scholarly journals Access to Routinely Collected Clinical Data for Research: A Process Implemented at an Academic Medical Center

2019 ◽  
Vol 12 (3) ◽  
pp. 231-235
Author(s):  
Susan C. Guerrero ◽  
Sujatha Sridhar ◽  
Cynthia Edmonds ◽  
Christina F. Solis ◽  
Jiajie Zhang ◽  
...  
Keyword(s):  
Clinical Data ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

scholarly journals Giving Your EHR a Checkup after COVID-19: A Practical Framework for Reviewing Clinical Decision Support in Light of the Telemedicine Expansion (Preprint)

2020 ◽  
Author(s):  
Jonah Feldman ◽  
Adam Szerencsy ◽  
Devin Mann ◽  
Jonathan Austrian ◽  
Ulka Kothari ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Data ◽  
Chronic Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Clinical Decision ◽  
Rapid Expansion ◽  
Office Visits ◽  
Academic Medical

BACKGROUND The transformation of healthcare during COVID-19 with the rapid expansion of telemedicine visits presents new challenges to chronic care and preventive health providers. Clinical decision support (CDS) is critically important to chronic care providers, and CDS malfunction is common during times of change. It is essential to regularly re-assess an organization's ambulatory CDS program to maintain care quality. This is especially true after an immense change, like the COVID-19 telemedicine expansion. OBJECTIVE Our objective is to re-assess the ambulatory CDS program at a large academic medical center in light of telemedicine's expansion in response to COVID-19. METHODS Our clinical informatics team devised a practical framework for an intra-pandemic ambulatory CDS assessment focused on the impact of the telemedicine expansion. This assessment began with a quantitative analysis comparing CDS alert performance in the context of in-person and telemedicine visits. Board-certified physician informaticists then completed a formal workflow review of alerts with inferior performance in telemedicine visits. Informaticists then reported on themes and optimization opportunities through the existing CDS governance structure. RESULTS Our assessment revealed that 10 of our top 40 alerts by volume were not firing as expected in telemedicine visits. In 3 out of the top 5 alerts, providers were significantly less likely to take action in telemedicine when compared to office visits. Cumulatively, alerts in telemedicine encounters had an action taken rate of 5.3% (3,257/64,938) compared to 8.3% (19,427/233,636) for office visits. Observations from a clinical informaticist workflow review included: (1) Telemedicine visits have different workflows than office visits. Some alerts developed for the office were not appearing at the optimal time in the telemedicine workflow. (2) Missing clinical data is a common reason for decreased alert firing seen in telemedicine visits. (3) Remote patient monitoring and patient-reported clinical data entered through the portal could replace data collection usually completed in the office by an MA or RN. CONCLUSIONS Conclusions: In a large academic medical center at the pandemic epicenter, an intra-pandemic ambulatory CDS assessment revealed clinically significant CDS malfunctions that highlight the importance of re-assessing ambulatory CDS performance after the telemedicine expansion. CLINICALTRIAL

scholarly journals iCONCUR: informed consent for clinical data and bio-sample use for research

2016 ◽  
Vol 24 (2) ◽  
pp. 380-387 ◽  
Author(s):  
Hyeoneui Kim ◽  
Elizabeth Bell ◽  
Jihoon Kim ◽  
Amy Sitapati ◽  
Joe Ramsdell ◽  
...  
Keyword(s):  
Informed Consent ◽  
Clinical Data ◽  
Patient Preferences ◽  
Medical Center ◽  
Academic Medical Center ◽  
Electronic Health Record Data ◽  
Web Based ◽  
For Profit ◽  
Academic Medical ◽  
Electronic Health

Background: Implementation of patient preferences for use of electronic health records for research has been traditionally limited to identifiable data. Tiered e-consent for use of de-identified data has traditionally been deemed unnecessary or impractical for implementation in clinical settings. Methods: We developed a web-based tiered informed consent tool called informed consent for clinical data and bio-sample use for research (iCONCUR) that honors granular patient preferences for use of electronic health record data in research. We piloted this tool in 4 outpatient clinics of an academic medical center. Results: Of patients offered access to iCONCUR, 394 agreed to participate in this study, among whom 126 patients accessed the website to modify their records according to data category and data recipient. The majority consented to share most of their data and specimens with researchers. Willingness to share was greater among participants from an Human Immunodeficiency Virus (HIV) clinic than those from internal medicine clinics. The number of items declined was higher for for-profit institution recipients. Overall, participants were most willing to share demographics and body measurements and least willing to share family history and financial data. Participants indicated that having granular choices for data sharing was appropriate, and that they liked being informed about who was using their data for what purposes, as well as about outcomes of the research. Conclusion: This study suggests that a tiered electronic informed consent system is a workable solution that respects patient preferences, increases satisfaction, and does not significantly affect participation in research.

Gender differences in career progress and satisfaction in an academic medical center

2002 ◽  
Vol 2 (3) ◽  
pp. 95-104 ◽  
Author(s):  
JoAnn Manson ◽  
Beverly Rockhill ◽  
Margery Resnick ◽  
Eleanor Shore ◽  
Carol Nadelson ◽  
...  
Keyword(s):  
Gender Differences ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Career Progress

Mo1760 Assessment of Postoperative Complications in Patients With IBD. A Single Academic Medical Center Experience

2013 ◽  
Vol 144 (5) ◽  
pp. S-1109 ◽  
Author(s):  
Samantha J. Quade ◽  
Joshua Mourot ◽  
Anita Afzali ◽  
Mika N. Sinanan ◽  
Scott D. Lee ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical
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