Health Information Technology Commons^™

Unveiling The Potential: The Role Of Ai-Enhanced Ecg In Cardiovascular Disease Detection, Alisha Vincent

Rowan-Virtua Research Day

Background: The Electrocardiogram (ECG) is a widely utilized, non-invasive, cost-effective cardiac test. Its integration with Artificial Intelligence (AI) has empowered it to become a potent screening tool and a predictor for various cardiovascular diseases, especially in asymptomatic individuals. Objective: This review investigates the utility of AI-powered ECG in early detection of cardiac conditions, focusing on conditions such as low ejection fraction (LEF), atrial fibrillation (AF), aortic valve stenosis (AVS), and cardiac amyloidosis (CA). Methods: A literature review spanning 2018 to 2024 was conducted, analyzing 10 articles - 3 on AF, 3 on AVS, 3 on LEF, and …

Effects Of Obesity On Patients Undergoing Cardiomems Procedure: Retrospective Cohort Study, Tony Elias, Mena Elmalh, Priya Brahmbhatt, Kyrillos Girgis, Taha Syed, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

★ Remote hemodynamic monitoring (CardioMEMs) is becoming increasingly important for management of chronic heart failure patients.

★ There is limited data looking specifically for obese patients who undergo CardioMEMs implantation.

★ We sought to examine the national inpatient sample database to describe in-hospital outcomes for this demographic

Clinical Practice Implementation To Address Ascvd Risk: A Practice Change In Primary Care, Elizabeth Wooten

Student Scholarly Projects

Practice Problem: Heart disease stands as the leading cause of mortality in the United States. While healthcare providers strive to identify and optimize prevention strategies, particularly in high-risk patient populations, notable gaps in care persist, notably in the management of modifiable risk factors such as low-density lipoprotein cholesterol (LDL). By harnessing the power of artificial intelligence (AI) integrated software within clinical settings, we can revolutionize the landscape of this devastating chronic disease.

PICOT: The PICOT question that guided this project was: In Primary Care Advanced Practice Providers (APP) caring for high-risk and/or very high-risk patients with atherosclerotic cardiovascular disease (ASCVD) …

A Study Of Heart Disease Diagnosis Using Machine Learning And Data Mining, Intisar Ahmed

Electronic Theses, Projects, and Dissertations

Heart disease is the leading cause of death for people around the world today. Diagnosis for various forms of heart disease can be detected with numerous medical tests, however, predicting heart disease without such tests is very difficult. Machine learning can help process medical big data and provide hidden knowledge which otherwise would not be possible with the naked eye. The aim of this project is to explore how machine learning algorithms can be used in predicting heart disease by building an optimized model. The research questions are; 1) What Machine learning algorithms are used in the diagnosis of heart …

Is Home Blood Pressure Monitoring Effective At Controlling Hypertension In African American Patients? A Clin-Iq, Rebecca Nye, Wilhelm Lehmann, Deborah Simpson

Journal of Patient-Centered Research and Reviews

African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed …

About The Article: Intermittent Fasting Scheme And Reduction Of Anthropometric Measurements, Lipid Profile, Blood Pressure And Cardiovascular Risk, Jamee Guerra Valencia, Geremi A. Gonzales Matta, Jenyfer M. Fuentes Mendoza, Cielo A. Estela Fernandez

Revista de la Facultad de Medicina Humana

Dear Editor: We have read with great interest the article "Intermittent fasting scheme and reduction of anthropometric measurements, lipid profile, blood pressure and cardiovascular risk" published by Dr Javier Wong-Gonzáles et al, in number 1, volume 22 of your magazine; where the purpose of the research focuses on the assessment of the efficacy of intermittent fasting as a strategy for the modification of anthropometric parameters and cardiovascular risk variables; We would like to contribute the importance of defining the times of the day in which the periods of food intake and abstinence are framed during intermittent fasting, since the induced …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

A Rollout Of A Blood Pressure Remote Patient Monitoring Program To Improve High-Risk Maternal Outcomes At A Pilot Clinic For Systemwide Expansion, Laura Geron

Seton Hall University Dissertations and Theses (ETDs)

An existing virtual care platform provides an innovative means of early recognition, identification, and intervention for women with elevated blood pressures during pregnancy, known as preeclampsia. A pilot program took place at a Northeastern prenatal care clinic where patients were identified as high-risk for preeclampsia, enrolled, educated by their providers, and equipped with Bluetooth-enabled blood pressure cuffs.

Through remote patient monitoring (RPM) technology, blood pressure readings could transmit from a patient’s residence to a portal accessible by their clinic provider at any time. This doctoral-level quality improvement project focuses on the identification of patients at high-risk for preeclampsia, their enrollment …

Diabetes Self-Management Training In Rural Mississippi, Nathan Foxworth

Honors Theses

The objective of this study is to evaluate participants’ attitudes towards and readiness to participate in an online Diabetes Self-Management Education and Support (DSMES) program in rural Mississippi, in light of the rapid shift to telemedicine necessitated by the CoVid19 pandemic. Semi- structured in-depth interviews were conducted with patients over 18 that live in areas considered rural in Mississippi. The findings of the study conclude that patients in rural settings are willing and ready to participate in DSMES online. Of the 12 participants in the study, 11 had access to the internet and had adequate infrastructure in order to participate …

Implementation Of A Postdischarge Virtual Visit And Nurse Follow-Up Protocol To Decrease 30-Day Readmission Rates For Patients With Pulmonary Arterial Hypertension, Kimberly Thompson

The Eleanor Mann School of Nursing Student Works

Pulmonary arterial hypertension (PAH) is a rare, chronic disease with no cure. Patients with this disease have high mortality and morbidity, experience frequent hospitalizations, readmissions, and psychosocial burdens, and require a high degree of self-care management skills (Doyle-Cox et al., 2016; Lattimer et al., 2016; McDevitt & Walter, 2019). More than half of PAH patients are hospitalized within the first year following diagnosis, and about 20% are readmitted to the hospital within thirty days of discharge (Bhattacharya et al., 2019: Tonelli, 2020). These patients also have a high symptom burden, and these symptoms significantly affect their physical and mental quality …

Implementation Of Telephone-Based Medication Adherence Conferences To Improve Health Outcomes Of Heart Failure Patients, Diana Marie Broadway

The Eleanor Mann School of Nursing Student Works

Cardiovascular disease (CVD) has been a significant health problem worldwide and is the leading cause of death globally. Heart failure (HF) is a chronic progressive form of CVD that affects millions of adults in the United States. The treatment for heart failure is very complex and requires an ongoing regimen of medications. In heart failure, many patients report nonadherence to their medication regimens, which leads to a magnitude of preventable deaths annually. With frequent medication nonadherence of the HF patients, there must be an intervention used to combat this problem. The use of telephone-based interventions (TBI) can modify nonadherent medication-taking …

Evaluating The Effect Of An Electronic Health Record Patient Portal On The Management Of Hypertension, Ashley Hall

DNP Projects

Background: Hypertension is the leading cause of cardiovascular disease and affects individuals globally, nationally, and locally. Consequences of uncontrolled hypertension include atherosclerosis, heart failure, stroke, and renal disease. The electronic health portal is a patient-specific, interactive tool that has been shown to promote adherence to provider recommendations and improve chronic disease management.

Purpose: The purpose of this project was to determine the effects of education via an electronic healthcare portal on the blood pressure management of adults at a primary care clinic in a small town in Kentucky.

Methods: This study was a one-group pre/post intervention designed to evaluate provider …

Ml-Medic: A Preliminary Study Of An Interactive Visual Analysis Tool Facilitating Clinical Applications Of Machine Learning For Precision Medicine, Laura Stevens, David Kao, Jennifer Hall, Carsten Görg, Kaitlyn Abdo, Erik Linstead

Engineering Faculty Articles and Research

Accessible interactive tools that integrate machine learning methods with clinical research and reduce the programming experience required are needed to move science forward. Here, we present Machine Learning for Medical Exploration and Data-Inspired Care (ML-MEDIC), a point-and-click, interactive tool with a visual interface for facilitating machine learning and statistical analyses in clinical research. We deployed ML-MEDIC in the American Heart Association (AHA) Precision Medicine Platform to provide secure internet access and facilitate collaboration. ML-MEDIC’s efficacy for facilitating the adoption of machine learning was evaluated through two case studies in collaboration with clinical domain experts. A domain expert review was also …

Retrospective Study Of Fmol Health System Utilization Using Geospatial Information, Deekshith Mandala

LSU Master's Theses

Medicaid Expansion and closing of Emergency Departments (ED) like Earl K. Long, Baton Rouge General Mid-City ED, and Champion Medical Center changed the health care landscape in East Baton Rouge Parish (EBRP). In this research study, a Geographical Information System (GIS) is used to analyze the impact of the expansion of Medicaid and the inauguration of Our Lady of the Lake North Baton Rouge ED (OLOL NBR ED) over the utilization of Franciscan Missionaries of our Lady Health System (FMOLHS) for both emergency and non-emergency health care services. This study is performed across the 58 neighborhoods of EBRP. Overutilization of …

Blood Pressure Management Education, Lauren G. Gernon, Cara Rathmell

Family Medicine Clerkship Student Projects

The expansion of telehealth with COVID-19 and recent recommendations to use at-home blood pressure monitoring to diagnose and monitor hypertension have increased the need for materials and education for clinicians and patients. A pilot project in Primary Care Internal Medicine UVM in Essex, VT, produced an electronic medical record dot phrase and compiled educational materials to initiate nurse visits for at-home BP measurements. Materials and experience with this pilot was researched for initiation of a similar program at UVM Family Medicine Hinesburg.

Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. Mcmanus

Apurv Soni

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for community-based AF …

High Burden Of Unrecognized Atrial Fibrillation In Rural India: An Innovative Community-Based Cross-Sectional Screening Program, Apurv Soni, Allison Earon, Anna Handorf, Nisha Fahey, Kandarp Talati, John Bostrom, Ki Chon, Craig Napolitano, Michael S. Chin, John Stephen Sullivan, Shyamsundar Raithatha, Robert J. Goldberg, Somashekhar Nimbalkar, Jeroan J. Allison, Sunil Thanvi, David D. Mcmanus

Apurv Soni

BACKGROUND: Atrial fibrillation, the world's most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly.

OBJECTIVE: The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor.

METHODS: Residents from 6 villages in Anand District, Gujarat, India, comprised the base population. After obtaining informed consent, a team …

Using Mobile-Based Technology To Screen For Atrial Fibrillation In India, Apurv Soni

Apurv Soni

As part of the mini-symposium entitled "Interdiscipllinary Mobile Health and Sensing Research," this presentation discusses use of a novel smartphone app for cardiovascular screening in rural India.

Representing The Patient Experience Of Heart Failure Through Empathy, Journey And Stakeholder Mapping, Leanna Woods, Jed Duff, Erin Roehrer, Kim Walker, Elizabeth Cummings

Patient Experience Journal

Heart failure is a long-term condition requiring those affected to manage numerous self-care related activities. People with heart failure report multiple challenges accommodating self-care activities in their every-day life. The aim of this study is to (1) understand the experience of people with heart failure and their caregivers in the local patient population, and (2) visually represent these experiences to inform the design of a mobile health intervention supporting self-care. Seven patients and four family caregivers were interviewed using an empathic approach. Data was collected using rapid design methods including an empathy map to uncover patient and caregiver perspectives and …

The Effectiveness Of Interventions And Bundles For Central Line-Associated Bloodstream Infections In The Neonatal Intensive Care Unit, Mohamad Alhamwi

Honors Undergraduate Theses

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs.

Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple …

Health Systems Readiness For Adopting Mhealth Interventions For Addressing Non-Communicable Diseases In Low- And Middle-Income Countries: A Current Debate, Anam Shahil Feroz, Muhammad Masood Kadir, Sarah Saleem

Community Health Sciences

In low-and-middle-income countries, epidemiologic transition is taking place very rapidly from communicable diseases to non-communicable diseases. NCDs mortality rates are increasing faster and nearly 80% of NCDs deaths occur in LMICs. Existing weak health systems of LMICs are undergoing a devastating human and economic toll as a result of increasing treatment costs and losses to productivity from NCDs. At the same time, the increasing penetration of mobile phone technology and the spread of cellular network and infrastructure have led to the introduction of the mHealth field. While mHealth field offers a great promise to prevent and control non-communicable diseases in …

Discordant Documentation Of Obesity Body Mass Index And Obesity Diagnosis In Electronic Medical Records, Jennifer T. Fink, George L. Morris Iii, Maharaj Singh, David A. Nelson, Renee E. Walker, Ron A. Cisler

Maharaj Singh

Purpose: This study examined concordance between presence of obesity body mass index (BMI), defined as BMI ≥ 30, in the patient’s electronic medical record (EMR) and a documented diagnosis of obesity.

Methods: We conducted a retrospective review of the EMR in a large health care system for a 1-year period (2012). A total of 397,313 patients met the study criteria of having at least one physician visit, being at least 18 years of age, and not being pregnant. Of those, 158,327 (40%) had a recorded BMI ≥ 30. We examined the EMR of these obese patients to determine whether a …

The Mind-Body Connection: The Association Between Adolescent Locus Of Control And Indicators Of Physical Health, C. Brahler, James Cropper

C. Jayne Brahler

Locus of control (LOC) describes an individual’s generalized beliefs or expectancies that their reinforcements are under internal versus external control (1). An individual exhibits either an internal or external LOC. This study examines the link between LOC and selected health risk factors in adolescents. A convenience sample of 167 high school physical education students completed a 13-item LOC questionnaire based on Rotter’s 1966 instrument. Various anthropometric measurements, blood pressure, body mass index (BMI), and body fat were recorded on all subjects. A subsample of 61 female students received blood chemistry analysis that included a lipid profile, hemoglobin A1c (HbA1c), Apo …

Development And Pilot Feasibility Study Of A Health Information Technology Tool To Calculate Mortality Risk For Patients With Asymptomatic Carotid Stenosis: The Carotid Risk Assessment Tool (Carat), Adrienne E. Faerber, Rebecca Horvath, Carey Stillman, Melissa L. O'Connell, Amy L. Hamilton, Karina A. Newhall, Donald S. Likosky, Philip P. Goodney

Dartmouth Scholarship

Patients with no history of stroke but with stenosis of the carotid arteries can reduce the risk of future stroke with surgery or stenting. At present, a physicians’ ability to recommend optimal treatments based on an individual’s risk profile requires estimating the likelihood that a patient will have a poor peri-operative outcomes and the likelihood that the patient will survive long enough to gain benefit from the procedure. We describe the development of the CArotid Risk Assessment Tool (CARAT) into a 2-year mortality risk calculator within the electronic medical record, integrating the tool into the clinical workflow, training the clinical …

Discordant Documentation Of Obesity Body Mass Index And Obesity Diagnosis In Electronic Medical Records, Jennifer T. Fink, George L. Morris Iii, Maharaj Singh, David A. Nelson, Renee E. Walker, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose: This study examined concordance between presence of obesity body mass index (BMI), defined as BMI ≥ 30, in the patient’s electronic medical record (EMR) and a documented diagnosis of obesity.

Methods: We conducted a retrospective review of the EMR in a large health care system for a 1-year period (2012). A total of 397,313 patients met the study criteria of having at least one physician visit, being at least 18 years of age, and not being pregnant. Of those, 158,327 (40%) had a recorded BMI ≥ 30. We examined the EMR of these obese patients to determine whether a …

Applying Novel Tree-Based Frameworks To Big Data For Classification Of Heart Failure Patients And Prediction Of Clinical Responses, Yan Zhang, Nicholas Downing, Emily Bucholz, Suganthi Balasubramanian, Shu-Xia Li, Tara Liptak, Harlan Krumholz, Mark Gerstein

Yale Day of Data

Over 5 million Americans suffer from heart failure, a condition with a 5-year survival that eclipses all cancers apart from that of lung cancer. Conventional understanding of heart failure is simplistic: it is viewed as a single syndrome, despite real heterogeneity. In addition, models predicting outcomes focus on dichotomous results, like 30-day readmission. A novel approach to classification of heart failure may improve our ability to target interventions, improve patient experiences, and predict outcomes.

The Healthcare Cost and Utilization Project is a family of administrative claims databases that describes patient demographics, comorbidities, procedures, acute care utilization and outcomes, such as …

The Identity Of The Heart Patient In The Context Of The Gift Economy: Heartnet And Media Framing, Lynsey Uridge

Theses: Doctorates and Masters

This health communication research examines the identity levels of the heart patient on a therapeutic website HeartNET through an empirical investigation of site interactions as manifestations of a gift economy. The thesis also explores the media’s representation of heart health in both television and print.

This research utilised a longitudinal qualitative ethnographic and netnographic approach involving twenty-six participants who completed two in-depth interviews. The first one-on-one interview occurred during the early stages of the participants’ heart journey, explored their heart story and use of interactive technology for heart health support. The second interview occurred six to twelve months later, and …

Improved Cardiovascular Risk Prediction Using Nonparametric Regression And Electronic Health Record Data, Edward Kennedy, Wyndy Wiitala, Rodney Hayward, Jeremy Sussman

Edward H. Kennedy

Use of the electronic health record (EHR) is expected to increase rapidly in the near future, yet little research exists on whether analyzing internal EHR data using flexible, adaptive statistical methods could improve clinical risk prediction. Extensive implementation of EHR in the Veterans Health Administration provides an opportunity for exploration. Our objective was to compare the performance of various approaches for predicting risk of cerebrovascular and cardiovascular (CCV) death, using traditional risk predictors versus more comprehensive EHR data. Regression methods outperformed the Framingham risk score, even with the same predictors (AUC increased from 71% to 73% and calibration also improved). …

The Mind-Body Connection: The Association Between Adolescent Locus Of Control And Indicators Of Physical Health, C. Jayne Brahler, James Cropper

Physical Therapy Faculty Publications

Locus of control (LOC) describes an individual’s generalized beliefs or expectancies that their reinforcements are under internal versus external control (1). An individual exhibits either an internal or external LOC. This study examines the link between LOC and selected health risk factors in adolescents. A convenience sample of 167 high school physical education students completed a 13-item LOC questionnaire based on Rotter’s 1966 instrument.

Various anthropometric measurements, blood pressure, body mass index (BMI), and body fat were recorded on all subjects. A subsample of 61 female students received blood chemistry analysis that included a lipid profile, hemoglobin A1c (HbA1c), Apo …