Appl Clin Inform - An electronic alert for HIV screening in the emergency department increases screening but not the diagnosis of HIV.

Tópicos

{ medic(1828) order(1363) alert(1069) }
{ detect(2391) sensit(1101) algorithm(908) }
{ treatment(1704) effect(941) patient(846) }
{ time(1939) patient(1703) rate(768) }
{ age(1611) year(1155) adult(843) }
{ patient(2837) hospit(1953) medic(668) }
{ survey(1388) particip(1329) question(1065) }
{ method(1219) similar(1157) match(930) }
{ record(1888) medic(1808) patient(1693) }
{ compound(1573) activ(1297) structur(1058) }
{ health(3367) inform(1360) care(1135) }
{ group(2977) signific(1463) compar(1072) }
{ implement(1333) system(1263) develop(1122) }
{ system(1976) rule(880) can(841) }
{ assess(1506) score(1403) qualiti(1306) }
{ chang(1828) time(1643) increas(1301) }
{ ehr(2073) health(1662) electron(1139) }
{ patient(1821) servic(1111) care(1106) }
{ sequenc(1873) structur(1644) protein(1328) }
{ clinic(1479) use(1117) guidelin(835) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ risk(3053) factor(974) diseas(938) }
{ studi(1119) effect(1106) posit(819) }
{ state(1844) use(1261) util(961) }
{ cost(1906) reduc(1198) effect(832) }
{ data(3008) multipl(1320) sourc(1022) }
{ use(976) code(926) identifi(902) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ 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) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ 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) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ 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) }
{ perform(1367) use(1326) method(1137) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ signal(2180) analysi(812) frequenc(800) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ 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) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ estim(2440) model(1874) function(577) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }

Resumo

JECTIVE: Based on US. Centers for Disease Control and Prevention recommendations, New York State enacted legislation in 2010 requiring healthcare providers to offer non-targeted human immunodeficiency virus (HIV) testing to all patients aged 13-64. Three New York City adult emergency departments implemented an electronic alert that required clinicians to document whether an HIV test was offered before discharging a patient. The purpose of this study was to assess the impact of the electronic alert on HIV testing rates and diagnosis of HIV positive individuals.METHODS: During the pre-intervention period (2.5-4 months), an electronic "HIV Testing" order set was available for clinicians to order a test or document a reason for not offering the test (e.g., patient is not conscious). An electronic alert was then added to enforce completion of the order set, effectively preventing ED discharge until an HIV test was offered to the patient. We analyzed data from 79,786 visits, measuring HIV testing and detection rates during the pre-intervention period and during the six months following the implementation of the alert.RESULTS: The percentage of visits where an HIV test was performed increased from 5.4% in the preintervention period to 8.7% (p<0.001) after the electronic alert. After the implementation of the electronic alert, there was a 61% increase in HIV tests performed per visit. However, the percentage of patients testing positive per total patients-tested was slightly lower in the post-intervention group than the pre-intervention group (0.48% vs. 0.55%), but this was not significant. The number of patients-testing positive per total-patient visit was higher in the post-intervention group (0.04% vs. 0.03%).CONCLUSIONS: An electronic alert which enforced non-targeted screening was effective at increasing HIV testing rates but did not significantly increase the detection of persons living with HIV. The impact of this electronic alert on healthcare costs and quality of care merits further examination.

Resumo Limpo

jectiv base us center diseas control prevent recommend new york state enact legisl requir healthcar provid offer nontarget human immunodefici virus hiv test patient age three new york citi adult emerg depart implement electron alert requir clinician document whether hiv test offer discharg patient purpos studi assess impact electron alert hiv test rate diagnosi hiv posit individualsmethod preintervent period month electron hiv test order set avail clinician order test document reason offer test eg patient conscious electron alert ad enforc complet order set effect prevent ed discharg hiv test offer patient analyz data visit measur hiv test detect rate preintervent period six month follow implement alertresult percentag visit hiv test perform increas preintervent period p electron alert implement electron alert increas hiv test perform per visit howev percentag patient test posit per total patientstest slight lower postintervent group preintervent group vs signific number patientstest posit per totalpati visit higher postintervent group vs conclus electron alert enforc nontarget screen effect increas hiv test rate signific increas detect person live hiv impact electron alert healthcar cost qualiti care merit examin

Resumos Similares

BMC Med Inform Decis Mak - Diagnostic accuracy of a screening electronic alert tool for severe sepsis and septic shock in the emergency department. ( 0,695776237990184 )
Med Decis Making - Overestimation error and unnecessary antibiotic prescriptions for acute cystitis in adult women. ( 0,68190983954873 )
J Med Syst - Implement the RFID position based system of automatic tablets packaging machine for patient safety. ( 0,677127679469865 )
Int J Med Inform - Online detection of potential duplicate medications and changes of physician behavior for outpatients visiting multiple hospitals using national health insurance smart cards in Taiwan. ( 0,664557461867314 )
BMC Med Inform Decis Mak - Evaluation of an automated safety surveillance system using risk adjusted sequential probability ratio testing. ( 0,66415108580982 )
J Am Med Inform Assoc - Phenotyping for patient safety: algorithm development for electronic health record based automated adverse event and medical error detection in neonatal intensive care. ( 0,660607788145003 )
Int J Med Inform - Functionality test for drug safety alerting in computerized physician order entry systems. ( 0,657429094990143 )
J Am Med Inform Assoc - Effectiveness of an information technology intervention to improve prophylactic antibacterial use in the postoperative period. ( 0,65158449079887 )
J Am Med Inform Assoc - Clinical decision support for atypical orders: detection and warning of atypical medication orders submitted to a computerized provider order entry system. ( 0,650871976141285 )
J Am Med Inform Assoc - Improving patient safety via automated laboratory-based adverse event grading. ( 0,648899483252652 )
Appl Clin Inform - Medication safety improves after implementation of positive patient identification. ( 0,643915613399912 )
BMC Med Inform Decis Mak - Impact of computerized physician order entry (CPOE) system on the outcome of critically ill adult patients: a before-after study. ( 0,635398814570102 )
BMC Med Inform Decis Mak - Effect of electronic prescribing with formulary decision support on medication tier, copayments, and adherence. ( 0,631806748472005 )
J Am Med Inform Assoc - Early cost and safety benefits of an inpatient electronic health record. ( 0,630964009884725 )
Int J Med Inform - Assessment of efficiency and safety of the comprehensive Chemotherapy Assistance Program for ordering oncology medications. ( 0,629656178256781 )
J Am Med Inform Assoc - Integrating pharmacogenetic information and clinical decision support into the electronic health record. ( 0,629230365166113 )
J Am Med Inform Assoc - Sensitivity and specificity of dosing alerts for dosing errors among hospitalized pediatric patients. ( 0,628245325480636 )
BMC Med Inform Decis Mak - Manual and automated methods for identifying potentially preventable readmissions: a comparison in a large healthcare system. ( 0,620440267908838 )
J Am Med Inform Assoc - Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool. ( 0,620184025355728 )
AMIA Annu Symp Proc - Effectiveness of bar coded medication alerts for elevated potassium. ( 0,615763359950077 )
AMIA Annu Symp Proc - Unexpected effects of unintended consequences: EMR prescription discrepancies and hemorrhage in patients on warfarin. ( 0,614635671913439 )
J Am Med Inform Assoc - Impact of clinical decision support preventing the use of QT-prolonging medications for patients at risk for torsade de pointes. ( 0,61462444602369 )
AMIA Annu Symp Proc - Effectiveness of Evidence-Based Congestive Heart Failure (CHF) CPOE Order Sets Measured by Health Outcomes. ( 0,612263750039035 )
J Am Med Inform Assoc - Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system. ( 0,61191868132508 )
AMIA Annu Symp Proc - Improving patient safety by modifying provider ordering behavior using alerts (CDSS) in CPOE system. ( 0,611590213669224 )
Artif Intell Med - Asynchronous gaze-independent event-related potential-based brain-computer interface. ( 0,610664286673557 )
J Am Med Inform Assoc - The impact of the heparin-induced thrombocytopenia (HIT) computerized alert on provider behaviors and patient outcomes. ( 0,608062345721495 )
Appl Clin Inform - Duplicate orders: an unintended consequence of computerized provider/physician order entry (CPOE) implementation: analysis and mitigation strategies. ( 0,607892440847806 )
AMIA Annu Symp Proc - Interpreting nurses' responses to clinical documentation alerts. ( 0,607404377898013 )
Int J Med Inform - The effect of using the health smart card vs. CPOE reminder system on the prescribing practices of non-obstetric physicians during outpatient visits for pregnant women in Taiwan. ( 0,606229009216191 )
J Am Med Inform Assoc - Ambulatory prescribing errors among community-based providers in two states. ( 0,605822831653529 )
J Med Syst - Development of a point-of-care HIV/AIDS medication dosing support system using the Android mobile platform. ( 0,604933826554186 )
Int J Med Inform - Impact of electronic order management on the timeliness of antibiotic administration in critical care patients. ( 0,60413127236383 )
Int J Med Inform - Prescription order risk factors for pediatric dosing alerts. ( 0,60351478270335 )
Int J Med Inform - Implementation of computerized provider order entry in a neonatal intensive care unit: Impact on admission workflow. ( 0,602347871732894 )
Med Decis Making - Comparing decisions for malaria testing and presumptive treatment: a net health benefit analysis. ( 0,60091390124245 )
Artif Intell Med - Evaluation of rule effectiveness and positive predictive value of clinical rules in a Dutch clinical decision support system in daily hospital pharmacy practice. ( 0,600342712231209 )
Appl Clin Inform - Real-time pharmacy surveillance and clinical decision support to reduce adverse drug events in acute kidney injury: a randomized, controlled trial. ( 0,600071046516584 )
AMIA Annu Symp Proc - Improving Patient Safety through Medical Alert Management: An Automated Decision Tool to Reduce Alert Fatigue. ( 0,59899226629802 )
J Am Med Inform Assoc - Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. ( 0,597842378743701 )
Perspect Health Inf Manag - Enhance the accuracy of medication histories for the elderly by using an electronic medication checklist. ( 0,596323297522019 )
J Am Med Inform Assoc - Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE). ( 0,595014080192813 )
AMIA Annu Symp Proc - I meant that med for Baylee not Bailey!: a mixed method study to identify incidence and risk factors for CPOE patient misidentification. ( 0,594104939666861 )
Int J Med Inform - Comparing the working time between Bar-Code Medication Administration system and traditional medication administration system: an observational study. ( 0,593715145919749 )
Comput Methods Programs Biomed - A prescription fraud detection model. ( 0,593645632899383 )
J Am Med Inform Assoc - Errors associated with outpatient computerized prescribing systems. ( 0,593352718731312 )
Med Decis Making - Better medicine by default. ( 0,593102552063133 )
Int J Med Inform - Junior doctors' prescribing work after-hours and the impact of computerized decision support. ( 0,592546350984186 )
J Am Med Inform Assoc - Evaluating the accuracy of electronic pediatric drug dosing rules. ( 0,592379711184088 )
J Am Med Inform Assoc - Guided medication dosing for elderly emergency patients using real-time, computerized decision support. ( 0,591069661945333 )
Appl Clin Inform - Effect of a laboratory result pager on provider behavior in a neonatal intensive care unit. ( 0,590259332992125 )
Comput Methods Programs Biomed - A guideline-based decision support for pharmacological treatment can improve the quality of hyperlipidemia management. ( 0,589566634005447 )
Med Biol Eng Comput - Strategy for NSAID administration to aspirin-intolerant asthmatics in combination with PGE2 analogue: a theoretical approach. ( 0,589137792265801 )
J Med Syst - Two RFID-based solutions for secure inpatient medication administration. ( 0,588608239379902 )
Telemed J E Health - Rural inpatient telepharmacy consultation demonstration for after-hours medication review. ( 0,588415263158972 )
Appl Clin Inform - Decision Support Alerts for Medication Ordering in a Computerized Provider Order Entry (CPOE) System: A systematic approach to decrease alerts. ( 0,588113311909753 )
BMC Med Inform Decis Mak - Variability of the impact of adverse events on physicians' decision making. ( 0,587571499686252 )
Int J Med Inform - Validity of a clinical decision rule-based alert system for drug dose adjustment in patients with renal failure intended to improve pharmacists' analysis of medication orders in hospitals. ( 0,586479038100942 )
J Am Med Inform Assoc - A framework for evaluating the appropriateness of clinical decision support alerts and responses. ( 0,586165754769358 )
J Am Med Inform Assoc - Appropriateness of commercially available and partially customized medication dosing alerts among pediatric patients. ( 0,585104474849525 )
Int J Med Inform - What, if all alerts were specific - estimating the potential impact on drug interaction alert burden. ( 0,583173354428933 )
J Am Med Inform Assoc - Development and use of active clinical decision support for preemptive pharmacogenomics. ( 0,582650281296574 )
J Am Med Inform Assoc - The safety of electronic prescribing: manifestations, mechanisms, and rates of system-related errors associated with two commercial systems in hospitals. ( 0,582333236774583 )
Appl Clin Inform - Computerized provider order entry reduces length of stay in a community hospital. ( 0,581750290981925 )
BMC Med Inform Decis Mak - Using a computerized provider order entry system to meet the unique prescribing needs of children: description of an advanced dosing model. ( 0,581057577476817 )
Comput Methods Programs Biomed - Physicians' responses to computerized drug-drug interaction alerts for outpatients. ( 0,579191194943406 )
J Am Med Inform Assoc - Factors contributing to an increase in duplicate medication order errors after CPOE implementation. ( 0,578444062540585 )
Int J Med Inform - Evaluation of medication dose alerts in pediatric inpatients. ( 0,577500080983588 )
J. Med. Internet Res. - Physician order entry or nurse order entry? Comparison of two implementation strategies for a computerized order entry system aimed at reducing dosing medication errors. ( 0,576454065597429 )
Appl Clin Inform - Provider use of and attitudes towards an active clinical alert: a case study in decision support. ( 0,575841802627453 )
J Biomed Inform - Assessing the reliability of an automated dose-rounding algorithm. ( 0,575163522024844 )
J Am Med Inform Assoc - Prescribers' expectations and barriers to electronic prescribing of controlled substances. ( 0,573903042687051 )
J Am Med Inform Assoc - Prevalence of medication administration errors in two medical units with automated prescription and dispensing. ( 0,570501577823968 )
J Am Med Inform Assoc - The effectiveness of a new generation of computerized drug alerts in reducing the risk of injury from drug side effects: a cluster randomized trial. ( 0,570455692123757 )
J Am Med Inform Assoc - Understanding and preventing wrong-patient electronic orders: a randomized controlled trial. ( 0,56969778563602 )
Int J Med Inform - Cost-effectiveness of an electronic medication ordering system (CPOE/CDSS) in hospitalized patients. ( 0,569362670513894 )
J Am Med Inform Assoc - Making electronic prescribing alerts more effective: scenario-based experimental study in junior doctors. ( 0,566209554996186 )
Comput Methods Programs Biomed - A smart medication recommendation model for the electronic prescription. ( 0,566055781008062 )
AMIA Annu Symp Proc - Evaluating the effectiveness of clinical alerts: a signal detection approach. ( 0,565940801370297 )
Comput Methods Programs Biomed - An automated decision-support system for non-proliferative diabetic retinopathy disease based on MAs and HAs detection. ( 0,565288096393208 )
BMC Med Inform Decis Mak - Reducing unnecessary testing in a CPOE system through implementation of a targeted CDS intervention. ( 0,563910027429472 )
J Am Med Inform Assoc - How to improve the delivery of medication alerts within computerized physician order entry systems: an international Delphi study. ( 0,562530789316317 )
AMIA Annu Symp Proc - Factors Contributing to CPOE Opiate Allergy Alert Overrides. ( 0,562059928914284 )
J Am Med Inform Assoc - A randomized-controlled trial of computerized alerts to reduce unapproved medication abbreviation use. ( 0,561336202948043 )
Appl Clin Inform - Response to medication dosing alerts for pediatric inpatients using a computerized provider order entry system. ( 0,561001688660056 )
Appl Clin Inform - Drug interaction alert override rates in the Meaningful Use era: no evidence of progress. ( 0,560487537315081 )
J Am Med Inform Assoc - Don't fuel the fire: decreasing intravenous haloperidol use in high risk patients via a customized electronic alert. ( 0,558499835159236 )
Telemed J E Health - Automatic event detection in lung transplant recipients based on home monitoring of spirometry and symptoms. ( 0,558203540257162 )
Health Informatics J - Effects of a computerized decision support system in improving pharmacological management in high-risk cardiovascular patients: A cluster-randomized open-label controlled trial. ( 0,55789375086833 )
AMIA Annu Symp Proc - An analysis and recommendations for multidisciplinary computerized handoff applications in hospitals. ( 0,55405091547208 )
Appl Clin Inform - Effect of EHR user interface changes on internal prescription discrepancies. ( 0,551926431014896 )
J Am Med Inform Assoc - Failure to utilize functions of an electronic prescribing system and the subsequent generation of 'technically preventable' computerized alerts. ( 0,551206106287843 )
BMC Med Inform Decis Mak - Predicting out of intensive care unit cardiopulmonary arrest or death using electronic medical record data. ( 0,549832765874502 )
Int J Med Inform - A human factors and survey methodology-based design of a web-based adverse event reporting system for families. ( 0,54974061727818 )
J Am Med Inform Assoc - Overrides of medication-related clinical decision support alerts in outpatients. ( 0,549592401280023 )
Appl Clin Inform - Electronic medical record prompts for lab orders in patients initiating statins. ( 0,549043224856194 )
Perspect Health Inf Manag - Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? ( 0,548888489764586 )
Appl Clin Inform - Computerized Physician Order Entry (CPOE) in pediatric and neonatal intensive care: Recommendations how to meet clinical requirements. ( 0,548441747795557 )
BMC Med Inform Decis Mak - Modeling screening, prevention, and delaying of Alzheimer's disease: an early-stage decision analytic model. ( 0,548018716104501 )
Telemed J E Health - A retrospective study on patient characteristics and telehealth alerts indicative of key medical events for heart failure patients at a home health agency. ( 0,547707462097971 )