Functionalities of open electronic health records system: A follow-up study

2013 ◽  
Author(s):  
Alejandro Enrique Flores ◽  
Victor Medel Vergara
Keyword(s):  
Electronic Health Records ◽  
Health Records ◽  
Follow Up Study ◽  
System A ◽  
Electronic Health

USE OF ELECTRONIC HEALTH RECORDS TO CHARACTERIZE A RARE DISEASE IN THE U.S.: TREATMENT, COMORBIDITIES, AND FOLLOW-UP TRENDS AMONG PATIENTS WITH A CONFIRMED DIAGNOSIS OF ACROMEGALY

2018 ◽  
Vol 24 (6) ◽  
pp. 517-526 ◽  
Author(s):  
Julie M. Silverstein ◽  
Erin D. Roe ◽  
Kashif M. Munir ◽  
Janet L. Fox ◽  
Birol Emir ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Rare Disease ◽  
Health Records ◽  
Electronic Health ◽  
The U.S

scholarly journals Electronic health records and clinician burnout: A story of three eras

2020 ◽  
Author(s):  
Kevin B Johnson ◽  
Michael J Neuss ◽  
Don Eugene Detmer
Keyword(s):  
Electronic Health Records ◽  
Technology Policy ◽  
Healthcare Delivery ◽  
Medical Documentation ◽  
Health Records ◽  
Behavioral Determinants ◽  
System A ◽  
History Of ◽  
Electronic Health ◽  
Time Required

Abstract Objective The study sought to provide physicians, informaticians, and institutional policymakers with an introductory tutorial about the history of medical documentation, sources of clinician burnout, and opportunities to improve electronic health records (EHRs). We now have unprecedented opportunities in health care, with the promise of new cures, improved equity, greater sensitivity to social and behavioral determinants of health, and data-driven precision medicine all on the horizon. EHRs have succeeded in making many aspects of care safer and more reliable. Unfortunately, current limitations in EHR usability and problems with clinician burnout distract from these successes. A complex interplay of technology, policy, and healthcare delivery has contributed to our current frustrations with EHRs. Fortunately, there are opportunities to improve the EHR and health system. A stronger emphasis on improving the clinician’s experience through close collaboration by informaticians, clinicians, and vendors can combine with specific policy changes to address the causes of burnout. Target audience This tutorial is intended for clinicians, informaticians, policymakers, and regulators, who are essential participants in discussions focused on improving clinician burnout. Learners in biomedicine, regardless of clinical discipline, also may benefit from this primer and review. Scope We include (1) an overview of medical documentation from a historical perspective; (2) a summary of the forces converging over the past 20 years to develop and disseminate the modern EHR; and (3) future opportunities to improve EHR structure, function, user base, and time required to collect and extract information.

scholarly journals Electronic health record note review in an outpatient specialty clinic: who is looking?

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Jimmy S Chen ◽  
Michelle R Hribar ◽  
Isaac H Goldstein ◽  
Adam Rule ◽  
Wei-Chun Lin ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Clinical Care ◽  
Office Visit ◽  
Health Record ◽  
Office Visits ◽  
Health Records ◽  
Ancillary Staff ◽  
Electronic Health

Abstract Note entry and review in electronic health records (EHRs) are time-consuming. While some clinics have adopted team-based models of note entry, how these models have impacted note review is unknown in outpatient specialty clinics such as ophthalmology. We hypothesized that ophthalmologists and ancillary staff review very few notes. Using audit log data from 9775 follow-up office visits in an academic ophthalmology clinic, we found ophthalmologists reviewed a median of 1 note per visit (2.6 ± 5.3% of available notes), while ancillary staff reviewed a median of 2 notes per visit (4.1 ± 6.2% of available notes). While prior ophthalmic office visit notes were the most frequently reviewed note type, ophthalmologists and staff reviewed no such notes in 51% and 31% of visits, respectively. These results highlight the collaborative nature of note review and raise concerns about how cumbersome EHR designs affect efficient note review and the utility of prior notes in ophthalmic clinical care.

Improving Follow-Up of Abnormal Cancer Screens Using Electronic Health Records

2013 ◽  
pp. 297-309
Author(s):  
Hardeep Singh ◽  
Lindsey Wilson ◽  
Laura Petersen ◽  
Mona Sawhney ◽  
Brian Reis ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health

scholarly journals Improving follow-up of abnormal cancer screens using electronic health records: trust but verify test result communication

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Hardeep Singh ◽  
Lindsey Wilson ◽  
Laura A Petersen ◽  
Mona K Sawhney ◽  
Brian Reis ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Health Records ◽  
Electronic Health ◽  
Test Result

scholarly journals Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

2016 ◽  
Vol 4 (17) ◽  
pp. 1-120 ◽  
Author(s):  
Martin C Gulliford ◽  
Judith Charlton ◽  
Helen P Booth ◽  
Alison Fildes ◽  
Omar Khan ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Health Care ◽  
Morbid Obesity ◽  
Cost Effectiveness ◽  
Electronic Health Records ◽  
Diabetes Remission ◽  
Health Records ◽  
Electronic Health ◽  
Care Costs

BackgroundBariatric surgery is known to be an effective treatment for extreme obesity but access to these procedures is currently limited.ObjectiveThis study aimed to evaluate the costs and outcomes of increasing access to bariatric surgery for severe and morbid obesity.Design and methodsPrimary care electronic health records from the UK Clinical Practice Research Datalink were analysed for 3045 participants who received bariatric surgery and 247,537 general population controls. The cost-effectiveness of bariatric surgery was evaluated in severe and morbid obesity through a probabilistic Markov model populated with empirical data from electronic health records.ResultsIn participants who did not undergo bariatric surgery, the probability of participants with morbid obesity attaining normal body weight was 1 in 1290 annually for men and 1 in 677 for women. Costs of health-care utilisation increased with body mass index category but obesity-related physical and psychological comorbidities were the main drivers of health-care costs. In a cohort of 3045 adult obese patients with first bariatric surgery procedures between 2002 and 2014, bariatric surgery procedure rates were greatest among those aged 35–54 years, with a peak of 37 procedures per 100,000 population per year in women and 10 per 100,000 per year in men. During 7 years of follow-up, the incidence of diabetes diagnosis was 28.2 [95% confidence interval (CI) 24.4 to 32.7] per 1000 person-years in controls and 5.7 (95% CI 4.2 to 7.8) per 1000 person-years in bariatric surgery patients (adjusted hazard ratio was 0.20, 95% CI 0.13 to 0.30;p < 0.0001). In 826 obese participants with type 2 diabetes mellitus who received bariatric surgery, the relative rate of diabetes remission, compared with controls, was 5.97 (95% CI 4.86 to 7.33;p < 0.001). There was a slight reduction in depression in the first 3 years following bariatric surgery that was not maintained. Incremental lifetime costs associated with bariatric surgery were £15,258 (95% CI £15,184 to £15,330), including costs associated with bariatric surgical procedures of £9164 per participant. Incremental quality-adjusted life-years (QALYs) were 2.142 (95% CI 2.031 to 2.256) per participant. The estimated cost per QALY gained was £7129 (95% CI £6775 to £7506). Estimates were similar across gender, age and deprivation subgroups.LimitationsIntervention effects were derived from a randomised trial with generally short follow-up and non-randomised studies of longer duration.ConclusionsBariatric surgery is associated with increased immediate and long-term health-care costs but these are exceeded by expected health benefits to obese individuals with reduced onset of new diabetes, remission of existing diabetes and lower mortality. Diverse obese individuals have clear capacity to benefit from bariatric surgery at acceptable cost.Future workFuture research should evaluate longer-term outcomes of currently used procedures, and ways of delivering these more efficiently and safely.FundingThe National Institute for Health Research (NIHR) Health Services and Delivery Research programme. Martin C Gulliford and A Toby Prevost were supported by the NIHR Biomedical Research Centre at Guy’s and St Thomas’ Hospitals. Peter Littlejohns was supported by the South London Collaboration for Leadership in Applied Health Research and Care. The funders did not engage in the design, conduct or reporting of the research.

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