Health Information Technology Commons^™

False-Negative Sars-Cov-2 Reverse Transcriptase Polymerase Chain Reaction (Rt-Pcr) Is An Important Consideration For Patient Management And Infection Prevention: A Case Report From The Louisville Covid-19 Epidemiology Study, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Clayton J. Patross, Bryan Denham, Paul Schulz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

We report a case of false-negative SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) on a nasopharyngeal swab. Treating clinicians and infection preventionists should maintain a high suspicion for COVID-19 in the appropriate clinical setting despite negative test results. Utilization of chest computed tomography (CT) should be strongly considered in the diagnostic work-up for suspected COVID-19, particularly in areas with limited RT-PCR availability.

Concomitant Invasive Pneumococcal Disease In A Patient With Covid-19 – A Case Report From The Louisville Epidemiology Study, Clayton J. Patross, Brian C. Bohn Pharmd, Sarah E. Moore Pharmd, Paul Schulz, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A 60-year-old male presented to the emergency department (ED) with a 1–2 day history of confusion, headache, and subjective fever. Because he had met with a contact two days prior to admission who had recently traveled from the Bahamas, a COVID-19 nasopharyngeal (NP) and oropharyngeal (OP) polymerase chain reaction (PCR) test was ordered. He was diagnosed with bacterial meningitis based on presenting neurologic symptoms and the identification of Streptococcus pneumoniae from blood cultures. The COVID-19 NP and OP test returned positive, although he never developed shortness of breath, cough, other respiratory symptoms, diarrhea, abdominal pain, nausea, vomiting, or any change …

Assessing Mobile Phone Access, Usage, And Willingness Among Women To Receive Voice Message-Based Mobile Health Intervention To Improve Antenatal Care Attendance In District Thatta, Sindh, Pakistan, Anam Shahil Feroz, Naureen Akber Ali, Sarah Saleem

Community Health Sciences

Background: Pakistan has one of the highest maternal mortality ratios worldwide at 276/100,000 live births and only 51% percent of women receive four or more ANC visits. This means that there are missed opportunities for almost half of the women who were not able to seek the recommended antenatal visits. In Thatta district, the maternal mortality ratio is estimated at 313/100,000 live births. Various studies reported that mHealth interventions have proven to be effective to improve antenatal care and postnatal care services. However, the feasibility and effectiveness of mobile health interventions to increase uptake of preventive maternal healthcare services among …

Strengthening The Evidence Base For Telehealth For Abortion Service Delivery, Nadi Kaonga

Journal of Maine Medical Center

Telehealth – which is the use of information and communication technology to provide clinical services to patients remotely – provides an opportunity to extend safe abortion services to women. A recent review article on telehealth for abortion service delivery found it to be acceptable, feasible and safe when compared to in-person service delivery. Despite the promising findings, the evidence base can and should be strengthened to optimize the impact of such services for women. Areas for improvement include evaluating the efficacy and effectiveness of telehealth implementations in more remote settings and with women across variable levels of technoliteracy, conducting cost-effectiveness …

Workshop #5: Workforce: Evacuations, Shelter Staffing, Workforce Structure, Capacity, Ppe, And Telemedicine: After-Action Report (Aar), Converge Nsf Working Group, Joshua G. Behr, Wie Yusuf, Jennifer Marshall, Elizabeth Dunn

Presentations, Lectures, Posters, Reports

Participants in the breakout sessions for the CONVERGE COVID-19 Working Group’s Workshop 5 (Workforce) identified several issues, including unique staffing challenges for this compound event, needed training revisions to address shelter protocols specific to COVID-19, additional staffing needs based on the unusual use of congregate and non-congregate shelters to address COVID-19 risks, and the increased need for ancillary services for staff and volunteers during and after an event.

Ensuring shelter operations are maintained despite COVID-19 will require adequate staffing. Layoffs, furloughs and hiring freezes have affected base employee numbers, where many jurisdictions rely on county and city employees, along with …

Stroke Management In The Time Of Covid, Marwa Elnazeir, Siddharth Narayanan, Kerri Remmel

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Covid-19 Radiological Library, Forest W. Arnold, Tracy Vanmeter, Lachlan Smith, Danny Mcgrath, Matthew Grassman, Nishant Patel, William Mattingly

The University of Louisville Journal of Respiratory Infections

No abstract provided.

A Patient With Escherichia Coli Bacteremia And Covid-19 Co-Infection: A Case Report For The Louisville Covid-19 Epidemiology Study, Sarah E. Moore Pharmd, Ashley M. Wilde Pharmd, Bcps-Aqid, Matthew Song Pharmd, Bcidp, Brian C. Bohn Pharmd, Clayton J. Patross Pharmd, Bcps, Bryan Denham Md, Paul Schulz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Patients with COVID-19 may have co-infections with other microorganisms. Here we report a case of a patient with an Escheria coli bacteremia secondary to a urinary tract infection, who experienced fevers while on active antimicrobial therapy. The patient was eventually tested for COVID-19 and found to be positive. This case emphasizes the need to suspect COVID-19 even in patients with documented bacterial infection.

Sars-Cov-2 And Bacterial Co-Infection, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Life In The Time Of Covid, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Healthcare Workers In The Time Of Covid, Julio A. Ramirez, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Development Of A Hospital Readmission Reduction Program For Patients Discharged To Skilled Nursing Facilities: An Application Of Artificial Intelligence And Machine Learning Techniques, Anna Stachel

Dissertations and Theses

Background

Hospital readmissions within 30 days after discharge have drawn national policy attention as they are a reflection of suboptimal patient care. Readmissions are costly, accounting for more than $17 billion in potentially avoidable Medicare expenditures - nearly 78% of readmissions may be avoidable. Rich electronic data from medical records, growing computing capacities, and open source machine learning algorithms offer new opportunities to predict patients at high risk for readmission and prevent readmission through focused interventions. Prediction models might also serve to provide a more nuanced context of patient characteristics that lead to variations in readmission rates. Furthermore, transitional care …

Abo Blood Group Type And Susceptibility To Covid-19 Infection, G. Rafael Fernandez-Botran

The University of Louisville Journal of Respiratory Infections

Since December 2019, the SARS-CoV-2 (COVID-19) pandemic has extended its reach over most of the world, infecting over four million people and causing well over 300,000 deaths so far.[1] A significant percentage of infected patients develop severe symptoms and life-threatening conditions. While COVID-19 infection can affect all ages, available evidence points to older age and pre-existing comorbidities, such as hypertension, diabetes, and coronary heart disease, as important risk factors related to increased mortality rates.[2-4] Moreover, recent reports from China and the U.S. have suggested that susceptibility, and perhaps even mortality, to COVID-19 infection might be influenced by the ABO blood …

Implementation Of The Louisville Covid-19 Surveillance Protocol: Experiences From The University Of Louisville Center Of Excellence For Research In Infectious Diseases [Cerid], Ruth Carrico, Dawn Balcom, William Johnson, Amr Aboelnasr, Mutasem Abuhalaweh, Stephen Furmanek, Montray Smith, Amanda Lasnik, Donghoon Chung, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

The lack of available testing for SARS-CoV-2 has been one of the primary challenges in the development and implementation of a comprehensive approach to infection prevention and transmission in the United States (US). In response to the need for increased testing capacities and capabilities, the University of Louisville (UofL) Division of Infectious Diseases Center of Excellence for Research in Infectious Diseases (CERID) initiated the Louisville Coronavirus Surveillance Program, a comprehensive approach to surveillance and testing of patients and healthcare workers. The first specimens were accepted on March 12, 2020, and parallel testing was done using a high-capacity testing process at …

Possible Role Of Tetracyclines On Covid-19: Recycling Well-Known Old Drugs From The Shelf, Martin Gnoni, Raul Vasquez-Gararatti, Angel Mena

The University of Louisville Journal of Respiratory Infections

We are in the midst of a pandemic due to the novel coronavirus SARS-CoV-2. Innovative therapies are in the lookup around the world. Recently, chloroquine and hydroxychloroquine in addition to azithromycin were proposed to be used in patients with severe disease even though strong evidence is lacking. We propose the use of tetracyclines in addition to anti-virals early in the curse of the disease in order to prevent the cytokine storm syndrome associated with COVID-19 and prevent ARDS. The proposed mechanisms of tetracyclines are: 1) anti-apoptotic properties; 2) decrease the Myeloperoxidase and ROS releaser from immune cells; 3) decrease neutrophil …

Electronic Health Records And Health Information Exchange And Their Impact On International Healthcare System Efficiency, David Pfaehler

Honors Theses

The 19th century epidemiological transition in healthcare caused a major shift in physician focus from curing one-time, deadly illness to managing chronic disease. Now, even the most advanced international healthcare systems must find a way to increase their efficiency in order to compensate for heightened strains on medical systems and swelling costs of healthcare delivery. Fortunately, recent technological innovation and, chiefly, the growth of Electronic Health Records (EHRs) provide a potential solution to this looming threat. EHRs are digital charts with the potential to store and share patient health data among providers to offer the most informed, streamlined care available. …

Examining The Possibilities Of Telehealth In Tallahatchie County, Taran Carrasco

Honors Theses

This thesis aims to analyze Tallahatchie County and determine the feasibility of establishing a telehealth program in the county. Telehealth is an evolving aspect in the medical field that incorporates technology with healthcare. This thesis used sociotechnical theory to explain how the feasibility of telehealth could be made more likely as the technology is used over time.Through interviewing UMMC telehealth directors, Tallahatchie Wellness center workers, and citizens of Charleston, this study aims to gauge professional and personal opinions on how feasible it would be to implement telehealth into the Charleston community, as well as how positively telehealth would be accepted …

Dnp Project: Improving No-Show Rates In Primary Care, Mai-Linh T. Nguyen, Sarah M. Kuzara

Doctor of Nursing Practice Projects

Abstract

This paper explores the factors that contribute to no-show rates in the primary care setting and effective interventions to improve no-show rates. The average no-show rate in the primary care setting is 23%, (Dantas, Fleck, Olivaria, & Humacher 2018). In 2018, the no-show rate at the WeCare Clinic was 50-60%. A literature review was conducted to gather information regarding why patients choose to no-show their appointments, the common causes of high no-show rates, and effective interventions found to decrease no-show rates. We investigated the primary causes of a high no-show rate at the WeCare Clinic by interviewing staff and …

Depression Is Associated With Decreased Severity And Lower Mortality In Non-Elderly Hospitalized Adults With Influenza In The United States, Timothy L. Wiemken, Daniel Hoft, Jeffrey Scherrer

The University of Louisville Journal of Respiratory Infections

Background: Depression is associated with risk for chronic disease, though its relationship with infectious diseases is less understood. Depression may modify the clinical outcomes of patients with infectious diseases such as influenza via its association with inflammation. The objective of this study was to evaluate the relationships between depression and clinical outcomes in non-elderly adults with influenza infection.

Methods: This was a secondary analysis of the Nationwide Inpatient Sample database, years 2012–2016. Hospitalized adults aged 18–65 admitted during each influenza season were included. Depression status was documented via ICD-10 codes. The association between depression and clinical outcomes (e.g., …

Who And When To Screen: Multi-Round Active Screening For Network Recurrent Infectious Diseases Under Uncertainty, Han-Ching Ou, Arunesh Sinha, Sze-Chuan Suen, Andrew Perrault, Alpan Raval, Milind Tambe

Research Collection School Of Computing and Information Systems

Controlling recurrent infectious diseases is a vital yet complicated problem in global health. During the long period of time from patients becoming infected to finally seeking treatment, their close contacts are exposed and vulnerable to the disease they carry. Active screening (or case finding) methods seek to actively discover undiagnosed cases by screening contacts of known infected people to reduce the spread of the disease. Existing practice of active screening methods often screen all contacts of an infected person, requiring a large budget. In cooperation with a research institute in India, we develop a model of the active screening problem …

How Immune T-Cell Augmentation Can Help Prevent Covid-19: A Possible Nutritional Solution Using Ketogenic Lifestyle, Ravi K. Kamepalli Md,Fidsa,Cwsp

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Mobile Consulting (Mconsulting) And Its Potential For Providing Access To Quality Healthcare For Populations Living In Low-Resource Settings Of Low- And Middle-Income Countries, Frances Griffiths, Jocelyn Anstey Watkins, Caroline Huxley, Bronwyn Harris, Jonathan Cave, Senga Pemba, Beatrice Chipwaza, Romaina Iqbal, Saleem Sayani, Komal Tabani

Community Health Sciences

Objective: The poorest populations of the world lack access to quality healthcare. We defined the key components of consulting via mobile technology (mConsulting), explored whether mConsulting can fill gaps in access to quality healthcare for poor and spatially marginalised populations (specifically rural and slum populations) of low- and middle-income countries, and considered the implications of its take-up.
Methods: We utilised realist methodology. First, we undertook a scoping review of mobile health literature and searched for examples of mConsulting. Second, we formed our programme theories and identified potential benefits and hazards for deployment of mConsulting for poor and spatially marginalised populations. …

The Population Health Outcomes And Information Exchange (Phoenix) Program - A Transformative Approach To Reduce The Burden Of Chronic Disease, Steven J. Korzeniewski, Carla Bezold, Jason T. Carbone, Shooshan Danagoulian, Bethany Foster, Dawn Misra, Maher M. El-Masri, Dongxiao Zhu, Robert Welch, Lauren Meloche, Alex B. Hill, Phillip Levy

Urban Studies and Planning Faculty Research Publications

This concept article introduces a transformative vision to reduce the population burden of chronic disease by focusing on data integration, analytics, implementation and community engagement. Known as PHOENIX (The Population Health OutcomEs aNd Information EXchange), the approach leverages a state level health information exchange and multiple other resources to facilitate the integration of clinical and social determinants of health data with a goal of achieving true population health monitoring and management. After reviewing historical context, we describe how multilevel and multimodal data can be used to facilitate core public health services, before discussing the controversies and challenges that lie ahead.

Copd Exacerbation Caused By Sars-Cov-2: A Case Report From The Louisville Covid-19 Surveillance Program, Forest W. Arnold, Kamran Mahmood, Angeline Prabhu, Darmaan Aden, Anupama Raghuram, Mark Burns, Leslie A. Beavin, Donghoon Chung, Kenneth E. Palmer, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A 53-year-old male with a history of chronic obstructive pulmonary disease (COPD) on home oxygen presented to the hospital with worsening shortness of breath plus cough. He was admitted to the intensive care unit for COPD exacerbation and respiratory failure. A routine evaluation was performed, including a nasopharyngeal swab for a respiratory viral panel, which was negative. His symptoms improved over 48 hours, after which time a surveillance test for SARS-CoV-2 returned as positive. After clinical improvement, he was discharged to home isolation.

How To Prevent Covid-19 In Nurses And Physicians In The Hospital Setting: Universal Test-And-Isolate For All Patients Admitted To Hospitals, Julio A. Ramirez, Ruth Carrico, Forest W. Arnold, Paul Schulz

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Abstracts From The 26th Annual Health Care Systems Research Network Conference, April 8–10, 2020

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of community-based care delivery systems with a shared mission to improve health and health care through research. The network’s annual conference serves as a forum for attendees to disseminate study findings, stimulate collaborations, and share insights about conducting research in real-world care settings. Although this year’s live conference was cancelled to help slow the spread of COVID-19, the oral and poster abstracts accepted for presentation at HCSRN 2020 are published in this open access supplement to Volume 7, Issue 1 of the Journal of Patient-Centered Research and Reviews, the …

Rural Caregivers: Identification Of Informational Needs Through Telemedicine Questions, Shoshana H. Bardach, Allison Gibson, Kelly Parsons, April Stauffer, Gregory A. Jicha

Sanders-Brown Center on Aging Faculty Publications

OBJECTIVES: The prevalence of Alzheimer's disease and associated disorders is increasing. Rural residents in the United States have less access to memory care specialists and educational and community resources than in other areas of the country. Over a decade ago, we initiated an interdisciplinary rural caregiving telemedicine program to reach Kentucky residents in areas of the state where resources for supporting individuals with dementia are limited. Telemedicine programs involve a short informational presentation followed by a question and answer session; programs are offered 4 times a year. The purpose of this study was to explore questions asked over 1 year …

Leveraging The Use Of Mhealth In Patients With Depression Among Low- And Middle- Income Countries, Naureen Akber Ali, Adeel Khoja

School of Nursing & Midwifery

No abstract provided.

Defining The Burden Of Covid-19 In The Kentuckiana Area: Incidence, Epidemiology & Clinical Outcomes Of Patients With Covid-19, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Rationale: Early evaluation of the burden of disease that COVID-19 may produce in a community is critical to appropriately allocate resources for COVID-19 prevention and treatment.

Objective: The primary objective of this study is to define the incidence, epidemiology, and clinical outcomes of patients with COVID-19 in the Louisville, Kentucky, and southern Indiana region (Kentuckiana) of the USA.

Methods: This will be a retrospective observational study of patients in the Kentuckiana region with the diagnosis of COVID-19.

Improving Hearing Screenings With Tele-Otology, Ryan J. Miller, Joshua George-Lopez, Robert S. Hong Md, Phd

Medical Student Research Symposium

Introduction: The Lions Hearing Center of Michigan (LHC-MI) is an assistance program in Detroit that provides hearing aids to individuals in need. LHC-MI has provided thousands of hearing aids, but such efforts have been costly, requiring patients to make multiple appointments at multiple locations. To streamline this process, the LHC-MI is piloting a new program, titled “Hear Now! Detroit!”, that uses telemedicine to reach patients at community sites.

Purpose: To evaluate the feasibility of a hearing screening program that uses telemedicine to reduce the number of visits required to acquire hearing aids.

Methods: Teams of community volunteers were deployed to …