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Author Interviews, BMJ, Electronic Records / 08.06.2014

Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MIMedicalResearch.com Interview with: Dr David A Hanauer MD MS Department of Pediatrics University of Michigan Medical School Ann Arbor, MI   MedicalResearch: What are the main findings of the study? Dr. Hanauer: In this study we analyzed requests made by patients who wanted to make changes to their medical record. The goal was to develop an understanding of what the main reasons were for making a request to change the medical record, and what types of information they wanted changed. One of the main findings was that about half of all requests were ultimately approved.  This suggests that patients reviewing their records can detect errors and have them corrected, which could ultimately lead to a more accurate record for a patient. In essence, giving patients the opportunity to further participate in their care by allowing them to review their record can lead to the identification and correction of errors or omissions. (more…)
Annals Internal Medicine, Author Interviews, Electronic Records, Outcomes & Safety / 05.06.2014

Lisa M. Kern, MD, MPH, FACP Associate Professor of Healthcare Policy and Research and of Medicine Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College New York, NY 10065MedicalResearch.com Interview with: Lisa M. Kern, MD, MPH, FACP Associate Professor of Healthcare Policy and Research and of Medicine Associate Director for Research, Center for Healthcare Informatics and Policy Deputy Director, Health Information Technology Evaluation Collaborative Weill Cornell Medical College New York, NY 10065 MedicalResearch: What are the main findings of the study? Dr. Kern: We found that primary care physicians participating in Patient-Centered Medical Homes (PCMHs) improved their quality of care over time at a significantly higher rate than their non-PCMH peers. (more…)
Author Interviews, Biomarkers, Electronic Records, JNCI, Prostate Cancer / 14.03.2014

Primo N. Lara, Jr, MD, Professor of Medicine, University of California Davis School of Medicine Associate Director for Translational Research UC Davis Comprehensive Cancer Center Sacramento, CA 95817MedicalResearch.com Interview with: Primo N. Lara, Jr, MD, Professor of Medicine, University of California Davis School of Medicine Associate Director for Translational Research UC Davis Comprehensive Cancer Center Sacramento, CA 95817 MedicalResearch.com: What are the main findings of the study: Dr. Lara:  “We found that blood markers of bone turnover can be used to predict outcomes in men with advanced prostate cancer with spread to bone. We also found that a small proportion of men could be predicted to benefit from an investigational drug based on these same markers.” (more…)
Author Interviews, BMJ, Electronic Records / 07.03.2014

MedicalResearch.com Interview with: Stephanie Parks Taylor MD MS Associate Professor Director of Clinical Research Associate Division Director, Hospital Medicine USF Department of Internal Medicine MedicalResearch.com: What are the main findings of your study? Dr. Parks Taylor: The integration of electronic medical records has been proposed to have many benefits for the healthcare system. We investigated the effect of EMR implementation on communication between physicians and nurses in a hospital setting. The primary finding was that overall agreement about a patient's plan of care actually worsened after the implementation of EMR. This seemed to be related to a decrease in face-to-face communication between physicians and nurses. (more…)
Author Interviews, BMJ, Cost of Health Care, Electronic Records / 13.02.2014

Dr Sarah Slight, School of Medicine Pharmacy and Health, Wolfson Research Institute University of Durham, United Kingdom.MedicalResearch.com Interview with; Dr Sarah Slight, School of Medicine Pharmacy and Health, Wolfson Research Institute University of Durham, United Kingdom. MedicalResearch.com: What are the main findings of the study? Dr. Slight: Our study identified four main cost categories associated with the implementation of EHR systems, namely: infrastructure (e.g., hardware and software), personnel (e.g., project management and training teams), estates / facilities (e.g., furniture and fittings), and other (e.g., consumables and training materials). Many factors were felt to impact on these costs, with different hospitals choosing varying amounts and types of infrastructure, diverse training approaches for staff, and different software applications to integrate with the new system. (more…)
Author Interviews, Electronic Records, Rheumatology / 05.02.2014

Gabriela Schmajuk M.D. M.S. Department of Medicine (Rheumatology) University of California, San Francisco San Francisco VA Medical Center San Francisco, CA 94121MedicalResearch.com Interview with: Gabriela Schmajuk M.D. M.S. Department of Medicine (Rheumatology) University of California, San Francisco San Francisco VA Medical Center San Francisco, CA 94121 MedicalResearch.com: What are the main findings of the study? Dr. Schmajuk: Our main findings were that moderate LFT abnormalities were uncommon in the first 7 months of methotrexate use among new users, and more likely to occur in patients with obesity, untreated high cholesterol, pre-methotrexate LFT elevations, biologic agent use, and lack of folic acid supplementation. (more…)
Annals Internal Medicine, Author Interviews, Electronic Records / 10.01.2014

Robert S. Rudin, Ph.D. Associate Policy Researcher RAND Corporation 20 Park Plaza, Suite 920 Boston, MA 02116MedicalResearch.com Interview with: Robert S. Rudin, Ph.D. Associate Policy Researcher RAND Corporation Boston, MA 02116 MedicalResearch.com: What are the main findings of the study? Dr. Rudin: We found that most published health IT implementation studies report positive effects on quality, safety, and efficiency. Most evaluations focus on clinical decision support and computerized provider order entry. However, not all studies report equally positive results, and differences in context and implementation are one likely reason for these varying results, yet details of context and implementation are rarely reported in these studies. (more…)
Author Interviews, Electronic Records / 29.12.2013

MedicalResearch.com Interview with: Leo Anthony Celi, MD, MS, MPH Massachusetts Institute of Technology Cambridge, MA 02139 Leo Anthony Celi, MD, MS, MPH Massachusetts Institute of Technology Cambridge, MA 02139 MedicalResearch.com: What are the main findings of the study? Dr. Celi: The main take home point from the paper is that we know little about how drug perform in the real world. Which patients truly benefit? Which patients are harmed? How do drugs interact with different acute (such as critical illness) and chronic conditions? These questions are almost never answered during pre-marketing research due to cost. We need a better system of following the life cycle of drugs post-marketing. Clinical databases provide us with this opportunity. (more…)
AHRQ, Author Interviews, Electronic Records, Hospital Readmissions, University of Pennsylvania / 28.11.2013

Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania Philadelphia, PA 19104MedicalResearch.com Interview with: Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania Philadelphia, PA 19104 MedicalResearch.com: What are the main findings of the study? Dr. Umscheid: We developed and successfully deployed into the electronic health record of the University of Pennsylvania Health System an automated prediction tool which identifies newly admitted patients who are at risk for readmission within 30 days of discharge.  Using local data, we found that having been admitted to the hospital two or more times in the 12 months prior to admission was the best way to predict which patients are at risk for being readmitted in the 30 days after discharge. Using this finding, our automated tool identifies patients who are “high risk” for readmission and creates a “flag” in their electronic health record (EHR). The flag appears next to the patient’s name in a column titled “readmission risk.” The flag can be double-clicked to display detailed information relevant to discharge planning.  In a one year prospective validation of the tool, we found that patients who triggered the readmission alert were subsequently readmitted 31 percent of the time. When an alert was not triggered, patients were readmitted only 11 percent of the time.  There was no evidence for an effect of the intervention on 30-day all-cause readmission rates in the 12-month period after implementation. (more…)
Author Interviews, Cost of Health Care, Electronic Records, NYU / 23.08.2013

MedicalResearch.com Interview with: Saul Blecker, MD, MHS Assistant Professor Department of Population Health NYU School of Medicine 227 East 30th St., #648 New York, NY 10016Saul Blecker, MD, MHS Assistant Professor Department of Population Health NYU School of Medicine 227 East 30th St., #648 New York, NY 10016 MedicalResearch.com: What are the main findings of the study? Dr. Blecker: We tracked utilization of the inpatient electronic health record (EHR) as a proxy for hospital intensity of care. EHR utilization was found to have variations over time, particularly when comparing days to nights and weekdays to weekends. (more…)