72,870 research outputs found

    Use of computerized clinical support systems in medical settings, United States, 2001-03

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    "OBJECTIVES: This report presents information on the use of electronic clinical systems to support patient care in physician offices and hospital emergency and outpatient settings. Percentages of hospital emergency and outpatient departments with electronic patient medical records and automated drug dispensing systems are presented by selected hospital characteristics for 2001-02. Percentages of physicians using electronic patient billing records, electronic patient medical records, and computerized prescription order entry systems are presented by selected physician characteristics for 2003. METHODS: Data are from provider induction interviews from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS), the ambulatory care component of the National Health Care Survey (NHCS). The NHCS is a family of provider-based surveys that collect information on the care provided in various medical care settings. RESULTS: During 2001-03, electronic medical records were used less often in physician offices (17 percent) than in hospital emergency (31 percent) and outpatient departments (29 percent). In physician offices, information technology was more frequently used for billing patients (73 percent) than for maintaining medical records electronically (17 percent) or ordering prescriptions electronically (8 percent). Automated drug dispensing systems were available in hospital emergency departments (40 percent) more frequently than in outpatient departments (18 percent)." - p. 1Catharine W. Burt and Esther Hing.Caption title."March 2, 2005."Also availalble via the World Wide Web

    Use of electronic medical records by ambulatory care providers: United States, 2006

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    OBJECTIVES: This report presents 2006 information on adoption of electronic medical records (EMRs) in five ambulatory care settings. Use of EMR systems within these settings is presented by selected provider characteristics. METHODS: Nationally representative estimates are from 2006 provider-based surveys, including the National Ambulatory Medical Care Survey (NAMCS), the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the National Survey of Ambulatory Surgery (NSAS). RESULTS: In 2006, 62.4 percent of hospital-based ambulatory surgery centers (ASCs) reported using EMR systems, almost triple the percentage reported by freestanding ASCs (22.3 percent). EMR use by hospital emergency departments (EDs) was 46.2 percent, followed by hospital outpatient departments (OPDs) (29.4 percent) and office-based physicians (29.2 percent). Based on items collected in the 2006 NAMCS, NHAMCS, and NSAS, 18.6 percent of hospital-based ASCs, 14.0 percent of hospital EDs, and 10.5 percent of office-based physicians had systems with similar features of a basic system, but only 1.7 percent of hospital EDs and 3.1 percent of office-based physicians had systems with similar features of a fully functional system. Fully functional systems are a subset of basic systems. Physicians in practices with 11 or more physicians were most likely to use EMRs (46.5 percent), whereas physicians in solo practices were least likely to use EMRs (24.0 percent). Use of EMR systems was higher among physicians located in the West (42.3 percent) than in other regions of the country (23.5 percent to 29.3 percent). EMR use did not vary by neighborhood poverty level for any of the ambulatory providers studied. From 2001 through 2005, EMR systems in hospital EDs increased by 47.2 percent. Use of EMRs among office-based physicians increased by 60.4 percent from 2001 through 2006. If those without EMR systems in 2006 with definite plans to install a system actually do so, 85.4 percent of hospital-based ASCs, 72.2 percent of EDs, 62.6 percent of OPDs, 47.3 percent of freestanding ASCs, and 47.0 percent of physicians will be using EMR systems in 2009.by Esther Hing, Margaret J. Hall and Jill J. Ashman.Includes bibliographical references (p. 8-9).Hing E, Hall MJ, Ashman JJ. Use of electronic medical records by ambulatory care providers: United States, 2006. National health statistics reports; no 22. Hyattsville, MD: National Center for Health Statistics. 2010.2080682

    Annotated Bibliography: Understanding Ambulatory Care Practices in the Context of Patient Safety and Quality Improvement.

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    The ambulatory care setting is an increasingly important component of the patient safety conversation. Inpatient safety is the primary focus of the vast majority of safety research and interventions, but the ambulatory setting is actually where most medical care is administered. Recent attention has shifted toward examining ambulatory care in order to implement better health care quality and safety practices. This annotated bibliography was created to analyze and augment the current literature on ambulatory care practices with regard to patient safety and quality improvement. By providing a thorough examination of current practices, potential improvement strategies in ambulatory care health care settings can be suggested. A better understanding of the myriad factors that influence delivery of patient care will catalyze future health care system development and implementation in the ambulatory setting

    EHR-Based Care Coordination Performance Measures in Ambulatory Care

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    Describes electronic health record-based measures for assessing coordination in referrals, including information communicated with referral, communication to patient, and specialist report to primary care physician. Offers preliminary evaluation findings

    Download entire PDF Prescriptions for Excellence in Health Care-Spring 2008, issue 3.

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    Performance Measures Using Electronic Health Records: Five Case Studies

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    Presents the experiences of five provider organizations in developing, testing, and implementing four types of electronic quality-of-care indicators based on EHR data. Discusses challenges, and compares results with those from traditional indicators

    Designing Clinical Data Presentation Using Cognitive Task Analysis Methods

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    Despite the many decades of research on effective use of clinical systems in medicine, the adoption of health information technology to improve patient care continues to be slow especially in ambulatory settings. This applies to dentistry as well, a primary care discipline with approximately 137,000 practicing dentists in the United States. One critical reason is the poor usability of clinical systems, which makes it difficult for providers to navigate through the system and obtain an integrated view of patient data during patient care. Cognitive science methods have shown significant promise to meaningfully inform and formulate the design, development and assessment of clinical information systems. Most of these methods were applied to evaluate the design of systems after they have been developed. Very few studies, on the other hand, have used cognitive engineering methods to inform the design process for a system itself. It is this gap in knowledge – how cognitive engineering methods can be optimally applied to inform the system design process – that this research seeks to address through this project proposal. This project examined the cognitive processes and information management strategies used by dentists during a typical patient exam and used the results to inform the design of an electronic dental record interface. The resulting 'proof of concept' was evaluated to determine the effectiveness and efficiency of such a cognitively engineered and application flow design. The results of this study contribute to designing clinical systems that provide clinicians with better cognitive support during patient care. Such a system will contribute to enhancing the quality and safety of patient care, and potentially to reducing healthcare costs
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