Diabetes and Hypertension Among South Asians in New York and Atlanta Leveraging Hospital Electronic Health Records

2021 ◽  
Author(s):  
Jeannette Beasley ◽  
Joyce C Ho ◽  
Sarah Conderino ◽  
Lorna E Thorpe ◽  
Megha Shah ◽  
...  
Keyword(s):  
New York ◽  
Electronic Health Records ◽  
Health Systems ◽  
South Asian ◽  
South Asians ◽  
New York University ◽  
Health Records ◽  
Asian Patients ◽  
The Us ◽  
Electronic Health

Abstract BACKGROUND: Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. METHODS: Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2+ encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2+ abnormal A1C levels (≥6.5%) and 1+ encounter with a diagnosis of diabetes. Hypertension was defined as having 3+ BP readings of systolic BP ≥130 mmHg or diastolic BP ≥80 mmHg, 2+ encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. RESULTS: Among South Asian patients at these two large health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC.CONCLUSIONS: These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.

scholarly journals Diabetes and hypertension among South Asians in New York and Atlanta leveraging hospital electronic health records

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jeannette M. Beasley ◽  
Joyce C. Ho ◽  
Sarah Conderino ◽  
Lorna E. Thorpe ◽  
Megha Shah ◽  
...  
Keyword(s):  
New York ◽  
Electronic Health Records ◽  
Health Systems ◽  
South Asian ◽  
South Asians ◽  
New York University ◽  
Health Records ◽  
Asian Patients ◽  
The Us ◽  
Electronic Health

Abstract Background Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. Methods Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2 + encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2 + abnormal A1C levels (≥ 6.5%) and 1 + encounter with a diagnosis of diabetes. Hypertension was defined as having 3 + BP readings of systolic BP ≥ 130 mmHg or diastolic BP ≥ 80 mmHg, 2 + encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. Results Among South Asian patients at these two large, private health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC. Conclusions These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.

Professional fission in medical routines: medical scribes and physicians in two US hospital departments

2020 ◽  
Author(s):  
Ann L Bryan ◽  
John C Lammers
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Community Hospital ◽  
Health Record ◽  
Health Departments ◽  
Health Records ◽  
The Us ◽  
Electronic Health ◽  
Medical Scribes ◽  
Digestive Health

Abstract In this study we argue that professionalism imposed from above can result in a type of fission, leading to the ambiguous emergence of new occupations. Our case focuses on the US’ federally mandated use of electronic health records and the increased use of medical scribes. Data include observations of 571 patient encounters across 48 scribe shifts, and 12 interviews with medical scribes and physicians in the ophthalmology and digestive health departments of a community hospital. We found substantial differences in scribes’ roles based on the pre-existing routines within each department, and that scribes developed agency in the interface between the electronic health record and the physicians’ work. Our study contributes to work on occupations as negotiated orders by drawing attention to external influences, the importance of considering differences across professional task routines, and the personal interactions between professional and technical workers.

scholarly journals Quality and Certification of Electronic Health Records

2010 ◽  
Vol 01 (02) ◽  
pp. 149-164 ◽  
Author(s):  
E. Ammenwerth ◽  
A. Hoerbst
Keyword(s):  
Information Systems ◽  
Electronic Health Records ◽  
Qualitative Content Analysis ◽  
Real Life ◽  
Health Records ◽  
Selection Processes ◽  
Quality Certification ◽  
The Us ◽  
Service Oriented ◽  
Electronic Health

Summary Background: Numerous projects, initiatives, and programs are dedicated to the development of Electronic Health Records (EHR) worldwide. Increasingly more of these plans have recently been brought from a scientific environment to real life applications. In this context, quality is a crucial factor with regard to the acceptance and utility of Electronic Health Records. However, the dissemination of the existing quality approaches is often rather limited. Objectives: The present paper aims at the description and comparison of the current major quality certification approaches to EHRs. Methods: A literature analysis was carried out in order to identify the relevant publications with regard to EHR quality certification. PubMed, ACM Digital Library, IEEExplore, CiteSeer, and Google (Scholar) were used to collect relevant sources. The documents that were obtained were analyzed using techniques of qualitative content analysis. Results: The analysis discusses and compares the quality approaches of CCHIT, EuroRec, IHE, openEHR, and EN13606. These approaches differ with regard to their focus, support of service-oriented EHRs, process of (re-)certification and testing, number of systems certified and tested, supporting organizations, and regional relevance. Discussion: The analyzed approaches show differences with regard to their structure and processes. System vendors can exploit these approaches in order to improve and certify their information systems. Health care organizations can use these approaches to support selection processes or to assess the quality of their own information systems. Citation: Hoerbst A, Ammenwerth E. Quality and certification of electronic health records – An overview of current approaches from the US and Europe. Appl Clin Inf 2010; 1: 149–164 http://dx.doi.org/10.4338/ACI-2010-02-R-0009

scholarly journals Signs of the 2009 Influenza Pandemic in the New York-Presbyterian Hospital Electronic Health Records

PLoS ONE ◽  
2010 ◽  
Vol 5 (9) ◽  
pp. e12658 ◽  
Author(s):  
Hossein Khiabanian ◽  
Antony B. Holmes ◽  
Brendan J. Kelly ◽  
Mrinalini Gururaj ◽  
George Hripcsak ◽  
...  
Keyword(s):  
New York ◽  
Electronic Health Records ◽  
Influenza Pandemic ◽  
Health Records ◽  
Presbyterian Hospital ◽  
Electronic Health ◽  
2009 Influenza Pandemic

scholarly journals Scaling-up social needs screening in practice: a retrospective, cross-sectional analysis of data from electronic health records from Bronx county, New York, USA

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e053633
Author(s):  
Kevin P Fiori ◽  
Caroline G Heller ◽  
Anna Flattau ◽  
Nicole R Harris-Hollingsworth ◽  
Amanda Parsons ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Electronic Health Records ◽  
Social Care ◽  
Social Needs ◽  
Cross Sectional ◽  
Health Records ◽  
Care Practices ◽  
Electronic Health ◽  
Primary Care Practices

ObjectivesThere has been renewed focus on health systems integrating social care to improve health outcomes with relatively less related research focusing on ‘real-world’ practice. This study describes a health system’s experience from 2018 to 2020, following the successful pilot in 2017, to scale social needs screening of patients within a large urban primary care ambulatory network.SettingAcademic medical centre with an ambulatory network of 18 primary care practices located in an urban county in New York City (USA).ParticipantsThis retrospective, cross-sectional study used electronic health records of 244 764 patients who had a clinical visit between 10 April 2018 and 8 December 2019 across any one of 18 primary care practices.MethodsWe organised measures using the RE-AIM framework domains of reach and adoption to ascertain the number of patients who were screened and the number of providers who adopted screening and associated documentation, respectively. We used descriptive statistics to summarise factors comparing patients screened versus those not screened, the prevalence of social needs screening and adoption across 18 practices.ResultsBetween April 2018 and December 2019, 53 093 patients were screened for social needs, representing approximately 21.7% of the patients seen. Almost one-fifth (19.6%) of patients reported at least one unmet social need. The percentage of screened patients varied by both practice location (range 1.6%–81.6%) and specialty within practices. 51.8% of providers (n=1316) screened at least one patient.ConclusionsThese findings demonstrate both the potential and challenges of integrating social care in practice. We observed significant variability in uptake across the health system. More research is needed to better understand factors driving adoption and may include harmonising workflows, establishing unified targets and using data to drive improvement.

scholarly journals Growth Of New York Physician Participation In Meaningful Use Of Electronic Health Records Was Variable, 2011–12

2015 ◽  
Vol 34 (6) ◽  
pp. 1035-1043 ◽  
Author(s):  
Hye-Young Jung ◽  
Mark A. Unruh ◽  
Rainu Kaushal ◽  
Joshua R. Vest
Keyword(s):  
New York ◽  
Electronic Health Records ◽  
Meaningful Use ◽  
Health Records ◽  
Physician Participation ◽  
Electronic Health
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