Appl Clin Inform - Comprehensive electronic medical record implementation levels not associated with 30-day all-cause read-missions within Medicare beneficiaries with heart failure.

Tópicos

{ ehr(2073) health(1662) electron(1139) }
{ patient(2837) hospit(1953) medic(668) }
{ risk(3053) factor(974) diseas(938) }
{ group(2977) signific(1463) compar(1072) }
{ age(1611) year(1155) adult(843) }
{ sampl(1606) size(1419) use(1276) }
{ high(1669) rate(1365) level(1280) }
{ estim(2440) model(1874) function(577) }
{ data(1737) use(1416) pattern(1282) }
{ studi(1410) differ(1259) use(1210) }
{ research(1085) discuss(1038) issu(1018) }
{ studi(1119) effect(1106) posit(819) }
{ model(3480) simul(1196) paramet(876) }
{ analysi(2126) use(1163) compon(1037) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ bind(1733) structur(1185) ligand(1036) }
{ featur(3375) classif(2383) classifi(1994) }
{ take(945) account(800) differ(722) }
{ general(901) number(790) one(736) }
{ system(1050) medic(1026) inform(1018) }
{ model(2341) predict(2261) use(1141) }
{ cost(1906) reduc(1198) effect(832) }
{ gene(2352) biolog(1181) express(1162) }
{ use(2086) technolog(871) perceiv(783) }
{ can(981) present(881) function(850) }
{ process(1125) use(805) approach(778) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ inform(2794) health(2639) internet(1427) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ care(1570) inform(1187) nurs(1089) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ perform(999) metric(946) measur(919) }
{ import(1318) role(1303) understand(862) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ monitor(1329) mobil(1314) devic(1160) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ decis(3086) make(1611) patient(1517) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Regulatory standards for 30-day readmissions incentivize hospitals to improve quality of care. Implementing comprehensive electronic health record systems potentially decreases readmission rates by improving medication reconciliation at discharge, demonstrating the additional benefits of inpatient EHRs beyond improved safety and decreased errors.OBJECTIVE: To compare 30-day all-cause readmission incidence rates within Medicare fee-for-service with heart failure discharged from hospitals with full implementation levels of comprehensive EHR systems versus those without.METHODS: This retrospective cohort study uses data from the American Hospital Association Health IT survey and Medicare Part A claims to measure associations between hospital EHR implementation levels and beneficiary readmissions. Multivariable Cox regressions estimate the hazard ratio of 30-day all-cause readmissions within beneficiaries discharged from hospitals implementing comprehensive EHRs versus those without, controlling for beneficiary health status and hospital organizational factors. Propensity scores are used to account for selection bias.RESULTS: The proportion of heart failure patients with 30-day all-cause readmissions was 30%, 29%, and 32% for those discharged from hospitals with full, some, and no comprehensive EHR systems. Heart failure patients discharged from hospitals with fully implemented comprehensive EHRs compared to those with no comprehensive EHR systems had equivalent 30-day readmission incidence rates (HR = 0.97, 95% CI 0.73 - 1.3).CONCLUSIONS: Implementation of comprehensive electronic health record systems does not necessarily improve a hospital's ability to decrease 30-day readmission rates. Improving the efficiency of post-acute care will require more coordination of information systems between inpatient and ambulatory providers.

Resumo Limpo

ckground regulatori standard day readmiss incentiv hospit improv qualiti care implement comprehens electron health record system potenti decreas readmiss rate improv medic reconcili discharg demonstr addit benefit inpati ehr beyond improv safeti decreas errorsobject compar day allcaus readmiss incid rate within medicar feeforservic heart failur discharg hospit full implement level comprehens ehr system versus withoutmethod retrospect cohort studi use data american hospit associ health survey medicar part claim measur associ hospit ehr implement level beneficiari readmiss multivari cox regress estim hazard ratio day allcaus readmiss within beneficiari discharg hospit implement comprehens ehr versus without control beneficiari health status hospit organiz factor propens score use account select biasresult proport heart failur patient day allcaus readmiss discharg hospit full comprehens ehr system heart failur patient discharg hospit fulli implement comprehens ehr compar comprehens ehr system equival day readmiss incid rate hr ci conclus implement comprehens electron health record system necessarili improv hospit abil decreas day readmiss rate improv effici postacut care will requir coordin inform system inpati ambulatori provid

Resumos Similares

J Am Med Inform Assoc - Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department. ( 0,926608105171614 )
AMIA Annu Symp Proc - Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation. ( 0,851878844579708 )
Comput Inform Nurs - Usability of the Clinical Care Classification System for Representing Nursing Practice According to Specialty. ( 0,846996942865523 )
BMC Med Inform Decis Mak - The impact of EHR and HIE on reducing avoidable admissions: controlling main differential diagnoses. ( 0,821740702773784 )
AMIA Annu Symp Proc - Impact of electronic medication reconciliation at hospital admission on clinician workflow. ( 0,821662548116756 )
Health Informatics J - Using electronic health record systems to optimize admission decisions: the Creatinine case study. ( 0,819878619550833 )
Healthc (Amst) - The effect of health information technology implementation in Veterans Health Administration hospitals on patient outcomes. ( 0,819159976953781 )
Appl Clin Inform - Use of Headings and Classifications by Physicians in Medical Narratives of EHRs: An evaluation study in a Finnish hospital. ( 0,773969647045458 )
J Am Med Inform Assoc - Data standards to support health information exchange between poison control centers and emergency departments. ( 0,770591203198515 )
J Am Med Inform Assoc - Electronic health record use and preventive counseling for US children and adolescents. ( 0,770087445912971 )
Healthc (Amst) - Electronic health records and technical assistance to improve quality of primary care: Lessons for regional extension centers. ( 0,765224377054143 )
Healthc (Amst) - The impact of electronic health record implementation on emergency physician efficiency and patient throughput. ( 0,751135954351779 )
J Med Syst - Benefits and challenges of electronic health record system on stakeholders: a qualitative study of outpatient physicians. ( 0,749650219365252 )
Int J Med Inform - EHR adoption across China's tertiary hospitals: a cross-sectional observational study. ( 0,747590690770402 )
Int J Med Inform - Rates, levels, and determinants of electronic health record system adoption: a study of hospitals in Riyadh, Saudi Arabia. ( 0,745471556268786 )
Healthc (Amst) - A novel community-based delivery model to combat cancer disparities. ( 0,743116764193205 )
J Am Med Inform Assoc - Evaluating and classifying the readiness of technology specifications for national standardization. ( 0,738305662365575 )
J Am Med Inform Assoc - Blue Button use by patients to access and share health record information using the Department of Veterans Affairs' online patient portal. ( 0,734955247011595 )
BMC Med Inform Decis Mak - IT adoption of clinical information systems in Austrian and German hospitals: results of a comparative survey with a focus on nursing. ( 0,730854014018605 )
J Am Med Inform Assoc - When does adoption of health information technology by physician practices lead to use by physicians within the practice? ( 0,729661919612122 )
J Med Syst - Mitigating error vulnerability at the transition of care through the use of health IT applications. ( 0,729303211658817 )
Perspect Health Inf Manag - Improving and measuring inpatient documentation of medical care within the MS-DRG system: education, monitoring, and normalized case mix index. ( 0,728512148475153 )
J Med Syst - Organization's quality maturity as a vehicle for EHR success. ( 0,723652315075156 )
Int J Med Inform - Adoption of electronic health records in Korean tertiary teaching and general hospitals. ( 0,722675319974925 )
Comput Methods Programs Biomed - A method to manage and share anti-retroviral (ARV) therapy information of human immunodeficiency virus (HIV) patients in Vietnam. ( 0,721799422217806 )
J Am Med Inform Assoc - Overcoming challenges to achieving meaningful use: insights from hospitals that successfully received Centers for Medicare and Medicaid Services payments in 2011. ( 0,720198107691262 )
Perspect Health Inf Manag - Health information technology: integration of clinical workflow into meaningful use of electronic health records. ( 0,720043025106013 )
Perspect Health Inf Manag - Electronic health record adoption and use by Nebraska pharmacists. ( 0,717039163923192 )
J Am Med Inform Assoc - Implications of an emerging EHR monoculture for hospitals and healthcare systems. ( 0,716792896616443 )
Appl Clin Inform - Predictors of success for electronic health record implementation in small physician practices. ( 0,716023171274553 )
J Am Med Inform Assoc - The potential for community-based health information exchange systems to reduce hospital readmissions. ( 0,71397650588342 )
Perspect Health Inf Manag - Evaluation of inpatient clinical documentation readiness for ICD-10-CM. ( 0,713202083694898 )
Appl Clin Inform - Physician specialty and variations in adoption of electronic health records. ( 0,712994153592496 )
J Am Med Inform Assoc - The impact of electronic health records on care of heart failure patients in the emergency room. ( 0,709591020039149 )
J Am Med Inform Assoc - The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs. ( 0,708927165706252 )
AMIA Annu Symp Proc - Assessing readiness for meeting meaningful use: identifying electronic health record functionality and measuring levels of adoption. ( 0,706278497250294 )
J Am Med Inform Assoc - Sequencing of EHR adoption among US hospitals and the impact of meaningful use. ( 0,705989818770255 )
Perspect Health Inf Manag - Electronic health records and information portability: a pilot study in a rural primary healthcare center in India. ( 0,705325086032874 )
Perspect Health Inf Manag - Use of health information technology by office-based physicians: comparison of two contemporaneous public-use physician surveys. ( 0,705055528359832 )
J Med Syst - Nurses' views on electronic medical records (EMR) in Turkey: an analysis according to use, quality and user satisfaction. ( 0,700369839174335 )
J Am Med Inform Assoc - Exploring the sociotechnical intersection of patient safety and electronic health record implementation. ( 0,700273401966654 )
AMIA Annu Symp Proc - Validating Health Information Exchange (HIE) Data For Quality Measurement Across Four Hospitals. ( 0,696904956754223 )
J Am Med Inform Assoc - Consumer experience with and attitudes toward health information technology: a nationwide survey. ( 0,694458537245699 )
J Med Syst - Quality and cost improvement of healthcare via complementary measurement and diagnosis of patient general health outcome using electronic health record data: research rationale and design. ( 0,694351613973487 )
Perspect Health Inf Manag - Impact of electronic health record systems on information integrity: quality and safety implications. ( 0,69245164700632 )
Perspect Health Inf Manag - Hospital characteristics related to the intention to apply for meaningful use incentive payments. ( 0,690315586116936 )
BMC Med Inform Decis Mak - Evaluating quality of care for patients with type 2 diabetes using electronic health record information in Mexico. ( 0,690116237475981 )
J Am Med Inform Assoc - Harmonized patient-reported data elements in the electronic health record: supporting meaningful use by primary care action on health behaviors and key psychosocial factors. ( 0,688525893983172 )
J Am Med Inform Assoc - A typology of electronic health record workarounds in small-to-medium size primary care practices. ( 0,687768370926797 )
Healthc (Amst) - Improving the value of healthcare delivery using publicly available performance data in Wisconsin and California. ( 0,686499896442904 )
J Am Med Inform Assoc - The use of open source electronic health records within the federal safety net. ( 0,682541676465832 )
Int J Med Inform - Do integrated record systems lead to integrated services? An observational study of a multi-professional system in a diabetes service. ( 0,682152429170984 )
AMIA Annu Symp Proc - Leveraging standards to support patient-centric interdisciplinary plans of care. ( 0,682086058933043 )
Comput Methods Programs Biomed - The relationship between usage intention and adoption of electronic health records at primary care clinics. ( 0,680823436227122 )
J Biomed Inform - Translating standards into practice: experience and lessons learned at the Department of Veterans Affairs. ( 0,679129040071107 )
J Biomed Inform - Implementations of the HL7 Context-Aware Knowledge Retrieval (Infobutton) Standard: challenges, strengths, limitations, and uptake. ( 0,6788803745111 )
J Am Med Inform Assoc - Phased implementation of electronic health records through an office of clinical transformation. ( 0,673405377423766 )
BMC Med Inform Decis Mak - A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review. ( 0,672871900510522 )
Telemed J E Health - Telehealth in primary healthcare: an analysis of Belo Horizonte's experience. ( 0,669622741390644 )
J Med Syst - Threat modeling for electronic health record systems. ( 0,666556873623151 )
J Am Med Inform Assoc - The Hub Population Health System: distributed ad hoc queries and alerts. ( 0,663638750923263 )
Appl Clin Inform - The impact of geography on hospital electronic health records implementation in alabama: implications for meaningful use. ( 0,661844963376843 )
Int J Med Inform - Comparison of electronic health record system functionalities to support the patient recruitment process in clinical trials. ( 0,661473838416325 )
J Biomed Inform - Use patterns of health information exchange through a multidimensional lens: conceptual framework and empirical validation. ( 0,661151254672634 )
Int J Med Inform - Collaboration in electronic medical evidence development: a case study of the Social Security Administration's MEGAHIT System. ( 0,659740404130555 )
Healthc (Amst) - Meaningful use: Floor or ceiling? ( 0,65912497464909 )
Appl Clin Inform - Capturing information needs of care providers to support knowledge sharing and distributed decision making. ( 0,658204126064706 )
J Am Med Inform Assoc - Factors associated with difficult electronic health record implementation in office practice. ( 0,655928201428217 )
J Am Med Inform Assoc - Validity of electronic health record-derived quality measurement for performance monitoring. ( 0,655673183826446 )
Telemed J E Health - Home telehealth in high-risk dialysis patients: a 3-year study. ( 0,654104086612201 )
J Telemed Telecare - The effect of ICU telemedicine on mortality and length of stay. ( 0,653117306239717 )
J Am Med Inform Assoc - How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use. ( 0,650523346043033 )
Appl Clin Inform - Associations between the concurrent use of clinical decision support and computerized provider order entry and the rates of appropriate prescribing at discharge. ( 0,646803973960608 )
Health Info Libr J - Do quality improvement systems improve health library services? A systematic review. ( 0,646739386803299 )
Methods Inf Med - Electronic health record interoperability as realized in the Turkish health information system. ( 0,646660347947074 )
J Am Med Inform Assoc - Health-information exchange: why are we doing it, and what are we doing? ( 0,64579874977413 )
BMC Med Inform Decis Mak - Use and satisfaction with key functions of a common commercial electronic health record: a survey of primary care providers. ( 0,645469125138391 )
J Biomed Inform - Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region. ( 0,644070790699373 )
J Am Med Inform Assoc - ICU nurses' acceptance of electronic health records. ( 0,641739267226115 )
AMIA Annu Symp Proc - Bridging informatics and implementation science: evaluating a framework to assess electronic health record implementations in community settings. ( 0,641493958833451 )
J Med Syst - Factors associated with health information exchange system usage in a safety-net ambulatory care clinic setting. ( 0,641276900938082 )
Int J Med Inform - Use of web-based patient education sessions on psychiatric wards. ( 0,640576657457897 )
Perspect Health Inf Manag - Leveraging the cloud for electronic health record access. ( 0,640054256898777 )
Methods Inf Med - SS-MIX: a ministry project to promote standardized healthcare information exchange. ( 0,639608586658382 )
Inform Health Soc Care - Design and implementation of wireless patient monitoring system for postoperative patients on general care floor. ( 0,638920873120154 )
Inform Health Soc Care - Attitudes of health professionals towards electronic health records in primary health care settings: a questionnaire survey. ( 0,637366682015849 )
Perspect Health Inf Manag - Family physician perceptions of personal health records. ( 0,637071095250382 )
AMIA Annu Symp Proc - Progress and challenge in meeting meaningful use at an integrated delivery network. ( 0,635394283141186 )
AMIA Annu Symp Proc - Health information exchange, Health Information Technology use, and hospital readmission rates. ( 0,634230916934294 )
Methods Inf Med - Utilizing IHE-based Electronic Health Record systems for secondary use. ( 0,633813713912125 )
AMIA Annu Symp Proc - Adoption of clinical data exchange in community settings: a comparison of two approaches. ( 0,632706079380105 )
Appl Clin Inform - Information technology improves Emergency Department patient discharge instructions completeness and performance on a national quality measure: a quasi-experimental study. ( 0,632004639188946 )
BMC Med Inform Decis Mak - Evaluation of an automated safety surveillance system using risk adjusted sequential probability ratio testing. ( 0,631642127734069 )
J Am Med Inform Assoc - The impact of electronic health records on people with diabetes in three different emergency departments. ( 0,629987575145386 )
Appl Clin Inform - Diffusion of Electronic Health Records and electronic communication in Norway. ( 0,627454327803998 )
Appl Clin Inform - Electronic Health Record Adoption - Maybe It's not about the Money: Physician Super-Users, Electronic Health Records and Patient Care. ( 0,626817853354743 )
Med Decis Making - Factors relating to patient visit time with a physician. ( 0,625668134543144 )
Healthc (Amst) - Health information exchange among U.S. hospitals: who's in, who's out, and why? ( 0,625282387021635 )
J Biomed Inform - Building a robust, scalable and standards-driven infrastructure for secondary use of EHR data: the SHARPn project. ( 0,624729934603874 )
Int J Med Inform - Learning from Taiwan patient-safety reporting system. ( 0,624307152311589 )