scholarly journals Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

10.2196/14487 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14487 ◽  
Author(s):  
Kwang Yul Jung ◽  
SuJin Kim ◽  
Kihyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Care Providers ◽  
Significant Inverse Relationship ◽  
The Relationship

Background Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. Objective For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. Methods This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mobile EMR, and we merged data using doctors’ deidentification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests. Results A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=–0.19; 95% CI –0.32 to –0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests (coefficient=–0.18; 95% CI –0.30 to –0.04; P=.009). Conclusions Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

scholarly journals Frequent Mobile Electronic Medical Records (EMR) Users Respond More Quickly to Emergency Department Consultation Requests (Preprint)

2019 ◽  
Author(s):  
Kwang Yul Jung ◽  
Su Jin Kim ◽  
Ki Hyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Significant Inverse Relationship ◽  
Clinical Scenarios ◽  
The Relationship

BACKGROUND Specialty consultation is a critical aspect of an emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen the ED overcrowding. Although mobile electronic medical records (mEMR) are being increasingly utilized and are known to improve the workflow of healthcare providers, limited studies have evaluated its effectiveness in real-life clinical scenarios. OBJECTIVE We aimed to determine the association between response duration to ED specialty consultation request and frequency of mEMR use. METHODS This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mEMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from the PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mEMR. We merged both data using doctors’ de-identification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mEMR usage and time interval from ED request to the completion of the consultation by specialty doctors. Secondary outcome was the relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests. RESULTS A total of 25,454 consultations requests were made for 15,555 patients, and 271 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mEMR, 212 doctors used mEMR in specialty consultation process. According to the mEMR usage pattern, the average usage frequency of all users was 13.3/day, and the average duration of the completion of the specialty consultation was 51.0 min. For 21,885 completed consultations, there was a significant inverse relationship between the frequency of mEMR usage and time interval from ED request to consultation completion by specialty doctors. (Coefficient: -0.19 (-0.32 to -0.06), P<.01) Of 23,692 consultations had response time stamp among inclusions. There was also a significant inverse relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests (coefficient: -0.17 (-0.30 to -0.04), P=.01). CONCLUSIONS Our findings suggest that frequent mEMR usage is associated with quicker response time to ED consultation requests.

scholarly journals Macronutrient Quality and All-Cause Mortality in the SUN Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 972
Author(s):  
Susana Santiago ◽  
Itziar Zazpe ◽  
Cesar I. Fernandez-Lazaro ◽  
Víctor de la de la O ◽  
Maira Bes-Rastrollo ◽  
...  
Keyword(s):  
Quality Index ◽  
Inverse Relationship ◽  
A Priori ◽  
The Sun ◽  
Significant Inverse Relationship ◽  
Carbohydrate Quality ◽  
All Cause Mortality ◽  
Middle Aged Adults ◽  
The Relationship

No previous study has assessed the relationship between overall macronutrient quality and all-cause mortality. We aimed to prospectively examine the association between a multidimensional macronutrient quality index (MQI) and all-cause mortality in the SUN (Seguimiento Universidad de Navarra) (University of Navarra Follow-Up) study, a Mediterranean cohort of middle-aged adults. Dietary intake information was obtained from a validated 136-item semi-quantitative food-frequency questionnaire. We calculated the MQI (categorized in quartiles) based on three quality indexes: the carbohydrate quality index (CQI), the fat quality index (FQI), and the healthy plate protein source quality index (HPPQI). Among 19,083 participants (mean age 38.4, 59.9% female), 440 deaths from all causes were observed during a median follow-up of 12.2 years (IQR, 8.3–14.9). No significant association was found between the MQI and mortality risk with multivariable-adjusted hazard ratio (HR) for the highest vs. the lowest quartile of 0.79 (95% CI, 0.59–1.06; Ptrend = 0.199). The CQI was the only component of the MQI associated with mortality showing a significant inverse relationship, with HR between extreme quartiles of 0.64 (95% CI, 0.45–0.90; Ptrend = 0.021). In this Mediterranean cohort, a new and multidimensional MQI defined a priori was not associated with all-cause mortality. Among its three sub-indexes, only the CQI showed a significant inverse relationship with the risk of all-cause mortality.

Psychological, Social and Technical Factors Influencing Electronic Medical Records Systems Adoption by U.S. Physicians: A Systematic Model

2020 ◽  
Author(s):  
Raghid El-Yafouri ◽  
Leslie Klieb ◽  
Valérie Sabatier
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Service Providers ◽  
Financial Burden ◽  
The United States ◽  
Care Providers ◽  
Intention To Adopt

Abstract Background: Wide adoption of electronic medical records (EMR) systems in the United States can lead to better quality medical care at a lower cost. Despite the laws and financial subsidies by the U.S. government for service providers and suppliers, the adoption has been slow. Understanding the EMR adoption drivers for physicians and the role of policymaking can translate into increased adoption rate and enhanced information sharing between medical care providers. Methods: Physicians across the United States were surveyed to gather primary data on their psychological, social, and technical perceptions toward EMR systems. This quantitative study builds on the Theory of Planned Behavior, the Technology Acceptance Model, and the Diffusion of Innovation theory to propose, test, and validate an innovation adoption model for the health care industry. 382 responses were collected and data were analyzed via linear regression to uncover the effects of 12 variables on the intention to adopt EMR systems.Results: Regression model testing uncovers that government policymaking or mandates and other social factors have little or negligible effect on physicians’ intention to adopt an innovation. Rather, physicians are directly driven by their attitudes and ability to control, and indirectly motivated by their knowledge of the innovation, the financial ability to acquire the system, the holistic benefits to their industry, and the relative advancement of the system compared to others.Conclusions: A unidirectional mandate from the government is not sufficient for physicians to adopt an innovation. Government, health care associations, and EMR system vendors can benefit from our findings by working toward increasing the physicians’ knowledge of the proposed innovation, socializing how medical care providers and the overall industry can benefit from EMR system adoption, and solving for the financial burden of system implementation and sustainment.

scholarly journals It matters to be in good hands: the relationship between good governance and pandemic spread inferred from cross-country COVID-19 data

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Munirul H. Nabin ◽  
Mohammad Tarequl Hasan Chowdhury ◽  
Sukanto Bhattacharya
Keyword(s):  
Fixed Effects ◽  
Inverse Relationship ◽  
Good Governance ◽  
Time Window ◽  
Significant Inverse Relationship ◽  
Key Factor ◽  
Positive Rate ◽  
Quality Of Governance ◽  
The Relationship

AbstractThis study examines the relationship between good governance and pandemic control using month-wise COVID-19 pandemic data within a time window from April to September 2020. The study argues that countries with better governance are more capable of adopting and implementing appropriate policies and that such governments are considered more trustworthy by their people. Combined, these factors enable such countries to better control a pandemic like COVID-19. Using several measures of good governance and two measures of pandemic spread, namely the COVID-19 positive rate and the COVID-19 growth rate, this paper tests its argument econometrically in a sample of 185 countries. The results show the existence of a significant inverse relationship between all measures of good governance, and the COVID-19 positive and growth rates. The significant inverse relationship largely persists even after controlling for continent-fixed effects and a host of geographic, demographic, and socio-economic factors. This indicates the presence of a strong systemic linkage between quality of governance and pandemic control. The findings empirically strengthen the argument of eminent medical historians concerning the importance of effective governmental intervention for epidemic control. The study reveals that the quality of governance is a key factor in a country’s success in pandemic management and encourages further investigation.

scholarly journals CORRELATION BETWEEN FRACTURES AND ABUSE IN CHILDREN: A RETROSPECTIVE ANALYSIS

2021 ◽  
Vol 29 (1) ◽  
pp. 30-33
Author(s):  
VITOR LUIS PEREIRA ◽  
BERNARDO LOPES CRISOSTOMO ◽  
GIULIA CARVALHO SILVA ◽  
EIFFEL TSUYOSHI DOBASHI
Keyword(s):  
Retrospective Study ◽  
Electronic Medical Records ◽  
Medical Records ◽  
National Literature ◽  
Level Of Evidence ◽  
Fracture Patterns ◽  
Associated Lesions ◽  
Reference Hospital ◽  
The Subject ◽  
The Relationship

ABSTRACT Objective: The aim of this work is to provide evidence for the relationship between suspicion and diagnosis of cases of child abuse and fractures, since, in national literature, studies are still scarce on the subject. Methods: Retrospective study involving electronic medical records of a public reference hospital, in a city of the state of São Paulo, in a 8-year period (2010 to 2018). Cases involving children up to 12 years of age were selected when notified as abuse and presenting fractures; data were statistically analyzed. Results: Among 83 cases of abuse, 19 patients (20.5%) had 23 different fractures. The victims were mainly boys (68.42%) with a mean age of 5 years old, who suffered physical aggression (79%). The majority had no identified aggressor (52%) and 21% were related to the mother. The fracture patterns found involved, mostly, skull fractures (43.48%) and diaphysary fractures (34.78%). Seven patients (30.43%) had other associated lesions and four patients died (21%). Conclusion: Despite the number of cases, it was possible to identify relevant characteristics and patterns. These data indicate that the diagnosis is underestimated and show small epidemiological differences compared with international literature. Level of Evidence II, Retrospective study.

scholarly journals Not All Patients with Hemiplegia Need Alteplase: A Case of Hemiplegic Migraine

2020 ◽  
Author(s):  
Sumeet Yadav ◽  
Michelle Talukder ◽  
Jacky Duong
Keyword(s):  
Emergency Department ◽  
Early Diagnosis ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Cerebrovascular Accident ◽  
Sensory Impairment ◽  
Hemiplegic Migraine ◽  
Rare Type ◽  
Head Ct ◽  
Work Up

Hemiplegic migraine (HM) is a rare type of migraine which presents with motor and sensory impairment like a cerebrovascular accident (CVA). We present a case of a 36-year-old female, with a prior CVA treated with alteplase, who presented to the emergency department with stroke-like symptoms with a duration of 1 hour. The NIH Stroke Scale score was 22 at presentation. The patient received alteplase under the supervision of a neurologist after head CT confirmed no bleed. Further work-up revealed no acute or remote ischaemia or infarction. This case demonstrates the importance of a thorough history, intercommunication between health systems and integrated Electronic Medical Records (EMR) for early diagnosis and management of HM.

scholarly journals Legal Protection of Patient Data Confidentiality Electronic Medical Records

SOEPRA ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 198
Author(s):  
Nabbilah Amir
Keyword(s):  
Electronic Medical Records ◽  
Health Care Providers ◽  
Medical Records ◽  
Positive Impact ◽  
Electronic Devices ◽  
Legal Protection ◽  
Patient Data ◽  
Care Providers ◽  
Legal Certainty ◽  
The Government

The use of electronic devices is inseparable from life today, entering the Industrial Revolution era where technological sophistication can replace human tasks, so the use of electronic devices can not only be found in domestic life, offices, and education but also in medical services. The various facilities offered by health care providers both hospitals and clinics in the form of technology utilization are increasingly rapidly becoming one of the electronic medical records that are expected to have a positive impact on reducing paper use. Medical records that used paper (conventional) were changed to electronic medical records. The purpose of this study is to find out and analyze the extent to which electronic medical records can protect the confidentiality of patient data and function as evidence in court in malpractice cases. This study uses normative legal research methods and uses the statute approach method. The results of this study indicate that there needs to be a concern from the government in providing legal certainty regarding the existence of electronic medical records, given that the application has been carried out by several hospitals and clinics in Indonesia. The government should provide standard legal certainty to the changes in conventional medical records to electronic medical records in the form of the issuance of specific laws and regulations regulating electronic medical records.

scholarly journals Predicting Biologic Therapy Outcome of Patients With Spondyloarthritis: Joint Models for Longitudinal and Survival Analysis

10.2196/26823 ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. e26823
Author(s):  
Carolina Barata ◽  
Ana Maria Rodrigues ◽  
Helena Canhão ◽  
Susana Vinga ◽  
Alexandra M Carvalho
Keyword(s):  
Survival Analysis ◽  
Electronic Medical Records ◽  
Rheumatic Diseases ◽  
Medical Records ◽  
Biologic Therapy ◽  
Disease Onset ◽  
Time Interval ◽  
Hla B27 ◽  
Joint Models ◽  
Therapy Failure

Background Rheumatic diseases are one of the most common chronic diseases worldwide. Among them, spondyloarthritis (SpA) is a group of highly debilitating diseases, with an early onset age, which significantly impacts patients’ quality of life, health care systems, and society in general. Recent treatment options consist of using biologic therapies, and establishing the most beneficial option according to the patients’ characteristics is a challenge that needs to be overcome. Meanwhile, the emerging availability of electronic medical records has made necessary the development of methods that can extract insightful information while handling all the challenges of dealing with complex, real-world data. Objective The aim of this study was to achieve a better understanding of SpA patients’ therapy responses and identify the predictors that affect them, thereby enabling the prognosis of therapy success or failure. Methods A data mining approach based on joint models for the survival analysis of the biologic therapy failure is proposed, which considers the information of both baseline and time-varying variables extracted from the electronic medical records of SpA patients from the database, Reuma.pt. Results Our results show that being a male, starting biologic therapy at an older age, having a larger time interval between disease start and initiation of the first biologic drug, and being human leukocyte antigen (HLA)–B27 positive are indicators of a good prognosis for the biological drug survival; meanwhile, having disease onset or biologic therapy initiation occur in more recent years, a larger number of education years, and higher values of C-reactive protein or Bath Ankylosing Spondylitis Functional Index (BASFI) at baseline are all predictors of a greater risk of failure of the first biologic therapy. Conclusions Among this Portuguese subpopulation of SpA patients, those who were male, HLA-B27 positive, and with a later biologic therapy starting date or a larger time interval between disease start and initiation of the first biologic therapy showed longer therapy adherence. Joint models proved to be a valuable tool for the analysis of electronic medical records in the field of rheumatic diseases and may allow for the identification of potential predictors of biologic therapy failure.

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