Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Nov 2014
Sequencing of EHR adoption among US hospitals and the impact of meaningful use.
To examine whether there is a common sequence of adoption of electronic health record (EHR) functions among US hospitals, identify differences by hospital type, and assess the impact of meaningful use. ⋯ While there is a common sequence underlying adoption of EHR functions, the degree of adherence to the sequence varies by key hospital characteristics. Stage 1 meaningful use likely alters the sequence.
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J Am Med Inform Assoc · Nov 2014
Area-level factors associated with electronic health record adoption and meaningful use in the Regional Extension Center Program.
To identify area-level correlates of electronic health record (EHR) adoption and meaningful use (MU) among primary care providers (PCPs) enrolled in the Regional Extension Center (REC) Program. ⋯ Federal efforts to spur EHR adoption and MU have demonstrated some early success; however, some geographic variations in EHR diffusion indicate that greater attention needs to be paid to ensuring equitable uptake and use of EHRs throughout the US.
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J Am Med Inform Assoc · Oct 2014
Evaluation of medium-term consequences of implementing commercial computerized physician order entry and clinical decision support prescribing systems in two 'early adopter' hospitals.
To understand the medium-term consequences of implementing commercially procured computerized physician order entry (CPOE) and clinical decision support (CDS) systems in 'early adopter' hospitals. ⋯ We identified little difference in the medium-term consequences of a CPOE and a CDS system. It is important that future studies investigate the medium- and longer-term consequences of CPOE and CDS systems in a wider range of hospitals.
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J Am Med Inform Assoc · Oct 2014
Effect of clinical decision support on documented guideline adherence for head CT in emergency department patients with mild traumatic brain injury.
Imaging utilization in emergency departments (EDs) has increased significantly. More than half of the 1.2 million patients with mild traumatic brain injury (MTBI) presenting to US EDs receive head CT. ⋯ We implemented clinical decision support (CDS) based on published evidence to guide emergency clinicians towards appropriate head CT use in patients with MTBI and automated data capture needed for unambiguous guideline adherence metrics. Implementation of the CDS was associated with a 56% relative increase in documented adherence to evidence-based guidelines for imaging in ED patients with MTBI.
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J Am Med Inform Assoc · Oct 2014
Sensitivity and specificity of dosing alerts for dosing errors among hospitalized pediatric patients.
To determine the sensitivity and specificity of a dosing alert system for dosing errors and to compare the sensitivity of a proprietary system with and without institutional customization at a pediatric hospital. ⋯ The dosing alert system had a low sensitivity and positive predictive value for dosing errors, but might have prevented dosing errors from reaching patients. Customization increased the sensitivity of the system for dosing errors.