Medicine and Health Sciences Commons^™

Adjuvant Concurrent Chemoradiation Using Intensity-Modulated Radiotherapy And Simultaneous Integrated Boost For Resected High-Risk Adenocarcinoma Of The Distal Esophagus And Gastro-Esophageal Junction., Brian Yaremko, David Palma, Abigail Erickson, Gregory Pierce, Richard Malthaner, Richard Inculet, Rashid Dar, George Rodrigues, Edward Yu

Richard A. Malthaner

Purpose: Multimodality therapy leads to improved outcomes for adenocarcinoma of the distal esophagus and gastroesophageal junction (GEJ) over surgery alone. At our institution, adjuvant chemoradiation (chemoRT) using IMRT and SIB is standard of care for resected high-risk disease. In this study, we review our experience with a recent cohort of patients treated in this manner. Methods and materials: We identified 18 patients with resected T3 and/or N1 adenocarcinoma of the distal esophagus and GEJ who received adjuvant chemoRT. A large elective volume (PTV1) and a smaller high-risk volume (PTV2) were irradiated simultaneously using IMRT and an SIB technique. All patients …

Adjuvant Concurrent Chemoradiation Using Intensity-Modulated Radiotherapy And Simultaneous Integrated Boost For Resected High-Risk Adenocarcinoma Of The Distal Esophagus And Gastro-Esophageal Junction., Brian Yaremko, David Palma, Abigail Erickson, Gregory Pierce, Richard Malthaner, Richard Inculet, Rashid Dar, George Rodrigues, Edward Yu

Richard A. Malthaner

Purpose: Multimodality therapy leads to improved outcomes for adenocarcinoma of the distal esophagus and gastroesophageal junction (GEJ) over surgery alone. At our institution, adjuvant chemoradiation (chemoRT) using IMRT and SIB is standard of care for resected high-risk disease. In this study, we review our experience with a recent cohort of patients treated in this manner. Methods and materials: We identified 18 patients with resected T3 and/or N1 adenocarcinoma of the distal esophagus and GEJ who received adjuvant chemoRT. A large elective volume (PTV1) and a smaller high-risk volume (PTV2) were irradiated simultaneously using IMRT and an SIB technique. All patients …

Design Of An Enterprise Architecture For Electronic Patient Care Record (Epcr) Information Exchange In Ems, Ben Schooley, Neset Hikmet

Neset Hikmet

EMS is an organized and collaborative effort between several organizations providing different levels or tiers of care designed to transport sick or injured patients to the hospital. Significant challenges to efficient, accurate, and integrated inter-organizational information exchange exist for communicating pre-hospital patient information to hospital emergency departments. The goal of this research was to investigate the requirements and design of a business process-oriented inter-organizational enterprise architecture from a multi-stakeholder perspective. This paper describes an action-design research effort aimed at improving information exchange across pre-hospital and hospital organizations in the Santa Clara County, CA Health and Hospital System. In this paper, …

Computer Physician Order Entry And Clinical Decision Support Systems: Benefits And Concerns, Joseph Shaffer, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Computerized Physician Order Entry has emerged as the greatest potential to decrease medications errors and improve efficiency. A literature review was conducted in systematic stages that included the research data from the last 25 years. Efficiencies were found with a decrease in overall workload of nurses, pharmacists and clerical workers. This led to decreased operating expenses. A secure way of transferring physician orders electronically will help hospitals and physicians practice a more efficient and higher quality of care in the US healthcare system.

Benefits And Constraints Of Telepsychiatry Utilization In The United States, Bruce A. Stec, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

This conference presentation describes the benefits and constraints of utilizing telemedicine primarily focusing on the field of psychiatry in the United States with the current system of healthcare. The utilization of telemedicine in the field of psychiatry is believed to provide better access, quality and care to the patients who necessitate psychiatric care in their overall medical care. Telemedicine has been a successfully integrated program into psychiatric facilities reaching rural, prisons or city facilities based on that it has increased the volume of patients in which physicians can reach out to and diagnose, as well as treat patients with limitations …

The Future Of Hipaa In The Cloud, Frank Pasquale, Tara Adams Ragone

Frank A. Pasquale

This white paper examines how cloud computing generates new privacy challenges for both healthcare providers and patients, and how American health privacy laws may be interpreted or amended to address these challenges. Given the current implementation of Meaningful Use rules for health information technology and the Omnibus HIPAA Rule in health care generally, the stage is now set for a distinctive law of “health information” to emerge. HIPAA has come of age of late, with more aggressive enforcement efforts targeting wayward healthcare providers and entities. Nevertheless, more needs to be done to assure that health privacy and all the values …

Testimony To Senator Mike Folmer, Harry Lukens, Donald Levick

Donald Levick MD

No abstract provided.

Reducing Rehospitalizations Through Automated Alerts To Primary Care Providers And Staff When Older Patients Are Discharged From The Hospital: A Randomized Trial, Jerry H. Gurwitz, Terry S. Field, Jessica Ogarek, Jennifer Tjia, Sarah L. Cutrona, Leslie R. Harrold, Jennifer L. Donovan, Abir O. Kanaan, Shawn J. Gagne, Peggy Preusse, Lawrence D. Garber

Jennifer Tjia

Background: Inadequate continuity of care places older patients at very high risk during transitions from the hospital to ambulatory setting.

Methods: We conducted a randomized controlled trial of an HIT-based transitional care intervention in patients aged 65 and older discharged from hospital to home. All patients were senior plan members of a Massachusetts-based health plan, and cared for by a multispecialty medical group using the EpicCare Ambulatory Medical Record. In addition to notifying providers about the patient’s recent transition, the system provided information about new drugs added during the inpatient stay, warnings about drug-drug interactions, recommendations for dose changes and …

Reducing Rehospitalizations Through Automated Alerts To Primary Care Providers And Staff When Older Patients Are Discharged From The Hospital: A Randomized Trial, Jerry H. Gurwitz, Terry S. Field, Jessica Ogarek, Jennifer Tjia, Sarah L. Cutrona, Leslie R. Harrold, Jennifer L. Donovan, Abir O. Kanaan, Shawn J. Gagne, Peggy Preusse, Lawrence D. Garber

Abir O. Kanaan

Background: Inadequate continuity of care places older patients at very high risk during transitions from the hospital to ambulatory setting.

Methods: We conducted a randomized controlled trial of an HIT-based transitional care intervention in patients aged 65 and older discharged from hospital to home. All patients were senior plan members of a Massachusetts-based health plan, and cared for by a multispecialty medical group using the EpicCare Ambulatory Medical Record. In addition to notifying providers about the patient’s recent transition, the system provided information about new drugs added during the inpatient stay, warnings about drug-drug interactions, recommendations for dose changes and …

Amdis Case Conference: Intrusive Medication Safety Alerts, J. Graham, Donald Levick, R. Schreiber

Donald Levick MD

No abstract provided.

The Implementation Of A Perinatal Continuum Of Care Information System: Lessons Learned, Donald Levick, Michael Sheinberg

Donald Levick MD

No abstract provided.

Organizational Challenges In The Implementation And Integration Of Vendor-Supplied Electronic Health Record System, Susan Sherer, Chad Myerhoefer, S Chou, M Deily, Donald Levick, M Sheinberg

Donald Levick MD

No abstract provided.

Plugging The Drip: Challenges With Business Intelligence, Donald Levick

Donald Levick MD

No abstract provided.

Treating Data As A Corporate Asset To Improve Clinical And Financial Management, Donald Levick

Donald Levick MD

No abstract provided.

Extending The Technology Acceptance Model In Healthcare: Identifying The Role Of Trust And Shared Information, Sabrina Terrizzi, Susan Sherer, Chad Meyerhoefer, Michael Scheinberg, Donald Levick

Donald Levick MD

We propose extensions to the Technology Acceptance Model for the adoption of integrated electronic health records that are shared by multiple health care providers. In particular, we propose a conceptual model in which we incorporate two new factors, trust and access to shared information, into the Technology Acceptance Model. Preliminary results confirm the statistically significant and positive impact of perceived usefulness on behavioral intent to use integrated electronic health records and a significant and positive impact of perceived ease of use on perceived usefulness. We also find a statistically significant effect of shared information on behavioral intent to use integrated …

A Qualitative Review Of Differential Diagnosis Generators, William Bond Md, Ms, Linda M. Schwartz Mde, Ahip, Cm, Kevin R. Weaver Do, Donald Levick Md, Mba, Michael Guliano Md, Med, Mhpe, Mark L. Graber Md

Donald Levick MD

No abstract provided.

Differential Diagnosis Generators: An Evaluation Of Currently Available Computer Programs, William Bond Md, Ms, Linda M. Schwartz Mde, Ahip, Cm, Kevin Weaver Do, Donald Levick Md, Michael Guliano Md, Med, Mhpe, Mark L. Graber

Donald Levick MD, MBA, CPHIMS

No abstract provided.

Clinical Decision Support Workshop: You Can't Have One Without The Order - Practical Cds & Quality Improvement, Donald Levick

Donald Levick MD

No abstract provided.

Clinical Decision Support (Cds) & Meaningful Use Frequently Asked Questions, Paul Kleeberg, Donald Levick, Jerome Osheroff, Jacob Reider, Jonathan Teich

Donald Levick MD

No abstract provided.

Clinical Decision Support: Where To Start, Donald Levick

Donald Levick MD

No abstract provided.

Health System Automates Medication Reconciliation. Solution Extracts Information Directly From The Clinical System Throughout A Patient's Stay And At Discharge, Donald Levick, Sandra Haldeman, Michelle Beck

Donald Levick MD

No abstract provided.

Improving Outcomes With Clinical Decision Support: An Implementer's Guide, Jerome Osheroff, Jonathan Teich, Donald Levick, Luis Saldana, Ferdinand Velasco, Dean Sittig, Kendall Rogers, Robert Jenders

Donald Levick MD

No abstract provided.

Physician Buy-In For Emr's, L. Yackanicz, R. Kerr, Donald Levick

Donald Levick MD

No abstract provided.

The Unintended Consequences Of Clinical Decision Support, Donald Levick, David Pucklavage

Donald Levick MD

No abstract provided.

Stopping The Drip (Data Rich, Information Poor), Donald Levick

Donald Levick MD

No abstract provided.

Enhancing Practice Value Through Meaningful Use And Health It, Donald Levick

Donald Levick MD

No abstract provided.

Implementing A Complete Perinatal Information System, Donald Levick

Donald Levick MD

No abstract provided.

Reducing Unnecessary Testing In A Cpoe System Through Implementation Of A Targeted Cds Intervention, Donald Levick Md, Glenn Stern, Chad D. Meyerhoefer, Aaron Levick, David Pucklavage Rn, Bsn, Cpm, Sme

Donald Levick MD, MBA, CPHIMS

No abstract provided.

Extending The Technology Acceptance Model In Healthcare: Identifying The Role Of Trust And Shared Information, Sabrina Terrizzi, Susan Sherer, Chad D. Meyerhoefer, Donald Levick Md, Michael Sheinberg Md

Donald Levick MD

We propose extensions to the Technology Acceptance Model for the adoption of integrated electronic health records that are shared by multiple health care providers. In particular, we propose a conceptual model in which we incorporate two new factors, trust and access to shared information, into the Technology Acceptance Model. Preliminary results confirm the statistically significant and positive impact of perceived usefulness on behavioral intent to use integrated electronic health records and a significant and positive impact of perceived ease of use on perceived usefulness. We also find a statistically significant effect of shared information on behavioral intent to use integrated …

Dr. Strangetech: Or How I Learned To Stop Worrying And Love Innovation, Donald Levick

Donald Levick MD

No abstract provided.