Appl Clin Inform - Monitoring adherence to evidence-based practices: a method to utilize HL7 messages from hospital information systems.

Tópicos

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

Resumo

CKGROUND: Clinical pathways are evidence-based recommendations for treating a diagnosis. Although implementations of clinical pathways have reduced medical errors, lowered costs, and improved patient outcomes, monitoring whether a patient is following the intended pathway is problematic. Implementing a variance reporting program is impeded by the lack of a reliable source of electronic data and automatic retrieval methods.OBJECTIVES: Our objective is to develop an automated method of measuring and reporting patient variance from a clinical pathway.METHODS: We identify a viable and ubiquitous data source for establishing the realized patient's path- Health Level Seven (HL7) formatted message exchanges between Hospital Information Systems. This is in contrast to current practices in most hospitals where data for clinical pathway variance reporting is obtained from multiple data sources, often retrospectively. This paper develops a method to use message exchanges to automatically establish and compare a patient's path against a clinical pathway. Our method not only considers pathway activities as is common practice, but also extracts patient outcomes from HL7 messages and reports this in addition to the variance.RESULTS: Using data from our partner hospital, we illustrate our clinical pathway variance analysis tool using major joint replacement patients. We validate our method by comparing audit results for a random sample of HL7 constructed pathways with data extracted from patient charts. We report several variances such as omitted laboratory tests or additional activities such as blood transfusions. Our method successfully identifies variances and reports them in a quantified way to support decisions related to quality control.CONCLUSIONS: OUR APPROACH DIFFERS FROM PREVIOUS STUDIES IN THAT A QUANTITATIVE MEASURE IS ESTABLISHED OVER THREE DIMENSIONS: (1) omissions from the pathway, (2) additions to the pathway, and (3) patient outcomes. By examining variances providers can evaluate clinical decisions, and support quality feedback and training mechanisms.

Resumo Limpo

ckground clinic pathway evidencebas recommend treat diagnosi although implement clinic pathway reduc medic error lower cost improv patient outcom monitor whether patient follow intend pathway problemat implement varianc report program imped lack reliabl sourc electron data automat retriev methodsobject object develop autom method measur report patient varianc clinic pathwaymethod identifi viabl ubiquit data sourc establish realiz patient path health level seven hl format messag exchang hospit inform system contrast current practic hospit data clinic pathway varianc report obtain multipl data sourc often retrospect paper develop method use messag exchang automat establish compar patient path clinic pathway method consid pathway activ common practic also extract patient outcom hl messag report addit varianceresult use data partner hospit illustr clinic pathway varianc analysi tool use major joint replac patient valid method compar audit result random sampl hl construct pathway data extract patient chart report sever varianc omit laboratori test addit activ blood transfus method success identifi varianc report quantifi way support decis relat qualiti controlconclus approach differ previous studi quantit measur establish three dimens omiss pathway addit pathway patient outcom examin varianc provid can evalu clinic decis support qualiti feedback train mechan

Resumos Similares

BMC Med Inform Decis Mak - A conceptual framework and protocol for defining clinical decision support objectives applicable to medical specialties. ( 0,755021132743153 )
J Biomed Inform - The impact of emerging standards adoption on automated quality reporting. ( 0,727341531278339 )
AMIA Annu Symp Proc - Extending the GuideLine Implementability Appraisal (GLIA) instrument to identify problems in control flow. ( 0,70782538307898 )
Methods Inf Med - An electronic specimen collection protocol schema (eSCPS). Document architecture for specimen management and the exchange of specimen collection protocols between biobanking information systems. ( 0,692992143145504 )
J Am Med Inform Assoc - Effect of clinical decision support on documented guideline adherence for head CT in emergency department patients with mild traumatic brain injury. ( 0,688816891299815 )
BMC Med Inform Decis Mak - Development of a prototype clinical decision support tool for osteoporosis disease management: a qualitative study of focus groups. ( 0,683506569367803 )
J Biomed Inform - Feasibility of encoding the Institute for Clinical Systems Improvement Depression Guideline using the Omaha System. ( 0,674949185172226 )
AMIA Annu Symp Proc - Making audit actionable: an example algorithm for blood pressure management in chronic kidney disease. ( 0,671955955814362 )
J Am Med Inform Assoc - An informatics approach to medication adherence assessment and improvement using clinical, billing, and patient-entered data. ( 0,662299480253647 )
J. Med. Internet Res. - Feasibility of a wiki as a participatory tool for patients in clinical guideline development. ( 0,661062453605546 )
BMC Med Inform Decis Mak - Practice guidelines and clinical risk assessment models: is it time to reform? ( 0,654572656961482 )
Int J Med Inform - From clinical practice guidelines, to clinical guidance in practice - impacts for computerization. ( 0,65437583948946 )
J Am Med Inform Assoc - Building better guidelines with BRIDGE-Wiz: development and evaluation of a software assistant to promote clarity, transparency, and implementability. ( 0,651325434656121 )
Res Synth Methods - A tool to assess the quality of a meta-analysis. ( 0,645272615038744 )
Healthc (Amst) - Meaningful use: Floor or ceiling? ( 0,644010008099676 )
AMIA Annu Symp Proc - An Algorithm Using Twelve Properties of Antibiotics to Find the Recommended Antibiotics, as in CPGs. ( 0,634299961761066 )
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. ( 0,632428741045432 )
Int J Med Inform - Complexity and the science of implementation in health IT--knowledge gaps and future visions. ( 0,632071530581514 )
Int J Med Inform - Towards an understanding of the information dynamics of the handover process in aged care settings--a prerequisite for the safe and effective use of ICT. ( 0,631483836319356 )
J. Med. Internet Res. - An evaluation of web-based clinical practice guidelines for managing problems associated with cannabis use. ( 0,630485856924061 )
Int J Med Inform - Updating clinical knowledge: an evaluation of current information alerting services. ( 0,627356217750895 )
Health Informatics J - Accessibility, usability, and usefulness of a Web-based clinical decision support tool to enhance provider-patient communication around Self-management TO Prevent (STOP) Stroke. ( 0,627047014743219 )
Methods Inf Med - From clinical practice guidelines to computer-interpretable guidelines. A literature overview. ( 0,622271786495471 )
Health Info Libr J - The application and value of information sources in clinical practice: an examination of the perspective of naturopaths. ( 0,619246082272216 )
Appl Clin Inform - An internet portal for the development of clinical practice guidelines. ( 0,618452622358526 )
Health Info Libr J - The Clinical Relevance of Information Index (CRII): assessing the relevance of health information to the clinical practice. ( 0,616015122785906 )
Comput Methods Programs Biomed - A real time online assessment system with modelized architecture on clinical infometrics for patient reported outcomes of prostate cancer. ( 0,614426320566946 )
J Biomed Inform - Authoring and verification of clinical guidelines: a model driven approach. ( 0,613909131802544 )
AMIA Annu Symp Proc - Exceptions handling within GLARE clinical guideline framework. ( 0,613491499663037 )
BMC Med Inform Decis Mak - Validating archetypes for the Multiple Sclerosis Functional Composite. ( 0,611176038845787 )
AMIA Annu Symp Proc - GEM at 10: a decade's experience with the Guideline Elements Model. ( 0,610895740976218 )
Telemed J E Health - Utilization of the American Telemedicine Association's clinical practice guidelines. ( 0,610289531580838 )
Healthc (Amst) - Experience-based design for integrating the patient care experience into healthcare improvement: Identifying a set of reliable emotion words. ( 0,608623551564132 )
BMC Med Inform Decis Mak - Beyond the threshold: real-time use of evidence in practice. ( 0,606980955280801 )
AMIA Annu Symp Proc - Representation of Clinical Nursing Protocols Using GEM II & GEM Cutter. ( 0,602855332078369 )
Perspect Health Inf Manag - Distributed guidelines (DiG): a software framework for extending automated health decision support to the general population. ( 0,601209089180902 )
Methods Inf Med - Snomed CT implementation. Mapping guidelines facilitating reuse of data. ( 0,601146034671801 )
J Am Med Inform Assoc - Validity of electronic health record-derived quality measurement for performance monitoring. ( 0,601077777723339 )
Int J Comput Assist Radiol Surg - AneuSearch: a software prototype for intracranial aneurysm searching and clinical decision support. ( 0,599680943275514 )
J Am Med Inform Assoc - The feasibility of automating audit and feedback for ART guideline adherence in Malawi. ( 0,595064443432589 )
J Am Med Inform Assoc - A multi-layered framework for disseminating knowledge for computer-based decision support. ( 0,594103924253333 )
Comput. Biol. Med. - Evaluation of personal health record systems through the lenses of EC research projects. ( 0,592533559695356 )
J Telemed Telecare - Clinical use of Skype: a review of the evidence base. ( 0,592063014602759 )
Comput Methods Programs Biomed - Supporting adaptive clinical treatment processes through recommendations. ( 0,590381899204736 )
AMIA Annu Symp Proc - Implementation of a computerized patient handoff application. ( 0,589595233581362 )
Int J Med Inform - The effect of computerized decision support on barriers to guideline implementation: a qualitative study in outpatient cardiac rehabilitation. ( 0,587594582714896 )
Int J Med Inform - Evaluation of a comprehensive EHR based on the DeLone and McLean model for IS success: approach, results, and success factors. ( 0,584264504491281 )
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. ( 0,584254756966233 )
J Am Med Inform Assoc - High-priority drug-drug interactions for use in electronic health records. ( 0,582798552000461 )
Appl Clin Inform - Actionable recommendations in the Bright Futures child health supervision guidelines. ( 0,58238722036247 )
Appl Clin Inform - Clinician preferences for verbal communication compared to EHR documentation in the ICU. ( 0,579999849088943 )
Comput. Biol. Med. - Towards automated generation and execution of clinical guidelines: engine design and implementation through the ICU Modified Schofield use case. ( 0,57801944833625 )
Brief. Bioinformatics - A survey of error-correction methods for next-generation sequencing. ( 0,577744320152931 )
Int J Med Inform - Dashboards for improving patient care: review of the literature. ( 0,577648550485545 )
AMIA Annu Symp Proc - Developing nursing computer interpretable guidelines: a feasibility study of heart failure guidelines in homecare. ( 0,577016780682385 )
Comput. Biol. Med. - LabSystem Gen, a tool for structuring and analyzing genetic data in histocompatibility laboratories. ( 0,576582005018053 )
J Biomed Inform - A review of causal inference for biomedical informatics. ( 0,573303503890782 )
Telemed J E Health - Is there an improvement on the Web sites of the national and international pharmaceutical companies in Turkey? A follow-up study. ( 0,571249118935628 )
BMC Med Inform Decis Mak - Use of handheld computers in clinical practice: a systematic review. ( 0,570488760169928 )
AMIA Annu Symp Proc - Locating relevant patient information in electronic health record data using representations of clinical concepts and database structures. ( 0,568653326431105 )
BMC Med Inform Decis Mak - A study of clinical and information management processes in the surgical pre-assessment clinic. ( 0,566096701685796 )
Appl Clin Inform - The association between use of a clinical decision support tool and adherence to monitoring for medication-laboratory guidelines in the ambulatory setting. ( 0,565981921010233 )
BMC Med Inform Decis Mak - A systematic review of the implementation and impact of asthma protocols. ( 0,565107011075259 )
J Telemed Telecare - Costs and benefits of tele-endoscopy clinics in a remote location. ( 0,563800701784567 )
Int J Med Inform - USB-based Personal Health Records: an analysis of features and functionality. ( 0,560770319101627 )
Methods Inf Med - Possible combinations of electronic data capture and randomization systems. principles and the realization with RANDI2 and OpenClinica. ( 0,559744795674982 )
J. Med. Internet Res. - Pain-QuILT: clinical feasibility of a web-based visual pain assessment tool in adults with chronic pain. ( 0,559343765711891 )
Int J Med Inform - Contingency planning for electronic health record-based care continuity: a survey of recommended practices. ( 0,556218702952211 )
J Biomed Inform - Transforming semi-structured life science diagrams into meaningful domain ontologies with DiDOn. ( 0,555891970532515 )
BMC Med Inform Decis Mak - The challenges of implementing a telestroke network: a systematic review and case study. ( 0,555869786639295 )
J Clin Monit Comput - Ventilator-associated pneumonia: current status and future recommendations. ( 0,553774966047787 )
Int J Med Inform - The impact of clinical leadership on health information technology adoption: systematic review. ( 0,552643240804993 )
J Biomed Inform - Content overlap in nurse and physician handoff artifacts and the potential role of electronic health records: a systematic review. ( 0,547784175043093 )
J Biomed Inform - Workflow mining and outlier detection from clinical activity logs. ( 0,547774069947021 )
J. Med. Internet Res. - Facebook apps for smoking cessation: a review of content and adherence to evidence-based guidelines. ( 0,547175655164583 )
AMIA Annu Symp Proc - Standardizing Clinical Document Names Using the HL7/LOINC Document Ontology and LOINC Codes. ( 0,545931062605456 )
BMC Med Inform Decis Mak - A systematic development process for patient decision aids. ( 0,545899844358546 )
J Am Med Inform Assoc - Let the left hand know what the right is doing: a vision for care coordination and electronic health records. ( 0,54440106887962 )
BMC Med Inform Decis Mak - Stage 1 of the meaningful use incentive program for electronic health records: a study of readiness for change in ambulatory practice settings in one integrated delivery system. ( 0,543252445899042 )
BMC Med Inform Decis Mak - Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study. ( 0,541154553970664 )
Healthc (Amst) - Improving the value of healthcare delivery using publicly available performance data in Wisconsin and California. ( 0,540834986820316 )
IEEE Trans Image Process - A protocol for evaluating video trackers under real-world conditions. ( 0,540506012022628 )
Int J Med Inform - Applying the archetype approach to the database of a biobank information management system. ( 0,540007998686726 )
Health Info Libr J - Do quality improvement systems improve health library services? A systematic review. ( 0,539819546827389 )
Appl Clin Inform - Interest in health information exchange in ambulatory care: a statewide survey. ( 0,539264347462987 )
Int J Med Inform - The effect of electronic medical record-based clinical decision support on HIV care in resource-constrained settings: a systematic review. ( 0,538902820111637 )
J Biomed Inform - Lexically suggest, logically define: quality assurance of the use of qualifiers and expected results of post-coordination in SNOMED CT. ( 0,53882686005749 )
J Am Med Inform Assoc - Evaluation of computer-generated reminders to improve CD4 laboratory monitoring in sub-Saharan Africa: a prospective comparative study. ( 0,535535272512154 )
J Am Med Inform Assoc - Governance for clinical decision support: case studies and recommended practices from leading institutions. ( 0,534988414794268 )
Health Info Libr J - Evidence-based medicine: is the evidence out there for primary care clinicians? ( 0,53447888920481 )
Comput Methods Programs Biomed - An HL7-CDA wrapper for facilitating semantic interoperability to rule-based Clinical Decision Support Systems. ( 0,533419588733017 )
Int J Neural Syst - Multimodal integration of micro-Doppler sonar and auditory signals for behavior classification with convolutional networks. ( 0,531361785378598 )
J. Med. Internet Res. - The establishment of an ethical guideline for genetic testing through citizen consensus via the Internet in Taiwan. ( 0,530451220795245 )
BMC Med Inform Decis Mak - Evaluation of data completeness in the electronic health record for the purpose of patient recruitment into clinical trials: a retrospective analysis of element presence. ( 0,530045782103629 )
Inform Health Soc Care - Nurses' use of an integrated electronic health record: results of a case site analysis. ( 0,529297309669477 )
J Biomed Inform - Probabilistic techniques for obtaining accurate patient counts in Clinical Data Warehouses. ( 0,528626716374405 )
BMC Med Inform Decis Mak - How to translate therapeutic recommendations in clinical practice guidelines into rules for critiquing physician prescriptions? Methods and application to five guidelines. ( 0,527068238328871 )
Int J Comput Assist Radiol Surg - Formal verification of software-based medical devices considering medical guidelines. ( 0,524654269380111 )
Methods Inf Med - Appropriateness of ICD-coded diagnostic inpatient hospital discharge data for medical practice assessment. A systematic review. ( 0,524165875958266 )
BMC Med Inform Decis Mak - Deficiencies in the transfer and availability of clinical trials evidence: a review of existing systems and standards. ( 0,523359679593057 )