Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Nov 2012
An improved model for predicting postoperative nausea and vomiting in ambulatory surgery patients using physician-modifiable risk factors.
Postoperative nausea and vomiting (PONV) is a frequent complication in patients undergoing ambulatory surgery, with an incidence of 20%-65%. A predictive model can be utilized for decision support and feedback for practitioner practice improvement. The goal of this study was to develop a better model to predict the patient's risk for PONV by incorporating both non-modifiable patient characteristics and modifiable practitioner-specific anesthetic practices. ⋯ The EM showed statistically significant improved discrimination over existing models and good calibration. However, the EM should be validated at another institution.
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Adoption studies of social media use by clinicians were systematically reviewed, up to July 26th, 2011, to determine the extent of adoption and highlight trends in institutional responses. This search led to 370 articles, of which 50 were selected for review, including 15 adoption surveys. The definition of social media is evolving rapidly; the authors define it broadly to include social networks and group-curated reference sites such as Wikipedia. ⋯ Wikipedia is widely used as a reference tool. Attempts at incorporating social media into clinical training have met with mixed success. Posting of unprofessional content and breaches of patient confidentiality, especially by students, are not uncommon and have prompted calls for social media guidelines.
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J Am Med Inform Assoc · Sep 2012
ReviewThe effectiveness of interventions using electronic reminders to improve adherence to chronic medication: a systematic review of the literature.
Many patients experience difficulties in adhering to long-term treatment. Although patients' reasons for not being adherent are diverse, one of the most commonly reported barriers is forgetfulness. Reminding patients to take their medication may provide a solution. Electronic reminders (automatically sent reminders without personal contact between the healthcare provider and patient) are now increasingly being used in the effort to improve adherence. ⋯ This review provides evidence for the short-term effectiveness of electronic reminders, especially SMS reminders. However, long-term effects remain unclear.
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J Am Med Inform Assoc · Jul 2012
ReviewThe impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature.
To assess evidence of the impact of Picture Archiving and Communication Systems (PACS) on clinicians' work practices in the intensive care unit (ICU). ⋯ The potential for PACS to impact positively on clinician work practices in the ICU and improve patient care is great. However, the evidence base is limited and does not reflect aspects of contemporary PACS technology. Performance measures developed in previous studies remain relevant, with much left to investigate to understand how PACS can support new and improved ways of delivering care in the intensive care setting.
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J Am Med Inform Assoc · Jul 2012
Multicenter Study Comparative StudyOrganizational complements to electronic health records in ambulatory physician performance: the role of support staff.
In industries outside healthcare, highly skilled employees enable substantial gains in productivity after adoption of information technologies. The authors explore whether the presence of highly skilled, autonomous clinical support staff is associated with higher performance among physicians with electronic health records (EHRs). ⋯ This relationship did not hold among physicians without EHRs (OR 1.0). As we begin a national push towards greater EHR adoption, it is critical to understand why some physicians gain from EHR use and others do not.