MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of the American Medical Informatics Association' source. Sun, 21 Mar 2010 15:18:53 +0100 http://www.medworm.com/index.php?rid=3323291&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190052%26dopt%3DAbstract Authors: Bloomrosen M, Detmer DE There is an increased level of activity in the biomedical and health informatics world (e-prescribing, electronic health records, personal health records) that, in the near future, will yield a wealth of available data that we can exploit meaningfully to strengthen knowledge building and evidence creation, and ultimately improve clinical and preventive care. The American Medical Informatics Association (AMIA) 2008 Health Policy Conference was convened to focus and propel discussions about informatics-enabled evidence-based care, clinical research, and knowledge management. Conference participants explored the potential of informatics tools and technologies to improve the evidence base on which providers and patients can draw to diagnose and treat health... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323291 Mon, 01 Mar 2010 00:00:00 +0100 3323291 http://www.medworm.com/index.php?rid=3323290&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190053%26dopt%3DAbstract Authors: Murphy SN, Weber G, Mendis M, Gainer V, Chueh HC, Churchill S, Kohane I Informatics for Integrating Biology and the Bedside (i2b2) is one of seven projects sponsored by the NIH Roadmap National Centers for Biomedical Computing (http://www.ncbcs.org). Its mission is to provide clinical investigators with the tools necessary to integrate medical record and clinical research data in the genomics age, a software suite to construct and integrate the modern clinical research chart. i2b2 software may be used by an enterprise's research community to find sets of interesting patients from electronic patient medical record data, while preserving patient privacy through a query tool interface. Project-specific mini-databases ("data marts") can be created from these sets to make highly de... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323290 Mon, 01 Mar 2010 00:00:00 +0100 3323290 http://www.medworm.com/index.php?rid=3323289&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190054%26dopt%3DAbstract Authors: Chute CG, Beck SA, Fisk TB, Mohr DN Mayo Clinic's Enterprise Data Trust is a collection of data from patient care, education, research, and administrative transactional systems, organized to support information retrieval, business intelligence, and high-level decision making. Structurally it is a top-down, subject-oriented, integrated, time-variant, and non-volatile collection of data in support of Mayo Clinic's analytic and decision-making processes. It is an interconnected piece of Mayo Clinic's Enterprise Information Management initiative, which also includes Data Governance, Enterprise Data Modeling, the Enterprise Vocabulary System, and Metadata Management. These resources enable unprecedented organization of enterprise information about patient, genomic, and research dat... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323289 Mon, 01 Mar 2010 00:00:00 +0100 3323289 http://www.medworm.com/index.php?rid=3323288&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190055%26dopt%3DAbstract Authors: Ferranti JM, Langman MK, Tanaka D, McCall J, Ahmad A Healthcare is increasingly dependent upon information technology (IT), but the accumulation of data has outpaced our capacity to use it to improve operating efficiency, clinical quality, and financial effectiveness. Moreover, hospitals have lagged in adopting thoughtful analytic approaches that would allow operational leaders and providers to capitalize upon existing data stores. In this manuscript, we propose a fundamental re-evaluation of strategic IT investments in healthcare, with the goal of increasing efficiency, reducing costs, and improving outcomes through the targeted application of health analytics. We also present three case studies that illustrate the use of health analytics to leverage pre-existing data resourc... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323288 Mon, 01 Mar 2010 00:00:00 +0100 3323288 http://www.medworm.com/index.php?rid=3323287&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190056%26dopt%3DAbstract Authors: Steindel SJ An object identifier (OID) has a central utility in providing a traceable source for the meaning of an identifier appearing in a cross-system communication. The views in this paper illustrate the problems with using the present OID registration system as a reliable source for the identifier, the confusion that the use of an OID introduces in messages, and the redundancy that the OID introduces at the expense of increased message size and no new content. In promoting clearly defined cross-system communication identifiers, Health Level 7 developed a standard that required use of OIDs outside of network addressing. This standard and its propagation by others may have paradoxically added more confusion than clarity. PMID: 20190056 [PubMed - in process] (Source: Jou... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323287 Mon, 01 Mar 2010 00:00:00 +0100 3323287 http://www.medworm.com/index.php?rid=3323286&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190057%26dopt%3DAbstract Conclusion There is a real risk of inadvertent disclosure of PHI through peer-to-peer file sharing networks, although the risk is not as large as for PFI. Anyone keeping PHI on their computers should avoid installing file sharing applications on their computers, or if they have to use such tools, actively manage the risks of inadvertent disclosure of their, their family's, their clients', or patients' PHI. PMID: 20190057 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323286 Mon, 01 Mar 2010 00:00:00 +0100 3323286 http://www.medworm.com/index.php?rid=3323285&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190058%26dopt%3DAbstract Conclusion The de-identification tool achieves high accuracy when training and test sets are homogeneous (ie, both real or resynthesized records). The resynthesis component regularizes the data to make them less "realistic," resulting in loss of performance particularly when training on resynthesized data and testing on real data. PMID: 20190058 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323285 Mon, 01 Mar 2010 00:00:00 +0100 3323285 http://www.medworm.com/index.php?rid=3323284&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190059%26dopt%3DAbstract Conclusions This work illustrates that blanket protection policies, such as Safe Harbor, leave different organizations vulnerable to re-identification at different rates. It provides justification for locally performed re-identification risk estimates prior to sharing data. PMID: 20190059 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323284 Mon, 01 Mar 2010 00:00:00 +0100 3323284 http://www.medworm.com/index.php?rid=3323283&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190060%26dopt%3DAbstract Authors: Pieczkiewicz DS, Finkelstein SM Clinicians face an increasing volume of biomedical data. Assessing the efficacy of systems that enable accurate and timely clinical decision making merits corresponding attention. This paper discusses the multiple-reader multiple-case (MRMC) experimental design and linear mixed models as means of assessing and comparing decision accuracy and latency (time) for decision tasks in which clinician readers must interpret visual displays of data. These tools can assess and compare decision accuracy and latency (time). These experimental and statistical techniques, used extensively in radiology imaging studies, offer a number of practical and analytic advantages over more traditional quantitative methods such as percent-correct measurements and ANOVAs,... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323283 Mon, 01 Mar 2010 00:00:00 +0100 3323283 http://www.medworm.com/index.php?rid=3323282&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190061%26dopt%3DAbstract Authors: Nadkarni PM, Marenco LA Maintaining a large controlled biomedical vocabulary requires ensuring the content's internal consistency. This is done through rules, specified by the vocabulary's curators, which denote how the vocabulary's concepts should be defined. When individual organizations deploy such vocabularies, local concepts are typically added and linked to concepts in the main vocabulary: the process of maintaining and linking local content should follow the same rules. The operation of content-maintenance software can be facilitated by maintaining such rules in computable form. In this paper, we demonstrate how to implement computable rules for attribute usage in SNOMED CT using a table-driven approach where a given rule is expressed as one or more rows in a table and ... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323282 Mon, 01 Mar 2010 00:00:00 +0100 3323282 http://www.medworm.com/index.php?rid=3323281&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190062%26dopt%3DAbstract Conclusions More detailed clinical information may result in quality measures that are not comparable across institutions due institution-specific workflow, differences that are exposed using EMR-derived data. PMID: 20190062 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323281 Mon, 01 Mar 2010 00:00:00 +0100 3323281 http://www.medworm.com/index.php?rid=3323280&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190063%26dopt%3DAbstract Conclusion Findings suggest patient-centeredness for personal health records can be improved, and recommendations are made for best practice guidelines. PMID: 20190063 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323280 Mon, 01 Mar 2010 00:00:00 +0100 3323280 http://www.medworm.com/index.php?rid=3323279&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190064%26dopt%3DAbstract Conclusion Telemedicine case management was not associated with a reduction in Medicare claims in this medically underserved population. The cost of implementing the telemedicine intervention was high, largely representing special purpose hardware and software costs required at the time. Lower implementation costs will need to be achieved using lower cost technology in order for telemedicine case management to be more widely used. PMID: 20190064 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323279 Mon, 01 Mar 2010 00:00:00 +0100 3323279 http://www.medworm.com/index.php?rid=3323278&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190065%26dopt%3DAbstract Conclusion VHA has used the ACSI to monitor satisfaction, and to better understand the characteristics, needs, and preferences of early adopters. The data provide an important source of direct feedback to inform program development. Future research will include monitoring the impact of enhancements and new features on satisfaction, and conducting additional research with nonadopters to identify barriers to adoption and use. PMID: 20190065 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323278 Mon, 01 Mar 2010 00:00:00 +0100 3323278 http://www.medworm.com/index.php?rid=3323277&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190066%26dopt%3DAbstract Conclusion A population-based informatics system for primary care practice significantly improved the rate of osteoporosis screening. PMID: 20190066 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323277 Mon, 01 Mar 2010 00:00:00 +0100 3323277 http://www.medworm.com/index.php?rid=3323276&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190067%26dopt%3DAbstract Authors: Lurio J, Morrison FP, Pichardo M, Berg R, Buck MD, Wu W, Kitson K, Mostashari F, Calman N Alerting providers to public health situations requires timeliness and context-relevance, both lacking in current systems. Incorporating decision support tools into electronic health records may provide a way to deploy public health alerts to clinicians at the point of care. A timely process for responding to Health Alert Network messages sent by the New York City Department of Health and Mental Hygiene was developed by a network of community health centers. Alerts with order sets and recommended actions were created to notify primary care providers of local disease outbreaks. The process, effect, and lessons learned from alerts for Legionella, toxogenic E coli, and measles outbreaks are ... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323276 Mon, 01 Mar 2010 00:00:00 +0100 3323276 http://www.medworm.com/index.php?rid=3323275&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190068%26dopt%3DAbstract Authors: Leroy G, Miller T This pilot study explores the impact of a health topics overview (HTO) on reading comprehension. The HTO is generated automatically based on the presence of Unified Medical Language System terms. In a controlled setting, we presented health texts and posed 15 questions for each. We compared performance with and without the HTO. The answers were available in the text, but not always in the HTO. Our study (n=48) showed that consumers with low health literacy or high stress performed poorly when the HTO was available without linking directly to the answer. They performed better with direct links in the HTO or when the HTO was not available at all. Consumers with high health literacy or low stress performed better regardless of the availability of the HTO. Our da... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323275 Mon, 01 Mar 2010 00:00:00 +0100 3323275 http://www.medworm.com/index.php?rid=3323274&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190069%26dopt%3DAbstract Authors: Kahn JS, Hilton JF, Van Nunnery T, Leasure S, Bryant KM, Hare CB, Thom DH Personal health records (PHRs) are information repositories; however, PHRs may be less available to persons in the safety net setting. We deployed a free, secure, internet-based PHR for persons receiving care at the AIDS/HIV clinic at San Francisco General Hospital. In our initial rollout, 221 persons registered for the PHR. Compared to the entire clinic, these initial users were more likely to be Caucasian, male, non-Hispanic, on antiretroviral medications, and have better control of their HIV infection. The median number of online sessions was 7 and the median session length was 4 min. Laboratory results were the most commonly accessed feature. Patients were satisfied with the PHR and more than 80% of ... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323274 Mon, 01 Mar 2010 00:00:00 +0100 3323274 http://www.medworm.com/index.php?rid=3323273&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20190070%26dopt%3DAbstract Authors: PMID: 20190070 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3323273 Mon, 01 Mar 2010 00:00:00 +0100 3323273 http://www.medworm.com/index.php?rid=3176023&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20069759%26dopt%3DAbstract Authors: Hunter JS PMID: 20069759 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3176023 Fri, 01 Jan 2010 00:00:00 +0100 3176023 http://www.medworm.com/index.php?rid=3167709&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064794%26dopt%3DAbstract Authors: Scotch M, Duggal M, Brandt C, Lin Z, Shiffman R Statistics is an essential aspect of biomedical informatics. To examine the use of statistics in informatics research, a literature review of recent articles in two high-impact factor biomedical informatics journals, the Journal of American Medical Informatics Association (JAMIA) and the International Journal of Medical Informatics was conducted. The use of statistical methods in each paper was examined. Articles of original investigations from 2000 to 2007 were reviewed. For each journal, the results by statistical methods were analyzed as: descriptive, elementary, multivariable, other regression, machine learning, and other statistics. For both journals, descriptive statistics were most often used. Elementary statistics such as... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167709 Fri, 01 Jan 2010 00:00:00 +0100 3167709 http://www.medworm.com/index.php?rid=3167708&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064795%26dopt%3DAbstract Authors: Kuperman GJ, Blair JS, Franck RA, Devaraj S, Low AF, In 2007, the Department of Health and Human Services commissioned the Nationwide Health Information Network (NHIN) Trial Implementations project to demonstrate the secure exchange of data among health information exchange organizations around the country. The project's Core Services Content Work Group (CSCWG) developed the content specifications for the project. The CSCWG developed content specifications for a summary patient record and for eight use cases that were implemented in demonstration events in 2008. The CSCWG developed tools to represent the specifications and facilitate implementation. The experience revealed that, in general, the Health Information Technology Standards Panel (HITSP) constructs served as a suita... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167708 Fri, 01 Jan 2010 00:00:00 +0100 3167708 http://www.medworm.com/index.php?rid=3167707&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064796%26dopt%3DAbstract Authors: Downs SM, van Dyck PC, Rinaldo P, McDonald C, Howell RR, Zuckerman A, Downing G Capture, coding and communication of newborn screening (NBS) information represent a challenge for public health laboratories, health departments, hospitals, and ambulatory care practices. An increasing number of conditions targeted for screening and the complexity of interpretation contribute to a growing need for integrated information-management strategies. This makes NBS an important test of tools and architecture for electronic health information exchange (HIE) in this convergence of individual patient care and population health activities. For this reason, the American Health Information Community undertook three tasks described in this paper. First, a newborn screening use case was establish... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167707 Fri, 01 Jan 2010 00:00:00 +0100 3167707 http://www.medworm.com/index.php?rid=3167706&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064797%26dopt%3DAbstract We describe a new natural language processing system (MedEx), which extracts medication information from clinical notes. MedEx was initially developed using discharge summaries. An evaluation using a data set of 50 discharge summaries showed it performed well on identifying not only drug names (F-measure 93.2%), but also signature information, such as strength, route, and frequency, with F-measures of 94.5%, 93.9%, and 96.0% respectively. We then applied MedEx unchanged to outpatient clinic visit notes. It performed similarly with F-measures over 90% on a set of 25 clinic visit notes. PMID: 20064797 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167706 Fri, 01 Jan 2010 00:00:00 +0100 3167706 http://www.medworm.com/index.php?rid=3167705&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064798%26dopt%3DAbstract Authors: Moxey A, Robertson J, Newby D, Hains I, Williamson M, Pearson SA There is wide variability in the use and adoption of recommendations generated by computerized clinical decision support systems (CDSSs) despite the benefits they may bring to clinical practice. We conducted a systematic review to explore the barriers to, and facilitators of, CDSS uptake by physicians to guide prescribing decisions. We identified 58 studies by searching electronic databases (1990-2007). Factors impacting on CDSS use included: the availability of hardware, technical support and training; integration of the system into workflows; and the relevance and timeliness of the clinical messages. Further, systems that were endorsed by colleagues, minimized perceived threats to professional autonomy, and did... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167705 Fri, 01 Jan 2010 00:00:00 +0100 3167705 http://www.medworm.com/index.php?rid=3167704&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064799%26dopt%3DAbstract Authors: Rajeev D, Staes CJ, Evans RS, Mottice S, Rolfs R, Samore MH, Whitney J, Kurzban R, Huff SM Clinicians are required to report selected conditions to public health authorities within a stipulated amount of time. The current reporting process is mostly paper-based and inefficient and may lead to delays in case investigation. As electronic medical records become more prevalent, electronic case reporting is becoming increasingly feasible. However, there is no existing standard for the electronic transmission of case reports from healthcare to public health entities. We identified the major requirements of electronic case reports and verified that the requirements support the work processes of the local health departments. We propose an extendable standards-based model to electronic... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167704 Fri, 01 Jan 2010 00:00:00 +0100 3167704 http://www.medworm.com/index.php?rid=3167703&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064800%26dopt%3DAbstract CONCLUSIONS: We present a framework that translates existing practice-manual infection detection-to an automated process for surveillance. Our experience details barriers and solutions discovered during development of electronic surveillance for central vascular catheter associated bloodstream infections at four hospitals in a variety of data environments. Moving electronic surveillance to the next level-availability at a majority of acute care hospitals nationwide-would be hastened by the incorporation of necessary data elements, vocabularies and standards into commercially available electronic health records. PMID: 20064800 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167703 Fri, 01 Jan 2010 00:00:00 +0100 3167703 http://www.medworm.com/index.php?rid=3167702&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064801%26dopt%3DAbstract CONCLUSION: The study established the feasibility of exploring redundancy in the narrative record with a known sequence alignment algorithm used frequently in the field of bioinformatics. The findings provide a foundation for studying the usefulness and risks of redundancy in the EHR. PMID: 20064801 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167702 Fri, 01 Jan 2010 00:00:00 +0100 3167702 http://www.medworm.com/index.php?rid=3167701&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064802%26dopt%3DAbstract CONCLUSIONS: In an academic medical center clinic, the presence of electronic records was not seen as a dramatic impediment to therapeutic communications. Concerns regarding privacy and data security were significant, and may contribute to reluctances to adopt electronic records in other settings. Further study of clinicians' views and use patterns may be helpful in guiding development and deployment of electronic records systems. PMID: 20064802 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167701 Fri, 01 Jan 2010 00:00:00 +0100 3167701 http://www.medworm.com/index.php?rid=3167700&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064803%26dopt%3DAbstract CONCLUSION: Finding ways to help RHIOs become operational and self-sustaining will bolster the current approach to nationwide health information exchange. Our work suggests that convening a broad coalition of stakeholders to focus on a narrow set of data is an important step in helping RHIOs become operational. Convincing stakeholders to financially commit early in the process may help RHIOs become self-sustaining. PMID: 20064803 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167700 Fri, 01 Jan 2010 00:00:00 +0100 3167700 http://www.medworm.com/index.php?rid=3167699&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064804%26dopt%3DAbstract CONCLUSIONS: Physicians perceive that HIE will have generally positive effects, though a considerable fraction harbor concerns about privacy. While physicians may be willing to participate in HIE, they are not consistently willing to pay to participate. HIE business models that require substantial physician subscription fees may face significant challenges. PMID: 20064804 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167699 Fri, 01 Jan 2010 00:00:00 +0100 3167699 http://www.medworm.com/index.php?rid=3167698&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064805%26dopt%3DAbstract CONCLUSION: Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results. PMID: 20064805 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167698 Fri, 01 Jan 2010 00:00:00 +0100 3167698 http://www.medworm.com/index.php?rid=3167697&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064806%26dopt%3DAbstract CONCLUSIONS: A basic CPOE system in a community setting was associated with a significant reduction in medication errors of most types and severity levels. PMID: 20064806 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167697 Fri, 01 Jan 2010 00:00:00 +0100 3167697 http://www.medworm.com/index.php?rid=3167696&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064807%26dopt%3DAbstract CONCLUSIONS: Incorporating recent, local population-level disease incidence improved the ability of a decision model to correctly identify infants with pertussis. Our findings support fostering bidirectional exchange between public health and clinical practice, and validate a method for integrating large-scale public health datasets with rich clinical data to improve decision-making and public health. PMID: 20064807 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167696 Fri, 01 Jan 2010 00:00:00 +0100 3167696 http://www.medworm.com/index.php?rid=3167695&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064808%26dopt%3DAbstract CONCLUSION: HCD systems improve communication access but users experience challenges integrating the system into workflow. Effective HCD use depends on how well organizations train users, adapt to changes brought about by HCD systems, and integrate HCD systems into physical surroundings. PMID: 20064808 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167695 Fri, 01 Jan 2010 00:00:00 +0100 3167695 http://www.medworm.com/index.php?rid=3167694&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064809%26dopt%3DAbstract Authors: Chang KC, Overhage JM, Hui SL, Were MC In today's environment, providers are extremely time-constrained. Assembling relevant contextual data to make decisions on laboratory results can take a significant amount of time from the day. The Regenstrief Institute has created a system which leverages data within Indiana Health Information Exchange's (IHIE's) repository, the Indiana Network for Patient Care (INPC), to provide well-organized and contextual information on returning laboratory results to outpatient providers. The system described here uses data extracted from INPC to add historical test results, medication-dispensing events, visit information, and clinical reminders to traditional laboratory result reports. These "Enhanced Laboratory Reports" (ELRs) are seamlessly deliv... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167694 Fri, 01 Jan 2010 00:00:00 +0100 3167694 http://www.medworm.com/index.php?rid=3167693&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064810%26dopt%3DAbstract Authors: Yackel TR, Embi PJ Test result management is an integral aspect of quality clinical care and a crucial part of the ambulatory medicine workflow. Correct and timely communication of results to a provider is the necessary first step in ambulatory result management and has been identified as a weakness in many paper-based systems. While electronic health records (EHRs) hold promise for improving the reliability of result management, the complexities involved make this a challenging task. Experience with test result management is reported, four new categories of result management errors identified are outlined, and solutions developed during a 2-year deployment of a commercial EHR are described. Recommendations for improving test result management with EHRs are then given. PMI... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167693 Fri, 01 Jan 2010 00:00:00 +0100 3167693 http://www.medworm.com/index.php?rid=3167692&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D20064811%26dopt%3DAbstract Authors: Payne TH, tenBroek AE, Fletcher GS, Labuguen MC UW Medicine teaching hospitals have seen a move from paper to electronic physician inpatient notes, after improving the availability of workstations, and wireless laptops and the technical infrastructure supporting the electronic medical record (EMR). The primary driver for the transition was to unify the medical record for all disciplines in one location. The main barrier faced was the time required to enter notes, which was addressed with data-rich templates tailored to rounding workflow, simplified login and other measures. After a 2-year transition, nearly all physician notes for hospitalized patients are now entered electronically, approximately 1500 physician notes per day. Remaining challenges include time for note entry, ... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3167692 Fri, 01 Jan 2010 00:00:00 +0100 3167692 http://www.medworm.com/index.php?rid=3149789&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567788%26dopt%3DAbstract Authors: Weber GM, Murphy SN, McMurry AJ, Macfadden D, Nigrin DJ, Churchill S, Kohane IS The authors developed a prototype Shared Health Research Information Network (SHRINE) to identify the technical, regulatory, and political challenges of creating a federated query tool for clinical data repositories. Separate Institutional Review Boards (IRBs) at Harvard's three largest affiliated health centers approved use of their data, and the Harvard Medical School IRB approved building a Query Aggregator Interface that can simultaneously send queries to each hospital and display aggregate counts of the number of matching patients. Our experience creating three local repositories using the open source Informatics for Integrating Biology and the Bedside (i2b2) platform can be used as a road map... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149789 Tue, 01 Sep 2009 00:00:00 +0100 3149789 http://www.medworm.com/index.php?rid=3149788&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567789%26dopt%3DAbstract CONCLUSION: By eliminating false-positive matches, the value-based weight modification can enhance the specificity of the F-S method with minimal decrease in sensitivity. PMID: 19567789 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149788 Tue, 01 Sep 2009 00:00:00 +0100 3149788 http://www.medworm.com/index.php?rid=3149787&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567790%26dopt%3DAbstract CONCLUSIONS: Differences in education, income, and Internet access did not account for the disparities in PHR registration by race. In the short-term, attempts to improve patient access to health care with PHRs may not ameliorate prevailing disparities between African Americans and whites. PMID: 19567790 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149787 Tue, 01 Sep 2009 00:00:00 +0100 3149787 http://www.medworm.com/index.php?rid=3149786&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567791%26dopt%3DAbstract Authors: Kilbridge PM, Noirot LA, Reichley RM, Berchelmann KM, Schneider C, Heard KM, Nelson M, Bailey TC There are limited data on adverse drug event rates in pediatrics. The authors describe the implementation and evaluation of an automated surveillance system modified to detect adverse drug events (ADEs) in pediatric patients. The authors constructed an automated surveillance system to screen admissions to a large pediatric hospital. Potential ADEs identified by the system were reviewed by medication safety pharmacists and a physician and scored for causality and severity. Over the 6 month study period, 6,889 study children were admitted to the hospital for a total of 40,250 patient-days. The ADE surveillance system generated 1226 alerts, which yielded 160 true ADEs. This represents... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149786 Tue, 01 Sep 2009 00:00:00 +0100 3149786 http://www.medworm.com/index.php?rid=3149785&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567792%26dopt%3DAbstract CONCLUSIONS: Automated literature prioritization could be helpful in assisting experts to organize their time when performing systematic reviews. Future work will focus on extending the algorithm to use additional sources of topic-specific data, and on embedding the algorithm in an interactive system available to systematic reviewers during the literature review process. PMID: 19567792 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149785 Tue, 01 Sep 2009 00:00:00 +0100 3149785 http://www.medworm.com/index.php?rid=3149784&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567793%26dopt%3DAbstract CONCLUSIONS: Despite parental involvement and prior heuristic testing, scenario-based testing demonstrated difficulties in navigation, medical language complexity, error recovery, and provider-based organizational schema. While such usability testing can be expensive, the current study demonstrates that it can assist in making healthcare system interfaces for laypersons more user-friendly and potentially more functional for patients and their families. PMID: 19567793 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149784 Tue, 01 Sep 2009 00:00:00 +0100 3149784 http://www.medworm.com/index.php?rid=3149783&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567794%26dopt%3DAbstract CONCLUSIONS: The data suggest it may be premature to embrace unilaterally the Internet as an effective asset for health promotion and disease prevention efforts that target the public. PMID: 19567794 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149783 Tue, 01 Sep 2009 00:00:00 +0100 3149783 http://www.medworm.com/index.php?rid=3149782&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567795%26dopt%3DAbstract CONCLUSIONS: For the de-identification of health datasets, OLA is an improvement on existing k-anonymity algorithms in terms of information loss and performance. PMID: 19567795 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149782 Tue, 01 Sep 2009 00:00:00 +0100 3149782 http://www.medworm.com/index.php?rid=3149781&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567796%26dopt%3DAbstract CONCLUSIONS: These findings have implications for four distinct constituencies: purchasers of clinical information systems, developers of clinical decision support, vendors of clinical information systems and certification bodies. PMID: 19567796 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149781 Tue, 01 Sep 2009 00:00:00 +0100 3149781 http://www.medworm.com/index.php?rid=3149780&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567797%26dopt%3DAbstract Authors: Nanji KC, Cina J, Patel N, Churchill W, Gandhi TK, Poon EG Technology has great potential to reduce medication errors in hospitals. This case report describes barriers to, and facilitators of, the implementation of a pharmacy bar code scanning system to reduce medication dispensing errors at a large academic medical center. Ten pharmacy staff were interviewed about their experiences during the implementation. Interview notes were iteratively reviewed to identify common themes. The authors identified three main barriers to pharmacy bar code scanning system implementation: process (training requirements and process flow issues), technology (hardware, software, and the role of vendors), and resistance (communication issues, changing roles, and negative perceptions about technolog... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149780 Tue, 01 Sep 2009 00:00:00 +0100 3149780 http://www.medworm.com/index.php?rid=3149779&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567798%26dopt%3DAbstract Authors: Reckmann MH, Westbrook JI, Koh Y, Lo C, Day RO Previous reviews have examined evidence of the impact of CPOE on medication errors, but have used highly variable definitions of "error". We attempted to answer a very focused question, namely, what evidence exists that CPOE systems reduce prescribing errors among hospital inpatients? We identified 13 papers (reporting 12 studies) published between 1998 and 2007. Nine demonstrated a significant reduction in prescribing error rates for all or some drug types. Few studies examined changes in error severity, but minor errors were most often reported as decreasing. Several studies reported increases in the rate of duplicate orders and failures to discontinue drugs, often attributed to inappropriate selection from a dropdown menu or to... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149779 Tue, 01 Sep 2009 00:00:00 +0100 3149779 http://www.medworm.com/index.php?rid=3149778&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567799%26dopt%3DAbstract CONCLUSIONS: Despite the increasing use of handheld computers for electronic data collection in clinical research, these devices should be used with caution. They double the duration of the data entry process and significantly increase the risk of typing errors and missing data. This may become a particularly crucial issue in studies where these devices are provided to patients or healthcare workers, unfamiliar with computer technologies, for self-reporting or research data collection processes. PMID: 19567799 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149778 Tue, 01 Sep 2009 00:00:00 +0100 3149778 http://www.medworm.com/index.php?rid=3149777&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567800%26dopt%3DAbstract Authors: Poon EG, Cusack CM, McGowan JJ The National Resource Center for Health Information Technology (NRC) was formed in the fall of 2004 as part of the Agency for Healthcare Research and Quality (AHRQ) health IT portfolio to support its grantees. One of the core functions of the NRC was to assist grantees in their evaluation efforts of Health IT. This manuscript highlights some common challenges experienced by health IT project teams at nonacademic institutions, including inappropriately scoped and resourced evaluation efforts, inappropriate choice of metrics, inadequate planning for data collection and analysis, and lack of consideration of qualitative methodologies. Many of these challenges can be avoided or overcome. The strategies adopted by various AHRQ grantees and the lessons... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149777 Tue, 01 Sep 2009 00:00:00 +0100 3149777 http://www.medworm.com/index.php?rid=3149776&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567801%26dopt%3DAbstract Authors: Marenco L, Wang R, Nadkarni P OBJECTIVE: To devise an automated approach for integrating federated database information using database ontologies constructed from their extended metadata. BACKGROUND: One challenge of database federation is that the granularity of representation of equivalent data varies across systems. Dealing effectively with this problem is analogous to dealing with precoordinated vs. postcoordinated concepts in biomedical ontologies. MODEL DESCRIPTION: The authors describe an approach based on ontological metadata mapping rules defined with elements of a global vocabulary, which allows a query specified at one granularity level to fetch data, where possible, from databases within the federation that use different granularities. This is implemented in OntoMe... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149776 Tue, 01 Sep 2009 00:00:00 +0100 3149776 http://www.medworm.com/index.php?rid=3149775&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567802%26dopt%3DAbstract CONCLUSION: The results show that the proposed auditing methodology can help to effectively and efficiently identify concepts lacking the assignment of a particular semantic type. PMID: 19567802 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149775 Tue, 01 Sep 2009 00:00:00 +0100 3149775 http://www.medworm.com/index.php?rid=3149774&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19567803%26dopt%3DAbstract CONCLUSIONS: Interdisciplinary ICU staff perceived wireless e-mail to improve communication, team relationships, staff satisfaction, and patient care. Further research should address the impact of wireless e-mail on efficiency and timeliness of staff workflow and clinical outcomes. PMID: 19567803 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=3149774 Tue, 01 Sep 2009 00:00:00 +0100 3149774 http://www.medworm.com/index.php?rid=2753287&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717793%26dopt%3DAbstract Authors: Prgomet M, Georgiou A, Westbrook JI The substantial growth in mobile handheld technologies has heralded the opportunity to provide physicians with access to information, resources and people at the right time and place. But is this technology delivering the benefits to workflow and patient care promised by increased mobility? We conducted a systematic review to examine evidence regarding the impact of mobile handheld technology on hospital physicians' work practices and patient care, focusing on quantification of the espoused virtues of mobile technologies. We identified thirteen studies that demonstrated the ability of personal digital assistants (PDAs) to positively impact on areas of rapid response, error prevention, and data management and accessibility. PDA use demonstrat... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753287 Thu, 27 Aug 2009 23:00:00 +0100 2753287 http://www.medworm.com/index.php?rid=2753286&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717794%26dopt%3DAbstract Authors: Backus LI, Gavrilov S, Loomis TP, Halloran JP, Phillips BR, Belperio PS, Mole LA The Department of Veterans Affairs (VA) has a system-wide, patient-centric electronic medical record system (EMR) within which we developed the Clinical Case Registries (CCR) to support population-centric delivery and evaluation of VA medical care. To date, we have applied the CCR to populations with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Local components use diagnosis codes and laboratory test results to identify patients who may have HIV or HCV and support queries on local care delivery with customizable reports. For each patient in a local registry, key EMR data are transferred via HL7 messaging to a single national registry. From 128 local registry systems, over 60,000... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753286 Thu, 27 Aug 2009 23:00:00 +0100 2753286 http://www.medworm.com/index.php?rid=2753285&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717795%26dopt%3DAbstract CONCLUSION The NIS' modular design and frequent, effective interactions between developers and users has positively affected the design, implementation, support, and modifications of the NIS. It demonstrates the success of collaboration between engineering and medical communities, and more importantly the feasibility for technology readily available in a modern country to contribute to healthcare delivery in developing countries like Kenya and other parts of sub-Saharan Africa. PMID: 19717795 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753285 Thu, 27 Aug 2009 23:00:00 +0100 2753285 http://www.medworm.com/index.php?rid=2753284&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717796%26dopt%3DAbstract CONCLUSION The HSSP Service Specification Framework provides a replicable and collaborative approach to defining standardized service specifications for healthcare. PMID: 19717796 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753284 Thu, 27 Aug 2009 23:00:00 +0100 2753284 http://www.medworm.com/index.php?rid=2753283&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717797%26dopt%3DAbstract This study evaluated the performance of an electronic screening (E-screening) method and used it to recruit patients for the NIH sponsored ACCORD trial. Out of the 193 E-screened patients, 125 met the age criterion ("age >/= 40"). For all of these 125 patients, the performance of E-screening was compared with investigator review. E-screening achieved a negative predictive accuracy of 100% (95% CI: 98%-100%), a positive predictive accuracy of 13% (95% CI: 6%-13%), a sensitivity of 100% (95% CI: 45%-100%), and a specificity of 84% (95% CI: 82%-84%). The method maximized the utility of a patient database query (i.e., excluded ineligible patients with a 100% accuracy and automatically assembled patient information to facilitate manual review of only patients who were classified as "potentia... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753283 Thu, 27 Aug 2009 23:00:00 +0100 2753283 http://www.medworm.com/index.php?rid=2753282&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717798%26dopt%3DAbstract CONCLUSION This study has shown that CPOE/CDSS reduces the incidence of medication errors. However, a direct effect on actual patient harm (pADEs) could not be demonstrated. PMID: 19717798 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753282 Thu, 27 Aug 2009 23:00:00 +0100 2753282 http://www.medworm.com/index.php?rid=2753281&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717799%26dopt%3DAbstract CONCLUSION The case studies validate, through example, the applicability of the RE-AIM framework to inform the design, implementation, evaluation, and reporting of clinical informatics intervention studies. PMID: 19717799 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753281 Thu, 27 Aug 2009 23:00:00 +0100 2753281 http://www.medworm.com/index.php?rid=2753280&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717800%26dopt%3DAbstract CONCLUSION The SecTag algorithm accurately identified both labeled and unlabeled sections in history and physical documents. This type of algorithm may assist in clinical note natural language processing applications, such as clinical decision support systems, clinical research, and competency assessment for medical trainees. PMID: 19717800 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753280 Thu, 27 Aug 2009 23:00:00 +0100 2753280 http://www.medworm.com/index.php?rid=2753279&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717801%26dopt%3DAbstract Authors: Tsafnat G, Coiera EW Computational support of clinical decisions frequently requires the integration of data in a variety of formats and from multiple sources and domains. In recent years some impressive multi-scale computational models of biological phenomena have been developed as part of the study of disease and healthcare systems. We can now contemplate harnessing these models arising from computational biology and using highly interconnected clinical data to support clinical decision making. Indeed, understanding how to build computational systems able to reason across heterogeneous models and data sets is one of the major and perhaps foundational challenges of translational biomedical informatics. In this paper we examine the use of multi-models (models composed of sever... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753279 Thu, 27 Aug 2009 23:00:00 +0100 2753279 http://www.medworm.com/index.php?rid=2753278&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717802%26dopt%3DAbstract CONCLUSIONS In response to the analysis of workflow and information flow, we developed ten guidelines for design of HIT to support chronic disease care, including recommendations to pursue modular approaches to design that would support disease-specific needs. The study demonstrates the importance of evaluating workflow and information flow in HIT design and implementation. PMID: 19717802 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753278 Thu, 27 Aug 2009 23:00:00 +0100 2753278 http://www.medworm.com/index.php?rid=2753277&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717803%26dopt%3DAbstract Authors: Boyd AD, Saxman PR, Hunscher DA, Smith KA, Morris TD, Kaston M, Bayoff F, Rogers B, Hayes P, Rajeev N, Kline-Rogers E, Eagle K, Clauw D, Greden JF, Green LA, Athey BD For the success of clinical and translational science, a seamless interoperation is required between clinical information technology and research information technology. However, data sharing between clinical providers and researchers remains a substantial challenge. Addressing this apparent need, the University of Michigan (U-M) created the Michigan Clinical Research Collaboratory (MCRC), supported by the NIH Roadmap "Re-Engineering the Clinical Research Enterprise" initiative. The MCRC employed a standards-driven Web Services architecture to create the U-M Honest Broker, which enabled us to share clinical and r... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753277 Thu, 27 Aug 2009 23:00:00 +0100 2753277 http://www.medworm.com/index.php?rid=2753276&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717804%26dopt%3DAbstract CONCLUSION We identified predictors of performance in an introductory informatics course including GRE-V, UGPA and URMS. Course performance was a very strong predictor of overall program performance. Our findings may be useful for selecting students for admission and identifying students at risk for Failure as early as possible. PMID: 19717804 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753276 Thu, 27 Aug 2009 23:00:00 +0100 2753276 http://www.medworm.com/index.php?rid=2753275&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717805%26dopt%3DAbstract Authors: Skouroliakou M, Kakavelaki C, Diamantopoulos K, Stathopoulou M, Vourvouhaki E, Souliotis K We developed "DIET", a computerized system preparing dietary prescriptions in clinical settings. "DIET" has the ability to calculate the nutritional requirements and to produce daily menus of patients automatically. Also, it serves as an electronic medical and dietetic record and it can produce daily reports regarding portions, quantities and cost of meals. We also conducted a preliminary evaluation of the system by comparing the creation of nutritional plans for 135 patients using "DIET" versus the customary manual methods. Its use resulted in a decrease of the error percentages, concerning appropriate food choices, data recording and calculations of daily nutrient requirements; from 11... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753275 Thu, 27 Aug 2009 23:00:00 +0100 2753275 http://www.medworm.com/index.php?rid=2753274&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717806%26dopt%3DAbstract Authors: van der Sijs H, Lammers L, van den Tweel A, Aarts J, Berg M, Vulto A, van Gelder T Time-dependent drug-drug interactions (TDDIs) are drug combinations that most often result in a decreased drug effect due to co-administration of a second drug which inhibits its absorption or affects metabolism. Such interactions can be prevented by separately administering the drugs after an appropriate intervening time interval. Our study attempted to reduce drug administration errors due to overridden TDDIs in a care provider order entry (CPOE) system. In four periods divided over two studies, logged TDDIs were investigated by reviewing the time intervals prescribed in the CPOE and recorded on the patient chart. The first study showed significant drug administration error reduction from 56.4... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753274 Thu, 27 Aug 2009 23:00:00 +0100 2753274 http://www.medworm.com/index.php?rid=2753273&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717807%26dopt%3DAbstract CONCLUSION The precision at which patients' locations are reported has the potential to effect to power of detection significantly. PMID: 19717807 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753273 Thu, 27 Aug 2009 23:00:00 +0100 2753273 http://www.medworm.com/index.php?rid=2753272&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717808%26dopt%3DAbstract We present a detailed study of germane issues including high dimensionality, multiple testing, scientific significance, dependence, information measurement, and information management with a focus on appropriate methodologies available to address these concerns. A firm understanding of the challenges and statistical technology involved ultimately contributes to better science. We further suggest that the community consider facilitating discussion through interdisciplinary panels, invited papers and curriculum enhancement in order to establish guidelines for analysis and reporting. PMID: 19717808 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753272 Thu, 27 Aug 2009 23:00:00 +0100 2753272 http://www.medworm.com/index.php?rid=2753271&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19717809%26dopt%3DAbstract This study introduces new information fusion algorithms to enhance disease surveillance systems with Bayesian decision support capabilities. A detection system was built and tested using chief complaints from emergency department visits, International Classification of Diseases Revision 9 (ICD-9) codes from records of outpatient visits to civilian and military facilities, and influenza surveillance data from health departments in the National Capital Region (NCR). Data anomalies were identified and distribution of time offsets between events in the multiple data streams were established. The Bayesian Network was built to fuse data from multiple sources and identify influenza-like epidemiologically relevant events. RESULTS showed increased specificity compared to the alerts generated by tem... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2753271 Thu, 27 Aug 2009 23:00:00 +0100 2753271 http://www.medworm.com/index.php?rid=2571443&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19574463%26dopt%3DAbstract Authors: Shortliffe EH, Bates DW, Bloomrosen M, Greenwood K, Safran C, Steen EB, Tang PC, Williamson JJ Don E. Detmer has served as President and Chief Executive Officer of the American Medical Informatics Association (AMIA) for the past five years, helping to set a course for the organization and demonstrating remarkable leadership as AMIA has evolved into a vibrant and influential professional association. On the occasion of Dr. Detmer's retirement, we fondly reflect on his professional life and his many contributions to biomedical informatics and, more generally, to health care in the U.S. and globally. PMID: 19574463 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2571443 Tue, 30 Jun 2009 23:00:00 +0100 2571443 http://www.medworm.com/index.php?rid=2571442&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19574464%26dopt%3DAbstract Authors: PMID: 19574464 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2571442 Tue, 30 Jun 2009 23:00:00 +0100 2571442 http://www.medworm.com/index.php?rid=2534013&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19407078%26dopt%3DAbstract Authors: Coiera E PMID: 19407078 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534013 Thu, 30 Apr 2009 23:00:00 +0100 2534013 http://www.medworm.com/index.php?rid=2534037&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390093%26dopt%3DAbstract CONCLUSIONS Telemedicine case management resulted in net improvements in HgbA1c, LDL-cholesterol and blood pressure levels over 5 years in medically underserved Medicare beneficiaries. Mortality was not different between the groups, although power was limited. PMID: 19390093 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534037 Wed, 22 Apr 2009 23:00:00 +0100 2534037 http://www.medworm.com/index.php?rid=2534036&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390094%26dopt%3DAbstract CONCLUSION In this cross-sectional study, we found no association between duration of using an EHR and performance with respect to quality of care, although power was limited. Intensifying the use of key EHR features, such as clinical decision support, may be needed to realize quality improvement from EHRs. Future studies should examine the relationship between the extent to which physicians use key EHR functions and their performance on quality measures over time. PMID: 19390094 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534036 Wed, 22 Apr 2009 23:00:00 +0100 2534036 http://www.medworm.com/index.php?rid=2534035&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390095%26dopt%3DAbstract CONCLUSIONS An automated electronic system that screens intubated ICU trauma patients, excluding patients with CHF, for ALI based on CXR reports and results of ABGs is sufficiently accurate to identify many early cases of ALI. PMID: 19390095 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534035 Wed, 22 Apr 2009 23:00:00 +0100 2534035 http://www.medworm.com/index.php?rid=2534034&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390096%26dopt%3DAbstract This article refers to obesity and co-morbidities as diseases. It refers to the categories Present, Absent, Questionable, and Unmentioned as classes. The task of classifying obesity and co-morbidities is called the Obesity Challenge. The data released by i2b2 was annotated for textual judgments reflecting the explicitly reported information on diseases, and intuitive judgments reflecting medical professionals' reading of the information presented in discharge summaries. There were very few examples of some disease classes in the data. The Obesity Challenge paid particular attention to the performance of systems on these less well-represented classes. A total of 30 teams participated in the Obesity Challenge. Each team was allowed to submit two sets of up to three system runs for evaluation... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534034 Wed, 22 Apr 2009 23:00:00 +0100 2534034 http://www.medworm.com/index.php?rid=2534033&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390097%26dopt%3DAbstract CONCLUSION Our results demonstrate the feasibility of our approach and show that even very simple systems with a shallow linguistic analysis can achieve remarkable accuracy scores for classifying clinical records on a limited set of concepts. PMID: 19390097 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534033 Wed, 22 Apr 2009 23:00:00 +0100 2534033 http://www.medworm.com/index.php?rid=2534032&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390098%26dopt%3DAbstract CONCLUSION The performance achieved was in line with the agreement between human annotators, indicating the potential of text mining for accurate and efficient prediction of disease statuses from clinical discharge summaries. PMID: 19390098 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534032 Wed, 22 Apr 2009 23:00:00 +0100 2534032 http://www.medworm.com/index.php?rid=2534031&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390099%26dopt%3DAbstract CONCLUSION Our system demonstrates that effective comorbidity status classification by an automated system is possible. PMID: 19390099 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534031 Wed, 22 Apr 2009 23:00:00 +0100 2534031 http://www.medworm.com/index.php?rid=2534030&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390100%26dopt%3DAbstract CONCLUSION The framework and approach used to detect clinical conditions was reasonably successful at extracting 16 diagnoses related to obesity. Our system and methodology merits further development, targeting clinically useful applications. PMID: 19390100 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534030 Wed, 22 Apr 2009 23:00:00 +0100 2534030 http://www.medworm.com/index.php?rid=2534029&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390101%26dopt%3DAbstract CONCLUSION We show in the paper that a simple rule-based classifier can tackle the semantic classification task more successfully than machine learning techniques, if the training data are limited and some semantic labels are very sparse. PMID: 19390101 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534029 Wed, 22 Apr 2009 23:00:00 +0100 2534029 http://www.medworm.com/index.php?rid=2534028&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390102%26dopt%3DAbstract CONCLUSION As shown by its ranking in the challenge results, this approach performed relatively well under conditions in which limited training data existed for some judgment categories. Further, the approach held up well in relation to more complex approaches applied to this classification task. The approach could be enhanced by the addition of expert rules to model more complex medical reasoning. PMID: 19390102 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534028 Wed, 22 Apr 2009 23:00:00 +0100 2534028 http://www.medworm.com/index.php?rid=2534027&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390103%26dopt%3DAbstract We describe our methodology and discuss the results of applying Lockheed Martin's rule-based Natural Language Processing (NLP) capability, ClinREAD.(TM) We tailored ClinREAD with medical domain expertise to create assigned default judgments based on the most probable results as defined in the ground truth. It then used rules to collect evidence similar to the evidence that the human judges likely relied upon, and applied a logic module to weigh the strength of all evidence collected to arrive at final judgments. The Challenge results suggest that rule-based systems guided by human medical expertise are capable of solving complex problems in machine processing of medical text. PMID: 19390103 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Associa... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534027 Wed, 22 Apr 2009 23:00:00 +0100 2534027 http://www.medworm.com/index.php?rid=2534025&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390104%26dopt%3DAbstract CONCLUSIONS By 2007, more than one-third of practices in Massachusetts reported having EHRs; the availability and use of electronic prescribing within these systems has increased. In contrast, physicians reported little change in the availability and use of other EHR functions. System refinements, certification efforts, and health policies, including standards development, should address the gaps in both EHR adoption and the use of key functions. PMID: 19390104 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534025 Wed, 22 Apr 2009 23:00:00 +0100 2534025 http://www.medworm.com/index.php?rid=2534022&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390105%26dopt%3DAbstract CONCLUSION Based on its search engine ranking and page view statistics, the English Wikipedia is a prominent source of online health information compared to the other online health information providers studied. PMID: 19390105 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534022 Wed, 22 Apr 2009 23:00:00 +0100 2534022 http://www.medworm.com/index.php?rid=2534021&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390106%26dopt%3DAbstract CONCLUSION E-prescribing users reported patient safety benefits but they did not perceive the enhanced benefits expected from using standardized medication history or formulary and benefit information. Additional work is needed for these standards to have the desired effects. PMID: 19390106 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534021 Wed, 22 Apr 2009 23:00:00 +0100 2534021 http://www.medworm.com/index.php?rid=2534020&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390107%26dopt%3DAbstract CONCLUSION Clinical decision support for physicians prescribing medications for long-term care residents with renal insufficiency can improve the quality of prescribing decisions. PMID: 19390107 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534020 Wed, 22 Apr 2009 23:00:00 +0100 2534020 http://www.medworm.com/index.php?rid=2534019&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390108%26dopt%3DAbstract CONCLUSION Our modeling approach was instrumental in helping us characterize key process parameters and estimate the impact of adding staff on the time between identifying patients with heart failure and connecting them with appropriate discharge services. PMID: 19390108 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534019 Wed, 22 Apr 2009 23:00:00 +0100 2534019 http://www.medworm.com/index.php?rid=2534018&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390109%26dopt%3DAbstract CONCLUSION Medication administration in nursing homes is prone to many errors. This study indicates that the handling of the medication after removing it from the robot packaging may contribute to this high error frequency, which may be reduced by training of nurse attendants, by automated clinical decision support and by measures to reduce workload. PMID: 19390109 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534018 Wed, 22 Apr 2009 23:00:00 +0100 2534018 http://www.medworm.com/index.php?rid=2534017&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390110%26dopt%3DAbstract Authors: Schedlbauer A, Prasad V, Mulvaney C, Phansalkar S, Stanton W, Bates DW, Avery AJ Alerts and prompts represent promising types of decision support in electronic prescribing to tackle inadequacies in prescribing. A systematic review was conducted to evaluate the efficacy of computerized drug alerts and prompts searching EMBASE, CINHAL, MEDLINE and PsychINFO up to May 2007. Studies assessing the impact of electronic alerts and prompts on clinicians' prescribing behavior were selected and categorized by decision support type. The majority of alerts and prompts (23 out of 27) demonstrated benefit in improving prescribing behavior and/or reducing error rates. The impact appeared to vary based on the type of decision support. Some of these alerts (n=5) reported a positive impact on c... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534017 Wed, 22 Apr 2009 23:00:00 +0100 2534017 http://www.medworm.com/index.php?rid=2534016&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390111%26dopt%3DAbstract CONCLUSION The PHT reliably extracts information from the electronic health record. Respondents found the PHT to be suitable, although opportunities for improvement were identified. PMID: 19390111 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534016 Wed, 22 Apr 2009 23:00:00 +0100 2534016 http://www.medworm.com/index.php?rid=2534015&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390112%26dopt%3DAbstract Authors: Or CK, Karsh BT A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycARTICLES, and PsycINFO were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. The majority of those tested (71%) were patient factors, including socio-demographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534015 Wed, 22 Apr 2009 23:00:00 +0100 2534015 http://www.medworm.com/index.php?rid=2534014&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19390113%26dopt%3DAbstract Authors: Niazkhani Z, Pirnejad H, Berg M, Aarts J Previous studies have shown the importance of workflow issues in the implementation of CPOE systems and patient safety practices. To understand the impact of CPOE on clinical workflow, we developed a conceptual framework and conducted a literature search for CPOE evaluations between 1990 and June 2007. Fifty-one publications were identified that disclosed mixed effects of CPOE systems. Among the frequently reported workflow advantages were the legible orders, remote accessibility of the systems, and the shorter order turnaround times. Among the frequently reported disadvantages were the time-consuming and problematic user-system interactions, and the enforcement of a pre-defined relationship between clinical tasks and between providers.... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2534014 Wed, 22 Apr 2009 23:00:00 +0100 2534014 http://www.medworm.com/index.php?rid=2240457&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261930%26dopt%3DAbstract Authors: Simborg DW Patients own their medical records. This truth has had a difficult history for those of us who wish to have a single record of our health, wellness and disease and want to convey that record to whomever we wish whenever we wish. The lack of interoperability among the many sources of our medical record coupled with the hassle associated with obtaining a copy of one or more of the fragments of our record under the control of providers has been and continues to be a consumer frustration. Hence the motivation, at least in part, for the movement toward Personal Health Records (PHRs). PMID: 19261930 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240457 Wed, 04 Mar 2009 05:00:00 +0100 2240457 http://www.medworm.com/index.php?rid=2240456&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261931%26dopt%3DAbstract CONCLUSIONS The external forces driving EHR diffusion have grown in importance since 2004 relative to physicians' internal motivation to adopt such systems. Several national forces are likely contributing to the slowing pace of EHR diffusion. PMID: 19261931 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240456 Wed, 04 Mar 2009 05:00:00 +0100 2240456 http://www.medworm.com/index.php?rid=2240455&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261932%26dopt%3DAbstract CONCLUSION This study provides a framework for the development of active, high-throughput and prospective systems which could potentially unveil drug safety profiles throughout their entire market life. Our results demonstrate that the framework is feasible although there are a number of challenging issues. To the best of our knowledge, this is the first study using comprehensive unstructured data from the EHR for pharmacovigilance. PMID: 19261932 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240455 Wed, 04 Mar 2009 05:00:00 +0100 2240455 http://www.medworm.com/index.php?rid=2240454&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261933%26dopt%3DAbstract Authors: Pathak J, Solbrig HR, Buntrock JD, Johnson TM, Chute CG Over the past several years, many biomedical terminologies, classifications and ontological resources such as the NCI Thesaurus (NCIT), International Classification of Diseases (ICD), Systematized Nomenclature of Medicine (SNOMED), Current Procedural Terminology (CPT), and Gene Ontology (GO) have been developed and used to build a variety of IT applications in biology, biomedicine and healthcare settings. However, virtually all these resources involve incompatible formats, are based on different modeling languages, and lack appropriate tooling and programming interfaces (APIs) that hinder their wide-scale adoption and usage in a variety of application contexts. The Lexical Grid (LexGrid) project introduced in this paper i... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240454 Wed, 04 Mar 2009 05:00:00 +0100 2240454 http://www.medworm.com/index.php?rid=2240453&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261934%26dopt%3DAbstract We present the resultant findings, including the 13 emergent themes describing major challenges and opportunities facing CRI and a formal definition of CRI, and we conclude with a discussion of major implications and proposed steps to advance the domain. PMID: 19261934 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240453 Wed, 04 Mar 2009 05:00:00 +0100 2240453 http://www.medworm.com/index.php?rid=2240452&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261935%26dopt%3DAbstract Authors: Kaplan B, Harris-Salamone KD With the US joining other countries in national efforts towards the many benefits health information technology use can bring for health care quality and savings, recent sobering reports recall the complexity and difficulties of implementing even smaller-scale systems. Despite best practice research identifying success factors for health information technology projects, a majority, in some sense, still fail. Similar problems plague a variety of different kinds of applications, and have done so for many years. Ten AMIA working groups sponsored a workshop entitled Avoiding The F-Word: IT Project Morbidity, Mortality, and Immortality at the AMIA Fall 2006 Symposium focussed on this under-addressed problem. PARTICIPANTS discussed communication, workflo... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240452 Wed, 04 Mar 2009 05:00:00 +0100 2240452 http://www.medworm.com/index.php?rid=2240451&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261936%26dopt%3DAbstract Authors: Hannah KJ, White PA, Nagle LM, Pringle DM The Canadian Health Outcomes for Better Information and Care (C-HOBIC) project introduced systematic use of standardized clinical nursing terminology for patient assessments. Implemented so far in three Canadian provinces, C-HOBIC comprises an innovative model for large-scale capture of standardized nursing-sensitive clinical outcomes data within electronic health records (EHRs). To support this activity, nursing assessment and outcomes concepts were mapped to the International Classification for Nursing Practice (ICNP(R)). By comparing serial data on a patient across multiple time points, the C-HOBIC model can generate nursing-sensitive patient outcome reports. A principle benefit of the C-HOBIC model is that it provides nurses with i... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240451 Wed, 04 Mar 2009 05:00:00 +0100 2240451 http://www.medworm.com/index.php?rid=2240450&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261937%26dopt%3DAbstract Authors: Effken JA, Abbott P This white paper explains the strong roles that nursing can play in using information technology (IT) to improve healthcare delivery in rural areas. Authors describe current challenges to providing care in rural areas, and how technology innovations can help rural communities to improve their health and health care. To maximize benefits, rural stakeholders (as individuals and groups) must collaborate to effect change. Because non-physician providers deliver much of the health care in rural communities, this paper focuses on the critical roles of nurses on IT-enabled care management teams. We propose changes in nursing practice, policy, and education to better prepare, encourage, and enable nurses to assume leadership roles in IT-enabled health care manageme... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240450 Wed, 04 Mar 2009 05:00:00 +0100 2240450 http://www.medworm.com/index.php?rid=2240449&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261938%26dopt%3DAbstract CONCLUSION Concept-based indexing of radiology journal figure captions achieved very high precision and recall, and significantly improved image retrieval. PMID: 19261938 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240449 Wed, 04 Mar 2009 05:00:00 +0100 2240449 http://www.medworm.com/index.php?rid=2240448&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261939%26dopt%3DAbstract CONCLUSION We found that it is feasible for residents to capture their clinical questions in natural language during workflow and that recording questions may prompt awareness of previously unrecognized information needs. However, the semantic complexity of typical questions and mapping failures due to residents' use of acronyms and abbreviations present challenges to machine-based extraction of semantic content. PMID: 19261939 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240448 Wed, 04 Mar 2009 05:00:00 +0100 2240448 http://www.medworm.com/index.php?rid=2240447&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261940%26dopt%3DAbstract CONCLUSION The UMLS has sufficient knowledge to enable discovery of potential terminological relationships. PMID: 19261940 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240447 Wed, 04 Mar 2009 05:00:00 +0100 2240447 http://www.medworm.com/index.php?rid=2240446&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261941%26dopt%3DAbstract CONCLUSION It is feasible to use electronic health records for syndromic surveillance. The structured data performed best but required knowledge engineering to match the health record data to the queries. The narrative data illustrated the potential performance of a broadly disseminated system and achieved mixed results. PMID: 19261941 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240446 Wed, 04 Mar 2009 05:00:00 +0100 2240446 http://www.medworm.com/index.php?rid=2240445&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261942%26dopt%3DAbstract Authors: Dugas M, Thun S, Frankewitsch T, Heitmann KU Hospital information systems (HIS) handle a large number of different types of documents. Exchange and analysis of data from different HIS is facilitated by the use of standardized codes to identify document types. HL7's Clinical Document Architecture (CDA) uses LOINC codes for clinical documents. We assessed the coverage of LOINC codes for document types in a German HIS. We analyzed document types that occurred more than 10 times in approximately 1.3 million documents in a commercial HIS at a major German University hospital. Document types were mapped manually to LOINC using the Regenstrief LOINC Mapping Assistant (RELMA). Each document type was coded by two physicians. In case of discrepancies a third expert was consulted to reac... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240445 Wed, 04 Mar 2009 05:00:00 +0100 2240445 http://www.medworm.com/index.php?rid=2240444&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261943%26dopt%3DAbstract CONCLUSION Our results demonstrate that data extracted from electronic medical records can be used to create predictive models. With improvements in data extraction and inclusion of more variables, such models may prove to be clinically useful in the near future. PMID: 19261943 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240444 Wed, 04 Mar 2009 05:00:00 +0100 2240444 http://www.medworm.com/index.php?rid=2240443&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261944%26dopt%3DAbstract Authors: Hu J, Yu H, Luo E, Song E, Xu X, Tan H, Wang Y This case study looked at the current level of computerization in dental clinics and the attitudes of dentists towards dental computerization in metropolises in China. A survey consisted of 22 questions was emailed or mailed to a random sample of 354 dentists. Of all respondents, 80.5% reported using a computer in their practice. We found that the administrative tasks were the first to be computerized. A majority of respondents supported the statement that computerization is a benefit to patient care. Generally the current situation of dental computerization in China metropolises is similar to that of west nations a couple of years ago, but bears its own features. PMID: 19261944 [PubMed - as supplied by publisher] (Source: Jou... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240443 Wed, 04 Mar 2009 05:00:00 +0100 2240443 http://www.medworm.com/index.php?rid=2240442&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261945%26dopt%3DAbstract Authors: Hyun S, Shapiro JS, Melton G, Schlegel C, Stetson PD, Johnson SB, Bakken S We summarize our experience in iteratively testing the adequacy of three versions of the Health Level Seven (HL7) Logical Observation Identifiers Names and Codes (LOINC) Clinical Document Ontology (CDO) to represent document names at Columbia University Medical Center. The percentage of documents fully represented increased from 23.4% (Version 1) to 98.5% (Version 3). The proportion of unique representations increased from 7.9% (Analysis 1) to 39.4% (Analysis 4); the proportion reflects the level of specificity in the document names as well as the completeness and level of granularity of the CDO. We shared the findings of each analysis with the Clinical LOINC committee and participated in the decision m... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240442 Wed, 04 Mar 2009 05:00:00 +0100 2240442 http://www.medworm.com/index.php?rid=2240441&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261946%26dopt%3DAbstract Authors: Ene-Iordache B, Carminati S, Antiga L, Rubis N, Ruggenenti P, Remuzzi G, Remuzzi A In the last few years, the use of electronic case report forms (CRF) to gather data in randomized clinical trials has grown to progressively replace paper-based forms. Computerized form designs must ensure the same data quality expected of paper CRF, by following Good Clinical Practice rules. Electronic data capture tools must also comply with applicable statutory and regulatory requirements. Here we focus on the development of computerized systems for clinical trials implementing FDA and EU recommendations and regulations, and we describe a laptop-based electronic CRF used in a randomized, multicenter clinical trial. PMID: 19261946 [PubMed - as supplied by publisher] (Source: Journal of the... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240441 Wed, 04 Mar 2009 05:00:00 +0100 2240441 http://www.medworm.com/index.php?rid=2240440&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261947%26dopt%3DAbstract CONCLUSION Narrative and structured electronic data sources provide complementary information on anti-hypertensive medication intensification. Clinical validity of information in both sources was demonstrated by correlation with changes in blood pressure. PMID: 19261947 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240440 Wed, 04 Mar 2009 05:00:00 +0100 2240440 http://www.medworm.com/index.php?rid=2240439&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261948%26dopt%3DAbstract CONCLUSION The ForecastED tool provides accurate forecasts of several input, throughput, and output measures of crowding up to 8 hours into the future. The real-time deployment of the system should be feasible at other emergency departments that have six patient-level variables available through information systems. PMID: 19261948 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240439 Wed, 04 Mar 2009 05:00:00 +0100 2240439 http://www.medworm.com/index.php?rid=2240438&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261949%26dopt%3DAbstract Authors: Lesselroth BJ, Felder RS, Adams SM, Cauthers PD, Dorr DA, Wong GJ, Douglas DM Errors associated with medication documentation account for a substantial fraction of preventable medical errors. Hence, the Joint Commission has called for the adoption of reconciliation strategies at all U.S. healthcare institutions. Although studies suggest that reconciliation tools can reduce errors, it remains unclear how to best implement systems and processes that are reliable and sensitive to clinical workflow. We designed a primary care process that supported reconciliation without compromising clinic efficiency. This manuscript describes the design and implementation of APHID: ambulatory check-in kiosks that allow patients to review the names, dosage, frequency, and pictures of their medica... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240438 Wed, 04 Mar 2009 05:00:00 +0100 2240438 http://www.medworm.com/index.php?rid=2240437&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19261950%26dopt%3DAbstract Authors: Sujansky WV, Overhage JM, Chang S, Frohlich J, Faus SA Electronic laboratory interfaces can significantly increase the value of ambulatory electronic health record (EHR) systems by providing laboratory result data automatically and in a computable form. However, many ambulatory EHRs cannot implement electronic lab interfaces despite the existence of messaging standards, such as Health Level 7 (HL7)(1) . Among several barriers to implementing lab interfaces is the extensive optionality within the HL7 message standard. This paper describes the rationale for and development of an HL7 implementation guide that seeks to eliminate most of the optionality inherent in HL7, but retain the information content required for reporting outpatient lab results. A work group of heterogeneous s... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2240437 Wed, 04 Mar 2009 05:00:00 +0100 2240437 http://www.medworm.com/index.php?rid=2141224&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952946%26dopt%3DAbstract CONCLUSION: The modified RSN provides an enhanced abstract view of the UMLS's chemical content. Its array of conjugate and complex types provides a more accurate model of the variety of combinations involving chemicals viewed structurally. This framework will help streamline the process of type assignments for such chemical concepts and improve user orientation to the richness of the chemical content of the UMLS. PMID: 18952946 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2141224 Thu, 01 Jan 2009 05:00:00 +0100 2141224 http://www.medworm.com/index.php?rid=2089847&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19127607%26dopt%3DAbstract Authors: Ohno-Machado L, Miller RA PMID: 19127607 [PubMed - in process] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2089847 Thu, 01 Jan 2009 05:00:00 +0100 2089847 http://www.medworm.com/index.php?rid=2046472&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074295%26dopt%3DAbstract Authors: Safran C, Shabot MM, Munger BS, Holmes JH, Steen EB, Lumpkin JR, Detmer DE, PMID: 19074295 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046472 Mon, 15 Dec 2008 05:00:00 +0100 2046472 http://www.medworm.com/index.php?rid=2046474&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074293%26dopt%3DAbstract Authors: Detmer DE, Lumpkin JR, Williamson JJ As the professional home for biomedical and health informaticians, AMIA is actively working to support high quality relevant professional education and research opportunities. This issue of JAMIA presents two key documents that provide tangible evidence of progress on this front. In this editorial, we describe the context and specific purpose of the two documents, how they were developed, and AMIA's plans to build upon the documents. PMID: 19074293 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046474 Thu, 11 Dec 2008 05:00:00 +0100 2046474 http://www.medworm.com/index.php?rid=2046473&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074294%26dopt%3DAbstract Authors: Friedman CP As best I can tell, the field of biomedical informatics continues to struggle to define itself. Those in the field refer often to large numbers of people in health care and biomedical research who "don't get it" with regard to informatics. Educational programs with "informatics" in their names are growing in number, but the increasing variation in level and scope of these programs further clouds the issue of what informatics is, and isn't. PMID: 19074294 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046473 Thu, 11 Dec 2008 05:00:00 +0100 2046473 http://www.medworm.com/index.php?rid=2046471&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074296%26dopt%3DAbstract Authors: Gardner RM, Overhage JM, Steen E, Munger BS, Holmes JH, Williamson JJ, Detmer DE, PMID: 19074296 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046471 Thu, 11 Dec 2008 05:00:00 +0100 2046471 http://www.medworm.com/index.php?rid=2046470&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074297%26dopt%3DAbstract CONCLUSION We empirically derived semantics behind statements of duration using "ago," and we verified intuitions about how numbers are used. PMID: 19074297 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046470 Thu, 11 Dec 2008 05:00:00 +0100 2046470 http://www.medworm.com/index.php?rid=2046469&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074298%26dopt%3DAbstract CONCLUSION The broad concept coverage and the logic-based structure of the ICNP make it a flexible and robust standard. The ICNP provides a framework from which to capture and reuse atomic level data to facilitate evidence-based practice. PMID: 19074298 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046469 Thu, 11 Dec 2008 05:00:00 +0100 2046469 http://www.medworm.com/index.php?rid=2046468&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074299%26dopt%3DAbstract CONCLUSION To manage re-identification risk, the prediction models can be used by public health professionals, health researchers and research ethics boards to decide when the geographic area population size is sufficiently large. PMID: 19074299 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046468 Thu, 11 Dec 2008 05:00:00 +0100 2046468 http://www.medworm.com/index.php?rid=2046467&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074300%26dopt%3DAbstract Authors: Chatterjee S, Price A While our Y2K worries about old computers "retiring" at midnight captured the television and news media attention, a more significant "old age" phenomenon snuck onto the scene with hardly a headline: the dawn of the age of the aged 1. The over burdened healthcare system will face a worldwide wave of retirees who will live longer, cost more to treat, and demand new goods and services to help them stay healthy, active, and independent. PMID: 19074300 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046467 Thu, 11 Dec 2008 05:00:00 +0100 2046467 http://www.medworm.com/index.php?rid=2046466&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074301%26dopt%3DAbstract CONCLUSION Users demonstrated consistent UI navigational patterns, some of which were not anticipated by system designers or the clinic management. Awareness of such unanticipated patterns may help identify undesirable user behavior as well as reengineering opportunities for improving the system's usability. PMID: 19074301 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046466 Thu, 11 Dec 2008 05:00:00 +0100 2046466 http://www.medworm.com/index.php?rid=2046465&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074302%26dopt%3DAbstract Authors: Torii M, Hu Z, Wu CH, Liu H OBJECTIVE Biomedical named entity recognition (BNER) is a critical component in automated systems that mine biomedical knowledge in free text. Among different types of entities in the domain, gene/protein would be the most studied one for BNER. Our goal is to develop a gene/protein name recognition system BioTagger-GM that exploits rich information in terminology sources using powerful machine learning frameworks and system combination. DESIGN BioTagger-GM consists of four main components: i) dictionary lookup - gene/protein names in BioThesaurus and terms in UMLS Metathesaurus in text are tagged, ii) machine learning - dictionary lookup results are incorporated as one type of features in recognition systems using machine learning, iii) post-process... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046465 Thu, 11 Dec 2008 05:00:00 +0100 2046465 http://www.medworm.com/index.php?rid=2046464&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074303%26dopt%3DAbstract Authors: Byrne JM, Elliott S, Firek A We implemented the first secure messaging system in a VA Medical Center. Since reimbursement for secure messaging is of less concern and our clinical data systems are fully computerized, we used several evaluation strategies to assess clinical adoption. To address known concerns of clinicians, we analyzed secure messaging use and performed a content analysis. Message volumes were low and the content analysis demonstrated that messages were appropriate. Despite this, a clinician survey showed that clinical adoption was impeded by several factors including introducing secure messaging to selected patients, workload concerns, and clinician communication preferences. In addition, we believe that our clinicians experienced clinical adoption inertia resu... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046464 Thu, 11 Dec 2008 05:00:00 +0100 2046464 http://www.medworm.com/index.php?rid=2046463&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074304%26dopt%3DAbstract Authors: Lester WT, Ashburner JM, Grant RW, Chueh HC, Barry MJ, Atlas SJ Healthcare information technology can be a means to improve quality and efficiency in the primary care setting. However, merely applying technology without addressing how it fits into provider workflow and existing systems is unlikely to achieve improvement goals. Improving quality of primary care, such as cancer screening rates, requires addressing barriers at system, provider, and patient levels. The authors report the development, implementation and preliminary use of a new breast cancer screening outreach program in a large multi-center primary care network. This installation paired population-based surveillance with customized information delivery based on a validated model linking patients to providers and p... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046463 Thu, 11 Dec 2008 05:00:00 +0100 2046463 http://www.medworm.com/index.php?rid=2046462&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D19074305%26dopt%3DAbstract CONCLUSIONS Alert activation was not followed by a significant decrease in inappropriate prescriptions in our study. The trend toward increased errors among a subgroup of users underscores the need to watch for unanticipated effects of decision support systems and to investigate their underlying causes. PMID: 19074305 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046462 Thu, 11 Dec 2008 05:00:00 +0100 2046462 http://www.medworm.com/index.php?rid=2046476&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18755988%26dopt%3DAbstract Authors: Bloomrosen M, Detmer D The fields of health informatics and biomedical research increasingly depend on the availability of aggregated health data. Yet, despite over fifteen years of policy work on health data issues, the United States (U.S.) lacks coherent policy to guide users striving to navigate the ethical, political, technical, and economic challenges associated with health data use. In 2007, building on more than a decade of previous work, the American Medical Informatics Association (AMIA) convened a panel of experts to stimulate discussion about and action on a national framework for health data use. This initiative is being carried out in the context of rapidly accelerating advances in the fields of health informatics and biomedical research, many of which are depende... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046476 Sat, 01 Nov 2008 04:00:00 +0100 2046476 http://www.medworm.com/index.php?rid=2046475&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18755999%26dopt%3DAbstract CONCLUSION: The results support the hypothesis that topic links are more efficient than nonspecific links regarding the time seeking for information. It is unclear whether the statistical difference demonstrated will result in a clinically significant impact. However, the overall results confirm previous evidence that infobuttons are effective at helping clinicians to answer questions at the point of care and demonstrate a modest incremental change in the efficiency of information delivery for routine users of this tool. PMID: 18755999 [PubMed - indexed for MEDLINE] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=2046475 Sat, 01 Nov 2008 04:00:00 +0100 2046475 http://www.medworm.com/index.php?rid=1914399&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952929%26dopt%3DAbstract Authors: Kilicoglu H, Demner-Fushman D, Rindflesch TC, Wilczynski NL, Haynes RB The growing numbers of topically relevant biomedical publications readily available due to advances in document retrieval methods pose a challenge to clinicians practicing evidence-based medicine. It is increasingly time consuming to acquire and critically appraise the available evidence. This problem could be addressed in part if methods were available to automatically recognize rigorous studies immediately applicable in a specific clinical situation. We approach the problem of recognizing studies containing useable clinical advice from retrieved topically relevant articles as a binary classification problem. The gold standard used in the development of PubMed clinical query filters forms the basis of our ... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914399 Fri, 24 Oct 2008 04:00:00 +0100 1914399 http://www.medworm.com/index.php?rid=1914398&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952930%26dopt%3DAbstract CONCLUSIONS In 2004, NH use of EIS for functions other than MDS and billing was highly variable, but considerably higher than previous estimates. PMID: 18952930 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914398 Fri, 24 Oct 2008 04:00:00 +0100 1914398 http://www.medworm.com/index.php?rid=1914397&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952931%26dopt%3DAbstract CONCLUSION StAC models that are developed on discharge summaries can be successfully applied to radiology reports. These models benefit the most from words found in the +/-4 word window of the target and can outperform ENegEx. PMID: 18952931 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914397 Fri, 24 Oct 2008 04:00:00 +0100 1914397 http://www.medworm.com/index.php?rid=1914396&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952932%26dopt%3DAbstract Authors: Lu Z, Kim W, Wilbur WJ This paper evaluates the retrieval effectiveness of relevance ranking strategies on a collection of 55 queries and about 160,000 MEDLINE(R) citations used in the 2006 and 2007 TREC Genomics Tracks. We study two relevance ranking strategies: TF-IDF weighting and sentence-level co-occurrence, and examine their ability to rank retrieved MEDLINE documents given user queries. Furthermore, we use the reverse chronological order-PubMed's default display option-as a baseline for comparison. Retrieval effectiveness is assessed using both mean average precision and mean rank precision. Experimental results show that retrievals based on the two strategies had improved performance over the baseline performance, and that TF-IDF weighting is more effective in retrievi... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914396 Fri, 24 Oct 2008 04:00:00 +0100 1914396 http://www.medworm.com/index.php?rid=1914395&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952933%26dopt%3DAbstract CONCLUSION The SPL-based approach is more sensitive and suggests that mapping local dictionaries to SPL, and enhancing the depth and breadth of coverage of SPL content are worth accelerating. The study also highlights specificity problems known to trouble drug-intolerance decision support and suggests how terminology and methods of recording drug-intolerances could be improved. PMID: 18952933 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914395 Fri, 24 Oct 2008 04:00:00 +0100 1914395 http://www.medworm.com/index.php?rid=1914394&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952934%26dopt%3DAbstract CONCLUSION Consultant recommendations were implemented 30% more often when there was electronic facilitation of recommendations. PMID: 18952934 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914394 Fri, 24 Oct 2008 04:00:00 +0100 1914394 http://www.medworm.com/index.php?rid=1914393&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952935%26dopt%3DAbstract CONCLUSION We developed an effective clustering-based method for building corpus-specific sense inventories for abbreviations in a clinical corpus. To the best of our knowledge, this is the first time clustering technologies have been used to help building sense inventories of abbreviations in clinical text. Our results demonstrated that the clustering-based method performed better than the manual annotation method using random samples for the task of building sense inventories of clinical abbreviations. PMID: 18952935 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914393 Fri, 24 Oct 2008 04:00:00 +0100 1914393 http://www.medworm.com/index.php?rid=1914392&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952936%26dopt%3DAbstract Authors: Corn M Retention policies for clinical records are set primarily by the States although the Federal government mandates minimum maintenance periods for certain classes of patients and selected types of information. State policies vary considerably, but most jurisdictions permit many types of data to be destroyed after some period usually shorter than ten years. Many health care organizations hold records longer than mandated, but over time much clinical data is discarded or becomes difficult to access. For improved care of patients and for support of research, the nation should recognize that clinical information, both paper and electronic, constitutes a valuable asset, the national phenome, that deserves long-term storage in archives which preserve both the records and access... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914392 Fri, 24 Oct 2008 04:00:00 +0100 1914392 http://www.medworm.com/index.php?rid=1914391&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952937%26dopt%3DAbstract Authors: Goroll AH, Simon SR, Tripathi M, Ascenzo C, Bates DW The Massachusetts eHealth Collaborative (MAeHC) was formed to improve patient safety and quality of care by promoting the use of health information technology through community-based implementation of electronic health records (EHRs) and health information exchange. The Collaborative has recently implemented EHRs in a diverse set of competitively selected communities, encompassing nearly 500 physicians serving over 500,000 patients. Targeting both EHR implementation and health information exchange at the community level has identified numerous challenges and strategies for overcoming them. This paper describes the formation and implementation phases of the Collaborative, focusing on barriers identified, lessons learned and p... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914391 Fri, 24 Oct 2008 04:00:00 +0100 1914391 http://www.medworm.com/index.php?rid=1914390&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952938%26dopt%3DAbstract Authors: Morrison FP, Li L, Lai AM, Hripcsak G Electronic clinical documentation can be useful for activities such as public health surveillance, quality improvement, and research, but existing methods of de-identification may not provide sufficient protection of patient data. MedLEE, a general-purpose natural language processor, retains medical concepts while excluding the remaining text, so, in addition to processing text into structured data, it may be able provide a secondary benefit of de-identification. Without modifying the system, we tested the ability of MedLEE to remove protected health information (PHI) by comparing 100 outpatient clinical notes with the corresponding XML-tagged output. Of 809 instances of PHI, 26 (3.2%) were detected in output as a result of processing and ... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914390 Fri, 24 Oct 2008 04:00:00 +0100 1914390 http://www.medworm.com/index.php?rid=1914389&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952939%26dopt%3DAbstract Authors: Reti SR, Feldman HJ, Safran C Personal health records (PHR) are a modern health technology with the ability to facilitate patient engagement in their own health journey. Despite widespread interest there has been little discussion around PHR governance at an organizational level. We develop a governance model and compare this to some of the early PHR adopters, including representation from hospital and ambulatory care settings, insurer and health plans, government departments and commercial sectors. Decision making structures varied between organizations. Business operations were present in all groups, but patients were not represented in any of the governance structures surveyed. To improve patient-centered care, policy making for PHRs needs to include patient representation ... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914389 Fri, 24 Oct 2008 04:00:00 +0100 1914389 http://www.medworm.com/index.php?rid=1914388&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952940%26dopt%3DAbstract Authors: Lazarus R, Klompas M, Campion FX, McNabb S, Hou X, Daniel J, Haney G, Demaria A, Lenert L, Platt R Health care providers are legally obliged to report cases of specified diseases to public health authorities, but existing manual, provider-initiated reporting systems generally result in incomplete, error-prone, and tardy information flow. Automated laboratory-based reports are more likely accurate and timely, but lack clinical information and treatment details. Here, we describe the Electronic Support for Public Health (ESP) application, a robust, automated, secure, portable public health detection and messaging system for cases of notifiable diseases. ESP applies disease specific logic to any complete source of electronic medical data in a fully automated process, and supports... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914388 Fri, 24 Oct 2008 04:00:00 +0100 1914388 http://www.medworm.com/index.php?rid=1914387&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952941%26dopt%3DAbstract CONCLUSION Tiered alerting by severity was associated with higher compliance rates of DDI alerts in the inpatient setting, and lack of tiering was associated with a high override rate of more severe alerts. PMID: 18952941 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914387 Fri, 24 Oct 2008 04:00:00 +0100 1914387 http://www.medworm.com/index.php?rid=1914386&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952942%26dopt%3DAbstract CONCLUSION The study shows the validity of video as well as live observations for modeling Surgical Process Models. For routine use, we recommend live observations due to their flexibility and effectiveness. If high precision is needed or the SPM parameters are altered during the study, video observations are the preferable approach. PMID: 18952942 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914386 Fri, 24 Oct 2008 04:00:00 +0100 1914386 http://www.medworm.com/index.php?rid=1914385&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952943%26dopt%3DAbstract Authors: Collins SA, Currie LM, Bakken S, Cimino JJ To effectively meet clinician information needs at the point of care we must understand how their needs are dependent upon both context and clinician type. The Infobutton Manager (IM), accessed through a clinical information system, anticipates the clinician's questions and provides links to pertinent electronic resources. We conducted an observational usefulness case study of medical residents (MDs), nurse practitioners (NPs), registered nurses (RNs), and a physician assistant (PA), using the IM in a laboratory setting. Generic question types and success rates for each clinician's information needs were characterized. Question type frequency differed by clinician type. All clinician types asked for institution-specific protocols. MDs... Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914385 Fri, 24 Oct 2008 04:00:00 +0100 1914385 http://www.medworm.com/index.php?rid=1914384&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952944%26dopt%3DAbstract CONCLUSION Our findings support using SNOMED CT to provide standardized representations of information created using these two terminologies, but suggest that enriching its semantics would improve representation of their terms. PMID: 18952944 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914384 Fri, 24 Oct 2008 04:00:00 +0100 1914384 http://www.medworm.com/index.php?rid=1914383&cid=s_34475_21_f&fid=34475&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D18952945%26dopt%3DAbstract CONCLUSION We found that non-interruptive medication laboratory monitoring alerts were not effective in improving receipt of recommended baseline laboratory test monitoring for medications. Further work is necessary to optimize compliance with non-critical recommendations. PMID: 18952945 [PubMed - as supplied by publisher] (Source: Journal of the American Medical Informatics Association) Journal of the American Medical Informatics Association journals http://www.medworm.com/rss/comments.php?id=1914383 Fri, 24 Oct 2008 04:00:00 +0100 1914383