Biomedical Informatics Commons^™

Modification Of Epic System’S Simple Visit Coding (Svc) Evaluation Rule To Reduce Medical Claim Denials, Edith Ballard

Translational Projects (Open Access)

Background: The recruitment, development, and retention of skilled medical coding staff has become increasingly challenging for healthcare providers. To alleviate staffing burdens, Epic Systems’ electronic health record (EHR) introduced the Simple Visit Coding (SVC) work queue, designed to evaluate hospital patient encounters and automatically assign International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes. However, the current SVC work queue evaluation rule at a prominent academic Oncology Care Organization (OCO) in the South does not utilize autonomous, generative, or computer-assisted coding (CAC) technologies. The work queue evaluation rule uses a simple rule-based program logic that relies on …

Enhancing Coagulase-Negative Staphylococcus Interpretation: Leveraging Data Visualization To Improve Diagnostic Accuracy And Patient Outcomes, Miriam Booker Barrett

Translational Projects (Open Access)

When implemented effectively, data displays can enhance interpretive decisions by helping physicians recognize patterns and relationships within various datasets. Data visualization has been widely studied for its role in converting raw data into actionable insights and supporting data-driven decision-making. However, few studies have been published that specifically explored using data displays to aid in interpreting coagulasenegative Staphylococcus (CoNS) in blood cultures.

One of the primary challenges infectious disease physicians face when interpreting CoNS in blood cultures is the disorganized nature of clinical data within electronic health records. The information necessary for accurate interpretation is often scattered across various sections of …

Translating The Hba1c Lab Test Name And Results From English To Arabic For Enhanced Patient Access And Workflow Efficiency, Aiman M. Alrawabdeh

Translational Projects (Open Access)

In Jordan, where the healthcare system primarily operates in English, Arabic-speaking patients encounter significant challenges in understanding laboratory test names and results, including Hemoglobin A1c (HbA1c), an essential diagnostic indicator for diabetes management. The lack of multilingual access to medical information limits health literacy and patient autonomy, increasing dependence on healthcare staff for translation assistance. This translational informatics project addressed these challenges by developing and implementing an Arabic translation process for the HbA1c lab test name and results. HbA1c was selected as it is a standard lab test among patients with diabetes in Jordan; nearly 30% of Jordanians had type …

Improving The Oral Pathology Referral Process In An Academic Dental Institution, Gregory Olson

Translational Projects (Open Access)

Introduction: Inefficiencies in the oral cancer referral process pose serious risks, including delayed diagnoses and poor patient outcomes. This project aimed to improve the reliability and efficiency of referrals between dental students and oral pathology residents for patients with suspected oral cancer. Although early detection is widely acknowledged as critical, significant process breakdowns were identified, including the absence of a standardized workflow, inconsistent follow-up practices, and a lack of accountability and tracking mechanisms. As a result, approximately half of the patients recommended for biopsy did not undergo the procedure, leading to delayed diagnoses and potentially worse prognoses.

Methodology: …

An Interoperability Framework Across Legacy Emr Systems, Sheena Rogers

Translational Projects (Open Access)

The 21st Century Cures Act (H.R.34 – 114th Congress, 2016) specifies that patients and authorized providers must be able to receive copies of their medical records with standard medical history details upon request. While the data archival system, DRIS (Data Retention Interoperability Solution), has comprehensive patient summary reports centralizing over 100 legacy electronic health records (EHR) with broad data elements, it is not 100% compliant with the upcoming 21st Century Cures Act’s interoperability standards. As a result, patients and providers are not receiving copies of their medical records with all of the required medical history and fields in this new …

Implementing A New Clinical Note Template To Reduce Documentation Burden At A Pediatric Organization, Nikki Blaze

Translational Projects (Open Access)

Clinical notes of a patient’s visit to a healthcare provider are necessary for patient care, reimbursement, and regulatory compliance with federal and state laws. Over time, non-standardized processes within the EHR have led to the increasing use of copy-paste to complete clinical notes, leading to irrelevant information being captured in the notes. Sinsky et al. (2020) shared that 49% of physicians' time is spent within the EHR, completing their documentation, placing orders, and reviewing the patient's chart. The documentation requirements for billing and coding created tension as clinicians sought ways to reduce the documentation burden. To reduce the documentation burden …

Improving Data Accuracy, Completeness, And Efficiency In The Pediatric Congenital Heart Surgery Registry, Kelly Brown

Translational Projects (Open Access)

Clinical patient registries, such as the pediatric congenital heart surgery registry, are designed to collect large amounts of varied clinical, administrative, and demographic data on specific patient populations. Data from these registries are used for multiple purposes, such as reporting, national benchmarking, research, quality improvement activities, and accreditation. Therefore, organizations must have accurate, complete, and timely data to meet these demands. However, manual data abstraction is the predominant method for populating a clinical patient registry. This method utilizes paid data abstractors, clinicians, and administrative staff and can be inefficient, incomplete, inaccurate, and costly.

The aim of this project was to …

Operationalizing The Datagauge Framework In A Health Information Exchange Utilizing Hepatitis C Data, Edward Yao

Translational Projects (Open Access)

This project aims to implement the DataGauge framework in a health information exchange (HIE) setting as a proof of concept. The modified DataGauge framework, described by Diaz-Garelli et al. (2019), is utilized to test its functionality and applicability with any dataset. The specific objective of the project is to determine the number of hepatitis C-positive tests within the HIE. The implementation involved multiple iterations following the DataGauge framework's steps for data extraction and analysis. Five iterations were conducted, resulting in both successful and failed queries based on the validity of the data standards. The findings revealed that the HIE, in …

Exploring The Use Of Bidirectional Text Messaging Reminders To Increase Colorectal Cancer Screening Rates In Patients Prescribed Cologuard®, James Harris

Translational Projects (Open Access)

Meaningfully engaging with patients through technology is becoming increasingly important in healthcare. Mailed letters, phone calls, and even one-way text messaging or some combination of these have all been utilized to communicate with patients regarding preventative healthcare screening measures, with varying degrees of success. While many studies have examined the use of bidirectional text messaging (BTM) to engage patients regarding mammograms, cervical cancer screening, and other issues, very little literature exists on BTM concerning colorectal cancer (CRC).

Therefore, this project sought to examine the impact of BTM between two primary care clinics and their respective patients who were prescribed and …

Virtual Patient/Family Communication In The Acute Care Setting, Kathleen Defigueiredo

Translational Projects (Open Access)

Patient and family-centered care strategies see patients and families as valuable healthcare team members. Such strategies thus treat these groups as essential clinical partners in providing safe, high-quality care. Participation, collaboration, and shared decision-making are central to this framework. Historically, hospitals have relied on physical presence at the bedside as a prerequisite to engaging families in the shared decision-making process. Visitor restrictions of the COVID-19 pandemic removed the primary strategy for family participation: physical presence. Healthcare organizations rapidly deployed mobile devices to help minimize the exposure of healthcare providers and provide video visits for family members. This deployment was often …

Implementation Of Telemedicine To Reduce No-Show Rates, Peter Kizza

Translational Projects (Open Access)

Missed appointments, or no-shows, are defined as “patients who neither kept nor canceled scheduled appointments” (Dayal, 2019, p.27). Missed appointments cost the United States healthcare system more than $150 billion annually. They disrupt the continuity of healthcare services, add to patients' dissatisfaction due to delays in getting new appointments, and hinder the detection and treatment of disease. The rates of missed appointments vary between countries and healthcare systems. Studies conducted previously in primary care settings found that the rate of missed appointments ranged from 5%–55% in different series in the United States. One study suggested that missed appointments are likely …

Implementing Clinical Decision Support Aimed At Reducing Co-Prescribing Of Opioids And Benzodiazepines At Adventist Healthcare Maryland, Monica Coley

Translational Projects (Open Access)

Clinical Decision Support (CDS) leverages computerized toolsets to provide condition specific guidance that aids providers in clinical decision making processes (AHRQ, 2019; AMIA, n.d.; ONC, 2018). Research has shown that applying CDS, interruptive within the electronic health record (EHR) prescribing workflow, can assist providers with avoiding unsafe medication prescribing, such as 1) multiple opioids and 2) opioid-benzodiazepine combinations (Malte et al., 2018; Smith et al., 2019, Price-Haywood et al., 2020; Nelson et al., 2022). In an effort to decrease the co-prescribing rate for 1) multiple opioids and 2) opioid-benzodiazepine combinations, Adventist HealthCare Maryland (AHC) launched a performance improvement project in …

Usability And Technology Acceptance Of An Electronic Child Abuse Screening Tool In A Pediatric Emergency Department, Angela Hayes

Translational Projects (Open Access)

Up to half of all child physical abuse victims with major abuse injuries seen in hospitals had sentinel injuries assessed by medical providers. Universal screening for child abuse and neglect in the emergency department can potentially increase detection at lower levels of injury. However, we must consider usability for the electronic health record embedded child abuse and neglect-screening tool to be most effective. The user most likely to interact with the screening tool is the bedside nurse. The interface of the initial screening tool and the process of inputting information must be perceived as useful, usable, and satisfying to the …

Visualization Literacy And Decision-Making In Healthcare, Stacy Weil

Translational Projects (Open Access)

The ability of workers in the healthcare industry to analyze, interpret and communicate with health data is critical to decision-making and impacts both health and business outcomes. Optimal decision-making requires having real-time access to information that provides useful insights and that lends itself to collaborative decision-making. Data visualizations have the potential to facilitate decision-making in healthcare when presented as a dashboard. However, dashboards have shown varying results in both effectiveness and adoption. Data or graphical literacy challenges experienced by health team members could complicate strategic decision-making through an inability to correctly interpret or summarize the information presented in a dashboard. …

Evaluation, Validation & Implementation Of A Computerized Diagnostic Decision Support System In Primary Practice, Joe Bridges

Translational Projects (Open Access)

Background: Medical diagnosis may be the most complex task attempted by humans. Studies estimate that 95% of diagnoses in outpatient care are accurate, implying that the annual rate of inaccurate diagnoses is 12 million in the US alone, with the potential for patient harm in about half. A well-researched differential might reduce inaccurate diagnoses by offering alternatives matching the patient’s symptoms. This study searched the literature for articles evaluating the diagnostic performance of commercially available computerized diagnostic decision support systems. This search led to selecting Isabel Pro, developed by Isabel Healthcare, Ltd. of Haslemere, UK.

Evaluation and Validation: …