J Am Med Inform Assoc - Using electronic health records to save money.

Tópicos

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

Resumo

JECTIVES: Health information technology, especially electronic health records (EHRs), can be used to improve the efficiency and effectiveness of healthcare providers. This study assessed the cost-savings of incorporating a list of preferred specialty care providers into the EHRs used by all primary care physicians (PCPs), accompanied by a comprehensive implementation plan.METHODS: On January 1, 2005, all specialty clinic providers at the Israeli Defense Forces were divided into one of four financial classes based on their charges, class 1, the least expensive, being the most preferred, followed by classes 2-4. This list was incorporated into the EHRs used by all PCPs in primary care clinics. PCPs received comprehensive training. Target referral goals were determined for each class and measured for 4 years, together with the total cost of all specialist visits in the first year compared to the following years. Quality assessment (QA) scores were used as a measure of the program's effect on the quality of patient care.RESULTS: During 2005-2008, a marginally significant decline in referrals to class 1 was observed (r=-0.254, p=0.078), however a significant increase in referral rates to class 2 was observed (r=0.957, p=0.042), concurrent with a decrease in referral rates to classes 3 and 4 (r=-0.312, p=0.024). An inverse correlation was observed between year and total costs for all visits to specialists (2008 prices; r=-0.96, p=0.04), and between the mean cost of one specialist visit over the 4 years, indicating a significant reduction in real costs (2008 prices; r=-0.995, p=0.005). QA was not affected by these changes (r=0.94, p=0.016).CONCLUSIONS: From a policy perspective, our data suggest that EHR can facilitate effective utilization of healthcare providers and decrease costs.

Resumo Limpo

jectiv health inform technolog especi electron health record ehr can use improv effici effect healthcar provid studi assess costsav incorpor list prefer specialti care provid ehr use primari care physician pcps accompani comprehens implement planmethod januari specialti clinic provid isra defens forc divid one four financi class base charg class least expens prefer follow class list incorpor ehr use pcps primari care clinic pcps receiv comprehens train target referr goal determin class measur year togeth total cost specialist visit first year compar follow year qualiti assess qa score use measur program effect qualiti patient careresult margin signific declin referr class observ r p howev signific increas referr rate class observ r p concurr decreas referr rate class r p invers correl observ year total cost visit specialist price r p mean cost one specialist visit year indic signific reduct real cost price r p qa affect chang r pconclus polici perspect data suggest ehr can facilit effect util healthcar provid decreas cost

Resumos Similares

Appl Clin Inform - The impact of geography on hospital electronic health records implementation in alabama: implications for meaningful use. ( 0,744977972427319 )
J Am Med Inform Assoc - Care transitions as opportunities for clinicians to use data exchange services: how often do they occur? ( 0,72494828205757 )
Int J Med Inform - Physician productivity and the ambulatory EHR in a large academic multi-specialty physician group. ( 0,723467991505319 )
BMC Med Inform Decis Mak - Use and satisfaction with key functions of a common commercial electronic health record: a survey of primary care providers. ( 0,699155504941956 )
Perspect Health Inf Manag - Exploring patient satisfaction before and after electronic health record (EHR) implementation: the Kuwait experience. ( 0,698907832507951 )
Appl Clin Inform - Physician specialty and variations in adoption of electronic health records. ( 0,695946436892108 )
J Am Med Inform Assoc - Transitioning between ambulatory EHRs: a study of practitioners' perspectives. ( 0,667666977823623 )
Healthc (Amst) - Meaningful Use IT reduces hospital-caused adverse drug events even at challenged hospitals. ( 0,666614416845262 )
Telemed J E Health - New technologies and nursing: use and perception of primary healthcare nurses about electronic health record in Catalonia, Spain. ( 0,656726299795159 )
Telemed J E Health - Assessing the cost of electronic health records: a review of cost indicators. ( 0,652688629090122 )
Appl Clin Inform - Diabetes and hypertension quality measurement in four safety-net sites: lessons learned after implementation of the same commercial electronic health record. ( 0,652565177485256 )
J Am Med Inform Assoc - Re-examining health IT policy: what will it take to derive value from our investment? ( 0,651444505282975 )
J Am Med Inform Assoc - Sequencing of EHR adoption among US hospitals and the impact of meaningful use. ( 0,650480095658391 )
J Am Med Inform Assoc - Data standards to support health information exchange between poison control centers and emergency departments. ( 0,645564009598748 )
Telemed J E Health - Teleconsultation for clinicians who provide human immunodeficiency virus care: experience of the national HIV telephone consultation service. ( 0,645382558932076 )
Perspect Health Inf Manag - Hospital characteristics related to the intention to apply for meaningful use incentive payments. ( 0,644060292355207 )
Healthc (Amst) - Electronic health records and technical assistance to improve quality of primary care: Lessons for regional extension centers. ( 0,643725725464024 )
J Med Syst - Factors associated with health information exchange system usage in a safety-net ambulatory care clinic setting. ( 0,642525243006705 )
J Telemed Telecare - A review of Medicare expenditure in Australia for psychiatric consultations delivered in person and via videoconference. ( 0,637186493895872 )
Telemed J E Health - Technologies in the patient-centered medical home: examining the model from an enterprise perspective. ( 0,636392113353608 )
Healthc (Amst) - Improving the value of healthcare delivery using publicly available performance data in Wisconsin and California. ( 0,633978285843987 )
J Med Syst - Challenges, alternatives, and paths to sustainability for health information exchange efforts. ( 0,631283478616022 )
Perspect Health Inf Manag - Health information technology: integration of clinical workflow into meaningful use of electronic health records. ( 0,631220654921192 )
Appl Clin Inform - An exploratory, population-based, mixed-methods program evaluation of user satisfaction of services provided by a regional extension center (REC). ( 0,626744823412179 )
AMIA Annu Symp Proc - Health information exchange, Health Information Technology use, and hospital readmission rates. ( 0,626022234756897 )
J Biomed Inform - Implementing standards for the interoperability among healthcare providers in the public regionalized Healthcare Information System of the Lombardy Region. ( 0,625717054294232 )
J Am Med Inform Assoc - Governance for clinical decision support: case studies and recommended practices from leading institutions. ( 0,625416703978224 )
Health Informatics J - Using electronic health record systems to optimize admission decisions: the Creatinine case study. ( 0,624630454636947 )
Perspect Health Inf Manag - Electronic health records and information portability: a pilot study in a rural primary healthcare center in India. ( 0,623566189986116 )
BMC Med Inform Decis Mak - Motivating medical information system performance by system quality, service quality, and job satisfaction for evidence-based practice. ( 0,622734918652014 )
AMIA Annu Symp Proc - Assessing readiness for meeting meaningful use: identifying electronic health record functionality and measuring levels of adoption. ( 0,622170381397909 )
J Am Med Inform Assoc - Electronic health record use and preventive counseling for US children and adolescents. ( 0,619434828151145 )
J Med Syst - Opioid prescribing by physicians with and without electronic health records. ( 0,619286697829731 )
Int J Med Inform - Collaboration in electronic medical evidence development: a case study of the Social Security Administration's MEGAHIT System. ( 0,618592948619449 )
J Am Med Inform Assoc - The long-term financial impact of electronic health record implementation. ( 0,615995970695177 )
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. ( 0,615538741995777 )
Appl Clin Inform - Diffusion of Electronic Health Records and electronic communication in Norway. ( 0,614920062771464 )
J Am Med Inform Assoc - A typology of electronic health record workarounds in small-to-medium size primary care practices. ( 0,614765387936899 )
Int J Med Inform - Adoption of electronic health records in Korean tertiary teaching and general hospitals. ( 0,614414023190055 )
Int J Med Inform - Rates, levels, and determinants of electronic health record system adoption: a study of hospitals in Riyadh, Saudi Arabia. ( 0,613645589671547 )
J Am Med Inform Assoc - Evaluating and classifying the readiness of technology specifications for national standardization. ( 0,612220748543207 )
J Telemed Telecare - Telehealth for nursing homes: the utilization of specialist services for residential care. ( 0,611441585051594 )
Telemed J E Health - Teledentistry in practice: literature review. ( 0,610293426532315 )
Int J Med Inform - Do integrated record systems lead to integrated services? An observational study of a multi-professional system in a diabetes service. ( 0,6099168256008 )
Appl Clin Inform - Utilizing an electronic health record system to improve vaccination coverage in children. ( 0,606646515320378 )
AMIA Annu Symp Proc - Initial Steps toward Validating and Measuring the Quality of Computerized Provider Documentation. ( 0,606532543371809 )
Int J Med Inform - Development of an in-house hospital information system in a hospital in Pakistan. ( 0,606086407213124 )
J Am Med Inform Assoc - When does adoption of health information technology by physician practices lead to use by physicians within the practice? ( 0,605830178070619 )
Healthc (Amst) - A novel community-based delivery model to combat cancer disparities. ( 0,604457345628574 )
Telemed J E Health - Centralized monitoring and virtual consultant models of tele-ICU care: a side-by-side review. ( 0,603493952652885 )
Perspect Health Inf Manag - Impact of electronic health record systems on information integrity: quality and safety implications. ( 0,602922592660094 )
Appl Clin Inform - Use of Headings and Classifications by Physicians in Medical Narratives of EHRs: An evaluation study in a Finnish hospital. ( 0,601918103031591 )
Artif Intell Med - Predicting the impact of hospital health information technology adoption on patient satisfaction. ( 0,601412034795465 )
Healthc (Amst) - Flipping primary health care: A personal story. ( 0,60084950586365 )
Telemed J E Health - Cost savings of telemedicine utilization for child psychiatry in a rural Kansas community. ( 0,600012092293338 )
Appl Clin Inform - Predictors of success for electronic health record implementation in small physician practices. ( 0,598062968941263 )
J Am Med Inform Assoc - Impact of electronic health record implementation on patient flow metrics in a pediatric emergency department. ( 0,59780784399349 )
J Med Syst - Usability evaluation of paper-based Hajji Health Record format. ( 0,596162687754187 )
J Telemed Telecare - The costs and potential savings of telemedicine for acute care neonatal consultation: preliminary findings. ( 0,595311689236441 )
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. ( 0,594864808001094 )
J Med Syst - Organization's quality maturity as a vehicle for EHR success. ( 0,59382408820213 )
Appl Clin Inform - Capturing information needs of care providers to support knowledge sharing and distributed decision making. ( 0,592795833545204 )
J Biomed Inform - Implementations of the HL7 Context-Aware Knowledge Retrieval (Infobutton) Standard: challenges, strengths, limitations, and uptake. ( 0,592333484243664 )
AMIA Annu Symp Proc - Leveraging standards to support patient-centric interdisciplinary plans of care. ( 0,592005823048745 )
Healthc (Amst) - Health information exchange among U.S. hospitals: who's in, who's out, and why? ( 0,591794944355585 )
Perspect Health Inf Manag - Leveraging the cloud for electronic health record access. ( 0,590497332631556 )
J Am Med Inform Assoc - Phased implementation of electronic health records through an office of clinical transformation. ( 0,590037435283117 )
Healthc (Amst) - Meaningful use: Floor or ceiling? ( 0,589558412533958 )
Perspect Health Inf Manag - Electronic health record adoption and use by Nebraska pharmacists. ( 0,589533971424802 )
Telemed J E Health - Online medical care: the current state of eVisits in acute primary care delivery. ( 0,588768948930925 )
Health Info Libr J - Do quality improvement systems improve health library services? A systematic review. ( 0,588405090317019 )
Health Informatics J - Mobile phone-based clinical guidance for rural health providers in India. ( 0,586988947022313 )
Int J Med Inform - The implementation of electronic health records: a case study of bush computing the Ngaanyatjarra lands. ( 0,586595122594254 )
Methods Inf Med - Semantic validation of standard-based electronic health record documents with W3C XML schema. ( 0,585263848492599 )
J Am Med Inform Assoc - Area-level factors associated with electronic health record adoption and meaningful use in the Regional Extension Center Program. ( 0,584857328444989 )
Appl Clin Inform - Electronic Health Record Adoption - Maybe It's not about the Money: Physician Super-Users, Electronic Health Records and Patient Care. ( 0,584079430089749 )
J Am Med Inform Assoc - Validity of electronic health record-derived quality measurement for performance monitoring. ( 0,582136320477737 )
AMIA Annu Symp Proc - Specialized Pediatric Growth Charts For Electronic Health Record Systems: the example of Down syndrome. ( 0,580526498752714 )
Telemed J E Health - Implementation of a regional virtual tumor board: a prospective study evaluating feasibility and provider acceptance. ( 0,580426251383137 )
Perspect Health Inf Manag - Use of health information technology by office-based physicians: comparison of two contemporaneous public-use physician surveys. ( 0,579516449188611 )
BMC Med Inform Decis Mak - Application of smart phone in Better Border Healthcare Program: a module for mother and child care. ( 0,579150979005853 )
Int J Med Inform - Physician experiences transitioning between an older versus newer electronic health record for electronic prescribing. ( 0,579052716907211 )
J Med Syst - Benefits and challenges of electronic health record system on stakeholders: a qualitative study of outpatient physicians. ( 0,57780010642013 )
Perspect Health Inf Manag - Evaluation of inpatient clinical documentation readiness for ICD-10-CM. ( 0,577635319865043 )
J Am Med Inform Assoc - Effects of health information exchange adoption on ambulatory testing rates. ( 0,576615805309349 )
Int J Med Inform - Electronic health records implementation: an evaluation of information system impact and contingency factors. ( 0,576560901997824 )
AMIA Annu Symp Proc - Progress and challenge in meeting meaningful use at an integrated delivery network. ( 0,575510189092119 )
J Biomed Inform - Content overlap in nurse and physician handoff artifacts and the potential role of electronic health records: a systematic review. ( 0,574859191168361 )
J Biomed Inform - Translating standards into practice: experience and lessons learned at the Department of Veterans Affairs. ( 0,574481378871065 )
J Telemed Telecare - Cost-effectiveness analysis of telemonitoring versus usual care in patients with heart failure: the TEHAF-study. ( 0,573542652855983 )
J Am Med Inform Assoc - Racial differences in cancer screening with electronic health records and electronic preventive care reminders. ( 0,573460324041238 )
J Am Med Inform Assoc - Implications of an emerging EHR monoculture for hospitals and healthcare systems. ( 0,573292727256092 )
J Am Med Inform Assoc - Factors associated with difficult electronic health record implementation in office practice. ( 0,572159950416987 )
Appl Clin Inform - Clinician perceptions of pediatric growth chart use and electronic health records in Kentucky. ( 0,571439319711198 )
BMC Med Inform Decis Mak - A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review. ( 0,569850474886961 )
J Am Med Inform Assoc - Exploring the sociotechnical intersection of patient safety and electronic health record implementation. ( 0,56726969599724 )
BMC Med Inform Decis Mak - Economic analysis of cloud-based desktop virtualization implementation at a hospital. ( 0,566126173622055 )
Int J Med Inform - Critical areas of national electronic health record programs-is our focus correct? ( 0,565515573510009 )
Artif Intell Med - A pilot study of distributed knowledge management and clinical decision support in the cloud. ( 0,565413635866603 )
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. ( 0,565373927003501 )