Health Care Systems, Technology / 15.10.2024

  With medical needs escalating and technology advancing at an incredible pace, the speed of patient care is about to become much faster and more effective. Healthcare organizations are under pressure to do more with less. Businesses are finally able to leave their tech logjam behind when they plug into lean IT project services. Suddenly, the thorny vines of procedure fall away, and genuine innovation gets a second wind. Low costs don't mean low-quality care.. What if healthcare operations could run like a well-oiled machine? For that to happen, they need to corral their IT projects, but that's a tall order given the specific challenges they face.

Streamlining Operations Through Digital Transformation

Hospitals and clinics are constantly faced with the challenge of reducing costs without sacrificing the level of care their patients receive. Efficient IT project services facilitate the implementation of digital tools and technologies that improve operational workflows and processes. One area where IT project services provide critical support is electronic health record (EHR) integration. Healthcare goes high-tech when EHR systems are properly set up. It's like having a bird’s-eye view of a patient's entire journey, allowing doctors to spot connections and make swift, informed decisions. Under the watchful eye of regulatory authorities like HIPAA, IT project managers expertly integrate these systems, implementing checks and balances to prevent malfunctions and mishaps. When automation technologies are properly integrated, they morph administrative tasks into background noise, allowing healthcare professionals to redirect their attention to the ones who need it most: their patients. Think of automation as a behind-the-scenes team player. By handing over the routine tasks, healthcare pros can refocus on what matters most: providing top-notch care. (more…)
AI and HealthCare, Technology / 12.09.2024

Integrating artificial intelligence (AI) into healthcare has opened numerous doors for improving efficiency and patient care. ChatGPT, an AI language model that can process and generate human-like text, is among the most promising advancements in AI-driven tools. Chat GPT for medical professionals is emerging as an innovative way to streamline workflows, assist with medical research, and enhance patient communication. This article delves into ChatGPT's opportunities for healthcare, its current use cases, and how it can transform the medical field. chat-gpt-image (more…)
Electronic Records / 10.09.2024

  In today’s healthcare environment, safeguarding patient data is a core responsibility. As technology continues to integrate into healthcare systems, from Electronic Health Records (EHR) to remote patient monitoring, organizations must address cybersecurity threats effectively. This article explains how advanced network solutions can strengthen patient data security, ensuring compliance and trust.

The Importance of Network Security in Healthcare

Healthcare organizations manage vast amounts of sensitive patient data, making them prime targets for cyberattacks. From ransomware to data breaches, these incidents can compromise patient privacy and disrupt essential services, leading to financial and reputational damage. Advanced network solutions are crucial in mitigating these risks. By adopting comprehensive security protocols and modern technologies, healthcare providers can protect patient data and maintain uninterrupted service.

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Education, Electronic Records, Technology / 06.09.2024

As we stand today, EHR systems are not a part of the medical curricula. But med students go on to work in hospitals or start their own practice that would definitely involve EHR systems. According to the Office of the National Coordinator for Health Information Technology (ONC), 96% of hospitals use EHR systems, which is almost the entirety of the healthcare setup. Integrating Electronic Health Records (EHR) into medical education can have several benefits for prepping future healthcare professionals. This approach can potentially make learning better for medical students and ultimately boost patient care quality. Moreover, specialized areas like cardiology medical billing could benefit significantly from early exposure to EHR systems, helping students understand the intricacies of managing billing in these complex fields. This article covers the potential benefits of EHR systems integration into medical education, challenges, solutions, and more. Key Takeaways:
  • Integrating EHRs makes learning better for medical students.
  • Improves doctor-patient communication.
  • Offers easy access and better organization for students.
  • Tackles challenges related to documentation and professionalism.
  • Hands-on experience and simulation training are key for effective learning.
  • Hospital policies and liability concerns can limit EHR access.
  • Proper educational frameworks are crucial for successful EHR adoption.
  • EHRs contain real-world scenarios and promote understanding of clinical workflows.
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Author Interviews, Duke, Electronic Records, Health Care Systems, JAMA / 20.04.2021

MedicalResearch.com Interview with: Eugenia McPeek Hinz MD MS FAMIA Associate CMIO - DHTS Duke University Health System MedicalResearch.com: What is the background for this study? Response: Clinician burnout rates have hovered around 50% for much of the past decade.  Burnout is a significant concern in healthcare for its effects on care givers and associated downstream adverse implications on patient care for quality and safety. The ubiquitous presence of Electronic Health Records (EHR) along with the increased clerical components and after hours use has been a significant concern for contributing to provider burnout.  (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, COVID -19 Coronavirus, Electronic Records, JAMA, Technology / 04.03.2021

MedicalResearch.com Interview with: Carlo Giovanni Traverso, MB, BChir, PhD Associate Physician, Brigham and Women's Hospital Assistant Professor, Peter R. Chai, MD, MMS Emergency Medicine Physician and Medical Toxicologist Harvard Medical School Brigham and Women's Hospital Department of Medicine   Dr-Spot-HealthCare-Assistant.jpgMedicalResearch.com: What is the background for this study? What are some of the functions that Dr. Spot can facilitate? Response: During the COVID-19 pandemic, we wanted to consider innovative methods to provide additional social distance for physicians evaluating low acuity individuals who may have COVID-19 disease in the emergency department. While other health systems had instituted processes like evaluating patients from outside of emergency department rooms or calling patients to obtain a history, we considered the use of a mobile robotic system in collaboration with Boston Dynamics to provide telemedicine triage on an agile platform that could be navigated around a busy emergency department. Dr. Spot was built with a camera system to help an operator navigate it through an emergency department into a patient room where an on-board tablet would permit face-to-face triage and assessment of individuals. (more…)
Author Interviews / 13.05.2020

MedicalResearch.com Interview with: Celine Latulipe PhD Associate Professor University of Manitoba MedicalResearch.com: What is the background for this study? What are the main findings? Response: We wanted to find out how many hospitals offer proxy accounts for caregivers of adult patients. Most patient portal systems allow proxy accounts for parents of pediatric patients, so we know the underlying systems support the creation of proxy accounts. When we were starting this research, the two big healthcare systems where I was located did NOT offer such proxy accounts for caregivers of adult patients, and a staff person at one of those hospitals suggested adult patients share their passwords with their caregiver, if the caregiver needed access to the portal. As a computer scientist, I am well aware of the security and privacy risks associated with password sharing, and I was appalled by this advice. So we did this survey across the US and we found that 45% of the staff contacted in our study gave similar password sharing advice. This is hugely problematic. Caregivers using a patient's password means the caregiver can see everything in the medical record, including things the patient might not want the caregiver to know, such as past diagnoses of stigmatized illnesses, substance abuse or reproductive health decisions. Also, because password re-use is common across systems, a caregiver with a patient's portal password may now have access to the patient's online banking. (more…)
Author Interviews, Cost of Health Care, Electronic Records / 20.03.2020

MedicalResearch.com Interview with: Rohit Bishnoi, M.D. Division of Hematology and Oncology Department of Medicine University of Florida Gainesville, FL MedicalResearch.com: What is the background for this study? Response: National Healthcare expenditure was $3.6 trillion in 2018 and 17.7% of Gross Domestic Product. Redundant laboratory testing is one part of this problem that is more pronounced in hospitalized patients as they are often seen by multiple physicians from the time of admission till discharge. This added burden on the US health care system leads to increased costs, decreased patient satisfaction, and unnecessary phlebotomy. It also leads to iatrogenic anemia over time and unnecessary transfusions. The Choosing Wisely initiative recommendation from the Society of Hospital Medicine, Society for the Advancement of Blood Management, and the Critical Care Societies Collaborative have recommended avoiding repetitive labs. As one of the physicians in the division of hospital medicine at the University of Florida (UF) Health Shands hospital, we encountered this problem frequently where a patient will get multiple HbA1c or lipid profiles or iron studies during the same hospital stay without any clear clinical indication. Most often these tests were ordered by different physicians seeing the same patient and not realizing that either the test has already been ordered or sometimes it is related to practice pattern of physicians. We often heard complaints about this from our nursing and laboratory staff and, most importantly by patients themselves. (more…)
Author Interviews, Compliance, Electronic Records, JAMA, University of Pennsylvania / 05.03.2020

MedicalResearch.com Interview with: Alexander C. Fanaroff, MD, MHS Assistant Professor of Medicine, Division of Cardiovascular Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: This is a secondary analysis of the ARTEMIS, a cluster randomized trial of copayment assistance for P2Y12 inhibitors in patients that had myocardial infarction. One of the primary endpoints of ARTEMIS was persistence with P2Y12 inhibitors: Did the patient continue to take a P2Y12 inhibitor over the entire 1 year following MI? In ARTEMIS, we captured persistence data in two ways, patient report and pharmacy fill records. What we did in this study was to look at the agreement between persistence as measured by these two methods. (more…)
Allergies, Author Interviews, Electronic Records / 13.11.2019

MedicalResearch.com Interview with: Sonam Sani MD Allergy & Immunology Fellow NYU Winthrop Hospital MedicalResearch.com: What is the background for this study? Response: Penicillin allergy label removal is becoming more common. Studies have shown that while 10% of the general population report an allergy to penicillin, after testing only 1% truly have an allergy. Allergists have the ability to evaluate patient’s for penicillin allergy by performing skin tests and oral challenges. However, even when people test negative for penicillin allergy, they still face barriers to having the label removed. We are noting more and more that despite having negative testing, upon further encounters, our patients still have their penicillin allergy label. (more…)
Annals Internal Medicine, Author Interviews, Electronic Records / 24.09.2019

MedicalResearch.com Interview with: John (Xuefeng) Jiang PhD Professor and Plante Moran Faculty Fellow Eli Broad College of Business Accounting & Information Systems Michigan State University East Lansing, MI MedicalResearch.com: How did you get interested in this issue? Response: This is the third project of our data breach trilogy. We first examined which healthcare providers (focusing on hospitals) more likely suffer from a data breach. We documented large hospitals, despite their resources, are more likely to experience a data breach. Some hospitals experienced multiple incidents (https://jamanetwork.altmetric.com/details/18464149). The findings made us wonder what happened? Besides size, what other factors contribute to data breaches? Based on detailed event descriptions, we documented the circumstances under which each data breach occurred (https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2715158). We found more than half of data breaches could be attributed to healthcare providers’ internal mistakes or negligence (e.g., forgot to encrypt laptop computers, used cc instead of bcc in emailing patients, didn’t revoke former employees’ login credentials after employment terminated) rather than external forces (e.g., hacking). We also found mobile devices (e.g. laptop computers, usb drives) are associated with most data breaches than paper records or network servers. Our results suggest if healthcare providers strengthen their internal control and limit the use of mobile device might be effective ways to reduce data breach risks.  (more…)
Author Interviews, Electronic Records, Emergency Care, JAMA / 19.09.2019

MedicalResearch.com Interview with: Carl Berdahl, MD, MS Emergency Physician and Health Services Researcher CEDARS-SINAI West Hollywood CA MedicalResearch.com: What is the background for this study? Response: The length of a doctor’s note is taken account when determining how much a doctor or medical center is paid for a visit. However, in the digital era, a doctor can generate large amounts of text with just a few keystrokes. Given this incentive structure, we were concerned doctors’ notes might be inaccurate in certain sections of the chart that are important for billing. We used observers to determine how accurately doctors’ notes reflected the interactions between patients and physicians. (more…)
Author Interviews, Electronic Records / 02.07.2019

MedicalResearch.com Interview with: Ming Tai-Seale, PhD, MPH Professor Department of Family Medicine and Public Health University of California San Diego School of Medicine  MedicalResearch.com: What is the background for this study? Response: The electronic health record (EHR) potentially creates a 24/7 work environment for physicians. Its impact on physicians’ wellness has become a challenge for most health care delivery organizations. Understanding the relationships between physicians’ well-being and “desktop medicine”1 work in the EHR and work environment is critical if burnout is to be addressed more effectively. (more…)
Author Interviews, Electronic Records, JAMA, Pediatrics, Primary Care / 07.05.2019

MedicalResearch.com Interview with: Cari McCarty, PhD Research Professor, UW Investigator, Seattle Children’s Research Institute  MedicalResearch.com: What is the background for this study? Response: Adolescence is a time when teens begin to take charge of their health, but it is also a time when they can be prone to health risk behaviors, such as insufficient physical activity, poor sleep, and substance use. We were interested in whether using an electronic health risk screening tool in primary care settings could improve healthcare and health for adolescents.  The tool was designed to provide screening as well as motivational feedback directly to adolescents, in addition to clinical decision support for the healthcare clinician.  We conducted a trial with 300 adolescent patients where one group received the screening tool prior to their health checkup, and the other group received usual care. (more…)
Author Interviews, Compliance, Electronic Records, Lung Cancer, Race/Ethnic Diversity / 07.02.2019

MedicalResearch.com Interview with: Samuel Cykert, MD Professor of Medicine and Director of the Program on Health and Clinical Informatics UNC School of Medicine, and Associate Director for Medical Education, NC AHEC Program Chapel Hill, NC MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reports going as far back as the early 1990’s through reports published very recently show that Black patients with early stage, curable lung cancer are not treated with aggressive, curative treatments as often as White patients. These type of results have been shown in other cancers also. It’s particularly important for lung cancer because over 90% of these patients are  dead within 4 years if left untreated. In 2010, our group published a study in the Journal of the American Medical Association that showed that Black patients who had poor perceptions of communication (with their provider), who did not understand their prognosis with vs. without treatment, and who did not have a regular source of care ( a primary care doctor) were much less likely to get curative surgery. Also our results suggested that physicians who treated lung cancer seemed less willing to take the risk of aggressive treatments in treating Black patients (who they did not identify with as well) who had other significant illnesses. Because of the persisting disparities and our 2010 findings, we worked with a community group, the Greensboro Health Disparities Collaborative to consider potential solutions.  As these omissions were not overt or intentional because of race on the part of the patients or doctors, we came up with the idea that we needed transparency to shine light on treatment that wasn’t progressing and better communication to ensure that patients were deciding on good information and not acting on mistrust or false beliefs.  We also felt the need for accountability – the care teams needed to know how things were going with patients and they needed to know this according to race. To meet these specifications, we designed a system that received data from electronic health records about patients’ scheduled appointments and procedures. If a patient missed an appointment this umbrella system triggered a warning. When a warning was triggered, a nurse navigator trained specially on communication issues, re-engaged the patient to bring him/her back into care. In the system, we also programmed the timing of expected milestones in care, and if these treatment milestones were not reached in the designated time frame, a physician leader would re-engage the clinical team to consider the care options. Using this system that combined transparency through technology, essentially our real time warning registry, and humans who were accountable for the triggered warnings, care improved for both Black and White patients and the treatment disparity for Black patients was dramatically reduced. In terms of the numbers, at baseline, before the intervention, 79% of White patients completed treatment compared to 69% of Black patients. For the group who received the intervention, the rate of completed treatment for White patients was 95% and for Black patients 96.5%.  (more…)
Author Interviews, Electronic Records, Mental Health Research / 18.12.2018

MedicalResearch.com Interview with: Katharine Phillips, M.D. Professor of Psychiatry DeWitt Wallace Senior Scholar Residency Research Director Department of Psychiatry Weill Cornell Medical College, Cornell University Attending Psychiatrist, New York-Presbyterian Hospital Adjunct Professor of Psychiatry and Human Behavior Alpert Medical School of Brown University Weill Cornell Psychiatry Specialty Center Weill Cornell Medicine I NewYork-Presbyterian MedicalResearch.com: What is the background for this study? What are the main findings?
  • Electronic prescribing of medication by clinicians is widespread; it is required in many institutions and in some states. Electronic prescribing systems commonly use computerized decision support algorithms that give prescribers automated warnings or alerts at the time of prescribing if the system identifies a potential prescribing error.
  • Some prior studies suggest that electronic prescribing warnings/alerts may reduce prescribing errors and thus can be clinically useful. However, other prior studies caution that these alerts may have substantial limitations.
  • Despite the importance of this topic, relatively few studies have examined the accuracy of automated prescribing warnings in electronic prescribing systems; to our knowledge, no prior study has focused primarily on prescribing of medications for psychiatric conditions.
  • This report presents results from a survey of members of the American Society of Clinical Psychopharmacology (ASCP), a specialty society that advances the science and practice of clinical psychopharmacology, regarding automated warnings generated by electronic prescribing systems.
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Author Interviews, Electronic Records / 06.12.2018

MedicalResearch.com Interview with: Rebekah L Gardner MD Associate Professor of Medicine Warren Alpert Medical School Brown University Providence, Rhode Island MedicalResearch.com: What is the background for this study? What are the main findings? Response: Burnout profoundly affects physicians, their patients, and the health care system.The role of technology in physician burnout, specifically health information technology (HIT), is not as well characterized as some of the other factors. We sought to understand how stress related to HIT use predicts burnout among physicians. Our main findings are that 70% of electronic health record (EHR) users reported HIT-related stress, with the highest prevalence in primary care-oriented specialties. We found that experiencing HIT-related stress independently predicted burnout in these physicians, even accounting for other characteristics like age, gender, and practice type. In particular, those with time pressures for documentation or those doing excessive “work after work” on their EHR at home had approximately twice the odds of burnout compared to physicians without these challenges. We found that physicians in different specialties had different rates of stress and burnout. (more…)
Annals Internal Medicine, Author Interviews, Blood Clots, Emergency Care, Kaiser Permanente, Pulmonary Disease, UC Davis / 13.11.2018

MedicalResearch.com Interview with: David R. Vinson, MD Department of Emergency Medicine Kaiser Permanente Sacramento Medical Center Sacramento, CA MedicalResearch.com: What is the background for this study? What are the main findings? Response: At least one-third of emergency department (ED) patients with acute blood clots in the lung, or pulmonary embolism (PE), are eligible for expedited discharged to home, either directly from the ED or after a short (<24 hour) period of observation. Yet in in most hospitals in the U.S. and around the world nearly all ED patients with acute PE are hospitalized. These unnecessary hospitalizations are a poor use of health care resources, tie up inpatient beds, and expose patients to the cost, inconvenience, and risk of inpatient care. The better-performing medical centers have two characteristics in common: they help their physicians identify which PE patients are candidates for outpatient care and they facilitate timely post-discharge follow-up. At Kaiser Permanente Northern California (KPNC), we have had the follow-up system in place for some time, but didn’t have a way to help our physicians sort out which patients with acute PE would benefit from home management. To correct this, we designed a secure, web-based clinical decision support system that was integrated with the electronic health record. When activated, it presented to the emergency physician the validated PE Severity Index, which uses patient demographics, vital signs, examination findings, and past medical history to classify patients into different risk strata, correlated with eligibility for home care. To make use of the PE Severity Index easier and more streamlined for the physician, the tool drew in information from the patient’s comprehensive medical records to accurately auto-populate the PE Severity Index. The tool then calculated for the physician the patient’s risk score and estimated 30-day mortality, and also offered a site-of-care recommendation, for example, “outpatient management is often possible.” The tool also reminded the physician of relative contraindications to outpatient management. At the time, only 10 EDs in KPNC had an on-site physician researcher, who for this study served as physician educator, study promotor, and enrollment auditor to provide physician-specific feedback. These 10 EDs functioned as the intervention sites, while the other 11 EDs within KPNC served as concurrent controls. Our primary outcome was the percentage of eligible ED patients with acute PE who had an expedited discharge to home, as defined above. During the 16-month study period (8-month pre-intervention and 8-months post-intervention), we cared for 1,703 eligible ED patients with acute PE. Adjusted home discharge increased at intervention sites from 17% to 28%, a greater than 60% relative increase. There were no changes in home discharge observed at the control sites (about 15% throughout the 16-month study). The increase in home discharge was not associated with an increase in short-term return visits or major complications.  (more…)
Author Interviews, Cost of Health Care, JAMA, Kaiser Permanente, Primary Care / 17.09.2018

MedicalResearch.com Interview with: Richard W. Grant MD MPH Research Scientist III, Kaiser Permanente Division of Resarch Adjunct Associate Professor, UCSF Dept Biostatistics & Epidemiology Director, Kaiser Permanente Delivery Science Fellowship Program Co-Director, NIDDK Diabetes Translational Research post-doctoral training program MedicalResearch.com: What is the background for this study? Response: Primary care in the United States is in a state of crisis, with fewer trainees entering the field and more current primary care doctors leaving due to professional burnout. Changes in the practice of primary care, including the many burdens related to EHR documentation, has been identified as a major source of physician burnout. There are ongoing efforts to reduce physician burnout by improving the work environment. One innovation has been the use of medical scribes in the exam room who are trained to enter narrative notes based on the patient-provider interview. To date, there have only been a handful of small studies that have looked at the impact of medical scribes on the provider’s experience of providing care. (more…)
Author Interviews, Brigham & Women's - Harvard, Electronic Records, JAMA / 07.07.2018

MedicalResearch.com Interview with: Li Zhou, MD, PhD, FACMI Associate Professor of Medicine Division of General Internal Medicine and Primary Care Brigham and Women’s Hospital, Harvard Medical School Somerville, MA 02145 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Documentation is one of the most time-consuming and costly aspects of electronic health record (EHR) use. Speech recognition (SR) technology, the automatic translation of voice to text, has been increasingly adopted to help clinicians complete their documentation in an efficient and cost-effective manner. One way in which SR can assist this process is commonly known as “back-end” SR, in which the clinician dictates into the telephone, the recorded audio is automatically transcribed to text by an speech recognition engine, and the text is edited by a professional medical transcriptionist and sent back to the EHR for the clinician to review and sign. In this study, we analyzed errors at different processing stages of clinical documents collected from 2 health care institutions using the same back-end SR vendor. We defined a comprehensive schema to systematically classify and analyze these errors, focusing particularly on clinically significant errors (errors that could plausibly affect a patient’s future care). We found an average of 7 errors per 100 words in raw  speech recognition transcriptions, and about 6% of those errors were clinically significant. 96.3% of the raw speech recognition transcriptions evaluated contained at least one error, and 63.6% had at least one clinically significant error. However, the rate of errors fell significantly after review by a medical transcriptionist, and it fell further still after the clinician reviewed the edited transcript. (more…)
Author Interviews, Electronic Records, Emergency Care / 09.02.2018

MedicalResearch.com Interview with: Shannon Toohey, MD, MAEd Associate Residency Director, Emergency Medicine Assistant Clinical Professor, Emergency Medicine University of California, Irvine Editor-in-Chief Journal of Education and Teaching in Emergency Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Electronic prescriptions (e-prescriptions) are now the predominant form of prescription used in the US. Concern has been raised that this form of prescription may be more difficult for emergency department (ED) patients to utilize than traditional printed prescriptions, given the unplanned nature of most ED visits at all times of day. While there are disincentives for physicians who choose not to use them, many emergency physicians are still concerned that it could decrease compliance in their patients. This study evaluated prescription compliance in insured patients at a single center. In our studied population, we found that patients were as equally likely to fill paper and e-Prescriptions. (more…)
Author Interviews, Electronic Records, Technology / 08.02.2018

MedicalResearch.com Interview with: http://www.timicoin.io/Will Lowe, Timicoin CEO Mr. Lower discusses the first cryptocurrency blockchain mobile platform for storing medical records that can be safely accessed from anywhere. MedicalResearch.com: What is the background for this announcement? Would you briefly explain what is meant by blockchain technology? How does it allow for more efficient storage and transmittal of encrypted medical records? Response: We do not store the data on any cloud storage to avoid any threat to data security and server overhead for data processing as well as to avoid temporary potential data unavailability. When a certain kind of data is queried by the consumer, our cloud engine first passes on the query to each of the providers (our gateway applications that are running on their node) and see if there are enough query results, it shows a sample to the consumer and if consumer decides to pay, it creates a Blockchain channel between the providers and the consumer that queried the data and all the provider nodes propagate the queried data onto that channel. So a common trust is built between the nodes and the consumer on that Blockchain channel and the shared query stays there as the trust builder. Then the consumer can anytime access the data needed from that blockchain channel. (more…)
Author Interviews, Dermatology, Electronic Records / 29.01.2018

MedicalResearch.com Interview with: “Computer” by FullCodePress is licensed under CC BY 2.0Matilda W. Nicholas, MD, PhD Duke Dermatology Durham, North Carolina MedicalResearch.com: What is the background for this study? Response: I have found many physicians overwhelmed by the electronic messaging feature in Electronic Health Record systems (EHRs). I found there was very little published about this phenomenon, particularly for specialists. So, we set out to take a look at the volume and effect these systems have.  MedicalResearch.com: What are the main findings?  Response: We found that, on average, clinicians receive 3.24 messages per patient visit, for an average of about 50 messages per full day of clinic. The number of messages also correlated with poor reported work life balance for dermatologists. (more…)
ASCO, Author Interviews, Cancer Research, Electronic Records, University Texas / 29.10.2017

MedicalResearch.com Interview with: Dr. Ali Haider, MBBS MD Assistant Professor, Department of Palliative Care and Rehabilitation Medicine Division of Cancer Medicine The University of Texas MD Anderson Cancer Center Houston, TX  MedicalResearch.com: What is the background for this study? Response: Patients with chronic and serious illnesses such as cancer often experience high physical and psychosocial symptoms. Recent studies have reported association of physicians' examination room computer use with less face to face interactions and eye contact. It's important for the clinicians to look for certain physical cues to better understand the well being of their patients. Therefore we conducted this randomized clinical trial to understand patients perception of physicians compassion, communication skills and professionalism with and without the use of examination room computer. (more…)
Author Interviews, Electronic Records, Heart Disease, JAMA / 06.09.2017

MedicalResearch.com Interview with: Rohan Khera MD Division of Cardiology University of Texas Southwestern Medical Center Texas  MedicalResearch.com: What is the background for this study? What are the main findings? Response: An increasing number of studies have used administrative claims (or billing) data to study in-hospital cardiac arrest with the goal of understanding differences in incidence and outcomes at hospitals that are not part of quality improvement initiatives like the American Heart Association’s Get With The Guidelines-Resuscitation (AHA’s GWTG-Resuscitation). These studies have important implications for health policies and determining targets for interventions for improving the care of patients with this cardiac arrest, where only in 1 in 5 patient survive the hospitalization. Therefore, in our study, we evaluated the validity of such an approach. We used data from 56,678 patients in AHA’s GWTG-Resuscitation with a confirmed in-hospital cardiac arrest, which were linked to Medicare claims data. We found: (1)  While most prior studies have used a diagnosis or procedure code alone to identify cases of in-hospital cardiac arrest, we found that the majority of confirmed cases in a national registry (AHA’s GWTG-Resuscitation) would not be captured using either administrative data strategy. (2)  Survival rates using administrative data to identify cases from the same reference population varied markedly and were 52% higher (28.4% vs. 18.7%) when using diagnosis codes alone to identify in-hospital cardiac arrest. (3)  There was large hospital variation in documenting diagnosis or procedure codes for patients with in-hospital cardiac arrest, which would have consequences for using administrative data to examine hospital-level variation in cardiac arrest incidence or survival, or conducting single-center studies to validate this administrative approach. (more…)
Author Interviews, Electronic Records, General Medicine / 28.07.2017

MedicalResearch.com Interview with: Macda Gerard M.D. Candidate | Class of 2021 Wayne State University School of Medicine MedicalResearch.com: What is the background for this study? Response: As electronic health records proliferate, patients are increasingly asking for their health information but little is known about how patients use that information or whether they encounter errors in their records. This comes at a time when we’re learning that understanding the patient and family experience, especially what is most valued in exchanges between doctors and patients is important and has many benefits. To learn more, we developed a formal mechanism for patients to provide feedback on what they like about accessing the information in their health records and to inform their clinical team about things like inaccuracies and perceived errors. So that’s the gap we tried to fill. The patient feedback tool is linked to the visit note in the electronic health record (EHR), and it’s part of a quality improvement initiative aimed at improving safety and learning what motivates patients to engage with their health information on the patient portal. Over the 12-month pilot period, 260 patients and care partners provided feedback using the OpenNotes patient feedback tool. Nearly all respondents found the tool to be valuable and about 70 percent provided additional information regarding what they liked about their notes and the feedback process. (more…)
Author Interviews, Critical Care - Intensive Care - ICUs, Electronic Records, Infections / 21.05.2017

MedicalResearch.com Interview with: Faheem Guirgis MD Assistant Professor of Emergency Medicine Department of Emergency Medicine Division of Research UF Health Jacksonville MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sepsis is quite prevalent among hospitals and the incidence is increasing. It is a life-threatening disease that can lead to poor outcomes if patients are not recognized and treated promptly. We recognized that our institution needed a strategic approach to the problem of sepsis, therefore the Sepsis Committee was created with the goal of creating a comprehensive sepsis program. We developed a system for sepsis recognition and rapid care delivery that would work in any area of the hospital. We found that we reduced overall mortality from sepsis, the number of patients requiring mechanical ventilation, intensive care unit length and overall hospital length of stay, and the charges to the patient by approximately $7000 per patient. (more…)
Author Interviews, Education, Electronic Records, JAMA, Johns Hopkins / 06.04.2017

MedicalResearch.com Interview with: Ge Bai, PhD, CPA Assistant Professor The Johns Hopkins Carey Business School Washington, DC 20036 MedicalResearch.com: What is the background for this study? What are the main findings? Response: We examined the hospital data breaches between 2009 and 2016 and found that larger hospitals and hospitals that have a major teaching mission have a higher risk of data breaches. (more…)
Author Interviews, Clots - Coagulation, Electronic Records, JAMA, NYU, Surgical Research / 23.03.2017

MedicalResearch.com Interview with: Zachary Borabm, Research fellow Hansjörg Wyss Department of Plastic Surgery NYU Langone Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent studies have shown that health care providers perform poorly in risk stratifying their patients for venous thromboembolism (VTE) which leads to inadequate VTE prophylaxis delivery, especially in surgical patients. Computerized Clinical Decision Support Systems (CCDSSs) are programs integrated into an electronic health record that have the power to aid health care providers. Using a meta-analysis study technique we were able to pool data from 11 studies, including 156,366 patients that either had CCDSSs intervention or routine care without CCDSSs. Our main outcome measures were the rate of prophylaxis for VTE and the rate of actual VTE events. We found that CCDSSs increased the rate of VTE prophylaxis (odds ratio 2.35, p<0.001) and decreased the risk of VTE events (risk ratio 0.78, p<0.001). (more…)