Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Mar 2015
Implications of an emerging EHR monoculture for hospitals and healthcare systems.
In many hospitals and health systems, a 'new' electronic health record means a shift to one vendor: Epic, a vendor that dominates in large and medium hospital markets and continues its success with smaller institutions and ambulatory practices. Our paper examines the implications of this emerging monoculture: its advantages and disadvantages for physicians and hospitals and its role in innovation, professional autonomy, implementation difficulties, workflow, flexibility, cost, data standards, interoperability, and interactions with other information technology (IT) systems.
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J Am Med Inform Assoc · Jan 2015
Randomized Controlled TrialEffects of electronic health record use on the exam room communication skills of resident physicians: a randomized within-subjects study.
The effects of electronic health records (EHRs) on doctor-patient communication are unclear. ⋯ Use of an EHR on a laptop computer appears to improve the ability of first-year residents to communicate with patients relative to using a paper chart.
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J Am Med Inform Assoc · Jan 2015
Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes.
To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). ⋯ The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value.
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J Am Med Inform Assoc · Jan 2015
Automated clinical trial eligibility prescreening: increasing the efficiency of patient identification for clinical trials in the emergency department.
(1) To develop an automated eligibility screening (ES) approach for clinical trials in an urban tertiary care pediatric emergency department (ED); (2) to assess the effectiveness of natural language processing (NLP), information extraction (IE), and machine learning (ML) techniques on real-world clinical data and trials. ⋯ By exploiting the text of trial criteria and the content of EHRs, we demonstrated that NLP-, IE-, and ML-based automated ES could successfully identify patients for clinical trials.
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J Am Med Inform Assoc · Nov 2014
Sequencing of EHR adoption among US hospitals and the impact of meaningful use.
To examine whether there is a common sequence of adoption of electronic health record (EHR) functions among US hospitals, identify differences by hospital type, and assess the impact of meaningful use. ⋯ While there is a common sequence underlying adoption of EHR functions, the degree of adherence to the sequence varies by key hospital characteristics. Stage 1 meaningful use likely alters the sequence.