98,303 research outputs found

    The Electronic Health Record Scorecard: A Measure of Utilization and Communication Skills

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    As the adoption rate of electronic health records (EHRs) in the United States continues to grow, both providers and patients will need to adapt to the reality of a third actor being present during the visit encounter. The purpose of this project is to provide insight on “best” practice patterns for effective communication and efficient use of the EHR in the clinical practice setting. Through the development of a comprehensive scorecard, this project assessed current status of EHR use and communication skills among health care providers in various clinical practice settings. Anticipated benefits of this project are increased comfortability in interfacing with the EHR and increased satisfaction on the part of the provider as well as the patient. Serving as a benchmark, this assessment has the potential to help guide future health information technology development, training, and education for both students and health care providers

    The complexities and challenges of introducing electronic Ongoing Achievement Records in the pre-registration nursing course using PebblePad and hand-held tablets

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    This paper reports on a small pilot study aimed at eliciting the lecturer and student experience of using PebblePad to record the students' Ongoing Achievement Record (OAR) using hand-held tablets, at one university in England. Android tablets were purchased and attempts were made to transfer the OAR into the PebblePad system in an attempt to enhance the student experience of feedback from their via PebblePad, embed PebblePad learning technology in the practice component of the curriculum, enable the student to more readily engage in reflection and feedback with their personal tutor, practice education link and mentor, develop skills in the use of PebblePad and pilot the use of PebblePad in developing the Ongoing Achievement Record. Focus groups were carried out with students nurses (n=6) and lecturers (n=5) where participants were asked to discuss the successes and challenges of using PebblePad for the Ongoing Achievement Record, and suggest ways in which this strategy may be implemented more widely. Through a thematic analysis of the focus groups three broad themes of 'timing', 'technology literacy' and 'the technology' were identified. The findings from the study indicated that whilst this was not a positive experience on the whole for a number of reasons, there are lessons that can be learnt when attempting to introduce new ways of engaging with technology to enhance the student experience. Recommendations for implementing such an approach in the future are also presente

    Technology Target Studies: Technology Solutions to Make Patient Care Safer and More Efficient

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    Presents findings on technologies that could enhance care delivery, including patient records and medication processes; features and functionality nurses require, including tracking, interoperability, and hand-held capability; and best practices

    Sentara Healthcare: A Case Study Series on Disruptive Innovation Within Integrated Health Systems

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    Examines how integration and ties with health plans, physicians, and hospitals helped protect against revenue volatility and enabled experimentation; factors that facilitate integration; innovative practices; lessons learned; and policy implications

    Telehealthcare for chronic obstructive pulmonary disease

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    BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a disease of irreversible airways obstruction in which patients often suffer exacerbations. Sometimes these exacerbations need hospital care: telehealthcare has the potential to reduce admission to hospital when used to administer care to the pateint from within their own home. OBJECTIVES: To review the effectiveness of telehealthcare for COPD compared with usual face‐to‐face care. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register, which is derived from systematic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO; last searched January 2010. SELECTION CRITERIA: We selected randomised controlled trials which assessed telehealthcare, defined as follows: healthcare at a distance, involving the communication of data from the patient to the health carer, usually a doctor or nurse, who then processes the information and responds with feedback regarding the management of the illness. The primary outcomes considered were: number of exacerbations, quality of life as recorded by the St George's Respiratory Questionnaire, hospitalisations, emergency department visits and deaths. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials for inclusion and extracted data. We combined data into forest plots using fixed‐effects modelling as heterogeneity was low (I(2) < 40%). MAIN RESULTS: Ten trials met the inclusion criteria. Telehealthcare was assessed as part of a complex intervention, including nurse case management and other interventions. Telehealthcare was associated with a clinically significant increase in quality of life in two trials with 253 participants (mean difference ‐6.57 (95% confidence interval (CI) ‐13.62 to 0.48); minimum clinically significant difference is a change of ‐4.0), but the confidence interval was wide. Telehealthcare showed a significant reduction in the number of patients with one or more emergency department attendances over 12 months; odds ratio (OR) 0.27 (95% CI 0.11 to 0.66) in three trials with 449 participants, and the OR of having one or more admissions to hospital over 12 months was 0.46 (95% CI 0.33 to 0.65) in six trials with 604 participants. There was no significant difference in the OR for deaths over 12 months for the telehealthcare group as compared to the usual care group in three trials with 503 participants; OR 1.05 (95% CI 0.63 to 1.75). AUTHORS' CONCLUSIONS: Telehealthcare in COPD appears to have a possible impact on the quality of life of patients and the number of times patients attend the emergency department and the hospital. However, further research is needed to clarify precisely its role since the trials included telehealthcare as part of more complex packages

    Formal nursing terminology systems: a means to an end

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    In response to the need to support diverse and complex information requirements, nursing has developed a number of different terminology systems. The two main kinds of systems that have emerged are enumerative systems and combinatorial systems, although some systems have characteristics of both approaches. Differences in the structure and content of terminology systems, while useful at a local level, prevent effective wider communication, information sharing, integration of record systems, and comparison of nursing elements of healthcare information at a more global level. Formal nursing terminology systems present an alternative approach. This paper describes a number of recent initiatives and explains how these emerging approaches may help to augment existing nursing terminology systems and overcome their limitations through mediation. The development of formal nursing terminology systems is not an end in itself and there remains a great deal of work to be done before success can be claimed. This paper presents an overview of the key issues outstanding and provides recommendations for a way forward

    Project HealthDesign: Rethinking the Power and Potential of Personal Health Records: Round One Final Report

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    Describes an initiative to develop prototypes for next-generation personal health record applications on a common platform focused on self-management for better health. Outlines grantees' prototypes for user-centered daily monitoring and lessons learned

    M-health review: joining up healthcare in a wireless world

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    In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint
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