scholarly journals The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review (Preprint)

2021 ◽  
Author(s):  
Tobias Hodgson ◽  
Andrew Burton-Jones ◽  
Raelene Donovan ◽  
Clair Sullivan
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Care Outcomes ◽  
Quadruple Aim ◽  
Care Outcomes ◽  
Clinical Variation ◽  
The Impact

BACKGROUND The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. OBJECTIVE A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. METHODS Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. RESULTS Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. CONCLUSIONS The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

scholarly journals The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review

10.2196/30432 ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. e30432
Author(s):  
Tobias Hodgson ◽  
Andrew Burton-Jones ◽  
Raelene Donovan ◽  
Clair Sullivan
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Care Outcomes ◽  
Quadruple Aim ◽  
Care Outcomes ◽  
Clinical Variation ◽  
The Impact

Background The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. Objective A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. Methods Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. Results Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. Conclusions The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

scholarly journals Electronic Medical Records in the American Health System: challenges and lessons learned

2020 ◽  
Vol 25 (4) ◽  
pp. 1293-1304 ◽  
Author(s):  
Robert S. Janett ◽  
Peter Pano Yeracaris
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Information Exchange ◽  
Improve Patient Care ◽  
Lessons Learned ◽  
Disruptive Technology ◽  
The Impact ◽  
Improve Patient

Abstract Electronic medical records have been touted as a solution to many of the shortcomings of health care systems. The aim of this essay is to review pertinent literature and present examples and recommendations from several decades of experience in the use of medical records in primary health care, in ways that can help primary care doctors to organize their work processes to improve patient care. Considerable problems have been noted to result from a lack of interoperability and standardization of interfaces among these systems, impairing the effective collaboration and information exchange in the care of complex patients. It is extremely important that regional and national health policies be established to assure standardization and interoperability of systems. Lack of interoperability contributes to the fragmentation of the information environment. The electronic medical record (EMR) is a disruptive technology that can revolutionize the way we care for patients. The EMR has been shown to improve quality and reliability in the delivery of healthcare services when appropriately implemented. Careful attention to the impact of the EMR on clinical workflows, in order to take full advantage of the potential of the EMR to improve patient care, is the key lesson from our experience in the deployment and use of these systems.

scholarly journals A systematic review examining the clinical and health-care outcomes for congenital heart disease patients using home monitoring programmes

2021 ◽  
pp. 1357633X2098405
Author(s):  
Rachel Crawford ◽  
Ciara Hughes ◽  
Sonyia McFadden ◽  
Jacqui Crawford
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Case Series ◽  
Home Monitoring ◽  
Risk Of Bias ◽  
Health Care Outcomes ◽  
Care Outcomes

Objectives This review aimed to present the clinical and health-care outcomes for patients with congenital heart disease (CHD) who use home monitoring technologies. Methods Five databases were systematically searched from inception to November 2020 for quantitative studies in this area. Data were extracted using a pre-formatted data-collection table which included information on participants, interventions, outcome measures and results. Risk of bias was determined using the Cochrane Risk of Bias 2 tool for randomised controlled trials (RCTs), the Newcastle–Ottawa Quality Assessment Scale for cohort studies and the Institute of Health Economics quality appraisal checklist for case-series studies. Data synthesis: Twenty-two studies were included in this systematic review, which included four RCTs, 12 cohort studies and six case-series studies. Seventeen studies reported on mortality rates, with 59% reporting that home monitoring programmes were associated with either a significant reduction or trend for lower mortality and 12% reporting that mortality trended higher. Fourteen studies reported on unplanned readmissions/health-care resource use, with 29% of studies reporting that this outcome was significantly decreased or trended lower with home monitoring and 21% reported an increase. Impact on treatment was reported in 15 studies, with 67% of studies finding that either treatment was undertaken significantly earlier or significantly more interventions were undertaken in the home monitoring groups. Conclusion The use of home monitoring programmes may be beneficial in reducing mortality, enabling earlier and more timely detection and treatment of CHD complication. However, currently, this evidence is limited due to weakness in study designs.

scholarly journals Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review

2015 ◽  
Vol 105 (12) ◽  
pp. 2588-2588 ◽  
Author(s):  
William J. Hall ◽  
Mimi V. Chapman ◽  
Kent M. Lee ◽  
Yesenia M. Merino ◽  
Tainayah W. Thomas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Ethnic Bias ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Racial Ethnic

scholarly journals Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review (Preprint)

2018 ◽  
Author(s):  
Ronald Dendere ◽  
Christine Slade ◽  
Andrew Burton-Jones ◽  
Clair Sullivan ◽  
Andrew Staib ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Outcomes ◽  
Electronic Medical Records ◽  
Patient Engagement ◽  
Medical Records ◽  
Provider Communication ◽  
Patient Portals ◽  
High Quality ◽  
Patient Provider Communication

BACKGROUND Engaging patients in the delivery of health care has the potential to improve health outcomes and patient satisfaction. Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication. OBJECTIVE The aim of this study was to review literature describing patient portals tethered to an EMR in inpatient settings, their role in patient engagement, and their impact on health care delivery in order to identify factors and best practices for successful implementation of this technology and areas that require further research. METHODS A systematic search for articles in the PubMed, CINAHL, and Embase databases was conducted using keywords associated with patient engagement, electronic health records, and patient portals and their respective subject headings in each database. Articles for inclusion were evaluated for quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR) for systematic review articles and the Quality Assessment Tool for Studies with Diverse Designs for empirical studies. Included studies were categorized by their focus on input factors (eg, portal design), process factors (eg, portal use), and output factors (eg, benefits) and by the valence of their findings regarding patient portals (ie, positive, negative, or mixed). RESULTS The systematic search identified 58 articles for inclusion. The inputs category was addressed by 40 articles, while the processes and outputs categories were addressed by 36 and 46 articles, respectively: 47 articles addressed multiple themes across the three categories, and 11 addressed only a single theme. Nineteen articles had high- to very high-quality, 21 had medium quality, and 18 had low- to very low-quality. Findings in the inputs category showed wide-ranging portal designs; patients’ privacy concerns and lack of encouragement from providers were among portal adoption barriers while information access and patient-provider communication were among facilitators. Several methods were used to train portal users with varying success. In the processes category, sociodemographic characteristics and medical conditions of patients were predictors of portal use; some patients wanted unlimited access to their EMRs, personalized health education, and nonclinical information; and patients were keen to use portals for communicating with their health care teams. In the outputs category, some but not all studies found patient portals improved patient engagement; patients perceived some portal functions as inadequate but others as useful; patients and staff thought portals may improve patient care but could cause anxiety in some patients; and portals improved patient safety, adherence to medications, and patient-provider communication but had no impact on objective health outcomes. CONCLUSIONS While the evidence is currently immature, patient portals have demonstrated benefit by enabling the discovery of medical errors, improving adherence to medications, and providing patient-provider communication, etc. High-quality studies are needed to fully understand, improve, and evaluate their impact.

The impact of a dedicated patent ductus arteriosus ligation team on neonatal health-care outcomes

2016 ◽  
Vol 36 (6) ◽  
pp. 463-468 ◽  
Author(s):  
M H F Resende ◽  
K More ◽  
D Nicholls ◽  
J Ting ◽  
A Jain ◽  
...  
Keyword(s):  
Health Care ◽  
Patent Ductus Arteriosus ◽  
Ductus Arteriosus ◽  
Neonatal Health ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
The Impact ◽  
Patent Ductus

scholarly journals Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review

2015 ◽  
Vol 105 (12) ◽  
pp. e60-e76 ◽  
Author(s):  
William J. Hall ◽  
Mimi V. Chapman ◽  
Kent M. Lee ◽  
Yesenia M. Merino ◽  
Tainayah W. Thomas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Ethnic Bias ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Racial Ethnic
Sign in / Sign up

Export Citation Format

Share Document