Acceptability of a decision-support electronic health record system and its impact on diabetes care goals in South Asia: a mixed-methods evaluation of the CARRS trial

2018 ◽  
Vol 35 (12) ◽  
pp. 1644-1654 ◽  
Author(s):  
K. Singh ◽  
L. Johnson ◽  
R. Devarajan ◽  
R. Shivashankar ◽  
P. Sharma ◽  
...  
Keyword(s):  
Decision Support ◽  
Mixed Methods ◽  
Electronic Health Record ◽  
South Asia ◽  
Diabetes Care ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Mixed Methods Evaluation ◽  
Electronic Health

scholarly journals Developing Clinical Decision Support within a Commercial Electronic Health Record System to Improve Antimicrobial Prescribing in the Neonatal ICU

2014 ◽  
Vol 05 (02) ◽  
pp. 368-387 ◽  
Author(s):  
K. Cato ◽  
B. Sheehan ◽  
S. Patel ◽  
J. Duchon ◽  
P. DeLaMora ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Antimicrobial Prescribing ◽  
Neonatal Icu ◽  
Electronic Health

SummaryObjective: To develop and implement a clinical decision support (CDS) tool to improve antibiotic prescribing in neonatal intensive care units (NICUs) and to evaluate user acceptance of the CDS tool.Methods: Following sociotechnical analysis of NICU prescribing processes, a CDS tool for empiric and targeted antimicrobial therapy for healthcare-associated infections (HAIs) was developed and incorporated into a commercial electronic health record (EHR) in two NICUs. User logs were reviewed and NICU prescribers were surveyed for their perceptions of the CDS tool.Results: The CDS tool aggregated selected laboratory results, including culture results, to make treatment recommendations for common clinical scenarios. From July 2010 to May 2012, 1,303 CDS activations for 452 patients occurred representing 22% of patients prescribed antibiotics during this period. While NICU clinicians viewed two culture results per tool activation, prescribing recommendations were viewed during only 15% of activations. Most (63%) survey respondents were aware of the CDS tool, but fewer (37%) used it during their most recent NICU rotation. Respondents considered the most useful features to be summarized culture results (43%) and antibiotic recommendations (48%).Discussion: During the study period, the CDS tool functionality was hindered by EHR upgrades, implementation of a new laboratory information system, and changes to antimicrobial testing methodologies. Loss of functionality may have reduced viewing antibiotic recommendations. In contrast, viewing culture results was frequently performed, likely because this feature was perceived as useful and functionality was preserved.Conclusion: To improve CDS tool visibility and usefulness, we recommend early user and information technology team involvement which would facilitate use and mitigate implementation challenges.Citation: Hum RS, Cato K, Sheehan B, Patel S, Duchon J, DeLaMora P, Ferng YH, Graham P, Vawdrey DK, Perlman J, Larson E, Saiman L. Developing clinical decision support within a commercial electronic health record system to improve antimicrobial prescribing in the neonatal ICU. Appl Clin Inf 2014; 5: 368–387 http://dx.doi.org/10.4338/ACI-2013-09-RA-0069

scholarly journals The Use of Evidence-Based, Problem-Oriented Templates as a Clinical Decision Support in an Inpatient Electronic Health Record System

2016 ◽  
Vol 07 (03) ◽  
pp. 790-802 ◽  
Author(s):  
Nila Radhakrishnan ◽  
Carrie Warring ◽  
Ankur Jain ◽  
Jorge Fuentes ◽  
Angela Dolganiuc ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Outcome Measurement ◽  
Clinical Decision ◽  
Electronic Health Record System ◽  
Evidence Based ◽  
Health Record ◽  
Record System ◽  
Electronic Health

SummaryThe integration of clinical decision support (CDS) in documentation practices remains limited due to obstacles in provider workflows and design restrictions in electronic health records (EHRs). The use of electronic problem-oriented templates (POTs) as a CDS has been previously discussed but not widely studied.We evaluated the voluntary use of evidence-based POTs as a CDS on documentation practices.This was a randomized cohort (before and after) study of Hospitalist Attendings in an Academic Medical Center using EPIC EHRs. Primary Outcome measurement was note quality, assessed by the 9-item Physician Documentation Quality Instrument (PDQI-9). Secondary Outcome measurement was physician efficiency, assessed by the total charting time per note.Use of POTs increased the quality of note documentation [score 37.5 vs. 39.0, P = 0.0020]. The benefits of POTs scaled with use; the greatest improvement in note quality was found in notes using three or more POTs [score 40.2, P = 0.0262]. There was no significant difference in total charting time [30 minutes vs. 27 minutes, P = 0.42].Use of evidence-based and problem-oriented templates is associated with improved note quality without significant change in total charting time. It can be used as an effective CDS during note documentation. Citation: Mehta R, Radhakrishnan NS, Warring CD, Jain A, Fuentes J, Dolganiuc A, Lourdes LS, Busigin J, Leverence RR. The use of evidence-based, problemoriented templates as a clinical decision support in an inpatient electronic health record system.

scholarly journals Implementing Pediatric Growth Charts into an Electronic Health Record System

2006 ◽  
Vol 13 (3) ◽  
pp. 302-308 ◽  
Author(s):  
S. T. Rosenbloom ◽  
X. Qi ◽  
W. R. Riddle ◽  
W. E. Russell ◽  
S. C. DonLevy ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Electronic Health Record System ◽  
Growth Charts ◽  
Health Record ◽  
Record System ◽  
Electronic Health

scholarly journals EHR Model for India: To address challenges in quality Healthcare (Preprint)

2018 ◽  
Author(s):  
Prashant Kanade ◽  
Dr Divya Bhatnagar ◽  
Dr Arun Kumar
Keyword(s):  
Electronic Health Record ◽  
Service Providers ◽  
Care Service ◽  
Health Care Service ◽  
Electronic Health Record System ◽  
Family Welfare ◽  
Health Record ◽  
Record System ◽  
Quality Healthcare ◽  
Electronic Health

UNSTRUCTURED Abstract: In this paper there is a discussion on providing a standard system for health care service providers and patients. We have carried out the detailed study of guidelines provided by ministry of health and family welfare to adopt the electronic health record system. The major aim is to eliminate the conventional health record system. The major focus in this research is to propose the interoperable electronic health Record system (IEHR), and test the feasibility and acceptance of the EHR. Further there is a scope to promote the services in select locations such as hospitals and primary health centres. Medical centres can store patient’s health information with minimal efforts.

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