Browsing by Subject "Electronic health record"

Now showing 1 - 4 of 4
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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 A mixture of redundant information (especially outdated and incorrect information) and new information in a single clinical note increases clinicians' cognitive burden and results in decision-making difficulties.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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    Deriving value from health information technology: impact of prior clinical information from an accessible electronic health record on laboratory and radiology testing in a pediatric population
    (2014-12) Knighton, Andrew John
    Repetition by clinicians of the same or similar tests with a given patient is common and varies by patient age. However, not all repeat tests are necessary or appropriate for care. Outcomes associated with over-testing include unnecessary emotional hardship and economic cost that may justify efforts to eliminate unnecessary or potentially redundant tests. Limited evidence suggests that the presence of an electronic health record (EHR) may reduce potentially redundant medical tests by making previous test results accessible to clinicians at the point of care. This population-based research characterizes multiple test instances of the same test in a pediatric population, including significant risk factors associated with repeat testing. Using a guideline-based criteria for classifying problematic repeat lead tests, we demonstrate the effect that multiple health system use by patients has on the incidence of problematic repeat lead testing. The results suggest that approximately 50% of repeat lead testing performed in the population was of questionable clinical value. Lead tests repeated within the same health system where a clinician had reasonable access to prior test results had significantly lower odds of being problematic.
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    ITS and Transportation Safety: EMS System Data Integration to Improve Traffic Crash Emergency Response and Treatment
    (University of Minnesota Center for Transportation Studies, 2009-01) Schooley, Benjamin; Horan, Thomas; Botts, Nathan; Noamani, Aisha
    This investigation is in response to the requirement for Strategic Highway Safety Plans (SHSPs), legislated by SAFETEA-LU, to address the need for data systems to allow for evidence-based safety planning. This study evaluates the use of information systems and intelligent transportation systems across the emergency response continuum of care to vehicle crash emergencies. Organizations that participate in the emergency response process often have siloed IT systems and are not able to share data with other agencies and organizations. An integrated system to produce data for real-time decision making and holistic performance and clinical analysis currently does not exist, but has the potential to improve emergency response and patient care. Proposed in this study is an Integrated Crash Trauma Information Network (ICTN) to allow for integrated information exchange. This study uses data collected from prior studies conducted in Minnesota, a literature review, case studies in Minnesota, and an in-depth analysis of the benefits of linking IT systems, the SHSP, Emergency Medical Services (EMS), 911, Trauma systems, and health information systems. A case study analysis was conducted across three overlapping dimensions to assess current challenges and potential benefits to integrated information sharing: operational, organizational, and governance. The study found potential health provision and data analysis benefits to integrated information sharing and posited a normative architecture to guide the design of systems to better use and analyze crash data. The design and development of a “proof of concept” system is recommended for the next phase of research.
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    ITS and Transportation Safety: EMS System Data Integration to Improve Traffic Crash Emergency Response and Treatment – Phases IV and V
    (Intelligent Transportation Systems Institute, Center for Transportation Studies, University of Minnesota, 2012-09) Schooley, Benjamin; Horan, Thomas A.; Abed, Yousef; Murad, Abdullah
    Researchers developed a software system called “CrashHelp” to improve the information exchange from emergency medical services (EMS) practitioners to emergency room/trauma center providers. The system combines mobile smartphone, multimedia, Web server, and location-based technologies for paramedics to send key information to hospital providers in a more data-rich manner than is currently available. This study outlines the development of a second version of CrashHelp and summarizes the results of an initial pilot testing in the Boise, Idaho, region. In addition, the study contains an analysis of the data system standards for EMS and intelligent transportation systems to understand how they should be applied to the CrashHelp system. Finally, the study investigates the potential sustainability of the CrashHelp system in several respects, including deployment in regions with little prior infrastructure, as well as in more urban and developed areas. This included investigating business models and deployment models for delivering CrashHelp as a product or service in the future.