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Respiratory viral illnesses place an enormous burden on human health and the healthcare system (2-3). Although multiple pathogenic respiratory viruses circulate, often simultaneously, public health has traditionally dedicated most of [...]

When it comes to the burdens facing medical practices, the challenges are many and varied. To make matters worse, many of the biggest problems are interconnected: Regulatory compliance and the [...]

Between 2011 and 2015 the government spent upwards of $35 billion subsidizing doctors' purchases of electronic health records (EHRs) through the Meaningful Use program. It did so mainly in the [...]

PURPOSE Evidence shows the value of home blood pressure (BP) monitoring in hypertension management. Questions exist about how to effectively incorporate these readings into BP follow-up visits. We developed and implemented a tool that combines clinical and home BP readings into an electronic health record (EHR)-integrated visualization tool. We examined how this tool was used during primary care visits and its effect on physician-patient communication and decision making about hypertension management, comparing it with home BP readings on paper. METHODS We video recorded the hypertension follow-up visits of 73 patients with 15 primary care physicians between July 2018 and April 2019. During visits, physicians reviewed home BP readings with patients, either directly from paper or as entered into the EHR visualization tool. We used conversation analysis to analyze the recordings. RESULTS Home BP readings were viewed on paper for 26 patients and in the visualization tool for 47 patients. Access to home BP readings during hypertension management visits, regardless of viewing mode, positioned the physician and patient to assess BP management and make decisions about treatment modification, if needed. Length of BP discussion with the visualization tool was similar to or shorter than that with paper. Advantages of the visualization tool included ease of use, and enhanced and faster sense making and decision making. Successful use of the tool required patients' ability to obtain their BP readings and enter them into the EHR via a portal, and an examination room configuration that allowed for screen sharing. CONCLUSIONS Reviewing home BP readings using a visualization tool is feasible and enhances sense making and patient engagement in decision making. Practices and their patients need appropriate infrastructure to realize these benefits. Key words: patient-generated health data; home blood pressure monitoring; hypertension control; clinical decision support; EHR; health information technology; ergonomics; data visualization; shared decision making, INTRODUCTION Hypertension is a serious, prevalent disease affecting more than 100 million American adults. (1) High blood pressure (BP) contributes 40.6% of the attributable risk for heart and cardiovascular disease [...]

THE INNOVATION A great contributor to primary care physician (PCP) burnout is the inability to 'unplug' from the electronic health record (EHR) for fear that urgent patient messages may be [...]

Introduction: Integrated health care is utilized in primary care clinics to meet patients' physical, behavioral, and social needs. Current methods to collect and evaluate the effectiveness of integrated care require refinement. Using informatics and electronic health records (EHR) to distill large amounts of clinical data may help researchers measure the impact of integrated care more efficiently. This exploratory pilot study aimed to (a) determine the feasibility of using EHR documentation to identify behavioral health and social care components of integrated care, using social work as a use case, and (b) develop a lexicon to inform future research using natural language processing. Method: Study steps included development of a preliminary lexicon of behavioral health and social care interventions to address basic needs, creation of an abstraction guide, identification of appropriate EHR notes, manual chart abstraction, revision of the lexicon, and synthesis of findings. Results: Notes (/V = 647) were analyzed from a random sample of 60 patients. Notes documented behavioral health and social care components of care but were difficult to identify due to inconsistencies in note location and titling. Although the interventions were not described in detail, the outcomes of screening, referral, and brief treatment were included. The integrated care team frequently used EHR to share information and communicate. Discussion: Opportunities and challenges to using EHR data were identified and need to be addressed to better understand the behavioral health and social care interventions in integrated care. To best leverage EHR data, future research must determine how to document and extract pertinent information about integrated team-based interventions. Public Significance Statement This paper assesses the feasibility of EHR (electronic health record) documentation to better understand aspects of integrated care that address behavioral health and social needs. More information on these aspects of care can help health systems identify, track, and evaluate the delivery of integrated care and how it may be improved to meet an individual's whole-health needs. Keywords: electronic health records, integrated care, team-based care, behavioral health providers, natural language processing (NLP) Supplemental materials: https://doi.org/10.1037/fsh0000584.supp, Health systems are rapidly implementing integrated health models in primary care clinics (Balasubramanian et al., 2017; Blount & Miller, 2009; Butler et al., 2008), and with good reason. Evidence indicates [...]

Digitized patient charts were supposed to revolutionize medical practice. Artificial intelligence could help unlock their potential. Digitized patient charts were supposed to revolutionize medical practice. Artificial intelligence could help unlock their potential., Author(s): Cassandra Willyard Author Affiliations: Can AI Fix Medical Records? Illustration by Harry Campbell A young man, let's call him Roger, arrives at the emergency department complaining of belly pain [...]

INTRODUCTION Health care in America traditionally is paid on a fee-for-service basis, with doctors billing and getting reimbursed for each service they provide. But in recent years, growing numbers of [...]

The Health Information Technology for Clinical Health (HITECH) Act of 2009 included about $35 billion for helping doctors and hospitals purchase electronic health records. One of the arguments for including [...]

Stanley Anderson, MD, founder of an independent three-physician family practice in Canton, Ohio, says he 'loved' the first electronic health record (EHR) system his practice implemented in 2012. 'It had [...]

Introduction: The difference between a financially and clinically successful practice and one that is struggling often comes down to whether they have the code right and document thoroughly. Changes in [...]

Penn State University Libraries developed an in-house electronic course reserves system in the mid-1990s to supplement traditional print reserves. As at many institutions at this time, the system consisted of [...]

Introduction: There is ample evidence that social and familial context significantly impacts health. However, family and social history templates typically used in clinical practice exclude prompts to explore important contextual [...]

AN ELDERLY female patient with nose/ear complaints mistakenly received a prescription for Flomax--a treatment for enlarged prostate, which isn't approved for use by women and has a side effect of [...]

Rapid and affordable tumor molecular profiling has led to an explosion of clinical and genomic data poised to enhance the diagnosis, prognostication and treatment of cancer. A critical point has now been reached at which the analysis and storage of annotated clinical and genomic information in unconnected silos will stall the advancement of precision cancer care. Information systems must be harmonized to overcome the multiple technical and logistical barriers to data sharing. Against this backdrop, the Global Alliance for Genomic Health (GA4GH) was established in 2013 to create a common framework that enables responsible, voluntary and secure sharing of clinical and genomic data. This Perspective from the GA4GH Clinical Working Group Cancer Task Team highlights the data-aggregation challenges faced by the field, suggests potential collaborative solutions and describes how GA4GH can catalyze a harmonized data-sharing culture., There is broad consensus that the identification of aberrations in tumor DNA is key not only to achieving a better understanding of cancer but also to developing an improved process [...]

The electronic health record (EHR) has become the third wheel in the exam room, often getting in the way of physicians making meaningful connections with their patients. 'Both as a [...]

Clinic Management systems are essential for tracking patient information, billing and scheduling appointments. Healthcare software systems are created to computerize manual operations in clinics. This Clinic Data Management system is tailored to manage day-to-day operations within a small clinic. It is a simple and cheap Desktop software solution that can be easily deployed and used. It identifies key information system characteristics and uses the software development life cycle to guide the implementation of the system as a proof-of-concept. Java Swing and MS Access technologies are used to create the software. Keywords: Clinic Management Systems, Desktop software solution, Java Swing, MS Access, INTRODUCTION Medical records are important to keep track of patient's medical history and current health status. Keeping track of medical records can be difficult, if the health information is captured [...]

A bout five years ago, Silver Hill Hospital was looking for a new electronic medical record solution. 'We felt that we needed a psychiatric system and, at the time, we [...]

Everyone is familiar with evidence based protocols (EBPs), the research-based guidelines or procedures used by clinicians to select and guide the course of individual treatment. EBPs originated to offer reliable [...]

Mental Health Centers of Central Illinois (MHCCI), an affiliate of Memorial Health System (Springfield, Ill.) is a private, not-for-profit provider of behavioral health and rehabilitation services, serving some 10,000 individuals [...]

Genome-wide association studies (GWAS) facilitate the discovery of genotype-phenotype relations from population-based sequence databases, which is an integral facet of personalized medicine. The increasing adoption of electronic medical records allows large amounts of patients' standardized clinical features to be combined with the genomic sequences of these patients and shared to support validation of GWAS findings and to enable novel discoveries. However, disseminating these data 'as is' may lead to patient reidentification when genomic sequences are linked to resources that contain the corresponding patients' identity information based on standardized clinical features. This work proposes an approach that provably prevents this type of data linkage and furnishes a result that helps support GWAS. Our approach automatically extracts potentially linkable clinical features and modifies them in a way that they can no longer be used to link a genomic sequence to a small number of patients, while preserving the associations between genomic sequences and specific sets of clinical features corresponding to GWAS-related diseases. Extensive experiments with real patient data derived from the Vanderbilt's University Medical Center verify that our approach generates data that eliminate the threat of individual reidentification, while supporting GWAS validation and clinical case analysis tasks.

Strategies that have been implemented by the Tulsa City-County Library in acquiring and managing digital resources are explored. A special committee has been tasked by the library to assess and make recommendations about the resources. A number of databases to which the Tulsa City-County Library subscribes are presented, along with evaluative methods applied in those resources.

INTRODUCTION I. DEFINING THE PROBLEM: EARLY APPROACHES TO COST SHIFTING A. Electronic Discovery Expenses as a Cost of Doing Business B. The Rise of Electronic Discovery C. The Move Toward [...]

OBJECTIVE: To develop and validate an informatics infrastructure for syndrome surveillance, decision support, reporting, and modeling of critical illness. METHODS: Using open-schema data feeds imported from electronic medical records (EMRs), [...]

Practicing medicine takes on a different feel when you're the only doctor in town. But Jim Selenke, MD, the lone physician in Hudson, Iowa, wouldn't have it any other way. [...]

I. INTRODUCTION A collection of factors has caused the United States to be poised on the precipice of a new wave of litigation--litigation arising from the improper use or collection [...], The ever-increasing use of information, coupled with changes in computing technology that make information easier to use, and more portable, ensure that privacy litigation will be a focus of government enforcement and plaintiffs in years to come. This article examines trends in privacy litigation, common theories of liability, damage issues faced by plaintiffs, as well as an examination of class action issues as plaintiffs typically frame their allegations in the class action context.

The only thing you can count on when implementing an electronic health record system is that little will go according to plan. In this second article in our series on [...]