Clinical and financial effects of smart pump–electronic medical record interoperability at a hospital in a regional health system

2018 ◽  
Vol 75 (14) ◽  
pp. 1064-1068 ◽  
Author(s):  
Jennifer Biltoft ◽  
Lonnye Finneman
Keyword(s):  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Regional Health ◽  
Smart Pump

scholarly journals Electronic medical record‐verified hepatitis C virus screening in a large health system

2019 ◽  
Vol 8 (10) ◽  
pp. 4555-4564 ◽  
Author(s):  
Monica L. Kasting ◽  
Anna R. Giuliano ◽  
Richard R. Reich ◽  
Linh M. Duong ◽  
Julie Rathwell ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Virus Screening

Electronic Medical Record Implementation Challenges for the National Health System in Greece

2018 ◽  
Vol 7 (1) ◽  
pp. 16-30 ◽  
Author(s):  
Dimitrios G. Katehakis
Keyword(s):  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
National Health ◽  
National Health System ◽  
Public Hospitals ◽  
Medical Decision ◽  
Significant Information ◽  
Implementation Challenges ◽  
Clinically Significant

The purpose of this work is to expose challenges related to the implementation of quality electronic medical record (EMR) systems in public hospitals in Greece, a country where the national health system (NHS) has already acquired electronic medical records (EMRs). The level of EMR implementation, together with organizational maturity at a hospital level, are explored. What is discovered is that there are different adoption levels, not recorded in a systematic manner. The majority of physicians are either reluctant to implement EMRs or do not know options available to them. Implications include not continuous flow of events, cut off of critical information, lower quality of health services, patients not empowered to carry with them clinically significant information, unnecessary repetition of medical procedures and higher costs. It is concluded that focus should be paid on enabling the use of quality, interoperable and secure EMRs to better support medical decision, in an effort to improve the health of the population and to better control costs.

Impact of interoperability of smart infusion pumps and an electronic medical record in critical care

2020 ◽  
Vol 77 (15) ◽  
pp. 1231-1236
Author(s):  
Roy Joseph ◽  
Sang Weon Lee ◽  
Scott V Anderson ◽  
Matthew J Morrisette
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Infusion Pump ◽  
Medication Administration ◽  
Absolute Difference ◽  
Infusion Pumps ◽  
Adult Intensive Care Unit ◽  
Incremental Value ◽  
The Impact ◽  
Smart Pump

Abstract Purpose To describe the benefits of smart infusion pump interoperability with an electronic medical record (EMR) system in an adult intensive care unit (ICU) setting. Summary In order to assess the impact of smart infusion pump and EMR interoperability, we observed whether there were changes in the frequency of electronic medication administration record (eMAR) documentation of dose titrations in epinephrine and norepinephrine infusions in the ICU setting. As a secondary endpoint, we examined whether smart pump/EMR interoperability had any impact on the rate of alerts triggered by the dose-error reduction software. Pharmacist satisfaction was measured to determine the impact of smart pump/EMR interoperability on pharmacist workflow. In the preimplementation phase, there were a total of 2,503 administrations of epinephrine and norepinephrine; 13,299 rate changes were documented, for an average of 5.31 documented rate changes per administration. With smart pump interoperability, a total of 13,024 rate changes were documented in association with 1,401 administrations, for an average of 9.29 documented rate changes per administration (a 74.9% increase). A total of 1,526 dose alerts were triggered in association with 76,145 infusions in the preimplementation phase; there were 820 dose alerts associated with 48,758 autoprogammed infusions in the postimplementation phase (absolute difference, –0.32%). ICU pharmacists largely agreed (75% of survey respondents) that the technology provided incremental value in providing patient care. Conclusion Interoperability between the smart pump and EMR systems proved beneficial in the administration and monitoring of continuous infusions in the ICU setting. Additionally, ICU pharmacists may be positively impacted by improved clinical data accuracy and operational efficiency.

scholarly journals Linkage of whole genome sequencing with administrative health, and electronic medical record data for the study of autism spectrum disorder: Feasibility, Opportunities and Challenges

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Jennifer Brooks ◽  
Evdokia Anagnostou ◽  
Farah Rahman ◽  
Karen Tu ◽  
Lavnaya Uruthiramoorthy ◽  
...  
Keyword(s):  
Health System ◽  
Whole Genome Sequencing ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Administrative Data ◽  
Genome Sequencing ◽  
Health Data ◽  
Spectrum Disorder ◽  
Whole Genome ◽  
Administrative Health Data

IntroductionAutism Spectrum Disorder (ASD) is a neurodevelopmental disorder (NDD) that presents with a high degree of heterogeneity (e.g., co-occurrence of other NDDs and other co-morbid conditions), contributing to differential health system needs. Genetics are known to play an important role in ASD and may be associated with different disease trajectories. Objectives and ApproachIn this proof of principle project, our objective is to link >2,200 children with a confirmed diagnosis of a NDD from the Province of Ontario Neurodevelopmental (POND) Study to administrative health data and electronic medical record (EMR) data in order to identify subgroups of ASD with unique health system trajectories. POND includes detailed phenotype and whole genome sequencing (WGS) data. Identified subgroups will be characterized based on clinical phenotype and genetics. To meet this goal, consideration of WGS-specific privacy and data issues is needed to implement processes which are above and beyond traditional requirements for analyzing individual-level administrative health data. ResultsLinkage of WGS data with administrative health data is an emerging area of research. As such it has presented a number of initial challenges for our study of ASD. Privacy concerns surrounding the use of WGS data and rare-variant analysis are of particular importance. Practical issues required the need for analysts with expertise in administrative data, EMR data and genetic analyses, and specialized software and sufficient processing power to analyze WGS data. Transdisciplinary discussions of the scope and significance of research questions addressed through this linkage were crucial. The identification of genetic determinants of phenotypes and trajectories in ASD could support targeted early interventions; EMR linkage may inform algorithms to identify ASD in broader populations. These approaches could improve both patient outcome and family experience. Conclusion/ImplicationsAs the cost of genetic sequencing decreases, WGS data will become part of the routine clinical management of patients. Linkage of WGS, EMR and administrative data has tremendous potential that has largely not been realized; including population-level ASD research to improve our ability to predict long-term outcomes associated with ASD.

scholarly journals FROM BRAIN DISEASE TO BRAIN HEALTH: PRIMARY PREVENTION OF ALZHEIMER’S DISEASE AND RELATED DISORDERS IN A HEALTH SYSTEM USING AN ELECTRONIC MEDICAL RECORD-BASED APPROACH

2017 ◽  
pp. 1-8
Author(s):  
A.M. Fosnacht ◽  
S. Patel ◽  
C. Yucus ◽  
A. Pham ◽  
E. Rasmussen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
At Risk ◽  
Primary Prevention ◽  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Brain Disease ◽  
Brain Health ◽  
Risk Patients

Background: Alzheimer’s disease and aging brain disorders are progressive, often fatal neurodegenerative diseases. Successful aging, modern lifestyles and behaviors have combined to result in an expected epidemic. Risks for these diseases include genetic, medical, and lifestyle factors; over 20 modifiable risks have been reported. Objectives: We aim to primarily prevent Alzheimer’s disease and related disorders through electronic medical record (EMR)-based screening, risk assessments, interventions, and surveillance. Design: We identified modifiable risks; developed human, systems and infrastructural resources; developed interventions; and targeted at-risk groups for the intervention. Setting: A Community Based Health System. Participants: In year one (June 2015 to May 2016), 133 at-risk patients received brain health services with the goal of delaying or preventing Alzheimer’s disease and related disorders. Measurements: We created mechanisms to identify patients at high risk of neurodegenerative disease; EMR-based structured clinical documentation support tools to evaluate risk factors and history; evidence-based interventions to modify risk; and the capacity for annual surveillance, pragmatic trials, and practice-based and genomic research using the EMR. Results: This paper describes our Center for Brain Health, our EMR tools, and our first year of healthy but at-risk patients. Conclusion: We are translating research into primary prevention of Alzheimer’s disease and related disorders in our health system and aim to shift the paradigm in Neurology from brain disease to brain health.

Validation of a Nurses’ Views on Electronic Medical Record Systems (EMR) Questionnaire in Turkish Health System

2015 ◽  
Vol 39 (6) ◽  
Author(s):  
Mehmet Top ◽  
Ali Yilmaz ◽  
Erdem Karabulut ◽  
Ochieng George Otieno ◽  
Melahat Saylam ◽  
...  
Keyword(s):  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Electronic Medical Record Systems

scholarly journals Early prescribing outcomes after exporting the EQUIPPED medication safety improvement programme

2021 ◽  
Vol 10 (4) ◽  
pp. e001369
Author(s):  
Camille P Vaughan ◽  
Ula Hwang ◽  
Ann E Vandenberg ◽  
Traci Leong ◽  
Daniel Wu ◽  
...  
Keyword(s):  
Older Adults ◽  
Health System ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Health Systems ◽  
Medication Safety ◽  
Potentially Inappropriate Medications ◽  
Health Administration ◽  
Academic Health ◽  
The Impact

Enhancing quality of prescribing practices for older adults discharged from the Emergency Department (EQUIPPED) aims to reduce the monthly proportion of potentially inappropriate medications (PIMs) prescribed to older adults discharged from the ED to 5% or less. We describe prescribing outcomes at three academic health systems adapting and sequentially implementing the EQUIPPED medication safety programme.EQUIPPED was adapted from a model developed in the Veterans Health Administration (VA) and sequentially implemented in one academic health system per year over a 3-year period. The monthly proportion of PIMs, as defined by the 2015 American Geriatrics Beers Criteria, of all medications prescribed to adults aged 65 years and older at discharge was assessed for 6 months preimplementation until 12 months postimplementation using a generalised linear time series model with a Poisson distribution.The EQUIPPED programme was translated from the VA health system and its electronic medical record into three health systems each using a version of the Epic electronic medical record. Adaptation occurred through local modification of order sets and in the generation and delivery of provider prescribing reports by local champions. Baseline monthly PIM proportions 6 months prior to implementation at the three sites were 5.6% (95% CI 5.0% to 6.3%), 5.8% (95% CI 5.0% to 6.6%) and 7.3% (95% CI 6.4% to 9.2%), respectively. Evaluation of monthly prescribing including the twelve months post-EQUIPPED implementation demonstrated significant reduction in PIMs at one of the three sites. In exploratory analyses, the proportion of benzodiazepine prescriptions decreased across all sites from approximately 17% of PIMs at baseline to 9.5%–12% postimplementation, although not all reached statistical significance.EQUIPPED is feasible to implement outside the VA system. While the impact of the EQUIPPED model may vary across different health systems, results from this initial translation suggest significant reduction in specific high-risk drug classes may be an appropriate target for improvement at sites with relatively low baseline PIM prescribing rates.

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