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Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor 2017 University of Massachusetts Medical School

Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor

Lawrence D. Garber

BACKGROUND: Clinical decision support (CDS), including computerized reminders for providers and patients, can improve health outcomes. CDS promoting influenza vaccination, delivered directly to patients via an electronic health record (EHR) patient portal and interactive voice recognition (IVR) calls, offers an innovative approach to improving patient care. OBJECTIVE: To test the effectiveness of an EHR patient portal and IVR outreach to improve rates of influenza vaccination in a large multispecialty group practice in central Massachusetts. METHODS: We describe a nonblinded, randomized controlled trial of EHR patient portal messages and IVR calls designed to promote influenza vaccination. In our preparatory phase, we ...


Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor 2017 University of Massachusetts Medical School

Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor

Kathleen M. Mazor

BACKGROUND: Clinical decision support (CDS), including computerized reminders for providers and patients, can improve health outcomes. CDS promoting influenza vaccination, delivered directly to patients via an electronic health record (EHR) patient portal and interactive voice recognition (IVR) calls, offers an innovative approach to improving patient care.

OBJECTIVE: To test the effectiveness of an EHR patient portal and IVR outreach to improve rates of influenza vaccination in a large multispecialty group practice in central Massachusetts.

METHODS: We describe a nonblinded, randomized controlled trial of EHR patient portal messages and IVR calls designed to promote influenza vaccination. In our preparatory phase, we ...


Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor 2017 University of Massachusetts Medical School

Improving Rates Of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls And Patient-Enabled Electronic Health Record Updates: Protocol For A Randomized Controlled Trial, Sarah L. Cutrona, Meera Sreedhara, Sarah L. Goff, Lloyd D. Fisher, Peggy Preusse, Madeline Jackson, Devi Sundaresan, Lawrence D. Garber, Kathleen M. Mazor

Sarah L. Cutrona

BACKGROUND: Clinical decision support (CDS), including computerized reminders for providers and patients, can improve health outcomes. CDS promoting influenza vaccination, delivered directly to patients via an electronic health record (EHR) patient portal and interactive voice recognition (IVR) calls, offers an innovative approach to improving patient care.

OBJECTIVE: To test the effectiveness of an EHR patient portal and IVR outreach to improve rates of influenza vaccination in a large multispecialty group practice in central Massachusetts.

METHODS: We describe a nonblinded, randomized controlled trial of EHR patient portal messages and IVR calls designed to promote influenza vaccination. In our preparatory phase, we ...


Sustained Use Of Patient Portal Features And Improvements In Diabetes Physiological Measures, Stephanie L. Shimada, Jeroan J. Allison, Amy K. Rosen, Hua Feng, Thomas K. Houston 2017 University of Massachusetts Medical School

Sustained Use Of Patient Portal Features And Improvements In Diabetes Physiological Measures, Stephanie L. Shimada, Jeroan J. Allison, Amy K. Rosen, Hua Feng, Thomas K. Houston

Jeroan J. Allison

BACKGROUND: Personal health records (PHRs) have the potential to improve patient self-management for chronic conditions such as diabetes. However, evidence is mixed as to whether there is an association between PHR use and improved health outcomes.

OBJECTIVE: The aim of this study was to evaluate the association between sustained use of specific patient portal features (Web-based prescription refill and secure messaging-SM) and physiological measures important for the management of type 2 diabetes.

METHODS: Using a retrospective cohort design, including Veterans with diabetes registered for the My Health e Vet patient portal who had not yet used the Web-based refill or ...


Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon 2017 Providence Hospital, Washington, DC

Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes included ...


Why A New Journal?, Julio A. Ramirez 2017 University of Louisville Division of Infectious Diseases, Louisville, KY

Why A New Journal?, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

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Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez 2017 University of Louisville, Louisville, KY

Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Time to clinical stability is a well-defined early clinical outcome in hospitalized patients with community-acquired pneumonia, but it has not been evaluated in patients with ventilator-associated pneumonia (VAP). The objective of this study was to compare time to clinical stability in patients with MRSA VAP treated with linezolid versus vancomycin.

Methods: This was a secondary analysis of the IMPACT-HAP study database. VAP was defined according to CDC criteria. MRSA VAP was considered when MRSA was isolated from a tracheal aspirate or bronchoalveolar lavage. A patient was considered to reach clinical stability the day that the following four criteria were ...


A Review Of Macrolide Based Regimens For Community-Acquired Pneumonia, Forest W. Arnold, Leslie A. Beavin 2017 University of Louisville, Louisville, KY

A Review Of Macrolide Based Regimens For Community-Acquired Pneumonia, Forest W. Arnold, Leslie A. Beavin

The University of Louisville Journal of Respiratory Infections

Community-acquired pneumonia (CAP) has significant morbidity and mortality. The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) guidelines recommend two antimicrobial regimens for hospitalized patients with CAP, one of which includes a macrolide, and one of which does not. Both regimens have antimicrobial properties, but macrolides also possess immunomodulatory properties. Macrolides, however, may also have potential arrhythmia adverse effects. The purpose of this review is to provide an update of studies evaluating outcomes for patients with CAP treated with or without a macrolide-based regimen. Two recent randomized controlled trials conflict with each other regarding the benefit versus noninferiority ...


Patient Portal As A Tool For Enhancing Patient Experience And Improving Quality Of Care In Primary Care Practices, Barbara Sorondo MD MBA, Amy Allen DPT, Samreen Fathima BDS MPH, Janet Bayleran, PhD, Iyad Sabbagh MD MBA 2017 Eastern Maine Medical Center

Patient Portal As A Tool For Enhancing Patient Experience And Improving Quality Of Care In Primary Care Practices, Barbara Sorondo Md Mba, Amy Allen Dpt, Samreen Fathima Bds Mph, Janet Bayleran, Phd, Iyad Sabbagh Md Mba

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: This study assessed whether patient portals influence patients’ ability for self-management, improve their perception of health state, improve their experience with primary care practices, and reduce healthcare utilization.

Methods: Patients participating in a nurse-led care coordination program received personalized training to use the portal to communicate with the care team. Data analysis included pre-post comparison of self-efficacy (CDSES), health state (EQVAS), functional status (PROMIS®), experience with the provider/practice (CG-CAHPS), and healthcare utilization (admissions and ED visits).

Results: A total of 94 patients were enrolled, and 92 (Intent to Treat) were followed up for 7 months to assess their ...


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 2017 University of Massachusetts Medical School

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

David D. McManus

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 ...


Physician Service Attribution Methods For Examining Provision Of Low-Value Care, Eva Chang PhD, MPH, Diana SM Buist PhD, MPH, Matthew Handley MD, Roy Pardee JD, MA, Gabrielle Gundersen MPH, Robert J. Reid MD, PhD 2017 echang@rti.org

Physician Service Attribution Methods For Examining Provision Of Low-Value Care, Eva Chang Phd, Mph, Diana Sm Buist Phd, Mph, Matthew Handley Md, Roy Pardee Jd, Ma, Gabrielle Gundersen Mph, Robert J. Reid Md, Phd

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Objectives: There has been significant research on provider attribution for quality and cost. Low-value care is an area of heightened focus, with little of the focus being on measurement; a key methodological decision is how to attribute delivered services and procedures. We illustrate the difference in relative and absolute physician- and panel-attributed services and procedures using overuse in cervical cancer screening.

Study Design: A retrospective, cross-sectional study in an integrated health care system.

Methods: We used 2013 physician-level data from Group Health Cooperative to calculate two utilization attributions: (1) panel attribution with the procedure assigned to the physician’s predetermined ...


The Development And Evaluation Of An Online Healthcare Toolkit For Autistic Adults And Their Primary Care Providers, Christina Nicolaidis, Dora Raymaker, Katherine E. McDonald, Steven K. Kapp, Michael Weiner, Elesia Ashkenazy, Martha Gerrity, Clarissa Kripke, Laura Platt, Amelia Baggs 2016 Portland State University

The Development And Evaluation Of An Online Healthcare Toolkit For Autistic Adults And Their Primary Care Providers, Christina Nicolaidis, Dora Raymaker, Katherine E. Mcdonald, Steven K. Kapp, Michael Weiner, Elesia Ashkenazy, Martha Gerrity, Clarissa Kripke, Laura Platt, Amelia Baggs

Christina Nicolaidis

BACKGROUND: The healthcare system is ill-equipped to meet the needs of adults on the autism spectrum.

OBJECTIVE: Our goal was to use a community-based participatory research (CBPR) approach to develop and evaluate tools to facilitate the primary healthcare of autistic adults. DESIGN: Toolkit development included cognitive interviewing and test–retest reliability studies. Evaluation consisted of a mixed-methods, single-arm pre/postintervention comparison.

PARTICIPANTS: A total of 259 autistic adults and 51 primary care providers (PCPs) residing in the United States.

INTERVENTIONS: The AASPIRE Healthcare toolkit includes the Autism Healthcare Accommodations Tool (AHAT)—a tool that allows patients to create a personalized ...


The Effect Of A Culturally Tailored Web-Based Physical Activity Promotion Program On Asian American Midlife Women’S Depressive Symptoms, Wonshik Chee, Sangmi Kim, Xiaopeng Ji, Sooyoung Park, Eunice Chee, Hsiu-Min Tsai, Eun-Ok Im 2016 Duke University

The Effect Of A Culturally Tailored Web-Based Physical Activity Promotion Program On Asian American Midlife Women’S Depressive Symptoms, Wonshik Chee, Sangmi Kim, Xiaopeng Ji, Sooyoung Park, Eunice Chee, Hsiu-Min Tsai, Eun-Ok Im

Asian/Pacific Island Nursing Journal

The benefits of physical activities on depressive symptoms have increasingly been reported in the literature, but the effect through which a Web-based physical activity promotion program alleviates depressive symptoms is not clearly known, especially among ethnic minority midlife women. The purpose of this pilot randomized control study is to examine the preliminary efficacy of the Web-based physical activity promotion program in enhancing the depressive symptoms of Asian American midlife women through increasing physical activity. This study adopted a randomized repeated measures pretest/posttest control group design. This study consisted of two groups of research participants: 18 in an intervention group ...


Implementation Of A Computerized Screening Inventory: Improved Usability Through Iterative Testing And Modification, Edwin D. Boudreaux, Andrew Christopher Fischer, Brianna Haskins, Zubair Saeed Zafar, Guanling Chen, Sneha A. Chinai 2016 University of Massachusetts Medical School

Implementation Of A Computerized Screening Inventory: Improved Usability Through Iterative Testing And Modification, Edwin D. Boudreaux, Andrew Christopher Fischer, Brianna Haskins, Zubair Saeed Zafar, Guanling Chen, Sneha A. Chinai

Edwin D. Boudreaux

BACKGROUND: The administration of health screeners in a hospital setting has traditionally required (1) clinicians to ask questions and log answers, which can be time consuming and susceptible to error, or (2) patients to complete paper-and-pencil surveys, which require third-party entry of information into the electronic health record and can be vulnerable to error and misinterpretation. A highly promising method that avoids these limitations and bypasses third-party interpretation is direct entry via a computerized inventory.

OBJECTIVE: To (1) computerize medical and behavioral health screening for use in general medical settings, (2) optimize patient acceptability and feasibility through iterative usability testing ...


Health Communication, It And The Public’S Attitude Toward Periodic Ghe, Quan-Hoang Vuong 2016 Universite Libre de Bruxelles

Health Communication, It And The Public’S Attitude Toward Periodic Ghe, Quan-Hoang Vuong

Quan-Hoang Vuong

Periodic general health examinations (GHEs) are gradually becoming more popular as they employ
subclinical screenings as a means of early detection. This study considers the effect of information
technology (IT), health communications and the public’s attitude towards GHEs in Vietnam. A total of
2,068 valid observations were obtained from a survey in Hanoi and its surrounding areas, out of which
42.12% said they were willing to use IT applications to recognise illness symptoms, nearly 2/3 of them
rated the healthcare quality at average level or below. The data, which is processed by the BCL model,
has ...


Leveraging A Statewide Clinical Data Warehouse To Expand Boundaries Of The Learning Health System, Christine B. Turley 2016 Health Sciences South Carolina

Leveraging A Statewide Clinical Data Warehouse To Expand Boundaries Of The Learning Health System, Christine B. Turley

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Learning Health Systems (LHS) require accessible, usable health data and a culture of collaboration—a challenge for any single system, let alone disparate organizations, with macro- and micro-systems. Recently, the National Science Foundation described this important setting as a cyber-social ecosystem. In 2004, in an effort to create a platform for transforming health in South Carolina, Health Sciences South Carolina (HSSC) was established as a research collaboration of the largest health systems, academic medical centers and research intensive universities in South Carolina. With work beginning in 2010, HSSC unveiled an integrated Clinical Data Warehouse (CDW) in 2013 as a crucial ...


Assessing The Performance Differences Between Hospitals With And Without Meaningful Use Of Electronic Health Records On Care Outcomes, Joseph G. Conte 2016 Seton Hall School Health Sciences

Assessing The Performance Differences Between Hospitals With And Without Meaningful Use Of Electronic Health Records On Care Outcomes, Joseph G. Conte

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: The U.S. healthcare system at $3 trillion, is the sixth largest economy in the world. The federal government is the largest purchaser of healthcare in the country. In the past decade it has been on a quest to refocus its purchasing from volume to value. While spending nearly double per capita than every other industrialized nation, U.S. healthcare outcomes are consistently in the lowest quartile for every major indicator from life expectancy to ambulatory sensitive conditions. The Crossing the Quality Chasm Report (IOM) focused a lens on the dearth of electronic health ...


Submitting Uds Reports In Athenanet: Assisting Clinics In Meeting Federal Requirements, Daniel Richard Eident 2016 University of Massachusetts Boston

Submitting Uds Reports In Athenanet: Assisting Clinics In Meeting Federal Requirements, Daniel Richard Eident

Instructional Design Capstones Collection

Athenahealth, Inc. is an electronic medical record company that provides services to medical care providers throughout the industry. In order to fully serve all of its clients, training is offered through hands-on coaching and training, and asynchronous e-learning. This paper explores the training developed to support one of athenahealth’s more unique clients, the Federally Qualified Healthcare Clinic, a type of clinic that serves underserved communities including the homeless, migrant-workers, and minorities. Through the process of a needs analysis and developing the instructional strategy, a curriculum was designed with the goal of increasing productivity of FQHCs through reducing calls for ...


Incidence Of Student Registered Nurse Anesthetists In The United States Who Own And Use Smartphone As Supplemental Learning Tools, Ruoyu Zhao 2016 University of Southern Mississippi

Incidence Of Student Registered Nurse Anesthetists In The United States Who Own And Use Smartphone As Supplemental Learning Tools, Ruoyu Zhao

Doctoral Nursing Capstone Projects

Background: Smartphones have a great potential for students to learn more efficiently. Students now have the ability to download applications with pertinent information in the palm of their hand for both educational and clinical duties. This descriptive correlational quantitative research examines whether student registered nurse anesthetists own and use smartphones as supplementary learning tools.

Methods: An online survey was sent through AANA to Masters and DNP student registered nurse anesthetists (SRNAs) in the United States. Respondents were asked if they owned smartphones and how often they used smartphones for educational and clinical duties. Data Analysis was conducted using a Chi-square ...


Electronic Communication Among Anesthesia Providers, Joseph K. Wells 2016 University of Southern Mississippi

Electronic Communication Among Anesthesia Providers, Joseph K. Wells

Doctoral Nursing Capstone Projects

Facilities in the United States are utilizing electronic communication devices (ECDs) for their nursing staff on intensive care units, general medical-surgical floors, and chemotherapy floors, but it is underutilized in the operating room where seconds truly matter (Wu et al., 2012). Situations arise daily within operating rooms that require quick and decisive communication to avoid poor patient outcomes. The ultimate goal is to prevent poor patient outcomes by enhancing communication among anesthesia providers.

This doctoral project evaluated an anesthesia group in southeast Mississippi regarding their satisfaction with current devices used for communication. This anesthesia group utilized smart phones and public ...


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