International journal of medical informatics
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Emergency departments in the United Kingdom (UK) experience significant difficulties in achieving the 95% NHS access standard due to unforeseen variations in patient flow. In order to maximize efficiency and minimize clinical risk, better forecasting of patient demand is necessary. The objective is therefore to create a tool that accurately predicts attendance at emergency departments to support optimal planning of human and physical resources. ⋯ This paper described a heuristic-based fuzzy logic model for predicting emergency department attendances which could help resource allocation and reduce pressure on busy hospitals. Valid and reproducible prediction tools could be generated from these hospital data. The methodology had an acceptable accuracy over a relatively short time period, and could be used to assist better bed management, staffing and elective surgery scheduling. When compared to other prediction models usually applied for emergency department attendances prediction, the proposed heuristic model had better accuracy.
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Pain gained recognition as a vital sign in the early 2000s, underscoring the importance of accurate documentation, characterization, and treatment of pain. No prior studies have demonstrated the utility of the 0-10 pain scale with respect to discharge opioid prescriptions, nor characterized the most influential factors in discharge prescriptions. ⋯ Pain scale was significantly negatively correlated with discharge MMEs in the ED and positively correlated in the inpatient population. Individual prescriber characteristics were the more influential variable, with prolific high prescribers writing for the largest MME amounts. The inverse association of pain and MMEs at discharge in the ED, and the large effect pre-existing prescriber patterns exhibited, both improved methodology for assessing and appropriately treating pain, and effective prescriber-targeted interventions, must be a priority.
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The aim of this study was to assess the feasibility of implementing a synchronous telemedicine platform in a pediatric intensive care unit (STEP-PICU). ⋯ The synchronous telemedicine service for PICU was feasible but would need good pre-implementation preparation to be truly helpful. Its usefulness during the night shift and holiday on-call periods was scored as low by the off-site pediatric intensivists and the on-site fellows. It would appear that such a service could be more beneficial for communications with other remote healthcare facilities, where there is a greater need for the expertise of a pediatric critical care intensivist.
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The management of hypertrophic cardiomyopathy (HCM) patients requires the knowledge of risk factors associated with sudden cardiac death (SCD). SCD risk factors such as syncope and family history of SCD (FH-SCD) as well as family history of HCM (FH-HCM) are documented in electronic health records (EHRs) as clinical narratives. Automated extraction of risk factors from clinical narratives by natural language processing (NLP) may expedite management workflow of HCM patients. The aim of this study was to develop and deploy NLP algorithms for automated extraction of syncope, FH-SCD, and FH-HCM from clinical narratives. ⋯ Automated extraction of syncope, FH-SCD and FH-HCM using NLP is feasible and has promise to increase efficiency of workflow for providers managing HCM patients.
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Medical Information Technology may be understood as an interdisciplinary study of the conception, design, development, adoption and use of Information Technology (IT) innovations for healthcare provision, management and planning. Concerning the use of IT in reproductive health, the aim of the diverse range of currently available applications (apps) is to assist in family planning, antenatal, intrapartum and postpartum care, along with neonatal and infant healthcare. End users are healthcare workers or women. Studies evaluating the effectiveness of these solutions have demonstrated promising results reflecting adherence to healthcare services and recommendations, information on management and risk identification in pregnancy, improvement in women's satisfaction with healthcare received, in addition to financial benefits for the healthcare system. ⋯ The systematic review demonstrated that it is an arduous task to search for mobile digital solutions that meet the guidelines for clinical use during antenatal care. Although the apps analyzed have great potential for use in different contexts, the bulk of these software systems are unavailable for "prompt delivery", since the test version cannot be downloaded or access is restricted.