Browsing by Subject "Clinical informatics"

Now showing 1 - 2 of 2
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    Automated methods to extract patient new information from clinical notes in electronic health record systems
    (2013-11) Zhang, Rui
    The widespread adoption of Electronic Health Record (EHR) has resulted in rapid text proliferation within clinical care. Clinicians' use of copying and pasting functions in EHR systems further compounds this by creating a large amount of redundant clinical information in clinical documents. A mixture of redundant information (especially outdated and incorrect information) and new information in a single clinical note increases clinicians' cognitive burden and results in decision-making difficulties. Moreover, replicated erroneous information can potentially cause risks to patient safety. However, automated methods to identify redundant or relevant new information in clinical texts have not been extensively investigated. The overarching goal of this research is to develop and evaluate automated methods to identify new and clinically relevant information in clinical notes using expert-derived reference standards. Modified global alignment methods were adapted to investigate the pattern of redundancy in individual longitudinal clinical notes as well as a larger group of patient clinical notes. Statistical language models were also developed to identify new and clinically relevant information in clinical notes. Relevant new information identified by automated methods will be highlighted in clinical notes to provide visualization cues to clinicians. New information proportion (NIP) was used to indicate the quantity of new information in each note and also navigate clinician notes with more new information. Classifying semantic types of new information further provides clinicians with specific types of new information that they are interested in finding. The techniques developed in this research can be incorporated into production EHR systems and could potentially aid clinicians in finding and synthesizing new information in a note more purposely, and could finally improve the efficiency of healthcare delivery.
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    Implementation and testing of a Web-based tool for improving communication between ovarian cancer patients and their providers through timely data collection and use
    (2013-08) Cragg, Julie Ann
    Background Research studies show that many symptoms of ovarian cancer are not addressed adequately in the communication between patient and oncologist. To complicate matters further, this patient population has unique, complex symptom clusters which need to be managed and which themselves often complicate the communication process. The advent of secure patient portals makes possible the use of real time patient-reported outcomes (PROs) in order to improve communication between patients and their providers and enhance individual patient management by clinicians. However, there is very little current research on how real-time PROs can be used effectively to improve patient-provider communication, leading to better health care delivery and patient outcomes. Beginning in August of 2012, a total of 53 patients from the University of Minnesota Gynecological Oncology Clinic were recruited and randomized into intervention and control groups to test a new, high-fidelity prototype created by the author for patient reported questions and concerns, as part of a website designed specifically for women with ovarian cancer. Pre/post surveys were administered electronically to obtain preliminary information on acceptability and frequency of use, perceptions of usefulness for improved communication, and self-reports of perceived reduction in anxiety about communication.Results No differences between the intervention and control groups were found on any of the measures. There was a high drop-out rate and low participation in overall use of the website. Significant barriers to successful patient entry in the communication tool and use of PRO's at the clinical level were found and included low patient technology skills, memory problems, symptom burden, lack of clinician engagement with the website, and no real-time response made available from a provider. Discussion. This online communication tool was designed to facilitate communication between cancer patients and their healthcare providers; however, uptake of the tool was sub-optimal. While supportive communication tools made possible through technology can assist in meeting the communication needs of cancer patients with complex symptoms, there is much more to learn about how to effectively accomplish this. Additional research is needed on how best to meet the needs of cancer patients for information and improved communication with their oncologists, as well as longitudinal studies linking better communication to better patient outcomes.