Factors Associated With Patient Electronic Health Record View, Download, and Transmit Rates at Critical Access Hospitals


Book Description

To date, the federal government has paid $35 billion in incentive payments to eligible hospitals who adopt electronic health records (EHRs) and meet certain criteria on EHR implementation and use, as part of what is called the meaningful use program. One such criteria is that hospitals provide patients with the ability to view, download, and transmit information about a hospital admission, also called VDT. Hospitals are penalized if too few patients view, download, or transmit their information after discharge. This study seeks to identify and quantify factors that affect whether or not a patient accesses their health information online by matching county level demographic data with the nation’s 1,423 critical access hospitals and VDT data from the subset of 1,062 CAHs participating in the meaningful use program. A Heckman selection model was run to address CAHs non-random selection into the meaningful use program. Correcting for hospital and county-level variables, I found that both the length of meaningful use program participation and the percent of patients provided the ability to VDT are positively associated (p




Registries for Evaluating Patient Outcomes


Book Description

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.




Taking Action Against Clinician Burnout


Book Description

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.







The Computer-Based Patient Record


Book Description

Most industries have plunged into data automation, but health care organizations have lagged in moving patients' medical records from paper to computers. In its first edition, this book presented a blueprint for introducing the computer-based patient record (CPR). The revised edition adds new information to the original book. One section describes recent developments, including the creation of a computer-based patient record institute. An international chapter highlights what is new in this still-emerging technology. An expert committee explores the potential of machine-readable CPRs to improve diagnostic and care decisions, provide a database for policymaking, and much more, addressing these key questions: Who uses patient records? What technology is available and what further research is necessary to meet users' needs? What should government, medical organizations, and others do to make the transition to CPRs? The volume also explores such issues as privacy and confidentiality, costs, the need for training, legal barriers to CPRs, and other key topics.




SAFER Electronic Health Records


Book Description

This important volume provide a one-stop resource on the SAFER Guides along with the guides themselves and information on their use, development, and evaluation. The Safety Assurance Factors for EHR Resilience (SAFER) guides, developed by the editors of this book, identify recommended practices to optimize the safety and safe use of electronic heal




Key Capabilities of an Electronic Health Record System


Book Description

Commissioned by the Department of Health and Human Services, Key Capabilities of an Electronic Health Record System provides guidance on the most significant care delivery-related capabilities of electronic health record (EHR) systems. There is a great deal of interest in both the public and private sectors in encouraging all health care providers to migrate from paper-based health records to a system that stores health information electronically and employs computer-aided decision support systems. In part, this interest is due to a growing recognition that a stronger information technology infrastructure is integral to addressing national concerns such as the need to improve the safety and the quality of health care, rising health care costs, and matters of homeland security related to the health sector. Key Capabilities of an Electronic Health Record System provides a set of basic functionalities that an EHR system must employ to promote patient safety, including detailed patient data (e.g., diagnoses, allergies, laboratory results), as well as decision-support capabilities (e.g., the ability to alert providers to potential drug-drug interactions). The book examines care delivery functions, such as database management and the use of health care data standards to better advance the safety, quality, and efficiency of health care in the United States.




Clinical Informatics Study Guide


Book Description

This completely updated study guide textbook is written to support the formal training required to become certified in clinical informatics. The content has been extensively overhauled to introduce and define key concepts using examples drawn from real-world experiences in order to impress upon the reader the core content from the field of clinical informatics. The book groups chapters based on the major foci of the core content: health care delivery and policy; clinical decision-making; information science and systems; data management and analytics; leadership and managing teams; and professionalism. The chapters do not need to be read or taught in order, although the suggested order is consistent with how the editors have structured their curricula over the years. Clinical Informatics Study Guide: Text and Review serves as a reference for those seeking to study for a certifying examination independently or periodically reference while in practice. This includes physicians studying for board examination in clinical informatics as well as the American Medical Informatics Association (AMIA) health informatics certification. This new edition further refines its place as a roadmap for faculty who wish to go deeper in courses designed for physician fellows or graduate students in a variety of clinically oriented informatics disciplines, such as nursing, dentistry, pharmacy, radiology, health administration and public health.




Bioinformatics for Omics Data


Book Description

Presenting an area of research that intersects with and integrates diverse disciplines, Bioinformatics for Omics Data: Methods and Protocols collects contributions from expert researchers in order to provide practical guidelines to this complex study.




Capturing Social and Behavioral Domains and Measures in Electronic Health Records


Book Description

Determinants of health - like physical activity levels and living conditions - have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful for diagnosis, treatment choices, policy, health care system design, and innovations to improve health outcomes and reduce health care costs. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 identifies domains and measures that capture the social determinants of health to inform the development of recommendations for the meaningful use of EHRs. This report is the second part of a two-part study. The Phase 1 report identified 17 domains for inclusion in EHRs. This report pinpoints 12 measures related to 11 of the initial domains and considers the implications of incorporating them into all EHRs. This book includes three chapters from the Phase 1 report in addition to the new Phase 2 material. Standardized use of EHRs that include social and behavioral domains could provide better patient care, improve population health, and enable more informative research. The recommendations of Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 will provide valuable information on which to base problem identification, clinical diagnoses, patient treatment, outcomes assessment, and population health measurement.