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 developed an informatics-based clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular risk scores and guideline-based treatment recommendations based on patient-specific data in the electronic heath record. OBJECTIVE:To assess the impact of our clinical decision support tool on the efficiency and accuracy of clinician calculation of cardiovascular risk and its effect on the delivery of guideline-consistent treatment recommendations. METHODS:Clinicians were asked to review the EHR records of selected patients. We evaluated the amount of time and the number of clicks and keystrokes needed to calculate cardiovascular risk and provide a treatment recommendation with and without our clinical decision support tool. We also compared the treatment recommendation arrived at by clinicians with and without the use of our tool to those recommended by the guidelines. RESULTS:Clinicians saved 3 minutes and 38 seconds in completing both tasks with MayoExpertAdvisor, used 94 fewer clicks and 23 fewer key strokes, and improved accuracy from the baseline of 60.61% to 100% for both the risk score calculation and guideline-consistent treatment recommendation. CONCLUSION:Informatics solution can greatly improve the efficiency and accuracy of individualized treatment recommendations and have the potential to increase guideline compliance.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Scheitel MR,Kessler ME,Shellum JL,Peters SG,Milliner DS,Liu H,Komandur Elayavilli R,Poterack KA,Miksch TA,Boysen J,Hankey RA,Chaudhry Rdoi
10.4338/ACI-2016-07-RA-0114subject
Has Abstractpub_date
2017-02-08 00:00:00pages
124-136issue
1issn
1869-0327pii
2016-07-RA-0114journal_volume
8pub_type
杂志文章abstract:BACKGROUND:Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes. METHODS:A data dictionary, and subsequent data model, were developed describing EH...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1651496
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Code status (CS) of a patient (part of their end-of-life wishes) can be critical information in healthcare delivery, which can change over time, especially at transitions of care. Although electronic health record (EHR) tools exist for medication reconciliation across transitions of care, much less attention...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-08-RA-0133
更新日期:2017-03-08 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: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: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::Objective Patient instructions are generally written by clinicians. However, clinician-centered language is challenging for patients to understand; in the case of pediatric medication instructions, consequences can be serious. Using examples of clinician-written medication instructions from an electronic health record...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2017-06-RA-0111
更新日期:2017-10-01 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: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: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: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:Electronic prescribing (e-prescribing) technology was introduced as an alternative to handwritten prescriptions allowing health care professionals to send prescriptions directly to pharmacies. While the technology has many advantages, such as improving pharmacy workflow and reducing medication errors, some l...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1691840
更新日期:2019-05-01 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: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: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: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:High-quality clinical data and biological specimens are key for medical research and personalized medicine. The Biobanking and Biomolecular Resources Research Infrastructure-European Research Infrastructure Consortium (BBMRI-ERIC) aims to facilitate access to such biological resources. The accompanying ADOPT...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1695793
更新日期:2019-08-01 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: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: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: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: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: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:BACKGROUND: Relaxation of laws and regulations around privacy and billing during the COVID-19 pandemic provide expanded opportunities to use telehealth to provide patient care at a distance. Many health systems have transitioned to providing outpatient care via telehealth; however, there is an opportunity to utilize te...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1713635
更新日期:2020-05-01 00:00:00
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...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-09-RA-0114
更新日期:2016-02-24 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: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: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: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: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
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