Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Feb 2014
The impact of electronic health records on people with diabetes in three different emergency departments.
To evaluate if electronic health records (EHR) with prior clinical information have observable effects for patients with diabetes presenting to emergency departments (ED), we examined measures of quality and resource utilization. ⋯ The presence of prior information in an EHR may be a valuable adjunct in the care of diabetes patients in ED settings but the pattern of impact may vary from ED to ED.
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J Am Med Inform Assoc · Feb 2014
A typology of electronic health record workarounds in small-to-medium size primary care practices.
Electronic health record (EHR) use in ambulatory care can improve safety and quality; however, problems with design, implementation, and poor interface with other systems lead users to develop 'workarounds', or behaviors users adopt to overcome perceived limitations in a technical system. We documented workarounds used in independent, community-based primary care practices, and developed a typology of their key features. ⋯ This workaround typology provides a framework for EHR users to identify and address workarounds in their own practices, and for researchers to examine the effect of different types of EHR workarounds on patient safety, care quality, and efficiency.
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J Am Med Inform Assoc · Feb 2014
Automated identification of patients with a diagnosis of binge eating disorder from narrative electronic health records.
Binge eating disorder (BED) does not have an International Classification of Diseases, 9th or 10th edition code, but is included under 'eating disorder not otherwise specified' (EDNOS). This historical cohort study identified patients with clinician-diagnosed BED from electronic health records (EHR) in the Department of Veterans Affairs between 2000 and 2011 using natural language processing (NLP) and compared their characteristics to patients identified by EDNOS diagnosis codes. ⋯ Patient characteristics were similar between the groups. This is the first study to use NLP as a method to identify BED patients from EHR data and will allow further epidemiological study of patients with BED in systems with adequate clinical notes.
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J Am Med Inform Assoc · Feb 2014
Classification of medication incidents associated with information technology.
Information technology (IT) plays a pivotal role in improving patient safety, but can also cause new problems for patient safety. This study analyzed the nature and consequences of a large sample of IT-related medication incidents, as reported by healthcare professionals in community pharmacies and hospitals. ⋯ A large sample of incidents shows that many of the incidents are related to IT, both in community pharmacies and hospitals. The interaction between human and machine plays a pivotal role in IT incidents in both settings.