the international council on medical & care compunetics


December, 2014


A randomized trial of computer kiosk-expedited management of cystitis in the emergency department

Stein JC et al, Academic Emergency Medicine, 18(10)

The objective was to assess the efficiency and safety of an interactive computer kiosk module for the management of uncomplicated urinary tract infections (UTI) in emergency departments (EDs).
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24 April 2012 | No Comments »
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Impact of Mobile Tablet Computers on Internal Medicine Resident Efficiency

Patel BK et al, Archives of Internal Medicine, 172(5)

Internal medicine residents’ increased workload compounded by limited work hours creates work compression and competition between service responsibilities and educational goals. Moreover, residents report spending the bulk of their time in indirect patient care, such as updating medical charts, documentation, and ordering tests, at the expense of direct patient care or education.
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13 March 2012 | No Comments »
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The impact of electronic health records on care of heart failure patients in the emergency room

Connelly DP et al, J Am Med Inform Assoc, 19(3)

To evaluate if electronic health records (EHR) have observable effects on care outcomes, we examined quality and efficiency measures for patients presenting to emergency departments (ED).

Materials and methods
We conducted a retrospective study of 5166 adults with heart failure in three metropolitan EDs. Patients were termed internal if prior information was in the EHR upon ED presentation, otherwise external. Associations of internality with hospitalization, mortality, length of stay (LOS), and numbers of tests, procedures, and medications ordered in the ED were examined after adjusting for age, gender, race, marital status, comorbidities and hospitalization as a proxy for acuity level where appropriate.
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15 November 2011 | No Comments »
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Teledermatology applied following patient selection by general practitioner in daily practice improves efficiency and quality of care at lower costs

van der Heijden JP et al, The British Journal of Dermatology, 2011

Teledermatology, the application of telemedicine in the field of dermatology has similar accuracy and reliability as physical dermatology. Teledermatology has been widely used in daily practice in The Netherlands since 2005 and is fully reimbursed.

This study prospectively investigated the effect of teledermatology on efficiency, quality and costs of care when integrated in daily practice and applied following patient selection by the general practitioner.
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5 September 2011 | No Comments »
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The accuracy and efficiency of electronic screening for recruitment into a clinical trial on COPD

Schmickl CN et al, Respiratory Medicine, 2011

Participant recruitment is an important process in successful conduct of randomized controlled trials. To facilitate enrollment into a National Institutes of Health–sponsored clinical trial involving patients with chronic obstructive pulmonary disease (COPD), we developed and prospectively validated an automated electronic screening tool based on boolean free-text search of admission notes in electronic medical records. During a 2-week validation period, all patients admitted to prespecified general medical services were screened for eligibility by both the electronic screening tool and a COPD nurse. Group discussion was the gold standard for confirmation of true-positive results.
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15 May 2011 | No Comments »
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Electronic Medical Records, Nurse Staffing, and Nurse-Sensitive Patient Outcomes: Evidence From the National Database of Nursing Quality Indicators

Furukawa MF et al, Medical Care Research and Review, 68(3)

Electronic medical records (EMR) have the potential to improve nursing care in the hospital setting. This study estimated the association of EMR implementation with nurse staffing levels, skill mix, contract/agency percent, and nurse-sensitive patient outcomes in U.S. hospitals. Data on nurse staffing and patient outcomes came from the 2004-2008 National Database of Nursing Quality Indicators. Data on EMR implementation came from the 2004-2008 HIMSS Analytics Database.
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4 May 2011 | No Comments »
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Tapping the Unmet Potential of Health Information Technology

O’Malley AS. N Engl J Med, 364(12)

Health information technology (HIT) holds promise for facilitating vast improvements in care and, ultimately, in the health of Americans, but achieving that potential remains a daunting task. A recent article in the Los Angeles Times described the new phenomenon of hiring computer-savvy undergraduate “scribes” to take notes for physicians during patient encounters and enter the information into electronic health records (EHRs) — a practice that suggests how far we must go to develop EHRs that clinicians will embrace.
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24 March 2011 | No Comments »
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Clinicians satisfaction with CPOE ease of use and effect on clinicians’ workflow, efficiency and medication safety

Khajouei R et al, International Journal of Medical Informatics, 2011

To study the satisfaction of end-users of a computerized physician order entry (CPOE) system concerning ease of use and the effect on users’ workflow, efficiency, and medication safety and to seek users’ opinions regarding required improvements of the system. Usability evaluation had shown that this system, which was in use for almost a decade, contained a number of severe usability problems. So another objective of the study was to determine whether there was a direct relation between user satisfaction and the results of a usability evaluation of the system.
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20 March 2011 | No Comments »
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The Benefits Of Health Information Technology: A Review Of The Recent Literature Shows Predominantly Positive Results

Buntin MB et al, Health Affairs, 30(3)

An unprecedented federal effort is under way to boost the adoption of electronic health records and spur innovation in health care delivery. We reviewed the recent literature on health information technology to determine its effect on outcomes, including quality, efficiency, and provider satisfaction. We found that 92 percent of the recent articles on health information technology reached conclusions that were positive overall. We also found that the benefits of the technology are beginning to emerge in smaller practices and organizations, as well as in large organizations that were early adopters.
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8 March 2011 | No Comments »
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A peach of a telehealth program: georgia connects rural communities to better healthcare

Brewer R et al, Perspectives in Health Information Management, 8(Winter)

This article presents Georgia’s telehealth response to some of the significant healthcare challenges and disparities facing the rural citizens of this state. When compared to their urban and suburban counterparts, rural communities have fewer healthcare providers, and residents must travel longer distances to reach them.
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12 February 2011 | No Comments »
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Does a mandatory telemedicine call prior to visiting a physician reduce costs or simply attract good risks?

Grandchamp C et al, Health Economics, 2010

This paper aims to estimate empirically the efficiency of a Swiss telemedicine service introduced in 2003. We used claims’ data gathered by a major Swiss health insurer, over a period of 6 years and involving 160 000 insured adults.
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19 October 2010 | No Comments »
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The impact of electronic health records on time efficiency of physicians and nurses: a systematic review

Poissant L et al, J Am Med Inform Assoc, 12(5)

A systematic review of the literature was performed to examine the impact of electronic health records (EHRs) on documentation time of physicians and nurses and to identify factors that may explain efficiency differences across studies. In total, 23 papers met our inclusion criteria; five were randomized controlled trials, six were posttest control studies, and 12 were one-group pretest-posttest designs. Most studies (58%) collected data using a time and motion methodology in comparison to work sampling (33%) and self-report/survey methods (8%). A weighted average approach was used to combine results from the studies.
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25 September 2010 | No Comments »
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Electronic Medical Records and the Efficiency of Hospital Emergency Departments

Furukawa MF. Medical Care Research and Review, 68(1)

This study examined the relationship between electronic medical records (EMR) sophistication and the efficiency of U.S. hospital emergency departments (EDs). Using data from the 2006 National Hospital Ambulatory Medical Care Survey, survey-weighted ordinary least squares regressions were used to estimate the association of EMR sophistication with ED throughput and probability a patient left without treatment.
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18 August 2010 | No Comments »
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Advanced Search of the Electronic Medical Record: Augmenting Safety and Efficiency in Radiology

Zalis M, Harris M. Journal of the American College of Radiology, 7(8)

The integration of electronic medical record (EMR) systems into clinical practice has been spurred by general consensus and recent federal incentives and is set to become a standard feature of clinical practice in the US.
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5 August 2010 | No Comments »
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It Ain’t Necessarily So: The Electronic Health Record And The Unlikely Prospect Of Reducing Health Care Costs

Sidorov J. Health Affairs, 25(4)

Electronic health record (EHR) advocates argue that EHRs lead to reduced errors and reduced costs. Many reports suggest otherwise. The EHR often leads to higher billings and declines in provider productivity with no change in provider-to-patient ratios. Error reduction is inconsistent and has yet to be linked to savings or malpractice premiums.
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9 July 2010 | No Comments »
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The Potential of RFID Technology in Blood Center Processes

Kebo V et al. Medical and Care Compunetics 6, 2010

Current RFID technology deployment is limited by safety, procedural and physical limitations in healthcare field. It is important to define and ensure safe operation of technologies without actual deployment in real operation. Potential problems could arise due to the consequences of technical and physical characteristics of RFID technology and its improper location.
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17 June 2010 | No Comments »
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Leveraging complex event processing for smart hospitals using RFID

Yao W et al, Journal of Network and Computer Applications, 2010

RFID technology has been examined in healthcare to support a variety of applications such as patient identification and monitoring, asset tracking and patient-drug compliance. However, managing the large volume of RFID data and understanding them in the medical context present new challenges. One effective solution for dealing with these challenges is Complex Event Processing (CEP), which can extract meaningful events for context-awareness applications.
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14 May 2010 | No Comments »
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Electronic medical records for the office

Bays RA, Kaelin LD, Journal of Vascular Surgery, 51(5)

Electronic medical records are gathering significant attention with the recent State and Federal initiatives, Medicare Physician Quality Reporting Initiatives (PQRI), and stimulus funds. The conversion to an electronic environment from the comfortable but inefficient paper record can be confusing, difficult, and costly if the practice does not complete the proper analysis and planning for the transformation.
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13 May 2010 | No Comments »
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Improve Office Efficiency by Putting Your Patients to Work: Patients’ Perspectives Regarding Online Self-service Appointment Scheduling in Family Practice (Part 3 of 3)

Ludwick, Dave A., and John Doucette, ElectronicHealthcare, 8(4)

This case study is the third part of a three-part study examining the impact of an online appointment scheduling system on physician office scheduling. The purpose of the study was to understand patients’ experiences when booking appointments through an online appointment scheduling system. A 24-question patient survey gathered perspectives from registered adult patients who had booked by either channel from August 8, 2008, to February 28, 2009. The online scheduling system was used by 128 unique patients, while 1,831 booked by telephone. Of the respondents, 186 were aware of the system but had not booked online, 107 were not aware of the system and 105 had booked online.
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18 March 2010 | No Comments »
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Editorial: Supporting healthcare reform with augmented electronic medical records system

Hsieh, Chang-Tseh, International Journal of Electronic Healthcare, 5(2)

The Healthcare Reform Program is by far the most debated and controversial issue confronting the Obama Administration. Much attention thus far has been focused on the Electronic Medical Records (EMR) system. Most healthcare practitioners seem to agree that computerised medical information at hospitals, doctors’ offices and all other healthcare institutes would lead to reduced waste, and minimised treatment mistakes that had amounted to billions of dollars and thousands of lives.
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14 November 2009 | No Comments »
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