Abstract:
OBJECTIVES:Discharging patients from the Neonatal Intensive Care Unit (NICU) can be delayed for non-medical reasons including the procurement of home medical equipment, parental education, and the need for children's services. We previously created a model to identify patients that will be medically ready for discharge in the subsequent 2-10 days. In this study we use Natural Language Processing to improve upon that model and discern why the model performed poorly on certain patients. METHODS:We retrospectively examined the text of the Assessment and Plan section from daily progress notes of 4,693 patients (103,206 patient-days) from the NICU of a large, academic children's hospital. A matrix was constructed using words from NICU notes (single words and bigrams) to train a supervised machine learning algorithm to determine the most important words differentiating poorly performing patients compared to well performing patients in our original discharge prediction model. RESULTS:NLP using a bag of words (BOW) analysis revealed several cohorts that performed poorly in our original model. These included patients with surgical diagnoses, pulmonary hypertension, retinopathy of prematurity, and psychosocial issues. DISCUSSION:The BOW approach aided in cohort discovery and will allow further refinement of our original discharge model prediction. Adequately identifying patients discharged home on g-tube feeds alone could improve the AUC of our original model by 0.02. Additionally, this approach identified social issues as a major cause for delayed discharge. CONCLUSION:A BOW analysis provides a method to improve and refine our NICU discharge prediction model and could potentially avoid over 900 (0.9%) hospital days.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Temple MW,Lehmann CU,Fabbri Ddoi
10.4338/ACI-2015-09-RA-0114subject
Has Abstractpub_date
2016-02-24 00:00:00pages
101-15issue
1issn
1869-0327journal_volume
7pub_type
杂志文章abstract:BACKGROUND: Prediabetes and type 2 diabetes mellitus (T2DM) are one of the major long-term health conditions affecting global healthcare delivery. One of the few effective approaches is to actively manage diabetes via a healthy and active lifestyle. OBJECTIVES: This research is focused on early detection of prediabete...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1719043
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:While evidence generally supports the use of medication management technology, systems are typically implemented and evaluated piecemeal rather than as part of a comprehensive model for medication management. Systems to support drug therapy optimization, increasingly a key role of pharmacists in our healthca...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0037-1620262
更新日期:2018-01-01 00:00:00
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 electron...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-02-CR-0022
更新日期:2015-10-21 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: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
abstract:BACKGROUND:Preventable adverse events continue to be a threat to hospitalized patients. Clinical decision support in the form of dashboards may improve compliance with evidence-based safety practices. However, limited research describes providers' experiences with dashboards integrated into vendor electronic health rec...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-3402756
更新日期:2020-01-01 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: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 electro...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-09-RA-0075
更新日期:2014-03-26 00:00:00
abstract:OBJECTIVE:With the increasing prevalence of type 2 diabetes (T2D) in youth, primary care providers must identify patients at high risk and implement evidence-based screening promptly. Clinical decision support systems (CDSSs) provide clinicians with personalized reminders according to best evidence. One example is the ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1710024
更新日期:2020-03-01 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: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:OBJECTIVES:To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED). METHODS:We employed a mixed met...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-01-RA-0014
更新日期:2015-07-08 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: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::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::Web 2.0 technologies, known as social media, social technologies or Web 2.0, have emerged into the mainstream. As they grow, these new technologies have the opportunity to influence the methods and procedures of many fields. This paper focuses on the clinical implications of the growing Web 2.0 technologies. Five deve...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2010-01-CR-0003
更新日期:2010-04-21 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:BACKGROUND:Early detection and efficient management of sepsis are important for improving health care quality, effectiveness, and costs. Due to its high cost and prevalence, sepsis is a major focus area across institutions and many studies have emerged over the past years with different models or novel machine learning...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1710525
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Care-management tools are typically utilized for chronic disease management. Sonoma County government agencies employed advanced health information technologies, artificial intelligence (AI), and interagency process improvements to help transform health and health care for socially disadvantaged groups and o...
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
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:OBJECTIVE:Efforts to promote adoption of electronic health records (EHRs) have focused on primary care physicians, who are now expected to exchange data electronically with other providers, including specialists. However, the variation of EHR adoption among specialists is underexplored. METHODS:We conducted a retrospe...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-02-RA-0015
更新日期:2013-05-22 00:00:00
abstract:BACKGROUND: Electronic health records (EHRs) are used in long-term care to document the patients' condition, medication, and care, thereby supporting communication among caregivers and counteracting adverse drug events. However, the use of EHRs in long-term care has lagged behind EHR use in hospitals. In addition, most...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721013
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The traditional concept of personalized nutrition is based on adapting diets according to individual needs and preferences. Discussions about personalized nutrition have been on since the Human Genome Project, which has sequenced the human genome. Thenceforth, topics such as nutrigenomics have been assessed ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1635115
更新日期:2018-01-01 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:Hospitals across the country are investing millions of dollars to adopt new Health Insurance Portability and Accountability Act (HIPAA)-compliant secure text messaging systems. However, in nearly all cases, these implementations are occurring without evaluation of their impact on patient care. OBJECTIVE:To ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1700868
更新日期:2019-10-01 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: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
abstract:OBJECTIVES:More patients are receiving their test results via patient portals. Given test results are written using medical jargon, there has been concern that patients may misinterpret these results. Using sample colonoscopy and Pap smear results, our objective was to assess how frequently people can identify the corr...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1679960
更新日期:2019-03-01 00:00:00
abstract:SUMMARY:Clinical decision support (CDS) can improve safety, quality, and cost-effectiveness of patient care, especially when implemented in computerized provider order entry (CPOE) applications. Medication-related decision support logic forms a large component of the CDS logic in any CPOE system. However, organizations...
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: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