Medicine and Health Sciences Commons^™

Infusing Machine Learning And Computational Linguistics Into Clinical Notes, Funke V. Alabi, Onyeka Omose, Omotomilola Jegede

Mathematics & Statistics Faculty Publications

Entering free-form text notes into Electronic Health Records (EHR) systems takes a lot of time from clinicians. A large portion of this paper work is viewed as a burden, which cuts into the amount of time doctors spend with patients and increases the risk of burnout. We will see how machine learning and computational linguistics can be infused in the processing of taking clinical notes. We are presenting a new language modeling task that predicts the content of notes conditioned on historical data from a patient's medical record, such as patient demographics, lab results, medications, and previous notes, with the …

Benchmark Study: Impact Of Electronic Health Records Vs. Paper-Based Records, Erin Emmerich

MSN Capstone Projects

Medical documentation is an essential part of healthcare and conducted at the highest standard; documentation ensures the delivery of safe and high-quality healthcare services (Noureldin et al., 2014). Performance Improvement team reports the same poor outcomes each quarter that may be a result of the paper-based documentation system. These outcomes include patient safety, patient satisfaction and cost-effectiveness. This narrative review’s purpose is to determine whether the implementation of an electronic health record (EHR) system could improve outcomes. Evidence-based guidelines for the implementation of an EHR need special consideration to have a successful transition. Further studies may need to be reviewed …

Leveraging Clinical Digitized Data To Understand Temporal Characteristics And Outcomes Of Acute Myocardial Infarctions At A Tertiary Care Medical Centre In Pakistan From 1988-2018 - Methods And Results, Zainab Samad, Ali Aahil Noorali, Awais Farhad, Safia Awan, Nada Qaiser Qureshi, Mushyada Ali, Laiba Masood, Ghurfan Adnan, Zulfiqar Ahmed Bhutta, Javed Tai

Section of Cardiology

Background and objective: Few data exist on trends in acute myocardial infarction (AMI) patterns spanning recent epidemiological shifts in low middle-income countries (LMICs). To understand temporal disease patterns of AMI characteristics and outcomes between 1988-2018, we used digitized legacy clinical data at a large tertiary care centre in Pakistan.
Methods: We reviewed digital health information capture systems maintained across the Aga Khan University Hospital and obtained structured elements to create a master dataset. We included index admissions of patients >18 years that were discharged between January 1, 1988, and December 31, 2018, with a primary discharge diagnosis of AMI (using …

Initial Steps For Integrating Academic Electronic Health Records Into Clinical Curricula Of Physical And Occupational Therapy In The United States: A Survey-Based Observational Study, Stephen C. Burrows, Lola Halperin, Eric C. Nemec, Wendy Romney

Healthcare Informatics Faculty Publications

Training programs must be designed to prepare physical and occupational therapy students for using Electronic Health Records (EHR) and interprofessional collaboration. This report aims to describe physical and occupational therapy students' perceptions of integrating Academic EHR in their Problem-Based Learning (PBL) curricula in the College of Health Professions, Sacred Heart University, Fairfield, Connecticut, the United States. A paper-based case approach to PBL was adapted by creating patient cases in an Academic EHR (AEHR). Students were asked to complete chart reviews and review provider notes to enhance their learning. An online survey was conducted to determine their perceptions of using AEHR …

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Understanding Subscription-Based Automated Electronic Notification Usage In Hospitals: A Qualitative Study, William J.K. Vervilles, Benjamin Slovis, Md, Ma, Jeffrey Riggio, Md

Phase 1

Introduction: The potential exists for patient harm when clinicians do not respond to clinical results in a timely manner. Much of the research on asynchronous electronic notifications (pager, cellphone or wearable devices) comes from home-grown electronic health records (EHR). Little is known about factors influencing notifications from vendor-based EHRs and the effect of subscription-based notifications, where providers select which results for notification. This study investigates what factors influence a clinician’s decision to order result notifications, the perceived role of these notifications in the clinical setting, and ways to improve notifications in a vendor-based EHR.

Methods: We queried the EHR to …

Electronic Health Records: All That They’Re Chalked Up To Be?, Mac Williams, Meghan Gannon, Phd

Phase 1

Introduction. The United States faces a challenge: how to improve access to healthcare with an aging physician workforce. An aging baby boomer population prompts higher medical demands, further heightening this challenge. Although measures to increase the longevity of practice for older physicians could help address this challenge, the federal government has lacked to create such policy.

Methods. This study looked at the role of electronic health records and the American Recovery and Reinvestment Act in the ability of primary care physicians to continue practice through in-depth qualitative interviews. A total of N=5 interviews were conducted in-person and remotely using a …

How Barriers To Using The Electronic Health Record Effects Behavioral Healthcare, Jennifer Woodard

Applied Research Projects

The healthcare scene is rapidly changing due to the introduction of the electronic health record (EHR) and advances in technology. This means more patient data is readily available for use and gives physicians and patients’ faster access to that data. With the passing of recent legislature such as the Health Information Technology for Economic and Clinical Health Act and the American Recovery and Reinvestment Act of 2009, resulting in the rapid adoption of electronic health records due to incentive payment programs. With this comes the push for use of the electronic health record to prepare for Meaningful Use and improved …

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 …

Examining Success In Health Information Technology Implementation Research, Madison Ngafeeson

Conference Presentations

The implementation of health information systems (IS) is rapidly increasing. In the United States, $70 billion will be invested by the government to facilitate the adoption of the electronic health record over a ten-year period. However, IS acceptance is not success. We use content analysis to investigate the success component.

An Exploratory Study Of User Resistance In Healthcare It, Madison Ngafeeson, Vishal Midha

Journal Articles

The US healthcare system is clearly experiencing a major transition. By 2015, the healthcare sector is expected to have migrated from a paper record system to a completely electronic health record (EHR) system. The adoption and use of these systems are expected to increase legibility, reduce costs, limit medical errors and improve the overall quality of healthcare. Hence, the US government is investing $70 billion over a 10-year period to facilitate the transition to an electronic system. However, early reports show that physicians and nurses among other health professionals continue to resist the full use of the system. This paper …

Electronic Health Record (Ehr) Adoption: Failure Or Success?, Madison Ngafeeson

Conference Presentations

Electronic Health Record (EHR) is hailed as a health information technology with great potential to significantly boost healthcare outcomes, reduce medical errors, increase legibility and minimize healthcare costs. The implementation of EHRs is expected to be completely mandatory in the United States by 2015. While evidence of EHR system implementation in research goes back over fifteen years ago, and is continually increasingly being adopted, it would seem be a good time to pause and take critical look down the years. Can it be said that EHR implementation has been a success, or, perhaps a failure? This study explores the subject …

Healthcare Information Systems: Opportunities And Challenges, Madison Ngafeeson

Book Sections/Chapters

No abstract provided.

Recognizing Patient Safety Importance Through Instrument Validation On Physicians' Assessment Of An Ehr, Cherie Notebloom, Kathryn Dempsey Cooper

Interdisciplinary Informatics Faculty Proceedings & Presentations

Patient safety and high quality patient care are critical concerns for healthcare providers. The Institute of Medicine report suggests medical errors account for up to 98,000 patient deaths each year. Therefore, the US healthcare system is looking to information technology applications as one means of making patient care safer. This paper compares the psychometric properties of the Electronic Health Record Nurse Satisfaction instrument (based on the Health Information Technology Research-based Evaluation Framework) to our study that employed the same instrument but measured clinical physicians' opinions of an EHR to determine if the instrument could be used across domains of users. …

Technical Desiderata For The Integration Of Genomic Data Into Electronic Health Records., Daniel R Masys, Gail P Jarvik, Neil F Abernethy, Nicholas R Anderson, George J Papanicolaou, Dina N Paltoo, Mark A Hoffman, Isaac S Kohane, Howard P Levy

Manuscripts, Articles, Book Chapters and Other Papers

The era of "Personalized Medicine," guided by individual molecular variation in DNA, RNA, expressed proteins and other forms of high volume molecular data brings new requirements and challenges to the design and implementation of Electronic Health Records (EHRs). In this article we describe the characteristics of biomolecular data that differentiate it from other classes of data commonly found in EHRs, enumerate a set of technical desiderata for its management in healthcare settings, and offer a candidate technical approach to its compact and efficient representation in operational systems.

Ehrs Connect Research And Practice: Where Predictive Modeling, Artificial Intelligence, And Clinical Decision Support Intersect, Casey C. Bennett, Thomas W. Doub, Rebecca Selove

Center for Prevention Research Publications

Objectives

Electronic health records (EHRs) are only a first step in capturing and utilizing health-related data—the challenge is turning that data into useful information. Furthermore, EHRs are increasingly likely to include data relating to patient outcomes, functionality such as clinical decision support, and genetic information as well, and, as such, can be seen as repositories of increasingly valuable information about patients’ health conditions and responses to treatment over time.

Methods

We describe a case study of 423 patients treated by Centerstone within Tennessee and Indiana in which we utilized electronic health record data to generate predictive algorithms of individual patient …

Trust In Government And Support For Governmental Regulation: The Case Of Electronic Health Records, Mitchel Herian, Nancy C. Shank, Tarik Abdel-Monem

University of Nebraska Public Policy Center: Publications

Background — This paper presents results from a public engagement effort in Nebraska, USA, which measured public opinions about governmental involvement in encouraging the use of electronic health records (EHRs).

Objective — We examine the role of trust in government in contributing to public support for government involvement in the development of EHR technologies. We hypothesize that trust in government will lead to support for federal and state governmental encouragement of the use of EHRs among doctors and insurance companies. Further, because individual experiences with health-care professionals will reduce perceptions of risk, we expect that support for governmental involvement will …

The Genome-Enabled Electronic Medical Record., M A Hoffman

Manuscripts, Articles, Book Chapters and Other Papers

The integration of patient-specific genomic information into the electronic medical record (EMR) will create many opportunities to improve patient care. Key to the successful incorporation of genomic information into the EMR will be the development of laboratory information systems capable of appropriately formatting molecular diagnostic and cytogenetic findings in the EMR. Due to the lack of granular genomics-related content in existing medical vocabularies, the adoption of new standards for describing clinically significant genomic information will be an important step toward recognizing the genome-enabled EMR. Appropriate capture of patient-specific genomic results in the EMR will generate new opportunities to utilize this …