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Studies in Health Technology and... Jun 2020The Problem Oriented Medical Record (POMR) is considered a key charting method to support clinical care. Although not uniformly represented amongst digital health...
The Problem Oriented Medical Record (POMR) is considered a key charting method to support clinical care. Although not uniformly represented amongst digital health systems, this paper presents a clinical model to represent multiple clinical perspectives from a single problem list. The contextual problem list model is defined according to primary diagnosis, comorbidities and problems arising from the primary condition. It is represented within the patient record as a single composition according to the prescribed context. The model pattern could help alleviate the traditional criticisms of paper and digitally based problem records.
Topics: Comorbidity; Medical Records
PubMed: 32570447
DOI: 10.3233/SHTI200224 -
Journal of Cardiovascular Translational... Jun 2023The use of electronic medical records has rapidly been adopted world-wide, which has resulted in multiple new opportunities for cardiovascular research. These include... (Review)
Review
The use of electronic medical records has rapidly been adopted world-wide, which has resulted in multiple new opportunities for cardiovascular research. These include the following: (1) the development and assessment of clinical decision tools, meant to increase quality of care; (2) harnessing data linkages to examine genetic, epidemiological, and pharmacological associations on an unprecedented scale; and (3) harnessing electronic medical records to facilitate the conduct of cardiovascular clinical trials. While these opportunities promise to revolutionize cardiovascular care and research, enthusiasm should be tempered while further assessment of true clinical utility has been undertaken.
Topics: Electronic Health Records; Cardiovascular Diseases; Biomedical Research
PubMed: 36103036
DOI: 10.1007/s12265-022-10313-1 -
Genetics in Medicine : Official Journal... May 2021Genetic testing and results return pose many challenges, even in the era of electronic medical records. Whether results are positive or negative, genetic testing and...
PURPOSE
Genetic testing and results return pose many challenges, even in the era of electronic medical records. Whether results are positive or negative, genetic testing and return of results necessitate patient follow-up, referrals, and coordination between providers. Genetic evaluations typically utilize a variety of testing modalities with differing timetables and/or avenues to return. Therefore, genetic information requires a secondary, unified mechanism for storing and tracking results and communication to facilitate patient care.
METHODS
We developed an electronic medical record (EMR) episodes-based module called Pediatric Genetic Tracking to provide a centralized summary of patient tracking information in a single-institution pediatric genetics setting.
RESULTS
We created episodes for 6,133 patients evaluated in our division over a 3-year period. They highlighted clinical information for 1,901 different diagnoses and 547 genetic tests, and the involvement of 9 providers, 7 genetic counselors, 61 trainees, and 15 students using two modes of follow-up.
CONCLUSION
This Pediatric Genetic Tracking episodes system serves as a "one-stop shop" living document for updated patient genetic information and can be easily expanded to include variant content for broader population level sharing or analysis. These episodes-based modules facilitate communication to support timely and accurate return of genetic test results and follow-up.
Topics: Child; Communication; Electronic Health Records; Genetic Testing; Humans
PubMed: 33500566
DOI: 10.1038/s41436-020-01057-x -
Studies in Health Technology and... Jun 2023Connected medical devices may send and receive orders from other devices or networks, such as the internet. A connected medical device is often equipped with wireless...
Connected medical devices may send and receive orders from other devices or networks, such as the internet. A connected medical device is often equipped with wireless connection, allowing it to interface with other devices or computers. Connected medical devices are becoming more popular in healthcare settings because they provide a variety of advantages, such as quicker patient monitoring and more efficient healthcare delivery. Connected medical devices may help doctors make educated treatment decisions, enhance patient outcomes, and lower costs. The usage of connected medical devices is especially beneficial for patients who reside in rural or distant locations, have mobility limitations that make traveling to a healthcare center difficult, or during the COVID-19 epidemic. Monitoring devices, infusion pumps, implanted devices, autoinjectors, and diagnostic devices are among the connected medical devices. Smartwatches or fitness trackers that monitor heart rate and activity levels, blood glucose meters that can upload data to a patient's electronic medical record, and implanted devices that can be monitored remotely by healthcare practitioners are examples of connected medical devices too. Yet, connected medical devices also carry risks that might jeopardize patient privacy and the integrity of medical records.
Topics: Humans; COVID-19; Electronic Health Records; Epidemics; Fitness Trackers; Health Facilities
PubMed: 37386972
DOI: 10.3233/SHTI230438 -
Medical Care Dec 2020Cancer survivors face many challenges including coordinating care across multiple providers and maintaining medical records from multiple institutions. Access and...
BACKGROUND
Cancer survivors face many challenges including coordinating care across multiple providers and maintaining medical records from multiple institutions. Access and utilization of online medical records could help cancer survivors manage this complexity. Here, we examined how cancer survivors differ from those without a history of cancer with regards to utilization and perception of medical records.
METHODS
We conducted a cross-sectional study of 3491 respondents, from the Health Information National Trends survey 5, cycle 2. The association of medical record utilization and perceptions with cancer survivorship was assessed using survey-weighted logistic regression.
RESULTS
Cancer survivors (n=593) were more likely to report that a provider maintains a computerized medical record [adjusted odds ratio (AOR)=2.05; 95% confidence (CI), 1.24-3.41] and were more likely to report confidence in medical record safeguards (AOR=1.44; 95% CI, 1.03-2.03). However, cancer survivors were no more likely to access online medical records than those without a history of cancer (AOR=1.13; 95% CI, 0.69-1.86). Cancer survivors were no more likely to report privacy concerns as a reason for not accessing online medical records, however, survivors were more likely to report a preference for speaking directly with a provider as a reason for not accessing online medical records (AOR=2.24; 95% CI, 0.99-5.05).
CONCLUSIONS
Although cancer survivors are more likely to trust medical record safe guards and do not express increased concerns about online medical record privacy, a preference to speak directly with provider is a barrier of use.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Cancer Survivors; Confidentiality; Cross-Sectional Studies; Electronic Health Records; Female; Humans; Internet; Male; Middle Aged; Perception; Sex Factors; Socioeconomic Factors; United States; Young Adult
PubMed: 32925466
DOI: 10.1097/MLR.0000000000001413 -
Medical Education Nov 2022
Topics: Humans; Medical Records
PubMed: 36000568
DOI: 10.1111/medu.14924 -
International Journal of Environmental... Dec 2022Historically, quality measurement analyses utilize manual chart abstraction from data collected primarily for administrative purposes. These methods are... (Review)
Review
Historically, quality measurement analyses utilize manual chart abstraction from data collected primarily for administrative purposes. These methods are resource-intensive, time-delayed, and often lack clinical relevance. Electronic Medical Records (EMRs) have increased data availability and opportunities for quality measurement. However, little is known about the effectiveness of Measurement Feedback Systems (MFSs) in utilizing EMR data. This study explores the effectiveness and characteristics of EMR-enabled MFSs in tertiary care. The search strategy guided by the PICO Framework was executed in four databases. Two reviewers screened abstracts and manuscripts. Data on effect and intervention characteristics were extracted using a tailored version of the Cochrane EPOC abstraction tool. Due to study heterogeneity, a narrative synthesis was conducted and reported according to PRISMA guidelines. A total of 14 unique MFS studies were extracted and synthesized, of which 12 had positive effects on outcomes. Findings indicate that quality measurement using EMR data is feasible in certain contexts and successful MFSs often incorporated electronic feedback methods, supported by clinical leadership and action planning. EMR-enabled MFSs have the potential to reduce the burden of data collection for quality measurement but further research is needed to evaluate EMR-enabled MFSs to translate and scale findings to broader implementation contexts.
Topics: Electronic Health Records; Feedback; Delivery of Health Care; Databases, Factual
PubMed: 36612522
DOI: 10.3390/ijerph20010200 -
Fundamental & Clinical Pharmacology Feb 2021Considering their novelty and cost, post-marketing evaluation is highly relevant for new anticancer drugs. Identify and characterize available and potentially useful... (Review)
Review
Considering their novelty and cost, post-marketing evaluation is highly relevant for new anticancer drugs. Identify and characterize available and potentially useful databases for post-marketing evaluation of these specific drugs is necessary. A review was conducted to identify available and accessible databases to study the post-marketing evaluation of drugs in real-life care setting. Databases identified have been classified into medico-administrative databases, medical record databases, and databases resulting from ad hoc collections. Taking as examples databases available in France, each type was described as well as its strengths and limits for a potential use in the oncology field. Record linkage of medico-administrative databases could cover almost the whole population and is now used to evaluate anticancer drugs (e.g., Système National des Données de Santé). Large medical record databases are still lacking, but efforts are currently made to give access to hospital data warehouses for research purposes. Finally, databases resulting from ad hoc collections are also available for some cancer localizations and allow to obtain highly valuable clinical and biological data. A range of important and valuable databases exist but, individually, none is enough to answer to all questions from health authorities, healthcare professionals, and patients. In order to obtain a complete overview on utilization, associated health outcomes and costs of these drugs, it seems necessary to better interlink available databases.
Topics: Antineoplastic Agents; Databases, Factual; France; Humans; Medical Records; Pharmacovigilance; Product Surveillance, Postmarketing; Registries
PubMed: 32740979
DOI: 10.1111/fcp.12592 -
BMC Medical Informatics and Decision... Sep 2020Electronic Medical Records (EMRs) are systems to store patient information like medical histories, test results, and medications electronically. It helps to give quality...
Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: using unified theory of acceptance and use technology 2(UTAUT2) model.
BACKGROUND
Electronic Medical Records (EMRs) are systems to store patient information like medical histories, test results, and medications electronically. It helps to give quality service by improving data handling and communication in healthcare setting. EMR implementation in developing countries is increasing exponentially. But, only few of them are successfully implemented. Intention to use EMRs by health care provider is crucial for successful implementation and adoption of EMRs. However, intention of health care providers to use EMR in Ethiopia is unknown.
OBJECTIVE
The aim of this study was to assess health care provider's intention to use and its predictors towards Electronic Medical Record systems at three referral hospitals in north-west, Ethiopia, 2019.
METHODS
Institutional based cross-sectional explanatory study design was conducted from March to September among 420 health care providers working at three referral hospitals in north-west Ethiopia. Data were analyzed using structural equation model (SEM). Simple and multiple SEM were used to assess the determinants of health care providers intention to use EMRs. Critical ratio and standardized coefficients were used to measure the association of dependent and independent variables, 95% confidence intervals and P-value were calculated to evaluate statistical significance. Qualitative data was analyzed using thematic analysis.
RESULT
The mean age of the study subjects was 32.4 years ±8.3 SD. More than two-third 293(69.8%) of the participants were male. Among 420 health care providers, only 167 (39.8%) were scored above the mean of intention to use EMRs. Factors positively associated with intention to use EMRs were performance expectancy (β = 0.39, p < 0.001), effort expectancy (β = 0.24,p < 0.001),social influence (β = 0.18,p < 0.001),facilitating condition (β = 0.23,p < 0.001), and computer literacy (β = 0.08,p < 0.001). Performance expectancy was highly associated with intention to use EMRs.
CONCLUSION
Generally, about 40 % of health care providers were scored above the mean of intention to use EMRs. Performance expectancy played a major role in determining health care providers' intention to use EMRs. The intention of health care providers to use EMRs was attributed by social influence, facilitating condition in the organization, effort expectancy, performance expectancy and computer literacy. Therefore, identifying necessary prerequisites before the actual implementation of EMRs will help to improve the implementation status.
Topics: Adult; Cross-Sectional Studies; Electronic Health Records; Ethiopia; Female; Health Personnel; Hospitals; Humans; Intention; Male; Referral and Consultation; Technology
PubMed: 32883267
DOI: 10.1186/s12911-020-01222-x -
Computers, Informatics, Nursing : CIN Jun 2021Nurses have experienced unintended consequences and workarounds associated with health information technology implementation. However, examination of this occurrence is...
Nurses have experienced unintended consequences and workarounds associated with health information technology implementation. However, examination of this occurrence is rare. This study aimed to examine the unintended consequences and workarounds produced by the implementation of electronic medical record systems in clinical nursing practice. A total of 143 nurses participated in a survey using statistically tested instruments. The data were analyzed using descriptive statistics and a nonparametric test. The descriptive data were analyzed by meaning. The participants experienced unintended consequences and workarounds related to electronic medical record implementation at moderate or high levels based on the responses to questions scored on 5-point Likert scales. The unintended consequences were closely associated with workarounds. The degree of experience with unintended consequences and the use of workarounds differed significantly according to the level of education, job position, and years in nursing practice. The nursing examples of unintended consequences and workarounds were organized into four categories of unintended consequences. By presenting unintended consequences and workarounds together, this study enhances the understanding of the problems encountered in EMR implementation and the action of nurses. Nurses' needs should be considered as an important resource in developing, redesigning, or purchasing and implementing health information technology in healthcare settings.
Topics: Delivery of Health Care; Electronic Health Records; Humans; Surveys and Questionnaires
PubMed: 34117159
DOI: 10.1097/CIN.0000000000000785