Medicine and Health Sciences Commons^™

Emr Templates For Age-Appropriate Well-Child Pediatric Visits, Alison Drerup, Kelsey Piper

Doctor of Nursing Practice Projects

The world of pediatric medicine is continually evolving. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) regularly update guidelines to have the most current information available to providers and their patients. The overwhelming majority of primary care offices have transitioned to electronic medical records (EMRs) for charting purposes. Templates included in EMRs ease the workflow and documentation process for providers. In the primary care setting, templates include essential information discussed at well-child visits, such as developmental milestones, vaccination schedules, and anticipatory guidance. The project’s purpose was to update the age-specific well-child templates at …

Assessment Of Organizational Readiness Towards Electronic Health Records In A Tertiary Care Hospital, Karachi, Pakistan, A Quantitative Analytical Cross-Sectional Study, Muhammad Javeed

Theses & Dissertations

Background: A medical error is one of the most preventable errors that occur frequently in hospitals, leading to millions of deaths yearly. Medical errors cost hospitals billions of dollars worldwide. Human error is also a common cause of medication errors, but this error is due to the failure of the system to detect errors. The electronic health record (EHR) is a complete set of computerized records of all information related to patient health that is used by one or more users in any care setting. This information includes demographic data of patients, patients’ progress notes, complaints and diagnoses, medications, vital …

Charting And Checking For Suicidality In A Family Medicine Residency Clinic, Bridget Murphy, Stacy Ogbeide

Journal of Human Services Scholarship and Interprofessional Collaboration

Suicide is a leading cause of death in the United States, and many individuals who die by suicide are likely to have seen a primary care physician (PCP) within the month of their death. Thus, the goal of this quality improvement (QI) project was to examine suicidality documentation practices of interprofessional clinicians within a Family Medicine residency clinic, thus providing rationale for continued research and a template for other clinics to emulate. The QI project used the Plan-Do-Study-Act cycle to survey 28 Family Medicine residents, faculty, and trainees for the Plan stage of the cycle in 2022 and assessed their …

Utilization Of A Simulation Electronic Documentation Model For Healthcare Providers To Reduce Documentation Errors In A Hospital Setting, Icy Moton-Hale

Doctor of Nursing Practice Projects

Background: Electronic health records (EHRs) are commonly used within healthcare systems across the United States. Although EHRs were developed to provide safe delivery of care, poor documentation quality remains a problem. Poor HER documentation can negatively affect many patients’ health outcomes.

Purpose: The purpose of the DNP project was to determine the degree to which using a simulated electronic documentation model to train nurses in an acute care unit would decrease documentation errors and missed care and decrease missed opportunities for patient education in EHRs.

Methods: The theoretical framework was underpinned by the Donabedian model, positing that factors associated with …

Ode To My Emr, Kelly T. Clouse

HCA Healthcare Journal of Medicine

Our EMRs should empower us, but unfortunately, they often bully and frustrate us. This poem is an expression of my frustration and disappointment with my own EMR. Creating it allowed me to channel my frustration and disappointment.

Implementing An Emr System In A Small Psychiatric Practice, Brandy Mccrudden

Doctor of Nursing Practice Projects

Electronic medical records (EMRs) can aid in improving surveillance, monitoring, adherence to practice guidelines, improving communication, and reducing medical errors. The adoption of EMRs in psychiatry and mental health settings has been slow despite the offered benefits. This project aimed to develop an implementation and training plan to successfully transition from paper charts to EMRs in a psychiatry practice. An extensive literature review was conducted on the adoption of EMRs in mental health settings, and a guideline for implementation was created to overcome identified barriers. Implementation guidelines included a planning phase, staff training plan, and rollout using a phase-in approach. …

Obesity Heterogeneity By Neighborhood Context In A Largely Latinx Sample, Ashley W. Kranjac, Dinko Kranjac, Zeev N. Kain, Louis Ehwerhemuepha, Brooke N. Jenkins

Sociology Faculty Articles and Research

Neighborhood socioeconomic context where Latinx children live may influence body weight status. Los Angeles County and Orange County of Southern California both are on the list of the top ten counties with the largest Latinx population in the USA. This heterogeneity allowed us to estimate differential impacts of neighborhood environment on children’s body mass index z-scores by race/ethnicity using novel methods and a rich data source. We geocoded pediatric electronic medical record data from a predominantly Latinx sample and characterized neighborhoods into unique residential contexts using latent profile modeling techniques. We estimated multilevel linear regression models that adjust for …

Prescribing Patterns Of Myopia Control Contact Lenses Among Optometrists In Ireland, Michael Moore, Daniel Ian Flitcroft, James Loughman

Articles

Purpose

This retrospective analysis of electronic medical record (EMR) data investigated the prescribing patterns of soft myopia control contact lens (MCCL) treatments since their introduction in Ireland in 2017.

Methods

Anonymised EMR data were sourced from 33 optometry practices in Ireland from 2017 to 2021 to determine the number of practices prescribing MCCLs to myopic children 5–18 years old. In MCCL-prescribing practices, the proportion of contact lens wearing children fitted with MCCLs and the proportion of progressive (≤−0.25 D/year) myopic children fitted with MCCLs were determined. Logistic regression was used to determine which factors influenced the likelihood of being prescribed …

Telehealth In Medicine: Predictions 2023–2024, Jiang Li, Ingrid Vasiliu-Feltes, Kathleen Mcgrow, Brendan F. Smith, Paul Barach, Sweta Sneha, Francis X. Campion

College of Population Health Faculty Papers

Each year, Telehealth and Medicine Today asks experts in the field to share their insights into the future and predict how telehealth will influence uptake and healthcare in the new year.

A Secure Emr Sharing System With Tamper Resistance And Expressive Access Control, Shengmin Xu, Jianting Ning, Yingjiu Li, Yinghui Zhang, Guowen Xu, Xinyi Huang, Robert H. Deng

Research Collection School Of Computing and Information Systems

To reduce the cost of human and material resources and improve the collaborations among medical systems, research laboratories and insurance companies for healthcare researches and commercial activities, electronic medical records (EMRs) have been proposed to shift from paperwork to friendly shareable electronic records. To take advantage of EMRs efficiently and reduce the cost of local storage, EMRs are usually outsourced to the remote cloud for sharing medical data with authorized users. However, cloud service providers are untrustworthy. In this paper, we propose an efficient, secure, and flexible EMR sharing system by introducing a novel cryptosystem called dual-policy revocable attribute-based encryption …

Using Electronic Medical Record Data To Establish And Monitor The Distribution Of Refractive Errors, Sean Longwill, Michael Moore, Daniel Ian Flitcroft, James Loughman

Articles

Objective

To establish the baseline distribution of refractive errors and associated factors amongst a population that attended primary care optometry clinics.

Design

Retrospective cross sectional cohort study of electronic medical records (EMR).

Methods

Electronic medical record data was extracted from forty optometry clinics, representing a mix of urban and rural areas in Ireland. The analysis was confined to demographic and clinical data gathered over a sixty-month period between 2015 and 2019. Distribution rates were calculated using the absolute and relative frequencies of refractive error in the dataset, stratified for age and gender using the following definitions: high myopia ≤ -6.00 …

Diabetes-Related Bias In Electronic Health Records And International Classification Of Diseases., Mihail Zilbermint

Journal of Community Hospital Internal Medicine Perspectives

Diabetes mellitus is a chronic health condition that affects the body's ability to convert food into energy. People living with diabetes, as well as doctors and hospitals, struggle to handle the challenge. Among these challenges is that the field of diabetology is filled with bias. People living with diabetes will say that “diabetes does not define them,” yet they often refer to themselves as “diabetics.” Doctors are frequently “trained” to call people “diabetics,” and I am one of them. Psychological consequences associated with diabetes and obesity bias and stigma have been previously reported studied. People with diabetes may experience stigma …

Sex Differences In The Clinical Presentation Of Early Psychosis In A Primary Care Setting, Brooke Carter

Electronic Thesis and Dissertation Repository

Psychotic disorders can be variable in clinical presentation, and there may be differences by sex. The objective of this thesis was to explore sex differences in the clinical presentation of early psychosis in the context of primary care. Our systematic review and meta-analysis found that men experienced more negative symptoms and had a higher prevalence of substance use issues, whereas women experienced more depressive symptoms and had higher functioning. Our electronic medical record analysis from primary care found that positive symptoms and substance use were less prevalent in the medical records of women. We also found that visits by women …

Big Data Analysis Of Vision Screening Standards Used To Evaluate Fitness To Drive, Michael Moore, John Butler, Daniel Ian Flitcroft, James Loughman

Articles

Purpose: Visual acuity (VA) assessment is the most commonly performed vision screening method for drivers. The standards and repeat assessment intervals used, however, are arbitrary, lack an evidence base and are highly variable across different countries. This study utilizes the power of Big Data to provide evidence-based recommendations for standardized driver vision screening.

Methods: Anonymized electronic medical record data were gathered from 40 Irish optometry practices comprising 81,184 unique patients. A Kaplan-Meier Survival (KMS) analysis was used to determine the effect of increasing age and time since screening on the likelihood of passing the VA standard for driving. A logistic …

Association Of Electronic Medical Records And Opioid Prescription, Archana Suwal, Jemimah Okonjo, Stacie Deslich, Alberto Coustasse

Management Faculty Research

A Prescription Drug Monitoring Program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate an agile and directed response. Electronic Prescribing for Controlled Substances (EPCS) aimed to eliminate paper prescriptions by allowing clinical prescribers to write prescriptions electronically, making them digital and trackable for both the prescriber and the pharmacist and has been an essential part of any health information technology system, as well as a requirement for 'meaningful use' (Blumenthal & Tavenner, 2010). However, one of …

Educational Intervention With Visual Cues To Increase Compliance With Postoperative Warming, Michael J. Domingo

Doctoral Projects

Millions of operations are performed annually in the United States. However, postoperative hypothermia still affects surgical patients who are not thermoregulated and can occur among them during the postoperative period. Postoperative warming compliance rates across countries and institutions are generally poor (Koh et. al, 2021). Therefore, the focus of the DNP project was to assess how providing education on postoperative warming and providing visual cues to the PACU RNs would increase postoperative warming compliance. The PACU RN participants were provided postoperative warming education with visual cues. Specifically reviewed with the PACU RNs was taking the patient’s temperature, connecting the patient …

Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott

Walden Dissertations and Doctoral Studies

Despite the 2009 mandate from the U.S. Government that healthcare organizations adopt and implement electronic medical records (EMR) systems to avoid fines and take advantage of the benefits EMR systems provide, adoption of EMR systems in the United States has been low. Since 2011, medical facilities have received incentive payments if they demonstrated “meaningful use” of certified EMR systems; however, medical facilities unable to demonstrate meaningful use beginning in 2015 have faced up to 5% penalties. Grounded in the diffusion of innovation theory, the purpose of this qualitative single case study was to explore strategies that hospital project managers use …

Estimating Weighted Panel Sizes For Primary Care Providers: An Assessment Of Clustering And Novel Methods Of Panel Size Estimation On Electronic Medical Records, Martin A. Lavallee

Theses and Dissertations

Primary Care is on the frontlines of healthcare, thus they see the most diverse set of patients. In order to achieve high functioning primary care, a practice must establish empanelment, the pairing of patients to providers. Enumeration of empanelment, or estimating panel sizes, helps ensure that the demands of the patients demand the supply of providers and optimize the balance of primary care resources to improve quality of care. Further we can adjust panel sizes by using patient-level data on healthcare utilization and complexity extracted from the electronic medial record to determine the amount of care or burden of work …

Implementation Of A Teaching Electronic Medical Record Within Didactic Instruction Using A Drug Information Question Assignment., Jacqueline Wasynczuk, Amy H Sheehan

College of Pharmacy Faculty Papers

BACKGROUND: Pharmacy graduates are expected to be practice-ready to deliver quality patient care, which includes having comprehensive knowledge of health informatics and electronic medical records (EMRs). The purpose of this study was to (1) incorporate an EMR within a pharmacy student assignment, and (2) assess student perceptions of use of the EMR.

METHODS: Student pharmacists received a patient-specific drug-related question and were required to use an EMR to provide an accurate response. Following completion of the assignment, students were invited to complete a retrospective, pre-post survey instrument to collect their perceptions.

RESULTS: Only 28.8% of respondents reported prior experience using …

Impact Of Patient Load On The Quality Of Electronic Medical Record Documentation, Aasems Jacob, Rishi Raj, Sayee Alagusundaramoorthy, Jing Wei, Jianrong Wu, Margaret Eng

Internal Medicine Faculty Publications

Objective:

American College of Graduate Medical Education (ACGME) recommends ongoing care of 10 patients per resident however its implication is unclear. We hypothesized EMR quality to vary based on patient load and call status.

Methods:

We conducted a double-blind, single-center, retrospective observational study between 2017 and 2019 to investigate the quality and accuracy of resident documentation using the Responsible Electronic Documentation (RED) Checklist, a validated scoring system.

Results:

A total of 234 independent charts were analyzed and 80 met scoring criteria. Average patients per residents was 4, 9.1, 7.2, and 5.5 on “call” day (D0), “post-call” day (D1), “mid-call” day …

Application Of Big-Data For Epidemiological Studies Of Refractive Error, Michael Moore, James Loughman, John Butler, Arne Ohlendorf, Siegfried Wahl, Daniel Ian Flitcroft

Articles

Purpose

To examine whether data sourced from electronic medical records (EMR) and a large industrial spectacle lens manufacturing database can estimate refractive error distribution within large populations as an alternative to typical population surveys of refractive error.

Subjects

A total of 555,528 patient visits from 28 Irish primary care optometry practices between the years 1980 and 2019 and 141,547,436 spectacle lens sales records from an international European lens manufacturer between the years 1998 and 2016.

Methods

Anonymized EMR data included demographic, refractive and visual acuity values. Anonymized spectacle lens data included refractive data. Spectacle lens data was separated into lenses …

A Systematic Approach To Big Data Analysis In Cataract Patients In Telangana State, India, Amna Alalawi

Full-Text Theses & Dissertations

Big data is the new gold, especially in healthcare. Advances in collecting and processing Electronic Medical Records (EMRs), coupled with increasing computer capabilities have resulted in an increased interest in the use of big data in healthcare. Big data require collection and analysis of data at an unprecedented scale and represents a paradigm shift in healthcare, offering on one hand the capacity to generate new knowledge more quickly than traditional scientific approaches, and, on the other hand, a holistic understanding of specific illnesses when socio-demographics are incorporated in the analysis. Big data promises more personalized and precision medicine for patients …

The Search For Optimal Oxygen Saturation Targets In Critically Ill: Patients Observational Data From Large Icu Databases, Willem Van Den Boom, Michael Hoy, Jagadish Sankaran, Mengru Liu, Haroun Chahed, Mengling Feng, Kay Choong See

Research Collection School Of Computing and Information Systems

Background: Although low oxygen saturations are generally regarded as deleterious, recent studies in ICU patients have shown that a liberal oxygen strategy increases mortality. However, the optimal oxygen saturation target remains unclear. The goal of this study was to determine the optimal range by using real-world data. Methods: Replicate retrospective analyses were conducted of two electronic medical record databases: the eICU Collaborative Research Database (eICU-CRD) and the Medical Information Mart for Intensive Care III database (MIMIC). Only patients with at least 48 h of oxygen therapy were included. Nonlinear regression was used to analyze the association between median pulse oximetry-derived …

Improving The Ethical Use Of E-Health And Emr, Josephine Tafie

Walden Dissertations and Doctoral Studies

Improving the Ethical Use of E-health and EMR

by

Josephine Tafie

MS, Walden University

BS, Washington Adventist University

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2020

Abstract

The healthcare industry is experiencing ethical problems with the integration of new technological applications, such as e-health and electronic medical records (EMRs) in service delivery. Thus, the purpose of this capstone project was to conduct a systematic literature review to determine the best practices that are well suited to a large urban hospital, to ensure patients’ privacy with the continued use …

Systemic Risk Management Plan For Electronic Medical Records (Emr): Why And How?, Ziniya Zahedi, Faisal Mahmud, Cesar Pinto

Engineering Management & Systems Engineering Faculty Publications

Electronic patient data use and handling are critical issues in terms of privacy, confidentiality, security, and the Health Insurance Portability and Accountability Act (HIPAA) regulations. The risks associated with electronic patient data are not limited to identity theft but rather include a person’s social, economic, and psychological well-being. However, there have not been many studies that have focused on the associated risk factors that could lead to these situations. This paper identifies those risks related to electronic patient data breaches by means of a grounded theory approach and develops a systemic risk management plan that enables engineering managers and risk …

Prognostic Predictive Model To Estimate The Risk Of Multiple Chronic Diseases: Constructing Copulas Using Electronic Medical Record Data, Jason E. Black

Electronic Thesis and Dissertation Repository

Introduction: Multimorbidity, the presence of two or more chronic diseases in an individual, is a pressing medical condition. Novel prevention methods are required to reduce the incidence of multimorbidity. Prognostic predictive models estimate a patient’s risk of developing chronic disease. This thesis developed a single predictive model for three diseases associated with multimorbidity: diabetes, hypertension, and osteoarthritis.

Methods: Univariate logistic regression models were constructed, followed by an analysis of the dependence that existed using copulas. All analyses were based on data from the Canadian Primary Care Sentinel Surveillance Network.

Results: All univariate models were highly predictive, as demonstrated by their …

The Effects Of Office-Based Interventions To Increase Patient Enrollment In An Online Electronic Medical Record Portal, Lionel Mcintosh, Md, Allison Rague, Md, Claire Thesing, Md, Amy Lachewitz, Md, Gillian Love, Md, Daniel Sizemore, Md, Zachary Klock, Md, Aimee Mcmullin, Md, Zeynep Uzumcu, Md, Patrick Mcmanus, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

We aimed to increase the number of JFMA patients signed up with MyChart by 50% over a 5 month time frame by educating providers and staff on ways to implement patient portal sign up into the office visit as well raising awareness of the portal for both providers and patients

Research Agenda In Developing Core Reference Ontology For Human Intelligence/Machine-Intelligence Electronic Medical Records System, Ziniya Zahedi, Teddy Steven Cotter

Engineering Management & Systems Engineering Faculty Publications

Beginning around 1990, efforts were initiated in the medical profession by the U.S. government to transition from paper based medical records to electronic medical records (EMR). By the late 1990s, EMR implementation had already encountered multiple barriers and failures. Then President Bush set forth the goal of implementing electronic health records (EHRs), nationwide within ten years. Again, progress toward EMR implementation was not realized. President Obama put new emphasis on promoting EMR and health care technology. The renewed emphasis did not overcome many of the original problems and induced new failures. Retrospective analyses suggest that failures were induced because programmers …

Multimorbidity Among Adult Primary Health Care Patients In Canada: Examining Multiple Chronic Diseases Using An Electronic Medical Record Database, Kathryn Nicholson

Electronic Thesis and Dissertation Repository

Introduction: The coexistence of multiple chronic diseases within an individual, also known as multimorbidity, is an ongoing challenge for patients, caregivers and primary health care (PHC) providers. An enhanced understanding of the burden of multimorbidity in Canada is needed.

Objectives: This research had two main objectives. Objective One aimed to understand the prevalence of multimorbidity among adult PHC patients, as well as the patterns of unordered and ordered clusters of multiple chronic diseases. Objective Two aimed to determine the natural progression of multimorbidity over time, as well as the patient-, provider- and practice-level predictors of progressing into more complex clinical …

Managing Diabetic A1c At A Primary Care Center: A Nurse Practitioner Perspective, Jacqueline Mcdonald

Student Theses, Dissertations and Capstones

Background: At a primary care center in Brooklyn, New York, approximately 27% of diabetic patients with abnormal Hgb A1C fail to return for follow-up appointments, as recommended by the Centers for Disease Control and Prevention (CDC). According to electronic medical records (EMR), healthcare providers demonstrated inconsistency in ordering and monitoring Hgb A1C and clinic follow-up appointments for patients.

Purpose: The purpose of this quality improvement project was to determine retrospectively the healthcare providers’ ordering, monitoring, and follow-up appointments for adult diabetic patients with abnormal Hgb A1Cs; to develop and implement astandardized process for healthcare providers to monitor and follow these …