Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Feb 2020
Evaluating a digital sepsis alert in a London multisite hospital network: a natural experiment using electronic health record data.
The study sought to determine the impact of a digital sepsis alert on patient outcomes in a UK multisite hospital network. ⋯ These findings strongly suggest that the introduction of a network-wide digital sepsis alert is associated with improvements in patient outcomes, demonstrating that digital based interventions can be successfully introduced and readily evaluated.
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J Am Med Inform Assoc · Jan 2020
Derivation and validation of a machine learning record linkage algorithm between emergency medical services and the emergency department.
Linking emergency medical services (EMS) electronic patient care reports (ePCRs) to emergency department (ED) records can provide clinicians access to vital information that can alter management. It can also create rich databases for research and quality improvement. Unfortunately, previous attempts at ePCR and ED record linkage have had limited success. In this study, we use supervised machine learning to derive and validate an automated record linkage algorithm between EMS ePCRs and ED records. ⋯ We were able to successfully derive and validate a record linkage algorithm from a single EMS ePCR provider to our hospital EMR.
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J Am Med Inform Assoc · Dec 2019
Internet search query data improve forecasts of daily emergency department volume.
Emergency departments (EDs) are increasingly overcrowded. Forecasting patient visit volume is challenging. Reliable and accurate forecasting strategies may help improve resource allocation and mitigate the effects of overcrowding. Patterns related to weather, day of the week, season, and holidays have been previously used to forecast ED visits. Internet search activity has proven useful for predicting disease trends and offers a new opportunity to improve ED visit forecasting. This study tests whether Google search data and relevant statistical methods can improve the accuracy of ED volume forecasting compared with traditional data sources. ⋯ This study demonstrates that search volume data can meaningfully improve forecasting of ED visit volume and could help improve quality and reduce cost.
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J Am Med Inform Assoc · Nov 2019
Multicenter StudyReduction of inappropriate medication in older populations by electronic decision support (the PRIMA-eDS project): a survey of general practitioners' experiences.
We sought to investigate the experiences of general practitioners (GPs) with an electronic decision support tool to reduce inappropriate polypharmacy in older patients (the PRIMA-eDS [Polypharmacy in chronic diseases: Reduction of Inappropriate Medication and Adverse drug events in older populations by electronic Decision Support] tool) in a multinational sample of GPs and to quantify the findings from a prior qualitative study on the PRIMA-eDS-tool. ⋯ GPs generally viewed the PRIMA-eDS medication check as useful and as informative. Recommendations were not always followed due to various reasons. Many GPs would use the medication check if integrated into the electronic health record.
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J Am Med Inform Assoc · Aug 2019
Randomized Controlled Trial Multicenter StudyAn electronic health record-based interoperable eReferral system to enhance smoking Quitline treatment in primary care.
The study sought to determine whether interoperable, electronic health record-based referral (eReferral) produces higher rates of referral and connection to a state tobacco quitline than does fax-based referral, thus addressing low rates of smoking treatment delivery in health care. ⋯ eReferral may help address the challenge of providing smokers with treatment for tobacco use during busy primary care visits.ClinicalTrials.gov; No. NCT02735382.