Abstract:
BACKGROUND:Preoperative assessments are a required and essential element of anesthetic care, yet little is known about the utilization of these documents by clinicians who are not part of the anesthesia care team. As part of perioperative workflow restructuring, we implemented a data visualization technique of electronic medical record audit log data to understand the utilization of preoperative anesthesia assessments by non-anesthesia personnel. METHODS:An audit log cache containing 140 days of data was queried for all accesses of preoperative anesthesia assessment documents for any patient who had a preoperative anesthesia assessment that was accessed during that period. User roles were aggregated into categories. Descriptive statistics and data visualization were generated using R (R Software Foundation, Vienna, Austria). Comparisons were performed with the Wilcoxon signed rank test with continuity correction. RESULTS:During the study period, 73 802 (0.015%) of the 485 062 902 audit log accesses were preoperative anesthesia assessments representing 412 departments, 302 user roles, and 3 916 distinct users who accessed preoperative anesthesia assessments from 14 235 surgical cases. Each assessment was accessed 2.9 times on average. Assessments performed in the preoperative anesthesia assessment clinic were accessed more frequently than those created on the day of surgery in the preoperative holding room (3.58 ± 5.18 v. 1.98 ± 1.76 average views; p<0.0001). We observed accesses of these documents by pathology and general surgery researchers, as well as orthopedics attending physicians accessing documents that were two years old. CONCLUSIONS:This approach revealed patterns of utilization that had not been previously identified, including usage by surgical residents, surgical faculty, and pathology researchers both before and after the surgical event for which the documents are generated. Knowledge of these dependencies directly informed perioperative workflow restructuring efforts. This visual analytic approach could be broadly utilized to understand documentation dependencies in a variety of clinical contexts.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Wanderer JP,Gruss CL,Ehrenfeld JMdoi
10.4338/ACI-2015-02-CR-0022subject
Has Abstractpub_date
2015-10-21 00:00:00pages
629-37issue
4issn
1869-0327journal_volume
6pub_type
杂志文章abstract:OBJECTIVES:This study evaluates the accuracy and portability of a natural language processing (NLP) tool for extracting clinical findings of influenza from clinical notes across two large healthcare systems. Effectiveness is evaluated on how well NLP supports downstream influenza case-detection for disease surveillance...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-12-RA-0211
更新日期:2017-05-31 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:Routine implementation of instruments to capture patient-reported outcomes could guide clinical practice and facilitate health services research. Audio interviews facilitate self-interviews across literacy levels. OBJECTIVES:To evaluate time burden for patients, and factors associated with response times fo...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-09-RA-0073
更新日期:2015-03-18 00:00:00
abstract:BACKGROUND:Medication dose adjustment is crucial for patients with renal dysfunction (RD). The assessment of renal function is generally mandatory; however, the renal function may change during the hospital stay and the manual assessment is sometimes challenging. OBJECTIVE:We developed the clinical decision support sy...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721056
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To understand clinician adoption of CDS tools as this may provide important insights for the implementation and dissemination of future CDS tools. MATERIALS AND METHODS:Clinicians (n=168) at a large academic center were randomized into intervention and control arms to assess the impact of strep and pneumonia...
journal_title:Applied clinical informatics
pub_type: 杂志文章,随机对照试验
doi:10.4338/ACI-2014-04-RA-0043
更新日期:2014-09-17 00:00:00
abstract:BACKGROUND:Prescribers' inappropriate use of the free-text Notes field in new electronic prescriptions can create confusion and workflow disruptions at receiving pharmacies that often necessitates contact with prescribers for clarification. The inclusion of inappropriate patient direction (Sig) information in the Notes...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-03-CR-0022
更新日期:2014-08-06 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: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: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:OBJECTIVES:Various computerized health risk appraisals (HRAs) are available, but few of them assess health-related quality of life (HRQoL) in a goal-directed framework. This study describes the user-centered development and usability testing of an innovative HRQoL module that extends a validated HRA tool in primary car...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-08-RA-0067
更新日期:2014-12-10 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:BACKGROUND:The assessment of user preferences for performance characteristics of patient-oriented clinical prediction models is lacking. It is unknown if complex statistical aspects of prediction models are readily understandable by a general audience. OBJECTIVE:A pilot study was conducted among nonclinical audiences ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1669457
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND: Poor self-management of heart failure (HF) has contributed to poor health outcomes. Sensor-controlled digital games (SCDGs) integrates data from behavior-tracking sensors to trigger progress, rewards, content, and positive feedback in a digital game to motivate real-time behaviors. OBJECTIVES: To assess th...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721399
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Several disease specific registers are operated by members of the 'TMF - Technology, Methods, and Infrastructure for Networked Medical Research', an umbrella organization of research networks in Germany. OBJECTIVE:To describe the coverage and the current state as well as financial and organizational issues ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2010-04-RA-0024
更新日期:2010-11-24 00:00:00
abstract:BACKGROUND:In 2015, the German Federal Ministry of Education and Research initiated a large data integration and data sharing research initiative to improve the reuse of data from patient care and translational research. The Observational Medical Outcomes Partnership (OMOP) common data model and the Observational Healt...
journal_title:Applied clinical informatics
pub_type: 杂志文章
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更新日期:2018-01-01 00:00:00
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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
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:OBJECTIVE:This article aimed to evaluate the effectiveness of newly established innovative smart home healthcare and health informatics laboratories, and a novel laboratory course that focuses on experiential health informatics training, and determine students' self-confidence to operate wireless home health monitoring...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2017-08-RA-0136
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:Telemonitoring of vital signs is an established option in treatment of patients with chronic heart failure (CHF). In order to allow for early detection of atrial fibrillation (AF) which is highly prevalent in the CHF population telemonitoring programs should include electrocardiogram (ECG) signals. It was th...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2010-12-RA-0078
更新日期:2011-11-23 00:00:00
abstract:BACKGROUND:Clinical trials are an important research method for improving medical knowledge and patient care. Multiple international and national guidelines stipulate the need for data quality and assurance. Many strategies and interventions are developed to reduce error in trials, including standard operating procedur...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0037-1621702
更新日期:2018-01-01 00:00:00
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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
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journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1715894
更新日期:2020-08-01 00:00:00
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journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2010-04-RA-0026
更新日期:2011-02-09 00:00:00
abstract:BACKGROUND:Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were develop...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-08-RA-0129
更新日期:2016-11-09 00:00:00
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journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-09-RA-0127
更新日期:2016-05-04 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:In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a revised guideline on statin therapy initiation. The guideline included a 10-year risk calculation based on regression modeling, which made hand calculation infeasible. Compliance to the guideline has been su...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1692186
更新日期:2019-05-01 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:BACKGROUND:The 2013 American College of Cardiology / American Heart Association Guidelines for the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk. But finding time in a primary care visit to manually calculate cardiovascular risk and prescribe treatment based on risk is challenging. We ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-07-RA-0114
更新日期:2017-02-08 00:00:00
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