The American journal of managed care
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Randomized Controlled Trial
Electronic health record feedback to improve antibiotic prescribing for acute respiratory infections.
To examine whether the Acute Respiratory Infection (ARI) Quality Dashboard, an electronic health record (EHR)-based feedback system, changed antibiotic prescribing. ⋯ The ARI Quality Dashboard was not associated with an overall change in antibiotic prescribing for ARIs, although when used, it was associated with improved antibiotic prescribing. EHR-based quality reporting, as part of "meaningful use," may not improve care in the absence of other changes to primary care practice.
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Comparative Study
Cost-effectiveness of 70-gene MammaPrint signature in node-negative breast cancer.
To evaluate the cost-effectiveness of 70-gene MammaPrint signature (Agendia Inc, Huntington Beach, CA) vs Adjuvant! Online software (AS) (http://www.adjuvantonline.com) in patients 60 years or younger with early-stage breast cancer. ⋯ A 70-gene signature is likely to be a cost-effective strategy to guide adjuvant chemotherapy treatment in younger patients with early-stage breast cancer.
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Comparative Study
Using electronic prescribing transaction data to estimate electronic health record adoption.
To determine whether electronic prescribing transaction data can be used to accurately and efficiently track national and regional electronic health record (EHR) adoption in order to evaluate progress toward national goals and identify and address regional disparities. ⋯ Surescripts transactional data may allow for the ongoing identification of regional trends and assist policy makers in identifying and mitigating emerging disparities in EHR adoption. Further analysis is needed to ensure that Surescripts data continue to correlate with NAMCS results for 2009-2010.
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To estimate the relationship between quality improvement and electronic health record (EHR) adoption in US hospitals. ⋯ Mixed results suggest that current practices for implementation and use of EHRs have had a limited effect on quality improvement in US hospitals. However, potential "ceiling effects" limit the ability of existing measures to assess the effect that EHRs have had on hospital quality. In addition to the development of standard criteria for EHR functionality and use, standard measures of the effect of EHRs on quality are needed.
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In healthcare, consumerism is not a product or program. Instead, it is an orientation to new care delivery models that encourage and enable greater patient responsibility through the intelligent use of information technology. ⋯ We recommend 4 guiding principles to ensure that next-generation innovation yields the returns that providers, patients, and other stakeholders expect: (1) keep the consumer at the center of innovation, (2) keep it simple, (3) link products and services to a broader "ecosystem" of care, and (4) encourage health in addition to treating illness. Now may be a particularly compelling time to invest in a consumerist approach.