Sample records for electronic catch recordings

  1. Quality of nursing documentation: Paper-based health records versus electronic-based health records.

    PubMed

    Akhu-Zaheya, Laila; Al-Maaitah, Rowaida; Bany Hani, Salam

    2018-02-01

    To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process and structure. Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. A retrospective, descriptive, comparative design was used to address the study's purposes. A convenient number of patients' records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses' knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and

  2. Popular media records reveal multi-decadal trends in recreational fishing catch rates.

    PubMed

    Thurstan, Ruth H; Game, Edward; Pandolfi, John M

    2017-01-01

    Despite threats to human wellbeing from ecological degradation, public engagement with this issue remains at low levels. However, studies have shown that crafting messages to resonate with people's personal experiences can enhance engagement. Recreational fishing is one of the principal ways in which people interact with aquatic environments, but long-term data from this perspective are considered rare. We uncovered 852 popular media records of recreational fishing for an Australian estuary across a 140-year period. Using information contained in these articles we analysed the species composition of recreational catches over time and constructed two distinct time series of catch and effort (n fish fisher-1 trip-1; kg fish fisher-1 trip-1) for recreational fishing trips and fishing club competitions (mean n and kg fish caught across all competitors, and n and kg fish caught by the competition winner). Reported species composition remained similar over time. Catch rates reported from recreational fishing trips (1900-1998) displayed a significant decline, averaging 32.5 fish fisher-1 trip-1 prior to 1960, and 18.8 fish fisher-1 trip-1 post-1960. Mean n fish fisher-1 competition-1 (1913-1983) also significantly declined, but best n fish fisher-1 competition-1 (1925-1980) displayed no significant change, averaging 31.2 fish fisher-1 competition-1 over the time series. Mean and best kg fish fisher-1 competition-1 trends also displayed no significant change, averaging 4.2 and 9.9 kg fisher-1 competition-1, respectively. These variable trends suggest that while some fishers experienced diminishing returns in this region over the last few decades, the most skilled inshore fishers were able to maintain their catch rates, highlighting the difficulties inherent in crafting conservation messages that will resonate with all sections of a community. Despite these challenges, this research demonstrates that popular media sources can provide multiple long-term trends at spatial

  3. Popular media records reveal multi-decadal trends in recreational fishing catch rates

    PubMed Central

    Game, Edward; Pandolfi, John M.

    2017-01-01

    Despite threats to human wellbeing from ecological degradation, public engagement with this issue remains at low levels. However, studies have shown that crafting messages to resonate with people’s personal experiences can enhance engagement. Recreational fishing is one of the principal ways in which people interact with aquatic environments, but long-term data from this perspective are considered rare. We uncovered 852 popular media records of recreational fishing for an Australian estuary across a 140-year period. Using information contained in these articles we analysed the species composition of recreational catches over time and constructed two distinct time series of catch and effort (n fish fisher-1 trip-1; kg fish fisher-1 trip-1) for recreational fishing trips and fishing club competitions (mean n and kg fish caught across all competitors, and n and kg fish caught by the competition winner). Reported species composition remained similar over time. Catch rates reported from recreational fishing trips (1900–1998) displayed a significant decline, averaging 32.5 fish fisher-1 trip-1 prior to 1960, and 18.8 fish fisher-1 trip-1 post-1960. Mean n fish fisher-1 competition-1 (1913–1983) also significantly declined, but best n fish fisher-1 competition-1 (1925–1980) displayed no significant change, averaging 31.2 fish fisher-1 competition-1 over the time series. Mean and best kg fish fisher-1 competition-1 trends also displayed no significant change, averaging 4.2 and 9.9 kg fisher-1 competition-1, respectively. These variable trends suggest that while some fishers experienced diminishing returns in this region over the last few decades, the most skilled inshore fishers were able to maintain their catch rates, highlighting the difficulties inherent in crafting conservation messages that will resonate with all sections of a community. Despite these challenges, this research demonstrates that popular media sources can provide multiple long-term trends at

  4. The Catch to Confidentiality: The Use of Electronic Health Records in Adolescent Health Care.

    PubMed

    Stablein, Timothy; Loud, Keith J; DiCapua, Christopher; Anthony, Denise L

    2018-05-01

    This study aims to understand pediatric health-care providers' expectations and the practices they employ to protect confidentiality in electronic health records (EHRs) and subsequently how EHRs affect the documentation and dissemination of information in the course of health-care delivery to adolescent minors. Twenty-six pediatric health-care providers participated in in-depth interviews about their experiences using EHRs to understand a broad spectrum of expectations and practices guiding the documentation and dissemination of information in the EHR. A thematic analysis of interviews was conducted to draw findings and conclusions. Two themes and several subthemes emerged centering on how EHRs affected confidentiality expectations and practices. Participants expressed confidentiality concerns due to the EHR's longevity as a legacy record, its multidimensional uses, and increased access by users (theme 1). These concerns affected practices for protecting adolescent confidentiality within the EHR (theme 2). Practices included selectively omitting or concealing information and utilizing sets of personal and collective codes designed to alert providers or teams of providers to confidential information within a patient's record. EHRs create new and unresolved challenges for pediatric health care as they alter expectations of confidentiality and the documentation and dissemination of information within the record. This is particularly relevant in the course of care to adolescent minors as EHRs may compromise the tenuous balance providers maintain between protecting confidentiality and effective documentation within the record. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  5. Structured electronic physiotherapy records.

    PubMed

    Buyl, Ronald; Nyssen, Marc

    2009-07-01

    With the introduction of the electronic health record, physiotherapists too are encouraged to store their patient records in a structured digital format. The typical nature of a physiotherapy treatment requires a specific record structure to be implemented, with special attention to user-friendliness and communication with other healthcare providers. The objective of this study was to establish a framework for the electronic physiotherapy record and to define a model for the interoperability with the other healthcare providers involved in the patients' care. Although we started from the Belgian context, we used a generic approach so that the results can easily be extrapolated to other countries. The framework we establish here defines not only the different building blocks of the electronic physiotherapy record, but also describes the structure and the content of the exchanged data elements. Through a combined effort by all involved parties, we elaborated an eight-level structure for the electronic physiotherapy record. Furthermore we designed a server-based model for the exchange of data between electronic record systems held by physicians and those held by physiotherapists. Two newly defined XML messages enable data interchange: the physiotherapy prescription and the physiotherapy report. We succeeded in defining a solid, structural model for electronic physiotherapist record systems. Recent wide scale implementation of operational elements such as the electronic registry has proven to make the administrative work easier for the physiotherapist. Moreover, within the proposed framework all the necessary building blocks are present for further data exchange and communication with other healthcare parties in the future. Although we completed the design of the structure and already implemented some new aspects of the electronic physiotherapy record, the real challenge lies in persuading the end-users to start using these electronic record systems. Via a quality label

  6. Electronic recorder study

    DOT National Transportation Integrated Search

    1998-06-01

    Information on the current use of electronic recorders and opinions on mandatory electronic recorder use was obtained from truck and bus fleets and owner operators through the cooperation of several trucking industry associations. Due to the low resp...

  7. 5 CFR 850.301 - Electronic records; other acceptable records.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... SERVICE REGULATIONS (CONTINUED) ELECTRONIC RETIREMENT PROCESSING Records § 850.301 Electronic records; other acceptable records. (a) Acceptable electronic records for retirement and insurance processing by... (SF 2806 or SF 3100), or data or images obtained from such documents, including images stored in EDMS...

  8. Estimating historical eastern North Pacific blue whale catches using spatial calling patterns.

    PubMed

    Monnahan, Cole C; Branch, Trevor A; Stafford, Kathleen M; Ivashchenko, Yulia V; Oleson, Erin M

    2014-01-01

    Blue whales (Balaenoptera musculus) were exploited extensively around the world and remain endangered. In the North Pacific their population structure is unclear and current status unknown, with the exception of a well-studied eastern North Pacific (ENP) population. Despite existing abundance estimates for the ENP population, it is difficult to estimate pre-exploitation abundance levels and gauge their recovery because historical catches of the ENP population are difficult to separate from catches of other populations in the North Pacific. We collated previously unreported Soviet catches and combined these with known catches to form the most current estimates of North Pacific blue whale catches. We split these conflated catches using recorded acoustic calls from throughout the North Pacific, the knowledge that the ENP population produces a different call than blue whales in the western North Pacific (WNP). The catches were split by estimating spatiotemporal occurrence of blue whales with generalized additive models fitted to acoustic call patterns, which predict the probability a catch belonged to the ENP population based on the proportion of calls of each population recorded by latitude, longitude, and month. When applied to the conflated historical catches, which totaled 9,773, we estimate that ENP blue whale catches totaled 3,411 (95% range 2,593 to 4,114) from 1905-1971, and amounted to 35% (95% range 27% to 42%) of all catches in the North Pacific. Thus most catches in the North Pacific were for WNP blue whales, totaling 6,362 (95% range 5,659 to 7,180). The uncertainty in the acoustic data influence the results substantially more than uncertainty in catch locations and dates, but the results are fairly insensitive to the ecological assumptions made in the analysis. The results of this study provide information for future studies investigating the recovery of these populations and the impact of continuing and future sources of anthropogenic mortality.

  9. 5 CFR 850.301 - Electronic records; other acceptable records.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...; other acceptable records. (a) Acceptable electronic records for processing by the electronic retirement and insurance processing system include— (1) Electronic employee data submitted by an agency or other entity through EHRI and stored within the new retirement and insurance processing system; (2) Electronic...

  10. 5 CFR 850.301 - Electronic records; other acceptable records.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...; other acceptable records. (a) Acceptable electronic records for processing by the electronic retirement and insurance processing system include— (1) Electronic employee data submitted by an agency or other entity through EHRI and stored within the new retirement and insurance processing system; (2) Electronic...

  11. 5 CFR 850.301 - Electronic records; other acceptable records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...; other acceptable records. (a) Acceptable electronic records for processing by the electronic retirement and insurance processing system include— (1) Electronic employee data submitted by an agency or other entity through EHRI and stored within the new retirement and insurance processing system; (2) Electronic...

  12. 5 CFR 850.301 - Electronic records; other acceptable records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...; other acceptable records. (a) Acceptable electronic records for processing by the electronic retirement and insurance processing system include— (1) Electronic employee data submitted by an agency or other entity through EHRI and stored within the new retirement and insurance processing system; (2) Electronic...

  13. Comparative evaluation of light-trap catches, electric motor mosquito catches and human biting catches of Anopheles in the Three Gorges Reservoir.

    PubMed

    Duo-quan, Wang; Lin-hua, Tang; Zhen-cheng, Gu; Xiang, Zheng; Man-ni, Yang; Wei-kang, Jiang

    2012-01-01

    The mosquito sampling efficiency of light-trap catches and electric motor mosquito catches were compared with that of human biting catches in the Three Gorges Reservoir. There was consistency in the sampling efficiency between light-trap catches and human biting catches for Anopheles sinensis (r = 0.82, P<0.01) and light-trap catches were 1.52 (1.35-1.71) times that of human biting catches regardless of mosquito density (r = 0.33, P>0.01), while the correlation between electric motor mosquito catches and human biting catches was found to be not statistically significant (r = 0.43, P>0.01) and its sampling efficiency was below that of human biting catches. It is concluded that light-traps can be used as an alternative to human biting catches of Anopheles sinensis in the study area and is a promising tool for sampling malaria vector populations.

  14. Estimating Historical Eastern North Pacific Blue Whale Catches Using Spatial Calling Patterns

    PubMed Central

    Monnahan, Cole C.; Branch, Trevor A.; Stafford, Kathleen M.; Ivashchenko, Yulia V.; Oleson, Erin M.

    2014-01-01

    Blue whales (Balaenoptera musculus) were exploited extensively around the world and remain endangered. In the North Pacific their population structure is unclear and current status unknown, with the exception of a well-studied eastern North Pacific (ENP) population. Despite existing abundance estimates for the ENP population, it is difficult to estimate pre-exploitation abundance levels and gauge their recovery because historical catches of the ENP population are difficult to separate from catches of other populations in the North Pacific. We collated previously unreported Soviet catches and combined these with known catches to form the most current estimates of North Pacific blue whale catches. We split these conflated catches using recorded acoustic calls from throughout the North Pacific, the knowledge that the ENP population produces a different call than blue whales in the western North Pacific (WNP). The catches were split by estimating spatiotemporal occurrence of blue whales with generalized additive models fitted to acoustic call patterns, which predict the probability a catch belonged to the ENP population based on the proportion of calls of each population recorded by latitude, longitude, and month. When applied to the conflated historical catches, which totaled 9,773, we estimate that ENP blue whale catches totaled 3,411 (95% range 2,593 to 4,114) from 1905–1971, and amounted to 35% (95% range 27% to 42%) of all catches in the North Pacific. Thus most catches in the North Pacific were for WNP blue whales, totaling 6,362 (95% range 5,659 to 7,180). The uncertainty in the acoustic data influence the results substantially more than uncertainty in catch locations and dates, but the results are fairly insensitive to the ecological assumptions made in the analysis. The results of this study provide information for future studies investigating the recovery of these populations and the impact of continuing and future sources of anthropogenic mortality. PMID

  15. Comparative Evaluation of Light-Trap Catches, Electric Motor Mosquito Catches and Human Biting Catches of Anopheles in the Three Gorges Reservoir

    PubMed Central

    Duo-quan, Wang; Lin-hua, Tang; Zhen-cheng, Gu; Xiang, Zheng; Man-ni, Yang; Wei-kang, Jiang

    2012-01-01

    The mosquito sampling efficiency of light-trap catches and electric motor mosquito catches were compared with that of human biting catches in the Three Gorges Reservoir. There was consistency in the sampling efficiency between light-trap catches and human biting catches for Anopheles sinensis (r = 0.82, P<0.01) and light-trap catches were 1.52 (1.35–1.71) times that of human biting catches regardless of mosquito density (r = 0.33, P>0.01), while the correlation between electric motor mosquito catches and human biting catches was found to be not statistically significant (r = 0.43, P>0.01) and its sampling efficiency was below that of human biting catches. It is concluded that light-traps can be used as an alternative to human biting catches of Anopheles sinensis in the study area and is a promising tool for sampling malaria vector populations. PMID:22235256

  16. 50 CFR 648.53 - Acceptable biological catch (ABC), annual catch limits (ACL), annual catch targets (ACT), DAS...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... catch limits (ACL), annual catch targets (ACT), DAS allocations, and individual fishing quotas (IFQ... limits (ACL), annual catch targets (ACT), DAS allocations, and individual fishing quotas (IFQ). (a... process specified in § 648.55 and is equal to the overall scallop fishery ACL. The ABC/ACL shall be...

  17. 50 CFR 648.53 - Acceptable biological catch (ABC), annual catch limits (ACL), annual catch targets (ACT), DAS...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... catch limits (ACL), annual catch targets (ACT), DAS allocations, and individual fishing quotas (IFQ... limits (ACL), annual catch targets (ACT), DAS allocations, and individual fishing quotas (IFQ). (a... process specified in § 648.55 and is equal to the overall scallop fishery ACL. The ABC/ACL shall be...

  18. 32 CFR 701.21 - Electronic record.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Electronic record. 701.21 Section 701.21... THE NAVY DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.21 Electronic record. Records (including e-mail) which are created, stored, and retrieved by electronic means. ...

  19. 32 CFR 701.21 - Electronic record.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Electronic record. 701.21 Section 701.21... THE NAVY DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.21 Electronic record. Records (including e-mail) which are created, stored, and retrieved by electronic means. ...

  20. 32 CFR 701.21 - Electronic record.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Electronic record. 701.21 Section 701.21... THE NAVY DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.21 Electronic record. Records (including e-mail) which are created, stored, and retrieved by electronic means. ...

  1. 32 CFR 701.21 - Electronic record.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Electronic record. 701.21 Section 701.21... THE NAVY DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.21 Electronic record. Records (including e-mail) which are created, stored, and retrieved by electronic means. ...

  2. 32 CFR 701.21 - Electronic record.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Electronic record. 701.21 Section 701.21... THE NAVY DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.21 Electronic record. Records (including e-mail) which are created, stored, and retrieved by electronic means. ...

  3. Global estimates of shark catches using trade records from commercial markets.

    PubMed

    Clarke, Shelley C; McAllister, Murdoch K; Milner-Gulland, E J; Kirkwood, G P; Michielsens, Catherine G J; Agnew, David J; Pikitch, Ellen K; Nakano, Hideki; Shivji, Mahmood S

    2006-10-01

    Despite growing concerns about overexploitation of sharks, lack of accurate, species-specific harvest data often hampers quantitative stock assessment. In such cases, trade studies can provide insights into exploitation unavailable from traditional monitoring. We applied Bayesian statistical methods to trade data in combination with genetic identification to estimate by species, the annual number of globally traded shark fins, the most commercially valuable product from a group of species often unrecorded in harvest statistics. Our results provide the first fishery-independent estimate of the scale of shark catches worldwide and indicate that shark biomass in the fin trade is three to four times higher than shark catch figures reported in the only global data base. Comparison of our estimates to approximated stock assessment reference points for one of the most commonly traded species, blue shark, suggests that current trade volumes in numbers of sharks are close to or possibly exceeding the maximum sustainable yield levels.

  4. Breaches of health information: are electronic records different from paper records?

    PubMed

    Sade, Robert M

    2010-01-01

    Breaches of electronic medical records constitute a type of healthcare error, but should be considered separately from other types of errors because the national focus on the security of electronic data justifies special treatment of medical information breaches. Guidelines for protecting electronic medical records should be applied equally to paper medical records.

  5. Electronic health records to facilitate clinical research.

    PubMed

    Cowie, Martin R; Blomster, Juuso I; Curtis, Lesley H; Duclaux, Sylvie; Ford, Ian; Fritz, Fleur; Goldman, Samantha; Janmohamed, Salim; Kreuzer, Jörg; Leenay, Mark; Michel, Alexander; Ong, Seleen; Pell, Jill P; Southworth, Mary Ross; Stough, Wendy Gattis; Thoenes, Martin; Zannad, Faiez; Zalewski, Andrew

    2017-01-01

    Electronic health records (EHRs) provide opportunities to enhance patient care, embed performance measures in clinical practice, and facilitate clinical research. Concerns have been raised about the increasing recruitment challenges in trials, burdensome and obtrusive data collection, and uncertain generalizability of the results. Leveraging electronic health records to counterbalance these trends is an area of intense interest. The initial applications of electronic health records, as the primary data source is envisioned for observational studies, embedded pragmatic or post-marketing registry-based randomized studies, or comparative effectiveness studies. Advancing this approach to randomized clinical trials, electronic health records may potentially be used to assess study feasibility, to facilitate patient recruitment, and streamline data collection at baseline and follow-up. Ensuring data security and privacy, overcoming the challenges associated with linking diverse systems and maintaining infrastructure for repeat use of high quality data, are some of the challenges associated with using electronic health records in clinical research. Collaboration between academia, industry, regulatory bodies, policy makers, patients, and electronic health record vendors is critical for the greater use of electronic health records in clinical research. This manuscript identifies the key steps required to advance the role of electronic health records in cardiovascular clinical research.

  6. Mitigating by-catch of diamondback terrapins in crab pots

    USGS Publications Warehouse

    Hart, Kristen M.; Crowder, Larry B.

    2011-01-01

    Chronic by-catch of diamondback terrapins (Malaclemys terrapin) in blue crab (Callinectes sapidus) pots is a concern for terrapin conservation along the United States Atlantic and Gulf of Mexico coasts. Despite the availability of by-catch reduction devices (BRDs) for crab pots, adoption of BRDs has not been mandated and by-catch of terrapins continues. We conducted experimental fishing studies in North Carolina's year-round blue crab fishery from 2000 to 2004 to evaluate the ability of various BRDs to reduce terrapin by-catch without a concomitant reduction in the catch of blue crabs. In 4,822 crab pot days fished, we recorded only 21 terrapin captures. Estimated capture rates were 0.003 terrapins/pot per day in hard crab experimental fishing and 0.008 terrapins/pot per day in peeler experimental fishing. All terrapin captures occurred from April to mid-May within 321.4 m of the shoreline. Longer soak times produced more dead terrapins, with 4 live and 4 dead during hard crab experimental fishing and 11 live and 2 dead during peeler experimental fishing. The 4.0-cm BRDs in fall and 4.5-cm and 5.0-cm BRDs in spring reduced the catch of legal-sized male hard crabs by 26.6%, 21.2%, and 5.7%, respectively. Only the 5.0-cm BRDs did not significantly affect the catch of legal-sized hard male crabs. However, BRDs had no measurable effect on catch of target crabs in the peeler crab fishery. Our results identify 3 complementary and economically feasible tools for blue crab fishery managers to exclude terrapins from commercially fished crab pots in North Carolina: 1) gear modifications (e.g., BRDs); 2) distance-to-shore restrictions; and 3) time-of-year regulations. These measures combined could provide a reduction in terrapin by-catch of up to 95% without a significant reduction in target crab catch.

  7. Extended use of electronic health records by primary care physicians: Does the electronic health record artefact matter?

    PubMed

    Raymond, Louis; Paré, Guy; Marchand, Marie

    2017-04-01

    The deployment of electronic health record systems is deemed to play a decisive role in the transformations currently being implemented in primary care medical practices. This study aims to characterize electronic health record systems from the perspective of family physicians. To achieve this goal, we conducted a survey of physicians practising in private clinics located in Quebec, Canada. We used valid responses from 331 respondents who were found to be representative of the larger population. Data provided by the physicians using the top three electronic health record software products were analysed in order to obtain statistically adequate sub-sample sizes. Significant differences were observed among the three products with regard to their functional capability. The extent to which each of the electronic health record functionalities are used by physicians also varied significantly. Our results confirm that the electronic health record artefact 'does matter', its clinical functionalities explaining why certain physicians make more extended use of their system than others.

  8. 77 FR 5473 - Pacific Halibut Fisheries; Catch Sharing Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-03

    ... NOAA-NMFS-2011-0292, by any of the following methods: Electronic Submissions: Submit all electronic... defined as follows: (1) WDFW Marine Catch Area 4B, which is all waters west of the Sekiu River mouth, as... DEPARTMENT OF COMMERCE National Oceanic and Atmospheric Administration 50 CFR Part 300 [Docket No...

  9. Grasping in One-Handed Catching in Relation to Performance

    PubMed Central

    Cesqui, Benedetta; Russo, Marta; Lacquaniti, Francesco; d’Avella, Andrea

    2016-01-01

    Catching a flying ball involves bringing the hand to the aimed interception point at the right time, adjusting the hand posture to receive the incoming ball and to absorb the ball momentum, and closing the hand to ensure a stable grip. A small error in any of these actions can lead to a failure in catching the ball. Here we sought to gather new insights on what aspects of the catching movements affect the interceptive performance most. In particular, we wondered whether the errors occurred in bringing the hand to the interception point or in closing the fingers on the ball, and whether these two phases of interception differed between individuals. To this end, we characterized grasping and wrist movement kinematics of eleven participants attempting to catch a ball projected in space with different ball arrival heights and flight durations. The spatial position of the ball and of several markers placed on the participant’s arm were recorded by a motion capture system, the hand joint angles were recorded with an instrumented glove, and several movement features were extracted. All participants were able to intercept the ball trajectory (i.e. to touch the ball) in over 90% of cases, but they differed in the ability to grasp the ball (success rate varied between 2% and 85%). Similar temporal features were observed across individuals when they caught the ball. In particular, all participants adapted their wrist movements under varying temporal and arrival height constraints, they aligned the time of peak hand closing velocity to the time of hand-ball contact, and they maintained the same hand closing duration in the different experimental conditions. These movement features characterized successful trials, and hence allowed to evaluate the possible sources of errors underlying unsuccessful trials. Thus, inter-individual and inter-trial variability in the modulation of each kinematic feature were related to catching performance. We observed that different participants

  10. Privacy, confidentiality, and electronic medical records.

    PubMed Central

    Barrows, R C; Clayton, P D

    1996-01-01

    The enhanced availability of health information in an electronic format is strategic for industry-wide efforts to improve the quality and reduce the cost of health care, yet it brings a concomitant concern of greater risk for loss of privacy among health care participants. The authors review the conflicting goals of accessibility and security for electronic medical records and discuss nontechnical and technical aspects that constitute a reasonable security solution. It is argued that with guiding policy and current technology, an electronic medical record may offer better security than a traditional paper record. PMID:8653450

  11. Electronic Recorder Study

    DOT National Transportation Integrated Search

    1999-02-01

    The Insurance Institute for Highway Safety (IIHS) petitioned the Federal Highway Administration (FHWA) in 1986 to initiate rulemaking to mandate the use of electronic recorders in all commercial motor vehicles (CMVs) required to maintain logbooks. In...

  12. Electronic Health Records

    MedlinePlus

    ... Doctors and hospitals are turning to new health information technology, and while these changes won't happen overnight, they are coming. Understanding EHRs Electronic health records (EHR) — ... information like your age, gender, ethnicity, health history, medications, ...

  13. Improving immunization delivery using an electronic health record: the ImmProve project.

    PubMed

    Bundy, David G; Persing, Nichole M; Solomon, Barry S; King, Tracy M; Murakami, Peter N; Thompson, Richard E; Engineer, Lilly D; Lehmann, Christoph U; Miller, Marlene R

    2013-01-01

    Though an essential pediatric preventive service, immunizations are challenging to deliver reliably. Our objective was to measure the impact on pediatric immunization rates of providing clinicians with electronic health record-derived immunization prompting. Operating in a large, urban, hospital-based pediatric primary care clinic, we evaluated 2 interventions to improve immunization delivery to children ages 2, 6, and 13 years: point-of-care, patient-specific electronic clinical decision support (CDS) when children overdue for immunizations presented for care, and provider-specific bulletins listing children overdue for immunizations. Overall, the proportion of children up to date for a composite of recommended immunizations at ages 2, 6, and 13 years was not different in the intervention (CDS active) and historical control (CDS not active) periods; historical immunization rates were high. The proportion of children receiving 2 doses of hepatitis A immunization before their second birthday was significantly improved during the intervention period. Human papillomavirus (HPV) immunization delivery was low during both control and intervention periods and was unchanged for 13-year-olds. For 14-year-olds, however, 4 of the 5 highest quarterly rates of complete HPV immunization occurred in the final year of the intervention. Provider-specific bulletins listing children overdue for immunizations increased the likelihood of identified children receiving catch-up hepatitis A immunizations (hazard ratio 1.32; 95% confidence interval 1.12-1.56); results for HPV and the composite of recommended immunizations were of a similar magnitude but not statistically significant. In our patient population, with high baseline uptake of recommended immunizations, electronic health record-derived immunization prompting had a limited effect on immunization delivery. Benefit was more clearly demonstrated for newer immunizations with lower baseline uptake. Copyright © 2013 Academic

  14. Catch a Star 2008!

    NASA Astrophysics Data System (ADS)

    2007-10-01

    ESO and the European Association for Astronomy Education have just launched the 2008 edition of 'Catch a Star', their international astronomy competition for school students. Now in its sixth year, the competition offers students the chance to win a once-in-a-lifetime trip to ESO's flagship observatory in Chile, as well as many other prizes. CAS logo The competition includes separate categories - 'Catch a Star Researchers' and 'Catch a Star Adventurers' - to ensure that every student, whatever their level, has the chance to enter and win exciting prizes. In teams, students investigate an astronomical topic of their choice and write a report about it. An important part of the project for 'Catch a Star Researchers' is to think about how ESO's telescopes such as the Very Large Telescope (VLT) or future telescopes such as the Atacama Large Millimeter/submillimeter Array (ALMA) and the European Extremely Large Telescope (E-ELT) could contribute to investigations of the topic. Students may also include practical activities such as observations or experiments. For the artistically minded, 'Catch a Star' also offers an artwork competition, 'Catch a Star Artists'. Last year, hundreds of students from across Europe and beyond took part in 'Catch a Star', submitting astronomical projects and artwork. "'Catch a Star' gets students thinking about the wonders of the Universe and the science of astronomy, with a chance of winning great prizes. It's easy to take part, whether by writing about astronomy or creating astronomically inspired artwork," said Douglas Pierce-Price, Education Officer at ESO. As well as the top prize - a trip to ESO's Very Large Telescope in Chile - visits to observatories in Austria and Spain, and many other prizes, can also be won. 'Catch a Star Researchers' winners will be chosen by an international jury, and 'Catch a Star Adventurers' will be awarded further prizes by lottery. Entries for 'Catch a Star Artists' will be displayed on the web and winners

  15. Optical Trajectories and the Informational Basis of Fly Ball Catching

    ERIC Educational Resources Information Center

    Marken, Richard S.

    2005-01-01

    D. M. Shaffer and M. K. McBeath (see record 2002-02027-006) plotted the optical trajectories of uncatchable fly balls and concluded that linear optical trajectory is the informational basis of the actions taken to catch these balls. P. McLeod, N. Reed, and Z. Dienes (see record 2002-11140-016) replotted these trajectories in terms of changes in…

  16. Electronic Transfer of School Records.

    ERIC Educational Resources Information Center

    Yeagley, Raymond

    2001-01-01

    Describes the electronic transfer of student records, notably the use of a Web-server named CHARLOTTE sponsored by the National Forum on Education Statistics and an Electronic Data Exchange system named SPEEDE/ExPRESS. (PKP)

  17. 22 CFR 503.9 - Electronic records.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... electronically by accessing the BBG's Home Page via the Internet at http://www.ibb.gov. To set up an appointment to view such records in hard copy or to access the Internet via the BBG's computer, please contact... copying, both electronically via the Internet and in hard copy, those records that have been previously...

  18. 22 CFR 503.9 - Electronic records.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... electronically by accessing the BBG's Home Page via the Internet at http://www.ibb.gov. To set up an appointment to view such records in hard copy or to access the Internet via the BBG's computer, please contact... copying, both electronically via the Internet and in hard copy, those records that have been previously...

  19. 22 CFR 503.9 - Electronic records.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... electronically by accessing the BBG's Home Page via the Internet at http://www.ibb.gov. To set up an appointment to view such records in hard copy or to access the Internet via the BBG's computer, please contact... copying, both electronically via the Internet and in hard copy, those records that have been previously...

  20. Catch reconstructions reveal that global marine fisheries catches are higher than reported and declining

    PubMed Central

    Pauly, Daniel; Zeller, Dirk

    2016-01-01

    Fisheries data assembled by the Food and Agriculture Organization (FAO) suggest that global marine fisheries catches increased to 86 million tonnes in 1996, then slightly declined. Here, using a decade-long multinational ‘catch reconstruction' project covering the Exclusive Economic Zones of the world's maritime countries and the High Seas from 1950 to 2010, and accounting for all fisheries, we identify catch trajectories differing considerably from the national data submitted to the FAO. We suggest that catch actually peaked at 130 million tonnes, and has been declining much more strongly since. This decline in reconstructed catches reflects declines in industrial catches and to a smaller extent declining discards, despite industrial fishing having expanded from industrialized countries to the waters of developing countries. The differing trajectories documented here suggest a need for improved monitoring of all fisheries, including often neglected small-scale fisheries, and illegal and other problematic fisheries, as well as discarded bycatch. PMID:26784963

  1. Electronic Ambient-Temperature Recorder

    NASA Technical Reports Server (NTRS)

    Russell, Larry; Barrows, William

    1995-01-01

    Electronic temperature-recording unit stores data in internal memory for later readout. Records temperatures from minus 40 degrees to plus 60 degrees C at intervals ranging from 1.875 to 15 minutes. With all four data channels operating at 1.875-minute intervals, recorder stores at least 10 days' data. For only one channel at 15-minute intervals, capacity extends to up to 342 days' data. Developed for recording temperatures of instruments and life-science experiments on satellites, space shuttle, and high-altitude aircraft. Adaptable to such terrestrial uses as recording temperatures of perishable goods during transportation and of other systems or processes over long times. Can be placed directly in environment to monitor.

  2. The Future Is Coming: Electronic Health Records

    MedlinePlus

    ... Current Issue Past Issues The Future Is Coming: Electronic Health Records Past Issues / Spring 2009 Table of ... special conference on the cutting-edge topic of electronic health records (EHR) on May 20-21, 2009, ...

  3. Integration of clinical research documentation in electronic health records.

    PubMed

    Broach, Debra

    2015-04-01

    Clinical trials of investigational drugs and devices are often conducted within healthcare facilities concurrently with clinical care. With implementation of electronic health records, new communication methods are required to notify nonresearch clinicians of research participation. This article reviews clinical research source documentation, the electronic health record and the medical record, areas in which the research record and electronic health record overlap, and implications for the research nurse coordinator in documentation of the care of the patient/subject. Incorporation of clinical research documentation in the electronic health record will lead to a more complete patient/subject medical record in compliance with both research and medical records regulations. A literature search provided little information about the inclusion of clinical research documentation within the electronic health record. Although regulations and guidelines define both source documentation and the medical record, integration of research documentation in the electronic health record is not clearly defined. At minimum, the signed informed consent(s), investigational drug or device usage, and research team contact information should be documented within the electronic health record. Institutional policies should define a standardized process for this integration in the absence federal guidance. Nurses coordinating clinical trials are in an ideal position to define this integration.

  4. The ImmProve Project: Leveraging electronic health record data to promote immunization delivery

    PubMed Central

    Bundy, David G.; Persing, Nichole M.; Solomon, Barry S.; King, Tracy M.; Murakami, Peter; Thompson, Richard E.; Engineer, Lilly D.; Lehmann, Christoph U.; Miller, Marlene R.

    2013-01-01

    Objective Though an essential pediatric preventive service, immunizations are challenging to deliver reliably. Our objective was to measure the impact on pediatric immunization rates of providing clinicians with electronic health record-derived immunization prompting. Methods Operating in a large, urban, hospital-based pediatric primary care clinic, we evaluated 2 interventions to improve immunization delivery to children ages 2, 6, and 13 years: point-of-care, patient-specific electronic clinical decision support (CDS) when children overdue for immunizations presented for care and provider-specific bulletins listing children overdue for immunizations. Results Overall, the proportion of children up-to-date for a composite of recommended immunizations at ages 2, 6, and 13 years was not different in the intervention (CDS active) and historical control (CDS not active) periods; historical immunization rates were high. The proportion of children receiving 2 doses of hepatitis A immunization prior to their second birthday was significantly improved during the intervention period. Human papilloma virus (HPV) immunization delivery was low during both control and intervention periods and was unchanged for 13-year-olds. For 14-year-olds, however, 4 of the 5 highest quarterly rates of complete HPV immunization occurred in the final year of the intervention. Provider-specific bulletins listing children overdue for immunizations increased the likelihood of identified children receiving catch-up hepatitis A immunizations (hazard ratio: 1.32 [95% confidence interval (CI): 1.12–1.56]); results for HPV and the composite of recommended immunizations were of a similar magnitude but not statistically significant. Conclusions In our patient population, with high baseline uptake of recommended immunizations, electronic health record-derived immunization prompting had a limited effect on immunization delivery. Benefit was more clearly demonstrated for newer immunizations with lower

  5. Electronic Health Record Implementation: A SWOT Analysis.

    PubMed

    Shahmoradi, Leila; Darrudi, Alireza; Arji, Goli; Farzaneh Nejad, Ahmadreza

    2017-10-01

    Electronic Health Record (EHR) is one of the most important achievements of information technology in healthcare domain, and if deployed effectively, it can yield predominant results. The aim of this study was a SWOT (strengths, weaknesses, opportunities, and threats) analysis in electronic health record implementation. This is a descriptive, analytical study conducted with the participation of a 90-member work force from Hospitals affiliated to Tehran University of Medical Sciences (TUMS). The data were collected by using a self-structured questionnaire and analyzed by SPSS software. Based on the results, the highest priority in strength analysis was related to timely and quick access to information. However, lack of hardware and infrastructures was the most important weakness. Having the potential to share information between different sectors and access to a variety of health statistics was the significant opportunity of EHR. Finally, the most substantial threats were the lack of strategic planning in the field of electronic health records together with physicians' and other clinical staff's resistance in the use of electronic health records. To facilitate successful adoption of electronic health record, some organizational, technical and resource elements contribute; moreover, the consideration of these factors is essential for HER implementation.

  6. Health-oriented electronic oral health record: development and evaluation.

    PubMed

    Wongsapai, Mansuang; Suebnukarn, Siriwan; Rajchagool, Sunsanee; Beach, Daryl; Kawaguchi, Sachiko

    2014-06-01

    This study aims to develop and evaluate a new Health-oriented Electronic Oral Health Record that implements the health-oriented status and intervention index. The index takes the principles of holistic oral healthcare and applies them to the design and implementation of the Health-oriented Electronic Oral Health Record. We designed an experiment using focus groups and a consensus (Delphi process) method to develop a new health-oriented status and intervention index and graphical user interface. A comparative intervention study with qualitative and quantitative methods was used to compare an existing Electronic Oral Health Record to the Health-oriented Electronic Oral Health Record, focusing on dentist satisfaction, accuracy, and completeness of oral health status recording. The study was conducted by the dental staff of the Inter-country Center for Oral Health collaborative hospitals in Thailand. Overall, the user satisfaction questionnaire had a positive response to the Health-oriented Electronic Oral Health Record. The dentists found it easy to use and were generally satisfied with the impact on their work, oral health services, and surveillance. The dentists were significantly satisfied with the Health-oriented Electronic Oral Health Record compared to the existing Electronic Oral Health Record (p < 0.001). The accuracy and completeness values of the oral health information recorded using the Health-oriented Electronic Oral Health Record were 97.15 and 93.74 percent, respectively. This research concludes that the Health-oriented Electronic Oral Health Record satisfied many dentists, provided benefits to holistic oral healthcare, and facilitated the planning, managing, and evaluation of the healthcare delivery system.

  7. Implementation of an Electronic Medical Records System

    DTIC Science & Technology

    2008-05-07

    Hartman, MAJ Roddex Barlow , CPT Christopher Besser and Capt Michael Emerson...thank you I am truly honored to call each of you my friends. Electronic... abnormal findings are addressed. 18 Electronic Medical Record Implementation Barriers of the Electronic Medical Records System There are several...examination findings • Psychological and social assessment findings N. The system provides a flexible mechanism for retrieval of encounter

  8. Plankton Production, Fish Catch, and the Potential for Sharp Regional Catch Trends Under Climate Change

    NASA Astrophysics Data System (ADS)

    Stock, C. A.; John, J. G.; Lam, V.; Rykaczewski, R. R.; Cheung, W. W. L.; Dunne, J. P.; Asch, R. G.; Sarmiento, J. L.

    2016-02-01

    Fish catch has been related to diverse plankton metrics with often ambiguous mechanistic linkages to fish and varying degrees of spatial and temporal robustness. Proposed fish catch indicators also exhibit different patterns of variability and projected change, hindering fisheries assessments and the formulation of resilient marine resource management strategies. We combine 1) a new catch reconstruction featuring improved estimates of illegal and under-reported catch, 2) a novel high-resolution global Earth System Model (GFDL-ESM2.6) featuring 10 km ocean resolution and regionally robust patterns of carbon flow through the planktonic food web, and 3) simple fish trophodynamic considerations, and revisit the relationship between catch and planktonic food web fluxes in a more mechanistic context. Realized 20-year peak catches across globally distributed coastal regions could be well explained by the estimated planktonic production available to fish (via mesozooplankton and the flux of carbon to the benthos) after accounting for the catch trophic level (r = 0.64, r = 0.74 after removing lightly fished Australian systems). Similar skill, however, could result from models invoking high trophic efficiencies within the fish food web and a modest fraction of energy available to fish taken as catch, or low trophic efficiencies and a high fraction. Projections using either parameter combination suggest that projected regional changes in fish yields may be considerably larger than those implied from primary production.

  9. A First Standardized Swiss Electronic Maternity Record.

    PubMed

    Murbach, Michel; Martin, Sabine; Denecke, Kerstin; Nüssli, Stephan

    2017-01-01

    During the nine months of pregnancy, women have to regularly visit several physicians for continuous monitoring of the health and development of the fetus and mother. Comprehensive examination results of different types are generated in this process; documentation and data transmission standards are still unavailable or not in use. Relevant information is collected in a paper-based maternity record carried by the pregnant women. To improve availability and transmission of data, we aim at developing a first prototype for an electronic maternity record for Switzerland. By analyzing the documentation workflow during pregnancy, we determined a maternity record data set. Further, we collected requirements towards a digital maternity record. As data exchange format, the Swiss specific exchange format SMEEX (swiss medical data exchange) was exploited. Feedback from 27 potential users was collected to identify further improvements. The relevant data is extracted from the primary care information system as SMEEX file, stored in a database and made available in a web and a mobile application, developed as prototypes of an electronic maternity record. The user confirmed the usefulness of the system and provided multiple suggestions for an extension. An electronical maternity record as developed in this work could be in future linked to the electronic patient record.

  10. Effect of survey design and catch rate estimation on total catch estimates in Chinook salmon fisheries

    USGS Publications Warehouse

    McCormick, Joshua L.; Quist, Michael C.; Schill, Daniel J.

    2012-01-01

    Roving–roving and roving–access creel surveys are the primary techniques used to obtain information on harvest of Chinook salmon Oncorhynchus tshawytscha in Idaho sport fisheries. Once interviews are conducted using roving–roving or roving–access survey designs, mean catch rate can be estimated with the ratio-of-means (ROM) estimator, the mean-of-ratios (MOR) estimator, or the MOR estimator with exclusion of short-duration (≤0.5 h) trips. Our objective was to examine the relative bias and precision of total catch estimates obtained from use of the two survey designs and three catch rate estimators for Idaho Chinook salmon fisheries. Information on angling populations was obtained by direct visual observation of portions of Chinook salmon fisheries in three Idaho river systems over an 18-d period. Based on data from the angling populations, Monte Carlo simulations were performed to evaluate the properties of the catch rate estimators and survey designs. Among the three estimators, the ROM estimator provided the most accurate and precise estimates of mean catch rate and total catch for both roving–roving and roving–access surveys. On average, the root mean square error of simulated total catch estimates was 1.42 times greater and relative bias was 160.13 times greater for roving–roving surveys than for roving–access surveys. Length-of-stay bias and nonstationary catch rates in roving–roving surveys both appeared to affect catch rate and total catch estimates. Our results suggest that use of the ROM estimator in combination with an estimate of angler effort provided the least biased and most precise estimates of total catch for both survey designs. However, roving–access surveys were more accurate than roving–roving surveys for Chinook salmon fisheries in Idaho.

  11. Deepening Thermocline Displaces Salmon Catch On The Oregon Coast

    NASA Astrophysics Data System (ADS)

    Harrison, C. S.; Lawson, P.

    2015-12-01

    Establishing a linkage between fish stock distributions and physical oceanography at a fine scale provides insights into the dynamic nature of near-shore ocean habitats. Characterization of habitat preferences adds to our understanding of the ecosystem, and may improve forecasts of distribution for harvest management. The Project CROOS (Collaborative Research on Oregon Ocean Salmon) Chinook salmon catch data set represents an unprecedented high-resolution record of catch location and depth, with associated in-situ temperature measurements and stock identification derived from genetic data. Here we connect this data set with physical ocean observations to gain understanding of how circulation affects salmon catch distributions. The CROOS observations were combined with remote and in situ observations of temperature, as well as a data assimilative regional ocean model that incorporates satellite and HF radar data. Across the CROOS data set, catch is primarily located within the upwelling front over the seamounts and reef structures associated with Heceta and Stonewall Banks along the shelf break. In late September of 2014 the anomalously warm "blob" began to arrive on the Oregon coast coincident with a strong downwelling event. At this time the thermocline deepened from 20 to 40 m, associated with a deepening of salmon catch depth. A cold "bulb" of water over Heceta Bank may have provided a thermal refuge for salmon during the initial onshore movement of the anomalously warm water. These observations suggest that a warming ocean, and regional warming events in particular, will have large effects on fish distributions at local and regional scales, in turn impacting fisheries.

  12. Security Techniques for the Electronic Health Records.

    PubMed

    Kruse, Clemens Scott; Smith, Brenna; Vanderlinden, Hannah; Nealand, Alexandra

    2017-08-01

    The privacy of patients and the security of their information is the most imperative barrier to entry when considering the adoption of electronic health records in the healthcare industry. Considering current legal regulations, this review seeks to analyze and discuss prominent security techniques for healthcare organizations seeking to adopt a secure electronic health records system. Additionally, the researchers sought to establish a foundation for further research for security in the healthcare industry. The researchers utilized the Texas State University Library to gain access to three online databases: PubMed (MEDLINE), CINAHL, and ProQuest Nursing and Allied Health Source. These sources were used to conduct searches on literature concerning security of electronic health records containing several inclusion and exclusion criteria. Researchers collected and analyzed 25 journals and reviews discussing security of electronic health records, 20 of which mentioned specific security methods and techniques. The most frequently mentioned security measures and techniques are categorized into three themes: administrative, physical, and technical safeguards. The sensitive nature of the information contained within electronic health records has prompted the need for advanced security techniques that are able to put these worries at ease. It is imperative for security techniques to cover the vast threats that are present across the three pillars of healthcare.

  13. The electronic medical record in dermatology.

    PubMed

    Grosshandler, Joshua A; Tulbert, Brittain; Kaufmann, Mark D; Bhatia, Ashish; Brodell, Robert T

    2010-09-01

    Governmental incentives to stimulate the "meaningful use" of electronic medical records and future disincentives for Medicaid and Medicare provide an impetus for dermatologists to consider adding this technology to their clinical practice. Dermatologists should carefully weigh the pros and cons of establishing an electronic medical record system before incorporating this expensive technology. This article reviews available scientific and economic data required for dermatologists to help make an informed choice.

  14. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Access to electronic records. 228.205 Section 228.205 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD...; SLEEPING QUARTERS Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and...

  15. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Access to electronic records. 228.205 Section 228.205 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD...; SLEEPING QUARTERS Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and...

  16. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Access to electronic records. 228.205 Section 228.205 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD...; SLEEPING QUARTERS Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and...

  17. Validation of asthma recording in electronic health records: a systematic review

    PubMed Central

    Nissen, Francis; Quint, Jennifer K; Wilkinson, Samantha; Mullerova, Hana; Smeeth, Liam; Douglas, Ian J

    2017-01-01

    Objective To describe the methods used to validate asthma diagnoses in electronic health records and summarize the results of the validation studies. Background Electronic health records are increasingly being used for research on asthma to inform health services and health policy. Validation of the recording of asthma diagnoses in electronic health records is essential to use these databases for credible epidemiological asthma research. Methods We searched EMBASE and MEDLINE databases for studies that validated asthma diagnoses detected in electronic health records up to October 2016. Two reviewers independently assessed the full text against the predetermined inclusion criteria. Key data including author, year, data source, case definitions, reference standard, and validation statistics (including sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) were summarized in two tables. Results Thirteen studies met the inclusion criteria. Most studies demonstrated a high validity using at least one case definition (PPV >80%). Ten studies used a manual validation as the reference standard; each had at least one case definition with a PPV of at least 63%, up to 100%. We also found two studies using a second independent database to validate asthma diagnoses. The PPVs of the best performing case definitions ranged from 46% to 58%. We found one study which used a questionnaire as the reference standard to validate a database case definition; the PPV of the case definition algorithm in this study was 89%. Conclusion Attaining high PPVs (>80%) is possible using each of the discussed validation methods. Identifying asthma cases in electronic health records is possible with high sensitivity, specificity or PPV, by combining multiple data sources, or by focusing on specific test measures. Studies testing a range of case definitions show wide variation in the validity of each definition, suggesting this may be important for obtaining

  18. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Access to electronic records. 228.205 Section 228... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and State inspectors participating under 49...

  19. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Access to electronic records. 228.205 Section 228... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and State inspectors participating under 49...

  20. Teaching Electronic Health Record Communication Skills.

    PubMed

    Palumbo, Mary Val; Sandoval, Marie; Hart, Vicki; Drill, Clarissa

    2016-06-01

    This pilot study investigated nurse practitioner students' communication skills when utilizing the electronic health record during history taking. The nurse practitioner students (n = 16) were videotaped utilizing the electronic health record while taking health histories with standardized patients. The students were videotaped during two separate sessions during one semester. Two observers recorded the time spent (1) typing and talking, (2) typing only, and (3) looking at the computer without talking. Total history taking time, computer placement, and communication skills were also recorded. During the formative session, mean history taking time was 11.4 minutes, with 3.5 minutes engaged with the computer (30.6% of visit). During the evaluative session, mean history taking time was 12.4 minutes, with 2.95 minutes engaged with the computer (24% of visit). The percentage of time individuals spent changed over the two visits: typing and talking, -3.1% (P = .3); typing only, +12.8% (P = .038); and looking at the computer, -9.6% (P = .039). This study demonstrated that time spent engaged with the computer during a patient encounter does decrease with student practice and education. Therefore, students benefit from instruction on electronic health record-specific communication skills, and use of a simple mnemonic to reinforce this is suggested.

  1. Clinical genomics in the world of the electronic health record.

    PubMed

    Marsolo, Keith; Spooner, S Andrew

    2013-10-01

    The widespread adoption of electronic health records presents a number of benefits to the field of clinical genomics. They include the ability to return results to the practitioner, to use genetic findings in clinical decision support, and to have data collected in the electronic health record that serve as a source of phenotypic information for analysis purposes. Not all electronic health records are created equal, however. They differ in their features, capabilities, and ease of use. Therefore, to understand the potential of the electronic health record, it is first necessary to understand its capabilities and the impact that implementation strategy has on usability. Specifically, we focus on the following areas: (i) how the electronic health record is used to capture data in clinical practice settings; (ii) how the implementation and configuration of the electronic health record affect the quality and availability of data; (iii) the management of clinical genetic test results and the feasibility of electronic health record integration; and (iv) the challenges of implementing an electronic health record in a research-intensive environment. This is followed by a discussion of the minimum functional requirements that an electronic health record must meet to enable the satisfactory integration of genomic results as well as the open issues that remain.

  2. Towards lifetime electronic health record implementation.

    PubMed

    Gand, Kai; Richter, Peggy; Esswein, Werner

    2015-01-01

    Integrated care concepts can help to diminish demographic challenges. Hereof, the use of eHealth, esp. overarching electronic health records, is recognized as an efficient approach. The article aims at rigorously defining the concept of lifetime electronic health records (LEHRs) and the identification of core factors that need to be fulfilled in order to implement such. A literature review was conducted. Existing definitions were identified and relevant factors were categorized. The derived assessment categories are demonstrated by a case study on Germany. Seven dimensions to differentiate types of electronic health records were found. The analysis revealed, that culture, regulation, informational self-determination, incentives, compliance, ICT infrastructure and standards are important preconditions to successfully implement LEHRs. The article paves the way for LEHR implementation and therewith for integrated care. Besides the expected benefits of LEHRs, there are a number of ethical, legal and social concerns, which need to be balanced.

  3. Catching the electron in action in real space inside a Ge-Si core-shell nanowire transistor.

    PubMed

    Jaishi, Meghnath; Pati, Ranjit

    2017-09-21

    Catching the electron in action in real space inside a semiconductor Ge-Si core-shell nanowire field effect transistor (FET), which has been demonstrated (J. Xiang, W. Lu, Y. Hu, Y. Wu, H. Yan and C. M. Lieber, Nature, 2006, 441, 489) to outperform the state-of-the-art metal oxide semiconductor FET, is central to gaining unfathomable access into the origin of its functionality. Here, using a quantum transport approach that does not make any assumptions on electronic structure, charge, and potential profile of the device, we unravel the most probable tunneling pathway for electrons in a Ge-Si core-shell nanowire FET with orbital level spatial resolution, which demonstrates gate bias induced decoupling of electron transport between the core and the shell region. Our calculation yields excellent transistor characteristics as noticed in the experiment. Upon increasing the gate bias beyond a threshold value, we observe a rapid drop in drain current resulting in a gate bias driven negative differential resistance behavior and switching in the sign of trans-conductance. We attribute this anomalous behavior in drain current to the gate bias induced modification of the carrier transport pathway from the Ge core to the Si shell region of the nanowire channel. A new experiment involving a four probe junction is proposed to confirm our prediction on gate bias induced decoupling.

  4. 50 CFR 660.17 - Catch monitors and catch monitor service providers. [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Catch monitors and catch monitor service providers. [Reserved] 660.17 Section 660.17 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OFF WEST COAST STATES West Coast Groundfish Fisherie...

  5. Are electronic health records ready for genomic medicine?

    PubMed

    Scheuner, Maren T; de Vries, Han; Kim, Benjamin; Meili, Robin C; Olmstead, Sarah H; Teleki, Stephanie

    2009-07-01

    The goal of this project was to assess genetic/genomic content in electronic health records. Semistructured interviews were conducted with key informants. Questions addressed documentation, organization, display, decision support and security of family history and genetic test information, and challenges and opportunities relating to integrating genetic/genomics content in electronic health records. There were 56 participants: 10 electronic health record specialists, 18 primary care clinicians, 16 medical geneticists, and 12 genetic counselors. Few clinicians felt their electronic record met their current genetic/genomic medicine needs. Barriers to integration were mostly related to problems with family history data collection, documentation, and organization. Lack of demand for genetics content and privacy concerns were also mentioned as challenges. Data elements and functionality requirements that clinicians see include: pedigree drawing; clinical decision support for familial risk assessment and genetic testing indications; a patient portal for patient-entered data; and standards for data elements, terminology, structure, interoperability, and clinical decision support rules. Although most said that there is little impact of genetics/genomics on electronic records today, many stated genetics/genomics would be a driver of content in the next 5-10 years. Electronic health records have the potential to enable clinical integration of genetic/genomic medicine and improve delivery of personalized health care; however, structured and standardized data elements and functionality requirements are needed.

  6. Permanent record. Electronic records aid in the aftermath of Joplin tornado.

    PubMed

    Russell, Matthew

    2011-09-01

    When a tornado struck St. John's Regional Medical Center in May 2011, its patient records were stored in a newly launched electronic health record system, helping prevent a bad situation from being worse.

  7. Influence of two catching methods on the occurrence of lesions in broilers.

    PubMed

    Langkabel, Nina; Baumann, Maximilian P O; Feiler, Annika; Sanguankiat, Arsooth; Fries, Reinhard

    2015-08-01

    During the catching of broilers for slaughter, 2 to 3 birds are grabbed per hand at one leg at the same time. From an animal welfare point of view, this procedure is under critical observation from animal welfare administration and the general public.In this paper 2 catching methods were compared: the routinely used 1-leg catching method, and a second tech-nique whereby birds were grabbed by both legs with a maximum of 2 birds per hand (2-leg catching method). Lesions on the body, legs, and wings (hemorrhages and fractures) were recorded by a camera system located after the plucking position. Two weight classes, 2 catching teams, and 2 flocks were included in the study.Heavy animals showed more lesions than birds of the light weight class. In all investigations, lesions on the body and legs were rare, whereas wing lesions occurred at a rate of up to 15.32%. Statistical analysis showed no significant difference between the 2 methods or between the catching teams for both weight classes. A correlation between lesions and weight was observed, with a significant odds ratio ( OR: ) of 3.6 (95% CI: 3.299-3.957).During 2-leg catching, the animals appeared to be more restless. Workers stated that the grabbing of both legs of a bird was more difficult and that working in a crouching position for a longer time was harder.We conclude that the cautious handling of animals to reduce stress is more important than "holding animals by both legs", as has been proposed. © 2015 Poultry Science Association Inc.

  8. 76 FR 52991 - Renewal of Advisory Committee on Electronic Records Archives

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Renewal of Advisory Committee on Electronic Records... Records Administration's (NARA) Advisory Committee on Electronic Records Archives. In accordance with... Committee on Electronic Records Archives in NARA's ceiling of discretionary advisory committees. FOR FURTHER...

  9. Principal Challenges Facing Electronic Records Management in Federal Agencies Today.

    ERIC Educational Resources Information Center

    Patterson, Giovanna; Sprehe, J. Timothy

    2002-01-01

    Discusses electronic records management in the federal government. Highlights include managing electronic mail; information technology planning, systems design, and architecture; updating conventional records management; integrating electronic records management with other information technology systems; challenges of end-user training; business…

  10. EMERSE: The Electronic Medical Record Search Engine

    PubMed Central

    Hanauer, David A.

    2006-01-01

    EMERSE (The Electronic Medical Record Search Engine) is an intuitive, powerful search engine for free-text documents in the electronic medical record. It offers multiple options for creating complex search queries yet has an interface that is easy enough to be used by those with minimal computer experience. EMERSE is ideal for retrospective chart reviews and data abstraction and may have potential for clinical care as well.

  11. Operating Room Delays: Meaningful Use in Electronic Health Record.

    PubMed

    Van Winkle, Rachelle A; Champagne, Mary T; Gilman-Mays, Meri; Aucoin, Julia

    2016-06-01

    Perioperative areas are the most costly to operate and account for more than 40% of expenses. The high costs prompted one organization to analyze surgical delays through a retrospective review of their new electronic health record. Electronic health records have made it easier to access and aggregate clinical data; 2123 operating room cases were analyzed. Implementing a new electronic health record system is complex; inaccurate data and poor implementation can introduce new problems. Validating the electronic health record development processes determines the ease of use and the user interface, specifically related to user compliance with the intent of the electronic health record development. The revalidation process after implementation determines if the intent of the design was fulfilled and data can be meaningfully used. In this organization, the data fields completed through automation provided quantifiable, meaningful data. However, data fields completed by staff that required subjective decision making resulted in incomplete data nearly 24% of the time. The ease of use was further complicated by 490 permutations (combinations of delay types and reasons) that were built into the electronic health record. Operating room delay themes emerged notwithstanding the significant complexity of the electronic health record build; however, improved accuracy could improve meaningful data collection and a more accurate root cause analysis of operating room delays. Accurate and meaningful use of data affords a more reliable approach in quality, safety, and cost-effective initiatives.

  12. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false What records management...

  13. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false What records management...

  14. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false What records management...

  15. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false What records management...

  16. [Electronic versus paper-based patient records: a cost-benefit analysis].

    PubMed

    Neubauer, A S; Priglinger, S; Ehrt, O

    2001-11-01

    The aim of this study is to compare the costs and benefits of electronic, paperless patient records with the conventional paper-based charts. Costs and benefits of planned electronic patient records are calculated for a University eye hospital with 140 beds. Benefit is determined by direct costs saved by electronic records. In the example shown, the additional benefits of electronic patient records, as far as they can be quantified total 192,000 DM per year. The costs of the necessary investments are 234,000 DM per year when using a linear depreciation over 4 years. In total, there are additional annual costs for electronic patient records of 42,000 DM. Different scenarios were analyzed. By increasing the time of depreciation to 6 years, the cost deficit reduces to only approximately 9,000 DM. Increased wages reduce the deficit further while the deficit increases with a loss of functions of the electronic patient record. However, several benefits of electronic records regarding research, teaching, quality control and better data access cannot be easily quantified and would greatly increase the benefit to cost ratio. Only part of the advantages of electronic patient records can easily be quantified in terms of directly saved costs. The small cost deficit calculated in this example is overcompensated by several benefits, which can only be enumerated qualitatively due to problems in quantification.

  17. Electronic medical records for otolaryngology office-based practice.

    PubMed

    Chernobilsky, Boris; Boruk, Marina

    2008-02-01

    Pressure is mounting on physicians to adopt electronic medical records. The field of health information technology is evolving rapidly with innovations and policies often outpacing science. We sought to review research and discussions about electronic medical records from the past year to keep abreast of these changes. Original scientific research, especially from otolaryngologists, is lacking in this field. Adoption rates are slowly increasing, but more of the burden is shouldered by physicians despite policy efforts and the clear benefits to third-party payers. Scientific research from the past year suggests lack of improvements and even decreasing quality of healthcare with electronic medical record adoption in the ambulatory care setting. The increasing prevalence and standardization of electronic medical record systems results in a new set of problems including rising costs, audits, difficulties in transition and public concerns about security of information. As major players in healthcare continue to push for adoption, increased effort must be made to demonstrate actual improvements in patient care in the ambulatory care setting. More scientific studies are needed to demonstrate what features of electronic medical records actually improve patient care. Otolaryngologists should help each other by disseminating research about improvement in patient outcomes with their systems since current adoption and outcomes policies do not apply to specialists.

  18. Electronic Health Record Meets Digital Library

    PubMed Central

    Humphreys, Betsy L.

    2000-01-01

    Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government envouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics. PMID:10984463

  19. EMERSE: The Electronic Medical Record Search Engine

    PubMed Central

    Hanauer, David A.

    2006-01-01

    EMERSE (The Electronic Medical Record Search Engine) is an intuitive, powerful search engine for free-text documents in the electronic medical record. It offers multiple options for creating complex search queries yet has an interface that is easy enough to be used by those with minimal computer experience. EMERSE is ideal for retrospective chart reviews and data abstraction and may have potential for clinical care as well. PMID:17238560

  20. Efficacy of Electrocuting Devices to Catch Tsetse Flies (Glossinidae) and Other Diptera

    PubMed Central

    Vale, Glyn A.; Hargrove, John W.; Cullis, N. Alan; Chamisa, Andrew; Torr, Stephen J.

    2015-01-01

    Background The behaviour of insect vectors has an important bearing on the epidemiology of the diseases they transmit, and on the opportunities for vector control. Two sorts of electrocuting device have been particularly useful for studying the behaviour of tsetse flies (Glossina spp), the vectors of the trypanosomes that cause sleeping sickness in humans and nagana in livestock. Such devices consist of grids on netting (E-net) to catch tsetse in flight, or on cloth (E-cloth) to catch alighting flies. Catches are most meaningful when the devices catch as many as possible of the flies potentially available to them, and when the proportion caught is known. There have been conflicting indications for the catching efficiency, depending on whether the assessments were made by the naked eye or assisted by video recordings. Methodology/Principal Findings Using grids of 0.5m2 in Zimbabwe, we developed catch methods of studying the efficiency of E-nets and E-cloth for tsetse, using improved transformers to supply the grids with electrical pulses of ~40kV. At energies per pulse of 35–215mJ, the efficiency was enhanced by reducing the pulse interval from 3200 to 1ms. Efficiency was low at 35mJ per pulse, but there seemed no benefit of increasing the energy beyond 70mJ. Catches at E-nets declined when the fine netting normally used became either coarser or much finer, and increased when the grid frame was moved from 2.5cm to 27.5cm from the grid. Data for muscoids and tabanids were roughly comparable to those for tsetse. Conclusion/Significance The catch method of studying efficiency is useful for supplementing and extending video methods. Specifications are suggested for E-nets and E-cloth that are ~95% efficient and suitable for estimating the absolute numbers of available flies. Grids that are less efficient, but more economical, are recommended for studies of relative numbers available to various baits. PMID:26505202

  1. Efficacy of Electrocuting Devices to Catch Tsetse Flies (Glossinidae) and Other Diptera.

    PubMed

    Vale, Glyn A; Hargrove, John W; Cullis, N Alan; Chamisa, Andrew; Torr, Stephen J

    2015-10-01

    The behaviour of insect vectors has an important bearing on the epidemiology of the diseases they transmit, and on the opportunities for vector control. Two sorts of electrocuting device have been particularly useful for studying the behaviour of tsetse flies (Glossina spp), the vectors of the trypanosomes that cause sleeping sickness in humans and nagana in livestock. Such devices consist of grids on netting (E-net) to catch tsetse in flight, or on cloth (E-cloth) to catch alighting flies. Catches are most meaningful when the devices catch as many as possible of the flies potentially available to them, and when the proportion caught is known. There have been conflicting indications for the catching efficiency, depending on whether the assessments were made by the naked eye or assisted by video recordings. Using grids of 0.5m2 in Zimbabwe, we developed catch methods of studying the efficiency of E-nets and E-cloth for tsetse, using improved transformers to supply the grids with electrical pulses of ~40kV. At energies per pulse of 35-215mJ, the efficiency was enhanced by reducing the pulse interval from 3200 to 1ms. Efficiency was low at 35mJ per pulse, but there seemed no benefit of increasing the energy beyond 70mJ. Catches at E-nets declined when the fine netting normally used became either coarser or much finer, and increased when the grid frame was moved from 2.5cm to 27.5cm from the grid. Data for muscoids and tabanids were roughly comparable to those for tsetse. The catch method of studying efficiency is useful for supplementing and extending video methods. Specifications are suggested for E-nets and E-cloth that are ~95% efficient and suitable for estimating the absolute numbers of available flies. Grids that are less efficient, but more economical, are recommended for studies of relative numbers available to various baits.

  2. 42 CFR 425.506 - Electronic health records technology.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Electronic health records technology. 425.506 Section 425.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Standards and Reporting § 425.506 Electronic health records technology. (a) ACOs, ACO participants, and ACO...

  3. 42 CFR 425.506 - Electronic health records technology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Electronic health records technology. 425.506 Section 425.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Standards and Reporting § 425.506 Electronic health records technology. (a) ACOs, ACO participants, and ACO...

  4. 42 CFR 425.506 - Electronic health records technology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Electronic health records technology. 425.506 Section 425.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Standards and Reporting § 425.506 Electronic health records technology. (a) ACOs, ACO participants, and ACO...

  5. 78 FR 22345 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-15

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives... and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic... United States, on technical, mission, and service issues related to the Electronic Records Archives (ERA...

  6. 77 FR 21812 - Advisory Committee on the Electronic Records Archives (ACERA).

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives... and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic... United States, on technical, mission, and service issues related to the Electronic Records Archives (ERA...

  7. Technology as friend or foe? Do electronic health records increase burnout?

    PubMed

    Ehrenfeld, Jesse M; Wanderer, Jonathan P

    2018-06-01

    To summarize recent relevant studies regarding the use of electronic health records and physician burnout. Recently acquired knowledge regarding the relationship between electronic health record use, professional satisfaction, burnout, and desire to leave clinical practice are discussed. Adoption of electronic health records has increased across the United States and worldwide. Although electronic health records have many benefits, there is growing concern about the adverse consequences of their use on physician satisfaction and burnout. Poor usability, incongruent workflows, and the addition of clerical tasks to physician documentation requirements have been previously highlighted as ongoing concerns with electronic health record adoption. In multiple recent studies, electronic health records have been shown to decrease professional satisfaction, increase burnout, and the likelihood that a physician will reduce or leave clinical practice. One interventional study demonstrated a positive effect of a dedicated electronic health record entry clerk on physicians working in an outpatient practice.

  8. Teaching Electronic Records Management in the Archival Curriculum

    ERIC Educational Resources Information Center

    Zhang, Jane

    2016-01-01

    Electronic records management has been incorporated into the archival curriculum in North America since the 1990s. This study reported in this paper provides a systematic analysis of the content of electronic records management (ERM) courses currently taught in archival education programs. Through the analysis of course combinations and their…

  9. 76 FR 19147 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives... Electronic Records Archives (ACERA). The meeting has been consolidated into one day. This meeting will be... number of individuals planning to attend must be submitted to the Electronic Records Archives Program at...

  10. Merging Electronic Health Record Data and Genomics for Cardiovascular Research

    PubMed Central

    Hall, Jennifer L.; Ryan, John J.; Bray, Bruce E.; Brown, Candice; Lanfear, David; Newby, L. Kristin; Relling, Mary V.; Risch, Neil J.; Roden, Dan M.; Shaw, Stanley Y.; Tcheng, James E.; Tenenbaum, Jessica; Wang, Thomas N.; Weintraub, William S.

    2017-01-01

    The process of scientific discovery is rapidly evolving. The funding climate has influenced a favorable shift in scientific discovery toward the use of existing resources such as the electronic health record. The electronic health record enables long-term outlooks on human health and disease, in conjunction with multidimensional phenotypes that include laboratory data, images, vital signs, and other clinical information. Initial work has confirmed the utility of the electronic health record for understanding mechanisms and patterns of variability in disease susceptibility, disease evolution, and drug responses. The addition of biobanks and genomic data to the information contained in the electronic health record has been demonstrated. The purpose of this statement is to discuss the current challenges in and the potential for merging electronic health record data and genomics for cardiovascular research. PMID:26976545

  11. Electronic Imaging in Admissions, Records & Financial Aid Offices.

    ERIC Educational Resources Information Center

    Perkins, Helen L.

    Over the years, efforts have been made to work more efficiently with the ever increasing number of records and paper documents that cross workers' desks. Filing records on optical disk through electronic imaging is an alternative that many feel is the answer to successful document management. The pioneering efforts in electronic imaging in…

  12. Technology Acceptance of Electronic Medical Records by Nurses

    ERIC Educational Resources Information Center

    Stocker, Gary

    2010-01-01

    The purpose of this study was to evaluate the Technology Acceptance Model's (TAM) relevance of the intention of nurses to use electronic medical records in acute health care settings. The basic technology acceptance research of Davis (1989) was applied to the specific technology tool of electronic medical records (EMR) in a specific setting…

  13. Reconciling fisheries catch and ocean productivity

    PubMed Central

    Stock, Charles A.; Asch, Rebecca G.; Cheung, William W. L.; Dunne, John P.; Friedland, Kevin D.; Lam, Vicky W. Y.; Sarmiento, Jorge L.; Watson, Reg A.

    2017-01-01

    Photosynthesis fuels marine food webs, yet differences in fish catch across globally distributed marine ecosystems far exceed differences in net primary production (NPP). We consider the hypothesis that ecosystem-level variations in pelagic and benthic energy flows from phytoplankton to fish, trophic transfer efficiencies, and fishing effort can quantitatively reconcile this contrast in an energetically consistent manner. To test this hypothesis, we enlist global fish catch data that include previously neglected contributions from small-scale fisheries, a synthesis of global fishing effort, and plankton food web energy flux estimates from a prototype high-resolution global earth system model (ESM). After removing a small number of lightly fished ecosystems, stark interregional differences in fish catch per unit area can be explained (r = 0.79) with an energy-based model that (i) considers dynamic interregional differences in benthic and pelagic energy pathways connecting phytoplankton and fish, (ii) depresses trophic transfer efficiencies in the tropics and, less critically, (iii) associates elevated trophic transfer efficiencies with benthic-predominant systems. Model catch estimates are generally within a factor of 2 of values spanning two orders of magnitude. Climate change projections show that the same macroecological patterns explaining dramatic regional catch differences in the contemporary ocean amplify catch trends, producing changes that may exceed 50% in some regions by the end of the 21st century under high-emissions scenarios. Models failing to resolve these trophodynamic patterns may significantly underestimate regional fisheries catch trends and hinder adaptation to climate change. PMID:28115722

  14. Reconciling fisheries catch and ocean productivity.

    PubMed

    Stock, Charles A; John, Jasmin G; Rykaczewski, Ryan R; Asch, Rebecca G; Cheung, William W L; Dunne, John P; Friedland, Kevin D; Lam, Vicky W Y; Sarmiento, Jorge L; Watson, Reg A

    2017-02-21

    Photosynthesis fuels marine food webs, yet differences in fish catch across globally distributed marine ecosystems far exceed differences in net primary production (NPP). We consider the hypothesis that ecosystem-level variations in pelagic and benthic energy flows from phytoplankton to fish, trophic transfer efficiencies, and fishing effort can quantitatively reconcile this contrast in an energetically consistent manner. To test this hypothesis, we enlist global fish catch data that include previously neglected contributions from small-scale fisheries, a synthesis of global fishing effort, and plankton food web energy flux estimates from a prototype high-resolution global earth system model (ESM). After removing a small number of lightly fished ecosystems, stark interregional differences in fish catch per unit area can be explained ( r = 0.79) with an energy-based model that ( i ) considers dynamic interregional differences in benthic and pelagic energy pathways connecting phytoplankton and fish, ( ii ) depresses trophic transfer efficiencies in the tropics and, less critically, ( iii ) associates elevated trophic transfer efficiencies with benthic-predominant systems. Model catch estimates are generally within a factor of 2 of values spanning two orders of magnitude. Climate change projections show that the same macroecological patterns explaining dramatic regional catch differences in the contemporary ocean amplify catch trends, producing changes that may exceed 50% in some regions by the end of the 21st century under high-emissions scenarios. Models failing to resolve these trophodynamic patterns may significantly underestimate regional fisheries catch trends and hinder adaptation to climate change.

  15. Spider webs designed for rare but life-saving catches

    PubMed Central

    Venner, Samuel; Casas, Jérôme

    2005-01-01

    The impact of rare but positive events on the design of organisms has been largely ignored, probably due to the paucity of recordings of such events and to the difficulty of estimating their impact on lifetime reproductive success. In this respect, we investigated the size of spider webs in relation to rare but large prey catches. First, we collected field data on a short time-scale using the common orb-weaving spider Zygiella x-notata to determine the distribution of the size of prey caught and to quantify the relationship between web size and daily capture success. Second, we explored, with an energetic model, the consequences of an increase in web size on spider fitness. Our results showed that (i) the great majority of prey caught are quite small (body length less than 2 mm) while large prey (length greater than 10 mm) are rare, (ii) spiders cannot survive or produce eggs without catching these large but rare prey and (iii) increasing web size increases the daily number of prey caught and thus long-term survival and fecundity. Spider webs seem, therefore, designed for making the best of the rare but crucial event of catching large prey. PMID:16048774

  16. Electronic Health Records Place 1st at Indy 500

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues EHR Electronic Health Records Place 1st at Indy 500 Past ... last May's Indy 500 had thousands of personal Electronic Health Records on hand for those attending—and ...

  17. Electronic heterodyne recording of interference patterns

    NASA Technical Reports Server (NTRS)

    Merat, F. L.; Claspy, P. C.

    1979-01-01

    An electronic heterodyne technique is being investigated for video (i.e., television rate and format) recording of interference patterns. In the heterodyne technique electro-optic modulation is used to introduce a sinusoidal phase shift between the beams of an interferometer. For phase modulation frequencies between 0.1 and 15 MHz an image dissector camera may be used to scan the resulting temporally modulated interference pattern. Heterodyne detection of the camera output is used to selectively record the interference pattern. An advantage of such synchronous recording is that it permits recording of low-contrast fringes in high ambient light conditions. The application of this technique to the recording of holograms is discussed.

  18. Ten tips for successful electronic health records deployment.

    PubMed

    Gasch, Art

    2012-01-01

    As healthcare providers are increasingly compelled to adopt electronic health records (EHRs) and paper records migrate to electronic files provided to dozens of healthcare intermediaries, breeches of protected health information are skyrocketing, and so are dissatisfaction rates with EHR solutions. This article provides 10 practical tips to ensure a successful EHR system deployment an circumvent EHR land mines.

  19. 50 CFR 660.18 - Certification and decertification procedures for catch monitors and catch monitor providers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Certification and decertification procedures for catch monitors and catch monitor providers. 660.18 Section 660.18 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF...

  20. Are In-Bed Electronic Weights Recorded in the Medical Record Accurate?

    PubMed

    Gerl, Heather; Miko, Alexandra; Nelson, Mandy; Godaire, Lori

    2016-01-01

    This study found large discrepancies between in-bed weights recorded in the medical record and carefully obtained standing weights with a calibrated, electronic bedside scale. This discrepancy appears to be related to inadequate bed calibration before patient admission and having excessive linen, clothing, and/or equipment on the bed during weighing by caregivers.

  1. 50 CFR 622.457 - Annual catch limits (ACLs), annual catch targets (ACTs), and accountability measures (AMs).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Spiny Lobster Fishery of Puerto Rico and the U.S. Virgin Islands § 622.457 Annual catch limits (ACLs), annual catch targets (ACTs), and accountability...

  2. 50 CFR 622.439 - Annual catch limits (ACLs), annual catch targets (ACTs), and accountability measures (AMs).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Reef Fish Fishery of Puerto Rico and the U.S. Virgin Islands § 622.439 Annual catch limits (ACLs), annual catch targets (ACTs), and accountability...

  3. 50 CFR 622.457 - Annual catch limits (ACLs), annual catch targets (ACTs), and accountability measures (AMs).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Spiny Lobster Fishery of Puerto Rico and the U.S. Virgin Islands § 622.457 Annual catch limits (ACLs), annual catch targets (ACTs), and accountability...

  4. 50 CFR 622.496 - Annual catch limits (ACLs), annual catch targets (ACTs), and accountability measures (AMs).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Queen Conch Resources of Puerto Rico and the U.S. Virgin Islands § 622.496 Annual catch limits (ACLs), annual catch targets (ACTs), and accountability...

  5. 50 CFR 622.496 - Annual catch limits (ACLs), annual catch targets (ACTs), and accountability measures (AMs).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Queen Conch Resources of Puerto Rico and the U.S. Virgin Islands § 622.496 Annual catch limits (ACLs), annual catch targets (ACTs), and accountability...

  6. 50 CFR 622.439 - Annual catch limits (ACLs), annual catch targets (ACTs), and accountability measures (AMs).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF THE CARIBBEAN, GULF OF MEXICO, AND SOUTH ATLANTIC Reef Fish Fishery of Puerto Rico and the U.S. Virgin Islands § 622.439 Annual catch limits (ACLs), annual catch targets (ACTs), and accountability...

  7. 36 CFR § 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true What records management...

  8. Method for Designing Electronic Assemblies without Potting for Gun Launched Applications Through the Use of Additive Manufacturing

    DTIC Science & Technology

    2016-12-01

    easily would be preferred. Many studies have been conducted to model the effects of potting materials on PCBs and their components: two such studies ...catch (SCAT) gun Guidance electronics On -board recorder (OBR) Precision guided munition (PGM) 16. SECURITY CLASSIFICATION OF: 17... On -board Recorder 2 Initial Method - Modeling Assumptions 2 Initial Method - Parts, Instances, and Simplifications in the Model 3 Initial Method

  9. The effect of load uncertainty on anticipatory muscle activity in catching.

    PubMed

    Eckerle, Jason J; Berg, William P; Ward, Rose Marie

    2012-08-01

    To investigate how the CNS copes with load uncertainty in catching, anticipatory postural adjustments (APAs) in one-handed catching of balls of known and unknown weights were compared. Twenty-nine (n = 29) men (mean age = 21.1 years) participated, all of whom had engaged in a sport activity requiring hand-eye coordination. Participants' muscle activity in the biceps brachii, triceps brachii, wrist flexor group, and bilateral erector spinae at L4-5 was recorded using electromyography (EMG) while they caught visually identical balls of four different weights (0.5, 1.33, 2.17, and 3.0 kg). EMG integrals were computed for the 1 s prior to ball drop (pre-drop period), and the interval between ball drop and catch (drop period). Uncertainty about ball weight had no effect on APA activity during the pre-drop period. During the drop period, however, load uncertainty did influence APA activity in the biceps brachii, triceps brachii, and the wrist flexor muscles (i.e., the effect of ball weight on APA magnitude depended on the presence or absence of load knowledge). In the known ball weight condition, participants exhibit greater APA magnitude with increases in ball weight. In contrast, under the unknown ball weight condition, APA magnitude was relatively consistent across ball weights and at a level similar to the APA magnitude for an intermediate weight (i.e., the second heaviest ball of four) in the known weight condition. In catching balls of unknown weights, the CNS appears to scale APA magnitude to afford the greatest chance of catching the ball, regardless of the weight.

  10. [From planning to realization of an electronic patient record].

    PubMed

    Krämer, T; Rapp, R; Krämer, K L

    1999-03-01

    The high complex requirements on information and information flow in todays hospitals can only be accomplished by the use of modern Information Systems (IS). In order to achieve this, the Stiftung Orthopädische Universitätsklinik has carried out first the Project "Strategic Informations System Planning" in 1993. Then realizing the necessary infrastructure (network; client-server) from 1993 to 1997, and finally started the introduction of modern IS (SAP R/3 and IXOS-Archive) in the clinical area. One of the approved goal was the replacement of the paper medical record by an up-to-date electronical medical record. In this article the following three topics will be discussed: the difference between the up-to-date electronical medical record and the electronically archived finished cases, steps performed by our clinic to realize the up-to-date electronical medical record and the problems occurred during this process.

  11. From planning to realisation of an electronic patient record.

    PubMed

    Krämer, T; Rapp, R; Krämer, K-L

    1999-03-01

    The high complex requirements on information and information flow in todays hospitals can only be accomplished by the use of modern Information Systems (IS). In order to achieve this, the Stiftung Orthopädische Universitätsklinik has carried out first the Project "Strategic Informations System Planning" in 1993. Then realizing the neccessary infrastructure (network; client-server) from 1993 to 1997, and finally started the introduction of modern IS (SAP R/3 and IXOS-Archive) in the clinical area. One of the approved goal was the replacement of the paper medical record by an up-to-date electronical medical record. In this article the following three topics will be discussed: the difference between the up-to-date electronical medical record and the electronically archived finished cases, steps performed by our clinic to realize the up-to-date electronical medical record and the problems occured during this process.

  12. Nurses' Experiences of an Initial and Reimplemented Electronic Health Record Use.

    PubMed

    Chang, Chi-Ping; Lee, Ting-Ting; Liu, Chia-Hui; Mills, Mary Etta

    2016-04-01

    The electronic health record is a key component of healthcare information systems. Currently, numerous hospitals have adopted electronic health records to replace paper-based records to document care processes and improve care quality. Integrating healthcare information system into traditional nursing daily operations requires time and effort for nurses to become familiarized with this new technology. In the stages of electronic health record implementation, smooth adoption can streamline clinical nursing activities. In order to explore the adoption process, a descriptive qualitative study design and focus group interviews were conducted 3 months after and 2 years after electronic health record system implementation (system aborted 1 year in between) in one hospital located in southern Taiwan. Content analysis was performed to analyze the interview data, and six main themes were derived, in the first stage: (1) liability, work stress, and anticipation for electronic health record; (2) slow network speed, user-unfriendly design for learning process; (3) insufficient information technology/organization support; on the second stage: (4) getting used to electronic health record and further system requirements, (5) benefits of electronic health record in time saving and documentation, (6) unrealistic information technology competence expectation and future use. It concluded that user-friendly design and support by informatics technology and manpower backup would facilitate this adoption process as well.

  13. Catching Sunlight

    NASA Astrophysics Data System (ADS)

    Friedman, Alan

    Everyone knows that astronomy is done in the dark. Astronomers are creatures of the night, like vampires, sleeping during the day and working all night long to catch the faint light of their elusive prey.

  14. Electronic Personal Health Record Use Among Nurses in the Nursing Informatics Community.

    PubMed

    Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L

    2015-07-01

    An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as

  15. 75 FR 63208 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-14

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National Archives and Records Administration. ACTION: Notice of meeting. SUMMARY: In... and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic...

  16. 76 FR 65218 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National Archives and Records Administration. ACTION: Notice of meeting. SUMMARY: In... and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic...

  17. The electronic patient record: a strategic planning framework.

    PubMed

    Gordon, D B; Marafioti, S; Carter, M; Kunov, H; Dolan, A

    1995-01-01

    Sunnybrook Health Science Center (Sunnybrook) is a multifacility academic teaching center. In May 1994, Sunnybrook struck an electronic patient record taskforce to develop a strategic plan for the implementation of a comprehensive, facility wide electronic patient record (EPR). The taskforce sought to create a conceptual framework which provides context and integrates decision-making related to the comprehensive electronic patient record. The EPR is very much broader in scope than the traditional paper-based record. It is not restricted to simply reporting individual patient data. By the Institute of Medicine's definition, the electronic patient record resides in a system specifically designed to support users through availability of complete and accurate data, practitioner reminders and alerts, clinical decision support systems, links to bodies of medical knowledge, and other aids [1]. It is a comprehensive resource for patient care. The taskforce proposed a three domain model for determining how the EPR affects Sunnybrook. The EPR enables Sunnybrook to have a high performance team structure (domain 1), to function as an integrated organization (domain 2), and to reach out and develop new relationships with external organizations to become an extended enterprise (domain 3) [2]. Domain 1: Sunnybrook's high performance teams or patient service units' (PSUs) are decentralized, autonomous operating units that provide care to patients grouped by 'like' diagnosis and resource needs. The EPR must provide functions and applications which promote patient focused care, such as cross functional charting and care maps, group scheduling, clinical email, and a range of enabling technologies for multiskilled workers. Domain 2: In the integrated organization domain, the EPR should facilitate closer linkages between the arrangement of PSUs into clinical teams and with other facilities within the center in order to provide a longitudinal record that covers a continuum of care

  18. Catch-up growth in stunted children: Definitions and predictors

    PubMed Central

    2017-01-01

    This paper examines the incidence and correlates of linear growth catch up in early childhood among stunted children, using a range of definitions of catch up. Catch-up growth between two and five years of age is defined in both absolute terms (i.e. the centimetre height deficit from the healthy reference population mean is reduced) and relative terms (the height-for-age z-score improved or passed the -2SD or -1SD cut-off points). Data from a cohort study from urban South Africa are used to estimate the percentage of children who caught up and the predictors of catch-up growth according to these varying definitions. The results show that our sample of stunted children exhibits catch-up growth regardless of the definition used, however prevalence of catch up is highly sensitive to the way catch up is classified, ranging from 19%-93%. Of the biological, early growth, socioeconomic status and maternal reproductive variables included in the multivariate probit regressions, only a few were found to be consistent predictors of the incidence of catch-up growth. Mother’s height was positively correlated with the incidence of catch-up growth and early stunting at one year was associated with a lower likelihood of subsequent catch up. PMID:29236728

  19. Catch-up growth in stunted children: Definitions and predictors.

    PubMed

    Desmond, Chris; Casale, Daniela

    2017-01-01

    This paper examines the incidence and correlates of linear growth catch up in early childhood among stunted children, using a range of definitions of catch up. Catch-up growth between two and five years of age is defined in both absolute terms (i.e. the centimetre height deficit from the healthy reference population mean is reduced) and relative terms (the height-for-age z-score improved or passed the -2SD or -1SD cut-off points). Data from a cohort study from urban South Africa are used to estimate the percentage of children who caught up and the predictors of catch-up growth according to these varying definitions. The results show that our sample of stunted children exhibits catch-up growth regardless of the definition used, however prevalence of catch up is highly sensitive to the way catch up is classified, ranging from 19%-93%. Of the biological, early growth, socioeconomic status and maternal reproductive variables included in the multivariate probit regressions, only a few were found to be consistent predictors of the incidence of catch-up growth. Mother's height was positively correlated with the incidence of catch-up growth and early stunting at one year was associated with a lower likelihood of subsequent catch up.

  20. Shift in tuna catches due to ocean warming.

    PubMed

    Monllor-Hurtado, Alberto; Pennino, Maria Grazia; Sanchez-Lizaso, José Luis

    2017-01-01

    Ocean warming is already affecting global fisheries with an increasing dominance of catches of warmer water species at higher latitudes and lower catches of tropical and subtropical species in the tropics. Tuna distributions are highly conditioned by sea temperature, for this reason and their worldwide distribution, their populations may be a good indicator of the effect of climate change on global fisheries. This study shows the shift of tuna catches in subtropical latitudes on a global scale. From 1965 to 2011, the percentage of tropical tuna in longliner catches exhibited a significantly increasing trend in a study area that included subtropical regions of the Atlantic and western Pacific Oceans and partially the Indian Ocean. This may indicate a movement of tropical tuna populations toward the poles in response to ocean warming. Such an increase in the proportion of tropical tuna in the catches does not seem to be due to a shift of the target species, since the trends in Atlantic and Indian Oceans of tropical tuna catches are decreasing. Our results indicate that as populations shift towards higher latitudes the catches of these tropical species did not increase. Thus, at least in the Atlantic and Indian Oceans, tropical tuna catches have reduced in tropical areas.

  1. The use of electronic health records in Spanish hospitals.

    PubMed

    Marca, Guillem; Perez, Angel; Blanco-Garcia, Martin German; Miravalles, Elena; Soley, Pere; Ortiga, Berta

    The aims of this study were to describe the level of adoption of electronic health records in Spanish hospitals and to identify potential barriers and facilitators to this process. We used an observational cross-sectional design. The survey was conducted between September and December 2011, using an electronic questionnaire distributed through email. We obtained a 30% response rate from the 214 hospitals contacted, all belonging to the Spanish National Health Service. The level of adoption of electronic health records in Spanish hospitals was found to be high: 39.1% of hospitals surveyed had a comprehensive EHR system while a basic system was functioning in 32.8% of the cases. However, in 2011 one third of the hospitals did not have a basic electronic health record system, although some have since implemented electronic functionalities, particularly those related to clinical documentation and patient administration. Respondents cited the acquisition and implementation costs as the main barriers to implementation. Facilitators for EHR implementation were: the possibility to hire technical support, both during and post implementation; security certification warranty; and objective third-party evaluations of EHR products. In conclusion, the number of hospitals that have electronic health records is in general high, being relatively higher in medium-sized hospitals.

  2. Electronic health record use, intensity of hospital care, and patient outcomes.

    PubMed

    Blecker, Saul; Goldfeld, Keith; Park, Naeun; Shine, Daniel; Austrian, Jonathan S; Braithwaite, R Scott; Radford, Martha J; Gourevitch, Marc N

    2014-03-01

    Previous studies have suggested that weekend hospital care is inferior to weekday care and that this difference may be related to diminished care intensity. The purpose of this study was to determine whether a metric for measuring intensity of hospital care based on use of the electronic health record was associated with patient-level outcomes. We performed a cohort study of hospitalizations at an academic medical center. Intensity of care was defined as the hourly number of provider accessions of the electronic health record, termed "electronic health record interactions." Hospitalizations were categorized on the basis of the mean difference in electronic health record interactions between the first Friday and the first Saturday of hospitalization. We used regression models to determine the association of these categories with patient outcomes after adjusting for covariates. Electronic health record interactions decreased from Friday to Saturday in 77% of the 9051 hospitalizations included in the study. Compared with hospitalizations with no change in Friday to Saturday electronic health record interactions, the relative lengths of stay for hospitalizations with a small, moderate, and large decrease in electronic health record interactions were 1.05 (95% confidence interval [CI], 1.00-1.10), 1.11 (95% CI, 1.05-1.17), and 1.25 (95% CI, 1.15-1.35), respectively. Although a large decrease in electronic health record interactions was associated with in-hospital mortality, these findings were not significant after risk adjustment (odds ratio 1.74, 95% CI, 0.93-3.25). Intensity of inpatient care, measured by electronic health record interactions, significantly diminished from Friday to Saturday, and this decrease was associated with length of stay. Hospitals should consider monitoring and correcting temporal fluctuations in care intensity. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Mandatory Use of Electronic Health Records: Overcoming Physician Resistance

    ERIC Educational Resources Information Center

    Brown, Viseeta K.

    2012-01-01

    Literature supports the idea that electronic health records hold tremendous value for the healthcare system in that it increases patient safety, improves the quality of care and provides greater efficiency. The move toward mandatory implementation of electronic health records is a growing concern in the United States health care industry. The…

  4. Integrated Electronic Health Record Database Management System: A Proposal.

    PubMed

    Schiza, Eirini C; Panos, George; David, Christiana; Petkov, Nicolai; Schizas, Christos N

    2015-01-01

    eHealth has attained significant importance as a new mechanism for health management and medical practice. However, the technological growth of eHealth is still limited by technical expertise needed to develop appropriate products. Researchers are constantly in a process of developing and testing new software for building and handling Clinical Medical Records, being renamed to Electronic Health Record (EHR) systems; EHRs take full advantage of the technological developments and at the same time provide increased diagnostic and treatment capabilities to doctors. A step to be considered for facilitating this aim is to involve more actively the doctor in building the fundamental steps for creating the EHR system and database. A global clinical patient record database management system can be electronically created by simulating real life medical practice health record taking and utilizing, analyzing the recorded parameters. This proposed approach demonstrates the effective implementation of a universal classic medical record in electronic form, a procedure by which, clinicians are led to utilize algorithms and intelligent systems for their differential diagnosis, final diagnosis and treatment strategies.

  5. Health Care Personnel Perception of the Privacy of Electronic Health Records.

    PubMed

    Saito, Kenji; Shofer, Frances S; Saberi, Poune; Green-McKenzie, Judith

    2017-06-01

    : Health care facilities are increasingly converting paper medical records to electronic health records. This study investigates the perception of privacy health care personnel have of electronic health records. A pilot tested, anonymous survey was administered to a convenience sample of health care personnel. Standard summary statistics and Chi-square analysis were used to assess differences in perception. Of the 93% (96/103) who responded, 65% were female and 43% white. The mean age was 44.3 years. Most (94%) felt that Medical Record privacy was important and one-third reported they would not seek care at their workplace if Electronic Health Records were used. Efforts to assure and communicate the integrity of electronic health records are essential toward reducing deterrents for health care personnel to access geographically convenient and timely health care.

  6. GSFC specification electronic data processing magnetic recording tape

    NASA Technical Reports Server (NTRS)

    Tinari, D. F.; Perry, J. L.

    1980-01-01

    The design requirements are given for magnetic oxide coated, electronic data processing tape, wound on reels. Magnetic recording tape types covered by this specification are intended for use on digital tape transports using the Non-Return-to-Zero-change-on-ones (NRZI) recording method for recording densities up to and including 800 characters per inch (cpi) and the Phase-Encoding (PE) recording method for a recording density of 1600 cpi.

  7. The need for academic electronic health record systems in nurse education.

    PubMed

    Chung, Joohyun; Cho, Insook

    2017-07-01

    The nursing profession has been slow to incorporate information technology into formal nurse education and practice. The aim of this study was to identify the use of academic electronic health record systems in nurse education and to determine student and faculty perceptions of academic electronic health record systems in nurse education. A quantitative research design with supportive qualitative research was used to gather information on nursing students' perceptions and nursing faculty's perceptions of academic electronic health record systems in nurse education. Eighty-three participants (21 nursing faculty and 62 students), from 5 nursing schools, participated in the study. A purposive sample of 9 nursing faculty was recruited from one university in the Midwestern United States to provide qualitative data for the study. The researcher-designed surveys (completed by faculty and students) were used for quantitative data collection. Qualitative data was taken from interviews, which were transcribed verbatim for analysis. Students and faculty agreed that academic electronic health record systems could be useful for teaching students to think critically about nursing documentation. Quantitative and qualitative findings revealed that academic electronic health record systems regarding nursing documentation could help prepare students for the future of health information technology. Meaningful adoption of academic electronic health record systems will help in building the undergraduate nursing students' competence in nursing documentation with electronic health record systems. Copyright © 2017. Published by Elsevier Ltd.

  8. 36 CFR § 1235.44 - What general transfer requirements apply to electronic records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements apply to electronic records? § 1235.44 Section § 1235.44 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF RECORDS TO THE NATIONAL... requirements apply to electronic records? (a) Each agency must retain a copy of permanent electronic records...

  9. Management of laboratory data and information exchange in the electronic health record.

    PubMed

    Wilkerson, Myra L; Henricks, Walter H; Castellani, William J; Whitsitt, Mark S; Sinard, John H

    2015-03-01

    In the era of the electronic health record, the success of laboratories and pathologists will depend on effective presentation and management of laboratory information, including test orders and results, and effective exchange of data between the laboratory information system and the electronic health record. In this third paper of a series that explores empowerment of pathology in the era of the electronic health record, we review key elements of managing laboratory information within the electronic health record and examine functional issues pertinent to pathologists and laboratories in the exchange of laboratory information between electronic health records and both anatomic and clinical pathology laboratory information systems. Issues with electronic order-entry and results-reporting interfaces are described, and considerations for setting up these interfaces are detailed in tables. The role of the laboratory medical director as mandated by the Clinical Laboratory Improvement Amendments of 1988 and the impacts of discordance between laboratory results and their display in the electronic health record are also discussed.

  10. The Regulation of Catch in Molluscan Muscle

    PubMed Central

    Twarog, Betty M.

    1967-01-01

    Molluscan catch muscles are smooth muscles. As with mammalian smooth muscles, there is no transverse ordering of filaments or dense bodies. In contrast to mammalian smooth muscles, two size ranges of filaments are present. The thick filaments are long as well as large in diameter and contain paramyosin. The thin filaments contain actin and appear to run into and join the dense bodies. Vesicles are present which may be part of a sarcoplasmic reticulum. Neural activation of contraction in Mytilus muscle is similar to that observed in mammalian smooth muscles, and in some respects to frog striated muscle. The relaxing nerves, which reduce catch, are unique to catch muscles. 5-Hydroxytryptamine, which appears to mediate relaxation, specifically blocks catch tension but increases the ability of the muscle to fire spikes. It is speculated that Mytilus muscle actomyosin is activated by a Ca++-releasing mechanism, and that 5-hydroxytryptamine may reduce catch and increase excitability by influencing the rate of removal of intracellular free Ca++. PMID:6050594

  11. Catch shares slow the race to fish.

    PubMed

    Birkenbach, Anna M; Kaczan, David J; Smith, Martin D

    2017-04-13

    In fisheries, the tragedy of the commons manifests as a competitive race to fish that compresses fishing seasons, resulting in ecological damage, economic waste, and occupational hazards. Catch shares are hypothesized to halt the race by securing each individual's right to a portion of the total catch, but there is evidence for this from selected examples only. Here we systematically analyse natural experiments to test whether catch shares reduce racing in 39 US fisheries. We compare each fishery treated with catch shares to an individually matched control before and after the policy change. We estimate an average policy treatment effect in a pooled model and in a meta-analysis that combines separate estimates for each treatment-control pair. Consistent with the theory that market-based management ends the race to fish, we find strong evidence that catch shares extend fishing seasons. This evidence informs the current debate over expanding the use of market-based regulation to other fisheries.

  12. Catch shares slow the race to fish

    NASA Astrophysics Data System (ADS)

    Birkenbach, Anna M.; Kaczan, David J.; Smith, Martin D.

    2017-04-01

    In fisheries, the tragedy of the commons manifests as a competitive race to fish that compresses fishing seasons, resulting in ecological damage, economic waste, and occupational hazards. Catch shares are hypothesized to halt the race by securing each individual’s right to a portion of the total catch, but there is evidence for this from selected examples only. Here we systematically analyse natural experiments to test whether catch shares reduce racing in 39 US fisheries. We compare each fishery treated with catch shares to an individually matched control before and after the policy change. We estimate an average policy treatment effect in a pooled model and in a meta-analysis that combines separate estimates for each treatment-control pair. Consistent with the theory that market-based management ends the race to fish, we find strong evidence that catch shares extend fishing seasons. This evidence informs the current debate over expanding the use of market-based regulation to other fisheries.

  13. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

  14. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

  15. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

  16. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

  17. Patient information: confidentiality and the electronic record.

    PubMed

    Griffith, Richard

    The rise of the electronic record now allows nurses to access a large archive of patient information that was more difficult to obtain when records consisted of manually held paper files. There have been several instances where curiosity and, occasionally, more malicious motivations have led nurses to access these records and read the notes of a celebrity or a person they know. In this article, Richard Griffith considers whether nurses' accessing and reading of the record of someone who is not in their care is in breach of their duty of confidentiality.

  18. Preserving electronic records: Not the easiest task

    NASA Technical Reports Server (NTRS)

    Eaton, Fynnette

    1993-01-01

    The National Archives and Records Administration has had a program for accessioning, describing, preserving and providing reference service to the electronic records (machine-readable records) created by Federal agencies for more than twenty years. Although there have been many changes in the name of the office, its basic mission has remained the same: to preserve and make available those records created by Federal agencies that the National Archives has determined to have value beyond the short-term need of the originating agency. A phrase that was once coined for a preservation conference still applies: the National Archives, when it decides to accept the transfer of records into its custody, is committing itself to preserving these records for perpetuity.

  19. 36 CFR 1236.20 - What are appropriate recordkeeping systems for electronic records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... into the electronic information system or records can be transferred to an electronic recordkeeping... and retrieval. Establish the appropriate rights for users to access the records and facilitate the search and retrieval of records. (6) Preserve records. Ensure that all records in the system are...

  20. 36 CFR 1236.20 - What are appropriate recordkeeping systems for electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... into the electronic information system or records can be transferred to an electronic recordkeeping... and retrieval. Establish the appropriate rights for users to access the records and facilitate the search and retrieval of records. (6) Preserve records. Ensure that all records in the system are...

  1. 36 CFR 1236.20 - What are appropriate recordkeeping systems for electronic records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... into the electronic information system or records can be transferred to an electronic recordkeeping... and retrieval. Establish the appropriate rights for users to access the records and facilitate the search and retrieval of records. (6) Preserve records. Ensure that all records in the system are...

  2. 36 CFR 1236.20 - What are appropriate recordkeeping systems for electronic records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... into the electronic information system or records can be transferred to an electronic recordkeeping... and retrieval. Establish the appropriate rights for users to access the records and facilitate the search and retrieval of records. (6) Preserve records. Ensure that all records in the system are...

  3. Assessment of Caspian Seal By-Catch in an Illegal Fishery Using an Interview-Based Approach

    PubMed Central

    Dmitrieva, Lilia; Kondakov, Andrey A.; Oleynikov, Eugeny; Kydyrmanov, Aidyn; Karamendin, Kobey; Kasimbekov, Yesbol; Baimukanov, Mirgaliy; Wilson, Susan; Goodman, Simon J.

    2013-01-01

    The Caspian seal (Pusa caspica) has declined by more than 90% since 1900 and is listed as endangered by IUCN. We made the first quantitative assessment of Caspian seal by-catch mortality in fisheries in the north Caspian Sea by conducting semi-structured interviews in fishing communities along the coasts of Russia (Kalmykia, Dagestan), Kazakhstan and Turkmenistan. We recorded a documented minimum by-catch of 1,215 seals in the survey sample, for the 2008–2009 fishing season, 93% of which occurred in illegal sturgeon fisheries. Due to the illegal nature of the fishery, accurately quantifying total fishing effort is problematic and the survey sample could reflect less than 10% of poaching activity in the north Caspian Sea. Therefore total annual by-catch may be significantly greater than the minimum documented by the survey. The presence of high by-catch rates was supported independently by evidence of net entanglement from seal carcasses, during a mass stranding on the Kazakh coast in May 2009, where 30 of 312 carcasses were entangled in large mesh sturgeon net remnants. The documented minimum by-catch may account for 5 to 19% of annual pup production. Sturgeon poaching therefore not only represents a serious threat to Caspian sturgeon populations, but may also be having broader impacts on the Caspian Sea ecosystem by contributing to a decline in one of the ecosystem’s key predators. This study demonstrates the utility of interview-based approaches in providing rapid assessments of by-catch in illegal small-scale fisheries, which are not amenable to study by other methods. PMID:23840590

  4. Assessment of Caspian Seal By-Catch in an Illegal Fishery Using an Interview-Based Approach.

    PubMed

    Dmitrieva, Lilia; Kondakov, Andrey A; Oleynikov, Eugeny; Kydyrmanov, Aidyn; Karamendin, Kobey; Kasimbekov, Yesbol; Baimukanov, Mirgaliy; Wilson, Susan; Goodman, Simon J

    2013-01-01

    The Caspian seal (Pusa caspica) has declined by more than 90% since 1900 and is listed as endangered by IUCN. We made the first quantitative assessment of Caspian seal by-catch mortality in fisheries in the north Caspian Sea by conducting semi-structured interviews in fishing communities along the coasts of Russia (Kalmykia, Dagestan), Kazakhstan and Turkmenistan. We recorded a documented minimum by-catch of 1,215 seals in the survey sample, for the 2008-2009 fishing season, 93% of which occurred in illegal sturgeon fisheries. Due to the illegal nature of the fishery, accurately quantifying total fishing effort is problematic and the survey sample could reflect less than 10% of poaching activity in the north Caspian Sea. Therefore total annual by-catch may be significantly greater than the minimum documented by the survey. The presence of high by-catch rates was supported independently by evidence of net entanglement from seal carcasses, during a mass stranding on the Kazakh coast in May 2009, where 30 of 312 carcasses were entangled in large mesh sturgeon net remnants. The documented minimum by-catch may account for 5 to 19% of annual pup production. Sturgeon poaching therefore not only represents a serious threat to Caspian sturgeon populations, but may also be having broader impacts on the Caspian Sea ecosystem by contributing to a decline in one of the ecosystem's key predators. This study demonstrates the utility of interview-based approaches in providing rapid assessments of by-catch in illegal small-scale fisheries, which are not amenable to study by other methods.

  5. Exploring patients' perceptions of accessing electronic health records: Innovation in healthcare.

    PubMed

    Wass, Sofie; Vimarlund, Vivian; Ros, Axel

    2017-04-01

    The more widespread implementation of electronic health records has led to new ways of providing access to healthcare information, allowing patients to view their medical notes, test results, medicines and so on. In this article, we explore how patients perceive the possibility to access their electronic health record online and whether this influences patient involvement. The study includes interviews with nine patients and a survey answered by 56 patients. Our results show that patients perceive healthcare information to be more accessible and that electronic health record accessibility improves recall, understanding and patient involvement. However, to achieve the goal of involving patients as active decision-makers in their own treatment, electronic health records need to be fully available and test results, referrals and information on drug interactions need to be offered. As patient access to electronic health records spreads, it is important to gain a deeper understanding of how documentation practices can be changed to serve healthcare professionals and patients.

  6. Implementation of standardized nomenclature in the electronic medical record.

    PubMed

    Klehr, Joan; Hafner, Jennifer; Spelz, Leah Mylrea; Steen, Sara; Weaver, Kathy

    2009-01-01

    To describe a customized electronic medical record documentation system which provides an electronic health record, Epic, which was implemented in December 2006 using standardized taxonomies for nursing documentation. Descriptive data is provided regarding the development, implementation, and evaluation processes for the electronic medical record system. Nurses used standardized nursing nomenclature including NANDA-I diagnoses, Nursing Interventions Classification, and Nursing Outcomes Classification in a measurable and user-friendly format using the care plan activity. Key factors in the success of the project included close collaboration among staff nurses and information technology staff, ongoing support and encouragement from the vice president/chief nursing officer, the ready availability of expert resources, and nursing ownership of the project. Use of this evidence-based documentation enhanced institutional leadership in clinical documentation.

  7. Implementation of electronic medical records

    PubMed Central

    Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

    2011-01-01

    Abstract Objective To study the effect of electronic medical record (EMR) implementation on preventive services covered by Ontario’s pay-for-performance program. Design Prospective double-cohort study. Participants Twenty-seven community-based family physicians. Setting Toronto, Ont. Intervention Eighteen physicians implemented EMRs, while 9 physicians continued to use paper records. Main outcome measure Provision of 4 preventive services affected by pay-for-performance incentives (Papanicolaou tests, screening mammograms, fecal occult blood testing, and influenza vaccinations) in the first 2 years of EMR implementation. Results After adjustment, combined preventive services for the EMR group increased by 0.7%, a smaller increase than that seen in the non-EMR group (P = .55, 95% confidence interval −2.8 to 3.9). Conclusion When compared with paper records, EMR implementation had no significant effect on the provision of the 4 preventive services studied. PMID:21998246

  8. Doctors' use of electronic medical records systems in hospitals: cross sectional survey

    PubMed Central

    Lærum, Hallvard; Ellingsen, Gunnar; Faxvaag, Arild

    2001-01-01

    Objectives To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. Design Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. Setting 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. Participants 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems. Main outcome measures Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar. Results Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems. Conclusions Doctors used electronic medical records systems for far fewer tasks than the systems supported. What is already known on this topicElectronic information systems in health care have not undergone systematic evaluation, and few comparisons between electronic medical records systems have been madeGiven the information intensive nature of clinical work, electronic medical records systems should be of help to doctors for most clinical tasksWhat this study addsDoctors in Norwegian hospitals reported a low level of use of all electronic medical records systems

  9. 76 FR 15349 - Advisory Committee on the Electronic Records Archives (ACERA); Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-21

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA); Meeting AGENCY: National Archives and Records Administration. ACTION: Notice of Meeting. SUMMARY... Archives and Records Administration (NARA) announces a meeting of the Advisory Committee on the Electronic...

  10. Moving electronic medical records upstream: incorporating social determinants of health.

    PubMed

    Gottlieb, Laura M; Tirozzi, Karen J; Manchanda, Rishi; Burns, Abby R; Sandel, Megan T

    2015-02-01

    Knowledge of the biological pathways and mechanisms connecting social factors with health has increased exponentially over the past 25 years, yet in most clinical settings, screening and intervention around social determinants of health are not part of standard clinical care. Electronic medical records provide new opportunities for assessing and managing social needs in clinical settings, particularly those serving vulnerable populations. To illustrate the feasibility of capturing information and promoting interventions related to social determinants of health in electronic medical records. Three case studies were examined in which electronic medical records have been used to collect data and address social determinants of health in clinical settings. From these case studies, we identified multiple functions that electronic medical records can perform to facilitate the integration of social determinants of health into clinical systems, including screening, triaging, referring, tracking, and data sharing. If barriers related to incentives, training, and privacy can be overcome, electronic medical record systems can improve the integration of social determinants of health into healthcare delivery systems. More evidence is needed to evaluate the impact of such integration on health care outcomes before widespread adoption can be recommended. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    PubMed

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration.

  12. Electronic health records: what are the most important barriers?

    PubMed

    Ayatollahi, Haleh; Mirani, Nader; Haghani, Hamid

    2014-01-01

    The process of design and adoption of electronic health records may face a number of barriers. This study aimed to compare the importance of the main barriers from the experts' point of views in Iran. This survey study was completed in 2011. The potential participants (62 experts) included faculty members who worked in departments of health information technology and individuals who worked in the Ministry of Health in Iran and were in charge of the development and adoption of electronic health records. No sampling method was used in this study. Data were collected using a Likert-scale questionnaire ranging from 1 to 5. The validity of the questionnaire was established using content and face validity methods, and the reliability was calculated using Cronbach's alpha coefficient. The response rate was 51.6 percent. The participants' perspectives showed that the most important barriers in the process of design and adoption of electronic health records were technical barriers (mean = 3.84). Financial and ethical-legal barriers, with the mean value of 3.80 were other important barriers, and individual and organizational barriers, with the mean values of 3.59 and 3.50 were found to be less important than other barriers from the experts' perspectives. Strategic planning for the creation and adoption of electronic health records in the country, creating a team of experts to assess the potential barriers and develop strategies to eliminate them, and allocating financial resources can help to overcome most important barriers to the adoption of electronic health records.

  13. The Relationship Between Magnet Designation, Electronic Health Record Adoption, and Medicare Meaningful Use Payments.

    PubMed

    Lippincott, Christine; Foronda, Cynthia; Zdanowicz, Martin; McCabe, Brian E; Ambrosia, Todd

    2017-08-01

    The objective of this study was to examine the relationship between nursing excellence and electronic health record adoption. Of 6582 US hospitals, 4939 were eligible for the Medicare Electronic Health Record Incentive Program, and 6419 were eligible for evaluation on the HIMSS Analytics Electronic Medical Record Adoption Model. Of 399 Magnet hospitals, 330 were eligible for the Medicare Electronic Health Record Incentive Program, and 393 were eligible for evaluation in the HIMSS Analytics Electronic Medical Record Adoption Model. Meaningful use attestation was defined as receipt of a Medicare Electronic Health Record Incentive Program payment. The adoption electronic health record was defined as Level 6 and/or 7 on the HIMSS Analytics Electronic Medical Record Adoption Model. Logistic regression showed that Magnet-designated hospitals were more likely attest to Meaningful Use than non-Magnet hospitals (odds ratio = 3.58, P < .001) and were more likely to adopt electronic health records than non-Magnet hospitals (Level 6 only: odds ratio = 3.68, P < .001; Level 6 or 7: odds ratio = 4.02, P < .001). This study suggested a positive relationship between Magnet status and electronic health record use, which involves earning financial incentives for successful adoption. Continued investigation is needed to examine the relationships between the quality of nursing care, electronic health record usage, financial implications, and patient outcomes.

  14. Catch-up Growth: Cellular and Molecular Mechanisms

    PubMed Central

    Finkielstain, GP; Lui, JC; Baron, J

    2012-01-01

    In mammals, after a period of growth inhibition, body growth often does not just return to a normal rate but actually exceeds the normal rate, resulting in catch-up growth. Recent evidence suggests that catch-up growth occurs because growth-inhibiting conditions delay progression of the physiological mechanisms that normally cause body growth to slow and cease with age. As a result, following the period of growth inhibition, tissues retain a greater proliferative capacity than normal, and therefore grow more rapidly than normal for age. There is evidence that this mechanism contributes both to catch-up growth in terms of body length, which involves proliferation in the growth plate, and to catch-up growth in terms of organ mass, which involves proliferation in multiple non-skeletal tissues. PMID:23428687

  15. High fishery catches through trophic cascades in China.

    PubMed

    Szuwalski, Cody S; Burgess, Matthew G; Costello, Christopher; Gaines, Steven D

    2017-01-24

    Indiscriminate and intense fishing has occurred in many marine ecosystems around the world. Although this practice may have negative effects on biodiversity and populations of individual species, it may also increase total fishery productivity by removing predatory fish. We examine the potential for this phenomenon to explain the high reported wild catches in the East China Sea-one of the most productive ecosystems in the world that has also had its catch reporting accuracy and fishery management questioned. We show that reported catches can be approximated using an ecosystem model that allows for trophic cascades (i.e., the depletion of predators and consequent increases in production of their prey). This would be the world's largest known example of marine ecosystem "engineering" and suggests that trade-offs between conservation and food production exist. We project that fishing practices could be modified to increase total catches, revenue, and biomass in the East China Sea, but single-species management would decrease both catches and revenue by reversing the trophic cascades. Our results suggest that implementing single-species management in currently lightly managed and highly exploited multispecies fisheries (which account for a large fraction of global fish catch) may result in decreases in global catch. Efforts to reform management in these fisheries will need to consider system wide impacts of changes in management, rather than focusing only on individual species.

  16. High fishery catches through trophic cascades in China

    PubMed Central

    Szuwalski, Cody S.; Burgess, Matthew G.; Costello, Christopher; Gaines, Steven D.

    2017-01-01

    Indiscriminate and intense fishing has occurred in many marine ecosystems around the world. Although this practice may have negative effects on biodiversity and populations of individual species, it may also increase total fishery productivity by removing predatory fish. We examine the potential for this phenomenon to explain the high reported wild catches in the East China Sea—one of the most productive ecosystems in the world that has also had its catch reporting accuracy and fishery management questioned. We show that reported catches can be approximated using an ecosystem model that allows for trophic cascades (i.e., the depletion of predators and consequent increases in production of their prey). This would be the world’s largest known example of marine ecosystem “engineering” and suggests that trade-offs between conservation and food production exist. We project that fishing practices could be modified to increase total catches, revenue, and biomass in the East China Sea, but single-species management would decrease both catches and revenue by reversing the trophic cascades. Our results suggest that implementing single-species management in currently lightly managed and highly exploited multispecies fisheries (which account for a large fraction of global fish catch) may result in decreases in global catch. Efforts to reform management in these fisheries will need to consider system wide impacts of changes in management, rather than focusing only on individual species. PMID:28028218

  17. Electronic health records: eliciting behavioral health providers' beliefs.

    PubMed

    Shank, Nancy; Willborn, Elizabeth; Pytlikzillig, Lisa; Noel, Harmonijoie

    2012-04-01

    Interviews with 32 community behavioral health providers elicited perceived benefits and barriers of using electronic health records. Themes identified were (a) quality of care, (b) privacy and security, and (c) delivery of services. Benefits to quality of care were mentioned by 100% of the providers, and barriers by 59% of providers. Barriers involving privacy and security concerns were mentioned by 100% of providers, and benefits by 22%. Barriers to delivery of services were mentioned by 97% of providers, and benefits by 66%. Most providers (81%) expressed overall positive support for electronic behavioral health records.

  18. Temperature effects on pitfall catches of epigeal arthropods: a model and method for bias correction.

    PubMed

    Saska, Pavel; van der Werf, Wopke; Hemerik, Lia; Luff, Martin L; Hatten, Timothy D; Honek, Alois; Pocock, Michael

    2013-02-01

    Carabids and other epigeal arthropods make important contributions to biodiversity, food webs and biocontrol of invertebrate pests and weeds. Pitfall trapping is widely used for sampling carabid populations, but this technique yields biased estimates of abundance ('activity-density') because individual activity - which is affected by climatic factors - affects the rate of catch. To date, the impact of temperature on pitfall catches, while suspected to be large, has not been quantified, and no method is available to account for it. This lack of knowledge and the unavailability of a method for bias correction affect the confidence that can be placed on results of ecological field studies based on pitfall data.Here, we develop a simple model for the effect of temperature, assuming a constant proportional change in the rate of catch per °C change in temperature, r , consistent with an exponential Q 10 response to temperature. We fit this model to 38 time series of pitfall catches and accompanying temperature records from the literature, using first differences and other detrending methods to account for seasonality. We use meta-analysis to assess consistency of the estimated parameter r among studies.The mean rate of increase in total catch across data sets was 0·0863 ± 0·0058 per °C of maximum temperature and 0·0497 ± 0·0107 per °C of minimum temperature. Multiple regression analyses of 19 data sets showed that temperature is the key climatic variable affecting total catch. Relationships between temperature and catch were also identified at species level. Correction for temperature bias had substantial effects on seasonal trends of carabid catches. Synthesis and Applications . The effect of temperature on pitfall catches is shown here to be substantial and worthy of consideration when interpreting results of pitfall trapping. The exponential model can be used both for effect estimation and for bias correction of observed data. Correcting for temperature

  19. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for managing...

  20. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for managing...

  1. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for managing...

  2. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for managing...

  3. Synthesis of underreported small-scale fisheries catch in Pacific island waters

    NASA Astrophysics Data System (ADS)

    Zeller, D.; Harper, S.; Zylich, K.; Pauly, D.

    2015-03-01

    We synthesize fisheries catch reconstruction studies for 25 Pacific island countries, states and territories, which compare estimates of total domestic catches with officially reported catch data. We exclude data for the large-scale tuna fleets, which have largely foreign beneficial ownership, even when flying Pacific flags. However, we recognize the considerable financial contributions derived from foreign access or charter fees for Pacific host countries. The reconstructions for the 25 entities from 1950 to 2010 suggested that total domestic catches were 2.5 times the data reported to FAO. This discrepancy was largest in early periods (1950: 6.4 times), while for 2010, total catches were 1.7 times the reported data. There was a significant difference in trend between reported and reconstructed catches since 2000, with reconstructed catches declining strongly since their peak in 2000. Total catches increased from 110,000 t yr-1 in 1950 (of which 17,400 t were reported) to a peak of over 250,000 t yr-1 in 2000, before declining to around 200,000 t yr-1 by 2010. This decrease is driven by a declining artisanal (small-scale commercial) catch, which was not compensated for by increasing domestic industrial (large-scale commercial) catches. The artisanal fisheries appear to be declining from a peak of 97,000 t yr-1 in 1992 to less than 50,000 t yr-1 by 2010. However, total catches were dominated by subsistence (small-scale, non-commercial) fisheries, which accounted for 69 % of total catches, with the majority missing from the reported data. Artisanal catches accounted for 22 %, while truly domestic industrial fisheries accounted for only 6 % of total catches. The smallest component is the recreational (small-scale, non-commercial and largely for leisure) sector (2 %), which, although small in catch, is likely of economic importance in some areas due to its direct link to tourism income.

  4. Natural communities in catch basins in southern Rhode Island

    USGS Publications Warehouse

    Butler, M.; Ginsberg, H.S.; LeBrun, R.A.; Gettman, A.D.; Pollnak, F.

    2007-01-01

    Storm-water drainage catch basins are manmade structures that often contain water and organic matter, making them suitable environments for various organisms. We censused organisms inhabiting catch basins in southern Rhode Island in 2002 in an effort to begin to describe these communities. Catch-basin inhabitants were mostly detritivores, including annelids, arthropods, and mollusks that could withstand low oxygen levels and droughts. Our results suggest that catch-basin inhabitants were mostly washed in with rainwater, and populations increased over the summer season as biotic activity resulted in increased nutrient levels later in the summer. In contrast, mosquitoes and other Diptera larvae were abundant earlier in the summer because the adults actively sought catch basins for oviposition sites. Mosquito larvae were likely to be abundant in catch basins with shallow, stagnant water that had relatively low dissolved oxygen and pH, and relatively high total suspended solids, carbon, and nitrogen.

  5. Personal, Electronic, Secure National Library of Medicine Hosts Health Records Conference

    MedlinePlus

    ... Bar Home Current Issue Past Issues EHR Personal, Electronic, Secure: National Library of Medicine Hosts Health Records ... One suggestion for saving money is to implement electronic personal health records. With this in mind, the ...

  6. Personal health records as portal to the electronic medical record.

    PubMed

    Cahill, Jennifer E; Gilbert, Mark R; Armstrong, Terri S

    2014-03-01

    This topic review discusses the evolving clinical challenges associated with the implementation of electronic personal health records (PHR) that are fully integrated with electronic medical records (EMR). The benefits of facilitating patient access to the EMR through web-based, PHR-portals may be substantial; foremost is the potential to enhance the flow of information between patient and healthcare practitioner. The benefits of improved communication and transparency of care are presumed to be a reduction in clinical errors, increased quality of care, better patient-management of disease, and better disease and symptom comprehension. Yet PHR databases allow patients open access to newly-acquired clinical data without the benefit of concurrent expert clinical interpretation, and therefore may create the potential for greater patient distress and uncertainty. With specific attention to neuro-oncology patients, this review focuses on the developing conflicts and consequences associated with the use of a PHR that parallels data acquisition of the EMR in real-time. We conclude with a discussion of recommendations for implementing fully-integrated PHR for neuro-oncology patients.

  7. Patient Perceptions of Electronic Health Records

    ERIC Educational Resources Information Center

    Lulejian, Armine

    2011-01-01

    Research objective. Electronic Health Records (EHR) are expected to transform the way medicine is delivered with patients/consumers being the intended beneficiaries. However, little is known regarding patient knowledge and attitudes about EHRs. This study examined patient perceptions about EHR. Study design. Surveys were administered following…

  8. Implementation of the Agitated Behavior Scale in the Electronic Health Record.

    PubMed

    Wilson, Helen John; Dasgupta, Kritis; Michael, Kathleen

    The purpose of the study was to implement an Agitated Behavior Scale through an electronic health record and to evaluate the usability of the scale in a brain injury unit at a rehabilitation hospital. A quality improvement project was conducted in the brain injury unit at a large rehabilitation hospital with registered nurses as participants using convenience sampling. The project consisted of three phases and included education, implementation of the scale in the electronic health record, and administration of the survey questionnaire, which utilized the system usability scale. The Agitated Behavior Scale was found to be usable, and there was 92.2% compliance with the use of the electronic Electronic Agitated Behavior Scale. The Agitated Behavior Scale was effectively implemented in the electronic health record and was found to be usable in the assessment of agitation. Utilization of the scale through the electronic health record on a daily basis will allow for an early identification of agitation in patients with traumatic brain injury and enable prompt interventions to manage agitation.

  9. Patients' experiences when accessing their on-line electronic patient records in primary care.

    PubMed Central

    Pyper, Cecilia; Amery, Justin; Watson, Marion; Crook, Claire

    2004-01-01

    BACKGROUND: Patient access to on-line primary care electronic patient records is being developed nationally. Knowledge of what happens when patients access their electronic records is poor. AIM: To enable 100 patients to access their electronic records for the first time to elicit patients' views and to understand their requirements. DESIGN OF STUDY: In-depth interviews using semi-structured questionnaires as patients accessed their electronic records, plus a series of focus groups. SETTING: Secure facilities for patients to view their primary care records privately. METHOD: One hundred patients from a randomised group viewed their on-line electronic records for the first time. The questionnaire and focus groups addressed patients' views on the following topics: ease of use; confidentiality and security; consent to access; accuracy; printing records; expectations regarding content; exploitation of electronic records; receiving new information and bad news. RESULTS: Most patients found the computer technology used acceptable. The majority found viewing their record useful and understood most of the content, although medical terms and abbreviations required explanation. Patients were concerned about security and confidentiality, including potential exploitation of records. They wanted the facility to give informed consent regarding access and use of data. Many found errors, although most were not medically significant. Many expected more detail and more information. Patients wanted to add personal information. CONCLUSION: Patients have strong views on what they find acceptable regarding access to electronic records. Working in partnership with patients to develop systems is essential to their success. Further work is required to address legal and ethical issues of electronic records and to evaluate their impact on patients, health professionals and service provision. PMID:14965405

  10. Ethical questions must be considered for electronic health records.

    PubMed

    Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

    2012-09-01

    National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

  11. 36 CFR § 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? § 1236.6 Section § 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General...

  12. A preliminary survey of whale shark Rhincodon typus catch and trade in China: an emerging crisis.

    PubMed

    Li, W; Wang, Y; Norman, B

    2012-04-01

    This study gives an account of spatial and temporal distribution of whale shark Rhincodon typus catch events in China on the basis of historical records and information obtained from interviews with fishing industry stakeholders. A total of 186 R. typus were recorded with key harvest areas identified as in Hainan and Zhejiang, and the peak catching seasons were May to June and September to October. Aspects of the R. typus trade are discussed, including products, markets and the process. The results suggest that R. typus is increasingly becoming a targeted resource in China as a consequence of fierce competition for large shark fins and an emerging local market for consumption of all body parts. Current obstacles and potential measures for sustainable exploitation and trade of R. typus are discussed. © 2012 The Authors. Journal of Fish Biology © 2012 The Fisheries Society of the British Isles.

  13. Impact of an electronic medication administration record on medication administration efficiency and errors.

    PubMed

    McComas, Jeffery; Riingen, Michelle; Chae Kim, Son

    2014-12-01

    The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors.

  14. MedlinePlus Connect: Linking Patient Portals and Electronic Health Records to Health Information

    MedlinePlus

    ... Patient portals, patient health record (PHR) systems, and electronic health record (EHR) systems can use MedlinePlus Connect ... patient portal, patient health record (PHR) system, or electronic health record (EHR) system sends a problem, medication, ...

  15. Quantitative analysis of catch-up saccades during sustained pursuit.

    PubMed

    de Brouwer, Sophie; Missal, Marcus; Barnes, Graham; Lefèvre, Philippe

    2002-04-01

    During visual tracking of a moving stimulus, primates orient their visual axis by combining two very different types of eye movements, smooth pursuit and saccades. The purpose of this paper was to investigate quantitatively the catch-up saccades occurring during sustained pursuit. We used a ramp-step-ramp paradigm to evoke catch-up saccades during sustained pursuit. In general, catch-up saccades followed the unexpected steps in position and velocity of the target. We observed catch-up saccades in the same direction as the smooth eye movement (forward saccades) as well as in the opposite direction (reverse saccades). We made a comparison of the main sequences of forward saccades, reverse saccades, and control saccades made to stationary targets. They were all three significantly different from each other and were fully compatible with the hypothesis that the smooth pursuit component is added to the saccadic component during catch-up saccades. A multiple linear regression analysis was performed on the saccadic component to find the parameters determining the amplitude of catch-up saccades. We found that both position error and retinal slip are taken into account in catch-up saccade programming to predict the future trajectory of the moving target. We also demonstrated that the saccadic system needs a minimum period of approximately 90 ms for taking into account changes in target trajectory. Finally, we reported a saturation (above 15 degrees /s) in the contribution of retinal slip to the amplitude of catch-up saccades.

  16. 36 CFR § 1236.20 - What are appropriate recordkeeping systems for electronic records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... into the electronic information system or records can be transferred to an electronic recordkeeping... and retrieval. Establish the appropriate rights for users to access the records and facilitate the search and retrieval of records. (6) Preserve records. Ensure that all records in the system are...

  17. Improving electrofishing catch consistency by standardizing power

    USGS Publications Warehouse

    Burkhardt, Randy W.; Gutreuter, Steve

    1995-01-01

    The electrical output of electrofishing equipment is commonly standardized by using either constant voltage or constant amperage, However, simplified circuit and wave theories of electricity suggest that standardization of power (wattage) available for transfer from water to fish may be critical for effective standardization of electrofishing. Electrofishing with standardized power ensures that constant power is transferable to fish regardless of water conditions. The in situ performance of standardized power output is poorly known. We used data collected by the interagency Long Term Resource Monitoring Program (LTRMP) in the upper Mississippi River system to assess the effectiveness of standardizing power output. The data consisted of 278 electrofishing collections, comprising 9,282 fishes in eight species groups, obtained during 1990 from main channel border, backwater, and tailwater aquatic areas in four reaches of the upper Mississippi River and one reach of the Illinois River. Variation in power output explained an average of 14.9% of catch variance for night electrofishing and 12.1 % for day electrofishing. Three patterns in catch per unit effort were observed for different species: increasing catch with increasing power, decreasing catch with increasing power, and no power-related pattern. Therefore, in addition to reducing catch variation, controlling power output may provide some capability to select particular species. The LTRMP adopted standardized power output beginning in 1991; standardized power output is adjusted for variation in water conductivity and water temperature by reference to a simple chart. Our data suggest that by standardizing electrofishing power output, the LTRMP has eliminated substantial amounts of catch variation at virtually no additional cost.

  18. Future of electronic health records: implications for decision support.

    PubMed

    Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

    2012-01-01

    The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data

  19. Comparing catch orientation among Minnesota walleye, northern pike, and bass anglers

    USGS Publications Warehouse

    Schroeder, Susan A.; Fulton, David C.

    2013-01-01

    We compared the catch orientations of Minnesota walleye (Sander vitreus), northern pike (Esox lucius), largemouth bass (Micropterus salmoides), and smallmouth bass (Micropterus dolomieu) anglers. Results were derived from 2009, 2010, and 2012 surveys of anglers targeting these different species. Consistent with previous research, we identified four dimensions of anglers’ catch orientation: (a) catching something, (b) catching big fish, (c) catching many fish, and (d) keeping fish. Walleye anglers were the most motivated to keep fish, while northern pike anglers were more oriented toward catching big fish. Largemouth bass anglers, and to a lesser extent smallmouth bass anglers, were also oriented toward catching big fish. Bass anglers reported the lowest interest in keeping fish. An orientation to keep fish was negatively related to more restrictive management actions, regardless of species. A stronger orientation to catch big fish was associated with support for increased harvest restrictions only for northern pike and smallmouth bass.

  20. Ethical, legal, and social implications of incorporating genomic information into electronic health records.

    PubMed

    Hazin, Ribhi; Brothers, Kyle B; Malin, Bradley A; Koenig, Barbara A; Sanderson, Saskia C; Rothstein, Mark A; Williams, Marc S; Clayton, Ellen W; Kullo, Iftikhar J

    2013-10-01

    The inclusion of genomic data in the electronic health record raises important ethical, legal, and social issues. In this article, we highlight these challenges and discuss potential solutions. We provide a brief background on the current state of electronic health records in the context of genomic medicine, discuss the importance of equitable access to genome-enabled electronic health records, and consider the potential use of electronic health records for improving genomic literacy in patients and providers. We highlight the importance of privacy, access, and security, and of determining which genomic information is included in the electronic health record. Finally, we discuss the challenges of reporting incidental findings, storing and reinterpreting genomic data, and nondocumentation and duty to warn family members at potential genetic risk.

  1. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional... accordance with the provisions of GRS 23, Item 5. (5) Draft documents that are circulated on electronic mail...

  2. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional... accordance with the provisions of GRS 23, Item 5. (5) Draft documents that are circulated on electronic mail...

  3. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional... accordance with the provisions of GRS 23, Item 5. (5) Draft documents that are circulated on electronic mail...

  4. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional... accordance with the provisions of GRS 23, Item 5. (5) Draft documents that are circulated on electronic mail...

  5. Muskie Lunacy: does the lunar cycle influence angler catch of muskellunge (Esox masquinongy)?

    PubMed

    Vinson, Mark R; Angradi, Ted R

    2014-01-01

    We analyzed angling catch records for 341,959 muskellunge (Esox masquinongy) from North America to test for a cyclic lunar influence on the catch. Using periodic regression, we showed that the number caught was strongly related to the 29-day lunar cycle, and the effect was consistent across most fisheries. More muskellunge were caught around the full and new moon than at other times. At night, more muskellunge were caught around the full moon than the new moon. The predicted maximum relative effect was ≈5% overall. Anglers fishing exclusively on the peak lunar day would, on average, catch 5% more muskellunge than anglers fishing on random days. On some lakes and at night, the maximum relative effect was higher. We obtained angler effort data for Wisconsin, Mille Lacs (MN), and Lake Vermilion (MN). For Lake Vermilion there was a significant effect of the lunar cycle on angler effort. We could therefore not conclude that the lunar effect on catch was due to an effect on fish behavior alone. Several factors affected the amount of variation explained by the lunar cycle. The lunar effect was stronger for larger muskellunge (>102 cm) than for smaller fish, stronger in midsummer than in June or October, and stronger for fish caught at high latitudes (>48°N) than for fish caught further south. There was no difference in the lunar effect between expert and novice muskellunge anglers. We argue that this variation is evidence that the effect of the lunar cycle on catch is mediated by biological factors and is not due solely to angler effort and reflects lunar synchronization in feeding. This effect has been attributed to variation among moon phases in lunar illumination, but our results do not support that hypothesis for angler-caught muskellunge.

  6. Muskie lunacy: does the lunar cycle influence angler catch of muskellunge (Esox masquinongy)?

    USGS Publications Warehouse

    Vinson, Mark R.; Angradi, Ted R.

    2014-01-01

    We analyzed angling catch records for 341,959 muskellunge (Esox masquinongy) from North America to test for a cyclic lunar influence on the catch. Using periodic regression, we showed that the number caught was strongly related to the 29-day lunar cycle, and the effect was consistent across most fisheries. More muskellunge were caught around the full and new moon than at other times. At night, more muskellunge were caught around the full moon than the new moon. The predicted maximum relative effect was ≈5% overall. Anglers fishing exclusively on the peak lunar day would, on average, catch 5% more muskellunge than anglers fishing on random days. On some lakes and at night, the maximum relative effect was higher. We obtained angler effort data for Wisconsin, Mille Lacs (MN), and Lake Vermilion (MN). For Lake Vermilion there was a significant effect of the lunar cycle on angler effort. We could therefore not conclude that the lunar effect on catch was due to an effect on fish behavior alone. Several factors affected the amount of variation explained by the lunar cycle. The lunar effect was stronger for larger muskellunge (>102 cm) than for smaller fish, stronger in midsummer than in June or October, and stronger for fish caught at high latitudes (>48°N) than for fish caught further south. There was no difference in the lunar effect between expert and novice muskellunge anglers. We argue that this variation is evidence that the effect of the lunar cycle on catch is mediated by biological factors and is not due solely to angler effort and reflects lunar synchronization in feeding. This effect has been attributed to variation among moon phases in lunar illumination, but our results do not support that hypothesis for angler-caught muskellunge.

  7. Muskie Lunacy: Does the Lunar Cycle Influence Angler Catch of Muskellunge (Esox masquinongy)?

    PubMed Central

    Vinson, Mark R.; Angradi, Ted R.

    2014-01-01

    We analyzed angling catch records for 341,959 muskellunge (Esox masquinongy) from North America to test for a cyclic lunar influence on the catch. Using periodic regression, we showed that the number caught was strongly related to the 29-day lunar cycle, and the effect was consistent across most fisheries. More muskellunge were caught around the full and new moon than at other times. At night, more muskellunge were caught around the full moon than the new moon. The predicted maximum relative effect was ≈5% overall. Anglers fishing exclusively on the peak lunar day would, on average, catch 5% more muskellunge than anglers fishing on random days. On some lakes and at night, the maximum relative effect was higher. We obtained angler effort data for Wisconsin, Mille Lacs (MN), and Lake Vermilion (MN). For Lake Vermilion there was a significant effect of the lunar cycle on angler effort. We could therefore not conclude that the lunar effect on catch was due to an effect on fish behavior alone. Several factors affected the amount of variation explained by the lunar cycle. The lunar effect was stronger for larger muskellunge (>102 cm) than for smaller fish, stronger in midsummer than in June or October, and stronger for fish caught at high latitudes (>48°N) than for fish caught further south. There was no difference in the lunar effect between expert and novice muskellunge anglers. We argue that this variation is evidence that the effect of the lunar cycle on catch is mediated by biological factors and is not due solely to angler effort and reflects lunar synchronization in feeding. This effect has been attributed to variation among moon phases in lunar illumination, but our results do not support that hypothesis for angler-caught muskellunge. PMID:24871329

  8. Perceptions of electronic health record implementation: a statewide survey of physicians in Rhode Island.

    PubMed

    Wylie, Matthew C; Baier, Rosa R; Gardner, Rebekah L

    2014-10-01

    Although electronic health record use improves healthcare delivery, adoption into clinical practice is incomplete. We sought to identify the extent of adoption in Rhode Island and the characteristics of physicians and electronic health records associated with positive experience. We performed a cross-sectional study of data collected by the Rhode Island Department of Health for the Health Information Technology Survey 2009 to 2013. Survey questions included provider and practice demographics, health record information, and Likert-type scaled questions regarding how electronic health record use affected clinical practice. The survey response rate ranged from 50% to 65%, with 62% in 2013. Increasing numbers of physicians in Rhode Island use an electronic health record. In 2013, 81% of physicians used one, and adoption varied by clinical subspecialty. Most providers think that electronic health record use improves billing and quality improvement but has not improved job satisfaction. Physicians with longer and more sophisticated electronic health record use report positive effects of introduction on all aspects of practice examined (P < .001). Older physician age is associated with worse opinion of electronic health record introduction (P < .001). Of the 18 electronic health record vendors most frequently used in Rhode Island, 5 were associated with improved job satisfaction. We report the largest statewide study of electronic health record adoption to date. We found increasing physician use in Rhode Island, and the extent of adoption varies by subspecialty. Although older physicians are less likely to be positive about electronic health record adoption, longer and more sophisticated use are associated with more positive opinions, suggesting acceptance will grow over time. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Are low income patients receiving the benefits of electronic health records? A statewide survey.

    PubMed

    Butler, Matthew J; Harootunian, Gevork; Johnson, William G

    2013-06-01

    There are concerns that physicians serving low-income, Medicaid patients, in the United States are less likely to adopt electronic health records and, if so, that Medicaid patients will be denied the benefits from electronic health record use. This study seeks to determine whether physicians treating Medicaid patients were less likely to have adopted electronic health records. Physician surveys completed during physicians' license renewal process in Arizona were merged with the physician licensing data and Medicaid administrative claims data. Survey responses were received from 50.7 percent (6,780 out of 13,380) of all physicians practicing in Arizona. Physician survey responses were used to identify whether the physician used electronic health records and the degree to which the physician exchanged electronic health records with other health-care providers. Medicaid claims data were used to identify which physicians provided health care to Medicaid beneficiaries. The primary outcome of interest was whether Medicaid providers were more or less likely to have adopted electronic health records. Logistic regression analysis was used to estimate average marginal effects. In multivariate analysis, physicians with 20 or more Medicaid patients during the survey cycle were 4.1 percent more likely to use an electronic health record and 5.2 percent more likely to be able to transmit electronic health records to at least one health-care provider outside of their practice. These effects increase in magnitude when the analysis is restricted to solo practice physicians This is the first study to find a pro-Medicaid gap in electronic health record adoption suggesting that the low income patients served by Arizona's Health Care Cost Containment System are not at a disadvantage with regard to electronic health record access and that Arizona's model of promoting electronic health record adoption merits further study.

  10. 36 CFR 1235.50 - What specifications and standards for transfer apply to electronic records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF REC- ORDS TO THE... Records Administration, Electronic/Special Media Records Services Division (NWME), 8601 Adelphi Road... and Records Administration, Electronic/Special Media Records Services Division (NWME), 8601 Adelphi...

  11. 50 CFR 635.26 - Catch and release.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Catch and release. 635.26 Section 635.26 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE ATLANTIC HIGHLY MIGRATORY SPECIES Management Measures § 635.26 Catch and release. (a...

  12. 75 FR 12573 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-16

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National Archives and Records Administration. ACTION: Notice of meeting. SUMMARY: In... and Records Administration (NARA) announces a [[Page 12574

  13. Customization of electronic medical record templates to improve end-user satisfaction.

    PubMed

    Gardner, Carrie Lee; Pearce, Patricia F

    2013-03-01

    Since 2004, increasing importance has been placed on the adoption of electronic medical records by healthcare providers for documentation of patient care. Recent federal regulations have shifted the focus from adoption alone to meaningful use of an electronic medical record system. As proposed by the Technology Acceptance Model, the behavioral intention to use technology is determined by the person's attitude toward usage. The purpose of this quality improvement project was to devise and implement customized templates into an existent electronic medical record system in a single clinic and measure the satisfaction of the clinic providers with the system before and after implementation. Provider satisfaction with the electronic medical record system was evaluated prior to and following template implementation using the current version 7.0 of the Questionnaire for User Interaction Satisfaction tool. Provider comments and improvement in the Questionnaire for User Interaction Satisfaction levels of rankings following template implementation indicated a positive perspective by the providers in regard to the templates and customization of the system.

  14. Neonatal Nurses Experience Unintended Consequences and Risks to Patient Safety With Electronic Health Records.

    PubMed

    Dudding, Katherine M; Gephart, Sheila M; Carrington, Jane M

    2018-04-01

    In this article, we examine the unintended consequences of nurses' use of electronic health records. We define these as unforeseen events, change in workflow, or an unanticipated result of implementation and use of electronic health records. Unintended consequences experienced by nurses while using electronic health records have been well researched. However, few studies have focused on neonatal nurses, and it is unclear to what extent unintended consequences threaten patient safety. A new instrument called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire has been validated, and secondary analysis using the tool explored the phenomena among neonatal nurses (N = 40). The purposes of this study were to describe unintended consequences of use of electronic health records for neonatal nurses and to explore relationships between the phenomena and characteristics of the nurse and the electronic health record. The most frequent unintended consequences of electronic health record use were due to interruptions, followed by a heavier workload due to the electronic health record, changes to the workflow, and altered communication patterns. Neonatal nurses used workarounds most often with motivation to better assist patients. Teamwork was moderately related to higher unintended consequences including patient safety risks (r = 0.427, P = .007), system design (r = 0.419, P = .009), and technology barriers (r = 0.431, P = .007). Communication about patients was reduced when patient safety risks were high (r = -0.437, P = .003). By determining the frequency with which neonatal nurses experience unintended consequences of electronic health record use, future research can be targeted to improve electronic health record design through customization, integration, and refinement to support patient safety and better outcomes.

  15. 36 CFR § 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements for managing unstructured electronic records? § 1236.24 Section § 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for...

  16. Nurse's use of power to standardise nursing terminology in electronic health records.

    PubMed

    Ali, Samira; Sieloff, Christina L

    2017-07-01

    To describe nurses' use of power to influence the incorporation of standardised nursing terminology within electronic health records. Little is known about nurses' potential use of power to influence the incorporation of standardised nursing terminology within electronic health records. The theory of group power within organisations informed the design of the descriptive, cross-sectional study used a survey method to assess nurses' use of power to influence the incorporation of standardised nursing terminology within electronic health records. The Sieloff-King Assessment of Group Power within Organizations © and Nursing Power Scale was used. A total of 232 nurses responded to the survey. The mean power capability score was moderately high at 134.22 (SD 18.49), suggesting that nurses could use power to achieve the incorporation of standardised nursing terminology within electronic health records. The nurses' power capacity was significantly correlated with their power capability (r = 0.96, P < 0.001). Nurses may use power to achieve their goals, such as the incorporation of standardised nursing terminology within electronic health records. Nurse administrators may use their power to influence the incorporation of standardised nursing terminology within electronic health records. If nurses lack power, this could decrease nurses' ability to achieve their goals and contribute to the achievement of effective patient outcomes. © 2017 John Wiley & Sons Ltd.

  17. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance and...

  18. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance and...

  19. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance and...

  20. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance and...

  1. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance and...

  2. 36 CFR § 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements for managing electronic mail records? § 1236.22 Section § 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT... management requirements for electronic mail records: (1) The names of sender and all addressee(s) and date...

  3. A study on agent-based secure scheme for electronic medical record system.

    PubMed

    Chen, Tzer-Long; Chung, Yu-Fang; Lin, Frank Y S

    2012-06-01

    Patient records, including doctors' diagnoses of diseases, trace of treatments and patients' conditions, nursing actions, and examination results from allied health profession departments, are the most important medical records of patients in medical systems. With patient records, medical staff can instantly understand the entire medical information of a patient so that, according to the patient's conditions, more accurate diagnoses and more appropriate in-depth treatments can be provided. Nevertheless, in such a modern society with booming information technologies, traditional paper-based patient records have faced a lot of problems, such as lack of uniform formats, low data mobility, slow data transfer, illegible handwritings, enormous and insufficient storage space, difficulty of conservation, being easily damaged, and low transferability. To improve such drawbacks, reduce medical costs, and advance medical quality, paper-based patient records are modified into electronic medical records and reformed into electronic patient records. However, since electronic patient records used in various hospitals are diverse and different, in consideration of cost, it is rather difficult to establish a compatible and complete integrated electronic patient records system to unify patient records from heterogeneous systems in hospitals. Moreover, as the booming of the Internet, it is no longer necessary to build an integrated system. Instead, doctors can instantly look up patients' complete information through the Internet access to electronic patient records as well as avoid the above difficulties. Nonetheless, the major problem of accessing to electronic patient records cross-hospital systems exists in the security of transmitting and accessing to the records in case of unauthorized medical personnels intercepting or stealing the information. This study applies the Mobile Agent scheme to cope with the problem. Since a Mobile Agent is a program, which can move among hosts and

  4. Validation of asthma recording in electronic health records: protocol for a systematic review.

    PubMed

    Nissen, Francis; Quint, Jennifer K; Wilkinson, Samantha; Mullerova, Hana; Smeeth, Liam; Douglas, Ian J

    2017-05-29

    Asthma is a common, heterogeneous disease with significant morbidity and mortality worldwide. It can be difficult to define in epidemiological studies using electronic health records as the diagnosis is based on non-specific respiratory symptoms and spirometry, neither of which are routinely registered. Electronic health records can nonetheless be valuable to study the epidemiology, management, healthcare use and control of asthma. For health databases to be useful sources of information, asthma diagnoses should ideally be validated. The primary objectives are to provide an overview of the methods used to validate asthma diagnoses in electronic health records and summarise the results of the validation studies. EMBASE and MEDLINE will be systematically searched for appropriate search terms. The searches will cover all studies in these databases up to October 2016 with no start date and will yield studies that have validated algorithms or codes for the diagnosis of asthma in electronic health records. At least one test validation measure (sensitivity, specificity, positive predictive value, negative predictive value or other) is necessary for inclusion. In addition, we require the validated algorithms to be compared with an external golden standard, such as a manual review, a questionnaire or an independent second database. We will summarise key data including author, year of publication, country, time period, date, data source, population, case characteristics, clinical events, algorithms, gold standard and validation statistics in a uniform table. This study is a synthesis of previously published studies and, therefore, no ethical approval is required. The results will be submitted to a peer-reviewed journal for publication. Results from this systematic review can be used to study outcome research on asthma and can be used to identify case definitions for asthma. CRD42016041798. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  5. Designing an Electronic Personal Health Record for Professional Iranian Athletes

    PubMed Central

    Abdolkhani, Robab; Halabchi, Farzin; Safdari, Reza; Dargahi, Hossein; Shadanfar, Kamran

    2014-01-01

    Background: By providing sports organizations with electronic records and instruments that can be accessed at any time or place, specialized care can be offered to athletes regardless of injury location, and this makes the follow-up from first aid through to full recovery more efficient. Objectives: The aim of this study was to develop an electronic personal health record for professional Iranian athletes. Patients and Methods: First, a comparative study was carried out on the types of professional athletes’existing handheld and electronic health information management systems currently being used in Iran and leading countries in the field of sports medicine including; Australia, Canada and the United States. Then a checklist was developed containing a minimum dataset of professional athletes’ personal health records and distributed to the people involved, who consisted of 50 specialists in sports medicine and health information management, using the Delphi method. Through the use of data obtained from this survey, a basic paper model of professional athletes' personal health record was constructed and then an electronic model was created accordingly. Results: Access to information in the electronic record was through a web-based, portal system. The capabilities of this system included: access to information at any time and location, increased interaction between the medical team, comprehensive reporting and effective management of injuries, flexibility and interaction with financial, radiology and laboratory information systems. Conclusions: It is suggested that a framework should be created to promote athletes’ medical knowledge and provide the education necessary to manage their information. This would lead to improved data quality and ultimately promote the health of community athletes. PMID:25741410

  6. Privacy preserving index for encrypted electronic medical records.

    PubMed

    Chen, Yu-Chi; Horng, Gwoboa; Lin, Yi-Jheng; Chen, Kuo-Chang

    2013-12-01

    With the development of electronic systems, privacy has become an important security issue in real-life. In medical systems, privacy of patients' electronic medical records (EMRs) must be fully protected. However, to combine the efficiency and privacy, privacy preserving index is introduced to preserve the privacy, where the EMR can be efficiently accessed by this patient or specific doctor. In the literature, Goh first proposed a secure index scheme with keyword search over encrypted data based on a well-known primitive, Bloom filter. In this paper, we propose a new privacy preserving index scheme, called position index (P-index), with keyword search over the encrypted data. The proposed index scheme is semantically secure against the adaptive chosen keyword attack, and it also provides flexible space, lower false positive rate, and search privacy. Moreover, it does not rely on pairing, a complicate computation, and thus can search over encrypted electronic medical records from the cloud server efficiently.

  7. An analysis of electronic health record-related patient safety incidents.

    PubMed

    Palojoki, Sari; Mäkelä, Matti; Lehtonen, Lasse; Saranto, Kaija

    2017-06-01

    The aim of this study was to analyse electronic health record-related patient safety incidents in the patient safety incident reporting database in fully digital hospitals in Finland. We compare Finnish data to similar international data and discuss their content with regard to the literature. We analysed the types of electronic health record-related patient safety incidents that occurred at 23 hospitals during a 2-year period. A procedure of taxonomy mapping served to allow comparisons. This study represents a rare examination of patient safety risks in a fully digital environment. The proportion of electronic health record-related incidents was markedly higher in our study than in previous studies with similar data. Human-computer interaction problems were the most frequently reported. The results show the possibility of error arising from the complex interaction between clinicians and computers.

  8. National electronic health record interoperability chronology.

    PubMed

    Hufnagel, Stephen P

    2009-05-01

    The federal initiative for electronic health record (EHR) interoperability began in 2000 and set the stage for the establishment of the 2004 Executive Order for EHR interoperability by 2014. This article discusses the chronology from the 2001 e-Government Consolidated Health Informatics (CHI) initiative through the current congressional mandates for an aligned, interoperable, and agile DoD AHLTA and VA VistA.

  9. Problem-oriented patient record model as a conceptual foundation for a multi-professional electronic patient record.

    PubMed

    De Clercq, Etienne

    2008-09-01

    It is widely accepted that the development of electronic patient records, or even of a common electronic patient record, is one possible way to improve cooperation and data communication between nurses and physicians. Yet, little has been done so far to develop a common conceptual model for both medical and nursing patient records, which is a first challenge that should be met to set up a common electronic patient record. In this paper, we describe a problem-oriented conceptual model and we show how it may suit both nursing and medical perspectives in a hospital setting. We started from existing nursing theory and from an initial model previously set up for primary care. In a hospital pilot site, a multi-disciplinary team refined this model using one large and complex clinical case (retrospective study) and nine ongoing cases (prospective study). An internal validation was performed through hospital-wide multi-professional interviews and through discussions around a graphical user interface prototype. To assess the consistency of the model, a computer engineer specified it. Finally, a Belgian expert working group performed an external assessment of the model. As a basis for a common patient record we propose a simple problem-oriented conceptual model with two levels of meta-information. The model is mapped with current nursing theories and it includes the following concepts: "health care element", "health approach", "health agent", "contact", "subcontact" and "service". These concepts, their interrelationships and some practical rules for using the model are illustrated in this paper. Our results are compatible with ongoing standardization work at the Belgian and European levels. Our conceptual model is potentially a foundation for a multi-professional electronic patient record that is problem-oriented and therefore patient-centred.

  10. 36 CFR § 1235.50 - What specifications and standards for transfer apply to electronic records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF RECORDS TO THE... Records Administration, Electronic/Special Media Records Services Division (NWME), 8601 Adelphi Road... and Records Administration, Electronic/Special Media Records Services Division (NWME), 8601 Adelphi...

  11. The impact of escaped farmed Atlantic salmon (Salmo salar L.) on catch statistics in Scotland.

    PubMed

    Green, Darren M; Penman, David J; Migaud, Herve; Bron, James E; Taggart, John B; McAndrew, Brendan J

    2012-01-01

    In Scotland and elsewhere, there are concerns that escaped farmed Atlantic salmon (Salmo salar L.) may impact on wild salmon stocks. Potential detrimental effects could arise through disease spread, competition, or inter-breeding. We investigated whether there is evidence of a direct effect of recorded salmon escape events on wild stocks in Scotland using anglers' counts of caught salmon (classified as wild or farmed) and sea trout (Salmo trutta L.). This tests specifically whether documented escape events can be associated with reduced or elevated escapes detected in the catch over a five-year time window, after accounting for overall variation between areas and years. Alternate model frameworks were somewhat inconsistent, however no robust association was found between documented escape events and higher proportion of farm-origin salmon in anglers' catch, nor with overall catch size. A weak positive correlation was found between local escapes and subsequent sea trout catch. This is in the opposite direction to what would be expected if salmon escapes negatively affected wild fish numbers. Our approach specifically investigated documented escape events, contrasting with earlier studies examining potentially wider effects of salmon farming on wild catch size. This approach is more conservative, but alleviates some potential sources of confounding, which are always of concern in observational studies. Successful analysis of anglers' reports of escaped farmed salmon requires high data quality, particularly since reports of farmed salmon are a relatively rare event in the Scottish data. Therefore, as part of our analysis, we reviewed studies of potential sensitivity and specificity of determination of farmed origin. Specificity estimates are generally high in the literature, making an analysis of the form we have performed feasible.

  12. The Impact of Escaped Farmed Atlantic Salmon (Salmo salar L.) on Catch Statistics in Scotland

    PubMed Central

    Green, Darren M.; Penman, David J.; Migaud, Herve; Bron, James E.; Taggart, John B.; McAndrew, Brendan J.

    2012-01-01

    In Scotland and elsewhere, there are concerns that escaped farmed Atlantic salmon (Salmo salar L.) may impact on wild salmon stocks. Potential detrimental effects could arise through disease spread, competition, or inter-breeding. We investigated whether there is evidence of a direct effect of recorded salmon escape events on wild stocks in Scotland using anglers' counts of caught salmon (classified as wild or farmed) and sea trout (Salmo trutta L.). This tests specifically whether documented escape events can be associated with reduced or elevated escapes detected in the catch over a five-year time window, after accounting for overall variation between areas and years. Alternate model frameworks were somewhat inconsistent, however no robust association was found between documented escape events and higher proportion of farm-origin salmon in anglers' catch, nor with overall catch size. A weak positive correlation was found between local escapes and subsequent sea trout catch. This is in the opposite direction to what would be expected if salmon escapes negatively affected wild fish numbers. Our approach specifically investigated documented escape events, contrasting with earlier studies examining potentially wider effects of salmon farming on wild catch size. This approach is more conservative, but alleviates some potential sources of confounding, which are always of concern in observational studies. Successful analysis of anglers' reports of escaped farmed salmon requires high data quality, particularly since reports of farmed salmon are a relatively rare event in the Scottish data. Therefore, as part of our analysis, we reviewed studies of potential sensitivity and specificity of determination of farmed origin. Specificity estimates are generally high in the literature, making an analysis of the form we have performed feasible. PMID:22970132

  13. National electronic medical records integration on cloud computing system.

    PubMed

    Mirza, Hebah; El-Masri, Samir

    2013-01-01

    Few Healthcare providers have an advanced level of Electronic Medical Record (EMR) adoption. Others have a low level and most have no EMR at all. Cloud computing technology is a new emerging technology that has been used in other industry and showed a great success. Despite the great features of Cloud computing, they haven't been utilized fairly yet in healthcare industry. This study presents an innovative Healthcare Cloud Computing system for Integrating Electronic Health Record (EHR). The proposed Cloud system applies the Cloud Computing technology on EHR system, to present a comprehensive EHR integrated environment.

  14. Catching Comet's Particles in the Earth's Atmosphere by Using Balloons

    NASA Astrophysics Data System (ADS)

    Potashko, Oleksandr; Viso, Michel

    The project is intended to catch cometary particles in the atmosphere by using balloons. The investigation is based upon knowledge that the Earth crosses the comet’s tails during the year. One can catch these particles at different altitudes in the atmosphere. So, we will be able to gradually advance in the ability to launch balloons from low to high altitudes and try to catch particles from different comet tails. The maximum altitude that we have to reach is 40 km. Both methods - distance observation and cometary samples from mission Stardust testify to the presence of organic components in comet’s particles. It would be useful to know more details about this organic matter for astrobiology; besides, the factor poses danger to the Earth. Moreover, it is important to prove that it is possible to get fundamental scientific results at low cost. In the last 5 years launching balloons has become popular and this movement looks like hackers’ one - as most of them occur without launch permission to airspace. The popularity of ballooning is connected with low cost of balloon, GPS unit, video recording unit. If you use iPhone, you have a light solution with GPS, video, picture and control function in one unit. The price of balloon itself begins from $50; it depends on maximum altitude, payload weight and material. Many university teams realized balloon launching and reached even stratosphere at an altitude of 33 km. But most of them take only video and picture. Meanwhile, it is possible to carry out scientific experiments by ballooning, for example to collect comet particles. There is rich experience at the moment of the use of mineral, chemical and isotopic analysis techniques and data of the comet’s dust after successful landing of StarDust capsule with samples in 2006. Besides, we may use absolutely perfect material to catch particles in the atmosphere, which was used by cosmic missions such as Stardust and Japanese Hayabusa. As to balloon launches, we could use

  15. Electronic dental records: start taking the steps.

    PubMed

    Bergoff, Jana

    2011-01-01

    Converting paper patient records charts into their electronic counterparts (EDRs) not only has many advantages, but also could become a legal requirement in the future. Several steps key to a successful transition includes assessing the needs of the dental team and what they require as a part of the implementation Existing software and hardware must be evaluated for continued use and expansion. Proper protocols for information transfer must be established to ensure complete records while maintaining HIPAA regulations regarding patient privacy. Reduce anxiety by setting realistic dead-lines and using trusted back-up methods.

  16. Exploring faculty perceptions towards electronic health records for nursing education.

    PubMed

    Kowitlawakul, Y; Chan, S W C; Wang, L; Wang, W

    2014-12-01

    The use of electronic health records in nursing education is rapidly increasing worldwide. The successful implementation of electronic health records for nursing education software program relies on students as well as nursing faculty members. This study aimed to explore the experiences and perceptions of nursing faculty members using electronic health records for nursing education software program, and to identify the influential factors for successful implementation of this technology. This exploratory qualitative study was conducted using in-depth individual interviews at a university in Singapore. Seven faculty members participated in the study. The data were gathered and analysed at the end of the semester in the 2012/2013 academic year. The participants' perceptions of the software program were organized into three main categories: innovation, transition and integration. The participants perceived this technology as innovative, with both values and challenges for the users. In addition, using the new software program was perceived as transitional process. The integration of this technology required time from faculty members and students, as well as support from administrators. The software program had only been implemented for 2-3 months at the time of the interviews. Consequently, the participants might have lacked the necessary skill and competence and confidence to implement it successfully. In addition, the unequal exposure to the software program might have had an impact on participants' perceptions. The findings show that the integration of electronic health records into nursing education curricula is dependent on the faculty members' experiences with the new technology, as well as their perceptions of it. Hence, cultivating a positive attitude towards the use of new technologies is important. Electronic health records are significant applications of health information technology. Health informatics competency should be included as a required competency

  17. Nutrient Needs for Catch-Up Growth in Low-Birthweight Infants.

    PubMed

    Ziegler, Ekhard E

    2015-01-01

    Growth restriction among low-birthweight (LBW) infants occurs prenatally as well as postnatally. Regardless of when and how the growth restriction occurs, growth-restricted infants have the potential for catch-up growth. Catch-up growth has decidedly beneficial effects on later cognition. It also may have adverse effects on cardiovascular and metabolic health. Although the benefits for later cognition are well documented in a number of studies, growth-restricted LBW infants often do not experience catch-up growth and therefore do not enjoy its benefits. One reason is that for catch-up growth to occur, extraordinarily high protein intakes are required. Nutrient intakes have been estimated with the use of the factorial method based on the assumption that catch-up growth comprises essentially a restoration of lean body mass, with restoration of fat mass optional. The basic (no catch-up) nutritional needs of growth-restricted LBW infants are altered to a modest degree, with energy needs increased and protein needs decreased. With catch-up, however, protein needs are increased sharply. Since energy needs are only modestly increased, the protein/energy ratio of requirements is appreciably increased. The high protein needs are difficult to meet with the usual feedings for LBW infants unless special measures are taken to increase protein intakes and to increase the protein/energy ratio. Without the necessary protein intake, catch-up growth is not possible or will be delayed, which may compromise the realization of the long-term benefits on cognition. © 2015 Nestec Ltd., Vevey/S. Karger AG, Basel.

  18. Estimating population diversity with CatchAll

    PubMed Central

    Bunge, John; Woodard, Linda; Böhning, Dankmar; Foster, James A.; Connolly, Sean; Allen, Heather K.

    2012-01-01

    Motivation: The massive data produced by next-generation sequencing require advanced statistical tools. We address estimating the total diversity or species richness in a population. To date, only relatively simple methods have been implemented in available software. There is a need for software employing modern, computationally intensive statistical analyses including error, goodness-of-fit and robustness assessments. Results: We present CatchAll, a fast, easy-to-use, platform-independent program that computes maximum likelihood estimates for finite-mixture models, weighted linear regression-based analyses and coverage-based non-parametric methods, along with outlier diagnostics. Given sample ‘frequency count’ data, CatchAll computes 12 different diversity estimates and applies a model-selection algorithm. CatchAll also derives discounted diversity estimates to adjust for possibly uncertain low-frequency counts. It is accompanied by an Excel-based graphics program. Availability: Free executable downloads for Linux, Windows and Mac OS, with manual and source code, at www.northeastern.edu/catchall. Contact: jab18@cornell.edu PMID:22333246

  19. Functional coupling of sensorimotor and associative areas during a catching ball task: a qEEG coherence study

    PubMed Central

    2012-01-01

    Background Catching an object is a complex movement that involves not only programming but also effective motor coordination. Such behavior is related to the activation and recruitment of cortical regions that participates in the sensorimotor integration process. This study aimed to elucidate the cortical mechanisms involved in anticipatory actions when performing a task of catching an object in free fall. Methods Quantitative electroencephalography (qEEG) was recorded using a 20-channel EEG system in 20 healthy right-handed participants performed the catching ball task. We used the EEG coherence analysis to investigate subdivisions of alpha (8-12 Hz) and beta (12-30 Hz) bands, which are related to cognitive processing and sensory-motor integration. Results Notwithstanding, we found the main effects for the factor block; for alpha-1, coherence decreased from the first to sixth block, and the opposite effect occurred for alpha-2 and beta-2, with coherence increasing along the blocks. Conclusion It was concluded that to perform successfully our task, which involved anticipatory processes (i.e. feedback mechanisms), subjects exhibited a great involvement of sensory-motor and associative areas, possibly due to organization of information to process visuospatial parameters and further catch the falling object. PMID:22364485

  20. Catch rates relative to angler party size with implications for monitoring angler success

    USGS Publications Warehouse

    Miranda, L.E.

    2005-01-01

    Angler catch rates often are used to monitor angler success, assess the need for additional management actions, and evaluate the effectiveness of management practices. Potential linkages between catch rate and angler party size were examined to assess how party size might affect the use of catch rate as an index of angler success in recreational fisheries. Data representing 22,355 completed interviews conducted at access points in lakes and reservoirs throughout Mississippi during 1987-2003 were analyzed. Total party catch was not proportional to total party effort; thus, catch rate decreased as party size increased. Depending on the taxa targeted, the average catch rate per angler decreased 40-50% between parties of one and parties of two, although subsequent decreases were less substantial. Because party size accounted for a considerable portion of the variability in catch rate over time and space, failure to remove this variability weakens the manager's ability to detect differences or changes in catch rates. Therefore, the use of catch rates to monitor fisheries may be inappropriate unless party size is taken into account. Party size may influence the angler's ability to catch fish through a variety of processes, including partitioning a limited number of catchable fish among members of a party and party composition. When catch rates are used to estimate total catch rather than to index angler success, party size is not a concern.

  1. Electronic health records and online medical records: an asset or a liability under current conditions?

    PubMed

    Allen-Graham, Judith; Mitchell, Lauren; Heriot, Natalie; Armani, Roksana; Langton, David; Levinson, Michele; Young, Alan; Smith, Julian A; Kotsimbos, Tom; Wilson, John W

    2018-02-01

    Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information. Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary. Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution. Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services. What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records

  2. Spatiotemporal characteristics of muscle patterns for ball catching

    PubMed Central

    D'Andola, M.; Cesqui, B.; Portone, A.; Fernandez, L.; Lacquaniti, F.; d'Avella, A.

    2013-01-01

    What sources of information and what control strategies the central nervous system (CNS) uses to perform movements that require accurate sensorimotor coordination, such as catching a flying ball, is still debated. Here we analyzed the EMG waveforms recorded from 16 shoulder and elbow muscles in six subjects during catching of balls projected frontally from a distance of 6 m and arriving at two different heights and with three different flight times (550, 650, 750 ms). We found that a large fraction of the variation in the muscle patterns was captured by two time-varying muscle synergies, coordinated recruitment of groups of muscles with specific activation waveforms, modulated in amplitude and shifted in time according to the ball's arrival height and flight duration. One synergy was recruited with a short and fixed delay from launch time. Remarkably, a second synergy was recruited at a fixed time before impact, suggesting that it is timed according to an accurate time-to-contact estimation. These results suggest that the control of interceptive movements relies on a combination of reactive and predictive processes through the intermittent recruitment of time-varying muscle synergies. Knowledge of the dynamic effect of gravity and drag on the ball may be then implicitly incorporated in a direct mapping of visual information into a small number of synergy recruitment parameters. PMID:23966939

  3. [Electronic patient record as the tool for better patient safety].

    PubMed

    Schneider, Henning

    2015-01-01

    Recent studies indicate again that there is a deficit in the use of electronic health records (EHR) in German hospitals. Despite good arguments in favour of their use, such as the rapid availability of data, German hospitals shy away from a wider implementation. The reason is the high cost of installing and maintaining the EHRs, for the benefit is difficult to evaluate in monetary terms for the hospital. Even if a benefit can be shown it is not necessarily evident within the hospital, but manifests itself only in the health system outside. Many hospitals only manage to partly implement EHR resulting in increased documentation requirements which reverse their positive effect.In the United States, electronic medical records are also viewed in light of their positive impact on patient safety. In particular, electronic medication systems prove the benefits they can provide in the context of patient safety. As a result, financing systems have been created to promote the digitalisation of hospitals in the United States. This has led to a large increase in the use of IT systems in the United States in recent years. The Universitätsklinikum Eppendorf (UKE) introduced electronic patient records in 2009. The benefits, in particular as regards patient safety, are numerous and there are many examples to illustrate this position. These positive results are intended to demonstrate the important role EHR play in hospitals. A financing system of the ailing IT landscape based on the American model is urgently needed to benefit-especially in terms of patient safety-from electronic medical records in the hospital.

  4. Using the Electronic Health Record in Nursing Research: Challenges and Opportunities.

    PubMed

    Samuels, Joanne G; McGrath, Robert J; Fetzer, Susan J; Mittal, Prashant; Bourgoine, Derek

    2015-10-01

    Changes in the patient record from the paper to the electronic health record format present challenges and opportunities for the nurse researcher. Current use of data from the electronic health record is in a state of flux. Novel data analytic techniques and massive data sets provide new opportunities for nursing science. Realization of a strong electronic data output future relies on meeting challenges of system use and operability, data presentation, and privacy. Nurse researchers need to rethink aspects of proposal development. Joining ongoing national efforts aimed at creating usable data output is encouraged as a means to affect system design. Working to address challenges and embrace opportunities will help grow the science in a way that answers important patient care questions. © The Author(s) 2015.

  5. Access Control Model for Sharing Composite Electronic Health Records

    NASA Astrophysics Data System (ADS)

    Jin, Jing; Ahn, Gail-Joon; Covington, Michael J.; Zhang, Xinwen

    The adoption of electronically formatted medical records, so called Electronic Health Records (EHRs), has become extremely important in healthcare systems to enable the exchange of medical information among stakeholders. An EHR generally consists of data with different types and sensitivity degrees which must be selectively shared based on the need-to-know principle. Security mechanisms are required to guarantee that only authorized users have access to specific portions of such critical record for legitimate purposes. In this paper, we propose a novel approach for modelling access control scheme for composite EHRs. Our model formulates the semantics and structural composition of an EHR document, from which we introduce a notion of authorized zones of the composite EHR at different granularity levels, taking into consideration of several important criteria such as data types, intended purposes and information sensitivities.

  6. Physician Interaction with Electronic Medical Records: A Qualitative Study

    ERIC Educational Resources Information Center

    Noteboom, Cherie Bakker

    2010-01-01

    The integration of EHR (Electronic Health Records) in IT infrastructures supporting organizations enable improved access to and recording of patient data, enhanced ability to make better and more-timely decisions, and improved quality and reduced errors. Despite these benefits, there are mixed results as to the use of EHR. The literature suggests…

  7. [From record keeping to scientific research: obstacles and opportunities for research with electronic health records].

    PubMed

    Scholte, R A; Opmeer, B C; Ploem, M C

    2017-01-01

    As a result of increasing digitisation of medical record keeping, electronic health records (EHRs) are an attractive source for data reuse. However, such record-based research is still suffering from poor quality of data stored in EHRs. Lack of consent for reuse of data also plays an impeding role, especially in retrospective record-based research. That said, increasing cooperation between healthcare institutions and current attention for EHR organisation also offer opportunities for record-based research. Patient data can be recorded in more standardised ways and in increasingly harmonised EHRs. In addition, if healthcare institutions were to establish a generic consent procedure - preferably with national scope - the potential of EHRs for scientific research could be exploited in considerably better ways.

  8. Effect of electronic report writing on the quality of nursing report recording

    PubMed Central

    Heidarizadeh, Khadijeh; Rassouli, Maryam; Manoochehri, Houman; Tafreshi, Mansoureh Zagheri; Ghorbanpour, Reza Kashef

    2017-01-01

    Background and Aim Recording performed nursery actions is one of the main chores of nurses. The findings have shown that recorded reports are not qualitatively valid. Since electronic reports can be regarded as a base to write reports, this study aims at determining the effect of utilizing electronic nursing reports on the quality of the records. Methods This quasi-experimental study was conducted with the aim of applying an electronic system of nursing recording in the heart department of Shahid Rahimi Medical Center, Lorestan University of Medical Science. The samples were nursing reports on the hospitalized patients in the heart department, the basis of complete enumeration (census) during the fall of 2014. The subjects were sixteen employed nurses. To do the study, the software of nursing records was set based on the Clinical Care Classification system (CCC). The research’s tool was the checklist of the Standards of Nursing Documentation. Results The findings indicated that before and after the intervention, the amount of reports’ adaption with the written standards, respectively, was (21.8%) and (71.3%), and the most complete recording was medicine status (58%) and (100%). The worst complete recording before the intervention, acute changes was (99.1%) and nursing processes was (78%) and after, the medicine status, intake and output status and patient’s education (100%); while the nursing report structure was regarded in all cases (100%). The results showed that there is a significant difference in the quality of reporting before and after using CCC (p<0.001). Conclusions Since the necessary parameters for recording a standard report do exist in electronic reporting (CCC), from one point, nurses are reminded to record the necessary parts and from the other point, the system does not allow the user to shut it down unless the necessary parameters are recorded. For this reason, the quality of recorded reports with electronic reporting improves. PMID:29238481

  9. Reconciling catch differences from multiple fishery independent gill net surveys

    USGS Publications Warehouse

    Kraus, Richard T.; Vandergoot, Christopher; Kocovsky, Patrick M.; Rogers, Mark W.; Cook, H. Andrew; Brenden, Travis O.

    2017-01-01

    Fishery independent gill net surveys provide valuable demographic information for population assessment and resource management, but relative to net construction, the effects of ancillary species, and environmental variables on focal species catch rates are poorly understood. In response, we conducted comparative deployments with three unique, inter-agency, survey gill nets used to assess walleye Sander vitreus in Lake Erie. We used an information-theoretic approach with Akaike’s second-order information criterion (AICc) to evaluate linear mixed models of walleye catch as a function of net type (multifilament and two types of monofilament netting), mesh size (categorical), Secchi depth, temperature, water depth, catch of ancillary species, and interactions among selected variables. The model with the greatest weight of evidence showed that walleye catches were positively associated with potential prey and intra-guild predators and negatively associated with water depth and temperature. In addition, the multifilament net had higher average walleye catches than either of the two monofilament nets. Results from this study both help inform decisions about proposed gear changes to stock assessment surveys in Lake Erie, and advance our understanding of how multispecies associations explain variation in gill net catches. Of broader interest to fishery-independent gill net studies, effects of abiotic variables and ancillary species on focal specie’s catch rates were small in comparison with net characteristics of mesh size or twine type.

  10. Problems with the electronic health record.

    PubMed

    de Ruiter, Hans-Peter; Liaschenko, Joan; Angus, Jan

    2016-01-01

    One of the most significant changes in modern healthcare delivery has been the evolution of the paper record to the electronic health record (EHR). In this paper we argue that the primary change has been a shift in the focus of documentation from monitoring individual patient progress to recording data pertinent to Institutional Priorities (IPs). The specific IPs to which we refer include: finance/reimbursement; risk management/legal considerations; quality improvement/safety initiatives; meeting regulatory and accreditation standards; and patient care delivery/evidence based practice. Following a brief history of the transition from the paper record to the EHR, the authors discuss unintended or contested consequences resulting from this change. These changes primarily reflect changes in the organization and amount of clinician work and clinician-patient relationships. The paper is not a research report but was informed by an institutional ethnography the aim of which was to understand how the EHR impacted clinicians and administrators in a large, urban hospital in the United States. The paper was also informed by other sources, including the philosophies of Jacques Ellul, Don Idhe, and Langdon Winner. © 2015 John Wiley & Sons Ltd.

  11. 77 FR 28924 - Requested Administrative Waiver of the Coastwise Trade Laws: Vessel VAN'S CATCH TWO; Invitation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... will be available for inspection and copying at the above address between 10 a.m. and 5 p.m., E.T., Monday through Friday, except federal holidays. An electronic version of this document and all documents...'S CATCH TWO is: Intended Commercial Use of Vessel: ``Sport Fishing Charter.'' Geographic Region...

  12. Requirements for prototyping an educational electronic health record: experiences and future directions.

    PubMed

    Kushniruk, Andre; Borycki, Elizabeth; Kuo, Mu-Hsing; Parapini, Eric; Wang, Shu Lin; Ho, Kendall

    2014-01-01

    Electronic health records and related technologies are being increasingly deployed throughout the world. It is expected that upon graduation health professionals will be able to use these technologies in effective and efficient ways. However, educating health professional students about such technologies has lagged behind. There is a need for software that will allow medical, nursing and health informatics students access to this important software to learn how it works and how to use it effectively. Furthermore, electronic health record educational software that is accessed should provide a range of functions including allowing instructors to build patient cases. Such software should also allow for simulation of a course of a patient's stay and the ability to allow instructors to monitor student use of electronic health records. In this paper we describe our work in developing the requirements for an educational electronic health record to support education about this important technology. We also describe a prototype system being developed based on the requirements gathered.

  13. Clinical Assistant Diagnosis for Electronic Medical Record Based on Convolutional Neural Network.

    PubMed

    Yang, Zhongliang; Huang, Yongfeng; Jiang, Yiran; Sun, Yuxi; Zhang, Yu-Jin; Luo, Pengcheng

    2018-04-20

    Automatically extracting useful information from electronic medical records along with conducting disease diagnoses is a promising task for both clinical decision support(CDS) and neural language processing(NLP). Most of the existing systems are based on artificially constructed knowledge bases, and then auxiliary diagnosis is done by rule matching. In this study, we present a clinical intelligent decision approach based on Convolutional Neural Networks(CNN), which can automatically extract high-level semantic information of electronic medical records and then perform automatic diagnosis without artificial construction of rules or knowledge bases. We use collected 18,590 copies of the real-world clinical electronic medical records to train and test the proposed model. Experimental results show that the proposed model can achieve 98.67% accuracy and 96.02% recall, which strongly supports that using convolutional neural network to automatically learn high-level semantic features of electronic medical records and then conduct assist diagnosis is feasible and effective.

  14. Nurses' Perceptions of the Electronic Health Record

    ERIC Educational Resources Information Center

    Crawley, Rocquel Devonne

    2013-01-01

    The implementation of electronic health records (EHR) by health care organizations has been limited. Despite the broad consensus on the potential benefits of EHRs, health care organizations have been slow to adopt the technology. The purpose of this qualitative phenomenological study was to explore licensed practical and registered nurses'…

  15. Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest.

    PubMed

    Stevenson, Jean E; Israelsson, Johan; Nilsson, Gunilla C; Petersson, Göran I; Bath, Peter A

    2016-03-01

    Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPAC™ Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. © The Author(s) 2014.

  16. Stakeholder engagement: a key component of integrating genomic information into electronic health records

    PubMed Central

    Hartzler, Andrea; McCarty, Catherine A.; Rasmussen, Luke V.; Williams, Marc S.; Brilliant, Murray; Bowton, Erica A.; Clayton, Ellen Wright; Faucett, William A.; Ferryman, Kadija; Field, Julie R.; Fullerton, Stephanie M.; Horowitz, Carol R.; Koenig, Barbara A.; McCormick, Jennifer B.; Ralston, James D.; Sanderson, Saskia C.; Smith, Maureen E.; Trinidad, Susan Brown

    2014-01-01

    Integrating genomic information into clinical care and the electronic health record can facilitate personalized medicine through genetically guided clinical decision support. Stakeholder involvement is critical to the success of these implementation efforts. Prior work on implementation of clinical information systems provides broad guidance to inform effective engagement strategies. We add to this evidence-based recommendations that are specific to issues at the intersection of genomics and the electronic health record. We describe stakeholder engagement strategies employed by the Electronic Medical Records and Genomics Network, a national consortium of US research institutions funded by the National Human Genome Research Institute to develop, disseminate, and apply approaches that combine genomic and electronic health record data. Through select examples drawn from sites of the Electronic Medical Records and Genomics Network, we illustrate a continuum of engagement strategies to inform genomic integration into commercial and homegrown electronic health records across a range of health-care settings. We frame engagement as activities to consult, involve, and partner with key stakeholder groups throughout specific phases of health information technology implementation. Our aim is to provide insights into engagement strategies to guide genomic integration based on our unique network experiences and lessons learned within the broader context of implementation research in biomedical informatics. On the basis of our collective experience, we describe key stakeholder practices, challenges, and considerations for successful genomic integration to support personalized medicine. PMID:24030437

  17. Nitrogen catch crops

    USDA-ARS?s Scientific Manuscript database

    High costs of nitrogen (N) fertilizer and the potential for N losses to ground and surface water have resulted in increased interest in using catch crops to recover this N. Research on potatoes has shown that the amount of N lost to leaching can be as much as the amount of N removed from the field ...

  18. Preparing for Electronic Medical Record Implementation: Carolina Care Communication in an Electronic Environment.

    PubMed

    Carroll, Tracy; Tonges, Mary; Ray, Joel

    2017-11-01

    This article describes 1 organization's successful approach to mitigating the potential negative effects of a new electronic medical record on patient experience. The Carolina Care model, developed at the University of North Carolina Hospitals to actualize caring theory in practice, helped to structure and greatly facilitate this work. Seven focus areas were integrated to create the "Communication in an Electronic Environment" program with a strong emphasis on nurse-patient communication.

  19. Electronic health record tools' support of nurses' clinical judgment and team communication.

    PubMed

    Kossman, Susan P; Bonney, Leigh Ann; Kim, Myoung Jin

    2013-11-01

    Nurses need to quickly process information to form clinical judgments, communicate with the healthcare team, and guide optimal patient care. Electronic health records not only offer potential for enhanced care but also introduce unintended consequences through changes in workflow, clinical judgment, and communication. We investigated nurses' use of improvised (self-made) and electronic health record-generated cognitive artifacts on clinical judgment and team communication. Tanner's Clinical Judgment Model provided a framework and basis for questions in an online survey and focus group interviews. Findings indicated that (1) nurses rated self-made work lists and medication administration records highest for both clinical judgment and communication, (2) tools aided different dimensions of clinical judgment, and (3) interdisciplinary tools enhance team communication. Implications are that electronic health record tool redesign could better support nursing work.

  20. Determinants of primary care nurses' intention to adopt an electronic health record in their clinical practice.

    PubMed

    Leblanc, Genevieve; Gagnon, Marie-Pierre; Sanderson, Duncan

    2012-09-01

    A provincial electronic health record is being developed in the Province of Quebec (and in all other provinces in Canada), and authorities hope that it will enable a safer and more efficient healthcare system for citizens. However, the expected benefits can occur only if healthcare professionals, including nurses, adopt this technology. Although attention to the use of the electronic health record by nurses is growing, better understanding of nurses' intention to use an electronic health record is needed and could help managers to better plan its implementation. This study examined the factors that influence primary care nurses' intention to adopt the provincial electronic health record, since intention influences electronic health record use and implementation success. Using a modified version of Ajzen's Theory of Planned Theory of Planned Behavior, a questionnaire was developed and pretested. Questionnaires were distributed to 199 primary care nurses. Multiple hierarchical regression indicated that the Theory of Planned Behavior variables explained 58% of the variance in nurses' intention to adopt an electronic health record. The strong intention to adopt the electronic health record is mainly determined by perceived behavioral control, normative beliefs, and attitudes. The implications of the study are that healthcare managers could facilitate adoption of an electronic health record by strengthening nurses' intention to adopt the electronic health record, which in turn can be influenced through interventions oriented toward the belief that using an electronic health record will improve the quality of patient care.

  1. Fishing effort and catch composition of urban market and rural villages in Brazilian Amazon.

    PubMed

    Hallwass, Gustavo; Lopes, Priscila Fabiana; Juras, Anastacio Afonso; Silvano, Renato Azevedo Matias

    2011-02-01

    The management of small-scale freshwater fisheries in Amazon has been based usually on surveys of urban markets, while fisheries of rural villages have gone unnoticed. We compared the fishing characteristics (catch, effort and selectivity) between an urban market and five small villages in the Lower Tocantins River (Brazilian Amazon), downstream from a large reservoir. We recorded 86 and 601 fish landings in the urban market and villages, respectively, using the same methodology. The urban fishers showed higher catch per unit of effort, higher amount of ice (related to a higher fishing effort, as ice is used to store fish catches) and larger crew size per fishing trip, but village fishers had a higher estimated annual fish production. Conversely, urban and village fishers used similar fishing gear (gillnets) and the main fish species caught were the same. However, village fishers showed more diverse strategies regarding gear, habitats and fish caught. Therefore, although it underestimated the total amount of fish caught in the Lower Tocantins River region, the data from the urban market could be a reliable indicator of main fish species exploited and fishing gear used by village fishers. Monitoring and management should consider the differences and similarities between urban and rural fisheries, in Amazon and in other tropical regions.

  2. Fishing Effort and Catch Composition of Urban Market and Rural Villages in Brazilian Amazon

    NASA Astrophysics Data System (ADS)

    Hallwass, Gustavo; Lopes, Priscila Fabiana; Juras, Anastacio Afonso; Silvano, Renato Azevedo Matias

    2011-02-01

    The management of small-scale freshwater fisheries in Amazon has been based usually on surveys of urban markets, while fisheries of rural villages have gone unnoticed. We compared the fishing characteristics (catch, effort and selectivity) between an urban market and five small villages in the Lower Tocantins River (Brazilian Amazon), downstream from a large reservoir. We recorded 86 and 601 fish landings in the urban market and villages, respectively, using the same methodology. The urban fishers showed higher catch per unit of effort, higher amount of ice (related to a higher fishing effort, as ice is used to store fish catches) and larger crew size per fishing trip, but village fishers had a higher estimated annual fish production. Conversely, urban and village fishers used similar fishing gear (gillnets) and the main fish species caught were the same. However, village fishers showed more diverse strategies regarding gear, habitats and fish caught. Therefore, although it underestimated the total amount of fish caught in the Lower Tocantins River region, the data from the urban market could be a reliable indicator of main fish species exploited and fishing gear used by village fishers. Monitoring and management should consider the differences and similarities between urban and rural fisheries, in Amazon and in other tropical regions.

  3. Simulated electronic heterodyne recording and processing of pulsed-laser holograms

    NASA Technical Reports Server (NTRS)

    Decker, A. J.

    1979-01-01

    The electronic recording of pulsed-laser holograms is proposed. The polarization sensitivity of each resolution element of the detector is controlled independently to add an arbitrary phase to the image waves. This method which can be used to simulate heterodyne recording and to process three-dimensional optical images, is based on a similar method for heterodyne recording and processing of continuous-wave holograms.

  4. 76 FR 40454 - Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... Access to VHA Electronic Health Records) Activity; Comment Request AGENCY: Veterans Health Administration... Access to VHA Electronic Health Records, VA Form 10- 0400. OMB Control Number: 2900-0710. Type of Review... were granted power of attorney by veterans who have medical information recorded in VHA electronic...

  5. Electronic health record use among cancer patients: Insights from the Health Information National Trends Survey.

    PubMed

    Strekalova, Yulia A

    2017-04-01

    Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute's Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access. Specifically, higher income, prior online information seeking, interest in accessing health information online, and normative beliefs were predictive of electronic health record access. Conversely, poorer general health status and lack of health care provider encouragement to use electronic health records were associated with lower utilization rates. The current findings provide theory-based evidence that contributes to the understanding of the explanatory factors of electronic health record use and suggest future directions for research and practice.

  6. A spatially explicit capture-recapture estimator for single-catch traps.

    PubMed

    Distiller, Greg; Borchers, David L

    2015-11-01

    Single-catch traps are frequently used in live-trapping studies of small mammals. Thus far, a likelihood for single-catch traps has proven elusive and usually the likelihood for multicatch traps is used for spatially explicit capture-recapture (SECR) analyses of such data. Previous work found the multicatch likelihood to provide a robust estimator of average density. We build on a recently developed continuous-time model for SECR to derive a likelihood for single-catch traps. We use this to develop an estimator based on observed capture times and compare its performance by simulation to that of the multicatch estimator for various scenarios with nonconstant density surfaces. While the multicatch estimator is found to be a surprisingly robust estimator of average density, its performance deteriorates with high trap saturation and increasing density gradients. Moreover, it is found to be a poor estimator of the height of the detection function. By contrast, the single-catch estimators of density, distribution, and detection function parameters are found to be unbiased or nearly unbiased in all scenarios considered. This gain comes at the cost of higher variance. If there is no interest in interpreting the detection function parameters themselves, and if density is expected to be fairly constant over the survey region, then the multicatch estimator performs well with single-catch traps. However if accurate estimation of the detection function is of interest, or if density is expected to vary substantially in space, then there is merit in using the single-catch estimator when trap saturation is above about 60%. The estimator's performance is improved if care is taken to place traps so as to span the range of variables that affect animal distribution. As a single-catch likelihood with unknown capture times remains intractable for now, researchers using single-catch traps should aim to incorporate timing devices with their traps.

  7. Platform links clinical data with electronic health records

    Cancer.gov

    To make data gathered from patients in clinical trials available for use in standard care, NCI has created a new computer tool to support interoperability between clinical research and electronic health record systems. This new software represents an inno

  8. Catch of channel catfish with tandem-set hoop nets and gill nets in lentic systems of Nebraska

    USGS Publications Warehouse

    Richters, Lindsey K.; Pope, Kevin L.

    2011-01-01

    Twenty-six Nebraska water bodies representing two ecosystem types (small standing waters and large standing waters) were surveyed during 2008 and 2009 with tandem-set hoop nets and experimental gill nets to determine if similar trends existed in catch rates and size structures of channel catfish Ictalurus punctatus captured with these gears. Gear efficiency was assessed as the number of sets (nets) that would be required to capture 100 channel catfish given observed catch per unit effort (CPUE). Efficiency of gill nets was not correlated with efficiency of hoop nets for capturing channel catfish. Small sample sizes prohibited estimation of proportional size distributions in most surveys; in the four surveys for which sample size was sufficient to quantify length-frequency distributions of captured channel catfish, distributions differed between gears. The CPUE of channel catfish did not differ between small and large water bodies for either gear. While catch rates of hoop nets were lower than rates recorded in previous studies, this gear was more efficient than gill nets at capturing channel catfish. However, comparisons of size structure between gears may be problematic.

  9. Changes to Workflow and Process Measures in the PICU During Transition From Semi to Full Electronic Health Record.

    PubMed

    Salib, Mina; Hoffmann, Raymond G; Dasgupta, Mahua; Zimmerman, Haydee; Hanson, Sheila

    2015-10-01

    Studies showing the changes in workflow during transition from semi to full electronic medical records are lacking. This objective study is to identify the changes in workflow in the PICU during transition from semi to full electronic health record. Prospective observational study. Children's Hospital of Wisconsin Institutional Review Board waived the need for approval so this study was institutional review board exempt. This study measured clinical workflow variables at a 72-bed PICU during different phases of transition to a full electronic health record, which occurred on November 4, 2012. Phases of electronic health record transition were defined as follows: pre-electronic health record (baseline data prior to transition to full electronic health record), transition phase (3 wk after electronic health record), and stabilization (6 mo after electronic health record). Data were analyzed for the three phases using Mann-Whitney U test with a two-sided p value of less than 0.05 considered significant. Seventy-two bed PICU. All patients in the PICU were included during the study periods. Five hundred and sixty-four patients with 2,355 patient days were evaluated in the three phases. Duration of rounds decreased from a median of 9 minutes per patient pre--electronic health record to 7 minutes per patient post electronic health record. Time to final note decreased from 2.06 days pre--electronic health record to 0.5 days post electronic health record. Time to first medication administration after admission also decreased from 33 minutes pre--electronic health record and 7 minutes post electronic health record. Time to Time to medication reconciliation was significantly higher pre-electronic health record than post electronic health record and percent of medication reconciliation completion was significantly lower pre--electronic health record than post electronic health record and percent of medication reconciliation completion was significantly higher pre--electronic

  10. 36 CFR 1225.24 - When can an agency apply previously approved schedules to electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... may apply a previously approved schedule for hard copy records to electronic versions of the permanent records when the electronic records system replaces a single series of hard copy permanent records or the... have been previously scheduled as permanent in hard copy form, including special media records as...

  11. Safeguarding Confidentiality in Electronic Health Records.

    PubMed

    Shenoy, Akhil; Appel, Jacob M

    2017-04-01

    Electronic health records (EHRs) offer significant advantages over paper charts, such as ease of portability, facilitated communication, and a decreased risk of medical errors; however, important ethical concerns related to patient confidentiality remain. Although legal protections have been implemented, in practice, EHRs may be still prone to breaches that threaten patient privacy. Potential safeguards are essential, and have been implemented especially in sensitive areas such as mental illness, substance abuse, and sexual health. Features of one institutional model are described that may illustrate the efforts to both ensure adequate transparency and ensure patient confidentiality. Trust and the therapeutic alliance are critical to the provider-patient relationship and quality healthcare services. All of the benefits of an EHR are only possible if patients retain confidence in the security and accuracy of their medical records.

  12. Habitat features influence catch rates of near-shore bull shark (Carcharhinus leucas) in the Queensland Shark Control Program, Australia 1996-2012

    NASA Astrophysics Data System (ADS)

    Haig, Jodie A.; Lambert, Gwladys I.; Sumpton, Wayne D.; Mayer, David G.; Werry, Jonathan M.

    2018-01-01

    Understanding shark habitat use is vital for informing better ecological management of coastal areas and shark populations. The Queensland Shark Control Program (QSCP) operates over ∼1800 km of Queensland coastline. Between 1996 and 2012, catch, total length and sex were recorded from most of the 1992 bull shark (Carcharhinus leucas) caught on drum lines and gill-nets as part of the QSCP (sex and length was not successfully recorded for all individuals). Gear was set at multiple sites within ten locations. Analysis of monthly catch data resulted in a zero-inflated dataset for the 17 years of records. Five models were trialled for suitability of standardising the bull shark catch per unit effort (CPUE) using available habitat and environmental data. Three separate models for presence-absence and presence-only were run and outputs combined using a delta-lognormal framework for generalized linear and generalized additive models. The delta-lognormal generalized linear model approach resulted in best fit to explain patterns in CPUE. Greater CPUE occurred on drum lines, and greater numbers of bull sharks were caught on both gear types in summer months, with tropical sites, and sites with greater adjacent wetland habitats catching consistently more bull sharks compared to sub-tropical sites. The CPUE data did not support a hypothesis of population decline indicative of coastal overfishing. However, the total length of sharks declined slightly through time for those caught in the tropics; subtropical catches were dominated by females and a large proportion of all bull sharks caught were smaller than the size-at-maturity reported for this species. These factors suggest that growth and sex overfishing of Queensland bull shark populations may be occurring but are not yet detectable in the available data. The data highlight available coastal wetlands, river size, length of coastline and distance to the 50 m depth contour are important for consideration in future whole of

  13. Signature of ocean warming in global fisheries catch.

    PubMed

    Cheung, William W L; Watson, Reg; Pauly, Daniel

    2013-05-16

    Marine fishes and invertebrates respond to ocean warming through distribution shifts, generally to higher latitudes and deeper waters. Consequently, fisheries should be affected by 'tropicalization' of catch (increasing dominance of warm-water species). However, a signature of such climate-change effects on global fisheries catch has so far not been detected. Here we report such an index, the mean temperature of the catch (MTC), that is calculated from the average inferred temperature preference of exploited species weighted by their annual catch. Our results show that, after accounting for the effects of fishing and large-scale oceanographic variability, global MTC increased at a rate of 0.19 degrees Celsius per decade between 1970 and 2006, and non-tropical MTC increased at a rate of 0.23 degrees Celsius per decade. In tropical areas, MTC increased initially because of the reduction in the proportion of subtropical species catches, but subsequently stabilized as scope for further tropicalization of communities became limited. Changes in MTC in 52 large marine ecosystems, covering the majority of the world's coastal and shelf areas, are significantly and positively related to regional changes in sea surface temperature. This study shows that ocean warming has already affected global fisheries in the past four decades, highlighting the immediate need to develop adaptation plans to minimize the effect of such warming on the economy and food security of coastal communities, particularly in tropical regions.

  14. 36 CFR 13.908 - Fishing limit of catch and in possession.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Fishing limit of catch and in possession. 13.908 Section 13.908 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF... Preserve General Provisions § 13.908 Fishing limit of catch and in possession. The limit of catch per...

  15. 36 CFR 13.908 - Fishing limit of catch and in possession.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Fishing limit of catch and in possession. 13.908 Section 13.908 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF... Preserve General Provisions § 13.908 Fishing limit of catch and in possession. The limit of catch per...

  16. Shared Electronic Health Record Systems: Key Legal and Security Challenges.

    PubMed

    Christiansen, Ellen K; Skipenes, Eva; Hausken, Marie F; Skeie, Svein; Østbye, Truls; Iversen, Marjolein M

    2017-11-01

    Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.

  17. Integrated Nationwide Electronic Health Records system: Semi-distributed architecture approach.

    PubMed

    Fragidis, Leonidas L; Chatzoglou, Prodromos D; Aggelidis, Vassilios P

    2016-11-14

    The integration of heterogeneous electronic health records systems by building an interoperable nationwide electronic health record system provides undisputable benefits in health care, like superior health information quality, medical errors prevention and cost saving. This paper proposes a semi-distributed system architecture approach for an integrated national electronic health record system incorporating the advantages of the two dominant approaches, the centralized architecture and the distributed architecture. The high level design of the main elements for the proposed architecture is provided along with diagrams of execution and operation and data synchronization architecture for the proposed solution. The proposed approach effectively handles issues related to redundancy, consistency, security, privacy, availability, load balancing, maintainability, complexity and interoperability of citizen's health data. The proposed semi-distributed architecture offers a robust interoperability framework without healthcare providers to change their local EHR systems. It is a pragmatic approach taking into account the characteristics of the Greek national healthcare system along with the national public administration data communication network infrastructure, for achieving EHR integration with acceptable implementation cost.

  18. Use of electronic medical record-enhanced checklist and electronic dashboard to decrease CLABSIs.

    PubMed

    Pageler, Natalie M; Longhurst, Christopher A; Wood, Matthew; Cornfield, David N; Suermondt, Jaap; Sharek, Paul J; Franzon, Deborah

    2014-03-01

    We hypothesized that a checklist enhanced by the electronic medical record and a unit-wide dashboard would improve compliance with an evidence-based, pediatric-specific catheter care bundle and decrease central line-associated bloodstream infections (CLABSI). We performed a cohort study with historical controls that included all patients with a central venous catheter in a 24-bed PICU in an academic children's hospital. Postintervention CLABSI rates, compliance with bundle elements, and staff perceptions of communication were evaluated and compared with preintervention data. CLABSI rates decreased from 2.6 CLABSIs per 1000 line-days before intervention to 0.7 CLABSIs per 1000 line-days after intervention. Analysis of specific bundle elements demonstrated increased daily documentation of line necessity from 30% to 73% (P < .001), increased compliance with dressing changes from 87% to 90% (P = .003), increased compliance with cap changes from 87% to 93% (P < .001), increased compliance with port needle changes from 69% to 95% (P < .001), but decreased compliance with insertion bundle documentation from 67% to 62% (P = .001). Changes in the care plan were made during review of the electronic medical record checklist on 39% of patient rounds episodes. Use of an electronic medical record-enhanced CLABSI prevention checklist coupled with a unit-wide real-time display of adherence was associated with increased compliance with evidence-based catheter care and sustained decrease in CLABSI rates. These data underscore the potential for computerized interventions to promote compliance with proven best practices and prevent patient harm.

  19. Electronic health records in an occupational health setting-Part II. Global deployment.

    PubMed

    Bey, Jean M; de Magalhães, Josiane S; Bojórquez, Lorena; Lin, Karen

    2013-03-01

    Electronic medical record systems are being used by more multi-national corporations. This article describes one corporation's considerations and process in successfully deploying a global electronic medical record system to international facilities in Brazil, Mexico, Singapore, and Taiwan. This article summarizes feedback from the experiences of occupational health nurse superusers in these countries. Copyright 2013, SLACK Incorporated.

  20. Activation of a medical emergency team using an electronic medical recording-based screening system*.

    PubMed

    Huh, Jin Won; Lim, Chae-Man; Koh, Younsuck; Lee, Jury; Jung, Youn-Kyung; Seo, Hyun-Suk; Hong, Sang-Bum

    2014-04-01

    To evaluate the efficacy of a medical emergency team activated using 24-hour monitoring by electronic medical record-based screening criteria followed by immediate intervention by a skilled team. Retrospective cohort study. Academic tertiary care hospital with approximately 2,700 beds. A total of 3,030 events activated by a medical emergency team from March 1, 2008, to February 28, 2010. None. We collected data for all medical emergency team activations: patient characteristics, trigger type for medical emergency team (electronic medical record-based screening vs calling criteria), interventions during each event, outcomes of the medical emergency team intervention, and 28-day mortality after medical emergency team activation. We analyzed data for 2009, when the medical emergency team functioned 24 hours a day, 7 days a week (period 2), compared with that for 2008, when the medical emergency team functioned 12 hours a day, 7 days a week (period 1). The commonest cause of medical emergency team activation was respiratory distress (43.6%), and the medical emergency team performed early goal-directed therapy (21.3%), respiratory care (19.9%), and difficult airway management (12.3%). For patients on general wards, 51.3% (period 1) and 38.4% (period 2) of medical emergency team activations were triggered by the electronic medical record-based screening system (electronic medical record-triggered group). In 23.4%, activation occurred because of an abnormality in laboratory screening criteria. The commonest activation criterion from electronic medical record-based screening was respiratory rate (39.4%). Over half the patients were treated in the general ward, and one third of the patients were transferred to the ICU. The electronic medical record-triggered group had lower ICU admission with an odds ratio of 0.35 (95% CI, 0.22-0.55). In surgical patients, the electronic medical record-triggered group showed the lower 28-day mortality (10.5%) compared with the call

  1. 36 CFR 1236.28 - What additional requirements apply to the selection and maintenance of electronic records storage...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... apply to the selection and maintenance of electronic records storage media for permanent records? 1236... What additional requirements apply to the selection and maintenance of electronic records storage media for permanent records? (a) Agencies must maintain the storage and test areas for electronic records...

  2. 36 CFR 1236.28 - What additional requirements apply to the selection and maintenance of electronic records storage...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... apply to the selection and maintenance of electronic records storage media for permanent records? 1236... What additional requirements apply to the selection and maintenance of electronic records storage media for permanent records? (a) Agencies must maintain the storage and test areas for electronic records...

  3. Nurses' perceptions of the impact of electronic health records on work and patient outcomes.

    PubMed

    Kossman, Susan P; Scheidenhelm, Sandra L

    2008-01-01

    This study addresses community hospital nurses' use of electronic health records and views of the impact of such records on job performance and patient outcomes. Questionnaire, interview, and observation data from 46 nurses in medical-surgical and intensive care units at two community hospitals were analyzed. Nurses preferred electronic health records to paper charts and were comfortable with technology. They reported use of electronic health records enhanced nursing work through increased information access, improved organization and efficiency, and helpful alert screens. They thought use of the records hindered nursing work through impaired critical thinking, decreased interdisciplinary communication, and a high demand on work time (73% reported spending at least half their shift using the records). They thought use of electronic health records enabled them to provide safer care but decreased the quality of care. Administrative implications include involving bedside nurses in system choice, streamlining processes, developing guidelines for consistent documentation quality and location, increasing system speed, choosing hardware that encourages bedside use, and improving system information technology support.

  4. Defining and incorporating basic nursing care actions into the electronic health record.

    PubMed

    Englebright, Jane; Aldrich, Kelly; Taylor, Cathy R

    2014-01-01

    To develop a definition of basic nursing care for the hospitalized adult patient and drive uptake of that definition through the implementation of an electronic health record. A team of direct care nurses, assisted by subject matter experts, analyzed nursing theory and regulatory requirements related to basic nursing care. The resulting list of activities was coded using the Clinical Care Classification (CCC) system and incorporated into the electronic health record system of a 170-bed community hospital. Nine basic nursing care activities were identified as a result of analyzing nursing theory and regulatory requirements in the framework of a hypothetical "well" patient. One additional basic nursing care activity was identified following the pilot implementation in the electronic health record. The pilot hospital has successfully passed a post-implementation regulatory review with no recommendations related to the documentation of basic patient care. This project demonstrated that it is possible to define the concept of basic nursing care and to distinguish it from the interdisciplinary, problem-focused plan of care. The use of the electronic health record can help clarify, document, and communicate basic care elements and improve uptake among nurses. This project to define basic nursing care activities and incorporate into the electronic health record represents a first step in capturing meaningful data elements. When fully implemented, these data could be translated into knowledge for improving care outcomes and collaborative processes. © 2013 Sigma Theta Tau International.

  5. New paradigms for measuring clinical performance using electronic health records.

    PubMed

    Weiner, Jonathan P; Fowles, Jinnet B; Chan, Kitty S

    2012-06-01

    Measures of provider success are the centerpiece of quality improvement and pay-for-performance programs around the globe. In most nations, these measures are derived from administrative records, paper charts and consumer surveys; increasingly, electronic patient record systems are also being used. We use the term 'e-QMs' to describe quality measures that are based on data found within electronic health records and other related health information technology (HIT). We offer a framework or typology for e-QMs and describe opportunities and impediments associated with the transition from old to new If public and private systems of care are to effectively use HIT to support and evaluate health-care system quality and safety, the quality measurement field must embrace new paradigms and strategically address a series of technical, conceptual and practical challenges.

  6. Weekend catch-up sleep is independently associated with suicide attempts and self-injury in Korean adolescents.

    PubMed

    Kang, Seung-Gul; Lee, Yu Jin; Kim, Seog Ju; Lim, Weonjeong; Lee, Heon-Jeong; Park, Young-Min; Cho, In Hee; Cho, Seong-Jin; Hong, Jin Pyo

    2014-02-01

    The current study aims to determine the associations of insufficient sleep with suicide attempts and self-injury in a large, school-based Korean adolescent sample. A sample of 4553 middle- and high-school students (grades 7-10) was recruited in this study. Finally, 4145 students completed self-report questionnaires including items on sleep duration (weekday/weekend), self-injury, suicide attempts during the past year, the Suicidal Ideation Questionnaire (SIQ), and the Beck Depression Inventory (BDI). A multiple linear regression model showed that higher SIQ scores were associated with longer weekend catch-up sleep duration (p=0.009), higher BDI score (p<0.001), and longer time spent in a private educational institute (p=0.025). The multiple logistic regression analysis revealed that longer weekend catch-up sleep duration (p=0.011), higher BDI score (p<0.001), longer time spent in a private educational institute (p=0.046), and poorer academic record (p=0.029) were associated with suicide attempt and self-injury during the past year. The present results suggest that weekend catch-up sleep duration--which is an indicator of insufficient weekday sleep--might be associated with suicide attempts and self-injury in Korean adolescents. © 2014.

  7. Efficacy of methoprene for mosquito control in storm water catch basins

    USGS Publications Warehouse

    Butler, M.; LeBrun, R.A.; Ginsberg, H.S.; Gettman, A.D.

    2006-01-01

    This study evaluated the efficacy of methoprene, a widely used juvenile hormone mimic, formulated as 30-day slow release Altosid? pellets, at controlling mosquitoes in underground storm water drainage catch basins. Data from applications to ?-sized cement catch basins in the laboratory, field observations from treated and untreated basins, and an experiment that confined mosquito larvae in floating emergence jars in catch basins showed that methoprene effectively controlled mosquitoes for a month under field conditions and substantially longer under laboratory conditions when applied at a dose of 3.5 g pellets per average-sized catch basin.

  8. Improving the Effectiveness of Electronic Health Record-Based Referral Processes

    PubMed Central

    2012-01-01

    Electronic health records are increasingly being used to facilitate referral communication in the outpatient setting. However, despite support by technology, referral communication between primary care providers and specialists is often unsatisfactory and is unable to eliminate care delays. This may be in part due to lack of attention to how information and communication technology fits within the social environment of health care. Making electronic referral communication effective requires a multifaceted “socio-technical” approach. Using an 8-dimensional socio-technical model for health information technology as a framework, we describe ten recommendations that represent good clinical practices to design, develop, implement, improve, and monitor electronic referral communication in the outpatient setting. These recommendations were developed on the basis of our previous work, current literature, sound clinical practice, and a systems-based approach to understanding and implementing health information technology solutions. Recommendations are relevant to system designers, practicing clinicians, and other stakeholders considering use of electronic health records to support referral communication. PMID:22973874

  9. The Generalized Optic Acceleration Cancellation Theory of Catching

    ERIC Educational Resources Information Center

    McLeod, Peter; Reed, Nick; Dienes, Zoltan

    2006-01-01

    The generalized optic acceleration cancellation (GOAC) theory of catching proposes that the path of a fielder running to catch a ball is determined by the attempt to satisfy 2 independent constraints. The 1st is to keep the angle of elevation of gaze to the ball increasing at a decreasing rate. The 2nd is to control the rate of horizontal rotation…

  10. Openness of patients' reporting with use of electronic records: psychiatric clinicians' views

    PubMed Central

    Blackford, Jennifer Urbano; Rosenbloom, S Trent; Seidel, Sandra; Clayton, Ellen Wright; Dilts, David M; Finder, Stuart G

    2010-01-01

    Objectives Improvements in electronic health record (EHR) system development will require an understanding of psychiatric clinicians' views on EHR system acceptability, including effects on psychotherapy communications, data-recording behaviors, data accessibility versus security and privacy, data quality and clarity, communications with medical colleagues, and stigma. Design Multidisciplinary development of a survey instrument targeting psychiatric clinicians who recently switched to EHR system use, focus group testing, data analysis, and data reliability testing. Measurements Survey of 120 university-based, outpatient mental health clinicians, with 56 (47%) responding, conducted 18 months after transition from a paper to an EHR system. Results Factor analysis gave nine item groupings that overlapped strongly with five a priori domains. Respondents both praised and criticized the EHR system. A strong majority (81%) felt that open therapeutic communications were preserved. Regarding data quality, content, and privacy, clinicians (63%) were less willing to record highly confidential information and disagreed (83%) with including their own psychiatric records among routinely accessed EHR systems. Limitations single time point; single academic medical center clinic setting; modest sample size; lack of prior instrument validation; survey conducted in 2005. Conclusions In an academic medical center clinic, the presence of electronic records was not seen as a dramatic impediment to therapeutic communications. Concerns regarding privacy and data security were significant, and may contribute to reluctances to adopt electronic records in other settings. Further study of clinicians' views and use patterns may be helpful in guiding development and deployment of electronic records systems. PMID:20064802

  11. Electronic health records to support obesity-related patient care: Results from a survey of United States physicians.

    PubMed

    Bronder, Kayla L; Dooyema, Carrie A; Onufrak, Stephen J; Foltz, Jennifer L

    2015-08-01

    Obesity-related electronic health record functions increase the rates of measuring Body Mass Index, diagnosing obesity, and providing obesity services. This study describes the prevalence of obesity-related electronic health record functions in clinical practice and analyzes characteristics associated with increased obesity-related electronic health record sophistication. Data were analyzed from DocStyles, a web-based panel survey administered to 1507 primary care providers practicing in the United States in June, 2013. Physicians were asked if their electronic health record has specific obesity-related functions. Logistical regression analyses identified characteristics associated with improved obesity-related electronic health record sophistication. Of the 88% of providers with an electronic health record, 83% of electronic health records calculate Body Mass Index, 52% calculate pediatric Body Mass Index percentile, and 32% flag patients with abnormal Body Mass Index values. Only 36% provide obesity-related decision support and 17% suggest additional resources for obesity-related care. Characteristics associated with having a more sophisticated electronic health record include age ≤45years old, being a pediatrician or family practitioner, and practicing in a larger, outpatient practice. Few electronic health records optimally supported physician's obesity-related clinical care. The low rates of obesity-related electronic health record functions currently in practice highlight areas to improve the clinical health information technology in primary care practice. More work can be done to develop, implement, and promote the effective utilization of obesity-related electronic health record functions to improve obesity treatment and prevention efforts. Published by Elsevier Inc.

  12. Use of electronic health records can improve the health care industry's environmental footprint.

    PubMed

    Turley, Marianne; Porter, Catherine; Garrido, Terhilda; Gerwig, Kathy; Young, Scott; Radler, Linda; Shaber, Ruth

    2011-05-01

    Electronic health records have the potential to improve the environmental footprint of the health care industry. We estimate that Kaiser Permanente's electronic health record system, which covers 8.7 million beneficiaries, eliminated 1,000 tons of paper records and 68 tons of x-ray film, and that it has lowered gasoline consumption among patients who otherwise would have made trips to the doctor by at least three million gallons per year. However, the use of personal computers resulted in higher energy consumption and generated an additional 250 tons of waste. We conclude that electronic health records have a positive net effect on the environment, and that our model for evaluating their impact can be used to determine whether their use can improve communities' health.

  13. [Access control management in electronic health records: a systematic literature review].

    PubMed

    Carrión Señor, Inmaculada; Fernández Alemán, José Luis; Toval, Ambrosio

    2012-01-01

    This study presents the results of a systematic literature review of aspects related to access control in electronic health records systems, wireless security and privacy and security training for users. Information sources consisted of original articles found in Medline, ACM Digital Library, Wiley InterScience, IEEE Digital Library, Science@Direct, MetaPress, ERIC, CINAHL and Trip Database, published between January 2006 and January 2011. A total of 1,208 articles were extracted using a predefined search string and were reviewed by the authors. The final selection consisted of 24 articles. Of the selected articles, 21 dealt with access policies in electronic health records systems. Eleven articles discussed whether access to electronic health records should be granted by patients or by health organizations. Wireless environments were only considered in three articles. Finally, only four articles explicitly mentioned that technical training of staff and/or patients is required. Role-based access control is the preferred mechanism to deploy access policy by the designers of electronic health records. In most systems, access control is managed by users and health professionals, which promotes patients' right to control personal information. Finally, the security of wireless environments is not usually considered. However, one line of research is eHealth in mobile environments, called mHealth. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. The development and validation of the clinicians' awareness towards cognitive errors (CATChES) in clinical decision making questionnaire tool.

    PubMed

    Chew, Keng Sheng; Kueh, Yee Cheng; Abdul Aziz, Adlihafizi

    2017-03-21

    Despite their importance on diagnostic accuracy, there is a paucity of literature on questionnaire tools to assess clinicians' awareness toward cognitive errors. A validation study was conducted to develop a questionnaire tool to evaluate the Clinician's Awareness Towards Cognitive Errors (CATChES) in clinical decision making. This questionnaire is divided into two parts. Part A is to evaluate the clinicians' awareness towards cognitive errors in clinical decision making while Part B is to evaluate their perception towards specific cognitive errors. Content validation for both parts was first determined followed by construct validation for Part A. Construct validation for Part B was not determined as the responses were set in a dichotomous format. For content validation, all items in both Part A and Part B were rated as "excellent" in terms of their relevance in clinical settings. For construct validation using exploratory factor analysis (EFA) for Part A, a two-factor model with total variance extraction of 60% was determined. Two items were deleted. Then, the EFA was repeated showing that all factor loadings are above the cut-off value of >0.5. The Cronbach's alpha for both factors are above 0.6. The CATChES questionnaire tool is a valid questionnaire tool aimed to evaluate the awareness among clinicians toward cognitive errors in clinical decision making.

  15. Opportunities and challenges in integrating electronic health records into undergraduate medical education: a national survey of clerkship directors.

    PubMed

    Hammoud, Maya M; Margo, Katherine; Christner, Jennifer G; Fisher, Jonathan; Fischer, Shira H; Pangaro, Louis N

    2012-01-01

    Few studies have reported on the utilization and the effect of electronic health records on the education of medical students. The purpose of this study was to describe the current use of electronic health records by medical students in the United States and explore the opportunities and challenges of integrating electronic health records into daily teaching of medical students. A survey with 24 questions regarding the use of electronic health records by medical students was developed by the Alliance for Clinical Educators and sent to clerkship directors across the United States. Both quantitative and qualitative responses were collected and analyzed to determine current access to and use of electronic health records by medical students. This study found that an estimated 64% of programs currently allow student use of electronic health records, of which only two thirds allowed students to write notes within the electronic record. Overall, clerkship directors' opinions on the effects of electronic health records on medical student education were neutral, and despite acknowledging many advantages to electronic health records, there were many concerns raised regarding their use in education. Medical students are using electronic health records at higher rates than physicians in practice. Although this is overall reassuring, educators have to be cautious about the limitations being placed on student's documentation in electronic health records as this can potentially have consequences on their training, and they need to explore ways to maximize the benefits of electronic health records in medical education.

  16. Use of Electronic Health Records in sub-Saharan Africa: Progress and challenges

    PubMed Central

    Akanbi, Maxwell O.; Ocheke, Amaka N.; Agaba, Patricia A.; Daniyam, Comfort A.; Agaba, Emmanuel I.; Okeke, Edith N.; Ukoli, Christiana O.

    2012-01-01

    Background The Electronic Health Record (EHR) is a key component of medical informatics that is increasingly being utilized in industrialized nations to improve healthcare. There is limited information on the use of EHR in sub-Saharan Africa. This paper reviews availability of EHRs in sub-Saharan Africa. Methods Searches were performed on PubMed and Google Scholar databases using the terms ‘Electronic Health Records OR Electronic Medical Records OR e-Health and Africa’. References from identified publications were reviewed. Inclusion criterion was documented use of EHR in Africa. Results The search yielded 147 publications of which 21papers from 15 sub-Saharan African countries documented the use of EHR in Africa and were reviewed. About 91% reported use of Open Source healthcare software, with OpenMRS being the most widely used. Most reports were from HIV related health centers. Barriers to adoption of EHRs include high cost of procurement and maintenance, poor network infrastructure and lack of comfort among health workers with electronic medical records. Conclusion There has been an increase in the use of EHRs in sub-Saharan Africa, largely driven by utilization by HIV treatment programs. Penetration is still however very low. PMID:25243111

  17. Spatial and temporal adaptations that accompany increasing catching performance during learning.

    PubMed

    Mazyn, Liesbeth I N; Lenoir, Matthieu; Montagne, Gilles; Savelsbergh, Geert J P

    2007-11-01

    The authors studied changes in performance and kinematics during the acquisition of a 1-handed catch. Participants were 8 women who took an intensive 2-week training program during which they evolved from poor catchers to subexpert catchers. An increased temporal consistency, shift in spatial location of ball-hand contact away from the body, and higher peak velocity of the transport of the hand toward the ball accompanied their improvement in catching performance. Moreover, novice catchers first adjusted spatial characteristics of the catch to the task constraints and fine-tuned temporal features only later during learning. A principal components analysis on a large set of kinematic variables indicated that a successful catch depends on (a) forward displacement of the hand and (b) the dynamics of the hand closure, thereby providing a kinematic underpinning for the traditional transport-manipulation dissociation in the grasping and catching literature.

  18. Effect of fishing effort on catch rate and catchability of largemouth bass in small impoundments

    USGS Publications Warehouse

    Wegener, M. G.; Schramm, Harold; Neal, J. W.; Gerard, P.D.

    2018-01-01

    Largemouth bass Micropterus salmoides (Lacepède) catch rates decline with sustained fishing effort, even without harvest. It is unclear why declines in catch rate occur, and little research has been directed at how to improve catch rate. Learning has been proposed as a reason for declining catch rate, but has never been tested on largemouth bass. If catch rate declines because fish learn to avoid lures, periods of no fishing could be a management tool for increasing catch rate. In this study, six small impoundments with established fish populations were fished for two May to October fishing seasons to evaluate the effect of fishing effort on catch rate. Closed seasons were implemented to test whether a 2‐month period of no fishing improved catch rates and to determine whether conditioning from factors other than being captured reduced catch rate. Mixed‐model analysis indicated catch rate and catchability declined throughout the fishing season. Catch rate and catchability increased after a 2‐month closure but soon declined to the lowest levels of the fishing season. These changes in catch rate and catchability support the conclusion of learned angler avoidance, but sustained catchability of fish not previously caught does not support that associative or social learning affected catchability.

  19. 2. CATCH BASIN, INFLOW PIPES AT CENTER, COLD FLOW LABORATORY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. CATCH BASIN, INFLOW PIPES AT CENTER, COLD FLOW LABORATORY AT LEFT, VIEW TOWARDS NORTHWEST. - Glenn L. Martin Company, Titan Missile Test Facilities, Catch Basin, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

  20. 76 FR 13121 - Electronic On-Board Recorders and Hours of Service Supporting Documents

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-10

    ... DEPARTMENT OF TRANSPORTATION Federal Motor Carrier Safety Administration 49 CFR Parts 385, 390, and 395 [Docket No. FMCSA-2010-0167] RIN 2126-AB20 Electronic On-Board Recorders and Hours of Service... comment period for the Electronic On-Board Recorder and Hours of Service Supporting Documents Notice of...

  1. Abstracting ICU Nursing Care Quality Data From the Electronic Health Record.

    PubMed

    Seaman, Jennifer B; Evans, Anna C; Sciulli, Andrea M; Barnato, Amber E; Sereika, Susan M; Happ, Mary Beth

    2017-09-01

    The electronic health record is a potentially rich source of data for clinical research in the intensive care unit setting. We describe the iterative, multi-step process used to develop and test a data abstraction tool, used for collection of nursing care quality indicators from the electronic health record, for a pragmatic trial. We computed Cohen's kappa coefficient (κ) to assess interrater agreement or reliability of data abstracted using preliminary and finalized tools. In assessing the reliability of study data ( n = 1,440 cases) using the finalized tool, 108 randomly selected cases (10% of first half sample; 5% of last half sample) were independently abstracted by a second rater. We demonstrated mean κ values ranging from 0.61 to 0.99 for all indicators. Nursing care quality data can be accurately and reliably abstracted from the electronic health records of intensive care unit patients using a well-developed data collection tool and detailed training.

  2. Retractable tool bit having latch type catch mechanism

    NASA Technical Reports Server (NTRS)

    Voellmer, George (Inventor)

    1993-01-01

    A retractable tool bit assembly for a tool such as an allen key is presented. The assembly includes one or more spring loaded nestable or telescoping tubular sections together with a catch mechanism for capturing and holding the tool in its retracted position. The catch mechanism consists of a latch mechanism located in a base section and which engages a conically shaped tool head located at the inner end of the tool. The tool head adjoins an eccentric oval type neck portion which extends to a rear lip of the tool head. The latch mechanism releases when the ovular neck portion rotates about the catch members upon actuation of a rotary tool drive motor. When released, all the telescoping sections and the tool extends fully outward to a use position.

  3. 77 FR 65416 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... Minutes ERA Program Update Business Priorities Presidential Directive on Records Management Online Public Access Discussions: Encouraging development of automated tools for electronic records management, impact of big data, and benchmarking Dated: October 24, 2012. Patrice Little Murray, Acting Committee...

  4. Confidentiality, electronic health records, and the clinician.

    PubMed

    Graves, Stuart

    2013-01-01

    The advent of electronic health records (EHRs) to improve access and enable research in the everyday clinical world has simultaneously made medical information much more vulnerable to illicit, non-beneficent uses. This wealth of identified, aggregated data has and will attract attacks by domestic governments for surveillance and protection, foreign governments for espionage and sabotage, organized crime for illegal profits, and large corporations for "legal" profits. Against these powers with almost unlimited resources no security scheme is likely to prevail, so the design of such systems should include appropriate security measures. Unlike paper records, where the person maintaining and controlling the existence of the records also controls access to them, these two functions can be separated for EHRs. By giving physical control over access to individual records to their individual owners, the aggregate is dismantled, thereby protecting the nation's identified health information from large-scale data mining or tampering. Control over the existence and integrity of all the records--yet without the ability to examine their contents--would be left with larger institutions. This article discusses the implications of all of the above for the role of the clinician in assuring confidentiality (a cornerstone of clinical practice), for research and everyday practice, and for current security designs.

  5. 77 FR 7562 - Electronic On-Board Recorders and Hours of Service Supporting Documents

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-13

    ..., and 395 [Docket No. FMCSA-2010-0167] RIN 2126-AB20 Electronic On-Board Recorders and Hours of Service... intent. SUMMARY: FMCSA announces its intent to move forward with the Electronic On-Board Recorders and... Appeals for the Seventh Circuit. OOIDA raised several concerns relating to EOBRs and their potential use...

  6. 26 CFR 1.414(v)-1 - Catch-up contributions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 5 2014-04-01 2014-04-01 false Catch-up contributions. 1.414(v)-1 Section 1.414(v)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.414(v)-1 Catch-up...

  7. 26 CFR 1.414(v)-1 - Catch-up contributions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Catch-up contributions. 1.414(v)-1 Section 1.414(v)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.414(v)-1 Catch-up...

  8. 26 CFR 1.414(v)-1 - Catch-up contributions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Catch-up contributions. 1.414(v)-1 Section 1.414(v)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.414(v)-1 Catch-up...

  9. 50 CFR 648.120 - Scup Annual Catch Limit (ACL).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Scup Annual Catch Limit (ACL). 648.120... Measures for the Scup Fishery § 648.120 Scup Annual Catch Limit (ACL). (a) The Scup Monitoring Committee... more specific ACL performance review criteria as part of a stock rebuilding plan following a...

  10. 50 CFR 648.120 - Scup Annual Catch Limit (ACL).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Scup Annual Catch Limit (ACL). 648.120... Measures for the Scup Fishery § 648.120 Scup Annual Catch Limit (ACL). (a) The Scup Monitoring Committee... more specific ACL performance review criteria as part of a stock rebuilding plan following a...

  11. 50 CFR 648.120 - Scup Annual Catch Limit (ACL).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Scup Annual Catch Limit (ACL). 648.120... Measures for the Scup Fishery § 648.120 Scup Annual Catch Limit (ACL). (a) The Scup Monitoring Committee... more specific ACL performance review criteria as part of a stock rebuilding plan following a...

  12. 50 CFR 648.290 - Tilefish Annual Catch Limit (ACL).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Tilefish Annual Catch Limit (ACL). 648... Measures for the Tilefish Fishery § 648.290 Tilefish Annual Catch Limit (ACL). (a) The Tilefish Monitoring Committee shall recommend to the MAFMC an ACL for the commercial tilefish fishery, which shall be equal to...

  13. 50 CFR 648.160 - Bluefish Annual Catch Limit (ACL).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Bluefish Annual Catch Limit (ACL). 648... Measures for the Atlantic Bluefish Fishery § 648.160 Bluefish Annual Catch Limit (ACL). (a) The Bluefish Monitoring Committee shall recommend to the MAFMC an ACL for the bluefish fishery, which shall be equal to...

  14. 50 CFR 648.160 - Bluefish Annual Catch Limit (ACL).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Bluefish Annual Catch Limit (ACL). 648... Measures for the Atlantic Bluefish Fishery § 648.160 Bluefish Annual Catch Limit (ACL). (a) The Bluefish Monitoring Committee shall recommend to the MAFMC an ACL for the bluefish fishery, which shall be equal to...

  15. 50 CFR 648.160 - Bluefish Annual Catch Limit (ACL).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Bluefish Annual Catch Limit (ACL). 648... Measures for the Atlantic Bluefish Fishery § 648.160 Bluefish Annual Catch Limit (ACL). (a) The Bluefish Monitoring Committee shall recommend to the MAFMC an ACL for the bluefish fishery, which shall be equal to...

  16. 50 CFR 648.290 - Tilefish Annual Catch Limit (ACL).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Tilefish Annual Catch Limit (ACL). 648... Measures for the Tilefish Fishery § 648.290 Tilefish Annual Catch Limit (ACL). (a) The Tilefish Monitoring Committee shall recommend to the MAFMC an ACL for the commercial tilefish fishery, which shall be equal to...

  17. 50 CFR 648.290 - Tilefish Annual Catch Limit (ACL).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Tilefish Annual Catch Limit (ACL). 648... Measures for the Tilefish Fishery § 648.290 Tilefish Annual Catch Limit (ACL). (a) The Tilefish Monitoring Committee shall recommend to the MAFMC an ACL for the commercial tilefish fishery, which shall be equal to...

  18. 26 CFR 1.414(v)-1 - Catch-up contributions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Catch-up contributions. 1.414(v)-1 Section 1.414(v)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.414(v)-1 Catch-up...

  19. 26 CFR 1.414(v)-1 - Catch-up contributions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Catch-up contributions. 1.414(v)-1 Section 1.414(v)-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Pension, Profit-Sharing, Stock Bonus Plans, Etc. § 1.414(v)-1 Catch-up contributions...

  20. Catch bonding in the forced dissociation of a polymer endpoint

    NASA Astrophysics Data System (ADS)

    Vrusch, Cyril; Storm, Cornelis

    2018-04-01

    Applying a force to certain supramolecular bonds may initially stabilize them, manifested by a lower dissociation rate. We show that this behavior, known as catch bonding and by now broadly reported in numerous biophysics bonds, is generically expected when either or both the trapping potential and the force applied to the bond possess some degree of nonlinearity. We enumerate possible scenarios and for each identify the possibility and, if applicable, the criterion for catch bonding to occur. The effect is robustly predicted by Kramers theory and Mean First Passage Time theory and confirmed in direct molecular dynamics simulation. Among the catch scenarios, one plays out essentially any time the force on the bond originates in a polymeric object, implying that some degree of catch bond behavior is to be expected in many settings relevant to polymer network mechanics or optical tweezer experiments.

  1. Design and implementation of an affordable, public sector electronic medical record in rural Nepal.

    PubMed

    Raut, Anant; Yarbrough, Chase; Singh, Vivek; Gauchan, Bikash; Citrin, David; Verma, Varun; Hawley, Jessica; Schwarz, Dan; Harsha Bangura, Alex; Shrestha, Biplav; Schwarz, Ryan; Adhikari, Mukesh; Maru, Duncan

    2017-06-23

    Globally, electronic medical records are central to the infrastructure of modern healthcare systems. Yet the vast majority of electronic medical records have been designed for resource-rich environments and are not feasible in settings of poverty. Here we describe the design and implementation of an electronic medical record at a public sector district hospital in rural Nepal, and its subsequent expansion to an additional public sector facility.DevelopmentThe electronic medical record was designed to solve for the following elements of public sector healthcare delivery: 1) integration of the systems across inpatient, surgical, outpatient, emergency, laboratory, radiology, and pharmacy sites of care; 2) effective data extraction for impact evaluation and government regulation; 3) optimization for longitudinal care provision and patient tracking; and 4) effectiveness for quality improvement initiatives. For these purposes, we adapted Bahmni, a product built with open-source components for patient tracking, clinical protocols, pharmacy, laboratory, imaging, financial management, and supply logistics. In close partnership with government officials, we deployed the system in February of 2015, added on additional functionality, and iteratively improved the system over the following year. This experience enabled us then to deploy the system at an additional district-level hospital in a different part of the country in under four weeks. We discuss the implementation challenges and the strategies we pursued to build an electronic medical record for the public sector in rural Nepal.DiscussionOver the course of 18 months, we were able to develop, deploy and iterate upon the electronic medical record, and then deploy the refined product at an additional facility within only four weeks. Our experience suggests the feasibility of an integrated electronic medical record for public sector care delivery even in settings of rural poverty.

  2. Design and implementation of an affordable, public sector electronic medical record in rural Nepal

    PubMed Central

    Raut, Anant; Yarbrough, Chase; Singh, Vivek; Gauchan, Bikash; Citrin, David; Verma, Varun; Hawley, Jessica; Schwarz, Dan; Harsha, Alex; Shrestha, Biplav; Schwarz, Ryan; Adhikari, Mukesh; Maru, Duncan

    2018-01-01

    Introduction Globally, electronic medical records are central to the infrastructure of modern healthcare systems. Yet the vast majority of electronic medical records have been designed for resource-rich environments and are not feasible in settings of poverty. Here we describe the design and implementation of an electronic medical record at a public sector district hospital in rural Nepal, and its subsequent expansion to an additional public sector facility. Development The electronic medical record was designed to solve for the following elements of public sector healthcare delivery: 1) integration of the systems across inpatient, surgical, outpatient, emergency, laboratory, radiology, and pharmacy sites of care; 2) effective data extraction for impact evaluation and government regulation; 3) optimization for longitudinal care provision and patient tracking; and 4) effectiveness for quality improvement initiatives. Application For these purposes, we adapted Bahmni, a product built with open-source components for patient tracking, clinical protocols, pharmacy, laboratory, imaging, financial management, and supply logistics. In close partnership with government officials, we deployed the system in February of 2015, added on additional functionality, and iteratively improved the system over the following year. This experience enabled us then to deploy the system at an additional district-level hospital in a different part of the country in under four weeks. We discuss the implementation challenges and the strategies we pursued to build an electronic medical record for the public sector in rural Nepal. Discussion Over the course of 18 months, we were able to develop, deploy and iterate upon the electronic medical record, and then deploy the refined product at an additional facility within only four weeks. Our experience suggests the feasibility of an integrated electronic medical record for public sector care delivery even in settings of rural poverty. PMID:28749321

  3. A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites.

    PubMed

    Adelman, Jason S; Berger, Matthew A; Rai, Amisha; Galanter, William L; Lambert, Bruce L; Schiff, Gordon D; Vawdrey, David K; Green, Robert A; Salmasian, Hojjat; Koppel, Ross; Schechter, Clyde B; Applebaum, Jo R; Southern, William N

    2017-09-01

    To reduce the risk of wrong-patient errors, safety experts recommend limiting the number of patient records providers can open at once in electronic health records (EHRs). However, it is unknown whether health care organizations follow this recommendation or what rationales drive their decisions. To address this gap, we conducted an electronic survey via 2 national listservs. Among 167 inpatient and outpatient study facilities using EHR systems designed to open multiple records at once, 44.3% were configured to allow ≥3 records open at once (unrestricted), 38.3% allowed only 1 record open (restricted), and 17.4% allowed 2 records open (hedged). Decision-making centered on efforts to balance safety and efficiency, but there was disagreement among organizations about how to achieve that balance. Results demonstrate no consensus on the number of records to be allowed open at once in EHRs. Rigorous studies are needed to determine the optimal number of records that balances safety and efficiency. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Physician Sensemaking and Readiness for Electronic Medical Records

    ERIC Educational Resources Information Center

    Riesenmy, Kelly Rouse

    2010-01-01

    Purpose: The purpose of this paper is to explore physician sensemaking and readiness to implement electronic medical records (EMR) as a first step to finding strategies that enhance EMR adoption behaviors. Design/methodology/approach: The case study approach provides a detailed analysis of individuals within an organizational unit. Using a…

  5. Legal issues of the electronic dental record: security and confidentiality.

    PubMed

    Szekely, D G; Milam, S; Khademi, J A

    1996-01-01

    Computer-based, electronic dental record keeping involves complex issues of patient privacy and the dental practitioner's ethical duty of confidentiality. Federal and state law is responding to the new legal issues presented by computer technology. Authenticating the electronic record in terms of ensuring its reliability and accuracy is essential in order to protect its admissibility as evidence in legal actions. Security systems must be carefully planned to limit access and provide for back-up and storage of dental records. Carefully planned security systems protect the patient from disclosure without the patient's consent and also protect the practitioner from the liability that would arise from such disclosure. Human errors account for the majority of data security problems. Personnel security is assured through pre-employment screening, employment contracts, policies, and staff education. Contracts for health information systems should include provisions for indemnification and ensure the confidentiality of the system by the vendor.

  6. Impact of catch shares on diversification of fishers' income and risk.

    PubMed

    Holland, Daniel S; Speir, Cameron; Agar, Juan; Crosson, Scott; DePiper, Geret; Kasperski, Stephen; Kitts, Andrew W; Perruso, Larry

    2017-08-29

    Many fishers diversify their income by participating in multiple fisheries, which has been shown to significantly reduce year-to-year variation in income. The ability of fishers to diversify has become increasingly constrained in the last few decades, and catch share programs could further reduce diversification as a result of consolidation. This could increase income variation and thus financial risk. However, catch shares can also offer fishers opportunities to enter or increase participation in catch share fisheries by purchasing or leasing quota. Thus, the net effect on diversification is uncertain. We tested whether diversification and variation in fishing revenues changed after implementation of catch shares for 6,782 vessels in 13 US fisheries that account for 20% of US landings revenue. For each of these fisheries, we tested whether diversification levels, trends, and variation in fishing revenues changed after implementation of catch shares, both for fishers that remained in the catch share fishery and for those that exited but remained active in other fisheries. We found that diversification for both groups was nearly always reduced. However, in most cases, we found no significant change in interannual variation of revenues, and, where changes were significant, variation decreased nearly as often as it increased.

  7. Impact of catch shares on diversification of fishers’ income and risk

    PubMed Central

    Speir, Cameron; Agar, Juan; Crosson, Scott; DePiper, Geret; Kasperski, Stephen; Kitts, Andrew W.; Perruso, Larry

    2017-01-01

    Many fishers diversify their income by participating in multiple fisheries, which has been shown to significantly reduce year-to-year variation in income. The ability of fishers to diversify has become increasingly constrained in the last few decades, and catch share programs could further reduce diversification as a result of consolidation. This could increase income variation and thus financial risk. However, catch shares can also offer fishers opportunities to enter or increase participation in catch share fisheries by purchasing or leasing quota. Thus, the net effect on diversification is uncertain. We tested whether diversification and variation in fishing revenues changed after implementation of catch shares for 6,782 vessels in 13 US fisheries that account for 20% of US landings revenue. For each of these fisheries, we tested whether diversification levels, trends, and variation in fishing revenues changed after implementation of catch shares, both for fishers that remained in the catch share fishery and for those that exited but remained active in other fisheries. We found that diversification for both groups was nearly always reduced. However, in most cases, we found no significant change in interannual variation of revenues, and, where changes were significant, variation decreased nearly as often as it increased. PMID:28808006

  8. CTEPP STANDARD OPERATING PROCEDURE FOR MAINTAINING AND RECORDING ELECTRONIC CHAIN-OF-CUSTODY (SOP-4.11)

    EPA Science Inventory

    The method for maintaining and recording electronic Chain-of-Custody (CoC) Records for CTEPP samples is summarized in this SOP. The CoC Records that will be logged electronically include the creation of a sample's identification code, bar code labels, and hard-copy CoC document...

  9. Adipose Tissue Plasticity During Catch-Up Fat Driven by Thrifty Metabolism

    PubMed Central

    Summermatter, Serge; Marcelino, Helena; Arsenijevic, Denis; Buchala, Antony; Aprikian, Olivier; Assimacopoulos-Jeannet, Françoise; Seydoux, Josiane; Montani, Jean-Pierre; Solinas, Giovanni; Dulloo, Abdul G.

    2009-01-01

    OBJECTIVE Catch-up growth, a risk factor for later type 2 diabetes, is characterized by hyperinsulinemia, accelerated body-fat recovery (catch-up fat), and enhanced glucose utilization in adipose tissue. Our objective was to characterize the determinants of enhanced glucose utilization in adipose tissue during catch-up fat. RESEARCH DESIGN AND METHODS White adipose tissue morphometry, lipogenic capacity, fatty acid composition, insulin signaling, in vivo glucose homeostasis, and insulinemic response to glucose were assessed in a rat model of semistarvation-refeeding. This model is characterized by glucose redistribution from skeletal muscle to adipose tissue during catch-up fat that results solely from suppressed thermogenesis (i.e., without hyperphagia). RESULTS Adipose tissue recovery during the dynamic phase of catch-up fat is accompanied by increased adipocyte number with smaller diameter, increased expression of genes for adipogenesis and de novo lipogenesis, increased fatty acid synthase activity, increased proportion of saturated fatty acids in triglyceride (storage) fraction but not in phospholipid (membrane) fraction, and no impairment in insulin signaling. Furthermore, it is shown that hyperinsulinemia and enhanced adipose tissue de novo lipogenesis occur concomitantly and are very early events in catch-up fat. CONCLUSIONS These findings suggest that increased adipose tissue insulin stimulation and consequential increase in intracellular glucose flux play an important role in initiating catch-up fat. Once activated, the machinery for lipogenesis and adipogenesis contribute to sustain an increased insulin-stimulated glucose flux toward fat storage. Such adipose tissue plasticity could play an active role in the thrifty metabolism that underlies glucose redistribution from skeletal muscle to adipose tissue. PMID:19602538

  10. Are anesthesia start and end times randomly distributed? The influence of electronic records.

    PubMed

    Deal, Litisha G; Nyland, Michael E; Gravenstein, Nikolaus; Tighe, Patrick

    2014-06-01

    To perform a frequency analysis of start minute digits (SMD) and end minute digits (EMD) taken from the electronic, computer-assisted, and manual anesthesia billing-record systems. Retrospective cross-sectional review. University medical center. This cross-sectional review was conducted on billing records from a single healthcare institution over a 15-month period. A total of 30,738 cases were analyzed. For each record, the start time and end time were recorded. Distributions of SMD and EMD were tested against the null hypothesis of a frequency distribution equivalently spread between zero and nine. SMD and EMD aggregate distributions each differed from equivalency (P < 0.0001). When stratified by type of anesthetic record, no differences were found between the recorded and expected equivalent distribution patterns for electronic anesthesia records for start minute (P < 0.98) or end minute (P < 0.55). Manual and computer-assisted records maintained nonequivalent distribution patterns for SMD and EMD (P < 0.0001 for each comparison). Comparison of cumulative distributions between SMD and EMD distributions suggested a significant difference between the two patterns (P < 0.0001). An electronic anesthesia record system, with automated time capture of events verified by the user, produces a more unified distribution of billing times than do more traditional methods of entering billing times. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Influence of anglers' specializations on catch, harvest, and bycatch of targeted taxa

    USGS Publications Warehouse

    Pope, Kevin L.; Chizinski, Christopher J.; Wiley, Christopher L.; Martin, Dustin R.

    2016-01-01

    Fishery managers often use catch per unit effort (CPUE) of a given taxon derived from a group of anglers, those that sought said taxon, to evaluate fishery objectives because managers assume CPUE for this group of anglers is most sensitive to changes in fish taxon density. Further, likelihood of harvest may differ for sought and non-sought taxa if taxon sought is a defining characteristic of anglers’ attitude toward harvest. We predicted that taxon-specific catch across parties and reservoirs would be influenced by targeted taxon after controlling for number of anglers in a party and time spent fishing (combine to quantify fishing effort of party); we also predicted similar trends for taxon-specific harvest. We used creel-survey data collected from anglers that varied in taxon targeted, from generalists (targeting “anything” [no primary target taxa, but rather targeting all fishes]) to target specialists (e.g., anglers targeting largemouth bass Micropterus salmoides) in 19 Nebraska reservoirs during 2009–2011 to test our predictions. Taxon-specific catch and harvest were, in general, positively related to fishing effort. More importantly, we observed differences of catch and harvest among anglers grouped by taxon targeted for each of the eight taxa assessed. Anglers targeting a specific taxon had the greatest catch for that taxon and anglers targeting anything typically had the second highest catch for that taxon. In addition, anglers tended to catch more of closely related taxa and of taxa commonly targeted with similar fishing techniques. We encourage managers to consider taxon-specific objectives of target and non-target catch and harvest.

  12. Evaluating the data completeness in the Electronic Health Record after the Implementation of an Outpatient Electronic Health Record.

    PubMed

    Soto, Mauricio; Capurro, Daniel; Catalán, Silvia

    2015-01-01

    Electronic health records (EHRs) present an opportunity for quality improvement in health organitations, particularly at the primary health level. However, EHR implementation impacts clinical workflows, and physicians frequently prefer to document in a non-structured way, which ultimately hinders the ability to measure quality indicators. We present an assessment of data completeness-a key data quality indicator-during the first 12 months after the implementation of an EHR at a teaching outpatient center in Santiago, Chile.

  13. Notification: Audit of Certain EPA Electronic Records Management Practices

    EPA Pesticide Factsheets

    Project #OA-FY13-0113, December 13, 2012. This memorandum is to notify you that the U.S. Environmental Protection Agency (EPA), Office of Inspector General, plans to begin an audit of certain EPA electronic records management practices.

  14. From discard ban to exemption: How can gear technology help reduce catches of undersized Nephrops and hake in the Bay of Biscay trawling fleet?

    PubMed

    Vogel, Camille; Kopp, Dorothée; Méhault, Sonia

    2017-01-15

    On January 1st, 2016, the French mixed Nephrops and hake fishery of the Grande Vasière, an area located in the Bay of Biscay, fell under the discard ban implemented as part of the new European Common Fisheries Policy. The fleet records historically high levels of discard despite numerous gear selectivity studies. Together with high discards survival, new technological solutions to minimize catches of undersized individuals could justify local exemptions from the discard ban. Our study focuses on the effects of two selective devices, a square mesh cylinder (SMC) and a grid, on the escapement of undersized individuals and discard reduction. Relative catch probability of the modified gear compared with the traditional gear was modelled using the catch comparison method. Potential losses from the commercial fraction of the catch were taken into account to assess their influence on the economic viability of fishing with the modified gears. The two devices had similar effects on undersized Nephrops escapement and on discard reduction, with median values of 26.5% and 23.6% for the SMC and of 30.4% and 21.4% for the grid, respectively. Only the grid was efficient for undersized hake, recording median values of escapement and discard reduction equal to 25.0% and 20.6%, respectively. Some loss from the commercial fraction of the catch was to be expected with both devices, which could be compensated for in the long term by the contribution of undersized individuals to the stock biomass. Our results support the use of selective gears technology as part of an integrated framework including control and management measures to mitigate the effect of the discard ban both for fishers and for the ecosystem. Further work is needed to quantify the effect of additional escapement from the gear on stock dynamics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Architecture for networked electronic patient record systems.

    PubMed

    Takeda, H; Matsumura, Y; Kuwata, S; Nakano, H; Sakamoto, N; Yamamoto, R

    2000-11-01

    There have been two major approaches to the development of networked electronic patient record (EPR) architecture. One uses object-oriented methodologies for constructing the model, which include the GEHR project, Synapses, HL7 RIM and so on. The second approach uses document-oriented methodologies, as applied in examples of HL7 PRA. It is practically beneficial to take the advantages of both approaches and to add solution technologies for network security such as PKI. In recognition of the similarity with electronic commerce, a certificate authority as a trusted third party will be organised for establishing networked EPR system. This paper describes a Japanese functional model that has been developed, and proposes a document-object-oriented architecture, which is-compared with other existing models.

  16. Perspectives of healthcare practitioners: An exploration of interprofessional communication using electronic medical records.

    PubMed

    Bardach, Shoshana H; Real, Kevin; Bardach, David R

    2017-05-01

    Contemporary state-of-the-art healthcare facilities are incorporating technology into their building design to improve communication and patient care. However, technological innovations may also have unintended consequences. This study seeks to better understand how technology influences interprofessional communication within a hospital setting based in the United States. Nine focus groups were conducted including a range of healthcare professions. The focus groups explored practitioners' experiences working on two floors of a newly designed hospital and included questions about the ways in which technology shaped communication with other healthcare professionals. All focus groups were recorded, transcribed, and coded to identify themes. Participant responses focused on the electronic medical record, and while some benefits of the electronic medical record were discussed, participants indicated use of the electronic medical record has resulted in a reduction of in-person communication. Different charting approaches resulted in barriers to communication between specialties and reduced confidence that other practitioners had received one's notes. Limitations in technology-including limited computer availability, documentation complexity, and sluggish sign-in processes-also were identified as barriers to effective and timely communication between practitioners. Given the ways in which technology shapes interprofessional communication, future research should explore how to create standardised electronic medical record use across professions at the optimal level to support communication and patient care.

  17. Impact of Adoption of a Comprehensive Electronic Health Record on Nursing Work and Caring Efficacy.

    PubMed

    Schenk, Elizabeth; Schleyer, Ruth; Jones, Cami R; Fincham, Sarah; Daratha, Kenn B; Monsen, Karen A

    2018-04-23

    Nurses in acute care settings are affected by the technologies they use, including electronic health records. This study investigated the impacts of adoption of a comprehensive electronic health record by measuring nursing locations and interventions in three units before and 12 months after adoption. Time-motion methodology with a handheld recording platform based on Omaha System standardized terminology was used to collect location and intervention data. In addition, investigators administered the Caring Efficacy Scale to better understand the effects of the electronic health record on nursing care efficacy. Several differences were noted after the electronic health record was adopted. Nurses spent significantly more time in patient rooms and less in other measured locations. They spent more time overall performing nursing interventions, with increased time in documentation and medication administration, but less time reporting and providing patient-family teaching. Both before and after electronic health record adoption, nurses spent most of their time in case management interventions (coordinating, planning, and communicating). Nurses showed a slight decrease in perceived caring efficacy after adoption. While initial findings demonstrated a trend toward increased time efficiency, questions remain regarding nurse satisfaction, patient satisfaction, quality and safety outcomes, and cost.

  18. Aspects of privacy for electronic health records.

    PubMed

    Haas, Sebastian; Wohlgemuth, Sven; Echizen, Isao; Sonehara, Noboru; Müller, Günter

    2011-02-01

    Patients' medical data have been originally generated and maintained by health professionals in several independent electronic health records (EHRs). Centralized electronic health records accumulate medical data of patients to improve their availability and completeness; EHRs are not tied to a single medical institution anymore. Nowadays enterprises with the capacity and knowledge to maintain this kind of databases offer the services of maintaining EHRs and adding personal health data by the patients. These enterprises get access on the patients' medical data and act as a main point for collecting and disclosing personal data to third parties, e.g. among others doctors, healthcare service providers and drug stores. Existing systems like Microsoft HealthVault and Google Health comply with data protection acts by letting the patients decide on the usage and disclosure of their data. But they fail in satisfying essential requirements to privacy. We propose a privacy-protecting information system for controlled disclosure of personal data to third parties. Firstly, patients should be able to express and enforce obligations regarding a disclosure of health data to third parties. Secondly, an organization providing EHRs should neither be able to gain access to these health data nor establish a profile about patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Disassociation for electronic health record privacy.

    PubMed

    Loukides, Grigorios; Liagouris, John; Gkoulalas-Divanis, Aris; Terrovitis, Manolis

    2014-08-01

    The dissemination of Electronic Health Record (EHR) data, beyond the originating healthcare institutions, can enable large-scale, low-cost medical studies that have the potential to improve public health. Thus, funding bodies, such as the National Institutes of Health (NIH) in the U.S., encourage or require the dissemination of EHR data, and a growing number of innovative medical investigations are being performed using such data. However, simply disseminating EHR data, after removing identifying information, may risk privacy, as patients can still be linked with their record, based on diagnosis codes. This paper proposes the first approach that prevents this type of data linkage using disassociation, an operation that transforms records by splitting them into carefully selected subsets. Our approach preserves privacy with significantly lower data utility loss than existing methods and does not require data owners to specify diagnosis codes that may lead to identity disclosure, as these methods do. Consequently, it can be employed when data need to be shared broadly and be used in studies, beyond the intended ones. Through extensive experiments using EHR data, we demonstrate that our method can construct data that are highly useful for supporting various types of clinical case count studies and general medical analysis tasks. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Evaluation of nontarget effects of methoprene applied to catch basins for mosquito control

    USGS Publications Warehouse

    Butler, Mari; Ginsberg, Howard S.; LeBrun, Roger A.; Gettman, Alan

    2010-01-01

    The mosquito larvicide methoprene is a juvenile growth hormone mimic that is widely used to control mosquito larvae in stormwater catch basins. This study addresses two concerns pertaining to methoprene's use for mosquito control. First, measurements of methoprene concentrations were made from water in catch basins that had been treated with methoprene and from an adjoining salt pond near where the treated catch basins emptied. The concentrations of methoprene in catch basins and at drainage outlets after application at the rates currently used for mosquito control in southern Rhode Island were 0.5 ppb and lower, orders of magnitude below what has been determined as detrimental to organisms other than mosquitoes. Second, the effects of methoprene on the communities that live in catch basins were evaluated both in simulated catch basins in the laboratory and in actual catch basins in the field. We found no evidence of declines in abundances of any taxa attributable to the application. Furthermore, we found no consistent changes in community-level parameters (e.g., taxonomic richness, and dominance-diversity relationships) related to methoprene application in either field or laboratory trials.

  1. Meaningful use and good catches: More appropriate metrics for checklist effectiveness.

    PubMed

    Putnam, Luke R; Anderson, Kathryn T; Diffley, Michael B; Hildebrandt, Aubrey A; Caldwell, Kelly M; Minzenmayer, Andrew N; Covey, Sarah E; Kawaguchi, Akemi L; Lally, Kevin P; Tsao, KuoJen

    2016-12-01

    The benefit of utilizing surgical safety checklists has been recently questioned. We evaluated our checklist performance after implementing a program that includes checklist-related good catches. Multifaceted interventions aimed at the preincision checklist and 5 prospective audits were conducted from 2011-2015. We documented adherence to the checklist (verbalization of each checkpoint), fidelity (meaningful performance of each checkpoint), and good catches (events with the potential to cause the patient harm but that were prevented from occurring). Good catches were divided into quality improvement-based categories (processes, medication, safety, communication, and equipment). A total of 1,346 checklist performances were observed (range, 144-373/yr). Adherence to the preincision checklist improved from 30% to 95% (P < .001), while adherence to the preinduction and debriefing checklists decreased (71% to 56%, P = .002) and remained unchanged (76%), respectively. Preincision fidelity decreased from 86% to 76% (P = .012). Good catches were identified during 16% of preincision checklist performances; process issues were most common (32%) followed by issues of medication administration (30%) and safety (22%). Implementation of a systematic checklist program resulted in significant and sustainable improvement in performance. Meaningful use and associated good catches may be more appropriate metric than actual patient harm for measuring checklist effectiveness. Although not previously described, checklist-related good catches represent an unknown benefit of checklists. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Electronic patient record and archive of records in Cardio.net system for telecardiology.

    PubMed

    Sierdziński, Janusz; Karpiński, Grzegorz

    2003-01-01

    In modern medicine the well structured patient data set, fast access to it and reporting capability become an important question. With the dynamic development of information technology (IT) such question is solved via building electronic patient record (EPR) archives. We then obtain fast access to patient data, diagnostic and treatment protocols etc. It results in more efficient, better and cheaper treatment. The aim of the work was to design a uniform Electronic Patient Record, implemented in cardio.net system for telecardiology allowing the co-operation among regional hospitals and reference centers. It includes questionnaires for demographic data and questionnaires supporting doctor's work (initial diagnosis, final diagnosis, history and physical, ECG at the discharge, applied treatment, additional tests, drugs, daily and periodical reports). The browser is implemented in EPR archive to facilitate data retrieval. Several tools for creating EPR and EPR archive were used such as: XML, PHP, Java Script and MySQL. The separate question is the security of data on WWW server. The security is ensured via Security Socket Layer (SSL) protocols and other tools. EPR in Cardio.net system is a module enabling the co-work of many physicians and the communication among different medical centers.

  3. Feasibility of a Catch-Up HPV Vaccination Program among College Students Attending a Large Rural University in the South

    ERIC Educational Resources Information Center

    Richman, Alice R.; Haithcox-Dennis, Melissa J.; Allsbrook, Ashley R.

    2012-01-01

    Our study explored the eligibility and willingness of students to participate in a university-wide catch-up Human papillomavirus (HPV) vaccination program. A total of 1804 electronic surveys (82% response) assessing demographics, HPV knowledge, eligibility, and willingness were gathered. HPV knowledge was moderate, with just over a quarter (26%)…

  4. Catch-and-release science and its application to conservation and management of recreational fisheries

    USGS Publications Warehouse

    Cooke, S.J.; Schramm, H.L.

    2007-01-01

    Catch-and-release angling is a well-established practice in recreational angler behaviour and fisheries management. Accompanying this is a growing body of catch-and-release research that can be applied to reduce injury, mortality and sublethal alterations in behaviour and physiology. Here, the status of catch-and-release research from a symposium on the topic is summarised. Several general themes emerged including the need to: (1) better connect sublethal assessments to population-level processes; (2) enhance understanding of the variation in fish, fishing practices and gear and their role in catch and release; (3) better understand animal welfare issues related to catch and release; (4) increase the exchange of information on fishing-induced stress, injury and mortality between the recreational and commercial fishing sectors; and (5) improve procedures for measuring and understanding the effect of catch-and-release angling. Through design of better catch-and-release studies, strategies could be developed to further minimise stress, injury and mortality arising from catch-and-release angling. These strategies, when integrated with other fish population and fishery characteristics, can be used by anglers and managers to sustain or enhance recreational fishing resources. ?? 2007 The Authors. Journal compilation 2007 Blackwell Publishing Ltd.

  5. Randomised trial comparing the recording ability of a novel, electronic emergency documentation system with the AHA paper cardiac arrest record.

    PubMed

    Grigg, Eliot; Palmer, Andrew; Grigg, Jeffrey; Oppenheimer, Peter; Wu, Tim; Roesler, Axel; Nair, Bala; Ross, Brian

    2014-10-01

    To evaluate the ability of an electronic system created at the University of Washington to accurately document prerecorded VF and pulseless electrical activity (PEA) cardiac arrest scenarios compared with the American Heart Association paper cardiac arrest record. 16 anaesthesiology residents were randomly assigned to view one of two prerecorded, simulated VF and PEA scenarios and asked to document the event with either the paper or electronic system. Each subject then repeated the process with the other video and documentation method. Five types of documentation errors were defined: (1) omission, (2) specification, (3) timing, (4) commission and (5) noise. The mean difference in errors between the paper and electronic methods was analysed using a single factor repeated measures ANOVA model. Compared with paper records, the electronic system omitted 6.3 fewer events (95% CI -10.1 to -2.5, p=0.003), which represents a 28% reduction in omission errors. Users recorded 2.9 fewer noise items (95% CI -5.3 to -0.6, p=0.003) when compared with paper, representing a 36% decrease in redundant or irrelevant information. The rate of timing (Δ=-3.2, 95% CI -9.3 to 3.0, p=0.286) and commission (Δ=-4.4, 95% CI -9.4 to 0.5, p=0.075) errors were similar between the electronic system and paper, while the rate of specification errors were about a third lower for the electronic system when compared with the paper record (Δ=-3.2, 95% CI -6.3 to -0.2, p=0.037). Compared with paper documentation, documentation with the electronic system captured 24% more critical information during a simulated medical emergency without loss in data quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. 36 CFR § 1236.28 - What additional requirements apply to the selection and maintenance of electronic records storage...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... unscheduled data on magnetic records storage media onto tested and verified new electronic media. ... apply to the selection and maintenance of electronic records storage media for permanent records? Â... storage media for permanent records? (a) Agencies must maintain the storage and test areas for electronic...

  7. Electronic Dental Records System Adoption.

    PubMed

    Abramovicz-Finkelsztain, Renata; Barsottini, Claudia G N; Marin, Heimar Fatima

    2015-01-01

    The use of Electronic Dental Records (EDRs) and management software has become more frequent, following the increase in prevelance of new technologies and computers in dental offices. The purpose of this study is to identify and evaluate the use of EDRs by the dental community in the São Paulo city area. A quantitative case study was performed using a survey on the phone. A total of 54 offices were contacted and only one declinedparticipation in this study. Only one office did not have a computer. EDRs were used in 28 offices and only four were paperless. The lack of studies in this area suggests the need for more usability and implementation studies on EDRs so that we can improve EDR adoption by the dental community.

  8. Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model.

    PubMed

    Ben-Assuli, Ofir; Leshno, Moshe

    2016-09-01

    In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians' diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments. © The Author(s) 2015.

  9. Organ Procurement Organizations and the Electronic Health Record.

    PubMed

    Howard, R J; Cochran, L D; Cornell, D L

    2015-10-01

    The adoption of electronic health records (EHRs) has adversely affected the ability of organ procurement organizations (OPOs) to perform their federally mandated function of honoring the donation decisions of families and donors who have signed the registry. The difficulties gaining access to potential donor medical record has meant that assessment, evaluation, and management of brain dead organ donors has become much more difficult. Delays can occur that can lead to potential recipients not receiving life-saving organs. For over 40 years, OPO personnel have had ready access to paper medical records. But the widespread adoption of EHRs has greatly limited the ability of OPO coordinators to readily gain access to patient medical records and to manage brain dead donors. Proposed solutions include the following: (1) hospitals could provide limited access to OPO personnel so that they could see only the potential donor's medical record; (2) OPOs could join with other transplant organizations to inform regulators of the problem; and (3) hospital organizations could be approached to work with Center for Medicare and Medicaid Services (CMS) to revise the Hospital Conditions of Participation to require OPOs be given access to donor medical records. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  10. 50 CFR 648.101 - Summer flounder Annual Catch Target (ACT).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Summer flounder Annual Catch Target (ACT... Management Measures for the Summer Flounder Fisheries § 648.101 Summer flounder Annual Catch Target (ACT). (a) The Summer Flounder Monitoring Committee shall identify and review the relevant sources of management...

  11. 50 CFR 648.101 - Summer flounder Annual Catch Target (ACT).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Summer flounder Annual Catch Target (ACT... Management Measures for the Summer Flounder Fisheries § 648.101 Summer flounder Annual Catch Target (ACT). (a) The Summer Flounder Monitoring Committee shall identify and review the relevant sources of management...

  12. 50 CFR 648.101 - Summer flounder Annual Catch Target (ACT).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Summer flounder Annual Catch Target (ACT... Management Measures for the Summer Flounder Fisheries § 648.101 Summer flounder Annual Catch Target (ACT). (a) The Summer Flounder Monitoring Committee shall identify and review the relevant sources of management...

  13. Nurses' Perceptions of Nursing Care Documentation in the Electronic Health Record

    ERIC Educational Resources Information Center

    Jensen, Tracey A.

    2013-01-01

    Electronic health records (EHRs) will soon become the standard for documenting nursing care. The EHR holds the promise of rapid access to complete records of a patient's encounter with the healthcare system. It is the expectation that healthcare providers input essential data that communicates important patient information to support quality…

  14. 76 FR 56503 - Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... power of attorney by veterans who have medical information recorded in VHA electronic health records... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0710] Agency Information Collection Activity (VSO Access to VHA Electronic Health Records) Under OMB Review AGENCY: Veterans Health Administration...

  15. Catch trials in force field learning influence adaptation and consolidation of human motor memory

    PubMed Central

    Stockinger, Christian; Focke, Anne; Stein, Thorsten

    2014-01-01

    Force field studies are a common tool to investigate motor adaptation and consolidation. Thereby, subjects usually adapt their reaching movements to force field perturbations induced by a robotic device. In this context, so-called catch trials, in which the disturbing forces are randomly turned off, are commonly used to detect after-effects of motor adaptation. However, catch trials also produce sudden large motor errors that might influence the motor adaptation and the consolidation process. Yet, the detailed influence of catch trials is far from clear. Thus, the aim of this study was to investigate the influence of catch trials on motor adaptation and consolidation in force field experiments. Therefore, 105 subjects adapted their reaching movements to robot-generated force fields. The test groups adapted their reaching movements to a force field A followed by learning a second interfering force field B before retest of A (ABA). The control groups were not exposed to force field B (AA). To examine the influence of diverse catch trial ratios, subjects received catch trials during force field adaptation with a probability of either 0, 10, 20, 30, or 40%, depending on the group. First, the results on motor adaptation revealed significant differences between the diverse catch trial ratio groups. With increasing amount of catch trials, the subjects' motor performance decreased and subjects' ability to accurately predict the force field—and therefore internal model formation—was impaired. Second, our results revealed that adapting with catch trials can influence the following consolidation process as indicated by a partial reduction to interference. Here, the optimal catch trial ratio was 30%. However, detection of consolidation seems to be biased by the applied measure of performance. PMID:24795598

  16. A Global Analysis of the Relationship between Farmed Seaweed Production and Herbivorous Fish Catch

    PubMed Central

    2016-01-01

    Globally, farmed seaweed production is expanding rapidly in shallow marine habitats. While seaweed farming provides vital income to millions of artisanal farmers, it can negatively impact shallow coral reef and seagrass habitats. However, seaweed farming may also potentially provide food subsidies for herbivorous reef fish such as the Siganidae, a valuable target family, resulting in increased catch. Comparisons of reef fish landings across the central Philippines revealed that the catch of siganids was positively correlated to farmed seaweed production whilst negatively correlated to total reef fish catch over the same period of time. We tested the generality of this pattern by analysing seaweed production, siganid catch, and reef fish catch for six major seaweed-producing countries in the tropics. We hypothesized that increased seaweed production would correspond with increased catch of siganids but not other reef fish species. Analysis of the global data showed a positive correlation between farmed seaweeds and siganids in Southeast Asia (Indonesia, Malaysia, and the Philippines) but not Africa (Tanzania and Zanzibar), or the Western Pacific (Fiji). In Southeast Asia, siganid catch increased disproportionately faster with seaweed production than did reef fish catch. Low continuity, sporadic production and smaller volumes of seaweed farming may explain the differences. PMID:26894553

  17. A Global Analysis of the Relationship between Farmed Seaweed Production and Herbivorous Fish Catch.

    PubMed

    Hehre, E James; Meeuwig, Jessica J

    2016-01-01

    Globally, farmed seaweed production is expanding rapidly in shallow marine habitats. While seaweed farming provides vital income to millions of artisanal farmers, it can negatively impact shallow coral reef and seagrass habitats. However, seaweed farming may also potentially provide food subsidies for herbivorous reef fish such as the Siganidae, a valuable target family, resulting in increased catch. Comparisons of reef fish landings across the central Philippines revealed that the catch of siganids was positively correlated to farmed seaweed production whilst negatively correlated to total reef fish catch over the same period of time. We tested the generality of this pattern by analysing seaweed production, siganid catch, and reef fish catch for six major seaweed-producing countries in the tropics. We hypothesized that increased seaweed production would correspond with increased catch of siganids but not other reef fish species. Analysis of the global data showed a positive correlation between farmed seaweeds and siganids in Southeast Asia (Indonesia, Malaysia, and the Philippines) but not Africa (Tanzania and Zanzibar), or the Western Pacific (Fiji). In Southeast Asia, siganid catch increased disproportionately faster with seaweed production than did reef fish catch. Low continuity, sporadic production and smaller volumes of seaweed farming may explain the differences.

  18. Urban Alabama Physicians and the Electronic Medical Record: A Qualitative Study

    ERIC Educational Resources Information Center

    Tiggle, Michele

    2012-01-01

    The electronic medical record (EMR) is an information technology tool supporting the examination, treatment, and care of a patient. The EMR allows physicians to view a patient's record showing current medications, a history of visits from health care providers with notes from those visits, a problem list, a functional status assessment, a schedule…

  19. Uncertainty in future projections of global and regional marine fisheries catches

    NASA Astrophysics Data System (ADS)

    Reygondeau, G.; Cheung, W. W. L.; Froelicher, T. L.; Stock, C. A.; Jones, M. C.; Sarmiento, J. L.

    2016-02-01

    Previous studies have projected the global redistribution of potential marine fisheries catches by mid-21st century under climate change, with increases in high latitude regions and pronounced decreases in tropical biomes. However, quantified confidence levels of such projections are not available, rendering it difficult to interpret the associated risk to society. This paper quantifies the confidence of changes in future fish production using a 30-member ensemble simulation of the Geophysical Fluid Dynamics Laboratory ESM2M (representing internal variability of oceanographic conditions), three structural variants of a mechanistic species distribution model (representing uncertainty in fisheries models and different greenhouse gas emission and fishing scenarios (representing scenario uncertainty). We project that total potential catches of 500 exploited fish and invertebrate stocks, that contribute most to regional fisheries catches and their variability, will likely decrease in the 21st century under a `business-as-usual' greenhouse gas emission scenario (RCP8.5). Fishing and it's management remains a main factor determining future fish stocks and their catches. Internal variability of projected ocean conditions, including temperature, oxygen level, pH, net primary production and sea ice contributes substantially to the uncertainty of potential catch projections. Regionally, climate-driven decreases in potential catches in tropical oceans and increases in the Arctic polar regions are projected with higher confidence than other regions, while the direction of changes in most mid-latitude (or temperate) regions is uncertain. Under a stringent greenhouse gas mitigation scenario (RCP 2.6), climate change impacts on potential catches may not emerge from their uncertainties. Overall, this study provides a foundation for quantifying risks of climate change impacts on marine fisheries globally and regionally, and how such risk may be altered by policy interventions.

  20. Medical narratives and patient analogs: the ethical implications of electronic patient records.

    PubMed

    Kluge, E H

    1999-12-01

    An electronic patient record consists of electronically stored data about a specific patient. It therefore constitutes a data-space. The data may be combined into a patient profile which is relative to a particular specialty as well as phenomenologically unique to the specific professional who constructs the profile. Further, a diagnosis may be interpreted as a path taken by a health care professional with a certain specialty through the data-space relative to the patient profile constructed by that professional. This way of looking at electronic patient records entails certain ethical implications about privacy and accessibility. However, it also permits the construction of artificial intelligence and competence algorithms for health care professionals relative to their specialties.

  1. Real-time Automated Sampling of Electronic Medical Records Predicts Hospital Mortality

    PubMed Central

    Khurana, Hargobind S.; Groves, Robert H.; Simons, Michael P.; Martin, Mary; Stoffer, Brenda; Kou, Sherri; Gerkin, Richard; Reiman, Eric; Parthasarathy, Sairam

    2016-01-01

    Background Real-time automated continuous sampling of electronic medical record data may expeditiously identify patients at risk for death and enable prompt life-saving interventions. We hypothesized that a real-time electronic medical record-based alert could identify hospitalized patients at risk for mortality. Methods An automated alert was developed and implemented to continuously sample electronic medical record data and trigger when at least two of four systemic inflammatory response syndrome criteria plus at least one of 14 acute organ dysfunction parameters was detected. The SIRS/OD alert was applied real-time to 312,214 patients in 24 hospitals and analyzed in two phases: training and validation datasets. Results In the training phase, 29,317 (18.8%) triggered the alert and 5.2% of such patients died whereas only 0.2% without the alert died (unadjusted odds ratio 30.1; 95% confidence interval [95%CI] 26.1, 34.5; P<0.0001). In the validation phase, the sensitivity, specificity, area under curve (AUC), positive and negative likelihood ratios for predicting mortality were 0.86, 0.82, 0.84, 4.9, and 0.16, respectively. Multivariate Cox-proportional hazard regression model revealed greater hospital mortality when the alert was triggered (adjusted Hazards Ratio 4.0; 95%CI 3.3, 4.9; P<0.0001). Triggering the alert was associated with additional hospitalization days (+3.0 days) and ventilator days (+1.6 days; P<0.0001). Conclusion An automated alert system that continuously samples electronic medical record-data can be implemented, has excellent test characteristics, and can assist in the real-time identification of hospitalized patients at risk for death. PMID:27019043

  2. 50 CFR 648.100 - Summer flounder Annual Catch Limit (ACL).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Summer flounder Annual Catch Limit (ACL... Management Measures for the Summer Flounder Fisheries § 648.100 Summer flounder Annual Catch Limit (ACL). (a... frequent or more specific ACL performance review criteria as part of a stock rebuilding plan following a...

  3. 50 CFR 648.100 - Summer flounder Annual Catch Limit (ACL).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Summer flounder Annual Catch Limit (ACL... Management Measures for the Summer Flounder Fisheries § 648.100 Summer flounder Annual Catch Limit (ACL). (a... frequent or more specific ACL performance review criteria as part of a stock rebuilding plan following a...

  4. 50 CFR 648.100 - Summer flounder Annual Catch Limit (ACL).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Summer flounder Annual Catch Limit (ACL... Management Measures for the Summer Flounder Fisheries § 648.100 Summer flounder Annual Catch Limit (ACL). (a... frequent or more specific ACL performance review criteria as part of a stock rebuilding plan following a...

  5. A sampling device for the fauna of storm water catch basins

    USGS Publications Warehouse

    Butler, M.; Casagrande, R.; LeBrun, R.; Ginsberg, H.; Gettman, A.

    2007-01-01

    Storm water drainage catch basins provide habitat to a variety of different aquatic organisms including arthropods, molluscs and annelid worms. Arthropods such as mosquitoes are known to use these environments as larval habitat. Because of health concerns, catch basins are often targeted for mosquito control exposing all inhabitants to pesticides such as methoprene or BTI. In this paper we describe a sampler that we used to evaluate catch basin communities in southern Rhode Island over a six month period. We also examine its efficacy and consistency. We found that the sampler effectively estimated organism abundances.

  6. Timely Healthcare Checkup Catches Melanoma Early

    MedlinePlus

    ... please turn Javascript on. Feature: Skin Cancer Timely Healthcare Checkup Catches Melanoma Early Past Issues / Summer 2013 ... left the Congress and starting working as a healthcare consultant, when I finally decided to have a ...

  7. Invasive blood pressure recording comparing nursing charts with an electronic monitor: a technical report.

    PubMed

    Wong, Benjamin T; Glassford, Neil J; Bion, Victoria; Chai, Syn Y; Bellomo, Rinaldo

    2014-03-01

    Blood pressure management (assessed using nursing charts) in the early phase of septic shock may have an effect on renal outcomes. Assessment of mean arterial pressure (MAP) values as recorded on nursing charts may be inaccurate. To determine the difference between hourly blood pressure values as recorded on the nursing charts and hourly average blood pressure values over the corresponding period obtained electronically from the bedside monitor. We studied 20 patients with shock requiring vasopressor support and invasive blood pressure monitoring. Hourly blood pressure measurements were recorded on the nursing charts over a 12-hour period. Blood pressure values recorded every 10 minutes were downloaded from electronic patient monitors over the corresponding period. The hourly average of the 10-minute blood pressure values was compared with the measurements recorded on the nursing charts. We assessed 240 chart readings and 1440 electronic recordings. Average chart MAP was 72.54 mmHg and average electronic monitor MAP was 71.54 mmHg. MAP data from the two sources showed a strong correlation (ρ0.71, P < 0.005). Bland-Altman assessment revealed acceptable agreement, with a mean bias of 1mmHg and 95% limits of agreement of -11.76 mmHg and 13.76 mmHg. Using average data over 6 hours, 95% limits of agreement narrowed to -6.79mmHg and 8.79mmHg. With multiple measurements over time, mean blood pressure as recorded on nursing charts reasonably approximates mean blood pressure recorded on the monitor.

  8. Dynamic optometer. [for electronic recording of human lens anterior surface

    NASA Technical Reports Server (NTRS)

    Wilson, D. C.

    1974-01-01

    A dynamic optometer that electronically records the position of the anterior surface of the human lens is described. The geometrical optics of the eye and optometer, and the scattering of light from the lens, are closely examined to determine the optimum conditions for adjustment of the instrument. The light detector and associated electronics are also considered, and the operating conditions for obtaining the best signal-to-noise ratio are determined.

  9. A minimum attention control law for ball catching.

    PubMed

    Jang, Cheongjae; Lee, Jee-eun; Lee, Sohee; Park, F C

    2015-10-06

    Digital implementations of control laws typically involve discretization with respect to both time and space, and a control law that can achieve a task at coarser levels of discretization can be said to require less control attention, and also reduced implementation costs. One means of quantitatively capturing the attention of a control law is to measure the rate of change of the control with respect to changes in state and time. In this paper we present an attention-minimizing control law for ball catching and other target tracking tasks based on Brockett's attention criterion. We first highlight the connections between this attention criterion and some well-known principles from human motor control. Under the assumption that the optimal control law is the sum of a linear time-varying feedback term and a time-varying feedforward term, we derive an LQR-based minimum attention tracking control law that is stable, and obtained efficiently via a finite-dimensional optimization over the symmetric positive-definite matrices. Taking ball catching as our primary task, we perform numerical experiments comparing the performance of the various control strategies examined in the paper. Consistent with prevailing theories about human ball catching, our results exhibit several familiar features, e.g., the transition from open-loop to closed-loop control during the catching movement, and improved robustness to spatiotemporal discretization. The presented control laws are applicable to more general tracking problems that are subject to limited communication resources.

  10. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    PubMed

    Rodriguez Torres, Yasaira; Huang, Jordan; Mihlstin, Melanie; Juzych, Mark S; Kromrei, Heidi; Hwang, Frank S

    2017-01-01

    This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p < 0.0005). Electronic Health Record A had high compliance (>90%) in 13 elements while Electronic Health Record B had high compliance (>90%) in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

  11. Perioperative nurses' attitudes toward the electronic health record.

    PubMed

    Yontz, Laura S; Zinn, Jennifer L; Schumacher, Edward J

    2015-02-01

    The adoption of an electronic health record (EHR) is mandated under current health care legislation reform. The EHR provides data that are patient centered and improves patient safety. There are limited data; however, regarding the attitudes of perioperative nurses toward the use of the EHR. The purpose of this project was to identify perioperative nurses' attitudes toward the use of the EHR. Quantitative descriptive survey was used to determine attitudes toward the electronic health record. Perioperative nurses in a southeastern health system completed an online survey to determine their attitudes toward the EHR in providing patient care. Overall, respondents felt the EHR was beneficial, did not add to the workload, improved documentation, and would not eliminate any nursing jobs. Nursing acceptance and the utilization of the EHR are necessary for the successful integration of an EHR and to support the goal of patient-centered care. Identification of attitudes and potential barriers of perioperative nurses in using the EHR will improve patient safety, communication, reduce costs, and empower those who implement an EHR. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  12. Catch of the Day, Tomorrow, and the Future

    NASA Astrophysics Data System (ADS)

    Brown, J.

    2017-12-01

    There are many fishermen and women in Pensacola, Florida, specifically at the Plaza De Luna Circle at the end of Palafox street. What are these fisherpeople hoping to catch? Do they want to eat their harvest or just catch for sport? Surveying the locals will help answer these questions and more. These answers will turn into data that will be shared and discussed with the Florida Fish and Wildlife Conservation Commission in hopes that it will give them ideas on how to manage our natural resources while best serving the interests our community.

  13. 75 FR 9157 - Proposed Information Collection; Comment Request; Alaska Region Scale and Catch Weighing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-01

    ... and catch weighing requirements address performance standards designed to ensure that all catch... motherships is based on the vessel meeting a series of design criteria. Because of the wide variations in factory layout for inshore processors, NMFS requires a performance-based catch monitoring system for...

  14. 50 CFR 679.32 - CDQ fisheries monitoring and catch accounting.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Applicability. This section contains requirements for CDQ groups, vessel operators, and managers of processors... once a CDQ group has reached its salmon PSQ or crab PSQ are listed in § 679.7(d)(5). The catch of... before CDQ catch is brought onboard the vessel and notify the observers of the CDQ group and CDQ number...

  15. Building a national electronic medical record exchange system - experiences in Taiwan.

    PubMed

    Li, Yu-Chuan Jack; Yen, Ju-Chuan; Chiu, Wen-Ta; Jian, Wen-Shan; Syed-Abdul, Shabbir; Hsu, Min-Huei

    2015-08-01

    There are currently 501 hospitals and about 20,000 clinics in Taiwan. The National Health Insurance (NHI) system, which is operated by the NHI Administration, uses a single-payer system and covers 99.9% of the nation's total population of 23,000,000. Taiwan's NHI provides people with a high degree of freedom in choosing their medical care options. However, there is the potential concern that the available medical resources will be overused. The number of doctor consultations per person per year is about 15. Duplication of laboratory tests and prescriptions are not rare either. Building an electronic medical record exchange system is a good method of solving these problems and of improving continuity in health care. In November 2009, Taiwan's Executive Yuan passed the 'Plan for accelerating the implementation of electronic medical record systems in medical institutions' (2010-2012; a 3-year plan). According to this plan, a patient can, at any hospital in Taiwan, by using his/her health insurance IC card and physician's medical professional IC card, upon signing a written agreement, retrieve all important medical records for the past 6 months from other participating hospitals. The focus of this plan is to establish the National Electronic Medical Record Exchange Centre (EEC). A hospital's information system will be connected to the EEC through an electronic medical record (EMR) gateway. The hospital will convert the medical records for the past 6 months in its EMR system into standardized files and save them on the EMR gateway. The most important functions of the EEC are to generate an index of all the XML files on the EMR gateways of all hospitals, and to provide search and retrieval services for hospitals and clinics. The EEC provides four standard inter-institution EMR retrieval services covering medical imaging reports, laboratory test reports, discharge summaries, and outpatient records. In this system, we adopted the Health Level 7 (HL7) Clinical Document

  16. 76 FR 3091 - National Annual Catch Limit Science Workshop; Meeting Announcement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-19

    ... Annual Catch Limit Science Workshop; Meeting Announcement AGENCY: National Marine Fisheries Service (NMFS...: Richard Methot, Office of Science and Technology, NMFS at [email protected] , or at (206) 860-3365. SUPPLEMENTARY INFORMATION: NOAA Fisheries Service is announcing a National Annual Catch Limit (ACL) Science...

  17. Electronic health records and improved nursing management of chronic obstructive pulmonary disease.

    PubMed

    Liu, Fengping; Zou, Yeqing; Huang, Qingmei; Zheng, Li; Wang, Wei

    2015-01-01

    This paper identifies evolving trends in the diagnosis and treatment of chronic obstructive pulmonary disease (COPD), and recommends the integration of nursing strategies in COPD management via widespread implementation of electronic health records. COPD is a complex lung disease with diverse origins, both physical and behavioral, manifested in a wide range of symptoms that further increase the patient's risk for comorbidities. Early diagnosis and effective management of COPD require monitoring of a dizzying array of COPD symptoms over extended periods of time, and nurses are especially well positioned to manage potential progressions of COPD, as frontline health care providers who obtain, record, and organize patient data. Developments in medical technology greatly aid nursing management of COPD, from the deployment of spirometry as a diagnostic tool at the family practice level to newly approved treatment options, including non-nicotine pharmacotherapies that reduce the cravings associated with tobacco withdrawal. Among new medical technologies, electronic health records have proven particularly advantageous in the management of COPD, enabling providers to gather, maintain, and reference more patient data than has ever been possible before. Thus, consistent and widespread implementation of electronic health records facilitates the coordination of diverse treatment strategies, resulting in increased positive health outcomes for patients with COPD.

  18. Development of clinical contents model markup language for electronic health records.

    PubMed

    Yun, Ji-Hyun; Ahn, Sun-Ju; Kim, Yoon

    2012-09-01

    To develop dedicated markup language for clinical contents models (CCM) to facilitate the active use of CCM in electronic health record systems. Based on analysis of the structure and characteristics of CCM in the clinical domain, we designed extensible markup language (XML) based CCM markup language (CCML) schema manually. CCML faithfully reflects CCM in both the syntactic and semantic aspects. As this language is based on XML, it can be expressed and processed in computer systems and can be used in a technology-neutral way. CCML HAS THE FOLLOWING STRENGTHS: it is machine-readable and highly human-readable, it does not require a dedicated parser, and it can be applied for existing electronic health record systems.

  19. Identifying patients with hypertension: a case for auditing electronic health record data.

    PubMed

    Baus, Adam; Hendryx, Michael; Pollard, Cecil

    2012-01-01

    Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).

  20. Developing iCare v.1.0: an academic electronic health record.

    PubMed

    Wyatt, Tami H; Li, Xueping; Indranoi, Chayawat; Bell, Matthew

    2012-06-01

    An electronic health record application, iCare v.1.0, was developed and tested that allows data input and retrieval while tracking student performance over time. The development and usability testing of iCare v.1.0 followed a rapid prototyping software development and testing model. Once the functionality was tested by engineers, the usability and feasibility testing began with a convenience sample of focus group members including undergraduate and graduate students and faculty. Three focus groups were created, and four subjects participated in each focus group (n = 12). Nielsen's usability heuristics and methods of evaluation were used to evaluate data captured from each focus group. Overall, users wanted a full-featured electronic health record with features that coached or guided users. The earliest versions of iCare v.1.0 did not provide help features and prompts to guide students but were later added. Future versions will incorporate a full-featured help section. The interface and design of iCare v.1.0 are similar to professional electronic health record applications. As a result of this usability study, future versions of iCare will include more robust help features along with advanced reporting and elements specific to specialty populations such as pediatrics and mental health services.

  1. Quality and Electronic Health Records in Community Health Centers

    ERIC Educational Resources Information Center

    Lesh, Kathryn A.

    2014-01-01

    Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…

  2. Resolving the molecular mechanism of cadherin catch bond formation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Manibog, Kristine; Li, Hui; Rakshit, Sabyasachi

    2014-06-02

    Classical cadherin Ca(2+)-dependent cell-cell adhesion proteins play key roles in embryogenesis and in maintaining tissue integrity. Cadherins mediate robust adhesion by binding in multiple conformations. One of these adhesive states, called an X-dimer, forms catch bonds that strengthen and become longer lived in the presence of mechanical force. Here we use single-molecule force-clamp spectroscopy with an atomic force microscope along with molecular dynamics and steered molecular dynamics simulations to resolve the molecular mechanisms underlying catch bond formation and the role of Ca(2+) ions in this process. Our data suggest that tensile force bends the cadherin extracellular region such that theymore » form long-lived, force-induced hydrogen bonds that lock X-dimers into tighter contact. When Ca(2+) concentration is decreased, fewer de novo hydrogen bonds are formed and catch bond formation is eliminated« less

  3. Electronic Health Record Application Support Service Enablers.

    PubMed

    Neofytou, M S; Neokleous, K; Aristodemou, A; Constantinou, I; Antoniou, Z; Schiza, E C; Pattichis, C S; Schizas, C N

    2015-08-01

    There is a huge need for open source software solutions in the healthcare domain, given the flexibility, interoperability and resource savings characteristics they offer. In this context, this paper presents the development of three open source libraries - Specific Enablers (SEs) for eHealth applications that were developed under the European project titled "Future Internet Social and Technological Alignment Research" (FI-STAR) funded under the "Future Internet Public Private Partnership" (FI-PPP) program. The three SEs developed under the Electronic Health Record Application Support Service Enablers (EHR-EN) correspond to: a) an Electronic Health Record enabler (EHR SE), b) a patient summary enabler based on the EU project "European patient Summary Open Source services" (epSOS SE) supporting patient mobility and the offering of interoperable services, and c) a Picture Archiving and Communications System (PACS) enabler (PACS SE) based on the dcm4che open source system for the support of medical imaging functionality. The EHR SE follows the HL7 Clinical Document Architecture (CDA) V2.0 and supports the Integrating the Healthcare Enterprise (IHE) profiles (recently awarded in Connectathon 2015). These three FI-STAR platform enablers are designed to facilitate the deployment of innovative applications and value added services in the health care sector. They can be downloaded from the FI-STAR cataloque website. Work in progress focuses in the validation and evaluation scenarios for the proving and demonstration of the usability, applicability and adaptability of the proposed enablers.

  4. Quality and Certification of Electronic Health Records

    PubMed Central

    Hoerbst, A.; Ammenwerth, E.

    2010-01-01

    Background Numerous projects, initiatives, and programs are dedicated to the development of Electronic Health Records (EHR) worldwide. Increasingly more of these plans have recently been brought from a scientific environment to real life applications. In this context, quality is a crucial factor with regard to the acceptance and utility of Electronic Health Records. However, the dissemination of the existing quality approaches is often rather limited. Objectives The present paper aims at the description and comparison of the current major quality certification approaches to EHRs. Methods A literature analysis was carried out in order to identify the relevant publications with regard to EHR quality certification. PubMed, ACM Digital Library, IEEExplore, CiteSeer, and Google (Scholar) were used to collect relevant sources. The documents that were obtained were analyzed using techniques of qualitative content analysis. Results The analysis discusses and compares the quality approaches of CCHIT, EuroRec, IHE, openEHR, and EN13606. These approaches differ with regard to their focus, support of service-oriented EHRs, process of (re-)certification and testing, number of systems certified and tested, supporting organizations, and regional relevance. Discussion The analyzed approaches show differences with regard to their structure and processes. System vendors can exploit these approaches in order to improve and certify their information systems. Health care organizations can use these approaches to support selection processes or to assess the quality of their own information systems. PMID:23616834

  5. Usability of a mobile electronic medical record prototype: a verbal protocol analysis.

    PubMed

    Wu, Robert C; Orr, M Scott; Chignell, Mark; Straus, Sharon E

    2008-06-01

    Point of care access to electronic medical records may provide clinicians with the information they want when they need it and may in turn improve patient safety. Yet providing an electronic medical record on handheld devices presents many usability challenges, and it is unclear whether clinicians will use them. An iterative design process for the development and evaluation of a prototype of a mobile electronic medical record was performed. Usability sessions were conducted in which physicians were asked to 'think aloud' while working through clinical scenarios using the prototype. Verbal protocol analysis, which consists of coding utterances, was conducted on the transcripts from the sessions and common themes were extracted. Usability sessions were held with five family physicians and four internists with varying levels of computer expertise. Physicians were able to use the device to complete 52 of 54 required tasks. Users commented that it was intuitive (9/9), would increase accessibility (5/9) but for them to use it, it would need the system to be fast and time-saving (5/9). Users had difficulty entering information (5/9) and reading the screen (4/9). In terms of functionality, users had concerns about completeness of information (6/9), details of ordering (5/9) and desired billing functionality (5/9) and integration with other systems (4/9). While physicians can use mobile electronic medical records in realistic scenarios, certain requirements likely need to be met including a fast system with easy data selection, easy data entry and improved display before widespread adoption occurs.

  6. Enabling Patient Control of Personal Electronic Health Records Through Distributed Ledger Technology.

    PubMed

    Cunningham, James; Ainsworth, John

    2017-01-01

    The rise of distributed ledger technology, initiated and exemplified by the Bitcoin blockchain, is having an increasing impact on information technology environments in which there is an emphasis on trust and security. Management of electronic health records, where both conformation to legislative regulations and maintenance of public trust are paramount, is an area where the impact of these new technologies may be particularly beneficial. We present a system that enables fine-grained personalized control of third-party access to patients' electronic health records, allowing individuals to specify when and how their records are accessed for research purposes. The use of the smart contract based Ethereum blockchain technology to implement this system allows it to operate in a verifiably secure, trustless, and openly auditable environment, features crucial to health information systems moving forward.

  7. Architecture of portable electronic medical records system integrated with streaming media.

    PubMed

    Chen, Wei; Shih, Chien-Chou

    2012-02-01

    Due to increasing occurrence of accidents and illness during business trips, travel, or overseas studies, the requirement for portable EMR (Electronic Medical Records) has increased. This study proposes integrating streaming media technology into the EMR system to facilitate referrals, contracted laboratories, and disease notification among hospitals. The current study encoded static and dynamic medical images of patients into a streaming video format and stored them in a Flash Media Server (FMS). Based on the Taiwan Electronic Medical Record Template (TMT) standard, EMR records can be converted into XML documents and used to integrate description fields with embedded streaming videos. This investigation implemented a web-based portable EMR interchanging system using streaming media techniques to expedite exchanging medical image information among hospitals. The proposed architecture of the portable EMR retrieval system not only provides local hospital users the ability to acquire EMR text files from a previous hospital, but also helps access static and dynamic medical images as reference for clinical diagnosis and treatment. The proposed method protects property rights of medical images through information security mechanisms of the Medical Record Interchange Service Center and Health Certificate Authorization to facilitate proper, efficient, and continuous treatment of patients.

  8. Develop security architecture for both in-house healthcare information systems and electronic patient record

    NASA Astrophysics Data System (ADS)

    Zhang, Jianguo; Chen, Xiaomeng; Zhuang, Jun; Jiang, Jianrong; Zhang, Xiaoyan; Wu, Dongqing; Huang, H. K.

    2003-05-01

    In this paper, we presented a new security approach to provide security measures and features in both healthcare information systems (PACS, RIS/HIS), and electronic patient record (EPR). We introduced two security components, certificate authoring (CA) system and patient record digital signature management (DSPR) system, as well as electronic envelope technology, into the current hospital healthcare information infrastructure to provide security measures and functions such as confidential or privacy, authenticity, integrity, reliability, non-repudiation, and authentication for in-house healthcare information systems daily operating, and EPR exchanging among the hospitals or healthcare administration levels, and the DSPR component manages the all the digital signatures of patient medical records signed through using an-symmetry key encryption technologies. The electronic envelopes used for EPR exchanging are created based on the information of signers, digital signatures, and identifications of patient records stored in CAS and DSMS, as well as the destinations and the remote users. The CAS and DSMS were developed and integrated into a RIS-integrated PACS, and the integration of these new security components is seamless and painless. The electronic envelopes designed for EPR were used successfully in multimedia data transmission.

  9. Interfacing with the brain using organic electronics (Presentation Recording)

    NASA Astrophysics Data System (ADS)

    Malliaras, George G.

    2015-10-01

    Implantable electrodes are being used for diagnostic purposes, for brain-machine interfaces, and for delivering electrical stimulation to alleviate the symptoms of diseases such as Parkinson's. The field of organic electronics made available devices with a unique combination of attractive properties, including mixed ionic/electronic conduction, mechanical flexibility, enhanced biocompatibility, and capability for drug delivery. I will present examples of organic electrodes, transistors and other devices for recording and stimulation of brain activity and discuss how they can improve our understanding of brain physiology and pathology, and how they can be used to deliver new therapies.

  10. A Drosera-bioinspired hydrogel for catching and killing cancer cells

    PubMed Central

    Li, Shihui; Chen, Niancao; Gaddes, Erin R.; Zhang, Xiaolong; Dong, Cheng; Wang, Yong

    2015-01-01

    A variety of bioinspired materials have been successfully synthesized to mimic the sophisticated structures or functions of biological systems. However, it is still challenging to develop materials with multiple functions that can be performed synergistically or sequentially. The purpose of this work was to demonstrate a novel bioinspired hydrogel that can interact with cancer cells, functionally similar to Drosera in catching and killing prey. This hydrogel had two layers with the top one functionalized with oligonucleotide aptamers and the bottom one functionalized with double-stranded DNA. The results show that the top hydrogel layer was able to catch target cells with high efficiency and specificity, and that the bottom hydrogel layer could sequester doxorubicin (Dox) for sustained drug release. Importantly, the released Dox could kill 90% of the cells after 1-h residence of the cells on the hydrogel. After the cell release, this bifunctional hydrogel could be regenerated for continuous cell catching and killing. Therefore, the data presented in this study has successfully demonstrated the potential of developing a material system with the functions of attracting, catching and killing diseased cells (e.g., circulating tumor cells) or even invading microorganisms (e.g., bacteria). PMID:26396063

  11. Markov chain model for demersal fish catch analysis in Indonesia

    NASA Astrophysics Data System (ADS)

    Firdaniza; Gusriani, N.

    2018-03-01

    As an archipelagic country, Indonesia has considerable potential fishery resources. One of the fish resources that has high economic value is demersal fish. Demersal fish is a fish with a habitat in the muddy seabed. Demersal fish scattered throughout the Indonesian seas. Demersal fish production in each Indonesia’s Fisheries Management Area (FMA) varies each year. In this paper we have discussed the Markov chain model for demersal fish yield analysis throughout all Indonesia’s Fisheries Management Area. Data of demersal fish catch in every FMA in 2005-2014 was obtained from Directorate of Capture Fisheries. From this data a transition probability matrix is determined by the number of transitions from the catch that lie below the median or above the median. The Markov chain model of demersal fish catch data was an ergodic Markov chain model, so that the limiting probability of the Markov chain model can be determined. The predictive value of demersal fishing yields was obtained by calculating the combination of limiting probability with average catch results below the median and above the median. The results showed that for 2018 and long-term demersal fishing results in most of FMA were below the median value.

  12. CATCH/IT: a data warehouse to support comprehensive assessment for tracking community health.

    PubMed

    Berndt, D J; Hevner, A R; Studnicki, J

    1998-01-01

    A systematic methodology, Comprehensive Assessment for Tracking Community Health (CATCH), for analyzing the health status of communities has been under development at the University of South Florida since the early 1990s. CATCH draws 226 health status indicators from multiple data sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered list of community health problems. CATCH has been applied successfully in many Florida counties; focusing attention on high priority health issues and measuring the impact of health expenditures on community health status outcomes. Previously performed manually, we are using information technology (IT) to automate the CATCH methodology with a full-scale data warehouse, user-friendly forms and reports, and extended analysis and data mining capabilities. The automated system, CATCH/IT, will reduce the time to prepare community health status reports from months to days. In this paper, we present the current status of the project, along with the principal research and development issues and future directions of the project.

  13. [Results of training in the electronic health records in a tertiary care hospital].

    PubMed

    Alva Espinosa, Carlos; Fuentes Domínguez, Marco Antonio; Garibay Huarte, Tania

    2014-12-01

    To assess the user evaluation of the electronic health records system together with its training program and to investigate the relation between the number of training sessions and the corresponding evaluation scores given by the participants. An anonymous survey was conducted between the medical, nursing and social worker personnel. The survey included seven multiple-choice questions with a numerical scale from 1 to 10 and an additional open question. IBM SPSS Statistics v18 software was used to perform ANOVA variance analysis. In total, 340 workers participated in this study; 317 were included in the statistical analysis, out of which 76% had one or two training sessions, 13.9% received three or more sessions and 10% had no training. The mean global training evaluation by the participants was 5.9 ± 2.3, median 6.3, while the electronic records system evaluation was 5.2 ± 2.3, median 5.5. In relation to the training and electronic records system it was observed that higher evaluation scores were obtained with increasing number of training sessions (p < 0.001). On the electronic records systems, personnel with no training evaluated the system with a mean score of 3.9 ± 2.7, while those who received three or more training sessions evaluated the system with a mean score of 6.1 ± 1.8 (p < 0.001).

  14. An assessment of West African seahorses in fisheries catch and trade.

    PubMed

    Cisneros-Montemayor, A M; West, K; Boiro, I S; Vincent, A C J

    2016-02-01

    This study provides the first assessment of a heavily traded West African seahorse species, Hippocampus algiricus, and the first information on short-snouted seahorse Hippocampus hippocampus biology in Africa. A total of 219 seahorses were sampled from fisher catch in Senegal and The Gambia, with estimated height at reproductive activity for H. algiricus (161 mm) larger than mean ± S.D. catch height (150 ± 31 mm). Catch composition, height at reproductive activity and potential biases in fishery retention are discussed with regard to the current Convention on International Trade of Endangered Species (CITES) guidelines. © 2015 The Fisheries Society of the British Isles.

  15. Cost-effectiveness analysis of catch-up hepatitis A vaccination among unvaccinated/partially-vaccinated children

    PubMed Central

    Hankin-Wei, Abigail; Rein, David B.; Hernandez-Romieu, Alfonso; Kennedy, Mallory J.; Bulkow, Lisa; Rosenberg, Eli; Trigg, Monica; Nelson, Noele P.

    2017-01-01

    Background Since 2006, the US Centers for Disease Control and Prevention has recommended hepatitis A (HepA) vaccination routinely for children aged 12–23 months to prevent hepatitis A virus (HAV) infection. However, a substantial proportion of US children are unvaccinated and susceptible to infection. We present results of economic modeling to assess whether a one-time catch-up HepA vaccination recommendation would be cost-effective. Methods We developed a Markov model of HAV infection that followed a single cohort from birth through death (birth to age 95 years). The model compared the health and economic outcomes from catch-up vaccination interventions for children at target ages from two through 17 years vs. outcomes resulting from maintaining the current recommendation of routine vaccination at age one year with no catch-up intervention. Results Over the lifetime of the cohort, catch-up vaccination would reduce the total number of infections relative to the baseline by 741 while increasing doses of vaccine by 556,989. Catch-up vaccination would increase net costs by $10.2 million, or $2.38 per person. The incremental cost of HepA vaccine catch-up intervention at age 10 years, the midpoint of the ages modeled, was $452,239 per QALY gained. Across age-cohorts, the cost-effectiveness of catch-up vaccination is most favorable at age 12 years, resulting in an Incremental Cost-Effectiveness Ratio of $189,000 per QALY gained. Conclusions Given the low baseline of HAV disease incidence achieved by current vaccination recommendations, our economic model suggests that a catch-up vaccination recommendation would be less cost-effective than many other vaccine interventions, and that HepA catch-up vaccination would become cost effective at a threshold of $50,000 per QALY only when incidence of HAV rises about 5.0 cases per 100,000 population. PMID:27317459

  16. Cost-effectiveness analysis of catch-up hepatitis A vaccination among unvaccinated/partially-vaccinated children.

    PubMed

    Hankin-Wei, Abigail; Rein, David B; Hernandez-Romieu, Alfonso; Kennedy, Mallory J; Bulkow, Lisa; Rosenberg, Eli; Trigg, Monica; Nelson, Noele P

    2016-07-29

    Since 2006, the US Centers for Disease Control and Prevention has recommended hepatitis A (HepA) vaccination routinely for children aged 12-23months to prevent hepatitis A virus (HAV) infection. However, a substantial proportion of US children are unvaccinated and susceptible to infection. We present results of economic modeling to assess whether a one-time catch-up HepA vaccination recommendation would be cost-effective. We developed a Markov model of HAV infection that followed a single cohort from birth through death (birth to age 95years). The model compared the health and economic outcomes from catch-up vaccination interventions for children at target ages from two through 17years vs. outcomes resulting from maintaining the current recommendation of routine vaccination at age one year with no catch-up intervention. Over the lifetime of the cohort, catch-up vaccination would reduce the total number of infections relative to the baseline by 741 while increasing doses of vaccine by 556,989. Catch-up vaccination would increase net costs by $10.2million, or $2.38 per person. The incremental cost of HepA vaccine catch-up intervention at age 10years, the midpoint of the ages modeled, was $452,239 per QALY gained. Across age-cohorts, the cost-effectiveness of catch-up vaccination is most favorable at age 12years, resulting in an Incremental Cost-Effectiveness Ratio of $189,000 per QALY gained. Given the low baseline of HAV disease incidence achieved by current vaccination recommendations, our economic model suggests that a catch-up vaccination recommendation would be less cost-effective than many other vaccine interventions, and that HepA catch-up vaccination would become cost effective at a threshold of $50,000 per QALY only when incidence of HAV rises about 5.0 cases per 100,000 population. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Feasibility of utilizing a commercial eye tracker to assess electronic health record use during patient simulation.

    PubMed

    Gold, Jeffrey Allen; Stephenson, Laurel E; Gorsuch, Adriel; Parthasarathy, Keshav; Mohan, Vishnu

    2016-09-01

    Numerous reports describe unintended consequences of electronic health record implementation. Having previously described physicians' failures to recognize patient safety issues within our electronic health record simulation environment, we now report on our use of eye and screen-tracking technology to understand factors associated with poor error recognition during an intensive care unit-based electronic health record simulation. We linked performance on the simulation to standard eye and screen-tracking readouts including number of fixations, saccades, mouse clicks and screens visited. In addition, we developed an overall Composite Eye Tracking score which measured when, where and how often each safety item was viewed. For 39 participants, the Composite Eye Tracking score correlated with performance on the simulation (p = 0.004). Overall, the improved performance was associated with a pattern of rapid scanning of data manifested by increased number of screens visited (p = 0.001), mouse clicks (p = 0.03) and saccades (p = 0.004). Eye tracking can be successfully integrated into electronic health record-based simulation and provides a surrogate measure of cognitive decision making and electronic health record usability. © The Author(s) 2015.

  18. Liberal Arts Catch-Up Revisited

    ERIC Educational Resources Information Center

    Goyder, John

    2014-01-01

    This paper replicates the work of Giles and Drewes from the 1990s. They showed a catch-up effect whereby graduates of liberal arts undergraduate programs, although at an early-career disadvantage compared with graduates of applied programs, had higher incomes by mid-career. Working with the Panel 5 Survey of Labour and Income Dynamics (2005-2010),…

  19. Catch-22 and Property Rights

    Treesearch

    Warren A. Flick

    1998-01-01

    Almost everone knows Catch-22 situations where the inherenct logic of something creates an absurdity or self-contridiction. Author Joesph Heller's original was a military rule designed to thwart airmen from pleading insanity to escape bombing missions--the rule said any airman rational enough to want to be grounded could not possibly be insane and therefore had to...

  20. Point-of-care cluster randomized trial in stroke secondary prevention using electronic health records.

    PubMed

    Dregan, Alex; van Staa, Tjeerd P; McDermott, Lisa; McCann, Gerard; Ashworth, Mark; Charlton, Judith; Wolfe, Charles D A; Rudd, Anthony; Yardley, Lucy; Gulliford, Martin C; Trial Steering Committee

    2014-07-01

    The aim of this study was to evaluate whether the remote introduction of electronic decision support tools into family practices improves risk factor control after first stroke. This study also aimed to develop methods to implement cluster randomized trials in stroke using electronic health records. Family practices were recruited from the UK Clinical Practice Research Datalink and allocated to intervention and control trial arms by minimization. Remotely installed, electronic decision support tools promoted intensified secondary prevention for 12 months with last measure of systolic blood pressure as the primary outcome. Outcome data from electronic health records were analyzed using marginal models. There were 106 Clinical Practice Research Datalink family practices allocated (intervention, 53; control, 53), with 11 391 (control, 5516; intervention, 5875) participants with acute stroke ever diagnosed. Participants at trial practices had similar characteristics as 47,887 patients with stroke at nontrial practices. During the intervention period, blood pressure values were recorded in the electronic health records for 90% and cholesterol values for 84% of participants. After intervention, the latest mean systolic blood pressure was 131.7 (SD, 16.8) mm Hg in the control trial arm and 131.4 (16.7) mm Hg in the intervention trial arm, and adjusted mean difference was -0.56 mm Hg (95% confidence interval, -1.38 to 0.26; P=0.183). The financial cost of the trial was approximately US $22 per participant, or US $2400 per family practice allocated. Large pragmatic intervention studies may be implemented at low cost by using electronic health records. The intervention used in this trial was not found to be effective, and further research is needed to develop more effective intervention strategies. http://www.controlled-trials.com. Current Controlled Trials identifier: ISRCTN35701810. © 2014 American Heart Association, Inc.

  1. 50 CFR 660.511 - Catch restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Catch restrictions. 660.511 Section 660.511 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OFF WEST COAST STATES Coastal Pelagics Fisheries...

  2. Renovating, Building, Expanding...Trying to Catch Up.

    ERIC Educational Resources Information Center

    Educational Record, 1989

    1989-01-01

    A collection of captioned photographs illustrates the range of campus construction needs, projects, and considerations in current efforts to catch up with the results of deferred maintenance and improvement. (MSE)

  3. Development of Clinical Contents Model Markup Language for Electronic Health Records

    PubMed Central

    Yun, Ji-Hyun; Kim, Yoon

    2012-01-01

    Objectives To develop dedicated markup language for clinical contents models (CCM) to facilitate the active use of CCM in electronic health record systems. Methods Based on analysis of the structure and characteristics of CCM in the clinical domain, we designed extensible markup language (XML) based CCM markup language (CCML) schema manually. Results CCML faithfully reflects CCM in both the syntactic and semantic aspects. As this language is based on XML, it can be expressed and processed in computer systems and can be used in a technology-neutral way. Conclusions CCML has the following strengths: it is machine-readable and highly human-readable, it does not require a dedicated parser, and it can be applied for existing electronic health record systems. PMID:23115739

  4. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209 of...

  5. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209 of...

  6. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209 of...

  7. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209 of...

  8. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209 of...

  9. Vital sign documentation in electronic records: The development of workarounds.

    PubMed

    Stevenson, Jean E; Israelsson, Johan; Nilsson, Gunilla; Petersson, Goran; Bath, Peter A

    2018-06-01

    Workarounds are commonplace in healthcare settings. An increase in the use of electronic health records has led to an escalation of workarounds as healthcare professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in electronic health records has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient's condition. We examined workflow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas, a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of handwritten notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and ensure patients safety.

  10. 50 CFR 648.141 - Black sea bass Annual Catch Target (ACT).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Black sea bass Annual Catch Target (ACT... Management Measures for the Black Sea Bass Fishery § 648.141 Black sea bass Annual Catch Target (ACT). (a) The Black Sea Bass Monitoring Committee shall identify and review the relevant sources of management...

  11. 50 CFR 648.141 - Black sea bass Annual Catch Target (ACT).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Black sea bass Annual Catch Target (ACT... Management Measures for the Black Sea Bass Fishery § 648.141 Black sea bass Annual Catch Target (ACT). (a) The Black Sea Bass Monitoring Committee shall identify and review the relevant sources of management...

  12. 50 CFR 648.141 - Black sea bass Annual Catch Target (ACT).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Black sea bass Annual Catch Target (ACT... Management Measures for the Black Sea Bass Fishery § 648.141 Black sea bass Annual Catch Target (ACT). (a) The Black Sea Bass Monitoring Committee shall identify and review the relevant sources of management...

  13. Comprehensive Quantification of the Spastic Catch in Children with Cerebral Palsy

    ERIC Educational Resources Information Center

    Lynn, Bar-On; Erwin, Aertbelien; Guy, Molenaers; Herman, Bruyninckx; Davide, Monari; Ellen, Jaspers; Anne, Cazaerck; Kaat, Desloovere

    2013-01-01

    In clinical settings, the spastic catch is judged subjectively. This study assessed the psychometric properties of objective parameters that define and quantify the severity of the spastic catch in children with cerebral palsy (CP). A convenience sample of children with spastic CP (N = 46; age range: 4-16 years) underwent objective spasticity…

  14. Merging Electronic Health Record Data and Genomics for Cardiovascular Research: A Science Advisory From the American Heart Association.

    PubMed

    Hall, Jennifer L; Ryan, John J; Bray, Bruce E; Brown, Candice; Lanfear, David; Newby, L Kristin; Relling, Mary V; Risch, Neil J; Roden, Dan M; Shaw, Stanley Y; Tcheng, James E; Tenenbaum, Jessica; Wang, Thomas N; Weintraub, William S

    2016-04-01

    The process of scientific discovery is rapidly evolving. The funding climate has influenced a favorable shift in scientific discovery toward the use of existing resources such as the electronic health record. The electronic health record enables long-term outlooks on human health and disease, in conjunction with multidimensional phenotypes that include laboratory data, images, vital signs, and other clinical information. Initial work has confirmed the utility of the electronic health record for understanding mechanisms and patterns of variability in disease susceptibility, disease evolution, and drug responses. The addition of biobanks and genomic data to the information contained in the electronic health record has been demonstrated. The purpose of this statement is to discuss the current challenges in and the potential for merging electronic health record data and genomics for cardiovascular research. © 2016 American Heart Association, Inc.

  15. How Accurate is Information that Patients Contribute to their Electronic Health Record?

    PubMed Central

    Wuerdeman, Lisa; Volk, Lynn; Pizziferri, Lisa; Tsurikova, Ruslana; Harris, Cathyann; Feygin, Raisa; Epstein, Marianna; Meyers, Kimberly; Wald, Jonathan S.; Lansky, David; Bates, David W.

    2005-01-01

    Increased patient interaction with medical records and the advent of personal health records (PHRs) may increase patients’ ability to contribute valid information to their Electronic Health Record (EHR) medical record. Patient input through a secure connection, whether it is a patient portal or PHR, will integrate many aspects of a patient’s health and may help lessen the information gap between patients and providers. Patient reported data should be considered a viable method of enhancing documentation but will not likely be as complete and accurate as more comprehensive data-exchange between providers. PMID:16779157

  16. The effect of the electronic medical record on nurses' work.

    PubMed

    Robles, Jane

    2009-01-01

    The electronic medical record (EMR) is a workplace reality for most nurses. Its advantages include a single consolidated record for each person; capacity for data interfaces and alerts; improved interdisciplinary communication; and evidence-based decision support. EMRs can add to work complexity, by forcing better documentation of previously unrecorded data and/or because of poor design. Well-designed and well-implemented computerized provider order entry (CPOE) systems can streamline nurses' work. Generational differences in acceptance of and facility with EMRs can be addressed through open, healthy communication.

  17. Profiling Lung Cancer Patients Using Electronic Health Records.

    PubMed

    Menasalvas Ruiz, Ernestina; Tuñas, Juan Manuel; Bermejo, Guzmán; Gonzalo Martín, Consuelo; Rodríguez-González, Alejandro; Zanin, Massimiliano; González de Pedro, Cristina; Méndez, Marta; Zaretskaia, Olga; Rey, Jesús; Parejo, Consuelo; Cruz Bermudez, Juan Luis; Provencio, Mariano

    2018-05-31

    If Electronic Health Records contain a large amount of information about the patient's condition and response to treatment, which can potentially revolutionize the clinical practice, such information is seldom considered due to the complexity of its extraction and analysis. We here report on a first integration of an NLP framework for the analysis of clinical records of lung cancer patients making use of a telephone assistance service of a major Spanish hospital. We specifically show how some relevant data, about patient demographics and health condition, can be extracted; and how some relevant analyses can be performed, aimed at improving the usefulness of the service. We thus demonstrate that the use of EHR texts, and their integration inside a data analysis framework, is technically feasible and worth of further study.

  18. Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff.

    PubMed

    Morrison, Cecily; Jones, Matthew; Blackwell, Alan; Vuylsteke, Alain

    2008-01-01

    Electronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record. A qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews. Our analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions. We discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round.

  19. Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff

    PubMed Central

    Morrison, Cecily; Jones, Matthew; Blackwell, Alan; Vuylsteke, Alain

    2008-01-01

    Introduction Electronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record. Methods A qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews. Results Our analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions. Conclusions We discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round. PMID:19025662

  20. 50 CFR 648.140 - Black sea bass Annual Catch Limit (ACL).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Black sea bass Annual Catch Limit (ACL... Management Measures for the Black Sea Bass Fishery § 648.140 Black sea bass Annual Catch Limit (ACL). (a) The Black Sea Bass Monitoring Committee shall recommend to the MAFMC separate ACLs for the commercial and...

  1. 50 CFR 648.140 - Black sea bass Annual Catch Limit (ACL).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Black sea bass Annual Catch Limit (ACL... Management Measures for the Black Sea Bass Fishery § 648.140 Black sea bass Annual Catch Limit (ACL). (a) The Black Sea Bass Monitoring Committee shall recommend to the MAFMC separate ACLs for the commercial and...

  2. 50 CFR 648.140 - Black sea bass Annual Catch Limit (ACL).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Black sea bass Annual Catch Limit (ACL... Management Measures for the Black Sea Bass Fishery § 648.140 Black sea bass Annual Catch Limit (ACL). (a) The Black Sea Bass Monitoring Committee shall recommend to the MAFMC separate ACLs for the commercial and...

  3. Identifying Patients with Hypertension: A Case for Auditing Electronic Health Record Data

    PubMed Central

    Baus, Adam; Hendryx, Michael; Pollard, Cecil

    2012-01-01

    Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3–1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5—1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9—1,377.9). PMID:22737097

  4. Positive Catch & Economic Benefits of Periodic Octopus Fishery Closures: Do Effective, Narrowly Targeted Actions ‘Catalyze’ Broader Management?

    PubMed Central

    Oliver, Thomas A.; Oleson, Kirsten L. L.; Ratsimbazafy, Hajanaina; Raberinary, Daniel; Benbow, Sophie; Harris, Alasdair

    2015-01-01

    Overview Eight years of octopus fishery records from southwest Madagascar reveal significant positive impacts from 36 periodic closures on: (a) fishery catches and (b) village fishery income, such that (c) economic benefits from increased landings outweigh costs of foregone catch. Closures covered ~20% of a village’s fished area and lasted 2-7 months. Fishery Catches from Each Closed Site Octopus landings and catch per unit effort (CPUE) significantly increased in the 30 days following a closure’s reopening, relative to the 30 days before a closure (landings: +718%, p<0.0001; CPUE: +87%, p<0.0001; n = 36). Open-access control sites showed no before/after change when they occurred independently of other management (“no ban”, n = 17/36). On the other hand, open-access control sites showed modest catch increases when they extended a 6-week seasonal fishery shutdown (“ban”, n = 19/36). The seasonal fishery shutdown affects the entire region, so confound all potential control sites. Fishery Income in Implementing Villages In villages implementing a closure, octopus fishery income doubled in the 30 days after a closure, relative to 30 days before (+132%, p<0.001, n = 28). Control villages not implementing a closure showed no increase in income after “no ban” closures and modest increases after “ban” closures. Villages did not show a significant decline in income during closure events. Net Economic Benefits from Each Closed Site Landings in closure sites generated more revenue than simulated landings assuming continued open-access fishing at that site (27/36 show positive net earnings; mean +$305/closure; mean +57.7% monthly). Benefits accrued faster than local fishers’ time preferences during 17-27 of the 36 closures. High reported rates of illegal fishing during closures correlated with poor economic performance. Broader Co-Management We discuss the implications of our findings for broader co-management arrangements, particularly for catalyzing

  5. Why are prices in wild catch and aquaculture industries so different?

    PubMed

    Villasante, Sebastián; Rodríguez-González, David; Antelo, Manel; Rivero-Rodríguez, Susana; Lebrancón-Nieto, Joseba

    2013-12-01

    Through a comparative analysis of prices in capture fisheries and aquaculture sectors, the objectives of this paper are a) to investigate three the trends in prices of forage catches to feed the aquaculture species, b) to analyze the amount of fish species need to feed aquaculture species in order to assess the level of efficiency in resource use, and c) to examine the degree of economic concentration either in wild-catch industry and aquaculture sectors. The results show that prices of cultivated species are higher than prices of the same species when harvested from the sea. We explain this fact by the interplay of three forces. First, the amount of wild fish to feed aquaculture species continues to improve over time. Second, the pressure of fishing activities has not been reduced since catches of most forage fishes are declining, which induce higher prices of capture species that feed aquaculture production. Third, the level of seafood market concentration is significantly higher in aquaculture than in wild catches, which generates higher prices in aquaculture.

  6. Patients prefer electronic medical records - fact or fiction?

    PubMed

    Masiza, Melissa; Mostert-Phipps, Nicky; Pottasa, Dalenca

    2013-01-01

    Incomplete patient medical history compromises the quality of care provided to a patient while well-kept, adequate patient medical records are central to the provision of good quality of care. According to research, patients have the right to contribute to decision-making affecting their health. Hence, the researchers investigated their views regarding a paper-based system and an electronic medical record (EMR). An explorative approach was used in conducting a survey within selected general practices in the Nelson Mandela Metropole. The majority of participants thought that the use of a paper-based system had no negative impact on their health. Participants expressed concerns relating to the confidentiality of their medical records with both storage mediums. The majority of participants indicated they prefer their GP to computerise their consultation details. The main objective of the research on which this poster is based was to investigate the storage medium of preference for patients and the reasons for their preference. Overall, 48% of the 85 participants selected EMRs as their preferred storage medium and the reasons for their preference were also uncovered.

  7. Electronic Health Records: VAs Efforts Raise Concerns about Interoperability Goals and Measures, Duplication with DOD, and Future Plans

    DTIC Science & Technology

    2016-07-13

    ELECTRONIC HEALTH RECORDS VA’s Efforts Raise Concerns about Interoperability Goals and Measures, Duplication with DOD...Agencies, Committee on Appropriations, U.S. Senate July 13, 2016 ELECTRONIC HEALTH RECORDS VA’s Efforts Raise Concerns about Interoperability Goals...initiatives with the Department of Defense (DOD) that were intended to advance the ability of the two departments to share electronic health records , the

  8. Estimating insect flight densities from attractive trap catches and flight height distributions

    USDA-ARS?s Scientific Manuscript database

    Insect species often exhibit a specific mean flight height and vertical flight distribution that approximates a normal distribution with a characteristic standard deviation (SD). Many studies in the literature report catches on passive (non-attractive) traps at several heights. These catches were us...

  9. Integration of the enterprise electronic health record and anesthesia information management systems.

    PubMed

    Springman, Scott R

    2011-09-01

    Fewer than 5% of anesthesia departments use an electronic medical record (EMR) that is anesthesia specific. Many anesthesia information management systems (AIMS) have been developed with a focus only on the unique needs of anesthesia providers, without being fully integrated into other electronic health record components of the entire enterprise medical system. To understand why anesthesia providers should embrace health information technology (HIT) on a health system-wide basis, this article reviews recent HIT history and reviews HIT concepts. The author explores current developments in efforts to expand enterprise HIT, and the pros and cons of full enterprise integration with an AIMS. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. A study of general practitioners' perspectives on electronic medical records systems in NHSScotland.

    PubMed

    Bouamrane, Matt-Mouley; Mair, Frances S

    2013-05-21

    Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs' perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees' responses, using Normalisation Process Theory as the underpinning conceptual framework. The majority of GPs' interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities - for example: in relation to usability, system navigation and information visualisation. Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs' interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors.

  11. A study of general practitioners’ perspectives on electronic medical records systems in NHSScotland

    PubMed Central

    2013-01-01

    Background Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. Methods We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs’ perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees’ responses, using Normalisation Process Theory as the underpinning conceptual framework. Results The majority of GPs’ interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities – for example: in relation to usability, system navigation and information visualisation. Conclusion Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs’ interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors. PMID:23688255

  12. Measure once, cut twice--adding patient-reported outcome measures to the electronic health record for comparative effectiveness research.

    PubMed

    Wu, Albert W; Kharrazi, Hadi; Boulware, L Ebony; Snyder, Claire F

    2013-08-01

    This article presents the current state of patient-reported outcome measures and explains new opportunities for leveraging the recent adoption of electronic health records to expand the application of patient-reported outcomes in both clinical care and comparative effectiveness research. Historic developments of patient-reported outcome, electronic health record, and comparative effectiveness research are analyzed in two dimensions: patient centeredness and digitization. We pose the question, "What needs to be standardized around the collection of patient-reported outcomes in electronic health records for comparative effectiveness research?" We identified three converging trends: the progression of patient-reported outcomes toward greater patient centeredness and electronic adaptation; the evolution of electronic health records into personalized and fully digitized solutions; and the shift toward patient-oriented comparative effectiveness research. Related to this convergence, we propose an architecture for patient-reported outcome standardization that could serve as a first step toward a more comprehensive integration of patient-reported outcomes with electronic health record for both practice and research. The science of patient-reported outcome measurement has matured sufficiently to be integrated routinely into electronic health records and other electronic health solutions to collect data on an ongoing basis for clinical care and comparative effectiveness research. Further efforts and ideally coordinated efforts from various stakeholders are needed to refine the details of the proposed framework for standardization. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. CATCH/IT: a data warehouse to support comprehensive assessment for tracking community health.

    PubMed Central

    Berndt, D. J.; Hevner, A. R.; Studnicki, J.

    1998-01-01

    A systematic methodology, Comprehensive Assessment for Tracking Community Health (CATCH), for analyzing the health status of communities has been under development at the University of South Florida since the early 1990s. CATCH draws 226 health status indicators from multiple data sources and uses an innovative comparative framework and weighted evaluation criteria to produce a rank-ordered list of community health problems. CATCH has been applied successfully in many Florida counties; focusing attention on high priority health issues and measuring the impact of health expenditures on community health status outcomes. Previously performed manually, we are using information technology (IT) to automate the CATCH methodology with a full-scale data warehouse, user-friendly forms and reports, and extended analysis and data mining capabilities. The automated system, CATCH/IT, will reduce the time to prepare community health status reports from months to days. In this paper, we present the current status of the project, along with the principal research and development issues and future directions of the project. PMID:9929220

  14. "Catch a Star !"

    NASA Astrophysics Data System (ADS)

    2002-05-01

    ESO and EAAE Launch Web-based Educational Programme for Europe's Schools Catch a star!... and discover all its secrets! This is the full title of an innovative educational project, launched today by the European Southern Observatory (ESO) and the European Association for Astronomy Education (EAAE). It welcomes all students in Europe's schools to an exciting web-based programme with a competition. It takes place within the context of the EC-sponsored European Week of Science and Technology (EWST) - 2002 . This unique project revolves around a web-based competition and is centred on astronomy. It is specifically conceived to stimulate the interest of young people in various aspects of this well-known field of science, but will also be of interest to the broad public. What is "Catch a Star!" about? [Go to Catch a Star Website] The programme features useful components from the world of research, but it is specifically tailored to (high-)school students. Younger participants are also welcome. Groups of up to four persons (e.g., three students and one teacher) have to select an astronomical object - a bright star, a distant galaxy, a beautiful comet, a planet or a moon in the solar system, or some other celestial body. Like detectives, they must then endeavour to find as much information as possible about "their" object. This information may be about the position and visibility in the sky, the physical and chemical characteristics, particular historical aspects, related mythology and sky lore, etc. They can use any source available, the web, books, newspaper and magazine articles, CDs etc. for this work. The group members must prepare a (short) summarising report about this investigation and "their" object, with their own ideas and conclusions, and send it to ESO (email address: eduinfo@eso.org). A jury, consisting of specialists from ESO and the EAAE, will carefully evaluate these reports. All projects that are found to fulfill the stipulated requirements, including a

  15. Passing and Catching in Rugby.

    ERIC Educational Resources Information Center

    Namudu, Mike M.

    This booklet contains the fundamentals for rugby at the primary school level. It deals primarily with passing and catching the ball. It contains instructions on (1) holding the ball for passing, (2) passing the ball to the left--standing, (3) passing the ball to the left--running, (4) making a switch pass, (5) the scrum half's normal pass, (6) the…

  16. Snow catch by conifer crowns

    Treesearch

    Donald R. Satterlund; Harold F. Haupt

    1967-01-01

    Study of interception storage of snow by two species of sapling conifers in northern Idaho revealed that cumulative snow catch follows the classical law of autocatakinetic growth, or [equation - see PDF] where I, is interception storage, e is the interception storage capacity of the tree, e is the base of the natural logarithm, k is a constant expressing the rate of...

  17. Validation of a Delirium Risk Assessment Using Electronic Medical Record Information.

    PubMed

    Rudolph, James L; Doherty, Kelly; Kelly, Brittany; Driver, Jane A; Archambault, Elizabeth

    2016-03-01

    Identifying patients at risk for delirium allows prompt application of prevention, diagnostic, and treatment strategies; but is rarely done. Once delirium develops, patients are more likely to need posthospitalization skilled care. This study developed an a priori electronic prediction rule using independent risk factors identified in a National Center of Clinical Excellence meta-analysis and validated the ability to predict delirium in 2 cohorts. Retrospective analysis followed by prospective validation. Tertiary VA Hospital in New England. A total of 27,625 medical records of hospitalized patients and 246 prospectively enrolled patients admitted to the hospital. The electronic delirium risk prediction rule was created using data obtained from the patient electronic medical record (EMR). The primary outcome, delirium, was identified 2 ways: (1) from the EMR (retrospective cohort) and (2) clinical assessment on enrollment and daily thereafter (prospective participants). We assessed discrimination of the delirium prediction rule with the C-statistic. Secondary outcomes were length of stay and discharge to rehabilitation. Retrospectively, delirium was identified in 8% of medical records (n = 2343); prospectively, delirium during hospitalization was present in 26% of participants (n = 64). In the retrospective cohort, medical record delirium was identified in 2%, 3%, 11%, and 38% of the low, intermediate, high, and very high-risk groups, respectively (C-statistic = 0.81; 95% confidence interval 0.80-0.82). Prospectively, the electronic prediction rule identified delirium in 15%, 18%, 31%, and 55% of these groups (C-statistic = 0.69; 95% confidence interval 0.61-0.77). Compared with low-risk patients, those at high- or very high delirium risk had increased length of stay (5.7 ± 5.6 vs 3.7 ± 2.7 days; P = .001) and higher rates of discharge to rehabilitation (8.9% vs 20.8%; P = .02). Automatic calculation of delirium risk using an EMR algorithm identifies patients at

  18. Electronic Versus Manual Data Processing: Evaluating the Use of Electronic Health Records in Out-of-Hospital Clinical Research

    PubMed Central

    Newgard, Craig D.; Zive, Dana; Jui, Jonathan; Weathers, Cody; Daya, Mohamud

    2011-01-01

    Objectives To compare case ascertainment, agreement, validity, and missing values for clinical research data obtained, processed, and linked electronically from electronic health records (EHR), compared to “manual” data processing and record abstraction in a cohort of out-ofhospital trauma patients. Methods This was a secondary analysis of two sets of data collected for a prospective, population-based, out-of-hospital trauma cohort evaluated by 10 emergency medical services (EMS) agencies transporting to 16 hospitals, from January 1, 2006 through October 2, 2007. Eighteen clinical, operational, procedural, and outcome variables were collected and processed separately and independently using two parallel data processing strategies, by personnel blinded to patients in the other group. The electronic approach included electronic health record data exports from EMS agencies, reformatting and probabilistic linkage to outcomes from local trauma registries and state discharge databases. The manual data processing approach included chart matching, data abstraction, and data entry by a trained abstractor. Descriptive statistics, measures of agreement, and validity were used to compare the two approaches to data processing. Results During the 21-month period, 418 patients underwent both data processing methods and formed the primary cohort. Agreement was good to excellent (kappa 0.76 to 0.97; intraclass correlation coefficient 0.49 to 0.97), with exact agreement in 67% to 99% of cases, and a median difference of zero for all continuous and ordinal variables. The proportions of missing out-of-hospital values were similar between the two approaches, although electronic processing generated more missing outcomes (87 out of 418, 21%, 95% CI = 17% to 25%) than the manual approach (11 out of 418, 3%, 95% CI = 1% to 5%). Case ascertainment of eligible injured patients was greater using electronic methods (n = 3,008) compared to manual methods (n = 629). Conclusions In this

  19. Positive Catch & Economic Benefits of Periodic Octopus Fishery Closures: Do Effective, Narrowly Targeted Actions 'Catalyze' Broader Management?

    PubMed

    Oliver, Thomas A; Oleson, Kirsten L L; Ratsimbazafy, Hajanaina; Raberinary, Daniel; Benbow, Sophie; Harris, Alasdair

    2015-01-01

    Eight years of octopus fishery records from southwest Madagascar reveal significant positive impacts from 36 periodic closures on: (a) fishery catches and (b) village fishery income, such that (c) economic benefits from increased landings outweigh costs of foregone catch. Closures covered ~20% of a village's fished area and lasted 2-7 months. Octopus landings and catch per unit effort (CPUE) significantly increased in the 30 days following a closure's reopening, relative to the 30 days before a closure (landings: +718%, p<0.0001; CPUE: +87%, p<0.0001; n = 36). Open-access control sites showed no before/after change when they occurred independently of other management ("no ban", n = 17/36). On the other hand, open-access control sites showed modest catch increases when they extended a 6-week seasonal fishery shutdown ("ban", n = 19/36). The seasonal fishery shutdown affects the entire region, so confound all potential control sites. In villages implementing a closure, octopus fishery income doubled in the 30 days after a closure, relative to 30 days before (+132%, p<0.001, n = 28). Control villages not implementing a closure showed no increase in income after "no ban" closures and modest increases after "ban" closures. Villages did not show a significant decline in income during closure events. Landings in closure sites generated more revenue than simulated landings assuming continued open-access fishing at that site (27/36 show positive net earnings; mean +$305/closure; mean +57.7% monthly). Benefits accrued faster than local fishers' time preferences during 17-27 of the 36 closures. High reported rates of illegal fishing during closures correlated with poor economic performance. We discuss the implications of our findings for broader co-management arrangements, particularly for catalyzing more comprehensive management.

  20. Contribution of Electronic Medical Records to the Management of Rare Diseases

    PubMed Central

    Bremond-Gignac, Dominique; Lewandowski, Elisabeth; Copin, Henri

    2015-01-01

    Purpose. Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR) in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients' data with ophthalmology-specific EMR. Methods. Ophthalmology-specific EMR software (Softalmo software Corilus) was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. Results. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. Discussion. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Conclusion. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease. PMID:26539543

  1. Contribution of Electronic Medical Records to the Management of Rare Diseases.

    PubMed

    Bremond-Gignac, Dominique; Lewandowski, Elisabeth; Copin, Henri

    2015-01-01

    Electronic health record systems provide great opportunity to study most diseases. Objective of this study was to determine whether electronic medical records (EMR) in ophthalmology contribute to management of rare eye diseases, isolated or in syndromes. Study was designed to identify and collect patients' data with ophthalmology-specific EMR. Ophthalmology-specific EMR software (Softalmo software Corilus) was used to acquire ophthalmological ocular consultation data from patients with five rare eye diseases. The rare eye diseases and data were selected and collected regarding expertise of eye center. A total of 135,206 outpatient consultations were performed between 2011 and 2014 in our medical center specialized in rare eye diseases. The search software identified 29 congenital aniridia, 6 Axenfeld/Rieger syndrome, 11 BEPS, 3 Nanophthalmos, and 3 Rubinstein-Taybi syndrome. EMR provides advantages for medical care. The use of ophthalmology-specific EMR is reliable and can contribute to a comprehensive ocular visual phenotype useful for clinical research. Routinely EMR acquired with specific software dedicated to ophthalmology provides sufficient detail for rare diseases. These software-collected data appear useful for creating patient cohorts and recording ocular examination, avoiding the time-consuming analysis of paper records and investigation, in a University Hospital linked to a National Reference Rare Center Disease.

  2. 30 CFR 57.19132 - Safety catches.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Safety catches. 57.19132 Section 57.19132 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Personnel Hoisting...

  3. 30 CFR 56.19132 - Safety catches.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Safety catches. 56.19132 Section 56.19132 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting...

  4. 30 CFR 57.19132 - Safety catches.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Safety catches. 57.19132 Section 57.19132 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Personnel Hoisting...

  5. 30 CFR 56.19132 - Safety catches.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Safety catches. 56.19132 Section 56.19132 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting...

  6. Physician Interactions with Electronic Health Records in Primary Care

    PubMed Central

    Montague, Enid; Asan, Onur

    2013-01-01

    Objective It is essential to design technologies and systems that promote appropriate interactions between physicians and patients. This study explored how physicians interact with Electronic Health Records (EHRs) to understand the qualities of the interaction between the physician and the EHR that may contribute to positive physician-patient interactions. Study Design Video-taped observations of 100 medical consultations were used to evaluate interaction patterns between physicians and EHRs. Quantified observational methods were used to contribute to ecological validity. Methods Ten primary care physicians and 100 patients from five clinics participated in the study. Clinical encounters were recorded with video cameras and coded using a validated objective coding methodology in order to examine how physicians interact with electronic health records. Results Three distinct styles were identified that characterize physician interactions with the EHR: technology-centered, human-centered, and mixed. Physicians who used a technology-centered style spent more time typing and gazing at the computer during the visit. Physicians who used a mixed style shifted their attention and body language between their patients and the technology throughout the visit. Physicians who used the human-centered style spent the least amount of time typing and focused more on the patient. Conclusion A variety of EHR interaction styles may be effective in facilitating patient-centered care. However, potential drawbacks of each style exist and are discussed. Future research on this topic and design strategies for effective health information technology in primary care are also discussed. PMID:24009982

  7. Incidence and cost of medications dispensed despite electronic medical record discontinuation.

    PubMed

    Baranowski, Patrick J; Peterson, Kristin L; Statz-Paynter, Jamie L; Zorek, Joseph A

    2015-01-01

    To determine the incidence and cost of medications dispensed despite discontinuation (MDDD) of the medications in the electronic medical record within an integrated health care organization. Dean Health System, with medical clinics and pharmacies linked by an electronic medical record, and a shared health plan and pharmacy benefits management company. Pharmacist-led quality improvement project using retrospective chart review. Electronic medical records, pharmacy records, and prescription claims data from patients 18 years of age or older who had a prescription filled for a chronic condition from June 2012 to August 2013 and submitted a claim through the Dean Health Plan were aggregated and cross-referenced to identify MDDD. Descriptive statistics were used to characterize demographics and MDDD incidence. Fisher's exact test and independent samples t tests were used to compare MDDD and non-MDDD groups. Wholesale acquisition cost was applied to each MDDD event. 7,406 patients met inclusion criteria. For 223 (3%) patients with MDDD, 253 independent events were identified. In terms of frequency per category, antihypertensive agents topped the list, followed, in descending order, by anticonvulsants, antilipemics, antidiabetics, and anticoagulants. Nine medications accounted for 59% (150 of 253) of all MDDD events; these included (again in descending order): gabapentin, atorvastatin, simvastatin, hydrochlorothiazide, lisinopril, warfarin, furosemide, metformin, and metoprolol. Mail-service pharmacies accounted for the highest incidence (5.3%) of MDDD, followed by mass merchandisers (4.6%) and small chains (3.9%). The total cost attributable to MDDD was $9,397.74. Development of a technology-based intervention to decrease the incidence of MDDD may be warranted to improve patient safety and decrease health care costs.

  8. A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review

    PubMed Central

    2010-01-01

    Background The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. Methods This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. Results The review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the

  9. Total Catch of a Red-Listed Marine Species Is an Order of Magnitude Higher than Official Data

    PubMed Central

    Kleiven, Alf Ring; Olsen, Esben Moland; Vølstad, Jon Helge

    2012-01-01

    Accurate information on total catch and effort is essential for successful fisheries management. Officially reported landings, however, may be underestimates of total catch in many fisheries. We investigated the fishery for the nationally red-listed European lobster (Homarus gammarus) in south-eastern Norway. Probability-based strip transect surveys were used to count buoys in the study area in combination with catch per unit effort data obtained independently from volunteer catch diaries, phone interviews, and questionnaires. We estimate that recreational catch accounts for 65% of total catch in the study area. Moreover, our results indicate that only a small proportion (24%) of lobsters landed commercially were sold through the legal market and documented. Total estimated lobster catch was nearly 14 times higher than reported officially. Our study highlights the need for adequate catch monitoring and data collection efforts in coastal areas, presents a clear warning to resource managers that illegal, unreported and unregulated (IUU) fisheries in coastal areas should not be ignored, and shows the potential impact of recreational fisheries. PMID:22363583

  10. Linking guidelines to Electronic Health Record design for improved chronic disease management.

    PubMed

    Barretto, Sistine A; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

    2003-01-01

    The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and workflow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR.

  11. Book review: Methods for catching beetles

    USDA-ARS?s Scientific Manuscript database

    Beetles are the most speciose animal group and found in virtually all habitats on Earth. Methods for Catching Beetles is a comprehensive general sourcebook about where and how to collect members of this diverse group. The book makes a compelling case in its Introduction about the value of scientif...

  12. Catching the Dream Annual Report, 2002.

    ERIC Educational Resources Information Center

    Chavers, Dean, Ed.

    2002-01-01

    In 2002, Catching the Dream (CTD) provided college scholarships to 208 American Indian students as well as grants to improve education in schools that serve Native students. This annual report describes CTD's programs and activities in 2002. Contents include short descriptions of CTD's scholarship, fellowship, and internship programs; describe…

  13. Electronic Medical Records and the Technological Imperative: The Retrieval of Dialogue in Community-Based Primary Care.

    PubMed

    Franz, Berkeley; Murphy, John W

    2015-01-01

    Electronic medical records are regarded as an important tool in primary health-care settings. Because these records are thought to standardize medical information, facilitate provider communication, and improve office efficiency, many practices are transitioning to these systems. However, much of the concern with improving the practice of record keeping has related to technological innovations and human-computer interaction. Drawing on the philosophical reflection raised in Jacques Ellul's work, this article questions the technological imperative that may be supporting medical record keeping. Furthermore, given the growing emphasis on community-based care, this article discusses important non-technological aspects of electronic medical records that might bring the use of these records in line with participatory primary-care medicine.

  14. Development of the electronic health records for nursing education (EHRNE) software program.

    PubMed

    Kowitlawakul, Yanika; Wang, Ling; Chan, Sally Wai-Chi

    2013-12-01

    This paper outlines preliminary research of an innovative software program that enables the use of an electronic health record in a nursing education curriculum. The software application program is called EHRNE, which stands for Electronic Heath Record for Nursing Education. The aim of EHRNE is to enhance student's learning of health informatics when they are working in the simulation laboratory. Integrating EHRNE into the nursing curriculum exposes students to electronic health records before they go into the workplace. A qualitative study was conducted using focus group interviews of nine nursing students. Nursing students' perceptions of using the EHRNE application were explored. The interviews were audio-taped and transcribed verbatim. The data was analyzed following the Colaizzi (1978) guideline. Four main categories that related to the EHRNE application were identified from the interviews: functionality, data management, timing and complexity, and accessibility. The analysis of the data revealed advantages and limitations of using EHRNE in the classroom setting. Integrating the EHRNE program into the curriculum will promote students' awareness of electronic documentation and enhance students' learning in the simulation laboratory. Preliminary findings suggested that before integrating the EHRNE program into the nursing curriculum, educational sessions for both students and faculty outlining the software's purpose, advantages, and limitations were needed. Following the educational sessions, further investigation of students' perceptions and learning using the EHRNE program is recommended. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Patients want granular privacy control over health information in electronic medical records.

    PubMed

    Caine, Kelly; Hanania, Rima

    2013-01-01

    To assess patients' desire for granular level privacy control over which personal health information should be shared, with whom, and for what purpose; and whether these preferences vary based on sensitivity of health information. A card task for matching health information with providers, questionnaire, and interview with 30 patients whose health information is stored in an electronic medical record system. Most patients' records contained sensitive health information. No patients reported that they would prefer to share all information stored in an electronic medical record (EMR) with all potential recipients. Sharing preferences varied by type of information (EMR data element) and recipient (eg, primary care provider), and overall sharing preferences varied by participant. Patients with and without sensitive records preferred less sharing of sensitive versus less-sensitive information. Patients expressed sharing preferences consistent with a desire for granular privacy control over which health information should be shared with whom and expressed differences in sharing preferences for sensitive versus less-sensitive EMR data. The pattern of results may be used by designers to generate privacy-preserving EMR systems including interfaces for patients to express privacy and sharing preferences. To maintain the level of privacy afforded by medical records and to achieve alignment with patients' preferences, patients should have granular privacy control over information contained in their EMR.

  16. The impact of using electronic patient records on practices of reading and writing.

    PubMed

    Laitinen, Heleena; Kaunonen, Marja; Åstedt-Kurki, Paivi

    2014-12-01

    The aim of this study was to investigate the use of electronic patient records in daily practice. In four wards of a large hospital district in Finland, N = 43 patients' care and activities were observed and analysed in terms of the Grounded Theory method. The findings revealed that using electronic patient records created a particular process of writing and reading. Wireless technology enabled simultaneous patient involvement and point-of-care documentation, additionally supporting real-time reading. Remote and retrospective documentation was distant in terms of both space and time. The remoteness caused double documentation, reduced accuracy and less-efficient use of time. 'Non-reading' practices were witnessed in retrospective reading, causing delays in patient care and increase in workload. Similarly, if documentation was insufficient or non-existent, the consequences were found to be detrimental to the patients. The use of an electronic patient record system has a significant impact on patient care. Therefore, it is crucial to develop wireless technology and interdisciplinary collaboration in order to improve and support high-quality patient care. © The Author(s) 2013.

  17. "Catch 22": Biosecurity awareness, interpretation and practice amongst poultry catchers.

    PubMed

    Millman, Caroline; Christley, Rob; Rigby, Dan; Dennis, Diana; O'Brien, Sarah J; Williams, Nicola

    2017-06-01

    Campylobacter contamination of chicken on sale in the UK remains at high levels and has a substantial public health impact. This has prompted the application of many interventions in the supply chain, including enhanced biosecurity measures on-farm. Catching and thinning are acknowledged as threats to the maintenance of good biosecurity, yet the people employed to undertake this critical work (i.e. 'catchers') are a rarely studied group. This study uses a mixed methods approach to investigate catchers' (n=53) understanding of the biosecurity threats posed by the catching and thinning, and the barriers to good biosecurity practice. It interrogated the role of training in both the awareness and practice of good biosecurity. Awareness of lapses in biosecurity was assessed using a Watch-&-Click hazard awareness survey (n=53). Qualitative interviews (n=49 catchers, 5 farm managers) explored the understanding, experience and practice of catching and biosecurity. All of the catchers who took part in the Watch-&-Click study identified at least one of the biosecurity threats with 40% detecting all of the hazards. Those who had undergone training were significantly more likely to identify specific biosecurity threats and have a higher awareness score overall (48% compared to 9%, p=0.03). Crucially, the individual and group interviews revealed the tensions between the high levels of biosecurity awareness evident from the survey and the reality of the routine practice of catching and thinning. Time pressures and a lack of equipment rather than a lack of knowledge appear a more fundamental cause of catcher-related biosecurity lapses. Our results reveal that catchers find themselves in a 'catch-22' situation in which mutually conflicting circumstances prevent simultaneous completion of their job and compliance with biosecurity standards. 3 Hence, although education about, and enforcement of, biosecurity protocols has been recommended, our findings suggest that further reforms

  18. An Enterprise Architecture Perspective to Electronic Health Record Based Care Governance.

    PubMed

    Motoc, Bogdan

    2017-01-01

    This paper proposes an Enterprise Architecture viewpoint of Electronic Health Record (EHR) based care governance. The improvements expected are derived from the collaboration framework and the clinical health model proposed as foundation for the concept of EHR.

  19. The Use of Electronic Medical Records

    PubMed Central

    Makoul, Gregory; Curry, Raymond H.; Tang, Paul C.

    2001-01-01

    Objective: To assess physician–patient communication patterns associated with use of an electronic medical record (EMR) system in an outpatient setting and provide an empirical foundation for larger studies. Design: An exploratory, observational study involving analysis of videotaped physician–patient encounters, questionnaires, and medical-record reviews. Setting: General internal medicine practice at an academic medical center. Participants: Three physicians who used an EMR system (EMR physicians) and three who used solely a paper record (control physicians). A total of 204 patient visits were included in the analysis (mean, 34 for each physician). Main Outcome Measures: Content analysis of whether physicians accomplished communication tasks during encounters; qualitative analysis of how EMR physicians used the EMR and how control physicians used the paper chart. Results: Compared with the control physicians, EMR physicians adopted a more active role in clarifying information, encouraging questions, and ensuring completeness at the end of a visit. A trend suggested that EMR physicians might be less active than control physicians in three somewhat more patient-centered areas (outlining the patient's agenda, exploring psychosocial/ emotional issues, discussing how health problems affect a patient's life). Physicians in both groups tended to direct their attention to the patient record during the initial portion of the encounter. The relatively fixed position of the computer limited the extent to which EMR physicians could physically orient themselves toward the patient. Although there was no statistically significant difference between the EMR and control physicians in terms of mean time across all visits, a difference did emerge for initial visits: Initial visits with EMR physicians took an average of 37.5 percent longer than those with control physicians. Summary: An EMR system may enhance the ability of physicians to complete informationintensive tasks but

  20. Improving patient-centered communication while using an electronic health record: Report from a curriculum evaluation.

    PubMed

    Fogarty, Colleen T; Winters, Paul; Farah, Subrina

    2016-05-01

    Researchers and clinicians are concerned about the impact of electronic health record use and patient-centered communication. Training about patient-centered clinical communication skills with the electronic health record may help clinicians adapt and remain patient-centered. We developed an interactive workshop eliciting challenges and opportunities of working with the electronic health record in clinical practice, introduction of specific patient-centered behaviors and mindful practice techniques, and video demonstrating contrasts in common behavior and "better practices." One hundred thirty-nine resident physicians and faculty supervisors in five residency training programs at the University of Rochester Medical Center participated in the workshops. Participants were asked to complete an 11-item survey of behaviors related to their use of the electronic health record prior to training and after attending training. We used paired t-tests to assess changes in self-reported behavior from pre-intervention to post-intervention. We trained 139 clinicians in the workshops; 110 participants completed the baseline assessment and 39 completed both the baseline and post-intervention assessment. Data from post-curriculum respondents found a statistically significant increase in "I told the patient when turning my attention from the patient to the computer," from 60% of the time prior to the training to 70% of the time after. Data from our program evaluation demonstrated improvement in one communication behavior. Sample size limited the detection of other changes; further research should investigate effective training techniques for patient-centered communication while using the electronic health record. © The Author(s) 2016.

  1. Monsoonal variation in catch of Rastrelliger kanagurta at east coast of Peninsular Malaysia

    NASA Astrophysics Data System (ADS)

    Tan, M. K.; Mustapha, M. A.

    2018-04-01

    Indian mackerel, Rastrelliger kanagurta plays an important role in marine fisheries of Malaysia. Distribution of R. kanagurta was reported to be influenced by various oceanographic conditions. In the waters off east coast of Peninsular Malaysia, monsoon is the main factor influencing this region. In this study, R. kanagurta catch data were categorised to four monsoon periods: southwest monsoon (SW) in May-Sep, 1st-intermonsoon (1st-inter) in Apr, northeast monsoon (NE) in Nov-Mac and 2nd-intermonsoon (2nd-inter) in Oct. During 2nd-intermonsoon, fish catch of R. kanagurta was found highest significantly among all four monsoon periods, while fish catch during northeast, southwest and 1st-intermonsoon did not differed significantly. COAST was identified as the most important variable in the RF models for northeast and southwest monsoon. From RF models, fish catch was highest when fishing effort was performed near the coast. During the 1st-intermonsoon, high fish catch was found with increasing CHL. During 2nd-intermonsoon, further studies are needed as variables used in this study could not contribute well in the RF model.

  2. New Optical Card for Sneaker’s Network in Place of Electronic Clinical Record

    NASA Astrophysics Data System (ADS)

    Goto, Kenya; Satsukawa, Takatoshi; Chiba, Seisho; Ohmori, Takaaki

    2006-02-01

    In order to solve problems in electronic medical records, a new optical card of the digital versatile disk (DVD) type with higher capacity and lower cost than conventional compact disc recording (CD-R)-type cards has been developed, which is thinner, stronger and wearable like a credit card.

  3. 49 CFR Appendix A to Part 395 - Electronic On-Board Recorder Performance Specifications

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... one-way transfer of these records through wired and wireless methods to authorized safety officials... facilitate the electronic transfer of records to roadside inspection personnel and compliance review... whenever there is a change in driver duty status, an EOBR diagnostic event (such as power-on/off, self test...

  4. A novel system architecture for the national integration of electronic health records: a semi-centralized approach.

    PubMed

    AlJarullah, Asma; El-Masri, Samir

    2013-08-01

    The goal of a national electronic health records integration system is to aggregate electronic health records concerning a particular patient at different healthcare providers' systems to provide a complete medical history of the patient. It holds the promise to address the two most crucial challenges to the healthcare systems: improving healthcare quality and controlling costs. Typical approaches for the national integration of electronic health records are a centralized architecture and a distributed architecture. This paper proposes a new approach for the national integration of electronic health records, the semi-centralized approach, an intermediate solution between the centralized architecture and the distributed architecture that has the benefits of both approaches. The semi-centralized approach is provided with a clearly defined architecture. The main data elements needed by the system are defined and the main system modules that are necessary to achieve an effective and efficient functionality of the system are designed. Best practices and essential requirements are central to the evolution of the proposed architecture. The proposed architecture will provide the basis for designing the simplest and the most effective systems to integrate electronic health records on a nation-wide basis that maintain integrity and consistency across locations, time and systems, and that meet the challenges of interoperability, security, privacy, maintainability, mobility, availability, scalability, and load balancing.

  5. Variation in angler distribution and catch rates of stocked rainbow trout in a small reservoir

    USGS Publications Warehouse

    Harmon, Brian S.; Martin, Dustin R.; Chizinski, Christopher J.; Pope, Kevin L.

    2018-01-01

    We investigated the spatial and temporal relationship of catch rates and angler party location for two days following a publicly announced put-and-take stocking of rainbow trout (Oncorhynchus mykiss). Catch rates declined with time since stocking and distance from stocking. We hypothesized that opportunity for high catch rates would cause anglers to fish near the stocking location and disperse with time, however distance between angler parties and stocking was highly variable at any given time. Spatially explicit differences in catch rates can affect fishing quality. Further research could investigate the variation between angler distribution and fish distribution within a waterbody.

  6. Comprehensive quantification of the spastic catch in children with cerebral palsy.

    PubMed

    Lynn, Bar-On; Erwin, Aertbeliën; Guy, Molenaers; Herman, Bruyninckx; Davide, Monari; Ellen, Jaspers; Anne, Cazaerck; Kaat, Desloovere

    2013-01-01

    In clinical settings, the spastic catch is judged subjectively. This study assessed the psychometric properties of objective parameters that define and quantify the severity of the spastic catch in children with cerebral palsy (CP). A convenience sample of children with spastic CP (N=46; age range: 4-16 years) underwent objective spasticity assessments. High velocity, passive stretches were applied to the gastrocnemius (GAS) and medial hamstrings (MEH). Muscle activity was measured with surface electromyography (sEMG), joint angle characteristics using inertial sensors and reactive torque using a force sensor. To test reliability, a group of 12 children were retested after an average of 13 ± 9 days. The angle of spastic catch (AOC) was estimated by three biomechanical definitions: joint angle at (1) maximum angular deceleration; (2) maximum change in torque; and (3) minimum power. Each definition was checked for reliability and validity. Construct and clinical validity were evaluated by correlating each AOC definition to the averaged root mean square envelope of EMG (RMS-EMG) and the Modified Tardieu Scale (MTS). Severity categories were created based on selected parameters to establish face validity. All definitions showed moderate to high reliability. Significant correlations were found between AOC3 and the MTS of both muscles and the RMS-EMG of the MEH, though coefficients were only weak. AOC3 further distinguished between mild, moderate and severe catches. Objective parameters can define and quantify the severity of the spastic catch in children with CP. However, a comprehensive understanding requires the integration of both biomechanical and RMS-EMG data. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Adoption of Electronic Personal Health Records in Canada: Perceptions of Stakeholders.

    PubMed

    Gagnon, Marie-Pierre; Payne-Gagnon, Julie; Breton, Erik; Fortin, Jean-Paul; Khoury, Lara; Dolovich, Lisa; Price, David; Wiljer, David; Bartlett, Gillian; Archer, Norman

    2016-04-06

    Healthcare stakeholders have a great interest in the adoption and use of electronic personal health records (ePHRs) because of the potential benefits associated with them. Little is known, however, about the level of adoption of ePHRs in Canada and there is limited evidence concerning their benefits and implications for the healthcare system. This study aimed to describe the current situation of ePHRs in Canada and explore stakeholder perceptions regarding barriers and facilitators to their adoption. Using a qualitative descriptive study design, we conducted semi-structured phone interviews between October 2013 and February 2014 with 35 individuals from seven Canadian provinces. The participants represented six stakeholder groups (patients, ePHR administrators, healthcare professionals, organizations interested in health technology development, government agencies, and researchers). A detailed summary of each interview was created and thematic analysis was conducted. We observed that there was no consensual definition of ePHR in Canada. Factors that could influence ePHR adoption were related to knowledge (confusion with other electronic medical records [EMRs] and lack of awareness), system design (usability and relevance), user capacities and attitudes (patient health literacy, education and interest, support for professionals), environmental factors (government commitment, targeted populations) and legal and ethical issues (information control and custody, confidentiality, privacy and security). ePHRs are slowly entering the Canadian healthcare landscape but provinces do not seem well-prepared for the implementation of this type of record. Guidance is needed on critical issues regarding ePHRs, such as ePHR definition, data ownership, access to information and interoperability with other electronic health records (EHRs). Better guidance on these issues would provide a greater awareness of ePHRs and inform stakeholders including clinicians, decision-makers, patients

  8. Adoption of Electronic Personal Health Records in Canada: Perceptions of Stakeholders

    PubMed Central

    Gagnon, Marie-Pierre; Payne-Gagnon, Julie; Breton, Erik; Fortin, Jean-Paul; Khoury, Lara; Dolovich, Lisa; Price, David; Wiljer, David; Bartlett, Gillian; Archer, Norman

    2016-01-01

    Background: Healthcare stakeholders have a great interest in the adoption and use of electronic personal health records (ePHRs) because of the potential benefits associated with them. Little is known, however, about the level of adoption of ePHRs in Canada and there is limited evidence concerning their benefits and implications for the healthcare system. This study aimed to describe the current situation of ePHRs in Canada and explore stakeholder perceptions regarding barriers and facilitators to their adoption. Methods: Using a qualitative descriptive study design, we conducted semi-structured phone interviews between October 2013 and February 2014 with 35 individuals from seven Canadian provinces. The participants represented six stakeholder groups (patients, ePHR administrators, healthcare professionals, organizations interested in health technology development, government agencies, and researchers). A detailed summary of each interview was created and thematic analysis was conducted. Results: We observed that there was no consensual definition of ePHR in Canada. Factors that could influence ePHR adoption were related to knowledge (confusion with other electronic medical records [EMRs] and lack of awareness), system design (usability and relevance), user capacities and attitudes (patient health literacy, education and interest, support for professionals), environmental factors (government commitment, targeted populations) and legal and ethical issues (information control and custody, confidentiality, privacy and security). Conclusion: ePHRs are slowly entering the Canadian healthcare landscape but provinces do not seem well-prepared for the implementation of this type of record. Guidance is needed on critical issues regarding ePHRs, such as ePHR definition, data ownership, access to information and interoperability with other electronic health records (EHRs). Better guidance on these issues would provide a greater awareness of ePHRs and inform stakeholders

  9. Linking Guidelines to Electronic Health Record Design for Improved Chronic Disease Management

    PubMed Central

    Barretto, Sistine A.; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

    2003-01-01

    The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and work-flow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR. PMID:14728135

  10. 75 FR 63434 - Availability of Compliance Guide for the Use of Video or Other Electronic Monitoring or Recording...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ...] Availability of Compliance Guide for the Use of Video or Other Electronic Monitoring or Recording Equipment in... the availability of a compliance guide on the use of video or other electronic monitoring or recording... Procedures video records. FSIS is soliciting comments on this compliance guide. Once FSIS receives OMB...

  11. Metrics for Electronic-Nursing-Record-Based Narratives: cross-sectional analysis.

    PubMed

    Kim, Kidong; Jeong, Suyeon; Lee, Kyogu; Park, Hyeoun-Ae; Min, Yul Ha; Lee, Joo Yun; Kim, Yekyung; Yoo, Sooyoung; Doh, Gippeum; Ahn, Soyeon

    2016-11-30

    We aimed to determine the characteristics of quantitative metrics for nursing narratives documented in electronic nursing records and their association with hospital admission traits and diagnoses in a large data set not limited to specific patient events or hypotheses. We collected 135,406,873 electronic, structured coded nursing narratives from 231,494 hospital admissions of patients discharged between 2008 and 2012 at a tertiary teaching institution that routinely uses an electronic health records system. The standardized number of nursing narratives (i.e., the total number of nursing narratives divided by the length of the hospital stay) was suggested to integrate the frequency and quantity of nursing documentation. The standardized number of nursing narratives was higher for patients aged ≥ 70 years (median = 30.2 narratives/day, interquartile range [IQR] = 24.0-39.4 narratives/day), long (≥ 8 days) hospital stays (median = 34.6 narratives/day, IQR = 27.2-43.5 narratives/day), and hospital deaths (median = 59.1 narratives/day, IQR = 47.0-74.8 narratives/day). The standardized number of narratives was higher in "pregnancy, childbirth, and puerperium" (median = 46.5, IQR = 39.0-54.7) and "diseases of the circulatory system" admissions (median = 35.7, IQR = 29.0-43.4). Diverse hospital admissions can be consistently described with nursing-document-derived metrics for similar hospital admissions and diagnoses. Some areas of hospital admissions may have consistently increasing volumes of nursing documentation across years. Usability of electronic nursing document metrics for evaluating healthcare requires multiple aspects of hospital admissions to be considered.

  12. Framing Electronic Medical Records as Polylingual Documents in Query Expansion

    PubMed Central

    Huang, Edward W; Wang, Sheng; Lee, Doris Jung-Lin; Zhang, Runshun; Liu, Baoyan; Zhou, Xuezhong; Zhai, ChengXiang

    2017-01-01

    We present a study of electronic medical record (EMR) retrieval that emulates situations in which a doctor treats a new patient. Given a query consisting of a new patient’s symptoms, the retrieval system returns the set of most relevant records of previously treated patients. However, due to semantic, functional, and treatment synonyms in medical terminology, queries are often incomplete and thus require enhancement. In this paper, we present a topic model that frames symptoms and treatments as separate languages. Our experimental results show that this method improves retrieval performance over several baselines with statistical significance. These baselines include methods used in prior studies as well as state-of-the-art embedding techniques. Finally, we show that our proposed topic model discovers all three types of synonyms to improve medical record retrieval. PMID:29854161

  13. Identification of factors influencing shark catch and mortality in the Marshall Islands tuna longline fishery and management implications.

    PubMed

    Bromhead, D; Clarke, S; Hoyle, S; Muller, B; Sharples, P; Harley, S

    2012-04-01

    Recent average annual catches of sharks by tuna longline vessels fishing in the Republic of the Marshall Islands (RMI) are estimated to be between 1583 and 2274 t. Although 22 shark species have been recorded by the observer programme for this fishery, 80% of the annual catch comprises only five species: blue shark Prionace glauca, silky shark Carcharhinus falciformis, bigeye thresher shark Alopias superciliosus, pelagic thresher shark Alopias pelagicus and oceanic whitetip shark Carcharhinus longimanus. Wire leaders (i.e. branch lines or traces) were also used by nearly all observed vessels. Generalized additive model (GAM)-based analyses of catch rates indicated that P. glauca and A. superciliosus are caught in higher numbers when vessels fish in relatively cooler waters, at night, close to the full moon, when the 27° C thermocline is close to the surface and during El Niño conditions. In contrast, C. falciformis, A. pelagicus and C. longimanus are caught in higher numbers when shark lines are used (all three species) or hooks are set at a shallow depth (A. pelagicus and C. longimanus and, also, P. glauca). These findings are generally consistent with current knowledge of these species' habitat preferences, movement and distribution. The results of these analyses were combined with information pertaining to shark condition and fate upon capture to compare the likely effectiveness of a range of potential measures for reducing shark mortality in the longline fishery. Of the options considered, the most effective would be to combine measures that reduce the catch rate (e.g. restrictions on the use of wire leaders, shark baits and shark lines) with measures that increase survival rates after post-capture release (e.g. finning bans). © 2012 Secrtariat of the Pacific Community. Journal of Fish Biology © 2012 The Fisheries Society of the British Isles.

  14. Knowledge management for the protection of information in electronic medical records.

    PubMed

    Lea, Nathan; Hailes, Stephen; Austin, Tony; Kalra, Dipak

    2008-01-01

    This paper describes foundational work investigating the protection requirements of sensitive medical information, which is being stored more routinely in repository systems for electronic medical records. These systems have increasingly powerful sharing capabilities at the point of clinical care, in medical research and for clinical and managerial audit. The potential for sharing raises concerns about the protection of individual patient privacy and challenges the duty of confidentiality by which medical practitioners are ethically and legally bound. By analysing the protection requirements and discussing the need to apply policy-based controls to discrete items of medical information in a record, this paper suggests that this is a problem for which existing privacy management solutions are not sufficient or appropriate to the protection requirements. It proposes that a knowledge management approach is required and it introduces a new framework based on the knowledge management techniques now being used to manage electronic medical record data. The background, existing work in this area, initial investigation methods, results to date and discussion are presented, and the paper is concluded with the authors' comments on the ramifications of the work.

  15. 78 FR 63406 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-Annual Catch Limit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ...-Annual Catch Limit (ACL) Harvested for Management Area 3 AGENCY: National Marine Fisheries Service (NMFS... the overfishing limit, acceptable biological catch, annual catch limit (ACL), optimum yield, domestic.... The 2013 Domestic Annual Harvest is 107,800 metric tons (mt); the 2013 sub-ACL allocated to Area 3 is...

  16. A Java-based electronic healthcare record software for beta-thalassaemia.

    PubMed

    Deftereos, S; Lambrinoudakis, C; Andriopoulos, P; Farmakis, D; Aessopos, A

    2001-01-01

    Beta-thalassaemia is a hereditary disease, the prevalence of which is high in persons of Mediterranean, African, and Southeast Asian ancestry. In Greece it constitutes an important public health problem. Beta-thalassaemia necessitates continuous and complicated health care procedures such as daily chelation; biweekly transfusions; and periodic cardiology, endocrinology, and hepatology evaluations. Typically, different care items are offered in different, often-distant, health care units, which leads to increased patient mobility. This is especially true in rural areas. Medical records of patients suffering from beta-thalassaemia are inevitably complex and grow in size very fast. They are currently paper-based, scattered over all units involved in the care process. This hinders communication of information between health care professionals and makes processing of the medical records difficult, thus impeding medical research. Our objective is to provide an electronic means for recording, communicating, and processing all data produced in the context of the care process of patients suffering from beta-thalassaemia. We have developed - and we present in this paper - Java-based Electronic Healthcare Record (EHCR) software, called JAnaemia. JAnaemia is a general-purpose EHCR application, which can be customized for use in all medical specialties. Customization for beta-thalassaemia has been performed in collaboration with 4 Greek hospitals. To be capable of coping with patient record diversity, JAnaemia has been based on the EHCR architecture proposed in the ENV 13606:1999 standard, published by the CEN/TC251 committee. Compliance with the CEN architecture also ensures that several additional requirements are fulfilled in relation to clinical comprehensiveness; to record sharing and communication; and to ethical, medico-legal, and computational issues. Special care has been taken to provide a user-friendly, form-based interface for data entry and processing. The

  17. 36 CFR 1235.44 - What general transfer requirements apply to electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., Electronic/Special Media Records Services Division (NWME), 8601 Adelphi Road, College Park, MD 20740, phone... Services Division (NWCS) for digital photographs, 8601 Adelphi Road, College Park, MD 20740, phone number...

  18. The role of electronic health records in clinical reasoning.

    PubMed

    Berndt, Markus; Fischer, Martin R

    2018-05-16

    Electronic health records (eHRs) play an increasingly important role in documentation and exchange of information in multi-and interdisciplinary patient care. Although eHRs are associated with mixed evidence in terms of effectiveness, they are undeniably the health record form of the future. This poses several learning opportunities and challenges for medical education. This review aims to connect the concept of eHRs to key competencies of physicians and elaborates current learning science perspectives on diagnostic and clinical reasoning based on a theoretical framework of scientific reasoning and argumentation. It concludes with an integrative vision of the use of eHRs, and the special role of the patient, for teaching and learning in medicine. © 2018 New York Academy of Sciences.

  19. Using electronic patient records to discover disease correlations and stratify patient cohorts.

    PubMed

    Roque, Francisco S; Jensen, Peter B; Schmock, Henriette; Dalgaard, Marlene; Andreatta, Massimo; Hansen, Thomas; Søeby, Karen; Bredkjær, Søren; Juul, Anders; Werge, Thomas; Jensen, Lars J; Brunak, Søren

    2011-08-01

    Electronic patient records remain a rather unexplored, but potentially rich data source for discovering correlations between diseases. We describe a general approach for gathering phenotypic descriptions of patients from medical records in a systematic and non-cohort dependent manner. By extracting phenotype information from the free-text in such records we demonstrate that we can extend the information contained in the structured record data, and use it for producing fine-grained patient stratification and disease co-occurrence statistics. The approach uses a dictionary based on the International Classification of Disease ontology and is therefore in principle language independent. As a use case we show how records from a Danish psychiatric hospital lead to the identification of disease correlations, which subsequently can be mapped to systems biology frameworks.

  20. 26 CFR 1.402(g)-2 - Increased limit for catch-up contributions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...(g)-2 Section 1.402(g)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY.... § 1.402(g)-2 Increased limit for catch-up contributions. (a) General rule. Under section 402(g)(1)(C...(g) for a catch-up eligible participant (within the meaning of § 1.414(v)-1(g)), the otherwise...

  1. Infant feeding practices within a large electronic medical record database.

    PubMed

    Bartsch, Emily; Park, Alison L; Young, Jacqueline; Ray, Joel G; Tu, Karen

    2018-01-02

    The emerging adoption of the electronic medical record (EMR) in primary care enables clinicians and researchers to efficiently examine epidemiological trends in child health, including infant feeding practices. We completed a population-based retrospective cohort study of 8815 singleton infants born at term in Ontario, Canada, April 2002 to March 2013. Newborn records were linked to the Electronic Medical Record Administrative data Linked Database (EMRALD™), which uses patient-level information from participating family practice EMRs across Ontario. We assessed exclusive breastfeeding patterns using an automated electronic search algorithm, with manual review of EMRs when the latter was not possible. We examined the rate of breastfeeding at visits corresponding to 2, 4 and 6 months of age, as well as sociodemographic factors associated with exclusive breastfeeding. Of the 8815 newborns, 1044 (11.8%) lacked breastfeeding information in their EMR. Rates of exclusive breastfeeding were 39.5% at 2 months, 32.4% at 4 months and 25.1% at 6 months. At age 6 months, exclusive breastfeeding rates were highest among mothers aged ≥40 vs. < 20 years (rate ratio [RR] 2.45, 95% confidence interval [CI] 1.62-3.68), urban vs. rural residence (RR 1.35, 95% CI 1.22-1.50), and highest vs. lowest income quintile (RR 1.18, 95% CI 1.02-1.36). Overall, immigrants had similar rates of exclusive breastfeeding as non-immigrants; yet, by age 6 months, among those residing in the lowest income quintile, immigrants were more likely to exclusively breastfeed than their non-immigrant counterparts (RR 1.43, 95% CI 1.12-1.83). We efficiently determined rates and factors associated with exclusive breastfeeding using data from a large EMR database.

  2. School Nurse Role in Electronic School Health Records. Position Statement

    ERIC Educational Resources Information Center

    Hiltz, Cynthia; Johnson, Katie; Lechtenberg, Julia Rae; Maughan, Erin; Trefry, Sharonlee

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that Electronic Health Records (EHRs) are essential for the registered professional school nurse (hereinafter referred to as school nurse) to provide efficient and effective care in the school and monitor the health of the entire student population. It is also the position of…

  3. Separate may not be equal: A preliminary investigation of clinical correlates of electronic psychiatric record accessibility in academic medical centers

    PubMed Central

    Kozubal, Dana E.; Samus, Quincy M.; Bakare, Aishat A.; Trecker, Carrilin C.; Wong, Hei-Wah; Guo, Huiying; Cheng, Jeffrey; Allen, Paul X.; Mayer, Lawrence S.; Jamison, Kay R.; Kaplin, Adam I.

    2014-01-01

    Objectives Electronic Medical Records (EMR) have the potential to improve the coordination of healthcare in this country, yet the field of psychiatry has lagged behind other medical disciplines in its adoption of EMR. Methods Psychiatrists at 18 of the top US hospitals completed an electronic survey detailing whether their psychiatric records were stored electronically and accessible to non-psychiatric physicians. Electronic hospital records and accessibility statuses were correlated with patient care outcomes obtained from the University Health System Consortium Clinical Database available for 13 of the 18 top US hospitals. Results 44% of hospitals surveyed maintained most or all of their psychiatric records electronically and 28% made psychiatric records accessible to non-psychiatric physicians; only 22% did both. Compared with hospitals where psychiatric records were not stored electronically, the average 7-day readmission rate of psychiatric patients was significantly lower at hospitals with psychiatric EMR (5.1% vs. 7.0%, p = .040). Similarly, the 14 and 30-day readmission rates at hospitals where psychiatric records were accessible to non-psychiatric physicians were lower than those of their counterparts with non-accessible records (5.8% vs. 9.5%, p = .019, 8.6% vs. 13.6%, p = .013, respectively). The 7, 14, and 30-day readmission rates were significantly lower in hospitals where psychiatric records were both stored electronically and made accessible than at hospitals where records were either not electronic or not accessible (4% vs 6.6%, 5.8% vs 9.1%, 8.9 vs 13%, respectively, all with p = 0.045). Conclusions Having psychiatric EMR that were accessible to non-psychiatric physicians correlated with improved clinical care as measured by lower readmission rates specific for psychiatric patients. PMID:23266060

  4. Pitch-catch only ultrasonic fluid densitometer

    DOEpatents

    Greenwood, Margaret S.; Harris, Robert V.

    1999-01-01

    The present invention is an ultrasonic fluid densitometer that uses a material wedge and pitch-catch only ultrasonic transducers for transmitting and receiving ultrasonic signals internally reflected within the material wedge. Density of a fluid is determined by immersing the wedge into the fluid and measuring reflection of ultrasound at the wedge-fluid interface.

  5. 77 FR 66746 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ...-ACL (Annual Catch Limit) Harvested for Management Area 1A AGENCY: National Marine Fisheries Service... catch, annual catch limit (ACL), optimum yield, domestic harvest and processing, U.S. at-sea processing, border transfer, and the sub-ACL for each management area. The 2012 Domestic Annual Harvest was set as 91...

  6. Using ISO 25040 standard for evaluating electronic health record systems.

    PubMed

    Oliveira, Marília; Novaes, Magdala; Vasconcelos, Alexandre

    2013-01-01

    Quality of electronic health record systems (EHR-S) is one of the key points in the discussion about the safe use of this kind of system. It stimulates creation of technical standards and certifications in order to establish the minimum requirements expected for these systems. [1] In other side, EHR-S suppliers need to invest in evaluation of their products to provide systems according to these requirements. This work presents a proposal of use ISO 25040 standard, which focuses on the evaluation of software products, for define a model of evaluation of EHR-S in relation to Brazilian Certification for Electronic Health Record Systems - SBIS-CFM Certification. Proposal instantiates the process described in ISO 25040 standard using the set of requirements that is scope of the Brazilian certification. As first results, this research has produced an evaluation model and a scale for classify an EHR-S about its compliance level in relation to certification. This work in progress is part for the acquisition of the degree of master in Computer Science at the Federal University of Pernambuco.

  7. Use of large electronic health record databases for environmental epidemiology studies.

    EPA Science Inventory

    Background: Electronic health records (EHRs) are a ubiquitous component of the United States healthcare system and capture nearly all data collected in a clinic or hospital setting. EHR databases are attractive for secondary data analysis as they may contain detailed clinical rec...

  8. Benefits of Implementing and Improving Collection of Sexual Orientation and Gender Identity Data in Electronic Health Records.

    PubMed

    Bosse, Jordon D; Leblanc, Raeann G; Jackman, Kasey; Bjarnadottir, Ragnhildur I

    2018-06-01

    Individuals in lesbian, gay, bisexual, and transgender communities experience several disparities in physical and mental health (eg, cardiovascular disease and depression), as well as difficulty accessing care that is compassionate and relevant to their unique needs. Access to care is compromised in part due to inadequate information systems that fail to capture identity data. Beginning in January 2018, meaningful use criteria dictate that electronic health records have the capability to collect data related to sexual orientation and gender identity of patients. Nurse informaticists play a vital role in the process of developing new electronic health records that are sensitive to the needs and identities of the lesbian, gay, bisexual, and transgender communities. Improved collection of sexual orientation and gender identity data will advance the identification of health disparities experienced by lesbian, gay, bisexual, and transgender populations. More inclusive electronic health records will allow providers to monitor risk behavior, assess progress toward the reduction of disparities, and provide healthcare that is patient and family centered. Concrete suggestions for the modification of electronic health record systems are presented, as well as how nurse informaticists may be able to bridge gaps in provider knowledge and discomfort through interprofessional collaboration when implementing changes in electronic health records.

  9. 26 CFR 1.402(g)-2 - Increased limit for catch-up contributions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ....402(g)-2 Section 1.402(g)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY.... § 1.402(g)-2 Increased limit for catch-up contributions. (a) General rule. Under section 402(g)(1)(C...(g) for a catch-up eligible participant (within the meaning of § 1.414(v)-1(g)), the otherwise...

  10. 26 CFR 1.402(g)-2 - Increased limit for catch-up contributions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....402(g)-2 Section 1.402(g)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY.... § 1.402(g)-2 Increased limit for catch-up contributions. (a) General rule. Under section 402(g)(1)(C...(g) for a catch-up eligible participant (within the meaning of § 1.414(v)-1(g)), the otherwise...

  11. 26 CFR 1.402(g)-2 - Increased limit for catch-up contributions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ....402(g)-2 Section 1.402(g)-2 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY.... § 1.402(g)-2 Increased limit for catch-up contributions. (a) General rule. Under section 402(g)(1)(C...(g) for a catch-up eligible participant (within the meaning of § 1.414(v)-1(g)), the otherwise...

  12. A review of security of electronic health records.

    PubMed

    Win, Khin Than

    The objective of this study is to answer the research question, "Are current information security technologies adequate for electronic health records (EHRs)?" In order to achieve this, the following matters have been addressed in this article: (i) What is information security in the context of EHRs? (ii) Why is information security important for EHRs? and (iii) What are the current technologies for information security available to EHRs? It is concluded that current EHR security technologies are inadequate and urgently require improvement. Further study regarding information security of EHRs is indicated.

  13. High agreement between the new Mongolian electronic immunization register and written immunization records: a health centre based audit

    PubMed Central

    Mungun, Tuya; Dorj, Narangerel; Volody, Baigal; Chuluundorj, Uranjargal; Munkhbat, Enkhtuya; Danzan, Gerelmaa; Nguyen, Cattram D; La Vincente, Sophie; Russell, Fiona

    2017-01-01

    Introduction Monitoring of vaccination coverage is vital for the prevention and control of vaccine-preventable diseases. Electronic immunization registers have been increasingly adopted to assist with the monitoring of vaccine coverage; however, there is limited literature about the use of electronic registers in low- and middle-income countries such as Mongolia. We aimed to determine the accuracy and completeness of the newly introduced electronic immunization register for calculating vaccination coverage and determining vaccine effectiveness within two districts in Mongolia in comparison to written health provider records. Methods We conducted a cross-sectional record review among children 2–23 months of age vaccinated at immunization clinics within the two districts. We linked data from written records with the electronic immunization register using the national identification number to determine the completeness and accuracy of the electronic register. Results Both completeness (90.9%; 95% CI: 88.4–93.4) and accuracy (93.3%; 95% CI: 84.1–97.4) of the electronic immunization register were high when compared to written records. The increase in completeness over time indicated a delay in data entry. Conclusion Through this audit, we have demonstrated concordance between a newly introduced electronic register and health provider records in a middle-income country setting. Based on this experience, we recommend that electronic registers be accompanied by routine quality assurance procedures for the monitoring of vaccination programmes in such settings. PMID:29051836

  14. Pitch-catch only ultrasonic fluid densitometer

    DOEpatents

    Greenwood, M.S.; Harris, R.V.

    1999-03-23

    The present invention is an ultrasonic fluid densitometer that uses a material wedge and pitch-catch only ultrasonic transducers for transmitting and receiving ultrasonic signals internally reflected within the material wedge. Density of a fluid is determined by immersing the wedge into the fluid and measuring reflection of ultrasound at the wedge-fluid interface. 6 figs.

  15. Using the eXtensible Markup Language (XML) in a regional electronic patient record for patients with malignant diseases.

    PubMed

    Wolff, A C; Mludek, V; van der Haak, M; Bork, W; Bülzebruck, H; Drings, P; Schmücker, P; Wannenmacher, M; Haux, R

    2001-01-01

    Communication between different institutions which are responsible for the treatment of the same patient is of outstanding significance, especially in the field of tumor diseases. Regional electronic patient records could support the co-operation of different institutions by providing ac-cess to all necessary information whether it belongs to the own institution or to a partner. The Department of Medical Informatics, University of Heidelberg is performing a project in co-operation with the Thoraxclinic-Heidelberg and the Department of Clinical Radiology, University of Heidelberg with the goal: to define an architectural concept for interlinking the electronic patient record of the two clinical institutions to build a common virtual electronic patient record and carry out an exemplary implementation, to examine composition, structure and content of medical documents for tumor patients with the aim of defining an XML-based markup language allowing summarizing overviews and suitable granularities, and to integrate clinical practice guidelines and other external knowledge with the electronic patient record using XML-technologies to support the physician in the daily decision process. This paper will show, how a regional electronic patient record could be built on an architectural level and describe elementary steps towards a on content-oriented structuring of medical records.

  16. Care team identification in the electronic health record: A critical first step for patient-centered communication.

    PubMed

    Dalal, Anuj K; Schnipper, Jeffrey L

    2016-05-01

    Patient-centered communication is essential to coordinate care and safely progress patients from admission through discharge. Hospitals struggle with improving the complex and increasingly electronic conversation patterns among care team members, patients, and caregivers to achieve effective patient-centered communication across settings. Accurate and reliable identification of all care team members is a precursor to effective patient-centered communication and ideally should be facilitated by the electronic health record. However, the process of identifying care team members is challenging, and team lists in the electronic health record are typically neither accurate nor reliable. Based on the literature and on experience from 2 initiatives at our institution, we outline strategies to improve care team identification in the electronic health record and discuss potential implications for patient-centered communication. Journal of Hospital Medicine 2016;11:381-385. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  17. 77 FR 10668 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ...-ACL (Annual Catch Limit) Harvested for Management Area 2 AGENCY: National Marine Fisheries Service... biological catch, annual catch limit (ACL), optimum yield, domestic harvest and processing, U.S. at-sea...,200 metric tons (mt); the 2012 sub-ACL allocated to Area 2 is 22,146 mt, and 0 mt of the sub-ACL is...

  18. Using social knowledge networking technology to enable meaningful use of electronic health record technology in hospitals and health systems.

    PubMed

    Rangachari, Pavani

    2014-12-01

    Despite the federal policy momentum towards "meaningful use" of Electronic Health Records, the healthcare organizational literature remains replete with reports of unintended adverse consequences of implementing Electronic Health Records, including: increased work for clinicians, unfavorable workflow changes, and unexpected changes in communication patterns & practices. In addition to being costly and unsafe, these unintended adverse consequences may pose a formidable barrier to "meaningful use" of Electronic Health Records. Correspondingly, it is essential for hospital administrators to understand and detect the causes of unintended adverse consequences, to ensure successful implementation of Electronic Health Records. The longstanding Technology-in-Practice framework emphasizes the role of human agency in enacting structures of technology use or "technologies-in-practice." Given a set of unintended adverse consequences from health information technology implementation, this framework could help trace them back to specific actions (types of technology-in-practice) and institutional conditions (social structures). On the other hand, the more recent Knowledge-in-Practice framework helps understand how information and communication technologies ( e.g. , social knowledge networking systems) could be implemented alongside existing technology systems, to create new social structures, generate new knowledge-in-practice, and transform technology-in-practice. Therefore, integrating the two literature streams could serve the dual purpose of understanding and overcoming unintended adverse consequences of Electronic Health Record implementation. This paper seeks to: (1) review the theoretical literatures on technology use & implementation, and identify a framework for understanding & overcoming unintended adverse consequences of implementing Electronic Health Records; (2) outline a broad project proposal to test the applicability of the framework in enabling "meaningful use

  19. Harnessing electronic healthcare data for wound care research: Standards for reporting observational registry data obtained directly from electronic health records.

    PubMed

    Fife, Caroline E; Eckert, Kristen A

    2017-04-01

    The United States Food and Drug Administration will consider the expansion of coverage indications for some drugs and devices based on real-world data. Real-world data accrual in patient registries has historically been via manual data entry from the medical chart at a time distant from patient care, which is fraught with systematic error. The efficient automated transmission of data directly from electronic health records is replacing this labor-intensive paradigm. However, real-world data collection is unfamiliar. The potential sources of bias arising from the source of data and data accrual, documentation, and aggregation have not been well defined. Furthermore, the technological aspects of data acquisition and transmission are less transparent. We explore opportunities for harnessing direct-from-electronic health record registry reporting and propose the ABCs of Registries (Analysis of Bias Criteria of Registries), which are an evaluation framework for publications to minimize potential bias of real-world data obtained directly from an electronic health record method. These standards are based on a point-of-care data documentation process using a common definitional framework and data dictionaries. By way of example, we describe a wound registry obtained directly from electronic health records. This qualified clinical data registry minimizes bias by ensuring complete and accurate point-of-care data capture, standardizes usual care linked to quality reporting, and prevents post-hoc vetting of outcomes. The resulting data are of high quality and integrity and can be used for comparative effectiveness research in wound care. In this way, the effort needed to succeed with the Quality Payment Program is leveraged to obtain the real-world data needed for comparative effectiveness research. © 2017 by the Wound Healing Society.

  20. Safety and fitness electronic records (SAFER) system : logical architecture document : working draft

    DOT National Transportation Integrated Search

    1997-01-31

    This Logical Architecture Document includes the products developed during the functional analysis of the Safety and Fitness Electronic Records (SAFER) System. This document, along with the companion Operational Concept and Physical Architecture Docum...

  1. Measure Once, Cut Twice – Adding Patient-Reported Outcome Measures to the Electronic Health Record for Comparative Effectiveness Research

    PubMed Central

    Wu, Albert W.; Kharrazi, Hadi; Boulware, L. Ebony; Snyder, Claire F.

    2013-01-01

    Objective This paper presents the current state of patient-reported outcome measures, and explains new opportunities for leveraging the recent adoption of electronic health records to expand the application of patient-reported outcomes in both clinical care and comparative effectiveness research. Study Design and Setting Historic developments of patient-reported outcome, electronic health record, and comparative effectiveness research are analyzed in two dimensions: patient-centeredness and digitization. We pose the question: “What needs to be standardized around the collection of patient-reported outcomes in electronic health records for comparative effectiveness research?” Results We identified three converging trends: the progression of patient-reported outcomes toward greater patient centeredness and electronic adaptation; the evolution of electronic health records into personalized and fully digitized solutions; the shift toward patient-oriented comparative effectiveness research. Related to this convergence, we propose an architecture for patient-reported outcome standardization that could serve as a first step toward a more comprehensive integration of patient-reported outcomes with electronic health record for both practice and research. Conclusion The science of patient-reported outcome measurement has matured sufficiently to be integrated routinely into electronic health records and other e-health solutions to collect data on an ongoing basis for clinical care and comparative effectiveness research. Further efforts and ideally coordinated efforts from various stakeholders are needed to refine the details of the proposed framework for standardization. PMID:23849145

  2. Combining Telephone Surveys and Fishing Catches Self-Report: The French Sea Bass Recreational Fishery Assessment

    PubMed Central

    Rocklin, Delphine; Levrel, Harold; Drogou, Mickaël; Herfaut, Johanna; Veron, Gérard

    2014-01-01

    Fisheries statistics are known to be underestimated, since they are mainly based on information about commercial fisheries. However, various types of fishing activities exist and evaluating them is necessary for implementing effective management plans. This paper assesses the characteristics and catches of the French European sea bass recreational fishery along the Atlantic coasts, through the combination of large-scale telephone surveys and fishing diaries study. Our results demonstrated that half of the total catches (mainly small fish) were released at sea and that the mean length of a kept sea bass was 46.6 cm. We highlighted different patterns of fishing methods and type of gear used. Catches from boats were greater than from the shore, both in abundance and biomass, considering mean values per fishing trip as well as CPUE. Spearfishers caught the highest biomass of sea bass per fishing trip, but the fishing rod with lure was the most effective type of gear in terms of CPUE. Longlines had the highest CPUE value in abundance but not in biomass: they caught numerous but small sea bass. Handlines were less effective, catching few sea bass in both abundance and biomass. We estimated that the annual total recreational sea bass catches was 3,173 tonnes of which 2,345 tonnes were kept. Since the annual commercial catches landings were evaluated at 5,160 tonnes, recreational landings represent 30% of the total fishing catches on the Atlantic coasts of France. Using fishers' self-reports was a valuable way to obtain new information on data-poor fisheries. Our results underline the importance of evaluating recreational fishing as a part of the total amount of fisheries catches. More studies are critically needed to assess overall fish resources caught in order to develop effective fishery management tools. PMID:24489885

  3. Combining telephone surveys and fishing catches self-report: the French sea bass recreational fishery assessment.

    PubMed

    Rocklin, Delphine; Levrel, Harold; Drogou, Mickaël; Herfaut, Johanna; Veron, Gérard

    2014-01-01

    Fisheries statistics are known to be underestimated, since they are mainly based on information about commercial fisheries. However, various types of fishing activities exist and evaluating them is necessary for implementing effective management plans. This paper assesses the characteristics and catches of the French European sea bass recreational fishery along the Atlantic coasts, through the combination of large-scale telephone surveys and fishing diaries study. Our results demonstrated that half of the total catches (mainly small fish) were released at sea and that the mean length of a kept sea bass was 46.6 cm. We highlighted different patterns of fishing methods and type of gear used. Catches from boats were greater than from the shore, both in abundance and biomass, considering mean values per fishing trip as well as CPUE. Spearfishers caught the highest biomass of sea bass per fishing trip, but the fishing rod with lure was the most effective type of gear in terms of CPUE. Longlines had the highest CPUE value in abundance but not in biomass: they caught numerous but small sea bass. Handlines were less effective, catching few sea bass in both abundance and biomass. We estimated that the annual total recreational sea bass catches was 3,173 tonnes of which 2,345 tonnes were kept. Since the annual commercial catches landings were evaluated at 5,160 tonnes, recreational landings represent 30% of the total fishing catches on the Atlantic coasts of France. Using fishers' self-reports was a valuable way to obtain new information on data-poor fisheries. Our results underline the importance of evaluating recreational fishing as a part of the total amount of fisheries catches. More studies are critically needed to assess overall fish resources caught in order to develop effective fishery management tools.

  4. A survey of user acceptance of electronic patient anesthesia records

    PubMed Central

    Jin, Hyun Seung; Lee, Suk Young; Jeong, Hui Yeon; Choi, Soo Joo; Lee, Hye Won

    2012-01-01

    Background An anesthesia information management system (AIMS), although not widely used in Korea, will eventually replace handwritten records. This hospital began using AIMS in April 2010. The purpose of this study was to evaluate users' attitudes concerning AIMS and to compare them with manual documentation in the operating room (OR). Methods A structured questionnaire focused on satisfaction with electronic anesthetic records and comparison with handwritten anesthesia records was administered to anesthesiologists, trainees, and nurses during February 2011 and the responses were collected anonymously during March 2011. Results A total of 28 anesthesiologists, 27 trainees, and 47 nurses responded to this survey. Most participants involved in this survey were satisfied with AIMS (96.3%, 82.2%, and 89.3% of trainees, anesthesiologists, and nurses, respectively) and preferred AIMS over handwritten anesthesia records in 96.3%, 71.4%, and 97.9% of trainees, anesthesiologists, and nurses, respectively. However, there were also criticisms of AIMS related to user-discomfort during short, simple or emergency surgeries, doubtful legal status, and inconvenient placement of the system. Conclusions Overall, most of the anesthetic practitioners in this hospital quickly accepted and prefer AIMS over the handwritten anesthetic records in the OR. PMID:22558502

  5. Electronic health records. A systematic review on quality requirements.

    PubMed

    Hoerbst, A; Ammenwerth, E

    2010-01-01

    Since the first concepts for electronic health records (EHRs) in the 1990s, the content, structure, and technology of such records were frequently changed and adapted. The basic idea to support and enhance health care stayed the same over time. To reach these goals, it is crucial that EHRs themselves adhere to rigid quality requirements. The present review aims at describing the currently available, mainly non-functional, quality requirements with regard to electronic health records. A combined approach - systematic literature analysis and expert interviews - was used. The literature analysis as well as the expert interviews included sources/experts from different domains such as standards and norms, scientific literature and guidelines, and best practice. The expert interviews were performed by using problem-centric qualitative computer-assisted telephone interviews (CATIs) or face-to-face interviews. All of the data that was obtained was analyzed using qualitative content analysis techniques. In total, more than 1200 requirements were identified of which 203 requirements were also mentioned during the expert interviews. The requirements are organized according to the ISO 9126 and the eEurope 2002 criteria. Categories with the highest number of requirements found include global requirements, (general) functional requirements and data security. The number of non-functional requirements found is by contrast lower. The manuscript gives comprehensive insight into the currently available, primarily non-functional, EHR requirements. To our knowledge, there are no other publications that have holistically reported on this topic. The requirements identified can be used in different ways, e.g. the conceptual design, the development of EHR systems, as a starting point for further refinement or as a basis for the development of specific sets of requirements.

  6. Metrics for Electronic-Nursing-Record-Based Narratives: Cross-sectional Analysis

    PubMed Central

    Kim, Kidong; Jeong, Suyeon; Lee, Kyogu; Park, Hyeoun-Ae; Min, Yul Ha; Lee, Joo Yun; Kim, Yekyung; Yoo, Sooyoung; Doh, Gippeum

    2016-01-01

    Summary Objectives We aimed to determine the characteristics of quantitative metrics for nursing narratives documented in electronic nursing records and their association with hospital admission traits and diagnoses in a large data set not limited to specific patient events or hypotheses. Methods We collected 135,406,873 electronic, structured coded nursing narratives from 231,494 hospital admissions of patients discharged between 2008 and 2012 at a tertiary teaching institution that routinely uses an electronic health records system. The standardized number of nursing narratives (i.e., the total number of nursing narratives divided by the length of the hospital stay) was suggested to integrate the frequency and quantity of nursing documentation. Results The standardized number of nursing narratives was higher for patients aged 70 years (median = 30.2 narratives/day, interquartile range [IQR] = 24.0–39.4 narratives/day), long (8 days) hospital stays (median = 34.6 narratives/day, IQR = 27.2–43.5 narratives/day), and hospital deaths (median = 59.1 narratives/day, IQR = 47.0–74.8 narratives/day). The standardized number of narratives was higher in “pregnancy, childbirth, and puerperium” (median = 46.5, IQR = 39.0–54.7) and “diseases of the circulatory system” admissions (median = 35.7, IQR = 29.0–43.4). Conclusions Diverse hospital admissions can be consistently described with nursing-document-derived metrics for similar hospital admissions and diagnoses. Some areas of hospital admissions may have consistently increasing volumes of nursing documentation across years. Usability of electronic nursing document metrics for evaluating healthcare requires multiple aspects of hospital admissions to be considered. PMID:27901174

  7. Evaluation of catch basin grates : final report.

    DOT National Transportation Integrated Search

    1972-10-01

    The Louisiana Department of Highways has adopted new designs for the Standard Plans for the RCB 22X catch basin to replace the old standard cast iron grate with either a welded bar steel grate or an alternate riveted steel reticuline grate. This revi...

  8. 78 FR 62331 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-Annual Catch Limit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-17

    ...-Annual Catch Limit (ACL) Harvested for Management Area 1A AGENCY: National Marine Fisheries Service (NMFS..., acceptable biological catch, annual catch limit (ACL), optimum yield, domestic harvest and processing, U.S... Harvest is 107,800 metric tons (mt); the 2013 sub-ACL allocated to Area 1A is 29,775 mt, and 0 mt of the...

  9. 76 FR 66654 - Fisheries of the Northeastern United States; Atlantic Herring Fishery; Sub-ACL (Annual Catch...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-27

    ...; Sub-ACL (Annual Catch Limit) Harvested for Management Area 1A AGENCY: National Marine Fisheries... biological catch, annual catch limit (ACL), optimum yield, domestic harvest and processing, U.S. at-sea...,200 metric tons (mt); the 2011 sub-ACL allocated to Area 1A is 26,546 mt, and 0 mt of the sub-ACL is...

  10. Measuring the success of electronic medical record implementation using electronic and survey data.

    PubMed Central

    Keshavjee, K.; Troyan, S.; Holbrook, A. M.; VanderMolen, D.

    2001-01-01

    Computerization of physician practices is increasing. Stakeholders are demanding demonstrated value for their Electronic Medical Record (EMR) implementations. We developed survey tools to measure medical office processes, including administrative and physician tasks pre- and post-EMR implementation. We included variables that were expected to improve with EMR implementation and those that were not expected to improve, as controls. We measured the same processes pre-EMR, at six months and 18 months post-EMR. Time required for most administrative tasks decreased within six months of EMR implementation. Staff time spent on charting increased with time, in keeping with our anecdotal observations that nurses were given more responsibility for charting in many offices. Physician time to chart increased initially by 50%, but went down to original levels by 18 months. However, this may be due to the drop-out of those physicians who had a difficult time charting electronically. PMID:11825201

  11. Evaluating Motivation for the Use of an Electronic Health Record Simulation Game.

    PubMed

    McLeod, Alexander; Hewitt, Barbara; Gibbs, David; Kristof, Caitlin

    2017-01-01

    Experiential learning via simulation offers a variety of benefits including reduced risks, repetitive exposure, and mastery of complex processes. How to motivate people to engage in and enjoy playing games is an important concept in the creation of serious games focused on learning new skills. This study sought to determine the motivators that increase users' pleasurable experience when playing an electronic health record simulation game. To examine how intrinsic and extrinsic motivation affected both engagement and enjoyment, we surveyed students of health professions at one university. Results indicate that while both forms of motivation are significant in increasing engagement and enjoyment, extrinsic motivation such as badges, points, and scoreboards were much more important than internal motivations for our participants. These findings have implications for the development of an electronic health record simulation game.

  12. Evaluating Motivation for the Use of an Electronic Health Record Simulation Game

    PubMed Central

    McLeod, Alexander; Hewitt, Barbara; Gibbs, David; Kristof, Caitlin

    2017-01-01

    Experiential learning via simulation offers a variety of benefits including reduced risks, repetitive exposure, and mastery of complex processes. How to motivate people to engage in and enjoy playing games is an important concept in the creation of serious games focused on learning new skills. This study sought to determine the motivators that increase users’ pleasurable experience when playing an electronic health record simulation game. To examine how intrinsic and extrinsic motivation affected both engagement and enjoyment, we surveyed students of health professions at one university. Results indicate that while both forms of motivation are significant in increasing engagement and enjoyment, extrinsic motivation such as badges, points, and scoreboards were much more important than internal motivations for our participants. These findings have implications for the development of an electronic health record simulation game. PMID:28566987

  13. Low Adoption Rates of Electronic Medical Records Systems: A Qualitative Study

    ERIC Educational Resources Information Center

    Slaughter, Andre

    2017-01-01

    This qualitative phenomenological research study explored the challenges of physicians working with Electronic Medical Records (EMR) systems for medical documentation. Additionally, this study sought to understand why many providers sought alternate means of patient documentation. Previous research studies focused on the use of EMR systems from…

  14. Examining the Relationship between Electronic Health Record Interoperability and Quality Management

    ERIC Educational Resources Information Center

    Purcell, Bernice M.

    2013-01-01

    A lack of interoperability impairs data quality among health care providers' electronic health record (EHR) systems. The problem is whether the International Organization for Standardization (ISO) 9000 principles relate to the problem of interoperability in implementation of EHR systems. The purpose of the nonexperimental quantitative research…

  15. Evolution of Medication Administration Workflow in Implementing Electronic Health Record System

    ERIC Educational Resources Information Center

    Huang, Yuan-Han

    2013-01-01

    This study focused on the clinical workflow evolutions when implementing the health information technology (HIT). The study especially emphasized on administrating medication when the electronic health record (EHR) systems were adopted at rural healthcare facilities. Mixed-mode research methods, such as survey, observation, and focus group, were…

  16. EFFECTS OF STROBOSCOPIC VISUAL TRAINING ON VISUAL ATTENTION, MOTION PERCEPTION, AND CATCHING PERFORMANCE.

    PubMed

    Wilkins, Luke; Gray, Rob

    2015-08-01

    It has been shown recently that stroboscopic visual training can improve visual-perceptual abilities, such as central field motion sensitivity and anticipatory timing. Such training should also improve a sports skill that relies on these perceptual abilities, namely ball catching. Thirty athletes (12 women, 18 men; M age=22.5 yr., SD=4.7) were assigned to one of two types of stroboscopic training groups: a variable strobe rate (VSR) group for which the off-time of the glasses was systematically increased (as in previous research) and a constant strobe rate group (CSR) for which the glasses were always set at the shortest off-time. Training involved simple, tennis ball-catching drills (9×20 min.) occurring over a 6-wk. In pre- and post-training, the participants completed a one-handed ball-catching task and the Useful Field of View (UFOV) and the Motion in Depth Sensitivity (MIDS) tests. Since the CSR condition used in the present study has been shown to have no effect on catching performance, it was predicted that the VSR group would show significantly greater improvement pre-post-training. There were no significant differences between the CSR and VSR on any of the tests. However, changes in catching performance (total balls caught) pre-post-training were significantly correlated with changes in scores for the UFOV single-task and MIDS tests. That is, regardless of group, participants whose perceptual-cognitive performance improved in the post-test were significantly more likely to improve their catching performance. This suggests that the perceptual changes observed in previous stroboscopic training studies may be linked to changes in sports skill performance.

  17. Electronic heterodyne recording and processing of optical holograms using phase modulated reference waves

    NASA Technical Reports Server (NTRS)

    Decker, A. J.; Pao, Y.-H.; Claspy, P. C.

    1978-01-01

    The use of a phase-modulated reference wave for the electronic heterodyne recording and processing of a hologram is described. Heterodyne recording is used to eliminate the self-interference terms of a hologram and to create a Leith-Upatnieks hologram with coaxial object and reference waves. Phase modulation is also shown to be the foundation of a multiple-view hologram system. When combined with hologram scale transformations, heterodyne recording is the key to general optical processing. Spatial filtering is treated as an example.

  18. [Views of health system administrators, professionals, and users concerning the electronic health record and facilitators and obstacles to its implementation].

    PubMed

    Costa, Jose Felipe Riani; Portela, Margareth Crisóstomo

    2018-02-05

    The design and deployment of complex technologies like the electronic health record (EHR) involve technical, personal, social, and organizational issues. The Brazilian public and private scenario includes different local and regional initiatives for implementation of the electronic health record. The Brazilian Ministry of Health also has a proposal to develop a national EHR. The current study aimed to provide a comprehensive view of perceptions by health system administrators, professionals, and users concerning their experiences with the electronic health record and their opinions of the possibility of developing a national EHR. This qualitative study involved 28 semi-structured interviews. The results revealed both the diversity of factors that can influence the implementation of an electronic health record and the existence of convergences and aspects that tend to be valued differently according to the different points of view. Key aspects include discussions on the electronic health record's attributes and it impact on healthcare, especially in the case of local electronic health records, concerns over costs and confidentiality and privacy pertaining to electronic health records in general, and the possible implications of centralized versus decentralized data storage in the case of a national EHR. The interviews clearly showed the need to establish more effective communication among the various stakeholders, and that the different perspectives should be considered when drafting and deploying an EHR at the local, regional, and national levels.

  19. Validity of electronic diet recording nutrient estimates compared to dietitian analysis of diet records: A randomized controlled trial

    USDA-ARS?s Scientific Manuscript database

    Background: Dietary intake assessment with diet records (DR) is a standard research and practice tool in nutrition. Manual entry and analysis of DR is time-consuming and expensive. New electronic tools for diet entry by clients and research participants may reduce the cost and effort of nutrient int...

  20. Considerations for choosing an electronic medical record for an ophthalmology practice.

    PubMed

    DeBry, P W

    2001-04-01

    To give a brief overview of issues pertinent to selecting an ophthalmic electronic medical record (EMR) program and to outline the company demographics and software capabilities of the major vendors in this area. Software companies shipping an EMR package were contacted to obtain information on their software and company demographics. The focus was on companies selectively marketing to ophthalmology practices, and, therefore, most were selected based on their representation at the 1998 and/or 1999 American Academy of Ophthalmology meeting. Software companies that responded to repeated inquiries in a timely fashion were included. Sixteen companies were evaluated. Electronic medical records packages ranged from $3000 to $80 000 (mean, approximately $30 000). Company demographics revealed a range from 1 to 1600 employees (mean, 204). Most of these companies have been in business for 6 years or less (range, 1-15 years; mean, 6 years). My opinions concerning various aspects of the EMR are presented. There is a wide range of EMR products available for the ophthalmology practice. Computer technology has matured to a point at which the graphical demands of the ophthalmology EMR can be satisfied. Weaknesses do exist in the inherent difficulty of recording an ophthalmology encounter, the relative adolescence of software companies, and the lack of standards in the industry.