scholarly journals EpiToMe: A Bespoke EHR for Epilepsy Care (Preprint)

2020 ◽  
Author(s):  
Shiqiang Tao ◽  
Samden Lhatoo ◽  
Johnson Hampson ◽  
Licong Cui ◽  
Guo-Qiang Zhang
Keyword(s):  
Patient Care ◽  
Care Management ◽  
Healthcare Delivery ◽  
Data Entry ◽  
General Purpose ◽  
Burden Of Care ◽  
Physician Burnout ◽  
Contributing Factors ◽  
Clinical Workflow ◽  
Redundant Data

BACKGROUND While EHR brings various benefits to healthcare, EHR systems are often criticized as cumbersome to use, failing to fulfill the promise of improved healthcare delivery with little more than a means of meeting regulatory and billing requirements. Besides, EHR systems have been recognized as one of the contributing factors for physician burnout. OBJECTIVE Specialty-specific Electronic Health Records (EHR) systems have been suggested as an alternative approach that can potentially address challenges associated with general-purpose EHRs. We introduce Epilepsy Tracking and optimized Management engine (EpiToMe), an exemplar bespoke EHR system for epilepsy care. EpiToMe uses agile, physician-centered development to optimize clinical workflow and patient care documentation. We also report the initial feedback of EpiToMe on its utility on physician burnout. METHODS Using collaborative, asynchronous data capturing interfaces anchored to a domain ontology, EpiToMe distributes reporting workload among technicians, clinical fellows, and attending physicians. Results of documentation are transmitted to the parent EHR to meet patient care requirements with a push of a button. An HL7 messaging engine exchanges information between EpiToMe and EHR to optimize clinical workflow tasks without redundant data entry. EpiToMe also provides live, interactive patient tracking interfaces to ease the burden of care management. RESULTS Since February 2019, 12,422 electroencephalogram (EEG) reports, 929 Epilepsy Monitoring Unit (EMU) daily reports, and 1,125 EMU phase reports have been completed in EpiToMe for 5,393 unique patients. A ten-question survey was completed by 11 (among 16 invited) senior clinical attendings. Consensus was found that EpiToMe eased the burden of care documentation for patient management, a contributing factor to physician burnout. CONCLUSIONS EpiToMe offers an exemplar bespoke EHR system combining physician-centered design with the latest advances in information technology. The bespoke approach has the potential to ease the burden of care management in epilepsy.

Infusion pump informatics approach to quantify impact of alerts and alarms on healthcare delivery

2017 ◽  
Vol 61 (1) ◽  
pp. 681-685 ◽  
Author(s):  
Denny Yu ◽  
Kang-Yu Hsu ◽  
Joon Hong Kim ◽  
Poching DeLaurentis
Keyword(s):  
Patient Care ◽  
Medical Devices ◽  
One Health ◽  
Infusion Pump ◽  
Healthcare Delivery ◽  
Health Practitioner ◽  
Contributing Factors ◽  
Infusion Pumps ◽  
Logistic Regressions ◽  
Current Impact

Infusion pumps are medical devices that deliver medication, fluids, and nutrients in a precise and controlled manner that is critical to patient care. This study proposes using infusion pump informatics on all-infusion datasets to understand current impact of alerts and alarms on patient care and health practitioner workflow. All-infusion datasets contain infusion data for both normal and abnormal use, i.e., error states. Ten months of continuous data was collected from one health institution. Analysis of variance with log-transformation and logistic regressions were used to analysis contributing factors for alerts and alarms states. A total 64,511 minutes of alarm activation were observed, where alarms were active prior to being resolved. Mean resolution times for 83% of alarms were one minute or less; however, 3% or alarms required >4 minutes before getting resolved. Risk factors for infusions with alerts included nursing shift variables. Specifically, odds for alerts were 1.3 times higher for infusions that span across shifts than infusions in the day shift.

scholarly journals A Qualitative Analysis of the Needs and Experiences of Hospital-based Clinicians when Accessing Medical Imaging

2021 ◽  
Author(s):  
Séan Cronin ◽  
Bridget Kane ◽  
Gavin Doherty
Keyword(s):  
Medical Imaging ◽  
Digital Imaging ◽  
Data Privacy ◽  
General Purpose ◽  
Structured Interviews ◽  
Clinical Workflow ◽  
Desktop Computers ◽  
Single Voice ◽  
Safety Officer ◽  
Basic Features

AbstractAs digital imaging is now a common and essential tool in the clinical workflow, it is important to understand the experiences of clinicians with medical imaging systems in order to guide future development. The objective of this paper was to explore health professionals’ experiences, practices and preferences when using Picture Archiving and Communications Systems (PACS), to identify shortcomings in the existing technology and inform future developments. Semi-structured interviews are reported with 35 hospital-based healthcare professionals (3 interns, 11 senior health officers, 6 specialist registrars, 6 consultants, 2 clinical specialists, 5 radiographers, 1 sonographer, 1 radiation safety officer). Data collection took place between February 2019 and December 2020 and all data are analyzed thematically. A majority of clinicians report using PACS frequently (6+ times per day), both through dedicated PACS workstations, and through general-purpose desktop computers. Most clinicians report using basic features of PACS to view imaging and reports, and also to compare current with previous imaging, noting that they rarely use more advanced features, such as measuring. Usability is seen as a problem, including issues related to data privacy. More sustained training would help clinicians gain more value from PACS, particularly less experienced users. While the majority of clinicians report being unconcerned about sterility when accessing digital imaging, clinicians were open to the possibility of touchless operation using voice, and the ability to execute multiple commands with a single voice command would be welcomed.

scholarly journals Data Science & Engineering into Food Science: A novel Big Data Platform for Low Molecular Weight Gelators’ Behavioral Analysis

2020 ◽  
Vol 20 (2) ◽  
pp. e08
Author(s):  
Verónica Cuello ◽  
Gonzalo Zarza ◽  
Maria Corradini ◽  
Michael Rogers
Keyword(s):  
Molecular Weight ◽  
Big Data ◽  
Data Science ◽  
Data Entry ◽  
Science Research ◽  
Food Science ◽  
Redundant Data ◽  
Data Platform ◽  
Assembly Behavior ◽  
Low Molecular Weight Gelators

The objective of this article is to introduce a comprehensiveend-to-end solution aimed at enabling the applicationof state-of-the-art Data Science and Analyticmethodologies to a food science related problem. Theproblem refers to the automation of load, homogenization,complex processing and real-time accessibility tolow molecular-weight gelators (LMWGs) data to gaininsights into their assembly behavior, i.e. whether agel can be mixed with an appropriate solvent or not.Most of the work within the field of Colloidal andFood Science in relation to LMWGs have centered onidentifying adequate solvents that can generate stablegels and evaluating how the LMWG characteristics canaffect gelation. As a result, extensive databases havebeen methodically and manually registered, storingresults from different laboratory experiments. Thecomplexity of those databases, and the errors causedby manual data entry, can interfere with the analysisand visualization of relations and patterns, limiting theutility of the experimental work.Due to the above mentioned, we have proposed ascalable and flexible Big Data solution to enable theunification, homogenization and availability of the datathrough the application of tools and methodologies.This approach contributes to optimize data acquisitionduring LMWG research and reduce redundant data processingand analysis, while also enabling researchersto explore a wider range of testing conditions and pushforward the frontier in Food Science research.

scholarly journals I-THS-1908 A Big Data Electronic Health Record for Patient Care Management and Analytics

2019 ◽  
Author(s):  
Ahmad Hidayat ◽  
Arief Hasani
Keyword(s):  
Big Data ◽  
Electronic Health Record ◽  
Patient Care ◽  
Care Management ◽  
Patient Care Management ◽  
Health Conditions ◽  
Health Record ◽  
Complex Variety ◽  
Electronic Health ◽  
Further Development

The I-THS-1908, a big data electronic health record platform, is capable of establishing its capability as an electronic health record to tackle the large volume of data with high velocity and complex variety of patient data by providing the value to the patient care management and analytics. The further development of I-THS-1908 opens the opportunity to use the electronic health record for patient care management and analytics for all type of health conditions.

Physician satisfaction with electronic medical records (EMRs): Time for an intelligent health record?

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 318-318
Author(s):  
Ajeet Gajra ◽  
Dewilka Simons ◽  
Yolaine Jeune-Smith ◽  
Amy W. Valley ◽  
Bruce A. Feinberg
Keyword(s):  
Medical Records ◽  
Healthcare Delivery ◽  
Data Entry ◽  
Community Setting ◽  
Clinical Information ◽  
Data Access ◽  
Physician Satisfaction ◽  
Remote Access ◽  
Direct Patient Care ◽  
Cancer Management

318 Background: EMRs are devised to improve the quality and efficiency of healthcare delivery and to reduce medical errors. Despite the widespread use of EMRs, various factors can limit their effectiveness in improving healthcare quality. General EMR use has been cited as a factor contributing to increased workload and clinician burnout in oncology and other specialties. The objective of this qualitative research study was to identify barriers perceived by medical oncologists and hematologists (mO/H) in utilizing EMR software and factors associated with levels of satisfaction. Methods: Between January and April 2021, mO/H from across the U.S. were invited to complete a web-based survey about various trends and critical issues in oncology care. Demographics about the physicians and characteristics of their practices were captured as well in the survey. Responses were aggregated and analyzed using descriptive statistics. Results: A total of 369 mO/H completed the survey: 72% practice in a community setting; 47% identified as a hospital employee; they have an average of 19 years of clinical experience and spend on average 86% of their working time in direct patient care, seeing 17 patients per day on average on clinic days. Most (99%) of mO/H surveyed use an EMR software at their practice, with Epic (45%) and OncoEMR (16%) being the most common. Regarding satisfaction, 16% and 50% reported feeling highly satisfied and satisfied, respectively, with their current EMR, and 3% and 11% reported feeling very dissatisfied or dissatisfied, respectively. Some (19%) stated that they have considered changing their EMR, and 68% are unsure how EMR licensing fees for their practice are paid. EMR pain points most commonly experienced were: time-consuming, e.g., too many steps/click (70%); interoperability, e.g., difficulty sharing information across institutions or other EMR software (45%); data entry issues, e.g., difficulty entering clinical information, scheduling patient visits and reminders, or ordering multiple labs (38%); and poor workflow support (31%). The most useful aspects/features of their EMR software reported were availability of information, e.g., preloaded protocols, chemotherapy regimens and pathways (64%); data access (64%); and multiple access points, including remote access (37%). Conclusions: Satisfaction with EMR were generally positive among the mO/H surveyed. However, there are multiple deterrents to the efficient use of current EMR systems. This information is essential in the design of next-generation EMR (an Intelligent Medical Records system) to allow for incorporation of aspects most useful to the end-users, such as pathway access, preloaded information on cancer management as well as ease of access and portability, and a user experience that minimizes clicks and reduces physician time with EMR.

Managing Knowledge to Improve Healthcare Quality in Banner Health

2005 ◽  
pp. 337-352 ◽  
Author(s):  
Twila Burdick ◽  
John Hensing ◽  
Bradford Kirkman-Liff ◽  
Pamela Nenaber ◽  
Howard Silverman ◽  
...  
Keyword(s):  
Patient Care ◽  
Organizational Performance ◽  
Care Management ◽  
Work Groups ◽  
Healthcare Quality ◽  
Organizational Boundaries ◽  
Profound Knowledge ◽  
Functional Teams

In 2001 Banner Health launched Care Management and Organizational Performance as a system-wide, collaborative and team-based effort to improve the performance consistency of the organization’s core product: patient care. Functional Teams are composed of recognized knowledgeable clinical leaders who were viewed by peers as being experts with profound knowledge. Functional Teams have created more than 36 Work Groups that cut across organizational boundaries.

Clinical Teams

2019 ◽  
pp. 231-235
Author(s):  
Mark E. Frisse ◽  
Karl E. Misulis
Keyword(s):  
Care Management ◽  
Chronic Care ◽  
Healthcare Delivery ◽  
Clinical Informatics ◽  
Care Plan ◽  
Collaborative Activity ◽  
Chronic Care Management ◽  
Complex Interactions ◽  
Acting In Concert

Healthcare delivery is a collaborative activity involving many individuals playing myriad roles. Clinical informatics often emphasizes the role of physicians, nurses, pharmacists, and other staff acting in concert to ensure that key clinical tasks are performed. Only recently have clinical informatics systems begun to model the complex interactions of the team supporting care in the home. Most posthospitalization care and most chronic care management require coordination across teams working from delivery organizations and both the formal and informal teams delivering care in the home. This degree of coordination requires targeted communication and maintenance of both a care record and a care plan.

Impact of Health Information Technologies on the Quality of Healthcare Deliveries

2021 ◽  
Vol 6 (1) ◽  
pp. 30-44
Author(s):  
Patricia Whitley ◽  
Hossain Shahriar ◽  
Sweta Sneha
Keyword(s):  
Patient Care ◽  
Health Information ◽  
Medical Errors ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Well Being ◽  
Quality Of Healthcare ◽  
Quality Healthcare ◽  
The Impact

Through a literary review of recent research, this paper examines the mixed impact of health information technology (HIT) on patient care, medical errors, and the quality of healthcare delivery in selected hospital settings such as emergency departments. Specific technologies examined include the electronic health record (EHR), medical devices, artificial intelligence, and robotics. The paper identifies that some healthcare technologies are increasingly valuable in reducing medical errors, improving healthcare quality, and in producing better patient-centered outcomes. It also determines that technologies have complicated the delivery of quality patient care, increased the incidences of clinician burnout, and made receiving quality healthcare in America's hospital systems possibly less sure. The paper concludes with some suggestions for improving HIT's implementations and confirms the need for further evaluation of the impact of HIT in increasing patient safety and clinician well-being.

scholarly journals Creation and implementation of a novel clinical workflow based on the AAST uniform anatomic severity grading system for emergency general surgery conditions

2020 ◽  
Vol 5 (1) ◽  
pp. e000552 ◽  
Author(s):  
Kovi E Bessoff ◽  
Jeff Choi ◽  
Sylvia Bereknyei Merrell ◽  
Aussama Khalaf Nassar ◽  
David Spain ◽  
...  
Keyword(s):  
Patient Care ◽  
General Surgery ◽  
Qualitative Interviews ◽  
Grading System ◽  
Clinical Workflow ◽  
Emergency General Surgery ◽  
Level Of Evidence ◽  
Severity Scores ◽  
Severity Grading ◽  
The Impact

ObjectiveEmergency general surgery (EGS) conditions encompass a variety of diseases treated by acute care surgeons. The heterogeneity of these diseases limits infrastructure to facilitate EGS-specific quality improvement (QI) and research. A uniform anatomic severity grading system for EGS conditions was recently developed to fill this need. We integrated this system into our clinical workflow and examined its impact on research, surgical training, communication, and patient care.MethodsThe grading system was integrated into our clinical workflow in a phased fashion through formal education and a written handbook. A documentation template was also deployed in our electronic medical record to prospectively assign severity scores at the time of patient evaluation. Mixed methods including a quantitative survey and qualitative interviews of trainees and attending surgeons were used to evaluate the impact of the new workflow and to identify obstacles to its adoption.ResultsWe identified 2291 patients presenting with EGS conditions during our study period. The most common diagnoses were small bowel obstruction (n=470, 20.5%), acute cholecystitis (n=384, 16.8%), and appendicitis (n=370, 16.1%). A total of 21 qualitative interviews were conducted. Twenty interviewees (95.2%) had a positive impression of the clinical workflow, citing enhanced patient care and research opportunities. Fifteen interviewees (75.0%) reported the severity grading system was a useful framework for clinical management, with five participants (25.0%) indicating the system was useful to facilitate clinical communication. Participants identified solutions to overcome barriers to adoption of the clinical workflow.ConclusionsThe uniform anatomic severity grading system can be readily integrated into a clinical workflow to facilitate prospective data collection for QI and research. The system is perceived as valuable by users. Educational initiatives that focus on increasing familiarity with the system and its benefits will likely improve adoption of the classification system and the clinical workflow that uses it.Level of evidenceLevel III.

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