Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Jul 2012
ReviewThe impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature.
To assess evidence of the impact of Picture Archiving and Communication Systems (PACS) on clinicians' work practices in the intensive care unit (ICU). ⋯ The potential for PACS to impact positively on clinician work practices in the ICU and improve patient care is great. However, the evidence base is limited and does not reflect aspects of contemporary PACS technology. Performance measures developed in previous studies remain relevant, with much left to investigate to understand how PACS can support new and improved ways of delivering care in the intensive care setting.
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Vanderbilt University has a widely adopted patient portal, MyHealthAtVanderbilt, which provides an infrastructure to deliver information that can empower patient decision making and enhance personalized healthcare. An interdisciplinary team has developed Flu Tool, a decision-support application targeted to patients with influenza-like illness and designed to be integrated into a patient portal. Flu Tool enables patients to make informed decisions about the level of care they require and guides them to seek timely treatment as appropriate. ⋯ During this time, Flu Tool was accessed 4040 times, and 1017 individual patients seen in the institution were diagnosed as having influenza. This early experience with Flu Tool suggests that healthcare consumers are willing to use patient-targeted decision support. The design, implementation, and lessons learned from the pilot release of Flu Tool are described as guidance for institutions implementing decision support through a patient portal infrastructure.
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J Am Med Inform Assoc · May 2012
Multicenter StudyThe financial impact of health information exchange on emergency department care.
To examine the financial impact health information exchange (HIE) in emergency departments (EDs). ⋯ Access to additional clinical data through HIE in emergency department settings is associated with net societal saving.
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J Am Med Inform Assoc · May 2012
Multicenter StudyThe impact of electronic health records on care of heart failure patients in the emergency room.
To evaluate if electronic health records (EHR) have observable effects on care outcomes, we examined quality and efficiency measures for patients presenting to emergency departments (ED). ⋯ An EHR may have the potential to be a valuable adjunct in the care of heart failure patients.
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J Am Med Inform Assoc · May 2012
A framework for evaluating the appropriateness of clinical decision support alerts and responses.
Alerting systems, a type of clinical decision support, are increasingly prevalent in healthcare, yet few studies have concurrently measured the appropriateness of alerts with provider responses to alerts. Recent reports of suboptimal alert system design and implementation highlight the need for better evaluation to inform future designs. The authors present a comprehensive framework for evaluating the clinical appropriateness of synchronous, interruptive medication safety alerts. ⋯ The new evaluation model offers a potentially effective method for assessing the clinical appropriateness of synchronous interruptive medication alerts prior to evaluating patient outcomes in a comparative trial. More work can determine the generalizability of the framework for use in other settings and other alert types.