without renal dysfunction or CVD, aged 30 years or more in Finnish primary care setting. Results More than half (54% of women and 53 % of men) of untreated patients did not meet the LDL-C target of <3 mmol/l and one third (35% of women and 33 % of men) of patients did not reach the target even with the lipid-lowering medication (LLM). Furthermore, higher age was strongly associated with better LDL-C control (p<0.001) and lower LDL-C level (p<0.001) in individuals with and without LLM. Higher age was also strongly associated with LLM prescription (p<0.001). In total, about half of the patients were on LLM (53% of women and 51 % of men). Conclusions Our findings indicate that dyslipidemia treatment among Finnish primary care hypertensive patients is generally insufficient, particularly in younger age groups who might benefit the most from CVD risk reduction over time. Clinicians should probably rely more on the lifetime risk of CVD, especially when treating working age hypertensive patients.

scholarly journals Approaches for combining primary care electronic health record data from multiple sources: a systematic review of observational studies

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037405
Author(s):  
Daniel Dedman ◽  
Melissa Cabecinha ◽  
Rachael Williams ◽  
Stephen J W Evans ◽  
Krishnan Bhaskaran ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Electronic Health Record ◽  
Observational Studies ◽  
Meta Analysis ◽  
Data Sources ◽  
Health Record ◽  
Two Stage ◽  
One Stage ◽  
Electronic Health

ObjectiveTo identify observational studies which used data from more than one primary care electronic health record (EHR) database, and summarise key characteristics including: objective and rationale for using multiple data sources; methods used to manage, analyse and (where applicable) combine data; and approaches used to assess and report heterogeneity between data sources.DesignA systematic review of published studies.Data sourcesPubmed and Embase databases were searched using list of named primary care EHR databases; supplementary hand searches of reference list of studies were retained after initial screening.Study selectionObservational studies published between January 2000 and May 2018 were selected, which included at least two different primary care EHR databases.Results6054 studies were identified from database and hand searches, and 109 were included in the final review, the majority published between 2014 and 2018. Included studies used 38 different primary care EHR data sources. Forty-seven studies (44%) were descriptive or methodological. Of 62 analytical studies, 22 (36%) presented separate results from each database, with no attempt to combine them; 29 (48%) combined individual patient data in a one-stage meta-analysis and 21 (34%) combined estimates from each database using two-stage meta-analysis. Discussion and exploration of heterogeneity was inconsistent across studies.ConclusionsComparing patterns and trends in different populations, or in different primary care EHR databases from the same populations, is important and a common objective for multi-database studies. When combining results from several databases using meta-analysis, provision of separate results from each database is helpful for interpretation. We found that these were often missing, particularly for studies using one-stage approaches, which also often lacked details of any statistical adjustment for heterogeneity and/or clustering. For two-stage meta-analysis, a clear rationale should be provided for choice of fixed effect and/or random effects or other models.

scholarly journals Electronic Health Record Acceptance by Physicians: A Single Hospital Experience in Daily Practice

2021 ◽  
Vol 1 (1) ◽  
pp. 6-17
Author(s):  
Andrija Pavlovic ◽  
Nina Rajovic ◽  
Jasmina Pavlovic Stojanovic ◽  
Debora Akinyombo ◽  
Milica Ugljesic ◽  
...  
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Electronic Health Record ◽  
Technology Acceptance ◽  
Daily Practice ◽  
Ease Of Use ◽  
Future Research ◽  
Health Record ◽  
Cross Sectional ◽  
Electronic Health

Introduction: Potential benefits of implementing an electronic health record (EHR) to increase the efficiency of health services and improve the quality of health care are often obstructed by the unwillingness of the users themselves to accept and use the available systems. Aim: The aim of this study was to identify factors that influence the acceptance of the use of an EHR by physicians in the daily practice of hospital health care. Material and Methods: The cross-sectional study was conducted among physicians in the General Hospital Pancevo, Serbia. An anonymous questionnaire, developed according to the technology acceptance model (TAM), was used for the assessment of EHR acceptance. The response rate was 91%. Internal consistency was assessed by Cronbach’s alpha coefficient. A logistic regression analysis was used to identify the factors influencing the acceptance of the use of EHR. Results: The study population included 156 physicians. The mean age was 46.4 ± 10.4 years, 58.8% participants were female. Half of the respondents (50.1%) supported the use of EHR in comparison to paper patient records. In multivariate logistic regression modeling of social and technical factors, ease of use, usefulness, and attitudes towards use of EHR as determinants of the EHR acceptance, the following predictors were identified: use of a computer outside of the office for reading daily newspapers (p = 0.005), EHR providing a greater amount of valuable information (p = 0.007), improvement in the productivity by EHR use (p < 0.001), and a statement that using EHR is a good idea (p = 0.014). Overall the percentage of correct classifications in the model was 83.9%. Conclusion: In this research, determinants of the EHR acceptance were assessed in accordance with the TAM, providing an overall good model fit. Future research should attempt to add other constructs to the TAM in order to fully identify all determinants of physician acceptance of EHR in the complex environment of different health systems.

Identifying Factors Predicting Immunization Delay for Children Followed in an Urban Primary Care Network Using an Electronic Health Record

PEDIATRICS ◽  
2006 ◽  
Vol 118 (6) ◽  
pp. e1680-e1686 ◽  
Author(s):  
A. G. Fiks ◽  
E. A. Alessandrini ◽  
A. A. Luberti ◽  
S. Ostapenko ◽  
X. Zhang ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Record ◽  
Health Record ◽  
Care Network ◽  
Electronic Health
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