emergency department
Unertl KM et al, J Am Med Inform Assoc, 19(3)
Objective
The goal of this study was to develop an in-depth understanding of how a health information exchange (HIE) fits into clinical workflow at multiple clinical sites.
Materials and Methods
The ethnographic qualitative study was conducted over a 9-month period in six emergency departments (ED) and eight ambulatory clinics in Memphis, Tennessee, USA. Data were collected using direct observation, informal interviews during observation, and formal semi-structured interviews. The authors observed for over 180 h, during which providers used the exchange 130 times.
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16 May 2012 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Ambulatory Care, Emergency Department, Health Information Exchange, Hospitals, United States, Workflow
Takahashi PY et al, Archives of Internal Medicine, 2012
Background
Efficiently caring for frail older adults will become an increasingly important part of health care reform; telemonitoring within homes may be an answer to improve outcomes. This study sought to assess differences in hospitalizations and emergency department (ED) visits among older adults using telemonitoring vs usual care.
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27 April 2012 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Elderly, Emergency Department, Randomized Controlled Trials, Telemedicine, Telemonitoring, United States
Stein JC et al, Academic Emergency Medicine, 18(10)
OBJECTIVES
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 »
Categories: Bibliography, Journal Article | Keyword(s): Efficiency, Emergency Department, Kiosk, Patient Satisfaction, Safety, United States
Kim MJ et al, International Journal of Medical Informatics, 2012
Purpose
Specialty consultations and waiting for admission to a hospital bed are major contributors to increased length of stay and overcrowding in the emergency department. We implemented a computerized short messaging service to inform care providers of patient delay in order to reduce length of stay. The purpose of this study was to evaluate the effects of this strategy on length of stay in the emergency department.
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1 February 2012 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Emergency Department, Korea, Reminder Systems, SMS
Johnson KB et al, J Am Med Inform Assoc, 18(5)
OBJECTIVE
Health information exchange (HIE) systems are being developed across the nation. Understanding approaches taken by existing successful exchanges can help new exchange efforts determine goals and plan implementations. The goal of this study was to explore characteristics of use and users of a successful regional HIE.
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23 January 2012 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Ambulatory Care, Electronic Health Records, Emergency Department, Health Information Exchange, United States
Dugas AF et al, Clinical Infectious Diseases, 2012
Background.
Google Flu Trends (GFT) is a novel Internet-based influenza surveillance system that uses search engine query data to estimate influenza activity and is available in near real time. This study assesses the temporal correlation of city GFT data to cases of influenza and standard crowding indices from an inner-city emergency department (ED).
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11 January 2012 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Emergency Department, Influenza, Internet, Surveillance, United States
Connelly DP et al, J Am Med Inform Assoc, 19(3)
Objective
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 »
Categories: Bibliography, Journal Article | Keyword(s): Efficiency, Electronic Health Records, Emergency Department, Heart Failure, Quality, United States
Frisse ME et al, J Am Med Inform Assoc, 19(3)
To examine the financial impact health information exchange (HIE) in emergency departments (EDs).Materials and MethodsWe studied all ED encounters over a 13-month period in which HIE data were accessed in all major emergency departments Memphis, Tennessee. HIE access encounter records were matched with similar encounter records without HIE access. Outcomes studied were ED-originated hospital admissions, admissions for observation, laboratory testing, head CT, body CT, ankle radiographs, chest radiographs, and echocardiograms. Our estimates employed generalized estimating equations for logistic regression models adjusted for admission type, length of stay, and Charlson co-morbidity index. Marginal probabilities were used to calculate changes in outcome variables and their financial consequences.ResultsHIE data were accessed in approximately 6.8% of ED visits across 12 EDs studied.
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9 November 2011 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Benefits, Emergency Department, Health Information Exchange, United States
Kennebeck SS et al, J Am Med Inform Assoc, 2011
Implementing electronic health records (EHR) in healthcare settings incurs challenges, none more important than maintaining efficiency and safety during rollout. This report quantifies the impact of offloading low-acuity visits to an alternative care site from the emergency department (ED) during EHR implementation. In addition, the report evaluated the effect of EHR implementation on overall patient length of stay (LOS), time to medical provider, and provider productivity during implementation of the EHR.
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7 November 2011 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Electronic Health Records, Emergency Department, Implementation, Pediatrics
Gerbier S et al, BMC Medical Informatics and Decision Making, 11(1)
BACKGROUND:
The identification of patients who pose an epidemic hazard when they are admitted to a health facility plays a role in preventing the risk of hospital acquired infection. An automated clinical decision support system to detect suspected cases, based on the principle of syndromic surveillance, is being developed at the University of Lyon’s Hopital de la Croix-Rousse. This tool will analyse structured data and narrative reports from computerized emergency department (ED) medical records. The first step consists of developing an application (UrgIndex) which automatically extracts and encodes information found in narrative reports. The purpose of the present article is to describe and evaluate this natural language processing system.
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8 August 2011 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Electronic Health Records, Electronic Medical Records, Emergency Department, France, NLP, Surveillance
Theera-Ampornpunt N et al, AMIA, Annual Symposium Proceedings, 2009
A patient’s prior clinical information available electronically can be helpful during the care process, particularly in the emergency department (ED). The effect of such information on quality and efficiency of ED patient care has not been adequately studied. This study uses secondary data to investigate its impact on surrogate measures of care quality and efficiency among 6,143 congestive heart failure, diabetic, and asthmatic patients in 3 EDs.
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1 May 2011 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Asthma, Chronic Diseases, Diabetes Mellitus, Electronic Health Records, Emergency Department, Heart Failure, Medical Informatics, United States
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 »
Categories: Bibliography, Journal Article | Keyword(s): Efficiency, Electronic Health Records, Electronic Medical Records, Emergency Department, United States
Terrell KM et al, Annals of Emergency Medicine, 2010
Study objective
Emergency physicians prescribe several discharge medications that require dosage adjustment for patients with renal disease. The hypothesis for this research was that decision support in a computerized physician order entry system would reduce the rate of excessive medication dosing for patients with renal impairment.
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14 May 2010 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): CPOE, Decision Support, Emergency Department, Medication, Nephrology, Randomized Controlled Trials, United States
Mastouri, Negin et al, ElectronicHealthcare, 8(3)
Introduction:
One of the root causes for Emergency Department (ED) overcrowding stems from challenges with patient flow from acute to post-acute care institutions. Significant improvements to the referral process can be made by moving to an electronic Resource Matching and Referral (RM&R) system, which could be used to facilitate accessing accurate and consistent data relating to referral patterns, waitlists, response times, referral efficiencies, and gaps in programs/services.
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15 March 2010 | No Comments »
Categories: Bibliography, Journal Article | Keyword(s): Acute Care, Canada, Emergency Department, Referral
Geisler BP et al, PLoS ONE, 5(2)
Background
Policymakers advocate universal electronic medical records (EMRs) and propose incentives for “meaningful use” of EMRs. Though emergency departments (EDs) are particularly sensitive to the benefits and unintended consequences of EMR adoption, surveillance has been limited. We analyze data from a nationally representative sample of US EDs to ascertain the adoption of various EMR functionalities.
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17 February 2010 | No Comments »
Categories: Journal Article | Keyword(s): CPOE, Electronic Health Records, Electronic Medical Records, Emergency Department, Meaningful Use, United States
Reis, Ben Y. et al, BMJ, 339 (sep29_1)
Objective
To determine whether longitudinal data in patients’ historical records, commonly available in electronic health record systems, can be used to predict a patient’s future risk of receiving a diagnosis of domestic abuse.
Design
Bayesian models, known as intelligent histories, used to predict a patient’s risk of receiving a future diagnosis of abuse, based on the patient’s diagnostic history. Retrospective evaluation of the model’s predictions using an independent testing set.
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30 September 2009 | No Comments »
Categories: Journal Article | Keyword(s): Alerts and Reminders, Bayesian, Decision Making, Domestic Abuse, Electronic Health Records, Emergency Department, ICD, Longitudinal Data, United States
Karahoca, Adem et al, Journal of Biomedical Informatics, Article in Press, Accepted Manuscript
Study objective
The purpose of this study is to evaluate the usability of emergency department (ED) software prototypes developed for Tablet personal computers (Tablet PCs) in order to keep electronic health records (EHRs) of patients errorless and accessible through mobile technologies. In order to serve this purpose, two alternative prototypes were developed for Tablet PCs: Mobile Emergency Department Software (MEDS) and Mobile Emergency Department Software Iconic (MEDSI) among which the user might choose the more appropriate one for ED operations based on a usability analysis involving the target users.
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21 September 2009 | No Comments »
Categories: Journal Article | Keyword(s): Electronic Health Records, Emergency Department, Hospital Information Systems, Medical Information Systems, Mobile Technology, Turkey, Usability
Heath, Barry et al, Pediatric Critical Care Medicine, 10(5)
Objective:
A disparity in access to health care exists between rural and urban areas. Although 21% of children in the United States live in rural areas, only 3% of pediatric intensivists practice in rural areas. In an attempt to address this issue, we implemented a program of pediatric critical care telemedicine consultations in rural emergency departments (EDs) and report our results.
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18 September 2009 | No Comments »
Categories: Journal Article | Keyword(s): Disparities, Emergency Department, Feasibility Studies, Pedriatics, Rural, Telemedicine, United States, Urban
Ayatollahi H et al, Health Informatics Journal, 15(3)
Although the potential benefits of computer-based records have been identified in different areas of the healthcare environment, in many settings paper-based records and computer-based records are still used in parallel. In this article, emergency department (ED) staff perspectives about the use of paper- or computer-based records are presented. This was a qualitative study in which data were collected using in-depth semi-structured interviews with the ED staff. The interviews were transcribed verbatim and data were analysed using framework analysis. In total, 34 interviews were undertaken.
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2 September 2009 | No Comments »
Categories: Journal Article, UK EHR | Keyword(s): Electronic Health Records, Emergency Department, Hospitals, Paper Based Medical Records, UK
Laskowski, Marek and Shamir Mukhi, Electronic Healthcare, 25-37, 2009
We describe an agent based model of an emergency department and its utility for evaluating workflow and assessing patient diversion policies. The overall goal of the research is to develop tools to better understand and manage emergency departments.
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4 April 2009 | No Comments »
Categories: Book Article | Keyword(s): Agent Based Modeling, Ambulance, Bio-inference, Emergency Department, Redeployment, Waiting Time Reduction
