The American journal of managed care
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Observational Study
Growth of electronic consultations in the Veterans Health Administration.
To evaluate the growth and variation of electronic consultation, or e-consult, use in the Veterans Health Administration (VHA) across regions and specialties. ⋯ Use of e-consults in the VHA grew substantially between 2012 and 2018, with variability across specialties. In-person follow-up after an e-consult was low, suggesting that e-consults may substitute for in-person visits and reduce considerable patient travel burden.
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The coronavirus disease 2019 (COVID-19) pandemic forced health systems to offer video and telephone visits as in-person visit alternatives. Although video visits offer some benefits compared with telephone visits, they require complex setup, which may disadvantage some patients due to the "digital divide." Our objective was to determine patient and neighborhood characteristics associated with visit modality. ⋯ Telemedicine access differences may compound disparities in chronic disease and COVID-19 outcomes. Institutions should monitor video visit use across demographics and equip patients, clinicians, and practices to promote telemedicine equity.
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Health care organizations are increasingly employing social workers to address patients' social needs. However, social work (SW) activities in health care settings are largely captured as text data within electronic health records (EHRs), making measurement and analysis difficult. This study aims to extract and classify, from EHR notes, interventions intended to address patients' social needs using natural language processing (NLP) and machine learning (ML) algorithms. ⋯ NLP and ML can be utilized for automated identification and classification of SW interventions documented in EHRs. Health care administrators can leverage this automated approach to gain better insight into the most needed social interventions in the patient population served by their organizations. Such information can be applied in managerial decisions related to SW staffing, resource allocation, and patients' social needs.
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A letter from the guest editor highlights the contributions of health information technology in improving health care delivery patient-centeredness through innovation in data analytics, connecting providers, and implementation of telehealth.
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Palliative care has been demonstrated to have positive effects for patients, families, health care providers, and health systems. Early identification of patients who are likely to benefit from palliative care would increase opportunities to provide these services to those most in need. This study predicted all-cause mortality of patients as a surrogate for patients who could benefit from palliative care. ⋯ LSTM models can effectively predict mortality by using a combination of EHR data and administrative claims data. The model could be used as a promising clinical tool to aid clinicians in early identification of appropriate patients for palliative care consultations.