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Electronic Health Records In The Academic World, Madeline Leapaldt 2016 University of Akron Main Campus

Electronic Health Records In The Academic World, Madeline Leapaldt

Honors Research Projects

Health or medical records are the backbone of the healthcare industry. They allow professions to practice patient-centered, interdisciplinary care. Electronic Health Records help accelerate the care process and allow for a smoother patient experience. However, many healthcare professionals have not used an Electronic Health Record prior to employment or internships. This can be detrimental to the process and slow down the entire team. Research shows that teaching Electronic Health Records in an academic setting allows students to safely explore the system and become comfortable with using technology for healthcare purposes. There are specific requirements that have been shown to aid ...


Healthcare Information Systems: Opportunities And Challenges, Madison Ngafeeson 2015 Northern Michigan University

Healthcare Information Systems: Opportunities And Challenges, Madison Ngafeeson

Madison Ngafeeson

No abstract provided.


Concussion Awareness And Educational Outreach Through A Website And Mobile Application, Daniel J. Brogan 2015 Ursinus College

Concussion Awareness And Educational Outreach Through A Website And Mobile Application, Daniel J. Brogan

Neuroscience Summer Fellows

In recent years concussions have become a more apparent problem in youth and adolescent sports. 1 in 5 high school students will sustain a concussion during the season. Due to medical and scientific advances, the diagnosis of concussions is becoming much simpler with key markers that are signs for an injury. Returning to play too soon before an athlete is fully recovered increases the likelihood that serious and irreversible neurological deficits can occur. Symptoms for concussions are necessary to track in order for an athlete to properly report their recovery to a physician. Doctors primarily rely on a patient’s ...


Cds, Ux, And System Redesign – Promising Techniques And Tools To Bridge The Evidence Gap, Thomas McGinn 2015 Hofstra North Shore-LIJ School of Medicine

Cds, Ux, And System Redesign – Promising Techniques And Tools To Bridge The Evidence Gap, Thomas Mcginn

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: In this special issue of eGEMs, we explore the struggles related to bringing evidence into day-to-day practice, what I define as the “evidence gap.” We are all aware of high quality evidence in the form of guidelines, randomized clinical trials for treatments and diagnostic tests, and clinical prediction rules, which are all readily available online. We also know that electronic health records (EHRs) are now ubiquitous in health care and in most practices across the country. How we marry this high quality evidence and the practice of medicine through effective decision support is a major challenge.

About the Issue ...


Teenbp: Development And Piloting Of An Ehr-Linked Clinical Decision Support System To Improve Recognition Of Hypertension In Adolescents, Elyse O. Kharbanda MD, MPH, James D. Nordin MD, MPH, Alan R. Sinaiko MD, Heidi L. Ekstrom MA, Jerry M. Stultz MD, Nancy E. Sherwood PhD, Patricia L. Fontaine MD, Steve E. Asche MA, Steven P. Dehmer PhD, Jerry H. Amundson BS, Deepika X. Appana BS, Anna R. Bergdall MPH, Marcia G. Hayes MPH, Patrick J. O'Connor MD, MPH, MA 2015 HealthPartners Institute for Education and Research

Teenbp: Development And Piloting Of An Ehr-Linked Clinical Decision Support System To Improve Recognition Of Hypertension In Adolescents, Elyse O. Kharbanda Md, Mph, James D. Nordin Md, Mph, Alan R. Sinaiko Md, Heidi L. Ekstrom Ma, Jerry M. Stultz Md, Nancy E. Sherwood Phd, Patricia L. Fontaine Md, Steve E. Asche Ma, Steven P. Dehmer Phd, Jerry H. Amundson Bs, Deepika X. Appana Bs, Anna R. Bergdall Mph, Marcia G. Hayes Mph, Patrick J. O'Connor Md, Mph, Ma

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Context: Blood pressure (BP) is routinely measured in children and adolescents during primary care visits. However, elevated BP or hypertension is frequently not diagnosed or evaluated further by primary care providers. Barriers to recognition include lack of clinician buy-in, competing priorities, and complexity of the standard BP tables.

Case Description: We have developed and piloted TeenBP— a web-based, electronic health record (EHR) linked system designed to improve recognition of prehypertension and hypertension in adolescents during primary care visits.

Major Themes: Important steps in developing TeenBP included the following: review of national BP guidelines, consideration of clinic workflow, engagement of clinical ...


A Framework For Usable And Effective Clinical Decision Support: Experience From The Icpr Randomized Clinical Trial, Joseph Kannry, Lauren McCullagh, Andre Kushniruk, Devin Mann, Daniel Edonyabo, Thomas McGinn 2015 Icahn School of Medicine at Mount Sinai

A Framework For Usable And Effective Clinical Decision Support: Experience From The Icpr Randomized Clinical Trial, Joseph Kannry, Lauren Mccullagh, Andre Kushniruk, Devin Mann, Daniel Edonyabo, Thomas Mcginn

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: The promise of Clinical Decision Support (CDS) has always been to transform patient care and improve patient outcomes through the delivery of timely and appropriate recommendations that are patient specific and, more often than not, are appropriately actionable. However, the users of CDS—providers—are frequently bombarded with inappropriate and inapplicable CDS that often are not informational, not integrated into the workflow, not patient specific, and that may present out of date and irrelevant recommendations.

Methods: The integrated clinical prediction rule (iCPR) project was a randomized clinical trial (RCT) conducted to determine if a novel form of CDS, i ...


Evidence-Based Practice In The New Millenium, Nicholus H. Yee 2015 Oakwood Annapolis Hospital Family Medicine Residency

Evidence-Based Practice In The New Millenium, Nicholus H. Yee

Clinical Research in Practice: The Journal of Team Hippocrates

A reflection on learning and education in practice.


A Multi-Step Maturity Model For The Implementation Of Electronic And Computable Diagnostic Clinical Prediction Rules (Ecprs), Derek Corrigan, Ronan McDonnell, Atieh Zarabzadeh, Tom Fahey 2015 HRB Centre for Primary Care Research, RCSI Medical School, Dublin

A Multi-Step Maturity Model For The Implementation Of Electronic And Computable Diagnostic Clinical Prediction Rules (Ecprs), Derek Corrigan, Ronan Mcdonnell, Atieh Zarabzadeh, Tom Fahey

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: The use of Clinical Prediction Rules (CPRs) has been advocated as one way of implementing actionable evidence-based rules in clinical practice. The current highly manual nature of deriving CPRs makes them difficult to use and maintain. Addressing the known limitations of CPRs requires implementing more flexible and dynamic models of CPR development. We describe the application of Information and Communication Technology (ICT) to provide a platform for the derivation and dissemination of CPRs derived through analysis and continual learning from electronic patient data.

Model Components: We propose a multistep maturity model for constructing electronic and computable CPRs (eCPRs). The ...


The Effectiveness Of Teleglaucoma Versus In-Patient Examination. Assessment: Systematic Review, Meta-Analysis, And Cost-Effectiveness Analysis, Sera-Melisa Thomas 2015 The University of Western Ontario

The Effectiveness Of Teleglaucoma Versus In-Patient Examination. Assessment: Systematic Review, Meta-Analysis, And Cost-Effectiveness Analysis, Sera-Melisa Thomas

Electronic Thesis and Dissertation Repository

Teleglaucoma is a screening device that remotely detects glaucoma cases at earlier stages using electronically-transferred stereoscopic digital imaging. Thus, patient wait and travel times are reduced, as well as, patient load in ophthalmic clinics. The purpose is to synthesize literature to evaluate teleglaucoma: its diagnostic accuracy, the healthcare system benefits, and its cost-effectiveness. A systematic review was conducted with published and unpublished studies. A meta-analysis was conducted to provide estimates of diagnostic accuracy, diagnostic odds ratio, and the relative percentage of glaucoma cases detected. Using Markov Modelling, a cost-effectiveness analysis was conducted. Of 11237 studies reviewed, 45 were included. Teleglaucoma ...


Back To The Bedside: Developing A Bedside Aid For Concussion And Brain Injury Decisions In The Emergency Department, Edward R. Melnick, Kevin Lopez, Erik P. Hess, Fuad Abujarad, Cynthia A. Brandt, Richard N. Shiffman, Lori A. Post 2015 Yale School of Medicine

Back To The Bedside: Developing A Bedside Aid For Concussion And Brain Injury Decisions In The Emergency Department, Edward R. Melnick, Kevin Lopez, Erik P. Hess, Fuad Abujarad, Cynthia A. Brandt, Richard N. Shiffman, Lori A. Post

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Context: Current information-rich electronic health record (EHR) interfaces require large, high-resolution screens running on desktop computers. This interface compromises the provider’s already limited time at the bedside by physically separating the patient from the doctor. The case study presented here describes a patient-centered clinical decision support (CDS) design process that aims to bring the physician back to the bedside by integrating a patient decision aid with CDS for shared use by the patient and provider on a touchscreen tablet computer for deciding whether or not to obtain a CT scan for minor head injury in the emergency department, a ...


Ehr-Based Visualization Tool: Adoption Rates, Satisfaction, And Patient Outcomes, Randi E. Foraker, Bobbie Kite, Marjorie Kelley, Albert M. Lai, Caryn Roth, Marcelo A. Lopetegui, Abigail B. Shoben, Michael Langan, Nicole Rutledge, Philip R.O. Payne 2015 The Ohio State University

Ehr-Based Visualization Tool: Adoption Rates, Satisfaction, And Patient Outcomes, Randi E. Foraker, Bobbie Kite, Marjorie Kelley, Albert M. Lai, Caryn Roth, Marcelo A. Lopetegui, Abigail B. Shoben, Michael Langan, Nicole Rutledge, Philip R.O. Payne

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Background: Electronic health records (EHRs) have the potential to enhance patient-provider communication and improve patient outcomes. However, in order to impact patient care, clinical decision support (CDS) and communication tools targeting such needs must be integrated into clinical workflow and be flexible with regard to the changing health care landscape.

Design: The Stroke Prevention in Healthcare Delivery Environments (SPHERE) team developed and implemented the SPHERE tool, an EHR-based CDS visualization, to enhance patient-provider communication around cardiovascular health (CVH) within an outpatient primary care setting of a large academic medical center.

Implementation: We describe our successful CDS alert implementation strategy and ...


Providing Information Across Multiple Devices To The Public Health Workforce: Challenges And Opportunities, E. Hatheway Simpson, Lisa Sedlar 2015 University of Massachusetts Medical School

Providing Information Across Multiple Devices To The Public Health Workforce: Challenges And Opportunities, E. Hatheway Simpson, Lisa Sedlar

Library Publications and Presentations

Public health workers are increasingly using mobile technology to access information. PHPartners.org, the web portal of the Partners in Information Access for the Public Health Workforce, has implemented a responsively designed website to allow users to access and easily view the same information across multiple devices including mobile phones, tablets, and desktop computers. This webinar will present an overview of the benefits of responsive web design, the challenges to implementation, and future developments.


Robotic Joint Replacement Surgery: Does Technology Improve Outcomes, Chelsea Hill, Reem El-Bash, Leslie Johnson, Alberto Coustasse 2015 Marshall University

Robotic Joint Replacement Surgery: Does Technology Improve Outcomes, Chelsea Hill, Reem El-Bash, Leslie Johnson, Alberto Coustasse

Management Faculty Research

Introduction: Osteoarthritis is a common disease that leads patients to seek Total Joint Replacement (TJR). Component misalignments leads to failure of TJR. Computer navigation enhances the precision of component alignment, but the addition of robotic guidance, can boost TJR to a higher level of accuracy.

Methodology: This literature reviewed 29 English language peer reviewed articles from 2002 – 2013 and one website. A conceptual framework was adapted to explain benefits and barriers of adoption of robotic TJR.

Results: A total of ten studies were reviewed with focus on more precise alignment, outcomes, length of stay, and costs. Cost to obtain robotic ...


Designing An Effective User Interface For A Mobile Application, Cynthia N. Kim 2015 California Polytechnic State University - San Luis Obispo

Designing An Effective User Interface For A Mobile Application, Cynthia N. Kim

Graphic Communication

The purpose of this study was to determine the best user interface design practices for an iOS mobile application created for Pre-R, a local start-up company that offers physician house calls and telemedicine services throughout San Luis Obispo. The study included initial background research on best user interface design practices, mapping out and implementing the entire process of designing for mobile applications, conducting usability tests on potential users, and making changes according to the test results. Usability tests allowed for a greater understanding of the effectiveness of Pre-R’s mobile interface design prototype. Results from the usability tests have indicated ...


Telehospitalist Program At Swedish Medical Center : Overview And Case Study Of A Novel Telemedicine Application, Jose Gude 2015 Oregon Health & Science University

Telehospitalist Program At Swedish Medical Center : Overview And Case Study Of A Novel Telemedicine Application, Jose Gude

Scholar Archive

Swedish Medical Center (SMC) in Seattle has been performing acute medical hospital admissions via Telemedicine since 2012. To date, no studies have been published to determine if this novel technological application is safe and effective. Telemedicine applications (namely, Telestroke and Tele-ICU), coupled with the shortage of physician resources, have been the basis for the creation of a “Telehospitalist” model. The current Telehospitalist model at SMC, including the technological and training requirements involved in its operation will be described in this capstone.

A case study of a non-critical medical patient admitted to the hospital via telemedicine will be presented. This case ...


Feasibility, Scope And Requirements For A Web Based Transition Of Care Application For Primary Care Providers, Thomas McCarrick 2015 Oregon Health & Science University

Feasibility, Scope And Requirements For A Web Based Transition Of Care Application For Primary Care Providers, Thomas Mccarrick

Scholar Archive

Research in transitions of care has shown that information flow from hospitals including notification of admission, discharge summaries and medication lists is often poor and undermines good transition handoffs. In spite of efforts to create interoperability and communicate important information about transitions of care, the flow of information is inconsistent, not supported by electronic health record (EHR) functionality, dependent on workarounds within the primary care provider (PCP) practice, and has little feedback to promote quality improvement efforts. EHRs typically do not have tools to track patients who are outside the office, in the hospital, emergency room, subacute or skilled nursing ...


Tele-Endocrinology: Providing Endocrine Consultative Service Using Telemedicine, Rabia Rehman MD, Nicole Pant MD, Jamie W. Tidwell MHA, Sydney J. Ashby MA, Ebenezer A. Nyenwe MD, FACP, FACE 2015 University of Tennessee Health Science Center

Tele-Endocrinology: Providing Endocrine Consultative Service Using Telemedicine, Rabia Rehman Md, Nicole Pant Md, Jamie W. Tidwell Mha, Sydney J. Ashby Ma, Ebenezer A. Nyenwe Md, Facp, Face

Tennessee Medicine E-Journal

Objective: To investigate the efficacy of a telemedicine-based endocrine consultative service in improving outcome measures in rural patients with endocrine disorders.

Materials and Methods: Patients from five rural communities were referred by their primary care providers (PCPs) to the Telemedicine Unit of the University of Tennessee Health Science Center (UTHSC). Patients and the telemedicine studio were connected via videoconference using Polycom VSX 7000 video cameras, television monitors and dedicated lines to transmit video and audio electronic records. Recommendations regarding management were sent to the PCP via fax. Data were summarized using mean and standard deviations for continuous variables, and percentages ...


Patient Access To Electronic Health Records: Strengths, Weaknesses And What’S Needed To Move Forward, Alicia V. Zuniga 2015 San Jose State University

Patient Access To Electronic Health Records: Strengths, Weaknesses And What’S Needed To Move Forward, Alicia V. Zuniga

iSchool Student Research Journal

Electronic health records (EHRs) are desired by both physicians and patients, but the transition to and acceptance of sensitive health information online has been slow. This paper reviews the current literature on EHR adoption and outlines barriers, advantages and explicit steps for moving toward the EHR ubiquity. Potential benefits of EHRs to patients and physicians include reduced costs for patients, hospitals and insurance providers, patient empowerment, less errors in records and better health outcomes, but security and privacy concerns, cost of implementation and poor electronic records management system design have proved barriers to adoption.


A Geospatial Analysis Of Norovirus Outbreaks In California, And An Investigation Of The Impact Of Environmental Variables, Alexandra Groen 2015 University of San Francisco

A Geospatial Analysis Of Norovirus Outbreaks In California, And An Investigation Of The Impact Of Environmental Variables, Alexandra Groen

Master's Projects

Previous studies and empirical evidence suggest norovirus outbreaks in California exhibit correlation with environmental variables and exhibit spatial spread patterns. Few studies have been done looking at what causes norovirus seasonality in temperate climates and more research is needed on the regional level. This study aims to find what relationships exist with outbreak occurrence and environmental variables in California, as well as any spatial patterns of spread or clustering of outbreaks. Spatial analysis tools were used to find any relationships between California norovirus outbreak data and environmental variables. The results showed a south to north spread of outbreaks in California ...


The Challenges Of Data Quality Evaluation In A Joint Data Warehouse, Charles J. Bae MD, Sandra Griffith PhD, Youran Fan PhD, Cheryl Dunphy RN, Nicolas Thompson MS, John Urchek, Alandra Parchman MHA, Irene L. Katzan MD MS 2015 Cleveland Clinic

The Challenges Of Data Quality Evaluation In A Joint Data Warehouse, Charles J. Bae Md, Sandra Griffith Phd, Youran Fan Phd, Cheryl Dunphy Rn, Nicolas Thompson Ms, John Urchek, Alandra Parchman Mha, Irene L. Katzan Md Ms

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: The use of clinically derived data from electronic health records (EHRs) and other electronic clinical systems can greatly facilitate clinical research as well as operational and quality initiatives. One approach for making these data available is to incorporate data from different sources into a joint data warehouse. When using such a data warehouse, it is important to understand the quality of the data. The primary objective of this study was to determine the completeness and concordance of common types of clinical data available in the Knowledge Program (KP) joint data warehouse, which contains feeds from several electronic systems including ...


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