usa
Bashshur RL. Telemedicine journal and e-health, 19(5)
Recent and impendent changes resulting from the Health Information Technology for Economic and Clinical Health Act (HITECH) (part of Title XIII of the American Recovery and Reinvestment Act) of 2009 and the Patient Protection and Affordable Care Act (ACA) of 2011 offer unprecedented potential for telemedicine to play a significant role not only in reforming the current U.S. healthcare system but also in shaping innovative health systems of the future.
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Published:
5 February 2013 |
Keyword(s): ACO, e-Health, Electronic Health Records, Personal Health Records, Telemedicine, United States
LePendu P et al, Clinical Pharmacology & Therapeutics, 2013
With increasing adoption of electronic health records (EHRs), there is an opportunity to use the free-text portion of EHRs for pharmacovigilance. We present novel methods that annotate the unstructured clinical notes and transform them into a deidentified patient–feature matrix encoded using medical terminologies. We demonstrate the use of the resulting high-throughput data for detecting drug–adverse event associations and adverse events associated with drug–drug interactions.
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Published:
10 April 2013 |
Keyword(s): Adverse Drug Events, Data Mining, Drug-drug interactions, Electronic Health Records, Free text, Pharmacology, United States
Flanagan ME et al, J Am Med Inform Assoc, 2013
BACKGROUND:
Healthcare professionals develop workarounds rather than using electronic health record (EHR) systems. Understanding the reasons for workarounds is important to facilitate user-centered design and alignment between work context and available health information technology tools.
OBJECTIVE:
To examine both paper- and computer-based workarounds to the use of EHR systems in three benchmark institutions.
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Published:
14 March 2013 |
Keyword(s): Electronic Health Records, Primary Care, United States
Baldwin G. Health Data Management Magazine, 21(4)
A little over a year ago, Deaconess Health System in Evansville, Ind., obtained a lofty perch on the digital health I.T. rung-the six-hospital system was named as a HIMSS Stage 7 organization, representing the pinnacle of electronic health record accomplishments.
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Published:
1 April 2013 |
Keyword(s): Electronic Health Records, HL7, Legal, Paper Conversion, United States, Workflow
Adler-Milstein J et al, Health Affairs, 32(3)
Health care providers remain uncertain about how they will fare financially if they adopt electronic health record (EHR) systems. We used survey data from forty-nine community practices in a large EHR pilot, the Massachusetts eHealth Collaborative, to project five-year returns on investment. We found that the average physician would lose $43,743 over five years; just 27 percent of practices would have achieved a positive return on investment; and only an additional 14 percent of practices would have come out ahead had they received the $44,000 federal meaningful-use incentive.
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Published:
March 2013 |
Keyword(s): Electronic Health Records, ROI, United States
Singh H et al, JAMA internal medicine, 2013
Electronic health record (EHR)-based alerts are often used to notify practitioners of abnormal test results, but follow-up failures (missed results) continue to occur in outpatient settings. In the Department of Veterans Affairs (VA), abnormal test result alerts are generated automatically for prespecified abnormal laboratory values or manually by the interpreting radiologist when an unexpected finding is noted.
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Published:
4 March 2013 |
Keyword(s): Alerts, Electronic Health Records, Primary Care Providers, Test results, United States
Singh H et al, JAMA internal medicine, 2013
IMPORTANCE
Diagnostic errors are an understudied aspect of ambulatory patient safety.
OBJECTIVES
To determine the types of diseases missed and the diagnostic processes involved in cases of confirmed diagnostic errors in primary care settings and to determine whether record reviews could shed light on potential contributory factors to inform future interventions.
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Published:
25 February 2013 |
Keyword(s): Ambulatory Care, Diagnostic Errors, Electronic Health Records, Patient Safety, United States
Agarwal R et al, Journal of medical Internet research, 15(2)
Background:
Personal health records (PHRs) are an important tool for empowering patients and stimulating health action. To date, the volitional adoption of publicly available PHRs by consumers has been low. This may be partly due to patient concerns about issues such as data security, accuracy of the clinical information stored in the PHR, and challenges with keeping the information updated. One potential solution to mitigate concerns about security, accuracy, and updating of information that may accelerate technology adoption is the provision of PHRs by employers where the PHR is pre-populated with patients’ health data. Increasingly, employers and payers are offering this technology to employees as a mechanism for greater patient engagement in health and well-being.
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Published:
26 February 2013 |
Keyword(s): Electronic Health Records, Messaging, Personal Health Records, United States
Wright A et al, New England Journal of Medicine, 368(8)
In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act established Medicare and Medicaid incentive programs to encourage the adoption of electronic health records (EHRs) by hospitals and eligible professionals.
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Published:
21 February 2013 |
Keyword(s): Electronic Health Records, Meaningful Use, United States
Chen LM et al, New England Journal of Medicine, 2013
The patient had not yet coded but was spiraling downward, prompting a request for a bed in the intensive care unit (ICU). But the ICU had no available beds. Hours passed before the decision was made that another patient could safely be “bumped” out of the unit to accommodate our patient.
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Published:
30 January 2013 |
Keyword(s): Critical Care, Electronic Health Records, Health Information Technology, Hospitals, Intensive Care Units, Meaningful Use, United States
Middleton B et al, J Am Med Inform Assoc, 2013
In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems.
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Published:
25 January 2013 |
Keyword(s): Electronic Health Records, Patient Safety, United States, Usability
Xierali IM et al, The Annals of Family Medicine, 11(1)
PURPOSE
Realizing the benefits of adopting electronic health records (EHRs) in large measure depends heavily on clinicians and providers’ uptake and meaningful use of the technology. This study examines EHR adoption among family physicians using 2 different data sources, compares family physicians with other office-based medical specialists, assesses variation in EHR adoption among family physicians across states, and shows the possibility for data sharing among various medical boards and federal agencies in monitoring and guiding EHR adoption.
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Published:
2 January 2013 |
Keyword(s): Adoption, Electronic Health Records, General practitioners, Primary Care, United States
Delbanco T et al, Annals of internal medicine, 157(7)
BACKGROUND
Little information exists about what primary care physicians (PCPs) and patients experience if patients are invited to read their doctors’ office notes.
OBJECTIVE
To evaluate the effect on doctors and patients of facilitating patient access to visit notes over secure Internet
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Published:
2 October 2012 |
Keyword(s): Communication, Confidentiality, Electronic Health Records, General practitioners, Internet, Patient Record Access, Physician-Patient Relationship, Primary Care, United States
Green LV et al, Health Affairs, 32(1)
Most existing estimates of the shortage of primary care physicians are based on simple ratios, such as one physician for every 2,500 patients. These estimates do not consider the impact of such ratios on patients’ ability to get timely access to care. They also do not quantify the impact of changing patient demographics on the demand side and alternative methods of delivering care on the supply side. We used simulation methods to provide estimates of the number of primary care physicians needed, based on a comprehensive analysis considering access, demographics, and changing practice patterns.
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Published:
January 2013 |
Keyword(s): Access, Electronic Health Records, Physicians, Primary Care, United States
Ryan AM et al, Health Affairs, 32(1)
The 2009 American Recovery and Reinvestment Act spurred adoption of electronic health records (EHRs) in the United States, through such measures as financial incentives to providers through Medicare and Medicaid and regional extension centers, which provide ongoing technical assistance to practices. Yet the relationship between EHR adoption and quality of care remains poorly understood. We evaluated the early effects on quality of the Primary Care Information Project, which provides subsidized EHRs and technical assistance to primary care practices in underserved neighborhoods in New York City, using the regional extension center model.
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Published:
1 January 2013 |
Keyword(s): Adoption, Electronic Health Records, Information Technology, Primary Care, Quality, United States
Kellermann AL, Jones SS. Health Affairs, 32(1)
A team of RAND Corporation researchers projected in 2005 that rapid adoption of health information technology (IT) could save the United States more than $81 billion annually. Seven years later the empirical data on the technology’s impact on health care efficiency and safety are mixed, and annual health care expenditures in the United States have grown by $800 billion. In our view, the disappointing performance of health IT to date can be largely attributed to several factors: sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and the failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT.
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Published:
1 January 2013 |
Keyword(s): Health Spending, Information Technology, Organization And Delivery Of Care, United States
Kozubal DE et al, International Journal of Medical Informatics, 2012
Objectives
Electronic Medical Records (EMR) have the potential to improve the coordination of healthcare in this country, yet the field of psychiatry has lagged behind other medical disciplines in its adoption of EMR.
Methods
Psychiatrists at 18 of the top US hospitals completed an electronic survey detailing whether their psychiatric records were stored electronically and accessible to non-psychiatric physicians. Electronic hospital records and accessibility statuses were correlated with patient care outcomes obtained from the University Health System Consortium Clinical Database available for 13 of the 18 top US hospitals.
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Published:
20 December 2012 |
Keyword(s): Accesibility, Adoption, e-Health, Electronic Health Records, Electronic Medical Records, Psychiatry, United States
Denny JC. PLoS Comput Biol, 8(12)
The combination of improved genomic analysis methods, decreasing genotyping costs, and increasing computing resources has led to an explosion of clinical genomic knowledge in the last decade. Similarly, healthcare systems are increasingly adopting robust electronic health record (EHR) systems that not only can improve health care, but also contain a vast repository of disease and treatment data that could be mined for genomic research. Indeed, institutions are creating EHR-linked DNA biobanks to enable genomic and pharmacogenomic research, using EHR data for phenotypic information.
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Published:
27 December 2012 |
Keyword(s): Biobank, Data Mining, Electronic Health Records, Free text, Genomics, Narrative, United States
Pruthi S et al, Mayo Clinic Proceedings, 88(1)
An interactive audio and video telemedicine feasibility program was established to provide counseling on breast cancer risk-reducing strategies for underserved, high-risk Alaskan native women through a collaboration among the Alaska Native Medical Center, the Mayo Clinic Breast Clinic, Mayo’s Center for Innovation, and the Alaska Federal Health Care Access Network. The telemedicine model included a navigator to facilitate patient encounters (referrals, electronic records, and scheduling) and a subscription billing contract. Between January 1 and December 31, 2011, 60 consultations were provided to the Alaska Native Medical Center.
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Published:
January 2013 |
Keyword(s): Breast Cancer, Implementation, Satisfaction, Telemedicine, United States
Schreiber JA. Oncology nursing forum, 40(1)
“The electronic world continues to advance in the 21st century. In 2009, the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act were enacted; in response, hospitals and oncology physician offices have or are implementing electronic health records (EHRs). As with any new technology or process, a steep learning curve is associated with the implementation of EHRs. Often, the full impact of a sweeping, nationwide change such as EHRs is not realized for many years after implementation, and many suppositions about the usefulness and benefits of EHRs still exist. The current article focuses on the initial impact of EHRs, their role in diagnosis, and the responses of healthcare providers in patient outcomes and in research.”
Published:
1 January 2013 |
Keyword(s): Electronic Health Records, Oncology, United States
