scholarly journals Analysis of Free Text with Omaha System Targets in Community-Based Care to Inform Practice and Terminology Development

2011 ◽  
Vol 02 (03) ◽  
pp. 304-316 ◽  
Author(s):  
O. Farri ◽  
K.A. Monsen ◽  
B.L. Westra ◽  
G.B. Melton
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Home Visiting ◽  
Care Program ◽  
Care Quality ◽  
Free Text ◽  
Maternal Child Health ◽  
Community Based ◽  
Record System ◽  
Omaha System

SummaryThe Omaha system is one of the most widely used interface terminologies for documentation of community-based care. It is influential in disseminating evidence-based practice and generating data for health care quality research. Thus, it is imperative to ensure that the Omaha system reflects current health care knowledge and practice. The purpose of this study was to evaluate free text associated with Omaha system terms to inform issues with electronic health record system use and future Omaha system standard development. Two years of client records from two diverse sites (a skilled homecare, hospice, and palliative care program and a maternal child health home visiting program) were analyzed for the use of free text as a component of the intervention when structured targets for interventions were not identified. Intervention text entries very commonly contained duplicate “carry forward entries”, multiple concepts, mismatched problem focus, or failure to identify an existing appropriate target. Our findings support the need to better address education gaps for clinicians. We identified additional suggested targets for Omaha system problems, and propose new targets for consideration in future Omaha system revisions.

scholarly journals The Potential of Research Drawing on Clinical Free Text to Bring Benefits to Patients in the United Kingdom: A Systematic Review of the Literature

2021 ◽  
Vol 3 ◽  
Author(s):  
Elizabeth Ford ◽  
Keegan Curlewis ◽  
Emma Squires ◽  
Lucy J. Griffiths ◽  
Robert Stewart ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Analytical Models ◽  
Free Text ◽  
Patient Privacy ◽  
Clinical Environment ◽  
Clinical Benefits ◽  
Potential Benefits ◽  
The Impact

Background: The analysis of clinical free text from patient records for research has potential to contribute to the medical evidence base but access to clinical free text is frequently denied by data custodians who perceive that the privacy risks of data-sharing are too high. Engagement activities with patients and regulators, where views on the sharing of clinical free text data for research have been discussed, have identified that stakeholders would like to understand the potential clinical benefits that could be achieved if access to free text for clinical research were improved. We aimed to systematically review all UK research studies which used clinical free text and report direct or potential benefits to patients, synthesizing possible benefits into an easy to communicate taxonomy for public engagement and policy discussions.Methods: We conducted a systematic search for articles which reported primary research using clinical free text, drawn from UK health record databases, which reported a benefit or potential benefit for patients, actionable in a clinical environment or health service, and not solely methods development or data quality improvement. We screened eligible papers and thematically analyzed information about clinical benefits reported in the paper to create a taxonomy of benefits.Results: We identified 43 papers and derived five themes of benefits: health-care quality or services improvement, observational risk factor-outcome research, drug prescribing safety, case-finding for clinical trials, and development of clinical decision support. Five papers compared study quality with and without free text and found an improvement of accuracy when free text was included in analytical models.Conclusions: Findings will help stakeholders weigh the potential benefits of free text research against perceived risks to patient privacy. The taxonomy can be used to aid public and policy discussions, and identified studies could form a public-facing repository which will help the health-care text analysis research community better communicate the impact of their work.

Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

2019 ◽  
Author(s):  
Ignatius Bau ◽  
Robert A. Logan ◽  
Christopher Dezii ◽  
Bernard Rosof ◽  
Alicia Fernandez ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Literacy ◽  
Cultural Competence ◽  
Health Care Quality ◽  
Care Quality ◽  
National Committee ◽  
Patient Centered ◽  
Organizational System ◽  
Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

scholarly journals Hearing Loss and Help-Seeking Behavior

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 797-797
Author(s):  
Nicholas Reed
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Help Seeking ◽  
Health Care Quality ◽  
Medicare Beneficiary ◽  
Care Quality ◽  
The Past ◽  
Help Seeking Behaviour ◽  
Seeking Behavior ◽  
Future Work

Abstract Hearing Loss (HL) is common among older adults and is associated with poor health care quality outcomes include 30-day readmissions, length of stay, poorer satisfaction, and increased medical expenditures. These associations may manifest in changes in help-seeking behaviour. In the 2015 Current Medicare Beneficiary Study (MCBS) (n=10848; weighted sample=46.3 million), participants reported whether they knowingly had avoided seeking care in the past year and self-reported HL was measured as degree of trouble (none, a little, or a lot) hearing when using a hearing aid if applicable. In a model adjusted for demographic, socioeconomic, and health factors, those with a little trouble (OR= 1.612; 95% CI= 1.334-1.947; P<0.001) and a lot of trouble hearing (OR= 2.011; 95% CI= 1.443-2.801; P<0.001) had 61.2% and 101.1% higher odds of avoiding health care over the past year relative to participants with no trouble hearing. Future work should examine whether hearing care modifies this association.

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