Int J Med Inform - Does single-source create an added value? Evaluating the impact of introducing x4T into the clinical routine on workflow modifications, data quality and cost-benefit.

Tópicos

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

Resumo

JECTIVES: The first objective of this study is to evaluate the impact of integrating a single-source system into the routine patient care documentation workflow with respect to process modifications, data quality and execution times in patient care as well as research documentation. The second one is to evaluate whether it is cost-efficient using a single-source system in terms of achieved savings in documentation expenditures.METHODS: We analyzed the documentation workflow of routine patient care and research documentation in the medical field of pruritus to identify redundant and error-prone process steps. Based on this, we established a novel documentation workflow including the x4T (exchange for Trials) system to connect hospital information systems with electronic data capture systems for the exchange of study data. To evaluate the workflow modifications, we performed a before/after analysis as well as a time-motion study. Data quality was assessed by measuring completeness, correctness and concordance of previously and newly collected data. A cost-benefit analysis was conducted to estimate the savings using x4T per collected data element and the additional costs for introducing x4T.RESULTS: The documentation workflow of patient care as well as clinical research was modified due to the introduction of the x4T system. After x4T implementation and workflow modifications, half of the redundant and error-prone process steps were eliminated. The generic x4T system allows direct transfer of routinely collected health care data into the x4T research database and avoids manual transcription steps. Since x4T has been introduced in March 2012, the number of included patients has increased by about 1000 per year. The average entire documentation time per patient visit has been significantly decreased by 70.1% (from 1116?185 to 334?83 s). After the introduction of the x4T system and associated workflow changes, the completeness of mandatory data elements raised from 82.2% to 100%. In case of the pruritus research study, the additional costs for introducing the x4T system are ?434.01 and the savings are 0.48ct per collected data element. So, with the assumption of a 5-year runtime and 82 collected data elements per patient, the amount of documented patients has to be higher than 1102 to create a benefit.CONCLUSION: Introduction of the x4T system into the clinical and research documentation workflow can optimize the data collection workflow in both areas. Redundant and cumbersome process steps can be eliminated in the research documentation, with the result of reduced documentation times as well as increased data quality. The usage of the x4T system is especially worthwhile in a study with a large amount of collected data or a high number of included patients.

Resumo Limpo

jectiv first object studi evalu impact integr singlesourc system routin patient care document workflow respect process modif data qualiti execut time patient care well research document second one evalu whether costeffici use singlesourc system term achiev save document expendituresmethod analyz document workflow routin patient care research document medic field pruritus identifi redund errorpron process step base establish novel document workflow includ xt exchang trial system connect hospit inform system electron data captur system exchang studi data evalu workflow modif perform beforeaft analysi well timemot studi data qualiti assess measur complet correct concord previous newli collect data costbenefit analysi conduct estim save use xt per collect data element addit cost introduc xtresult document workflow patient care well clinic research modifi due introduct xt system xt implement workflow modif half redund errorpron process step elimin generic xt system allow direct transfer routin collect health care data xt research databas avoid manual transcript step sinc xt introduc march number includ patient increas per year averag entir document time per patient visit signific decreas s introduct xt system associ workflow chang complet mandatori data element rais case pruritus research studi addit cost introduc xt system save ct per collect data element assumpt year runtim collect data element per patient amount document patient higher creat benefitconclus introduct xt system clinic research document workflow can optim data collect workflow area redund cumbersom process step can elimin research document result reduc document time well increas data qualiti usag xt system especi worthwhil studi larg amount collect data high number includ patient

Resumos Similares

BMC Med Inform Decis Mak - CIS-based registration of quality of life in a single source approach. ( 0,842568310456863 )
J Med Syst - Building clinical data groups for electronic medical record in China. ( 0,790508743771388 )
J Am Med Inform Assoc - Implementing an interface terminology for structured clinical documentation. ( 0,788571368989641 )
J Am Med Inform Assoc - The Mid-South clinical Data Research Network. ( 0,780051375669956 )
J Chem Inf Model - Electronic laboratory notebook: the academic point of view. ( 0,765269501816228 )
Appl Clin Inform - Using a scripted data entry process to transfer legacy immunization data while transitioning between electronic medical record systems. ( 0,762906210245671 )
AMIA Annu Symp Proc - An application for monitoring order set usage in a commercial electronic health record. ( 0,724174705537417 )
BMC Med Inform Decis Mak - Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system. ( 0,715228429513215 )
J Am Med Inform Assoc - Evaluation of record linkage between a large healthcare provider and the Utah Population Database. ( 0,704583950065256 )
Perspect Health Inf Manag - Integrating research data capture into the electronic health record workflow: real-world experience to advance innovation. ( 0,698879872242779 )
Appl Clin Inform - An analysis of free-text alcohol use documentation in the electronic health record: early findings and implications. ( 0,69010847482945 )
AMIA Annu Symp Proc - Quantifying clinical data quality using relative gold standards. ( 0,688824767597037 )
Methods Inf Med - Harmonization of detailed clinical models with clinical study data standards. ( 0,688076827604035 )
Int J Med Inform - Structured electronic operative reporting: comparison with dictation in kidney cancer surgery. ( 0,682157857178691 )
Int J Med Inform - Concept and implementation of a computer-based reminder system to increase completeness in clinical documentation. ( 0,678543023977959 )
J Med Syst - Performance assessment of EMR systems based on post-relational database. ( 0,672049704144563 )
Int J Med Inform - Caring for individual patients and beyond: enhancing care through secondary use of data in a general practice setting. ( 0,66825667531768 )
Appl Clin Inform - Rapid implementation of inpatient electronic physician documentation at an academic hospital. ( 0,665693504695938 )
Int J Med Inform - The perception of medical professionals and medical students on the usefulness of an emergency medical card and a continuity of care report in enhancing continuity of care. ( 0,665229158812553 )
Inform Health Soc Care - Multicentre clinical trials' data management: a hybrid solution to exploit the strengths of electronic data capture and electronic health records systems. ( 0,664253994850473 )
Comput Methods Programs Biomed - Comparison of documentation time between an electronic and a paper-based record system by optometrists at an eye hospital in south India: a time-motion study. ( 0,66298912870599 )
AMIA Annu Symp Proc - Capture of osteoporosis and fracture information in an electronic medical record database from primary care. ( 0,659592179881976 )
J Biomed Inform - Integrating electronic health record information to support integrated care: practical application of ontologies to improve the accuracy of diabetes disease registers. ( 0,654656694648701 )
J Am Med Inform Assoc - Clinical documentation: composition or synthesis? ( 0,651610010765935 )
Health Informatics J - Clinical Document Architecture integration system to support patient referral and reply letters. ( 0,645687961883465 )
Int J Med Inform - Description and comparison of quality of electronic versus paper-based resident admission forms in Australian aged care facilities. ( 0,645459950051774 )
AMIA Annu Symp Proc - You can lead a horse to water: physicians' responses to clinical reminders. ( 0,641379378635573 )
J Med Syst - An approach to medical knowledge sharing in a hospital information system using MCLink. ( 0,637415358738485 )
AMIA Annu Symp Proc - Federating clinical data from six pediatric hospitals: process and initial results for microbiology from the PHIS+ consortium. ( 0,636253309924597 )
J Am Med Inform Assoc - Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial. ( 0,635775151524013 )
J Am Med Inform Assoc - HARVEST, a longitudinal patient record summarizer. ( 0,635451025941389 )
J Am Med Inform Assoc - Implementation of the Department of Veterans Affairs' first point-of-care clinical trial. ( 0,635286834117531 )
J Am Med Inform Assoc - Medical decision support using machine learning for early detection of late-onset neonatal sepsis. ( 0,634171471324557 )
J Biomed Inform - Utilizing RxNorm to support practical computing applications: capturing medication history in live electronic health records. ( 0,633951930950058 )
Int J Med Inform - The effects of an electronic medical record on the completeness of documentation in the anesthesia record. ( 0,630527823030906 )
J Am Med Inform Assoc - Data from clinical notes: a perspective on the tension between structure and flexible documentation. ( 0,629636113034407 )
AMIA Annu Symp Proc - Validation and enhancement of a computable medication indication resource (MEDI) using a large practice-based dataset. ( 0,629356720533732 )
J Am Med Inform Assoc - Use of electronic medical records differs by specialty and office settings. ( 0,628936911676248 )
Comput. Biol. Med. - Clinicians' evaluation of computer-assisted medication summarization of electronic medical records. ( 0,628156347712863 )
J Med Syst - Study of the cost-benefit analysis of electronic medical record systems in general hospital in China. ( 0,624190028137606 )
AMIA Annu Symp Proc - Lexical concept distribution reflects clinical practice. ( 0,621627689834427 )
J Am Med Inform Assoc - Presence of key findings in the medical record prior to a documented high-risk diagnosis. ( 0,620364198750687 )
J Biomed Inform - The National Institutes of Health's Biomedical Translational Research Information System (BTRIS): design, contents, functionality and experience to date. ( 0,619875551446343 )
AMIA Annu Symp Proc - What Is Asked in Clinical Data Request Forms? A Multi-site Thematic Analysis of Forms Towards Better Data Access Support. ( 0,614603348666615 )
Comput Methods Programs Biomed - QAIT: a quality assurance issue tracking tool to facilitate the improvement of clinical data quality. ( 0,611894470150064 )
Telemed J E Health - Users and nonusers of university-based dermatology services following a teledermatology encounter: a retrospective descriptive analysis. ( 0,605050694987052 )
J Am Med Inform Assoc - Electronic medical record use in pediatric primary care. ( 0,604436674084654 )
AMIA Annu Symp Proc - qDIET: toward an automated, self-sustaining knowledge base to facilitate linking point-of-sale grocery items to nutritional content. ( 0,604082704413091 )
J Am Med Inform Assoc - Data quality assessment in healthcare: a 365-day chart review of inpatients' health records at a Nigerian tertiary hospital. ( 0,603180086621075 )
AMIA Annu Symp Proc - Continuity of Care Document (CCD) Enables Delivery of Medication Histories to the Primary Care Clinician. ( 0,602598431503524 )
AMIA Annu Symp Proc - The physical attractiveness of electronic physician notes. ( 0,601949313001971 )
Appl Clin Inform - Determining primary care physician information needs to inform ambulatory visit note display. ( 0,601434947329903 )
Int J Med Inform - Secondary use of routinely collected patient data in a clinical trial: an evaluation of the effects on patient recruitment and data acquisition. ( 0,600561464448199 )
Comput Methods Programs Biomed - Efficient data management in a large-scale epidemiology research project. ( 0,599867160134962 )
J Am Med Inform Assoc - Automating the medication regimen complexity index. ( 0,599683150033197 )
Med Decis Making - Continuous versus intermittent data collection of health care utilization. ( 0,599478825981817 )
J Med Syst - A secure integrated medical information system. ( 0,598569733353472 )
AMIA Annu Symp Proc - Comparing content coverage in medical curriculum to trainee-authored clinical notes. ( 0,598410837919848 )
AMIA Annu Symp Proc - The NIH Office of Rare Diseases Research patient registry Standard: a report from the University of New Mexico's Oculopharyngeal Muscular Dystrophy Patient Registry. ( 0,598102986710375 )
J Am Med Inform Assoc - Modeling return on investment for an electronic medical record system in Lilongwe, Malawi. ( 0,594654294091124 )
BMC Med Inform Decis Mak - HIS-based Kaplan-Meier plots--a single source approach for documenting and reusing routine survival information. ( 0,593236476081199 )
J Biomed Inform - The utility of general purpose versus specialty clinical databases for research: warfarin dose estimation from extracted clinical variables. ( 0,592193373529079 )
Methods Inf Med - Development of an open metadata schema for prospective clinical research (openPCR) in China. ( 0,592133377609959 )
AMIA Annu Symp Proc - Potential value of health information exchange for people with epilepsy: crossover patterns and missing clinical data. ( 0,589322795560438 )
Methods Inf Med - Survey on medical records and EHR in Asia-Pacific region: languages, purposes, IDs and regulations. ( 0,589066462978019 )
J Am Med Inform Assoc - A framework for assessing patient crossover and health information exchange value. ( 0,588930272121221 )
Int J Med Inform - Understanding data requirements of retrospective studies. ( 0,588916086734036 )
Int J Med Inform - Separate may not be equal: a preliminary investigation of clinical correlates of electronic psychiatric record accessibility in academic medical centers. ( 0,588342343734102 )
IEEE J Biomed Health Inform - Utility-aware anonymization of diagnosis codes. ( 0,587667519044744 )
BMC Med Inform Decis Mak - Clinical data needs in the neonatal intensive care unit electronic medical record. ( 0,587189674830708 )
Int J Health Geogr - Identifying risk factors for healthcare-associated infections from electronic medical record home address data. ( 0,584327245016528 )
J Biomed Inform - Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base. ( 0,582910508538211 )
J Med Syst - Linkage of data from diverse data sources (LDS): a data combination model provides clinical data of corresponding specimens in biobanking information system. ( 0,581281242739857 )
J Med Syst - Organizational performance and regulatory compliance as measured by clinical pertinence indicators before and after implementation of Anesthesia Information Management System (AIMS). ( 0,579600816598408 )
AMIA Annu Symp Proc - Analysis of medication and indication occurrences in clinical notes. ( 0,577890450622085 )
AMIA Annu Symp Proc - Precision and negative predictive value of links between ClinicalTrials.gov and PubMed. ( 0,575359368809347 )
J Am Med Inform Assoc - Challenges in creating an opt-in biobank with a registrar-based consent process and a commercial EHR. ( 0,574135884443253 )
J Chem Inf Model - How does the quality of phospholipidosis data influence the predictivity of structural alerts? ( 0,573354598562175 )
BMC Med Inform Decis Mak - Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support. ( 0,573030909192868 )
Int J Med Inform - Overcoming challenges integrating patient-generated data into the clinical EHR: lessons from the CONtrolling Disease Using Inexpensive IT--Hypertension in Diabetes (CONDUIT-HID) Project. ( 0,570668577237612 )
J. Med. Internet Res. - Use of an electronic patient portal among the chronically ill: an observational study. ( 0,570055672584574 )
J Biomed Inform - Integrating clinical research with the Healthcare Enterprise: from the RE-USE project to the EHR4CR platform. ( 0,569831150845981 )
Comput. Biol. Med. - Informatics can identify systemic sclerosis (SSc) patients at risk for scleroderma renal crisis. ( 0,567446205681691 )
AMIA Annu Symp Proc - Extracting and integrating data from entire electronic health records for detecting colorectal cancer cases. ( 0,56702157044185 )
J Biomed Inform - A multi-technique approach to bridge electronic case report form design and data standard adoption. ( 0,565146125468477 )
J Am Med Inform Assoc - Breast cancer survivability prediction using labeled, unlabeled, and pseudo-labeled patient data. ( 0,565118748681738 )
Int J Health Geogr - Defining socially-based spatial boundaries in the region of Peel, Ontario, Canada. ( 0,563366011401429 )
AMIA Annu Symp Proc - Demonstrating collect once, use many--assimilating public health secondary data use requirements into an existing Domain Analysis Model. ( 0,563341609229158 )
BMC Med Inform Decis Mak - Clinical map document based on XML (cMDX): document architecture with mapping feature for reporting and analysing prostate cancer in radical prostatectomy specimens. ( 0,562822490395759 )
AMIA Annu Symp Proc - ClinData Express--a metadata driven clinical research data management system for secondary use of clinical data. ( 0,561187493403983 )
AMIA Annu Symp Proc - Prevalence and Clinical Significance of Discrepancies within Three Computerized Pre-Admission Medication Lists. ( 0,560769558440588 )
J Am Med Inform Assoc - Two open access, high-quality datasets from anesthetic records. ( 0,560086111302047 )
J Med Syst - An assessment of patient safety in acupuncture process under EMR support. ( 0,559706674668845 )
J Med Syst - Use of digital patient photographs and electronic medical record data as diagnostic tools in Japan. ( 0,559313911922287 )
J Am Med Inform Assoc - Patient access to medical records and healthcare outcomes: a systematic review. ( 0,558250690059286 )
J Am Med Inform Assoc - Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. ( 0,557486937616641 )
BMC Med Inform Decis Mak - Improved de-identification of physician notes through integrative modeling of both public and private medical text. ( 0,55665129298078 )
AMIA Annu Symp Proc - Type 2 diabetes risk forecasting from EMR data using machine learning. ( 0,554177383800223 )
J Med Syst - Electronic hand-drafting and picture management system. ( 0,553369893589118 )
J Am Med Inform Assoc - Handling anticipated exceptions in clinical care: investigating clinician use of 'exit strategies' in an electronic health records system. ( 0,551710719701636 )