Barriers to Implementing Efficient Use of Electronic Medical Records in Long Term Care

2008 ◽  
Vol 9 (3) ◽  
pp. B7 ◽  
Author(s):  
Joshua J. Raymond ◽  
Geronima G. Alday ◽  
Lynn Schwenzer
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Long Term Care ◽  
Term Care

Electronic Medical Records in Long-Term Care

2010 ◽  
Vol 20 (2) ◽  
pp. 131-142 ◽  
Author(s):  
Krista Phillips ◽  
Chris Wheeler ◽  
Josh Campbell ◽  
Alberto Coustasse
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Long Term Care ◽  
Term Care

scholarly journals Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Systematic Review (Preprint)

2018 ◽  
Author(s):  
Leandra Falck ◽  
Marco Zoller ◽  
Thomas Rosemann ◽  
Nahara Anani Martínez-González ◽  
Corinne Chmiel
Keyword(s):  
Primary Care ◽  
Chronic Diseases ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Chronic Conditions ◽  
Long Term Care ◽  
Evidence Based ◽  
Term Care ◽  
Term Monitoring

BACKGROUND Long-term care for patients with chronic diseases poses a huge challenge in primary care. In particular, there is a deficit regarding monitoring and structured follow-up. Appropriate electronic medical records (EMRs) could help improving this but, so far, there are no evidence-based specifications concerning the indicators that should be monitored at regular intervals. OBJECTIVE The aim was to identify and collect a set of evidence-based indicators that could be used for monitoring chronic conditions at regular intervals in primary care using EMRs. METHODS We searched MEDLINE (Ovid), Embase (Elsevier), the Cochrane Library (Wiley), the reference lists of included studies and relevant reviews, and the content of clinical guidelines. We included primary studies and guidelines reporting about indicators that allow for the assessment of care and help monitor the status and process of disease for five chronic conditions, including type 2 diabetes mellitus, asthma, arterial hypertension, chronic heart failure, and osteoarthritis. RESULTS The use of the term “monitoring” in terms of disease management and long-term care for patients with chronic diseases is not widely used in the literature. Nevertheless, we identified a substantial number of disease-specific indicators that can be used for routine monitoring of chronic diseases in primary care by means of EMRs. CONCLUSIONS To our knowledge, this is the first systematic review summarizing the existing scientific evidence on the standardized long-term monitoring of chronic diseases using EMRs. In a second step, our extensive set of indicators will serve as a generic template for evaluating their usability by means of an adapted Delphi procedure. In a third step, the indicators will be summarized into a user-friendly EMR layout.

scholarly journals Association between Serum 25-hydroxyvitamin D Levels and Incidences of Infection in Long-Term Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 678-678
Author(s):  
Ronna Robbins ◽  
Monica Serra ◽  
Margaret Briley
Keyword(s):  
Medical Records ◽  
Long Term Care ◽  
Infection Rates ◽  
Double Blind ◽  
Cross Sectional ◽  
Term Care ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Tract Infections

Abstract Insufficient serum 25-hydroxyvitamin D (25(OH)D) concentrations are associated with increased respiratory tract infections, influenza, and other infectious diseases. As the world deals with the COVID-19 pandemic, the interest of adequate serum levels to reduce the risk of infection has surfaced. This study determined if the number of infections per year are associated with serum 25(OH)D concentrations in long-term care (LTC). Participants (≥ 65 years) in a cross-sectional study were recruited across five LTC communities in Texas. Medical records were used to collect a one-year medical history using double-blind protocols. Blood draws were collected to measure serum 25(OH)D concentrations. Medical records were used to classify infections based upon documentation of signs and symptoms of infection concurrent with either a physician’s note or antibiotic/antiviral medication prescription. Race, BMI, sex, age, and liver and renal disease diagnoses were used as confounders. Of the 177 participants (89% Caucasian, 63% female, mean age 83 years) 69% had ≥1 infection over year and 55% had insufficient serum 25(OH)D concentrations <30 mg/mL (mean 32.6 ng/mL). Linear regression did not show a significant association between serum 25(OH)D concentrations and number of infections (β 0.003; 95% CI -0.014, 0.018; p=0.760). Additionally, insufficient serum concentration did not increase the odds of having an infection (OR 1.02; 95% CI 0.05, -19.34; p=0.987). This study did not show a significant association between infection rates and serum 25(OH)D concentrations. However, further research is needed to determine if vitamin D supplementation could be an effective therapeutic intervention to reduce infection rates, including COVID-19.

An estimate of the prevalence of dementia among residents of long-term care geriatric institutions in the Jerusalem area

2006 ◽  
Vol 18 (4) ◽  
pp. 643-652 ◽  
Author(s):  
Helena Feldman ◽  
A. Mark Clarfield ◽  
Jenny Brodsky ◽  
Yaron King ◽  
Tzvi Dwolatzky
Keyword(s):  
Cognitive Impairment ◽  
Medical Records ◽  
Long Term Care ◽  
The Elderly ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Term Care ◽  
Prevalence Of Dementia

Background: To determine the prevalence of dementia among the residents of geriatric institutions in the greater Jerusalem area.Methods: A population-based, cross-sectional survey of a representative sample, weighted according to the level of care, of 11 of the 88 long-term care (LTC) wards in 34 LTC institutions providing care for the elderly residents in the greater Jerusalem area in 1999. A single physician interviewed 311 residents. The presence of dementia was determined from medical records and by performance on the Modified Mini-mental State Examination (3MS) instrument (with a score less than 78/100 indicating significant cognitive impairment or suspected dementia), and professional care providers were interviewed for their opinion regarding the presence of dementia in each subject.Results: The mean age of the patients was 83.9 years and 75% were women. Overall, 180 residents, representing 49.9% of the weighted sample in Jerusalem LTC facilities, were determined to have dementia according to medical records, ranging from 22.9% in independent and frail care units to 97.7% in skilled nursing care wards. However, based on their performance on the 3MS, the prevalence of cognitive impairment with suspected dementia among the subjects was substantially greater, with the staff being unaware of this diagnosis in about one-quarter of the subjects.Conclusions: There is a high prevalence of dementia in geriatric institutions in the Jerusalem area, particularly in those providing greater care. Moreover, significant cognitive impairment is probably under-reported in the medical records.

scholarly journals Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Development of a Tool by Adapted Delphi Procedure

10.2196/14483 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e14483
Author(s):  
Leandra Falck ◽  
Marco Zoller ◽  
Thomas Rosemann ◽  
Nahara Anani Martínez-González ◽  
Corinne Chmiel
Keyword(s):  
Primary Care ◽  
Chronic Diseases ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Chronic Conditions ◽  
Evidence Based ◽  
Term Care ◽  
Delphi Procedure ◽  
User Friendly

Background Long-term care for patients with chronic diseases poses a huge challenge in primary care. There are deficits in care, especially regarding monitoring and creating structured follow-ups. Appropriate electronic medical records (EMR) could support this, but so far, no generic evidence-based template exists. Objective The aim of this study is to develop an evidence-based standardized, generic template that improves the monitoring of patients with chronic conditions in primary care by means of an EMR. Methods We used an adapted Delphi procedure to evaluate a structured set of evidence-based monitoring indicators for 5 highly prevalent chronic diseases (ie, diabetes mellitus type 2, asthma, arterial hypertension, chronic heart failure, and osteoarthritis). We assessed the indicators’ utility in practice and summarized them into a user-friendly layout. Results This multistep procedure resulted in a monitoring tool consisting of condensed sets of indicators, which were divided into sublayers to maximize ergonomics. A cockpit serves as an overview of fixed goals and a set of procedures to facilitate disease management. An additional tab contains information on nondisease-specific indicators such as allergies and vital signs. Conclusions Our generic template systematically integrates the existing scientific evidence for the standardized long-term monitoring of chronic conditions. It contains a user-friendly and clinically sensible layout. This template can improve the care for patients with chronic diseases when using EMRs in primary care.

scholarly journals Toward Standardized Monitoring of Patients With Chronic Diseases in Primary Care Using Electronic Medical Records: Development of a Tool by Adapted Delphi Procedure (Preprint)

2019 ◽  
Author(s):  
Leandra Falck ◽  
Marco Zoller ◽  
Thomas Rosemann ◽  
Nahara Anani Martínez-González ◽  
Corinne Chmiel
Keyword(s):  
Primary Care ◽  
Chronic Diseases ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Chronic Conditions ◽  
Evidence Based ◽  
Term Care ◽  
Delphi Procedure ◽  
User Friendly

BACKGROUND Long-term care for patients with chronic diseases poses a huge challenge in primary care. There are deficits in care, especially regarding monitoring and creating structured follow-ups. Appropriate electronic medical records (EMR) could support this, but so far, no generic evidence-based template exists. OBJECTIVE The aim of this study is to develop an evidence-based standardized, generic template that improves the monitoring of patients with chronic conditions in primary care by means of an EMR. METHODS We used an adapted Delphi procedure to evaluate a structured set of evidence-based monitoring indicators for 5 highly prevalent chronic diseases (ie, diabetes mellitus type 2, asthma, arterial hypertension, chronic heart failure, and osteoarthritis). We assessed the indicators’ utility in practice and summarized them into a user-friendly layout. RESULTS This multistep procedure resulted in a monitoring tool consisting of condensed sets of indicators, which were divided into sublayers to maximize ergonomics. A cockpit serves as an overview of fixed goals and a set of procedures to facilitate disease management. An additional tab contains information on nondisease-specific indicators such as allergies and vital signs. CONCLUSIONS Our generic template systematically integrates the existing scientific evidence for the standardized long-term monitoring of chronic conditions. It contains a user-friendly and clinically sensible layout. This template can improve the care for patients with chronic diseases when using EMRs in primary care.

scholarly journals Prevalence of Insufficient Serum 25-hydroxyvitamin D (25(OH)D) Greater Among Medicaid Residents Living in Long-Term Care Communities (P01-011-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Ronna Robbins ◽  
Nalini Ranjit ◽  
Sara Sweitzer ◽  
Maragaret Briley
Keyword(s):  
Logistic Regression ◽  
Serum Level ◽  
Medical Records ◽  
Long Term Care ◽  
Serum Levels ◽  
Term Care ◽  
Hydroxyvitamin D ◽  
Payer Source ◽  
25 Hydroxyvitamin D

Abstract Objectives Evaluate the association between insufficient 25-hydroxyvitamin D [25(OH)D] serum levels and healthcare payer source of older adults living in long-term care (LTC) communities. Methods Residents (age >65 yo) of five LTC communities in Central, Texas were recruited to participated in the multi-site, cross-sectional study. A one-year medical history was abstracted from medical records using double-blinded data abstraction and entry protocols. Medical history included but not limited to: diagnosis, medications, history of supplementation, BMI, mini-nutritional assessment, diet order, total mood assessments, hospitalizations and number of infections. Data on payer source and other demographics were also obtained via medical records. Blood draws were collected to measure serum 25(OH)D levels. Logistic regression models were uses to assess the association between insufficient25(OH)Dserum levels (defined as <30 ng/ml) and healthcare payer source. Total vitamin D supplemented per day along with amount provided in meals, body mass index, race, gender, age, years living in community, and diagnosis of liver and renal disease were used as confounders. Results The 174 participants (89% Caucasian, mean age 83 yo) included 63% females. Payer source was distributed as follows: 55% private pay, 8.6% Medicare, 35% Medicaid, and 1% insurance. Fifty-five % had insufficient25(OH)D serum levels (mean serum level = 32.6 ng/ml; mean supplementation rate of 1138 IU per/d). Insufficient serum levels were seen in 48% of participants with private pay (mean serum level = 36 mg/ml) and 58% with Medicaid (mean serum level = 30.5 ng/ml). Adjusted logistic regression showed that payer source was a significant determinant of insufficient25(OH)D serum levels. Medicaid residents had significantly greater odds of having insufficient 25(OH)D serum levels (adjusted odd ratio (OR) 3.26; CL: 1.25, 8.48; P = 0.015) than private pay participants. Conclusions Practitioners working in LTC can use these results to ensure equity in the provision of medical nutritional therapy across Medicaid residents and private pay residents. Funding Sources Funding for study was provided through the private funds of research team.

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