scholarly journals Retrospective analysis of electronic health records of patients with heart failure: the first Russian experience

2021 ◽  
Vol 26 (5) ◽  
pp. 4502
Author(s):  
S. R. Gilyarevsky ◽  
D. V. Gavrilov ◽  
A. V. Gusev
Keyword(s):  
Heart Failure ◽  
Electronic Health Records ◽  
Treatment Quality ◽  
Health Records ◽  
Brain Natriuretic Peptides ◽  
Number Of Patients ◽  
Patients With Heart Failure ◽  
Electronic Health ◽  
Therapy Quality

The article presents the first experience of analyzing the treatment quality of hospitalized patients with heart failure based on electronic health records (EHR). We analyzed EHR of patients hospitalized in three large hospitals in Kirov. The results of the analysis indicated insufficient detailed information in the EHR, which complicates analyzing the accuracy of diagnosis and therapy quality. In particular, attention is drawn to the disproportionate number of patients with heart failure with reduced and preserved ejection fractionю This, apparently, is due to the low prevalence of assessing brain natriuretic peptides and conducting Doppler echocardiography. A separate part of the analysis is devoted to assessing the therapy quality in patients with concomitant diabetes. Despite the study limitations, the presented results can be useful for improving the quality of EHR filling for performing further observational clinical trials.

scholarly journals Multimorbidity patterns in patients with heart failure: an observational Spanish study based on electronic health records

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033174 ◽  
Author(s):  
Antonio Gimeno-Miguel ◽  
Anyuli Gracia Gutiérrez ◽  
Beatriz Poblador-Plou ◽  
Carlos Coscollar-Santaliestra ◽  
J Ignacio Pérez-Calvo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Electronic Health Records ◽  
Health Outcomes ◽  
Chronic Diseases ◽  
Large Scale ◽  
Health Records ◽  
Men And Women ◽  
Patients With Heart Failure ◽  
Electronic Health ◽  
The Impact

ObjectivesTo characterise the comorbidities of heart failure (HF) in men and women, to explore their clustering into multimorbidity patterns, and to measure the impact of such patterns on the risk of hospitalisation and mortality.DesignObservational retrospective population study based on electronic health records.SettingEpiChron Cohort (Aragón, Spain).ParticipantsAll the primary and hospital care patients of the EpiChron Cohort with a diagnosis of HF on 1 January 2011 (ie, 8488 women and 6182 men). We analysed all the chronic diseases registered in patients’ electronic health records until 31 December 2011.Primary outcomeWe performed an exploratory factor analysis to identify the multimorbidity patterns in men and women, and logistic and Cox proportional-hazards regressions to investigate the association between the patterns and the risk of hospitalisation in 2012, and of 3-year mortality.ResultsAlmost all HF patients (98%) had multimorbidity, with an average of 7.8 chronic diseases per patient. We identified six different multimorbidity patterns, named cardiovascular, neurovascular, coronary, metabolic, degenerative and respiratory. The most prevalent were the degenerative (64.0%) and cardiovascular (29.9%) patterns in women, and the metabolic (49.3%) and cardiovascular (43.2%) patterns in men. Every pattern was associated with higher hospitalisation risks; and the cardiovascular, neurovascular and respiratory patterns significantly increased the likelihood of 3-year mortality.ConclusionsMultimorbidity is the norm rather than the exception in patients with heart failure, whose comorbidities tend to cluster together beyond simple chance in the form of multimorbidity patterns that have different impact on health outcomes. This knowledge could be useful to better understand common pathophysiological pathways underlying this condition and its comorbidities, and the factors influencing the prognosis of men and women with HF. Further large scale longitudinal studies are encouraged to confirm the existence of these patterns as well as their differential impact on health outcomes.

Electronic health records and quality of care for heart failure

2010 ◽  
Vol 159 (4) ◽  
pp. 635-642.e1 ◽  
Author(s):  
Mary Norine Walsh ◽  
Clyde W. Yancy ◽  
Nancy M. Albert ◽  
Anne B. Curtis ◽  
Wendy Gattis Stough ◽  
...  
Keyword(s):  
Heart Failure ◽  
Quality Of Care ◽  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health

Automated Review of Electronic Health Records to Assess Quality of Care for Outpatients with Heart Failure

2007 ◽  
Vol 146 (4) ◽  
pp. 270 ◽  
Author(s):  
David W. Baker ◽  
Stephen D. Persell ◽  
Jason A. Thompson ◽  
Neilesh S. Soman ◽  
Karen M. Burgner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Quality Of Care ◽  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health ◽  
Assess Quality

Telemonitoring in Heart Failure Rehabilitation

2011 ◽  
Vol 7 (1) ◽  
pp. 66 ◽  
Author(s):  
Ewa Piotrowicz ◽  
Ryszard Piotrowicz ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Ecg Monitoring ◽  
Heart Rate Monitoring ◽  
Electrocardiographic Monitoring ◽  
Number Of Patients ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related

Exercise training (ET) is now recommended as an important component of a comprehensive approach to patients with heart failure (HF). Despite the existence of proven benefits of ET, many HF patients remain physically inactive. Introducing telerehabilitation (TR) may eliminate most of the factors that result in the currently low number of patients undergoing outpatient-based rehabilitation programmes and thus increase the percentage of those who will undergo cardiac rehabilitation. Despite the fact that TR is highly applicable and effective, there are few papers dedicated to the study of TR in HF patients. Until recently, only a couple of home rehabilitation-monitoring models have been presented, from the simplest, i.e. heart rate monitoring and transtelephonic electrocardiographic monitoring, through to the more advanced tele-electocardiogram (tele-ECG) monitoring (via a remote device) and realtime electrocardiographic and voice transtelephonic monitoring. It seems the last two are the most useful and reliable. Based on published studies, TR in HF patients could be equally effective as and provide similar improvements in health-related quality of life to standard outpatient cardiac rehabilitation. In addition, adherence to cardiac rehabilitation seems to be better during TR. Due to disease-related limitations, TR seems to be a viable alternative for comprehensive cardiac rehabilitation in HF patients. Further studies are needed to confirm the utility of this type of rehabilitation in routine clinical practice, including its cost-effectiveness. Because of the diversity of technological systems, it is necessary to create a platform to ensure compatibility between the devices used in telemedicine.

scholarly journals Putting the “why” in “EHR”: capturing and coding clinical cognition

2019 ◽  
Vol 26 (11) ◽  
pp. 1379-1384 ◽  
Author(s):  
James J Cimino
Keyword(s):  
Electronic Health Records ◽  
Information Overload ◽  
Data Retrieval ◽  
Formal Structure ◽  
Health Records ◽  
Clinical Notes ◽  
Electronic Health ◽  
Physical Findings ◽  
Substantial Effort

Abstract Complaints about electronic health records, including information overload, note bloat, and alert fatigue, are frequent topics of discussion. Despite substantial effort by researchers and industry, complaints continue noting serious adverse effects on patient safety and clinician quality of life. I believe solutions are possible if we can add information to the record that explains the “why” of a patient’s care, such as relationships between symptoms, physical findings, diagnostic results, differential diagnoses, therapeutic plans, and goals. While this information may be present in clinical notes, I propose that we modify electronic health records to support explicit representation of this information using formal structure and controlled vocabularies. Such information could foster development of more situation-aware tools for data retrieval and synthesis. Informatics research is needed to understand what should be represented, how to capture it, and how to benefit those providing the information so that their workload is reduced.

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