Journal of the American Medical Informatics Association : JAMIA
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J Am Med Inform Assoc · Nov 2017
Electronic health record adoption in US hospitals: the emergence of a digital "advanced use" divide.
While most hospitals have adopted electronic health records (EHRs), we know little about whether hospitals use EHRs in advanced ways that are critical to improving outcomes, and whether hospitals with fewer resources - small, rural, safety-net - are keeping up. ⋯ Hospital EHR adoption is widespread and many hospitals are using EHRs to support performance measurement and patient engagement. However, this is not happening across all hospitals.
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J Am Med Inform Assoc · Jun 2020
Electronic Personal Protective Equipment: A Strategy to Protect Emergency Department Providers in the Age of COVID-19.
Emergent policy changes related to telemedicine and the Emergency Medical Treatment and Labor Act during the novel coronavirus disease 2019 (COVID-19) pandemic have created opportunities for technology-based clinical evaluation, which serves to conserve personal protective equipment (PPE) and protect emergency providers. We define electronic PPE as an approach using telemedicine tools to perform electronic medical screening exams while satisfying the Emergency Medical Treatment and Labor Act. We discuss the safety, legal, and technical factors necessary for implementing such a pathway. This approach has the potential to conserve PPE and protect providers while maintaining safe standards for medical screening exams in the emergency department for low-risk patients in whom COVID-19 is suspected.
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J Am Med Inform Assoc · Jun 2020
Rapid Response to COVID-19: Health Informatics Support for Outbreak Management in an Academic Health System.
To describe the implementation of technological support important for optimizing clinical management of the COVID-19 pandemic. ⋯ The EHR is an essential tool in supporting the clinical needs of a health system managing the COVID-19 pandemic.
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J Am Med Inform Assoc · Jan 2021
Observational StudyTelemedicine and healthcare disparities: a cohort study in a large healthcare system in New York City during COVID-19.
Through the coronavirus disease 2019 (COVID-19) pandemic, telemedicine became a necessary entry point into the process of diagnosis, triage, and treatment. Racial and ethnic disparities in healthcare have been well documented in COVID-19 with respect to risk of infection and in-hospital outcomes once admitted, and here we assess disparities in those who access healthcare via telemedicine for COVID-19. ⋯ Telemedicine access disparities reflect those in in-person healthcare access. Roots of disparate use are complex and reflect individual, community, and structural factors, including their intersection-many of which are due to systemic racism. Evidence regarding disparities that manifest through telemedicine can be used to inform tool design and systemic efforts to promote digital health equity.
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J Am Med Inform Assoc · Jul 2021
Development and validation of prediction models for mechanical ventilation, renal replacement therapy, and readmission in COVID-19 patients.
Coronavirus disease 2019 (COVID-19) patients are at risk for resource-intensive outcomes including mechanical ventilation (MV), renal replacement therapy (RRT), and readmission. Accurate outcome prognostication could facilitate hospital resource allocation. We develop and validate predictive models for each outcome using retrospective electronic health record data for COVID-19 patients treated between March 2 and May 6, 2020. ⋯ We develop and validate prognostic models targeting MV, RRT, and readmission for hospitalized COVID-19 patients which produce accurate, interpretable predictions. Additional external validation studies are needed to further verify the generalizability of our results.