Topics in health information management最新文献

Advances in technology can have direct and indirect benefits to clinical practice. The challenge that clinicians face is to properly match resources and outcomes, along with patient preferences. This article explores the use of an innovative interactive voice response system to increase patient compliance with antidepressant medication prescribed in primary care settings. The development of the interactive voice response system, its implementation, and clinical outcomes are described. The findings underscore the need to carefully match intervention strategies with the needs of specific patient populations, and the importance of human dialog in the context of healing.

To evaluate group visits in the management of underinsured patients with uncontrolled type 2 diabetes, 120 eligible patients enrolled were randomly assigned to receive care in groups or continue usual care. Feasibility, acceptability, and concordance with American Diabetes Association standards of care (Diab Camre. 25[suppl 1]:533-549) were evaluated. Patients who received care in groups exhibited improvement in American Diabetes Association standards of care (p < .001), improved sense of trust in physician (p = .02), and tended to report better coordination of care (p = .07), better community orientation (p = .09), and more culturally competent care (p = .09). Group visits offer a promising model for delivering health care to these patients.

Electronic prescribing tools are currently available but most medical practices are not using them. The literature was reviewed for data on adverse drug events and the expected dollar savings that could occur if these events were prevented. In addition to cost savings from improved patient safety, the effect of these systems on formulary compliance and drug cost savings was examined. Improved physician, nurse, and staff efficiencies were calculated using time trial comparisons between a paper system of handling prescription refills and a representative electronic prescribing system. The conclusion is made that electronic prescribing software is cost-effective for all size practices with a more rapid return on investment in larger practices.

Organizations are impacted by their environments, and health care settings are no different. Individuals charged with improving a practice are often impeded by environmental barriers, including incomplete information for decision making. One strategy to empower an organization for change is to form a self-managing team. This paper discusses the self-managing team concept and uses a case study to illustrate its application in primary care. Factors contributing to team success are presented as a guide, and a reminder--there is more to an effective team than gathering people in a room.

To improve the functionality of our MAternal Record System (MARS), we reviewed the clinical problems entered into the MARS database from approximately 2800 patient records and interviewed representative clinicians about their use of the Clinical Comments and Problem List sections of MARS. Problems were assigned a unique term that corrected for spelling, spacing, synonyms, and abbreviation variations. Analysis of these terms suggested design changes that would increase the number of unique entries into the Problem List, including (1) modifications in the automated problem entry functions within MARS and (2) integration of the Problem List and Clinical Comments sections.

This article presents a case study from a primary care practice that achieves blood pressure control (ie, less than 130/85 mm Hg) in a majority of patients with diabetes. Fifty-three percent of the last blood pressures measured in 2001 were controlled and 38% of patients achieved blood pressure control without medications or with a single agent. Blood pressure control is achieved in a majority of patients in this practice secondary to their focus on guidelines, involvement of nursing staff in case management, and medication use consistent with recommendations.

As a result of the Human Genome Project, genetic testing could result in the availability of detailed genetic information (presence of disease, genetic risk or predisposition to disease, and characteristics or traits) that can ultimately be used for healthcare-related decisions. This study explored whether gender, role, and professional discipline would influence attitudes toward genetic testing when making reproductive decisions, as interpreted by 2 roles--as a parent making decisions or as a professional giving advice. An original research instrument was administered to masters and doctoral genetics students, pediatric residents, and masters-level ministry students. Statistical analyses revealed that discipline strongly influenced decision making while gender rarely did. In addition, differences in attitudes were also found based on parental and professional roles.

This article focuses on the importance of monitoring and identifying those early discharged infants who are at risk for developing complications of jaundice. By utilizing standing orders in monitoring babies within 24 hours of discharge, bilirubin levels can be assessed in the home setting, required interventions can be implemented, and unplanned, emergency room visits and hospital readmissions can be averted.

For over a decade, most health care information technology (IT) professionals erroneously learned that document imaging, which is one of the many component technologies of an electronic document management system (EDMS), is the only technology of an EDMS. In addition, many health care IT professionals erroneously believed that EDMSs have either a limited role or no place in IT environments. As a result, most health care IT professionals do not understand documents and unstructured data and their value as structured data partners in most aspects of transaction and information processing systems.

Over the last 10 to 15 years, the health care industry has experienced dramatic changes in health care delivery, consumer needs, and demands. The medical record, a recapitulation of the care patients receive, continues to be one of the most vital components of the health care delivery system. It serves as a crucial administrative, clinical, financial, and research tool. Health information managers, striving to meet ever-changing requirements, have turned to electronic record processing to meet these changes. The following article describes one hospital's journey from a cumbersome paper environment to an electronic environment that not only resulted in improved customer service but also provided employees with renewed job satisfaction and increased skill levels.