the international council on medical & care compunetics


December, 2014


Improving diabetes management with electronic health records and patients’ health records

Benhamou P-Y. Diabetes & Metabolism, 37S4

The lack of patient engagement and clinical inertia both contribute to suboptimal diabetes care. However, both obstacles are amenable to informatics- and Internet-based interventions. The use of electronic medical records (EMRs) is now established as being useful for improving diabetes care. Intelligent records that integrate computerized decision-support systems are now able to recommend care protocols tailored to risk levels. Web-based personal health record (PHR) systems, shared with healthcare providers, could also provide added value by promoting self-management of the behaviours related to diabetes. These Web-based programmes include patients’ access to EMRs, uploading of glucose monitoring results, a glucose diary, secure e-mail with providers, manual or automated feedback on blood glucose readings and other risk factors, an educational website, and an online diary for entering personal information on exercise, diet and medication.
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4 January 2012 | No Comments »
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Étude exploratoire sur les blogs personnels santé et maladie

Legros M. Santé Publique, 21(hs2)

Having first emerged in the 1990s, online blogs had developed significantly by 2004, reaching an estimated 30 to 40 million in France. While they are particularly active in literary, technical and political fields, the authors of blogs are also active in the realm of healthcare. The object of this paper is to provide an assessment of roughly 2 to 3 per thousand of those personal blogs which focus on health and illness.
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21 November 2011 | No Comments »
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First medical contact and physicians’ opinion after the implementation of an electronic record system

Claret P-G et al, The American Journal of Emergency Medicine, 2011

Hospitals implement electronic medical record systems (EMRSs) that are intended to support medical and nursing staff in their daily work. Evolution toward more computerization seems inescapable. Nevertheless, this evolution introduced new problems of organization.

This before-and-after observational study evaluated the door-to-first-medical-contact (FMC) times before and after the introduction of EMRS. A satisfaction questionnaire, administered after the “after” period, measured clinicians’ satisfaction concerning computerization in routine clinical use. The following 5 questions were asked: Do you spare time in your note taking with EMRS? Do you spare time in the medical care that you provide to the patients with EMRS? Does EMRS improve the quality of medical care for your patients? Are you satisfied with the EMRS implementation? Would you prefer a return to handwritten records?

Results showed an increase in door-to-FMC time induced by EMRS and a lower triage capacity. In the satisfaction questionnaire, clinicians reported minimal satisfaction but refused to return to handwritten records.

The increase in door-to-FMC time may be explained by the improved quantity/quality of data and by the many interruptions due to the software. Medical reorganization was requested after the installation of the EMRS.

25 October 2011 | No Comments »
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Home telemonitoring (FEV1) in children with severe asthma does not reduce exacerbations

Deschildre A et al, The European Respiratory Journal, 2011

Some children with severe asthma develop frequent exacerbations despite intensive treatment. we sought to assess the outcome (severe exacerbations and health-care use, lung function, quality of life, maintenance treatment) of a strategy based on daily home spirometry with teletransmission to an expert medical centre and wether it differs from that of a conventional strategy. 50 children with severe uncontrolled asthma were enrolled in a 12-month prospective study and randomized into two groups: treatment managed with daily home spirometry and medical feedback (HM) and conventional treatment (CT).
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29 September 2011 | No Comments »
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Automated home telephone self-monitoring reduces hospitalization in patients with advanced heart failure

Kurtz B et al, Journal of Telemedicine and Telecare, 17(6)

We studied 138 patients admitted for heart failure (HF). Patients were allocated one of three treatment strategies. Group 1 (G1, n = 50) were given usual care for HF, Group 2 (G2, n = 56) received a multi-disciplinary team approach, while Group 3 (G3, n = 32) had home telephone self-monitoring. Telemonitoring was based on the answers to three simple queries about bodyweight change, dyspnoea and general health. The system stratified the HF severity of each patient once a week, and recommended a prompt medical appointment or simple follow-up.
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25 September 2011 | No Comments »
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Evaluation of natural language processing from emergency department computerized medical records for intra-hospital syndromic surveillance

Gerbier S et al, BMC Medical Informatics and Decision Making, 11(1)

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 »
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Full access to medical records does not modify anxiety in cancer patients

Gravis G et al, Cancer, 2011

Information is crucial for increasing the patients’ empowerment and autonomy in relevant decision‐making processes, especially in malignant diseases. However, the extent to which information should be delivered is debated. The objective of this study was to assess the impact of providing systematic full access (SFA) to the medical record on anxiety, quality of life, and satisfaction.

Patients with newly diagnosed breast cancer, colon cancer, or lymphoma who had received adjuvant chemotherapy in an outpatient setting were included in a randomized controlled trial comparing those who requested access (RA) and those who provided SFA to the medical record. Anxiety was assessed using the Spielberger State‐Trait Anxiety Inventory before, during, and at the end of treatment. Quality of life was evaluated using the European Organization for Research and Cancer quality‐of‐life questionnaire (EORTC QLQ‐C30) before and at the end of treatment. Patients’ satisfaction and perception of the organized medical record (OMR) were evaluated using a specifically designed questionnaire at the end of treatment.
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24 May 2011 | No Comments »
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Facebook activity of residents and fellows and its impact on the doctor-patient relationship

Moubarak G et al, Journal of Medical Ethics, 37(2)

Facebook is an increasingly popular online social networking site. The purpose of this study was to describe the Facebook activity of residents and fellows and their opinions regarding the impact of Facebook on the doctor-patient relationship.

An anonymous questionnaire was emailed to 405 residents and fellows at the Rouen University Hospital, France, in October 2009.
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17 December 2010 | 1 Comment »
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Smart Card Technology: The Cornerstone of the Application of Health Information Technology in Lombardy, Italy

Pinciroli F et al, ElectronicHealthcare, 9(3)

The diffusion of smart cards within the health field is common in many countries and regions throughout the world. Italy’s Regione Lombardia enjoys one of the more successful applications of health information technology in Europe, and the current state of its accomplishments is examined in this article.
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29 September 2010 | No Comments »
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Extracting medical information from narrative patient records: the case of medication-related information

Deléger L et al, J Am Med Inform Assoc, 17(5)

While essential for patient care, information related to medication is often written as free text in clinical records and, therefore, difficult to use in computerized systems. This paper describes an approach to automatically extract medication information from clinical records, which was developed to participate in the i2b2 2009 challenge, as well as different strategies to improve the extraction.
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24 September 2010 | No Comments »
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Teleconsultation using multimedia messaging service for management plan in pediatric orthopaedics: a pilot study

Elkaim M et al, Journal of Pediatric Orthopedics, 30(3)

Application and assessment of the usefulness of image transfer through a mobile telephone in pediatric orthopaedic practice was investigated.
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1 July 2010 | No Comments »
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[Telemedicine in diabetes: Current results and perspectives]

Franc S et al, Médecine des Maladies Métaboliques, 4(3)

The goals of telemedicine (TM) probably differ depending on whether one considers patients with type 1 diabetes for whom TM has been designed to help them to better control their blood glucose values or patients with type 2 diabetes (T2D) for whom TM could be used to reinforce an inefficient healthcare system due to the decreasing number of physicians facing a rapidly growing disease. Numerous trials have been published, most of them failed to demonstrate the superiority for TM intervention vs. usual care.
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13 June 2010 | No Comments »
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[The Internet and shared decision-making between patients and healthcare providers]

Silber D. Presse Médicale, 38(10)

Insurance companies like Kaiser Permanente in the United States remunerate physicians for their email correspondence with patients, increasing the efficiency of office visits. A survey by the French National Board of Physicians regarding the computerization of medical practices in April 2009, confirms that both physicians and patients in France are very favorable to the development of these tools.
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24 May 2010 | No Comments »
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[La télépsychiatrie au service de l'autisme]

Saint-André S et al, L'Encéphale, 2010

The authors report on the set-up of a telehealth system developed to facilitate exchanges between the Autism Resource Centre of Brittany (centre de ressources pour l’autisme [CRA]) located in Brest and an adult psychiatry structure of Vannes’ Hospital in the Morbihan region, these sites are about 200 kilometres distant.
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22 May 2010 | No Comments »
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Determinants of the frequency of online health information seeking: Results of a Web-based survey conducted in France in 2007

Renahy, Emilie et al, Informatics for Health and Social Care, 35(1)

In the general population, social disparities in Internet practices have been less described than disparities in health information access. Aim is to determine whether there are differences in the frequency of Internet use for health information among health seekers. We conducted an Internet-based survey from November 2006 to March 2007. We considered the 3720 residents of France who had searched for health information during the previous 12 months. This study reveals different uses of the Internet for health information seeking (HIS) between men and women and between the general population and people who work in the health sector. Health status, taking care of somebody who is sick, and active Internet use were associated with higher frequencies of online HIS to varying degrees.
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21 March 2010 | No Comments »
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[Telemedicine: An unfruitful experience of tele-expertise in nephrology.]

Alamartine, Eric et al, Presse Médicale, 2010

We developed a new system of medical tele-expertise to improve detection and care of chronic renal failure by way of a better communication between general practitioners and specialists. It has been known for long that the incidence of chronic renal failure is increasing while cost of its treatment is very high. Unfortunately, late referral of patients with kidney diseases remains around 30%. Our goal was to help physicians to get access to nephrologists, hence to improve the cure of renal diseases. An early treatment of nephropathies may avoid the evolution to the stage of dialysis.
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15 February 2010 | No Comments »
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A survey of primary care physicians in eleven countries, 2009: perspectives on care, costs, and experiences

Schoen, Cathy et al, Health Affairs, 28(6)

This 2009 survey of primary care doctors in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States finds wide differences in practice systems, incentives, perceptions of access to care, use of health information technology (IT), and programs to improve quality. Response rates exceeded 40 percent except in four countries: Canada, France, the United Kingdom, and the United States.
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6 November 2009 | No Comments »
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[Medicine 2.0: the stakes of participatory medicine]

Silber D Presse Médicale, 38(10)

Web 2.0: interactive, collaborative tools (wikis, social networks, blogs, virtual worlds) make Internet users active participants rather than simple consumers. Medicine 2.0: mentalities, approaches, and medical practices are changing, thanks to greater access to information, communal exchanges, and the comparison of personal experiences.
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14 September 2009 | No Comments »
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Using Discharge Abstracts to Evaluate a Regional Perinatal Network: Assessment of the Linkage Procedure of Anonymous Data

Quantin, Catherine et al, International Journal of Telemedicine and Applications, 2009, Article ID 181842

To assess the Burgundy perinatal network (18 obstetrical units; 18 500 births per year), discharge abstracts and additional data were collected for all mothers and newborns. In accordance with French law, data were rendered anonymous before statistical analysis, and were linked to patients using a specific procedure.
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17 April 2009 | No Comments »
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Teleconsultation in remote care stations: cost-minimisation analysis of the Guianese experiment

Nassiri, N. et al, International Journal of Biomedical Engineering and Technology, 2(1)

The aim of the paper is to carry out a cost-minimisation analysis in order to measure the cost saving performances of teleconsultation in Guiana. Fixed and variable costs are estimated in order to identify the break-even point of teleconsultation. It also takes into account organisational and quality effects.
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10 December 2008 | No Comments »
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