scholarly journals Adverse drug events: description of an active search process in a teaching hospital of the Sentinela Network

Author(s):  
Wanessa S. NOGUEIRA ◽  
Lunara T. SILVA ◽  
Mércia P. PROVIN ◽  
Rita G. AMARAL ◽  
Tatyana M. FERREIRA ◽  
...  

Objective: To describe the implementation of an active search service for adverse drug events (ADE) in a teaching hospital in the Midwest region of Brazil. Method: Observational sectional study conducted at the Pharmacovigilance Service in a University hospital in the Midwest Region of Brazil, from March to August/2019. All patients admitted to a medical clinic unit were included and those who did not find medical records were excluded. A work process structured in six stages was elaborated: 1) elaboration of a list of triggers through literature review; 2) elaboration of a list of patients whose previously selected triggers appeared; 3) visiting the wards and reviewing medical records; 4) validation of ADE; 5) notification of ADE to Agência Nacional de Vigilância Sanitária; 6) registration of information in databases. Results: The Positive Predictive Value (PPV) of each tracker was calculated individually and globally. The relative and absolute frequency of ADE was calculated as to the type, description and the drug involved. A total of 479 searches were made in the period and the frequency of ADE was 7.48%. The global triggers PPV was 0.04. The trigger with the best performance was promethazine (1.00), followed by the Activated Partial Thromboplastin Time (0.67). Regarding the identified ADE, it was observed that most of the time, 24.14% were related to infusion reactions. It was observed that 53.85% of the drugs involved in ADE were high alert medications. Conclusion: It was observed that the implementation of an active search service for ADE in hospitals that do not have the support of an electronic medical record system is feasible to be performed. It was also observed a high frequency of ADE and that the active search guided by triggers allows to identify events that otherwise could not be identified.

Sensors ◽  
2021 ◽  
Vol 21 (22) ◽  
pp. 7765
Author(s):  
Weizhe Chen ◽  
Shunzhi Zhu ◽  
Jianmin Li ◽  
Jiaxin Wu ◽  
Chin-Ling Chen ◽  
...  

With the popularity of the internet 5G network, the network constructions of hospitals have also rapidly developed. Operations management in the healthcare system is becoming paperless, for example, via a shared electronic medical record (EMR) system. A shared electronic medical record system plays an important role in reducing diagnosis costs and improving diagnostic accuracy. In the traditional electronic medical record system, centralized database storage is typically used. Once there is a problem with the data storage, it could cause data privacy disclosure and security risks. Blockchain is tamper-proof and data traceable. It can ensure the security and correctness of data. Proxy re-encryption technology can ensure the safe sharing and transmission of relatively sensitive data. Based on the above situation, we propose an electronic medical record system based on consortium blockchain and proxy re-encryption to solve the problem of EMR security sharing. Electronic equipment in this process is connected to the blockchain network, and the security of data access is ensured through the automatic execution of blockchain chaincodes; the attribute-based access control method ensures fine-grained access to the data and improves the system security. Compared with the existing electronic medical records based on cloud storage, the system not only realizes the sharing of electronic medical records, but it also has advantages in privacy protection, access control, data security, etc.


Author(s):  
Muhammad Sarfraz ◽  
Anwar F. Al-Hussainan ◽  
Farah Mohammad ◽  
Hanouf Al-Azmi

This research proposes, designs, and implements a new online system for electronic medical records (EMR) for assisting the current processes of labs and hospitals. Specific consideration is given to the records of blood donors. It provides an online automated alternate to the traditional manual processes adopted for various medical labs. The proposed system provides an easy way to communicate with the world. The article presents use case diagrams that model the logics of the system. It also proposes schema for supporting databases in the system. The system is prototyped, and ready to be used. To achieve the targeted system, in addition to investigating the latest studies in this area, the needed data was collected through a questionnaire survey with the community. The system, as a special case, has been oriented for the communities of the state of Kuwait to improve its healthcare sector. However, this design can be easily ported to other countries platforms due to its generic formulation.


2019 ◽  
Vol 76 (2) ◽  
pp. 249-255 ◽  
Author(s):  
Johan Lönnbro ◽  
Susanna M. Wallerstedt

Abstract Background As prescribing skills are a prerequisite for rational use of medicines, and education and training are important in acquiring these skills, we aimed to explore what aspects junior physicians find important when being taught the art of prescribing. Methods Written feedback from 34 interns after participating in an educational session as part of a randomized controlled study at a university hospital formed the qualitative data in this study. Manifest content analysis was performed, guided by the research question “Educating junior physicians in the art of prescribing: what aspects do they find important?” Meaning units were extracted and categorized, and emergent themes were identified. Results Five themes emerged. The first, clinical relevance, was exemplified by the categories valuable for health care; perceived relevance for one’s own work; and translating theory into practice while the second, applicable content, included categories such as clinical advice; practical tips on using the electronic medical record system; and tools that facilitate. The third and fourth themes, reality-based teaching and creative discussions, were exemplified by the categories patient cases and feedback; and discussion-based teaching; wide-ranging discussions and a permissive and open atmosphere, respectively. In the last theme, effective structure, we identified the categories clear structure; small group teaching; allocated time for discussion; well-organized administration; and home assignment for practice. Conclusion Creative discussions, effectively structured in small group sessions, with clinically relevant, reality-based content built on case studies and feedback, are aspects which junior physicians find important when educated in the art of prescribing.


2020 ◽  
pp. bjophthalmol-2020-317330
Author(s):  
Anthony Vipin Das ◽  
Sayan Basu

AimsTo describe the clinical profile of epidemic keratoconjunctivitis (EKC) in patients presenting to a multitier ophthalmology hospital network in India.MethodsThis retrospective hospital-based study included 2 408 819 patients presenting between August 2010 and February 2020. Patients with a clinical diagnosis of EKC in at least one eye with a recent onset (≤1 week) were included as cases. The data were collected using the eyeSmart electronic medical record system.ResultsOverall, 21 196 (0.9%) new patients were diagnosed with EKC, of which 19 203 (90.6%) patients reported a recent onset (≤1 week) and were included for analysis. The median age was 32 (IQR: 22–45) years and adults (84.5%) were commonly affected. Most of the patients were male (62.1%) and unilateral (53.4%) affliction was commoner. The most common presenting symptom was redness (63.7%), followed by watering (42.1%). Preauricular lymphadenopathy or tenderness was documented in 1406 (7.3%) cases at presentation. A minority of the eyes had visual impairment worse than 20/200 (7.8%) due to associated ocular comorbidities. The involvement of the cornea was seen in 7338 (38.2%) patients and corneal signs included subepithelial infiltrates (26.3%), epithelial defect (1.4%), corneal oedema (0.9%) and filaments (0.4%). Of the patients who had corneal involvement, 496 (2.6%) patients had a chronic course beyond 1 month of which 105 (0.5%) had a course beyond 1 year.ConclusionEKC is a self-limiting condition that is commonly unilateral and predominantly affects males. About one-third of the patients have corneal involvement which rarely has a chronic course.


2005 ◽  
Vol 11 (5) ◽  
pp. 251-255 ◽  
Author(s):  
Markus Rumpsfeld ◽  
Eli Arild ◽  
Jan Norum ◽  
Elin Breivik

A common workplace was established between the renal unit at the University Hospital of North Norway and two satellite dialysis centres, in Alta and Hammerfest. A 2 Mbit/s ATM network was employed for IP-based videoconferencing. A common electronic medical record system and dialysis monitoring software were used. During an eight-month study period, nine patients were enrolled and 225 videoconferences were performed for daily visits and regular rounds. A bandwidth of 768 kbit/s was required for satisfactory teledialysis. Although technical (28%) and logistical problems (10%) were frequent, five hospitalizations and one-third of the planned visiting rounds were avoided. An economic analysis showed that annual savings amounted to US$46,613, while annual costs were US$79,489. Despite the technical difficulties in about 30% of conferences, the nurses were satisfied with the videoconferencing system. Digital X-rays were communicated without problems. The pilot study indicates that satellite units may be incorporated into the daily management at the central institution by telemedicine.


2011 ◽  
Vol 26 (4) ◽  
pp. 268-275 ◽  
Author(s):  
Theodore C. Chan ◽  
William G. Griswold ◽  
Colleen Buono ◽  
David Kirsh ◽  
Joachim Lyon ◽  
...  

AbstractIntroduction: The use of wireless, electronic, medical records and communications in the prehospital and disaster field is increasing.Objective: This study examines the role of wireless, electronic, medical records and communications technologies on the quality of patient documentation by emergency field responders during a mass-casualty exercise.Methods: A controlled, side-to-side comparison of the quality of the field responder patient documentation between responders utilizing National Institutes of Health-funded, wireless, electronic, field, medical record system prototype (“Wireless Internet Information System for medicAl Response to Disasters” or WIISARD) versus those utilizing conventional, paper-based methods during a mass-casualty field exercise. Medical data, including basic victim identification information, acuity status, triage information using Simple Triage and Rapid Treatment (START), decontamination status, and disposition, were collected for simulated patients from all paper and electronic logs used during the exercise. The data were compared for quality of documentation and record completeness comparing WIISARD-enabled field responders and those using conventional paper methods. Statistical analysis was performed with Fisher’s Exact Testing of Proportions with differences and 95% confidence intervals reported.Results: One hundred simulated disaster victim volunteers participated in the exercise, 50 assigned to WIISARD and 50 to the conventional pathway. Of those victims who completed the exercise and were transported to area hospitals, medical documentation of victim START components and triage acuity were significantly better for WIISARD compared to controls (overall acuity was documented for 100% vs 89.5%, respectively, difference = 10.5% [95%CI = 0.5–24.1%]). Similarly, tracking of decontamination status also was higher for the WIISARD group (decontamination status documented for 59.0% vs 0%, respectively, difference = 9.0% [95%CI = 40.9–72.0%]). Documentation of disposition and destination of victims was not different statistically (92.3% vs. 89.5%, respectively, difference = 2.8% [95%CI = -11.3–17.3%]).Conclusions: In a simulated, mass-casualty field exercise, documentation and tracking of victim status including acuity was significantly improved when using a wireless, field electronic medical record system compared to the use of conventional paper methods.


Author(s):  
Megan M Cory ◽  
Wasif A Osmani ◽  
Kevin S Cory ◽  
Staci Young ◽  
Rebecca Lundh

Objective As appointments become more rushed, it is crucial that primary care clinicians consider new and effective ways to provide preventive health education to patients. Currently, patient education is often handouts printed from the electronic medical record system; however, these pieces of paper often do not have the desired impact. Well-established advertising methods reveal that repeated exposure is key in recall and swaying consumer decisions. The Creating Health Education for Constructive Knowledge in Underserved Populations (CHECK UP) Program is a medical student-led program that aims to improve patient recall of health information, health promoting behaviors and health outcomes by applying modified advertising concepts to the delivery of health education. Methods Patients were given large magnets containing health education information. These patients were interviewed 3–4 months afterwards to assess use and effectiveness of magnets as a means to provide health education. Results In total, 25 of the 28 patients given CHECK UP magnets agreed to participate. The majority of participants (23/25) kept the magnets and reported that they, as well as others in their households, see the magnets daily. All 23 participants recalled at least 1 health tip from 1 of the magnets. Conclusions The use of non-traditional materials for patient education allowed for repeated exposure and recall of health information. Consideration for modified use of evidence-based advertising and marketing strategies for the delivery of patient education may be an easy and effective way to provide information to patients outside of the clinical setting and promote health behavioral changes.


Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 749
Author(s):  
Gumpili Sai Prashanthi ◽  
Nareen Molugu ◽  
Priyanka Kammari ◽  
Ranganath Vadapalli ◽  
Anthony Vipin Das

India is home to 1.3 billion people. The geography and the magnitude of the population present unique challenges in the delivery of healthcare services. The implementation of electronic health records and tools for conducting predictive modeling enables opportunities to explore time series data like patient inflow to the hospital. This study aims to analyze expected outpatient visits to the tertiary eyecare network in India using datasets from a domestically developed electronic medical record system (eyeSmart™) implemented across a large multitier ophthalmology network in India. Demographic information of 3,384,157 patient visits was obtained from eyeSmart EMR from August 2010 to December 2017 across the L.V. Prasad Eye Institute network. Age, gender, date of visit and time status of the patients were selected for analysis. The datapoints for each parameter from the patient visits were modeled using the seasonal autoregressive integrated moving average (SARIMA) modeling. SARIMA (0,0,1)(0,1,7)7 provided the best fit for predicting total outpatient visits. This study describes the prediction method of forecasting outpatient visits to a large eyecare network in India. The results of our model hold the potential to be used to support the decisions of resource planning in the delivery of eyecare services to patients.


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