Implementation of a Web-based medication tracking system in a large academic medical center

2012 ◽  
Vol 69 (19) ◽  
pp. 1651-1658 ◽  
Author(s):  
Sam V. Calabrese ◽  
Jonathan P. Williams
Keyword(s):  
Medical Center ◽  
Tracking System ◽  
Academic Medical Center ◽  
Web Based ◽  
Academic Medical

Impact of Changes in EHR Use during COVID-19 on Physician Trainee Mental Health

2021 ◽  
Vol 12 (03) ◽  
pp. 507-517
Author(s):  
Katherine J. Holzer ◽  
Sunny S. Lou ◽  
Charles W. Goss ◽  
Jaime Strickland ◽  
Bradley A. Evanoff ◽  
...  
Keyword(s):  
Stress Disorder ◽  
Medical Center ◽  
Academic Medical Center ◽  
Well Being ◽  
Health Record ◽  
Depression And Anxiety ◽  
Web Based ◽  
Academic Medical ◽  
Multivariable Models ◽  
Physician Trainee

Abstract Objectives This article investigates the association between changes in electronic health record (EHR) use during the coronavirus disease 2019 (COVID-19) pandemic on the rate of burnout, stress, posttraumatic stress disorder (PTSD), depression, and anxiety among physician trainees (residents and fellows). Methods A total of 222 (of 1,375, 16.2%) physician trainees from an academic medical center responded to a Web-based survey. We compared the physician trainees who reported that their EHR use increased versus those whose EHR use stayed the same or decreased on outcomes related to depression, anxiety, stress, PTSD, and burnout using univariable and multivariable models. We examined whether self-reported exposure to COVID-19 patients moderated these relationships. Results Physician trainees who reported increased use of EHR had higher burnout (adjusted mean, 1.48 [95% confidence interval [CI] 1.24, 1.71] vs. 1.05 [95% CI 0.93, 1.17]; p = 0.001) and were more likely to exhibit symptoms of PTSD (adjusted mean = 15.09 [95% CI 9.12, 21.05] vs. 9.36 [95% CI 7.38, 11.28]; p = 0.035). Physician trainees reporting increased EHR use outside of work were more likely to experience depression (adjusted mean, 8.37 [95% CI 5.68, 11.05] vs. 5.50 [95% CI 4.28, 6.72]; p = 0.035). Among physician trainees with increased EHR use, those exposed to COVID-19 patients had significantly higher burnout (2.04, p < 0.001) and depression scores (14.13, p = 0.003). Conclusion Increased EHR use was associated with higher burnout, depression, and PTSD outcomes among physician trainees. Although preliminary, these findings have implications for creating systemic changes to manage the wellness and well-being of trainees.

scholarly journals Physicians' Attitudes Toward Complementary and Alternative Medicine and Their Knowledge of Specific Therapies: A Survey at an Academic Medical Center

2006 ◽  
Vol 3 (4) ◽  
pp. 495-501 ◽  
Author(s):  
Dietlind L. Wahner-Roedler ◽  
Ann Vincent ◽  
Peter L. Elkin ◽  
Laura L. Loehrer ◽  
Stephen S. Cha ◽  
...  
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Medical Center ◽  
Clinical Care ◽  
Academic Medical Center ◽  
Educational Interventions ◽  
Level Of Evidence ◽  
Web Based ◽  
Academic Medical ◽  
Complementary And Alternative

The purpose of this study was to evaluate the attitudes of physicians at an academic medical center toward complementary and alternative medicine (CAM) therapies and the physicians' knowledge base regarding common CAM therapies. A link to a Web-based survey was e-mailed to 660 internists at Mayo Clinic in Rochester, MN, USA. Physicians were asked about their attitudes toward CAM in general and their knowledge regarding specific CAM therapies. The level of evidence a physician would require before incorporating such therapies into clinical care was also assessed. Of the 233 physicians responding to the survey, 76% had never referred a patient to a CAM practitioner. However, 44% stated that they would refer a patient if a CAM practitioner were available at their institution. Fifty-seven percent of physicians thought that incorporating CAM therapies would have a positive effect on patient satisfaction, and 48% believed that offering CAM would attract more patients. Most physicians agreed that some CAM therapies hold promise for the treatment of symptoms or diseases, but most of them were not comfortable in counseling their patients about most CAM treatments. Prospective, randomized controlled trials were considered the level of evidence required for most physicians to consider incorporating a CAM therapy into their practice. The results of this survey provide insight into the attitudes of physicians toward CAM at an academic medical center. This study highlights the need for educational interventions and the importance of providing physicians ready access to evidence-based information regarding CAM.

scholarly journals Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center—A Web-Based Survey

PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0140768 ◽  
Author(s):  
Erica Rose Denhoff ◽  
Carly E. Milliren ◽  
Sarah D. de Ferranti ◽  
Sarah K. Steltz ◽  
Stavroula K. Osganian
Keyword(s):  
Clinical Research ◽  
Medical Center ◽  
Academic Medical Center ◽  
Web Based ◽  
Research Recruitment ◽  
Factors Associated ◽  
Academic Medical

scholarly journals Prevalence of Potentially Distracting Noncare Activities and Their Effects on Vigilance, Workload, and Nonroutine Events during Anesthesia Care

2018 ◽  
Vol 128 (1) ◽  
pp. 44-54 ◽  
Author(s):  
Jason M. Slagle ◽  
Eric S. Porterfield ◽  
Amanda N. Lorinc ◽  
David Afshartous ◽  
Matthew S. Shotwell ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Nurse Anesthetists ◽  
Web Based ◽  
Anesthesia Providers ◽  
Academic Medical ◽  
Actual Care ◽  
Case Type ◽  
American Society ◽  
American Society Of Anesthesiologists

Abstract Background When workload is low, anesthesia providers may perform non–patient care activities of a clinical, educational, or personal nature. Data are limited on the incidence or impact of distractions on actual care. We examined the prevalence of self-initiated nonclinical distractions and their effects on anesthesia workload, vigilance, and the occurrence of nonroutine events. Methods In 319 qualifying cases in an academic medical center using a Web-based electronic medical chart, a trained observer recorded video and performed behavioral task analysis. Participant workload and response to a vigilance (alarm) light were randomly measured. Postoperatively, participants were interviewed to elicit possible nonroutine events. Two anesthesiologists reviewed each event to evaluate their association with distractions. Results At least one self-initiated distraction was observed in 171 cases (54%), largely during maintenance. Distractions accounted for 2% of case time and lasted 2.3 s (median). The most common distraction was personal internet use. Distractions were more common in longer cases but were not affected by case type or American Society of Anesthesiologists physical status. Workload ratings were significantly lower during distraction-containing case periods and vigilance latencies were significantly longer in cases without any distractions. Three distractions were temporally associated with, but did not cause, events. Conclusions Both nurse anesthetists and residents performed potentially distracting tasks of a personal and/or educational nature in a majority of cases. Self-initiated distractions were rarely associated with events. This study suggests that anesthesia professionals using sound judgment can self-manage nonclinical activities. Future efforts should focus on eliminating more cognitively absorbing and less escapable distractions, as well as training in distraction management.

scholarly journals 2085

2017 ◽  
Vol 1 (S1) ◽  
pp. 11-11
Author(s):  
Rebecca Namenek Brouwer ◽  
Rebbecca Moen ◽  
Iain Sanderson ◽  
Ebony Boulware ◽  
Johanna O’Dell ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Information Access ◽  
Research Community ◽  
Web Based ◽  
Engagement Strategies ◽  
Industry Standard ◽  
Academic Medical ◽  
Hands On ◽  
Duke University

OBJECTIVES/SPECIFIC AIMS: Describe (1) the features of the first release of Duke’s myRESEARCHhome portal for researchers, and 2) the methods and results of adoption strategies METHODS/STUDY POPULATION: Through methods described previously (cite ACTS poster, 2016), the myRESEARCHhome portal team conducted a needs assessment to determine priorities for inclusion in the tool. Based on results of that assessment, the “minimal viable product” launched in June 2016 included the following features, organized into 9 distinct widgets: Access to all web-based research applications; ability to find and request research services; at-a-glance view of financial, protocol, and salary distribution information; access to financial and personnel reports; access to status of agreements and patents; access to CTSA-supported navigation services; visibility into required training and expiration dates; listing of announcements relevant to researchers; customized links area; ability to customize portal. The portal was developed using Ruby on Rails™, with a REACT grid framework. The development team, internal to Duke University, followed industry-standard best practices for development. After the initial release, the team employed several strategies to ensure awareness and adoption. Although written communications were an important factor for awareness, the presentations and hands-on studios proved most important. RESULTS/ANTICIPATED RESULTS: Use of the portal was directly related to in-person outreach efforts. There were small spikes after written communications, but strategies such as presentations, hands-on demonstrations, training sessions, and faculty meetings garnered the steadiest adoption rates. As of early January, 2017, almost 3000 users have interacted with the portal, with numbers rising steadily. There are an estimated 10,000+ faculty, staff, and trainees engaged in research at Duke. DISCUSSION/SIGNIFICANCE OF IMPACT: To maintain high adoption rates with the research community, engagement strategies must be ongoing. In addition to frequent in-person demonstrations, updates via written communications, and attendance at events, the portal team will employ a key adopt strategy—engaging the researchers in ongoing needs assessments. By maintaining the portal’s relevance to the needs of the research community, the tool can better improve the efficiency of research at a large academic medical center.

scholarly journals Neurological Dashboards and Consultation Turnaround Time at an Academic Medical Center

2019 ◽  
Vol 10 (05) ◽  
pp. 849-858
Author(s):  
Benjamin R. Kummer ◽  
Joshua Z. Willey ◽  
Michael J. Zelenetz ◽  
Yiping Hu ◽  
Soumitra Sengupta ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Medical Center ◽  
Academic Medical Center ◽  
Turnaround Time ◽  
Health Record ◽  
Web Based ◽  
Patient Chart ◽  
Academic Medical ◽  
Before And After ◽  
The Difference

Abstract Background Neurologists perform a significant amount of consultative work. Aggregative electronic health record (EHR) dashboards may help to reduce consultation turnaround time (TAT) which may reflect time spent interfacing with the EHR. Objectives This study was aimed to measure the difference in TAT before and after the implementation of a neurological dashboard. Methods We retrospectively studied a neurological dashboard in a read-only, web-based, clinical data review platform at an academic medical center that was separate from our institutional EHR. Using our EHR, we identified all distinct initial neurological consultations at our institution that were completed in the 5 months before, 5 months after, and 12 months after the dashboard go-live in December 2017. Using log data, we determined total dashboard users, unique page hits, patient-chart accesses, and user departments at 5 months after go-live. We calculated TAT as the difference in time between the placement of the consultation order and completion of the consultation note in the EHR. Results By April 30th in 2018, we identified 269 unique users, 684 dashboard page hits (median hits/user 1.0, interquartile range [IQR] = 1.0), and 510 unique patient-chart accesses. In 5 months before the go-live, 1,434 neurology consultations were completed with a median TAT of 2.0 hours (IQR = 2.5) which was significantly longer than during 5 months after the go-live, with 1,672 neurology consultations completed with a median TAT of 1.8 hours (IQR = 2.2; p = 0.001). Over the following 7 months, 2,160 consultations were completed and median TAT remained unchanged at 1.8 hours (IQR = 2.5). Conclusion At a large academic institution, we found a significant decrease in inpatient consult TAT 5 and 12 months after the implementation of a neurological dashboard. Further study is necessary to investigate the cognitive and operational effects of aggregative dashboards in neurology and to optimize their use.

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
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