BACKGROUND Persons with multiple chronic conditions and disability face access barriers to office-based primary care and have very high rates of emergency department (ED) use and hospital admissions. Home-based primary care (HBPC) has been proposed as a way to improve disease management and prevent health crises. HYPOTHESIS Enrollment of patients with disability and multiple chronic condition...

UNLABELLED Medical Record Department (MRD) has a vital role in making short and long term plans to improve health system services. The aim of this study was to describe performance improvement indicators of hospital MRD and information technology (IT). COLLECTION OF DATA A search was conducted in various databases, through related keywords in articles, books, and abstracts of conferences from...

Order checks are important error prevention tools when used in conjunction with practitioner order entry systems. We studied characteristics of order checks generated in a sample of consecutively entered orders during a 4 week period in an electronic medical record at VA Puget Sound. We found that in the 42,641 orders where an order check could potentially be generated, 11% generated at least o...

INTRODUCTION The adoption of electronic medical records (EMRs) in emergency departments (EDs) has changed the way that healthcare information is collected, charted, and stored. A challenge for researchers is to determine how EMRs may be leveraged to facilitate study data collection efforts. Our objective is to describe the use of a unique data collection system leveraging EMR technology and to ...

BACKGROUND Data on complications of gastrointestinal endoscopic procedures are limited. We evaluated prospectively the incidence and cost of hospital visits resulting from outpatient endoscopy. METHODS We developed an electronic medical record-based system to record automatically admissions to the emergency department (ED) within 14 days after endoscopy. Physicians evaluated all reported case...

BACKGROUND Self-reported medical history data are frequently used in epidemiological studies. Self-reported diagnoses may differ from medical record diagnoses due to poor patient-clinician communication, self-diagnosis in the absence of a satisfactory explanation for symptoms, or the "health literacy" of the patient. METHODS The US Department of Defense military health system offers a unique ...

OBJECTIVES To explore the feasibility of implementing an Internet-based communication network for communication of health care information during skilled nursing facility (SNF)-to-ED care transitions, and to identify potential barriers to system implementation. METHODS Qualitative. SETTING The largest SNF affiliated with the ED of an urban tertiary care center. PARTICIPANTS Consecutive sa...

1 the bmj | BMJ 2015;350:h1885 | doi: 10.1136/bmj.h1885 1Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA 02115, USA 2Harvard Medical School, Boston 3Department of Biostatistics, Harvard School of Public Health, Boston 4Department of Pediatrics, Children’s Hospital of Boston, Boston 5Department of Neurology, Massachusetts General Hospital, Boston 6Depar...

Syndromic surveillance systems that incorporate electronic free-text data have primarily focused on extracting concepts of interest from chief complaint text, emergency department visit notes, and nurse triage notes. Due to availability and access, there has been limited work in the area of surveilling the full text of all electronic note documents compared with more specific document sources. ...