Abstract:
OBJECTIVE: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.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Schnall R,Liu N,Sperling J,Green R,Clark S,Vawdrey Ddoi
10.4338/ACI-2013-09-RA-0075subject
Has Abstractpub_date
2014-03-26 00:00:00pages
299-312issue
1issn
1869-0327journal_volume
5pub_type
杂志文章abstract::Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustaine...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2017-05-RA-0088
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Although diagnostic error (DE) is a significant problem, it remains challenging for clinicians to identify it reliably and to recognize its contribution to the clinical trajectory of their patients. The purpose of this work was to evaluate the reliability of real-time electronic health record (EHR) reviews u...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1713750
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Homecare is an important and effective way of managing chronic illnesses using skilled nursing care in the home. Unlike hospitals and ambulatory settings, clinicians visit patients at home at different times, independent of each other. Twenty-nine percent of 10,000 homecare agencies in the United States have...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-12-RA-0106
更新日期:2014-04-30 00:00:00
abstract::Patient-generated health data are coming into broader use across the health care spectrum and hold great promise as a means to improve care and health outcomes. At the same time, rapid evolution in the social media and mobile health (mHealth) market has promoted an environment in which creation and transmission of per...
journal_title:Applied clinical informatics
pub_type: 杂志文章,评审
doi:10.4338/ACI-2014-09-R-0082
更新日期:2015-01-14 00:00:00
abstract:BACKGROUND:We previously demonstrated that a general purpose text mining system, the Vaccine adverse event Text Mining (VaeTM) system, could be used to automatically classify reports of an-aphylaxis for post-marketing safety surveillance of vaccines. OBJECTIVE:To evaluate the ability of VaeTM to classify reports to th...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-11-RA-0049
更新日期:2013-02-27 00:00:00
abstract:BACKGROUND:Care plan concordance among patients and clinicians during hospitalization is suboptimal. OBJECTIVE:This article determines whether an electronic health record (EHR)-integrated patient portal was associated with increased understanding of the care plan, including the key recovery goal, among patients and cl...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1688831
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this lead...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1718753
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Asthma exacerbations are one of the most common medical reasons for children to be brought to the hospital emergency department (ED). Various prediction models have been proposed to support diagnosis of exacerbations and evaluation of their severity. OBJECTIVES:First, to evaluate prediction models construct...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-04-RA-0029
更新日期:2013-08-07 00:00:00
abstract:OBJECTIVE:The Instrument for Evaluating Human-Factor Principles in Medication-Related Decision Support Alerts (I-MeDeSA) was developed recently in the US with a view towards improving considerations of human-factor principles when designing alerts for clinical decision support (CDS) systems. This study evaluated the ge...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-01-RA-0005
更新日期:2014-06-18 00:00:00
abstract:BACKGROUND:Smartphones are increasingly important for clinical decision support, but smartphone and Internet use are limited by cost or coverage in many settings. txt2MEDLINE provides access to published medical evidence by text messaging. Previous studies have evaluated this approach, but we found no comparisons with ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-06-RA-0024
更新日期:2012-09-06 00:00:00
abstract:OBJECTIVES:To understand and build a collective vision of all existing institutions in the Portuguese National Health Service as well as to perceive how and how far the interaction between those multiple institutions is supported by Information Systems (IS). METHODS:Upon identification of the institutions involved in ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-08-RA-0135
更新日期:2016-12-21 00:00:00
abstract:BACKGROUND:Effective communication is essential to safe and efficient patient care. Additionally, many health information technology (HIT) developments, innovations, and standards aim to implement processes to improve data quality and integrity of electronic health records (EHR) for the purpose of clinical information ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2011-02-RA-0011
更新日期:2011-06-08 00:00:00
abstract:OBJECTIVES:Transitions in patient care pose an increased risk to patient safety. One way to reduce this risk is to ensure accurate medication reconciliation during the transition. Here we present an evaluation of an electronic medication reconciliation module we developed to reduce the transition risk in patients refer...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-11-RA-0154
更新日期:2016-05-25 00:00:00
abstract:BACKGROUND:Electronic health records (EHRs) have potential to facilitate reliable communication and follow-up of test results. However, limitations in EHR functionality remain, leading practitioners to use workarounds while managing test results. Workarounds can lead to patient safety concerns and signify indications a...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-10-RA-0135
更新日期:2016-06-22 00:00:00
abstract:OBJECTIVE:The use of text messaging in clinical care has become ubiquitous. Due to security and privacy concerns, many hospital systems are evaluating secure text messaging applications. This paper highlights our evaluation process, and offers an overview of secure messaging functionalities, as well as a framework for ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1678607
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To understand how clinicians utilize image uploading tools in a home grown electronic health records (EHR) system. METHODS:A content analysis of patient notes containing non-radiological images from the EHR was conducted. Images from 4,000 random notes from July 1, 2009 - June 30, 2010 were reviewed and manu...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-10-RA-0180
更新日期:2017-07-12 00:00:00
abstract:BACKGROUND:Medical students may observe and subsequently perpetuate redundancy in clinical documentation, but the degree of redundancy in student notes and whether there is an association with scholastic performance are unknown. OBJECTIVES:This study sought to quantify redundancy, defined generally as the proportion o...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1692402
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Discrepancies in controlled substance documentation are common and can lead to legal and regulatory repercussions. We introduced a visual analytics dashboard to assist in a quality improvement project to reduce the discrepancies in controlled substance documentation in the operating room (OR) of our free-sta...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1693688
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To evaluate informatics-enabled quality improvement (QI) strategies for promoting time spent on face-to-face communication between ophthalmologists and patients. METHODS:This prospective study involved deploying QI strategies during implementation of an enterprise-wide vendor electronic health record (EHR) i...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1701255
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. OBJECTIVES:This study explored information literacy, a set of skills required to effectively navigate population health information syst...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-06-RA-0083
更新日期:2017-02-15 00:00:00
abstract:OBJECTIVE:More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider's response to any EHR alert. The primary goal was to evaluate the...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-10-RA-0168
更新日期:2017-05-10 00:00:00
abstract:BACKGROUND:Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient's problem list for patients with eligible body mass indexes (BMI) as contained in the patients' electronic medical rec...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-07-RA-0115
更新日期:2017-01-25 00:00:00
abstract:OBJECTIVES:Unwarranted variance in healthcare has been associated with prolonged length of stay, diminished health and increased cost. Practice variance in the management of asthma can be significant and few investigators have evaluated strategies to reduce this variance. We hypothesized that selective redesign of orde...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2011-01-RA-0002
更新日期:2012-02-08 00:00:00
abstract:OBJECTIVES:The authors investigated the impact of computerized provider order entry (CPOE) on the delivery times of analgesia and subsequent patient outcomes. We hypothesized that patients would report less pain and use less pain medications compared with the previous paper-based system. METHODS:Two groups of patients...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-12-RA-0114
更新日期:2015-09-23 00:00:00
abstract:BACKGROUND:UW Medicine was one of the first health systems to encounter and treat COVID-19 patients in the United States, starting in late February 2020. OBJECTIVE:Here we describe the rapid rollout of capabilities by UW Medicine Information Technology Services (ITS) to support our clinical response to the COVID-19 pa...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1709715
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiot...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-12-RA-0209
更新日期:2017-06-20 00:00:00
abstract:BACKGROUND:Semantic interoperability between routine healthcare and clinical research is an unsolved issue, as information systems in the healthcare domain still use proprietary and site-specific data models. However, information exchange and data harmonization are essential for physicians and scientists if they want t...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-03-RA-0011
更新日期:2012-07-11 00:00:00
abstract:OBJECTIVES:An important challenge for biomedical informatics researchers is determining the best approach for healthcare providers to use when generating clinical notes in settings where electronic health record (EHR) systems are used. The goal of this qualitative study was to explore healthcare providers' and administ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-10-RA-0081
更新日期:2014-02-26 00:00:00
abstract:OBJECTIVE:1. To conduct a review of the role of informatics in pediatric disaster preparedness using all medical databases. 2. To provide recommendations to improve pediatric disaster preparedness by the application of informatics. METHODS:A literature search was conducted using MEDLINE, CINHL and the Cochrane Library...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2009-12-R-0019
更新日期:2010-08-04 00:00:00
abstract:BACKGROUND:A structured report for imaging exams aims at increasing the precision in information retrieval and communication between physicians. However, it is more concise than free text and may limit specialists' descriptions of important findings not covered by pre-defined structures. A computational ontological str...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-03-RA-0037
更新日期:2016-08-24 00:00:00