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1

Time Trends and Risk Factors for Diabetes Mellitus in Dogs: Analysis of Veterinary Medical Data Base Records (1970–1999)  

Microsoft Academic Search

The objectives of the study were to identify recent trends in the prevalence of diabetes mellitus (DM) in dogs and to identify host risk factors. Veterinary Medical Data Base (VMDB) electronic records of 6860 dogs with a diagnosis of DM (VMDB code 870178500) between 1970 and 1999 were evaluated to determine time trends. Records of 6707 dogs with DM and

L. Guptill; L. Glickman; N. Glickman

2003-01-01

2

Veterinary Medical Needs in Florida.  

ERIC Educational Resources Information Center

There is a wide agreement that (1) Florida needs more practicing veterinarians and veterinary medical services than it now has, especially in the area of large animal and food animal practice, and (2) there is a deficiency of opportunities to study veterinary medicine for those Floridians who would elect this profession. This report takes into…

Florida State Board of Regents, Tallahassee.

3

Implications for Veterinary Medical Education: Postprofessional Education.  

ERIC Educational Resources Information Center

Concern about delivery of veterinary medical services to animal agriculture and implications for postprofessional veterinary medical education are discussed. The individual needs and goals of livestock producers, practicing veterinarians, and veterinary academicians are so varied that actual delivery of veterinary medical services is difficult to…

Kahrs, Robert F.

1980-01-01

4

Postgraduate Prospectus College of Medical, Veterinary  

E-print Network

Postgraduate Prospectus College of Medical, Veterinary & Life Sciences 2013 #12;1 Choose Glasgow and approachable, so you'll find plenty of like-minded people to share your ideas and interests with. At Glasgow we 20 International students 22 Our college Medical, Veterinary & Life Sciences 24 Important information

Guo, Zaoyang

5

Ideal Personality Characteristics for Veterinary Medical Students  

ERIC Educational Resources Information Center

An Adjective Check List was used to compare and contrast the desired personality traits for veterinarians. Data were collected from members of an admissions committee, the general public, and veterinary medical students. (LBH)

Birchard, S. J.; And Others

1976-01-01

6

Implications for Veterinary Medical Education: Paraprofessional Education.  

ERIC Educational Resources Information Center

The emergence of the veterinary technician as an extension of the veterinarian's capability into animal agriculture is discussed. Some aspects reviewed include: technician education, current restrictions imposed by practice acts, general acceptance by the consumer, and effective relationships for veterinary technicians working under the…

Lukens, Roger

1980-01-01

7

Guidelines for zoo and aquarium veterinary medical programs and veterinary hospitals.  

PubMed

These guidelines for veterinary medical care and veterinary hospitals are written to conform with the requirements of the Animal Welfare Act, which states that programs of disease prevention and parasite control, euthanasia, and adequate veterinary care shall be established and maintained under the supervision of a veterinarian. Ideally the zoo and aquarium should be providing the best possible veterinary medical care for the animals in their collections. Many of these animals are rare and endangered and the institutions should endeavor both to provide for the long term health and well being of these animals and to advance the field of non-domestic animal medicine. It is hoped that this publication will aid in this process. PMID:22946394

Backues, Kay; Clyde, Vickie; Denver, Mary; Fiorello, Christine; Hilsenroth, Rob; Lamberski, Nadine; Larson, Scott; Meehan, Tom; Murray, Mike; Ramer, Jan; Ramsay, Ed; Suedmeyer, Kirk; Whiteside, Doug

2011-03-01

8

Your Medical Records  

MedlinePLUS

... Own Medical Records? It's a great idea. Many health care experts recommend that patients keep their own medical summaries or Personal Medical Records (PMRs). That way, they can bring them along ...

9

Veterinary Homeopathy: The Implications of Its History for Unorthodox Veterinary Concepts and Veterinary Medical Education.  

ERIC Educational Resources Information Center

The history of veterinary homeopathy, its future and implications are discussed. The need for investigation into the validity of both allopathic and homeopathic claims is stressed and it is suggested that maintenance of quality is the key factor in any approach. (BH)

Coulter, Dwight B.

1979-01-01

10

College of Medical, Veterinary & Life School of Medicine  

E-print Network

College of Medical, Veterinary & Life Sciences School of Medicine Nursing & Health Care School 2014 1400 - 1630 Health Screening Clinical Skills Suite Wolfson Medical School Building, University Uniforms Nursing & Health Care 59 Oakfield Avenue Thurs 18 Sept 2014 1000 - 1200 Unions Nursing & Health

Glasgow, University of

11

21 CFR 530.5 - Veterinary records.  

Code of Federal Regulations, 2013 CFR

...manner, and be readily accessible to permit prompt retrieval of information. Such records shall be adequate to substantiate...Records shall be adequate to provide the following information: (1) The established name of the drug...

2013-04-01

12

21 CFR 530.5 - Veterinary records.  

...manner, and be readily accessible to permit prompt retrieval of information. Such records shall be adequate to substantiate...Records shall be adequate to provide the following information: (1) The established name of the drug...

2014-04-01

13

21 CFR 530.5 - Veterinary records.  

Code of Federal Regulations, 2012 CFR

...manner, and be readily accessible to permit prompt retrieval of information. Such records shall be adequate to substantiate...Records shall be adequate to provide the following information: (1) The established name of the drug...

2012-04-01

14

21 CFR 530.5 - Veterinary records.  

Code of Federal Regulations, 2011 CFR

...manner, and be readily accessible to permit prompt retrieval of information. Such records shall be adequate to substantiate...Records shall be adequate to provide the following information: (1) The established name of the drug...

2011-04-01

15

College of Veterinary Medicine University of Illinois On May 19, the board of the Illinois Veterinary Medical Alumni  

E-print Network

Veterinary Medical Alumni Association became the very first group to hold a meeting in the new Alice Campbell." --William L. Hollis, DVM President Illinois Veterinary Medical Alumni Association Intentional Acts,000 magazines, newspapers, periodicals, scientific and professional journals and trade publications

Gilbert, Matthew

16

Access to Medical Records.  

ERIC Educational Resources Information Center

Although confidentiality with regard to medical records is supposedly protected by the American Medical Associaton's principles of Ethics and the physician-patient privilege, there are a number of laws that require a physician to release patient information to public authorities without the patient's consent. These exceptions include birth and…

Cooper, Nancy

17

Assessing changes in competency of fourth-year veterinary medical students following a defined clinical experience  

E-print Network

The purpose of this study was to measure the competency of problem solving skills of fourth-year veterinary students. The study identified two primary objectives, (a) define clinical competency for fourth-year veterinary medical students, and (b...

Espitia, Noberto Francisco

2009-05-15

18

Guideline for Animal Medical Record Keeping and Transfer of Records Between NIH Intramural Animal Facilities  

E-print Network

under the Animal Welfare Act while setting forth the minimum requirement for records to be sent will be maintained as mandated by USDA's Animal Care Policy #3, Veterinary Care, July 17, 2007 http://www.aphis.usda.gov/animal_welfareGuideline for Animal Medical Record Keeping and Transfer of Records Between NIH Intramural Animal

Bandettini, Peter A.

19

Intelligent information mining from veterinary clinical records and open source repository  

Microsoft Academic Search

This paper reports an implementation of an intelligent mining approach from veterinary clinical records and an external source of information. The system retrieves information from a local veterinary clinical database and then complements this information with related records from an external source, OAIster. It utilizes text-mining, Web service technologies and domain knowledge, in order to extract keywords, to retrieve related

Ploy Tangtulyangkul; Timothy S Hocking; Chun Che Fung

2009-01-01

20

Veterinary Medical Education in Florida. Report and Recommendations of the Postsecondary Education Planning Commission, Report No. 3, 1987.  

ERIC Educational Resources Information Center

A report on veterinary medical education in Florida and the need for veterinary care in Florida is presented. Overviews of the veterinary profession and veterinary medical education are also given, including the areas of history, careers in the field, licensure, salaries, animal disease research, accreditation, curriculum, enrollment, educational…

Florida State Postsecondary Education Commission, Tallahassee.

21

The impact of AVMA COE's accreditation on veterinary medical education.  

PubMed

Point 1: the American Veterinary Medical Association Council on Education's (AVMA COE's) accreditation pro-cess is aimed at minimum training for entry-level veterinarians. This has a two-fold consequence: 1. The opportunity to discover the absolute minimum number of necessary resources is opened. While this is a threat to the standard model of veterinary education, it might have value if it is cost-efficient and students graduate with minimal or no debt. 2. There is no mechanism to measure training,research, or service programs above the minimum or beyond the entry level. Point 2: the implication of the minimum entry-level general standard is also two-fold: 1. We must measure performance above the mini-mum. A separate process is necessary (a) to develop and implement objective metrics and (b) to publicize superior achievement as opposed to minimal performance. 2. We must measure and publicize institutions or programs that advance the field beyond training entry-level veterinarians. Service, research, and training aimed at advancing the field, providing leadership, and improving public health and safety(One Health) require separate measurement and advocacy in order to obtain and justify the necessary resources. I conclude that in the absence of a new process by which to measure excellence, market forces will push the entire profession toward the most cost-effective method of providing minimal training for entry-level veterinarians. But what about the far more expensive goal of providing a global public good of which our profession is so proud?The public health and safety mission of veterinary medi-cine, including the entire One Health initiative, requires separate measurement in order to give objective metrics to the institutions and components of the profession committed to those goals to pursue vigorous advocacy and obtain or retain the necessary resources. PMID:22616138

Hendricks, Joan C

2012-01-01

22

Medication concepts, records, and lists in electronic medical record systems  

E-print Network

A well-designed implementation of medication concepts, records, and lists in an electronic medical record (EMR) system allows it to successfully perform many functions vital for the provision of quality health care. A ...

Chang, Jaime

2006-01-01

23

Adopting electronic medical records  

PubMed Central

Abstract Objective To understand the key challenges to adoption of advanced features of electronic medical records (EMRs) in office practice, and to better understand these challenges in a Canadian context. Design Mixed-methods study. Setting Manitoba. Participants Health care providers and staff in 5 primary care offices. Methods Level of EMR adoption was assessed, and field notes from interviews and discussion groups were qualitatively analyzed for common challenges and themes across all sites. Main findings Fifty-seven interviews and 4 discussion groups were conducted from November 2011 to January 2012. Electronic medical record adoption scores ranged from 2.3 to 3.0 (out of a theoretical maximum of 5). Practices often scored lower than expected on use of decision support, providing patients with access to their own data, and use of practice-reporting tools. Qualitative analysis showed there were ceiling effects to EMR adoption owing to how the EMR was implemented, the supporting eHealth infrastructure, lack of awareness or availability of EMR functionality, and poor EMR data quality. Conclusion Many practitioners used their EMRs as “electronic paper records” and were not using advanced features of their EMRs that could further enhance practice. Data-quality issues within the EMRs could affect future attempts at using these features. Education and quality improvement activities to support data quality and EMR optimization are likely needed to support practices in maximizing their use of EMRs. PMID:23851560

Price, Morgan; Singer, Alex; Kim, Julie

2013-01-01

24

Medical records and record-keeping standards.  

PubMed

The structure of medical records becomes ever more critical with the advent of electronic records. The Health Informatics Unit (HIU) of the Royal College of Physicians has two work streams in this area. The Records Standards programme is developing generic standards for all entries into medical notes and standards for the content of admission, handover and discharge records. The Information Laboratory (iLab) focuses on hospital episode statistics and their use for monitoring clinician performance. Clinician endorsement of the work is achieved through extensive consultations. Generic medical record-keeping standards are now available. PMID:17882846

Carpenter, Iain; Ram, Mala Bridgelal; Croft, Giles P; Williams, John G

2007-08-01

25

Medical History Record Health Services Medical  

E-print Network

the Medical History Record and the Student Immunization Record. A tuberculin test (Note: tine or monovac Hearing loss left or right ear Knee problem Severe or frequent headaches Severe head injury Concussion

Nelson, Tim

26

A qualitative study to explore communication skills in veterinary medical education  

PubMed Central

Objectives: To explore and gain an understanding of what “clinical communication skills” mean to veterinarians working in private practice and what implications this might have for veterinary medical education. Methods: Qualitative research methods were used to purposefully sample a range of veterinary practitioners from a pool of South Australian veterinary practices who were interviewed to determine their understanding of what communication skills mean in the context of veterinary practice. Interviews were conducted with fourteen veterinary practitioners. Participants were sampled from a range of ages, veterinary schools of graduation plus urban and rural locations. Interview transcripts were analysed for themes, definitions and contexts. Results: Participants’ accounts included a number of skills which they considered to be “communication”. Some of the definitions of these skills parallel communication skills and competencies for human medicine on which communication skills training incorporated into veterinary curricula to date have largely been based. However, the veterinarians in this study also raised interesting contextual differences unique to the veterinary profession, such as communication with the animal, selling service, discussing money in relation to decisions for care, and communicating about euthanasia. Conclusions: Veterinary practitioners require high level communication skills. Education and training in veterinary medicine may be better tailored to reflect the unique context of the veterinary profession. PMID:25341230

Hamood, Wendy J.; Chur-Hansen, Anna; McArthur, Michelle L.

2014-01-01

27

Reading Your Medical Record  

MedlinePLUS

... H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical ... a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in ...

28

Medical and Veterinary Entomology (1988) 2, 117-127 Allergens of non-bitingmidges (Diptera: Chironomidae)  

E-print Network

Medical and Veterinary Entomology (1988) 2, 117-127 Allergens of non-bitingmidges (Diptera suggestions that Chironomidae should be seen as important environmental and occupational allergens are clearly substantiated. Key words. Allergens, haemoglobin, Chironomidae. Introduction Chironomidae, known popularly

Cranston, Peter S.

29

An intelligent integrated querying system for free-form information extraction from veterinary clinical records  

Microsoft Academic Search

The aim of this paper is to report an intelligent integrated query system that provides and uses information from local veterinary clinical records supplemented with information from external resources. The information from the local records is used to remotely retrieve related information from external sources, in order to supplement the existing records for diagnosis and decision purposes. In Murdoch University,

PLOY TANGTULYANGKUL; Chun Che Fung

2009-01-01

30

Calendar 2010-11 COLLEGE OF MEDICAL, VETERINARY & LIFE SCIENCES  

E-print Network

of Science in Veterinary Science ................... 30 Graduate Certificate in Burns and Plastic Surgery Supplementary Undergraduate Regulations Degree of Bachelor of Dental Surgery ....................................... 9 Degrees of Bachelor of Medicine and Bachelor of Surgery ............ 12 Degree of Bachelor

Glasgow, University of

31

Family Health and Medical Record.  

E-print Network

.................................... . ............................... 12 Accidental Injury Record ........... . ..... .... .......... .... . . .. . .. . ... . ..................... 13 Allergy/Sensitivity Record ................................................. .. ................ 14 Medical and Dental Checkups...! __________________________________________________________________ _ Can you answer all these questions "yes"? ? Do you know the important health and medical events for each of your family members? ? Do you have a complete listing of all the shots and x-rays your children have received, and when they received them...

Shirer, Mary Ann

1982-01-01

32

The application of medical informatics to the veterinary management programs at companion animal practices in Alberta, Canada: a case study.  

PubMed

Companion animals closely share their domestic environment with people and have the potential to, act as sources of zoonotic diseases. They also have the potential to be sentinels of infectious and noninfectious, diseases. With the exception of rabies, there has been minimal ongoing surveillance of, companion animals in Canada. We developed customized data extraction software, the University of, Calgary Data Extraction Program (UCDEP), to automatically extract and warehouse the electronic, medical records (EMR) from participating private veterinary practices to make them available for, disease surveillance and knowledge creation for evidence-based practice. It was not possible to build, generic data extraction software; the UCDEP required customization to meet the specific software, capabilities of the veterinary practices. The UCDEP, tailored to the participating veterinary practices', management software, was capable of extracting data from the EMR with greater than 99%, completeness and accuracy. The experiences of the people developing and using the UCDEP and the, quality of the extracted data were evaluated. The electronic medical record data stored in the data, warehouse may be a valuable resource for surveillance and evidence-based medical research. PMID:24299904

Anholt, R M; Berezowski, J; Maclean, K; Russell, M L; Jamal, I; Stephen, C

2014-02-01

33

Making Medical Records More Resilient  

E-print Network

Hurricane Katrina showed that the current methods for handling medicalrecords are minimally resilient to large scale disasters. This research presents a preliminary model for measuring the resilience of medical records ...

Rudin, Robert

2008-02-17

34

Geriatric veterinary dentistry: medical and client relations and challenges.  

PubMed

Quality of life is an important issue for geriatric patients. Allowing periodontal disease, fractured teeth, and neoplasia to remain untreated decreases this quality of life. Age itself should be recognized; however, it should not be a deterrent to successful veterinary dental care. PMID:15833566

Holmstrom, Steven E

2005-05-01

35

Predictors of success in a UK veterinary medical undergraduate course.  

PubMed

Admission procedures for veterinary undergraduate training programs often include an interview as well as assessment of previous academic performance. In addition to pre-course factors, within-course factors such as performance in earlier years may play a role in determining success in the veterinary course. This study investigated the relationship between pre-course factors and within-course factors as predictors of success within the course. The study population consisted of six first-year cohorts, five second-year cohorts, four third-year cohorts, three fourth-year cohorts, and two fifth-year cohorts. There were a total of 1,347 students from the five-year Bachelor of Veterinary Medicine (BVetMed) program at the Royal Veterinary College (RVC). Data from these cohorts consisted of pre-entry demographic (sex, age, and nationality) and admission variables and within-course assessments. Logistic regression was used to examine the relationship between predictors and outcome. The study confirmed the value of previous academic performance in selecting students for the veterinary degree course but the value of interviews in the selection process was less clear. Within-course examination results were associated with later course outcome and high marks in continuous assessments were associated with overall success in the course. The study supports selection of students on the basis of previous academic performance but not interview scores. Continuous assessment and within-course examination results may be of value in identifying those students most likely to fail and therefore, those who need to be monitored and advised more closely. PMID:23187031

Muzyamba, Morris Chivwaba; Goode, Nigel; Kilyon, Margaret; Brodbelt, Dave

2012-01-01

36

Effective information design for PDAs in veterinary medical education.  

PubMed

Until recently, personal digital assistants (PDAs) have been ignominiously characterized as a solution without a problem. To many, they were glorified versions of calendars, address books, notepads, and calculators that appeared only minimally more useful than their paper predecessors. Today's PDAs cater to a wider range of mobile computing needs, especially in the veterinary field, where they support mobile, information-centric work. Despite the PDA's resurgent popularity, hardware constraints limit its wide-scale integration. Most notably, small screen sizes limit the PDA designers who compose texts, videos, and images for PDA delivery. This article addresses the problem of designing for small screens by re-characterizing the issue as an information design problem rather than a hardware problem. By analyzing how fourth-year students in a veterinary medicine program use their PDAs in their clinical education, we offer suggestions for designing information to meet their needs. PMID:18339966

Swarts, Jason; Vannorman, Maggie

2008-01-01

37

Promoting well-being among veterinary medical students: protocol and preliminary findings.  

PubMed

The veterinary medical profession has been the focus of increased concern as students and professionals have been found to be at risk of poor mental health outcomes. Two interventions were proposed as an attempt to improve student well-being individually and within romantic relationships. Preliminary results indicated that students who participated in the interventions experienced significant improvements in decreasing symptoms of depression and stress and relative improvements in relationship satisfaction with their partner. These noteworthy findings provide encouragement for the development of new interventions and future research focused on enhancing veterinary medical students' well-being. PMID:25000881

Siqueira Drake, Adryanna; Hafen, McArthur; Rush, Bonnie R

2014-01-01

38

A Current Overview of Veterinary Medical Education in the South: A Staff Report to the Southern Regional Education Board.  

ERIC Educational Resources Information Center

The need for veterinarians and the capacity of the South for providing veterinary medical education are examined. Summarized are eight current veterinary medical education programs in the region and planned developments in education (in Kentucky, North Carolina, Virginia, Maryland, West Virginia, and Arkansas). Projected are the effects of the…

Southern Regional Education Board, Atlanta, GA.

39

14 CFR 67.413 - Medical records.  

Code of Federal Regulations, 2011 CFR

...2011-01-01 2011-01-01 false Medical records. 67.413 Section 67...TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Certification Procedures § 67.413 Medical records. (a) Whenever the...

2011-01-01

40

14 CFR 67.413 - Medical records.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 2010-01-01 false Medical records. 67.413 Section 67...TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Certification Procedures § 67.413 Medical records. (a) Whenever the...

2010-01-01

41

Access to children's medical records.  

PubMed

Case histories are based on actual medical negligence claims or medicolegal referrals; however certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. When the parents of a young child are separated or divorced, it is not uncommon for general practitioners to receive requests from one of the parents for information about the medical management of the child, including a request for a copy of the child's medical records. The role of the GP is to provide medical care to the child and act in the child's best interests. This article outlines some strategies for GPs to minimise the possibility of becoming 'piggy in the middle' of a dispute between the parents. PMID:18523700

Bird, Sara

2008-06-01

42

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2011 CFR

...certain medical records (e.g., drug and alcohol abuse treatment and psychiatric records...the records are maintained by a military medical facility, these statutes...access. (3) All members of the military services and all married...

2011-07-01

43

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2010 CFR

...certain medical records (e.g., drug and alcohol abuse treatment and psychiatric records...the records are maintained by a military medical facility, these statutes...access. (3) All members of the military services and all married...

2010-07-01

44

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2013 CFR

...certain medical records (e.g., drug and alcohol abuse treatment and psychiatric records...the records are maintained by a military medical facility, these statutes...access. (3) All members of the military services and all married...

2013-07-01

45

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2012 CFR

...certain medical records (e.g., drug and alcohol abuse treatment and psychiatric records...the records are maintained by a military medical facility, these statutes...access. (3) All members of the military services and all married...

2012-07-01

46

Medical Services: Nursing Records and Reports.  

National Technical Information Service (NTIS)

Contents: (1) Documentation of daily patient acuity classification on DA Form 4677 (Clinical Record--Therapeutic Documentation Care Plan (Non-Medication)) (chap 2); (2) Documentation of the nursing discharge summary, DA Form 3888-3 (Medical Record--Nursin...

1991-01-01

47

Medical Records and Health Information Technicians  

MedlinePLUS

... requirements with other professionals such as physicians and finance personnel. Technical skills. Health information technicians must be ... Medical Records and Health Information Technicians, on the Internet at http://www.bls.gov/ooh/healthcare/medical- ...

48

Salmonella enterica serovar Oranienburg outbreak in a veterinary medical teaching hospital with evidence of nosocomial and on-farm transmission.  

PubMed

Nosocomial salmonellosis continues to pose an important threat to veterinary medical teaching hospitals. The objectives of this study were to describe an outbreak of salmonellosis caused by Salmonella enterica serovar Oranienburg within our hospital and to highlight its unique features, which can be used to help mitigate or prevent nosocomial outbreaks in the future. We retrospectively analyzed data from patients that were fecal culture-positive for Salmonella Oranienburg between January 1, 2006, and June 1, 2011, including historical, clinical, and pulsed-field gel electrophoresis (PFGE) data. Salmonella Oranienburg was identified in 20 horses, five alpacas, and three cows during this time frame, with dates of admission spanning the period from August, 2006, through January, 2008. We consider most of these patients to have become infected through either nosocomial or on-farm transmission, as evidenced by molecular subtyping results and supportive epidemiologic data. Interpretation of PFGE results in this outbreak was challenging because of the identification of several closely related Salmonella Oranienburg subtypes. Furthermore, a high percentage of cases were fecal culture-positive for Salmonella Oranienburg within 24 h of admission. These patients initially appeared to represent new introductions of Salmonella into the hospital, but closer inspection of their medical records revealed epidemiologic links to the hospital following the index case. Cessation of this outbreak was observed following efforts to further heighten biosecurity efforts, with no known cases or positive environmental samples after January, 2008. This study demonstrates that a Salmonella-positive culture result within 24 h of admission does not exclude the hospital as the source of infection, and it underscores the important role played by veterinary medical teaching hospitals as nodes of Salmonella infection that can promote transmission outside of the hospital setting. PMID:24902121

Cummings, Kevin J; Rodriguez-Rivera, Lorraine D; Mitchell, Katharyn J; Hoelzer, Karin; Wiedmann, Martin; McDonough, Patrick L; Altier, Craig; Warnick, Lorin D; Perkins, Gillian A

2014-07-01

49

From theory to practice: integrating instructional technology into veterinary medical education.  

PubMed

Technology has changed the landscape of teaching and learning. The integration of instructional technology into teaching for meaningful learning is an issue for all educators to consider. In this article, we introduce educational theories including constructivism, information-processing theory, and dual-coding theory, along with the seven principles of good practice in undergraduate education. We also discuss five practical instructional strategies and the relationship of these strategies to the educational theories. From theory to practice, the purpose of the article is to share our application of educational theory and practice to work toward more innovative teaching in veterinary medical education. PMID:23975076

Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; Herman, Cheryl; Miesner, Matt; Renter, David; Gehring, Ronette

2013-01-01

50

42 CFR 460.210 - Medical records.  

Code of Federal Regulations, 2011 CFR

...2011-10-01 false Medical records. 460.210 Section 460.210 Public Health CENTERS FOR MEDICARE...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Data Collection, Record Maintenance, and Reporting...permitting disclosure of personal information....

2011-10-01

51

42 CFR 460.210 - Medical records.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 false Medical records. 460.210 Section 460.210 Public Health CENTERS FOR MEDICARE...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Data Collection, Record Maintenance, and Reporting...permitting disclosure of personal information....

2012-10-01

52

42 CFR 460.210 - Medical records.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 false Medical records. 460.210 Section 460.210 Public Health CENTERS FOR MEDICARE...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Data Collection, Record Maintenance, and Reporting...permitting disclosure of personal information....

2013-10-01

53

42 CFR 460.210 - Medical records.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Medical records. 460.210 Section 460.210 Public Health CENTERS FOR MEDICARE...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Data Collection, Record Maintenance, and Reporting...permitting disclosure of personal information....

2010-10-01

54

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:25359743

2014-11-01

55

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:25081876

2014-08-01

56

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK, and on other relevant issues. PMID:25193757

2014-09-01

57

Veterinary medicines: product update.  

PubMed

The following information has been produced for Veterinary Record by the Veterinary Medicines Directorate (VMD) to provide an update for veterinary surgeons on recent changes to marketing authorisations for veterinary medicines in the UK and on other relevant issues. PMID:25281450

2014-10-01

58

Refereed papers Implementing electronic medical record  

E-print Network

, diabetes and cardiovascular disease in developing countries.8 Growing use of electronic medical record (EMR)Refereed papers Implementing electronic medical record systems in developing countries Hamish SFZulu Natal, Durban, South Africa Sharon Choi MS Research Assistant, Program in Infectious Disease and Social

Szolovits, Peter

59

Basic Workshops for Medical Record Clerical Personnel.  

ERIC Educational Resources Information Center

This curriculum guide is an outline of the content for basic workshop training sessions of hospital medical record personnel. Following a two-page topical outline of five content areas, there is a detailed presentation of this content as follows: (1) the medical record and its contribution to patient care (Joint Commission for Accreditation of…

Intermountain Regional Medical Program, Salt Lake City, UT.

60

The need for closer collaboration between the medical and veterinary professions  

PubMed Central

It is increasingly apparent that physicians and veterinarians share the same pool of scientific knowledge and that diseases of animals have many direct and indirect connexions with human health. Nowadays it is realized that, given the opportunity, the veterinarian can make substantial contributions to the medical services by (a) controlling zoonoses, (b) supervising the hygiene of food, especially food of animal origin, (c) assisting in the detection and prevention of environmental pollution, (d) facilitating exchange of research information on analagous problems in man and animals, and (e) ensuring a supply of healthy, standardized laboratory animals. Appropriate administrative machinery at government level is necessary to enable the veterinarian to develop and exercise his potential in this field and to ensure full and effective collaboration between the medical and veterinary professions. Conventional veterinary education provides an excellent background for public health work, but special training is also necessary, at both the undergraduate and postgraduate levels, for veterinarians who are to assume responsibilities in public health. A fuller partnership between these two health professions, which have so much in common, should be encouraged in various ways, for example by sharing some courses during university education, and by joint meetings to discuss problems of mutual concern. PMID:310728

Beveridge, W. I. B.

1978-01-01

61

10 CFR 712.38 - Maintenance of medical records.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Maintenance of medical records. 712.38 Section 712.38 Energy DEPARTMENT OF ENERGY HUMAN RELIABILITY PROGRAM Medical Standards § 712.38 Maintenance of medical records. (a) The medical records of...

2010-01-01

62

Mining free-text medical records for companion animal enteric syndrome surveillance.  

PubMed

Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals. PMID:24485708

Anholt, R M; Berezowski, J; Jamal, I; Ribble, C; Stephen, C

2014-03-01

63

Texas A&M Veterinary Medical Diagnostic Lab Procedures 33.04.01.V0.01 Use of Agency Resources for External Employment  

E-print Network

for External Employment Approved: December 28, 2012 Next Scheduled Review: December 28, 2014 Texas A&M Veterinary Medical Diagnostic Lab Procedures 33.04.01.A0.01 Use of Agency Resources for External Employment Resources for External Employment, and this procedure, Texas A&M Veterinary Medical Diagnostic Laboratory

64

Access to Personal Medical Records.  

ERIC Educational Resources Information Center

Whether individuals should be allowed to see and correct their health records evokes controversy that revolves about citizens' rights to know what information is kept on them, society's duty to protect individuals' and doctors' rights, and the rights of employers and other parties to maintain the confidentiality of their files. A review of the…

Weisenstein, Sharon

65

Texas A&M Veterinary Medical Diagnostic Laboratory Procedures 34.07.99.V0.01 Emergency Management  

E-print Network

Texas A&M Veterinary Medical Diagnostic Laboratory Procedures 34.07.99.V0.01 Emergency Management Laboratory Procedures 34.07.99.V0.01 Emergency Management Page 1 of 5 PROCEDURE STATEMENT Texas A 1.0) and develop (off­campus locations) emergency management plans and emergency alert systems (EAS

66

Linking medical records to an expert system  

NASA Technical Reports Server (NTRS)

This presentation will be done using the IMR-Entry (Intelligent Medical Record Entry) system. IMR-Entry is a software program developed as a front-end to our diagnostic consultant software MEDAS (Medical Emergency Decision Assistance System). MEDAS (the Medical Emergency Diagnostic Assistance System) is a diagnostic consultant system using a multimembership Bayesian design for its inference engine and relational database technology for its knowledge base maintenance. Research on MEDAS began at the University of Southern California and the Institute of Critical Care in the mid 1970's with support from NASA and NSF. The MEDAS project moved to Chicago in 1982; its current progress is due to collaboration between Illinois Institute of Technology, The Chicago Medical School, Lake Forest College and NASA at KSC. Since the purpose of an expert system is to derive a hypothesis, its communication vocabulary is limited to features used by its knowledge base. The development of a comprehensive problem based medical record entry system which could handshake with an expert system while creating an electronic medical record at the same time was studied. IMR-E is a computer based patient record that serves as a front end to the expert system MEDAS. IMR-E is a graphically oriented comprehensive medical record. The programs major components are demonstrated.

Naeymi-Rad, Frank; Trace, David; Desouzaalmeida, Fabio

1991-01-01

67

38 CFR 46.6 - Medical quality assurance records confidentiality.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 false Medical quality assurance records confidentiality...NATIONAL PRACTITIONER DATA BANK Miscellaneous § 46.6 Medical quality assurance records confidentiality... Note that medical quality assurance records...National Practitioner Data...

2010-07-01

68

21 CFR 870.2800 - Medical magnetic tape recorder.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Medical magnetic tape recorder. 870.2800 Section...Monitoring Devices § 870.2800 Medical magnetic tape recorder. (a) Identification. A medical magnetic tape recorder is a device used...

2013-04-01

69

Veterinary homeopathy: systematic review of medical conditions studied by randomised placebo-controlled trials.  

PubMed

A systematic review of randomised controlled trials (RCTs) of veterinary homeopathy has not previously been undertaken. Using Cochrane methods, this review aims to assess risk of bias and to quantify the effect size of homeopathic intervention compared with placebo for each eligible peer-reviewed trial. Judgement in seven assessment domains enabled a trial's risk of bias to be designated as low, unclear or high. A trial was judged to comprise reliable evidence if its risk of bias was low or was unclear in specified domains. A trial was considered to be free of vested interest if it was not funded by a homeopathic pharmacy. The 18 eligible RCTs were disparate in nature, representing four species and 11 different medical conditions. Reliable evidence, free from vested interest, was identified in two trials: homeopathic Coli had a prophylactic effect on porcine diarrhoea (odds ratio 3.89, 95 per cent confidence interval [CI], 1.19 to 12.68, P=0.02); and individualised homeopathic treatment did not have a more beneficial effect on bovine mastitis than placebo intervention (standardised mean difference -0.31, 95 per cent CI, -0.97 to 0.34, P=0.35). Mixed findings from the only two placebo-controlled RCTs that had suitably reliable evidence precluded generalisable conclusions about the efficacy of any particular homeopathic medicine or the impact of individualised homeopathic intervention on any given medical condition in animals. PMID:25324413

Mathie, Robert T; Clausen, Jürgen

2014-10-18

70

Outpatient medical records: improvements through layout engineering.  

PubMed

Dissatisfied with some functional aspects of the problem-oriented medical records used by their medical group, a committee of member physicians redesigned their office charts. Applying techniques of systematic layout planning, employed regularly as a tool of industrial engineering, these clinicians devised what they feel to be outpatient document with unique features. The resulting product forms a cohesive unit, eliminates duplication and provides many medicolegal safeguards. PMID:304275

Cook, G B

1977-12-01

71

Prevalence of disorders recorded in dogs attending primary-care veterinary practices in England.  

PubMed

Purebred dog health is thought to be compromised by an increasing occurence of inherited diseases but inadequate prevalence data on common disorders have hampered efforts to prioritise health reforms. Analysis of primary veterinary practice clinical data has been proposed for reliable estimation of disorder prevalence in dogs. Electronic patient record (EPR) data were collected on 148,741 dogs attending 93 clinics across central and south-eastern England. Analysis in detail of a random sample of EPRs relating to 3,884 dogs from 89 clinics identified the most frequently recorded disorders as otitis externa (prevalence 10.2%, 95% CI: 9.1-11.3), periodontal disease (9.3%, 95% CI: 8.3-10.3) and anal sac impaction (7.1%, 95% CI: 6.1-8.1). Using syndromic classification, the most prevalent body location affected was the head-and-neck (32.8%, 95% CI: 30.7-34.9), the most prevalent organ system affected was the integument (36.3%, 95% CI: 33.9-38.6) and the most prevalent pathophysiologic process diagnosed was inflammation (32.1%, 95% CI: 29.8-34.3). Among the twenty most-frequently recorded disorders, purebred dogs had a significantly higher prevalence compared with crossbreds for three: otitis externa (P?=?0.001), obesity (P?=?0.006) and skin mass lesion (P?=?0.033), and popular breeds differed significantly from each other in their prevalence for five: periodontal disease (P?=?0.002), overgrown nails (P?=?0.004), degenerative joint disease (P?=?0.005), obesity (P?=?0.001) and lipoma (P?=?0.003). These results fill a crucial data gap in disorder prevalence information and assist with disorder prioritisation. The results suggest that, for maximal impact, breeding reforms should target commonly-diagnosed complex disorders that are amenable to genetic improvement and should place special focus on at-risk breeds. Future studies evaluating disorder severity and duration will augment the usefulness of the disorder prevalence information reported herein. PMID:24594665

O Neill, Dan G; Church, David B; McGreevy, Paul D; Thomson, Peter C; Brodbelt, Dave C

2014-01-01

72

Cost Saving Innovation: The Electronic Medical Record  

Microsoft Academic Search

need to be kept private, although physi- cians of other specialties are permitted to view prescription information (2). Earlier this year, the Obama Admin- istration set aside funds in stimulus money for electronic medical record pro- grams, with the goal of freeing health- care workers from a paper-based system by 2014. The poten- tial cost savings from these programs has

Ada Ikeako; Benjamin Franklin

73

32 CFR 701.122 - Medical records.  

...could have an adverse effect on the mental or physical health of the individual...her medical and psychological records if that access...or physical health of the individual...mental or physical effect on the individual...drug and alcohol abuse treatment and...

2014-07-01

74

Present and future potential of plant-derived products to control arthropods of veterinary and medical significance  

PubMed Central

The use of synthetic pesticides and repellents to target pests of veterinary and medical significance is becoming increasingly problematic. One alternative approach employs the bioactive attributes of plant-derived products (PDPs). These are particularly attractive on the grounds of low mammalian toxicity, short environmental persistence and complex chemistries that should limit development of pest resistance against them. Several pesticides and repellents based on PDPs are already available, and in some cases widely utilised, in modern pest management. Many more have a long history of traditional use in poorer areas of the globe where access to synthetic pesticides is often limited. Preliminary studies support that PDPs could be more widely used to target numerous medical and veterinary pests, with modes of action often specific to invertebrates. Though their current and future potential appears significant, development and deployment of PDPs to target veterinary and medical pests is not without issue. Variable efficacy is widely recognised as a restraint to PDPs for pest control. Identifying and developing natural bioactive PDP components in place of chemically less-stable raw or 'whole’ products seems to be the most popular solution to this problem. A limited residual activity, often due to photosensitivity or high volatility, is a further drawback in some cases (though potentially advantageous in others). Nevertheless, encapsulation technologies and other slow-release mechanisms offer strong potential to improve residual activity where needed. The current review provides a summary of existing use and future potential of PDPs against ectoparasites of veterinary and medical significance. Four main types of PDP are considered (pyrethrum, neem, essential oils and plant extracts) for their pesticidal, growth regulating and repellent or deterrent properties. An overview of existing use and research for each is provided, with direction to more extensive reviews given in many sections. Sections to highlight potential issues, modes of action and emerging and future potential are also included. PMID:24428899

2014-01-01

75

Medical Terminology of the Circulatory System. Medical Records. Instructional Unit for the Medical Transcriber.  

ERIC Educational Resources Information Center

Developed as a result of an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis…

Gosman, Minna L.

76

Providing an information prescription in veterinary medical clinics: a pilot study  

PubMed Central

Objective: The study assesses the impact on client behavior and attitudes toward receiving an information prescription as part of a veterinary office visit. Methods: A random sample of veterinary clinics from a Western US metropolitan area was asked to distribute an information prescription in addition to their customary veterinary services. All clients, regardless of the reason for their visit, were presented with an information prescription: a handout that included the uniform resource locator (URL) to a general veterinary medicine website and several tips to help their clients make more informed choices about where to seek pet health information online. Results: Nearly 40% of clients who reported that they remembered receiving the information prescription accessed the website at least once. Of the clients who reported accessing the suggested website, 86.3% reported finding it “very helpful” or “somewhat helpful.” Nearly all the clients (87.9%) reported feeling the information on the site helped them make better decisions for their pets. Most clients reported that it helped them talk to their veterinarians (89.9%) and added to the information they received during their veterinary visits (83.5%). Conclusions: Clients appreciate and utilize veterinary prescriptions, suggesting that this is a tool that both veterinarians and librarians can use to improve animal health and client relations. Implications: The value placed on reliable Internet information by veterinary clients suggests several opportunities for librarians to become more proactive in partnering with veterinarians to facilitate the education of pet owners. PMID:24415918

Kogan, Lori R.; Schoenfeld-Tacher, Regina; Gould, Lauren; Viera, Ann R.; Hellyer, Peter W.

2014-01-01

77

Veterinary medicines and competition animals: the question of medication versus doping control.  

PubMed

In racing and other equine sports, it is possible to increase artificially both the physical capability and the presence of a competitive instinct, using drugs, such as anabolic steroids and agents stimulating the central nervous system. The word doping describes this illegitimate use of drugs and the primary motivation of an equine anti-doping policy is to prevent the use of these substances. However, an anti-doping policy must not impede the use of legitimate veterinary medications and most regulatory bodies in the world now distinguish the control of illicit substances (doping control) from the control of therapeutic substances (medication control). For doping drugs, the objective is to detect any trace of drug exposure (parent drug or metabolites) using the most powerful analytical methods (generally chromatographic/mass spectrometric techniques). This so-called "zero tolerance rule" is not suitable for medication control, because the high level of sensitivity of current screening methods allows the detection of totally irrelevant plasma or urine concentrations of legitimate drugs for long periods after their administration. Therefore, a new approach for these legitimate compounds, based upon pharmacokinetic/pharmacodynamic (PK/PD) principles, has been developed. It involves estimating the order of magnitude of the irrelevant plasma concentration (IPC) and of the irrelevant urine concentration (IUC) in order to limit the impact of the high sensitivity of analytical techniques used for medication control. The European Horserace Scientific Liaison Committee (EHSLC), which is the European scientific committee in charge of harmonising sample testing and policies for racehorses in Europe, is responsible for estimating the IPCs and IUCs in the framework of a Risk Analysis. A Risk Analysis approach for doping/medication control involves three sequential steps, namely risk assessment, risk management, and risk communication. For medication control, the main task of EHLSC in the risk management procedure is the establishment of harmonised screening limits (HSL). The HSL is a confidential instruction to laboratories from racing authorities to screen in plasma or urine for the presence of drugs commonly used in equine medication. The HSL is derived from the IPC (for plasma) or from the IUC (for urine), established during the risk assessment step. The EHSLC decided to keep HSL confidential and to inform stakeholders of the duration of the detection time (DT) of the main medications when screening is performed with the HSL. A DT is the time at which the urinary (or plasma) concentration of a drug, in all horses involved in a trial conducted according to the EHSLC guidance rules, is shown to be lower than the HSL when controls are performed using routine screening methods. These DTs, as issued by the EHSLC (and adopted by the Fédération Equestre Internationale or FEI) provide guidance to veterinarians enabling them to determine a withdrawal time (WT) for a given horse under treatment. A WT should always be longer than a DT because the WT takes into account the impact of all sources of animal variability as well as the variability associated with the medicinal product actually administered in order to avoid a positive test. The major current scientific challenges faced in horse doping control are those instances of the administration of recombinant biological substances (EPO, GH, growth factors etc.) having putative long-lasting effects while being difficult or impossible to detect for more than a few days. Innovative bioanalytical approaches are now addressing these challenges. Using molecular tools, it is expected in the near future that transcriptional profiling analysis will be able to identify some molecular "signatures" of exposure to doping substances. The application of proteomic (i.e. the large scale investigation of protein biomarkers) and metabolomic (i.e. the study of metabolite profiling in biological samples) techniques also deserve attention for establishing possible unique fingerprints of drug

Toutain, Pierre-Louis

2010-01-01

78

Electronic medical records in clinical teaching.  

PubMed

The purpose of the project was to provide students with experiences to develop their technology competency and examine student perceptions about an academic electronic medical record (EMR) as a learning tool. Nurse educators need to integrate EMRs into their curricula to give students practice in the use of electronic documentation and retrieval of clinical information. The findings of this study indicated that students' use of EMRs at least 5 times resulted in the development of positive perceptions about their EMR experience. PMID:25073041

Warboys, Ina; Mok, Wai Yin; Frith, Karen H

2014-01-01

79

Electronic medical records and the gastroenterologist.  

PubMed

This is an age of disruptive innovation in health care in which the business model is changing. Fee-for-service, volume-based systems are being replaced by fixed-fee, value-based systems. One of the major facilitating forces behind this change has been the development of the electronic health record, which is providing the medical community with the ability to have real-time quality metrics that will drive the development of web-based clinical decision support tools that will transform the current peer-review-based rules of practice with an eclectic fluid environment of continuous quality measurement and improvement. PMID:22099712

Kosinski, Lawrence R

2012-01-01

80

Student versus Faculty Attitudes toward the Veterinary Medical Profession and Education.  

ERIC Educational Resources Information Center

Surveyed and interviewed first-year students and faculty in veterinary medicine at the Swedish University of Agricultural Sciences on attitudes toward education and practice. Students placed emphasis on specific knowledge and practical skills, while faculty spoke in favor of basic theory; students also wanted integrated exams. Both agreed that…

Hoppe, Astrid; Trowald-Wigh, Gunilla

2000-01-01

81

College of Medical, Veterinary and Life Sciences Institute of Biodiversity, Animal Health and Comparative Medicine  

E-print Network

of ecology, evolution or organismal biology. To undertake administration as requested by the Director biology and ecology with that in comparative and veterinary medicine. Unique in the UK, the range of our. Investigating key questions in environmental change, emerging diseases, and animal and ecosystem health requires

Glasgow, University of

82

College of Medical, Veterinary and Life Sciences Institute of Biodiversity, Animal Health and Comparative Medicine  

E-print Network

of ecology, evolution or organismal biology. To undertake administration as requested by the Director and ecology with that in comparative and veterinary medicine. Unique in the UK, the range of our studies spans in environmental change, emerging diseases, and animal and ecosystem health requires an integration of empirical

Glasgow, University of

83

Indiana's Need for Assistants in Veterinary Medical Practice. Manpower Report, No. 68-2.  

ERIC Educational Resources Information Center

The need for technicians and attendants in veterinary medicine was examined to determine the necessity of implementing training programs. Returns from 215 licensed veterinarians were obtained from the 692 surveyed. Some findings were: (1) The largest number of job vacancies were reported for animal technician graduates at the associate degree…

Morse, Erskine V.; Lisack, J.P.

84

Essentials of an Acceptable School for Medical Record Technicians.  

ERIC Educational Resources Information Center

The Council on Medical Education of the American Medical Association in collaboration with the American Association of Medical Record Librarians establishes standards for medical record technician education, surveys and approves educational programs, and publishes lists of approved programs. The standards presented are intended as a guide for…

American Medical Association, Chicago, IL. Council on Medical Education.

85

Video Recording Paper - Innovation In Medical Video Recording  

NASA Astrophysics Data System (ADS)

Traditionally, multiple format recording emulsions for medical video imaging have utilized a film (transparent) base. The major reason for this is probably because the film and camera manufacturers felt the diagnostician is accustomed to viewing x-ray images on a film base and would prefer to view video images that way also. Because of the need to keep radiation exposure to patients at a minimum and the fact that photographic emulsions are generally very inefficient in utilizing x-ray radiation, a film base was the logical requirement for direct x-ray imaging as it enabled the image to be recorded by two emulsions rather than one. The transparent base thus allows viewing a photograph which is the result of the additive effect of the two emulsions. The use of transparent base imposed specific requirements that necessitated the development of a whole complex of equipment designed for the particular use of film such as the processing machines, their chemical solutions, and the famous viewbox and alternators that characterize the radiology departments of today.

Shalit, Hanoch

1985-09-01

86

Electronic Medical Records in Colorectal Surgery  

PubMed Central

Electronic medical records (EMRs) are being widely implemented today, either as stand-alone applications in smaller practices or as systems-based integrated network solutions in larger health care organizations. Advantages include rapid accessibility, worldwide availability, ease of storage, and secure transfer of protected health information (PHI). Computerized physician order entry (CPOE) and decision-support capabilities such as the triggering of an alarm when multiple medications with known interactions are ordered, as well as the seemingly endless possibilities for electronic integration and extraction of PHI for clinical and research purposes, have created opportunities and pitfalls alike. Risks include breaches of confidentiality with a need to implement tighter measures for electronic security. These measures contrast efforts required for the realization of common data formats that have national and even international compatibility. EMRs provide a common platform that could potentially allow for the integration and administration of clinical care, research, and quality metrics, thus promoting optimal outcomes for patients. Technical and medicolegal difficulties need to be overcome in the years to come so that the safe use of PHI can be ensured while still maintaining the benefits and convenience of modern EMR systems. PMID:24436643

Turina, Matthias; Kiran, Ravi P.

2013-01-01

87

Informing web-based communication curricula in veterinary education: a systematic review of web-based methods used for teaching and assessing clinical communication in medical education.  

PubMed

We determined the Web-based configurations that are applied to teach medical and veterinary communication skills, evaluated their effectiveness, and suggested future educational directions for Web-based communication teaching in veterinary education. We performed a systematic search of CAB Abstracts, MEDLINE, Scopus, and ERIC limited to articles published in English between 2000 and 2012. The review focused on medical or veterinary undergraduate to clinical- or residency-level students. We selected studies for which the study population was randomized to the Web-based learning (WBL) intervention with a post-test comparison with another WBL or non-WBL method and that reported at least one empirical outcome. Two independent reviewers completed relevancy screening, data extraction, and synthesis of results using Kirkpatrick and Kirkpatrick's framework. The search retrieved 1,583 articles, and 10 met the final inclusion criteria. We identified no published articles on Web based communication platforms in veterinary medicine; however, publications summarized from human medicine demonstrated that WBL provides a potentially reliable and valid approach for teaching and assessing communication skills. Student feedback on the use of virtual patients for teaching clinical communication skills has been positive,though evidence has suggested that practice with virtual patients prompted lower relation-building responses.Empirical outcomes indicate that WBL is a viable method for expanding the approach to teaching history taking and possibly to additional tasks of the veterinary medical interview. PMID:24418922

Artemiou, Elpida; Adams, Cindy L; Toews, Lorraine; Violato, Claudio; Coe, Jason B

2014-01-01

88

Health Professions & Veterinary Medicine  

E-print Network

or veterinary medicine, undergraduate study at Virginia Tech provides a solid academic background for graduate, dentistry, optometry, pharmacy, physical and occupational therapy, physician assistant, clinical science Admission Test (MCAT) for medical schools, Optometry Admission Test (OAT) for optometry schools, Pharmacy

Virginia Tech

89

awards and contracts The College of Veterinary Medicine's Research Office recorded  

E-print Network

-Ingram Harry M. Zweig Memorial Fund for Equine Research T-Cell Mediated Immunity and Vaccine Development Production for Implantable Medical Devices $762,300 Biomedical Sciences $4,367,166 Klaus Beyenbach FNIH- Ohio

Manning, Sturt

90

Automated de-identification of free-text medical records  

E-print Network

Background: Text-based patient medical records are a vital resource in medical research. In order to preserve patient confidentiality, however, the U.S. Health Insurance Portability and Accountability Act (HIPAA) requires ...

Neamatullah, Ishna

91

Medical records department and balanced scorecard approach  

PubMed Central

Context: The Medical Records Department (MRD) is an important source for evaluating and planning of healthcare services; therefore, hospital managers should improve their performance not only in the short-term but also in the long-term plans. The Balanced Scorecard (BSC) is a tool in the management system that enables organizations to correct operational functions and provides feedback around both the internal processes and the external outcomes, in order to improve strategic performance and outcomes continuously. Aims: The main goal of this study was to assess the MRD performance with BSC approach in a hospital. Materials and Methods: This research was an analytical cross-sectional study in which data was collected by questionnaires, forms and observation. The population was the staff of the MRD in a hospital in Najafabad, Isfahan, Iran. Statistical Analysis Used: To analyze data, first, objectives of the MRD, according to the mission and perspectives of the hospital, were redefined and, second, indicators were measured. Subsequently, findings from the performance were compared with the expected score. In order to achieve the final target, the programs, activities, and plans were reformed. Results: The MRD was successful in absorbing customer satisfaction. From a customer perspective, score in customer satisfaction of admission and statistics sections were 82% and 83%, respectively. Conclusions: The comprehensive nature of the strategy map makes the MRD especially useful as a consensus building and communication tool in the hospital. PMID:24083257

Ajami, Sima; Ebadsichani, Afsaneh; Tofighi, Shahram; Tavakoli, Nahid

2013-01-01

92

Report on Health Manpower and Programs in Ohio: Part Two. Allied Health, Area Health Education Centers, Dentistry, Emergency Medical Services, Nursing, Optometry, Pharmacy, Podiatry, and Veterinary Medicine.  

ERIC Educational Resources Information Center

Information on health occupations educational programs in Ohio and current and projected employment needs for health professionals are presented. The following health fields are examined: allied health, dentistry, emergency medical service, nursing, optometry, pharmacy, podiatry, and veterinary medicine. Issues and trends affecting each field are…

Ohio Board of Regents, Columbus.

93

Context identification in electronic medical records  

E-print Network

In order to automate data extraction from electronic medical documents, it is important to identify the correct context of the extracted information. Context in medical documents is provided by the layout of documents, ...

Stephen, Reejis, 1977-

2004-01-01

94

Development of a tool within the electronic medical record to facilitate medication reconciliation after hospital discharge  

Microsoft Academic Search

Serious medication errors occur commonly in the period after hospital discharge. Medication reconciliation in the postdischarge ambulatory setting may be one way to reduce the frequency of these errors. The authors describe the design and implementation of a novel tool built into an ambulatory electronic medical record (EMR) to facilitate postdischarge medication reconciliation. The tool compares the preadmission medication list

Jeffrey L Schnipper; Catherine L Liang; Claus Hamann; Andrew S Karson; Matvey B Palchuk; Patricia C McCarthy; Melanie Sherlock; Alexander Turchin; David W Bates

2011-01-01

95

doi: 10.1136/vr.138.10.229 1996 138: 229-233Veterinary Record  

E-print Network

of the donkeys was developed, using a scale from 1 (emaciated) to 9 (obese). A RELIABLE method for assessing and circumference of the foreleg cannon bone) of 516 donkeys used to transport goods in Morocco were recorded) and Eley and French (1993) each developed a pre- diction equation for donkeys, because they found

Diggle, Peter J.

96

Technology Acceptance of Electronic Medical Records by Nurses  

ERIC Educational Resources Information Center

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…

Stocker, Gary

2010-01-01

97

Research on the distributed electronic medical records storage model  

Microsoft Academic Search

The traditional electronic medical records storage pattern has became the bottleneck of its rapid development, this paper introduce the cloud storage mechanism for electronic medical records, HBase is a distributed column-oriented database built on top of Hadoop Distributed File System based on the common computer cluster. After researched on the distribution storage mechanism of Hadoop Distributed File System and the

Yang Jin; Tang Deyu; Zheng Xianrong

2011-01-01

98

[Audit: medical record documentation among advanced cancer patients].  

PubMed

Medical record documentation of cancer inpatients is a core component of continuity of care. The main goal of the study was an assessment of medical record documentation in a palliative care unit (PCU) using a targeted clinical audit based on deceased inpatients' charts. Stage 1 (2010): a clinical audit of medical record documentation assessed by a list of items (diagnosis, prognosis, treatment, power of attorney directive, advance directives). Stage 2 (2011): corrective measures. Stage 3 (2012): re-assessment with the same items' list after six month. Forty cases were investigated during stage 1 and 3. After the corrective measures, inpatient's medical record documentation was significantly improved, including for diagnosis (P?=?0.01), diseases extension and treatment (P?medical record documentation for advanced directives (P?=?0.145). PMID:24556159

Perceau, Elise; Chirac, Anne; Rhondali, Wadih; Ruer, Murielle; Chabloz, Claire; Filbet, Marilène

2014-02-01

99

A flexible framework for deriving assertions from electronic medical records  

E-print Network

(primarily medical journals and other scholarly research) and clinical notes (hospital discharge summariesA flexible framework for deriving assertions from electronic medical records Kirk Roberts, Sanda M: identification of medical concepts in clinical text, and classification of assertions, which indicate

Harabagiu, Sanda M.

100

Exploring the use of tablet PCs in veterinary medical education: opportunity or obstacle?  

PubMed

A tablet PC is a laptop computer with a touch screen and a digital pen or stylus that can be used for handwritten notes and drawings. The use of tablet PCs has been investigated in many disciplines such as engineering, mathematics, science, and education. The purpose of this article is to explore student and faculty attitudes toward and experiences with tablet PCs 6 years after the implementation of a tablet PC program in the College of Veterinary Medicine (CVM) at Kansas State University (K-State). This study reports that the use of tablet PCs has enhanced students' learning experiences through learner-interface interaction, learner-content interaction, learner-instructor interaction, and learner-learner interaction. This study also identifies digital distraction as the major negative experience with tablet PCs during class time. The tablet PC program provides CVM faculty the potential to pursue technology integration strategies that support expected learning outcomes and provides students the potential to develop self-monitoring and self-discipline skills that support learning with digital technologies. PMID:24855031

Wang, Hong; Rush, Bonnie R; Wilkerson, Melinda; van der Merwe, Deon

2014-01-01

101

New directions for veterinary technology.  

PubMed

Veterinary technology has generally established itself well in companion-animal and mixed-animal veterinary medical practice, but the career's growth trajectory is uncertain. Michigan State University (MSU) convened a national conference, "Creating the Future of Veterinary Technology-A National Dialogue," in November 2011 to explore ways to elevate the veterinary technician/technologist's role in the veterinary medical profession and to identify new directions in which the career could expand. Veterinary technicians/technologists might advance their place in private practice by not only improving their clinical skills, but by also focusing on areas such as practice management, leadership training, business training, conflict resolution, information technology, and marketing/communications. Some new employment settings for veterinary technicians/technologists include more participation within laboratory animal medicine and research, the rural farm industry, regulatory medicine, and shelter medicine. Achieving these ends would call for new training options beyond the current 2-year and 4-year degree programs. Participants suggested specialty training programs, hybrid programs of various types, online programs, veterinary technician residency programs of 12-18 months, and more integration of veterinary technician/technology students and veterinary medicine students at colleges of veterinary medicine. PMID:24393780

Chadderdon, Linda M; Lloyd, James W; Pazak, Helene E

2014-01-01

102

Global health: setting the agenda for veterinary medical education to enable veterinarians to meet their responsibilities in the field.  

PubMed

We regard the set of papers in this issue (OIE Rev. sci. tech. Off. int. Epiz., 28 [2]) as a blueprint for an agenda to bridge the divides within the global scope of the veterinary profession, so that it will meet its responsibilities to the world as it develops in the coming decades. It defines the areas with which all veterinary students should be knowledgeable, provides emphasis on the need to expand the education of all veterinary students in terms of their global health responsibilities, and then provides insights into the educational approaches that can result in the inclusion of global health issues within the veterinary curriculum. PMID:20128499

Soulsby, L; Walsh, D A

2009-08-01

103

Dynamic security for medical record sharing  

E-print Network

Information routinely collected by health care organizations is used by researchers to analyze the causes of illness and evaluate the effectiveness of potential cures. Medical information sharing systems are built to ...

Cody, Patrick M. (Patrick Michael), 1980-

2003-01-01

104

38 CFR 17.905 - Medical records.  

Code of Federal Regulations, 2011 CFR

... 17.905 Section 17.905 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida...

2011-07-01

105

38 CFR 17.905 - Medical records.  

Code of Federal Regulations, 2013 CFR

... 17.905 Section 17.905 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida...

2013-07-01

106

38 CFR 17.905 - Medical records.  

Code of Federal Regulations, 2010 CFR

... 17.905 Section 17.905 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children of Vietnam Veterans-Spina Bifida and Covered Birth Defects § 17.905...

2010-07-01

107

38 CFR 17.905 - Medical records.  

Code of Federal Regulations, 2012 CFR

... 17.905 Section 17.905 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida...

2012-07-01

108

38 CFR 17.905 - Medical records.  

... 17.905 Section 17.905 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Health Care Benefits for Certain Children of Vietnam Veterans and Veterans with Covered Service in Korea-Spina Bifida...

2014-07-01

109

Diagnostic Decision Support by Intelligent Medical Image Retrieval with Electronic Medical Record for Dementia Treatment Enhancement  

Microsoft Academic Search

In most hospitals, medical images such as computed tomography (CT), magnetic resonance imaging (MRI), and X-ray films are stored in Picture Archiving and Communication System (PACS). However, clinicians make differential diagnosis of patients in the Electronic Medical Record (EMR) system with references to laboratory results and the medical images reports. To establish a prototype model for intelligent access of medical

Mei-Ju SU; Heng-Shuen CHEN; Chung-Yi YANG; Sao-Jie CHEN; Robert CHEN; Wen-Jeng LEE; Po-Hsun CHENG; Ping-Kung YIP; Hon-Mon LIU; Fei-Pei LAI; Daniel RACOCEANU

2007-01-01

110

College of Veterinary Medicine University of Illinois Faculty and Staff Awards  

E-print Network

, and continuing education Dr. Anne Barger Clinical Assistant Professor, Veterinary Diagnostic Laboratory Dr Medicine Chicago Veterinary Medical Association Outstanding Instructor Award for an instructor who provides creativity and initiative, and interpersonal skills Kim Knapp Veterinary Technician I, Veterinary Clinical

Gilbert, Matthew

111

Developing the Master Educator: Cross Disciplinary Teaching Scholars Program for Human and Veterinary Medical Faculty  

ERIC Educational Resources Information Center

Objective: At the University of California, Davis (UCD), the authors sought to develop an institutional network of reflective educational leaders. The authors wanted to enhance faculty understanding of medical education's complexity, and improve educators' effectiveness as regional/national leaders. Methods: The UCD Teaching Scholars Program is a…

Srinivasan, Malathi; Pratt, Daniel D.; Collins, John; Bowe, Constance M.; Stevenson, Frazier T.; Pinney, Stephen J.; Wilkes, Michael S.

2007-01-01

112

[Accessing medical records for research purposes].  

PubMed

The Organic Law 15/1999 of 13 December on the Protection of Personal Data and the Law 41/2002 of 14 November regulating patient autonomy and rights and obligations of information and clinical documentation are the basic rules which govern the medical history in Spain. However, the lack of development of these laws regarding data protection in clinical research, particularly in terms of access to the medical history, repeatedly causes doubts about its construction by the Research Ethics Committees. Therefore, the aim of this paper is to analyze the rules which govern the access to the medical history for research purposes, with particular emphasis on the common problems that arise in the Committees for the ethical evaluation of these projects and finally setting a series of recommendations. The use for research purpose of genetic personal data contained in the medical history is also addressed in this paper. In this sense, a key contribution of the Law on Biomedical Research is relating to the specific regulation of the genetic personal data, both with respect to their production and access to the data as a support and regarding to its use for research purpose. PMID:24868961

Alcalde Bezhold, Guillermo; Alfonso Farnós, Iciar

2013-01-01

113

12 CFR 1102.104 - Special procedure: Medical records.  

Code of Federal Regulations, 2012 CFR

12 Banks and Banking 9 2012-01-01 2012-01-01 false Special procedure...Medical records. 1102.104 Section 1102.104 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION...

2012-01-01

114

12 CFR 1102.104 - Special procedure: Medical records.  

Code of Federal Regulations, 2010 CFR

12 Banks and Banking 7 2010-01-01 2010-01-01 false Special procedure...Medical records. 1102.104 Section 1102.104 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION...

2010-01-01

115

Automated de-identification of free-text medical records  

E-print Network

This paper presents a de-identification study at the Harvard-MIT Division of Health Science and Technology (HST) to automatically de-identify confidential patient information from text medical records used in intensive ...

Neamatullah, Ishna

2006-01-01

116

[Information extraction methodology used in electronic medical records].  

PubMed

We try to use information extraction technology in some parts of the medical records and extract disease information to accumulate experience for extracting complete information from medical records. This paper attempts to use dictionary and rules to achieve the named entity recognition. Information extraction is based on shallow parsing and use pattern sentence matching method with the help of a 3 levels finite state automaton. PMID:21553535

Chen, Yingying; Ye, Feng

2011-01-01

117

INFORMATION FLOW CONTROL FOR A MEDICAL RECORDS WEB PORTAL  

E-print Network

INFORMATION FLOW CONTROL FOR A MEDICAL RECORDS WEB PORTAL Thomas F. J.-M. Pasquier University application prototype1 developed for brain tumour patients to access their medical data. The prototype has security requirements. With these constraints in mind we developed an architecture incorporating

Cambridge, University of

118

Cost, Staffing and Quality Impact of Bedside Electronic Medical Record  

E-print Network

), improvements were documented in sev- eral quality indicators, including pressure ulcers, range of SinclairCost, Staffing and Quality Impact of Bedside Electronic Medical Record (EMR) in Nursing Homes political pressure for nurs- ing homes to implement the electronic medical re- cord (EMR

He, Zhihai "Henry"

119

Electronic Medical Records and Their Impact on Resident and Medical Student Education  

ERIC Educational Resources Information Center

Objective: Electronic medical records (EMRs) are becoming prevalent and integral tools for residents and medical students. EMRs can integrate point-of-service information delivery within the context of patient care. Though it may be an educational tool, little is known about how EMR technology is currently used for medical learners. Method: The…

Keenan, Craig R.; Nguyen, Hien H.; Srinivasan, Malathi

2006-01-01

120

Comparison between dairy cow disease incidence in data registered by farmers and in data from a disease-recording system based on veterinary reporting.  

PubMed

Sweden has a national disease-recording system based on veterinary reporting. From this system, all cattle-disease records are transferred to the dairy industry cattle database (DDD) where they are used for several purposes including research and dairy-health statistics. Our objective was to evaluate the completeness of this data source by comparing it with disease data registered by dairy farmers. The proportion of veterinary-treated disease events was estimated, by diagnosis. Disease incidence in the DDD was compared, by diagnosis and age, with disease data registered by the farmers. Comparison was made, by diagnosis, for (i) all disease events and (ii) those reported as veterinary-treated. Disease events, defined as "observed deviations in health, from the normal" were recorded by the farmers during January, April, July and October 2004. For the diagnoses calving problems, peripartum disorders, puerperal paresis and retained placenta, incidence proportions (IP) with 95% confidence intervals (CIs) were estimated. For all other disease problems, incidence rates (IR) were used. In total, 177 farmers reported at least 1 month and 148 reported all 4 months. Fifty-four percent of all disease events in the farmers' data were reported as veterinary-treated. For several of the most common diagnoses, the IRs and IPs for all events were significantly higher in farmers' data than in the DDD. Examples are, in cows: clinical mastitis, cough, gastro-intestinal disorders and lameness in hoof and limb; and in young stock: cough and gastro-intestinal disorders. For veterinary-treated events only, significant differences with higher IR in the farmers' data were found in young stock for sporadic cough and sporadic gastro-intestinal disorders. The diagnosis "other disorders" had significantly more events in the DDD than in farmers' data, i.e. veterinarians tended to choose more unspecific diagnoses than the farmers. This result indicates that the true completeness is likely to be higher than our estimate. We conclude that for the time period studied there was differential under-reporting associated with the diagnosis, the age of the animal and whether the herd was served by a state-employed or private veterinarian. PMID:19178966

Mörk, M; Lindberg, A; Alenius, S; Vågsholm, I; Egenvall, A

2009-04-01

121

42 CFR 482.24 - Condition of participation: Medical record services.  

Code of Federal Regulations, 2013 CFR

...system of coding and indexing medical records. The system must allow...procedure, in order to support medical care evaluation studies. (3) The hospital must...alter patient records. Original medical records must be released...

2013-10-01

122

42 CFR 482.24 - Condition of participation: Medical record services.  

Code of Federal Regulations, 2011 CFR

...system of coding and indexing medical records. The system must allow...procedure, in order to support medical care evaluation studies. (3) The hospital must...alter patient records. Original medical records must be released...

2011-10-01

123

42 CFR 482.24 - Condition of participation: Medical record services.  

Code of Federal Regulations, 2010 CFR

...system of coding and indexing medical records. The system must allow...procedure, in order to support medical care evaluation studies. (3) The hospital must...alter patient records. Original medical records must be released...

2010-10-01

124

12 CFR 792.57 - Special procedures: Information furnished by other agencies; medical records.  

Code of Federal Regulations, 2010 CFR

...furnished by other agencies; medical records. 792.57...furnished by other agencies; medical records. (a...appropriate agency prior to making a decision to disclose or refuse...system manager. (b) Medical records may be...

2010-01-01

125

12 CFR 792.57 - Special procedures: Information furnished by other agencies; medical records.  

Code of Federal Regulations, 2011 CFR

...furnished by other agencies; medical records. 792.57...furnished by other agencies; medical records. (a...appropriate agency prior to making a decision to disclose or refuse...system manager. (b) Medical records may be...

2011-01-01

126

12 CFR 792.57 - Special procedures: Information furnished by other agencies; medical records.  

...furnished by other agencies; medical records. 792.57...furnished by other agencies; medical records. (a...appropriate agency prior to making a decision to disclose or refuse...system manager. (b) Medical records may be...

2014-01-01

127

12 CFR 792.57 - Special procedures: Information furnished by other agencies; medical records.  

Code of Federal Regulations, 2012 CFR

...furnished by other agencies; medical records. 792.57...furnished by other agencies; medical records. (a...appropriate agency prior to making a decision to disclose or refuse...system manager. (b) Medical records may be...

2012-01-01

128

12 CFR 792.57 - Special procedures: Information furnished by other agencies; medical records.  

Code of Federal Regulations, 2013 CFR

...furnished by other agencies; medical records. 792.57...furnished by other agencies; medical records. (a...appropriate agency prior to making a decision to disclose or refuse...system manager. (b) Medical records may be...

2013-01-01

129

20 CFR 10.800 - What kind of medical records must providers keep?  

Code of Federal Regulations, 2010 CFR

...Information for Medical Providers Medical Records and Bills § 10.800 What kind of medical records must providers keep? Agency medical officers, private physicians...the results of any diagnostic studies performed, the nature of...

2010-04-01

130

20 CFR 10.800 - What kind of medical records must providers keep?  

Code of Federal Regulations, 2011 CFR

...Information for Medical Providers Medical Records and Bills § 10.800 What kind of medical records must providers keep? Agency medical officers, private physicians...the results of any diagnostic studies performed, the nature of...

2011-04-01

131

20 CFR 30.700 - What kinds of medical records must providers keep?  

Code of Federal Regulations, 2012 CFR

...Information for Medical Providers Medical Records and Bills § 30.700 What kinds of medical records must providers keep? Federal Government medical officers, private physicians...results of any diagnostic studies performed, and the...

2012-04-01

132

20 CFR 30.700 - What kinds of medical records must providers keep?  

Code of Federal Regulations, 2011 CFR

...Information for Medical Providers Medical Records and Bills § 30.700 What kinds of medical records must providers keep? Federal Government medical officers, private physicians...results of any diagnostic studies performed, and the...

2011-04-01

133

20 CFR 30.700 - What kinds of medical records must providers keep?  

Code of Federal Regulations, 2013 CFR

...Information for Medical Providers Medical Records and Bills § 30.700 What kinds of medical records must providers keep? Federal Government medical officers, private physicians...results of any diagnostic studies performed, and the...

2013-04-01

134

20 CFR 30.700 - What kinds of medical records must providers keep?  

...Information for Medical Providers Medical Records and Bills § 30.700 What kinds of medical records must providers keep? Federal Government medical officers, private physicians...results of any diagnostic studies performed, and the...

2014-04-01

135

20 CFR 30.700 - What kinds of medical records must providers keep?  

Code of Federal Regulations, 2010 CFR

...Information for Medical Providers Medical Records and Bills § 30.700 What kinds of medical records must providers keep? Federal Government medical officers, private physicians...results of any diagnostic studies performed, and the...

2010-04-01

136

Web-based technology: its effects on small group "problem-based learning" interactions in a professional veterinary medical program.  

PubMed

The objective of this investigation was to ascertain whether and how the introduction of a new technology (WebCT) influenced faculty teaching styles while facilitating small group problem-based learning (PBL) sessions in a professional veterinary medical (PVM) program. The following questions guided the study: (1) How does the use of technology affect faculty teaching behaviors? (2) Do the facilitators' interactions with WebCT technology change over the course of one semester? (3) What is the perceived impact of WebCT on facilitators' role in PBL? The study employed a combination of qualitative (case study) and semi-quantitative (survey) methods to explore these issues. Nine clinical sciences faculty members, leading a total of six PBL groups, were observed over the course of an academic semester for a total of 20 instructional sessions. The qualitative data gathered by observing faculty as they facilitated PBL sessions yielded three major themes: (1) How do PBL facilitators adapt to the addition of WebCT technology? (2) Does this technology affect teaching? and (3) How do PBL facilitators interact with their students and each other over the course of a semester? No direct evidence was found to suggest that use of WebCT affected teaching behaviors (e.g., student-centered vs. teacher-centered instruction). However, all facilitators showed a moderate increase in comfort with the technology during the semester, and one participant showed remarkable gains in technology skills. The teaching theme provided insight into how facilitators foster learning in a PBL setting as compared to a traditional lecture. A high degree of variability in teaching styles was observed, but individuals' styles tended to remain stable over the course of the semester. Nevertheless, all facilitators interacted similarly with students, in a more caring and approachable manner, when compared to the classroom or clinic atmospheres. PMID:15834826

Schoenfeld-Tacher, Regina; Bright, Janice M; McConnell, Sherry L; Marley, Wanda S; Kogan, Lori R

2005-01-01

137

Medical records and privacy: empirical effects of legislation.  

PubMed Central

OBJECTIVE: To determine the effects of state legislation requiring patient informed consent prior to medical record abstraction by external researchers for a specific study. DATA SOURCES/STUDY SETTING: Informed consent responses obtained from November 1997 through April 1998 from members of a Minnesota-based IPA model health plan. STUDY DESIGN: Descriptive case study of consent to gain access to medical records for a pharmaco-epidemiologic study of seizures associated with use of a pain medication that was conducted as part of the FDA's post-marketing safety surveillance program to evaluate adverse events associated with approved drugs. DATA COLLECTION: The informed consent process approved by an institutional review board consisted of three phases: (1) a letter from the health plan's medical director requesting participation, (2) a second mailing to nonrespondents, and (3) a follow-up telephone call to nonrespondents. PRINCIPAL FINDINGS: Of 140 Minnesota health plan members asked to participate in the medical records study, 52 percent (73) responded and 19 percent (26) returned a signed consent form authorizing access to their records for the study. For 132 study subjects enrolled in five other health plans in states where study-specific consent was not required, health care providers granted access to patient medical records for 93 percent (123) of the members. CONCLUSION: Legislation requiring patient informed consent to gain access to medical records for a specific research study was associated with low participation and increased time to complete that observational study. Efforts to protect patient privacy may come into conflict with the ability to produce timely and valid research to safeguard and improve public health. PMID:10199685

McCarthy, D B; Shatin, D; Drinkard, C R; Kleinman, J H; Gardner, J S

1999-01-01

138

Clinical documentation improvement for outpatients by implementing electronic medical records.  

PubMed

This observational study was conducted before and after implementing an electronic medical record (EMR) system to evaluate the change in outpatient workflow by implementation of EMR and the effectiveness of clinical documentation improvement (CDI). The number of hours for patient care increased by 89.2% (p < .05) and the hours for writing medical records after consulting decreased after implementation of EMR by 27.3% (p < .01). Implementation of EMR reduced nurses' workload to handle medical records by 78.8 (p < .05) but not changed for physicians. The necessary change in the information management process occurred after using the CDI indicator. We recommend that the "working hours of health professionals" and "handling hours for information resources" should be used widely as CDI indicators to improve workflow when implementing EMR. PMID:24943531

Seto, Ryoma; Inoue, Toshitaka; Tsumura, Hiroshi

2014-01-01

139

The medical record entrepreneur: a future of opportunities.  

PubMed

In summary, medical record practitioners can become successful entrepreneurs with the right motivation. It will be important to overcome the fear and inertia inherent in any bold new venture, to find our "niche," to assume the roles of explorer, artist, judge, and champion, as well as to encourage and promote our development within an organization or in a business of our own. Medical record entrepreneurs need to evaluate and understand current and potential consumers, their current needs, perceptions, and future needs. Entrepreneurs should capitalize on strengths, develop innovative marketing approaches, and apply them. In the current climate of the health care industry, there is a myriad of entrepreneurial opportunities available to the medical record profession. It all begins with the individual. PMID:10293512

Dietz, M S; Nath, D D

1989-06-01

140

On-line medical record/RIS/PACS interface  

NASA Astrophysics Data System (ADS)

The University of Florida Medical Center has developed an On-Line Medical Record (OLMR) that serves as a repository of patient information from a number of individual department databases, the Radiology Information System included, and builds a comprehensive electronic patient based chart. The OLMR, widely used by clinicians to view information on test results, will be expanded to add image and graphics display capabilities, and will require pointers to PACS images.

Honeyman-Buck, Janice C.; Frost, Meryll M.; Staab, Edward V.

1994-05-01

141

Design and Implementation of Mobile Electronic Medication Administration Record  

Microsoft Academic Search

Patients’ safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In\\u000a order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System\\u000a (HIS) to facilitate patients’ safety and to improve the quality of medical care. During the medical care processing, all the\\u000a tasks are based

Sung-Huai Hsieh; I-Ching Hou; Ching-Ting Tan; Po-Chao Shen; Hui-Chu Yu; Sheau-Ling Hsieh; Po-Hsun Cheng; Feipei Lai

142

Electronic medical record use in pediatric primary care  

Microsoft Academic Search

ObjectivesTo characterize patterns of electronic medical record (EMR) use at pediatric primary care acute visits.DesignDirect observational study of 529 acute visits with 27 experienced pediatric clinician users.MeasurementsFor each 20 s interval and at each stage of the visit according to the Davis Observation Code, we recorded whether the physician was communicating with the family only, using the computer while communicating,

Alexander G. Fiks; Evaline A. Alessandrini; Christopher B. Forrest; Saira Khan; A. Russell Localio; Andreas Gerber

2011-01-01

143

Notre Dame medical students attempt stair-climbing world record  

Microsoft Academic Search

Two University of Notre Dame Australia medical students will attempt to break a world record by running up and down Jacob’s ladder in Western Australia’s Kings Park for 24 hours.\\u000aJonathan Hague and classmate Bernard Cregan will try to break the Guinness World record for the most height climbed in 24 hours by attempting to ascend the popular 43 metre

Michelle Ebbs

2006-01-01

144

Carrying their own medical records: the perspective of pregnant women.  

PubMed

Freedom of information, access to and ownership of medical records are current and controversial issues in Australia. Relating to pregnancy and birth the debate provokes emotional responses and raises important questions about access to information, decision-making, responsibility, power and control. The aim of this qualitative study was to explore the impact on pregnant women of carrying their medical records throughout pregnancy Twenty-one women participated in face-to-face individual interviews, which were coded for thematic analysis. The study found the reaction of women toward carrying their own records to be overwhelmingly positive. Maternal record holding had the potential to improve the level of communication between the health care worker and the pregnant woman and provided a greater sense of sharing and communication within the family The study also established that maternal record holding was of benefit to the woman's partner who was better informed and more involved in the pregnancy All but one of the women who participated favoured carrying their records in subsequent pregnancies. A concern about the potential for losing or misplacing records was not seen in this study, as no women lost their records. A sense of ownership would argue against this possible drawback. PMID:11787912

Phipps, H

2001-11-01

145

Taking a history on veterinary education.  

PubMed

In this article, another in the series marking 125 years of Veterinary Record, Andrew Gardiner and Susan Rhind consider some common themes in the history of veterinary education. They look at how veterinary teaching and education have evolved over time and discuss what may happen in years to come. PMID:24163043

Gardiner, Andrew; Rhind, Susan

2013-10-26

146

Services Bldg. Veterinary Medical  

E-print Network

building-- map site Ag. Engineering Shed--B2 Agronomy Hall--E3 Agronomy Laboratory--F2 Bessey Hall--E3 Memorial Union Parks Library Food Sciences Agronom y H all Heady Hall East Hall Farm House Agronomy Lab

Lin, Zhiqun

147

Biobanks and electronic medical records: enabling cost-effective research.  

PubMed

The use of electronic medical record data linked to biological specimens in health care settings is expected to enable cost-effective and rapid genomic analyses. Here, we present a model that highlights potential advantages for genomic discovery and describe the operational infrastructure that facilitated multiple simultaneous discovery efforts. PMID:24786321

Bowton, Erica; Field, Julie R; Wang, Sunny; Schildcrout, Jonathan S; Van Driest, Sara L; Delaney, Jessica T; Cowan, James; Weeke, Peter; Mosley, Jonathan D; Wells, Quinn S; Karnes, Jason H; Shaffer, Christian; Peterson, Josh F; Denny, Joshua C; Roden, Dan M; Pulley, Jill M

2014-04-30

148

Biobanks and Electronic Medical Records: Enabling Cost-Effective Research  

PubMed Central

The use of electronic medical record data linked to biological specimens in health care settings is expected to enable cost-effective and rapid genomic analyses. Here, we present a model that highlights potential advantages for genomic discovery and describe the operational infrastructure that facilitated multiple simultaneous discovery efforts. PMID:24786321

Bowton, Erica; Field, Julie R.; Wang, Sunny; Schildcrout, Jonathan S.; Van Driest, Sara L.; Delaney, Jessica T.; Cowan, James; Weeke, Peter; Mosley, Jonathan D.; Wells, Quinn S.; Karnes, Jason H.; Shaffer, Christian; Peterson, Josh F.; Denny, Joshua C.; Roden, Dan M.; Pulley, Jill M.

2014-01-01

149

Current and Projected Modes of Delivery of Veterinary Medical Services to Animal Agriculture: Industrial/Commercial Services.  

ERIC Educational Resources Information Center

Veterinary education must re-establish its teaching objectives. Students need practical knowledge in areas such as business management, communications, marketing, public relations, facility management, and personnel management. Industry must also meet its obligations to continue to provide safe, dependable products that fill a practice need. (MLW)

Glick, Phillip Ray

1980-01-01

150

A Codasyl-Type Schema for Natural Language Medical Records  

PubMed Central

This paper describes a CODASYL (network) database schema for information derived from narrative clinical reports. The goal of this work is to create an automated process that accepts natural language documents as input and maps this information into a database of a type managed by existing database management systems. The schema described here represents the medical events and facts identified through the natural language processing. This processing decomposes each narrative into a set of elementary assertions, represented as MEDFACT records in the database. Each assertion in turn consists of a subject and a predicate classed according to a limited number of medical event types, e.g., signs/symptoms, laboratory tests, etc. The subject and predicate are represented by EVENT records which are owned by the MEDFACT record associated with the assertion. The CODASYL-type network structure was found to be suitable for expressing most of the relations needed to represent the natural language information. However, special mechanisms were developed for storing the time relations between EVENT records and for recording connections (such as causality) between certain MEDFACT records. This schema has been implemented using the UNIVAC DMS-1100 DBMS.

Sager, N.; Tick, L.; Story, G.; Hirschman, L.

1980-01-01

151

MEDICAL RECORD TECHNOLOGY, A COURSE OF STUDY DESIGNED FOR COOPERATIVE PART-TIME STUDENTS EMPLOYED IN MEDICAL RECORD LIBRARIES.  

ERIC Educational Resources Information Center

DESIGNED FOR USE BY ELEVENTH GRADE COOPERATIVE PART-TIME STUDENTS EMPLOYED IN MEDICAL RECORD LIBRARIES, THIS GUIDE MAY ALSO BE USED IN AREA VOCATIONAL OR POST-HIGH SCHOOL SETTINGS. IT WAS DEVELOPED BY A CONSULTANT COMMITTEE, TEACHER EDUCATORS, AND RESEARCH ASSISTANTS AT THE STATE LEVEL AND REVISED AFTER USE IN THE FIELD. THE CONTENT OBJECTIVES ARE…

KARNES, JAMES B.

152

32 CFR 324.13 - Access to medical and psychological records.  

Code of Federal Regulations, 2013 CFR

...medical and psychological records. Individual access...medical and psychological records should be provided...mental or physical health of the individual...provide the name of a personal physician, and the record will be provided...

2013-07-01

153

32 CFR 324.13 - Access to medical and psychological records.  

Code of Federal Regulations, 2011 CFR

...medical and psychological records. Individual access...medical and psychological records should be provided...mental or physical health of the individual...provide the name of a personal physician, and the record will be provided...

2011-07-01

154

32 CFR 324.13 - Access to medical and psychological records.  

Code of Federal Regulations, 2010 CFR

...medical and psychological records. Individual access...medical and psychological records should be provided...mental or physical health of the individual...provide the name of a personal physician, and the record will be provided...

2010-07-01

155

32 CFR 324.13 - Access to medical and psychological records.  

Code of Federal Regulations, 2012 CFR

...medical and psychological records. Individual access...medical and psychological records should be provided...mental or physical health of the individual...provide the name of a personal physician, and the record will be provided...

2012-07-01

156

The Veterinary Teaching Hospital at Colorado State University has an opening for a position as an Equine Field Service Veterinarian. Equine Field Service provides general medical care, preventive health, herd  

E-print Network

as an Equine Field Service Veterinarian. Equine Field Service provides general medical care, preventive health, professional integrity, a solid work ethic and a desire to teach veterinary medical students. #12;Reporting Relationship: The Equine Field Service Veterinarian reports directly to the Hospital Director but is expected

157

Assistant Professor, Veterinary Ophthalmology Department of Clinical Sciences, James L. Voss Veterinary Teaching Hospital  

E-print Network

Veterinary Teaching Hospital College of Veterinary Medicine and Biomedical Sciences Colorado State University year of direct clinical activity in the ophthalmology hospital service. This includes overseeing assistance for all other services in the Veterinary Teaching Hospital and will provide medical and surgical

Stephens, Graeme L.

158

Development of Ambulatory Quality Assurance Program Using Computerized Medical Records  

PubMed Central

As part of the computerization of the ambulatory teaching facility for our residency program, we have successfully utilized a comprehensive computerized medical records system to develop a specific quality assurance program. Our QA program includes allergy audits, health screening audits, drug utilization and recall audits, and nursing care plan audits. With a computerized QA program, specific question about individual patients as well as questions regarding our patient population are quickly addressed. Also, our routine health screening has been greatly enhanced.

Shrader, J.; Wright, C.; Mieczkowski, L.; McDonald, S.

1993-01-01

159

Meta-modelling the Medical Record: Design and Application  

PubMed Central

This project is based on a user-oriented design for medical record, thanks to a meta-model able to generate various models for an application domain. The meta-model is constituted of basic concepts: User Semantic Group, sentence-type, variable, graph. A beginning of implementation is in echocardiography report; The advantages are a very thorough personalization of the document for the user, and a greater independence of the design diagram from the technological platform.

Huet, Bernard; Lesueur, Bruno; Lebeux, Pierre; Blain, Gilles

2000-01-01

160

Visualization index for image-enabled medical records  

NASA Astrophysics Data System (ADS)

With the widely use of healthcare information technology in hospitals, the patients' medical records are more and more complex. To transform the text- or image-based medical information into easily understandable and acceptable form for human, we designed and developed an innovation indexing method which can be used to assign an anatomical 3D structure object to every patient visually to store indexes of the patients' basic information, historical examined image information and RIS report information. When a doctor wants to review patient historical records, he or she can first load the anatomical structure object and the view the 3D index of this object using a digital human model tool kit. This prototype system helps doctors to easily and visually obtain the complete historical healthcare status of patients, including large amounts of medical data, and quickly locate detailed information, including both reports and images, from medical information systems. In this way, doctors can save time that may be better used to understand information, obtain a more comprehensive understanding of their patients' situations, and provide better healthcare services to patients.

Dong, Wenjie; Zheng, Weilin; Sun, Jianyong; Zhang, Jianguo

2011-03-01

161

Data-driven approach for creating synthetic electronic medical records  

PubMed Central

Background New algorithms for disease outbreak detection are being developed to take advantage of full electronic medical records (EMRs) that contain a wealth of patient information. However, due to privacy concerns, even anonymized EMRs cannot be shared among researchers, resulting in great difficulty in comparing the effectiveness of these algorithms. To bridge the gap between novel bio-surveillance algorithms operating on full EMRs and the lack of non-identifiable EMR data, a method for generating complete and synthetic EMRs was developed. Methods This paper describes a novel methodology for generating complete synthetic EMRs both for an outbreak illness of interest (tularemia) and for background records. The method developed has three major steps: 1) synthetic patient identity and basic information generation; 2) identification of care patterns that the synthetic patients would receive based on the information present in real EMR data for similar health problems; 3) adaptation of these care patterns to the synthetic patient population. Results We generated EMRs, including visit records, clinical activity, laboratory orders/results and radiology orders/results for 203 synthetic tularemia outbreak patients. Validation of the records by a medical expert revealed problems in 19% of the records; these were subsequently corrected. We also generated background EMRs for over 3000 patients in the 4-11 yr age group. Validation of those records by a medical expert revealed problems in fewer than 3% of these background patient EMRs and the errors were subsequently rectified. Conclusions A data-driven method was developed for generating fully synthetic EMRs. The method is general and can be applied to any data set that has similar data elements (such as laboratory and radiology orders and results, clinical activity, prescription orders). The pilot synthetic outbreak records were for tularemia but our approach may be adapted to other infectious diseases. The pilot synthetic background records were in the 4-11 year old age group. The adaptations that must be made to the algorithms to produce synthetic background EMRs for other age groups are indicated. PMID:20946670

2010-01-01

162

An Ontology-Based Electronic Medical Record for Chronic Disease Management.  

E-print Network

??Effective chronic disease management ensures better treatment and reduces medical costs. Representing knowledge through building an ontology for Electronic Medical Records (EMRs) is important to… (more)

Author Not Available

2011-01-01

163

Automated de-identification of free-text medical records  

PubMed Central

Background Text-based patient medical records are a vital resource in medical research. In order to preserve patient confidentiality, however, the U.S. Health Insurance Portability and Accountability Act (HIPAA) requires that protected health information (PHI) be removed from medical records before they can be disseminated. Manual de-identification of large medical record databases is prohibitively expensive, time-consuming and prone to error, necessitating automatic methods for large-scale, automated de-identification. Methods We describe an automated Perl-based de-identification software package that is generally usable on most free-text medical records, e.g., nursing notes, discharge summaries, X-ray reports, etc. The software uses lexical look-up tables, regular expressions, and simple heuristics to locate both HIPAA PHI, and an extended PHI set that includes doctors' names and years of dates. To develop the de-identification approach, we assembled a gold standard corpus of re-identified nursing notes with real PHI replaced by realistic surrogate information. This corpus consists of 2,434 nursing notes containing 334,000 words and a total of 1,779 instances of PHI taken from 163 randomly selected patient records. This gold standard corpus was used to refine the algorithm and measure its sensitivity. To test the algorithm on data not used in its development, we constructed a second test corpus of 1,836 nursing notes containing 296,400 words. The algorithm's false negative rate was evaluated using this test corpus. Results Performance evaluation of the de-identification software on the development corpus yielded an overall recall of 0.967, precision value of 0.749, and fallout value of approximately 0.002. On the test corpus, a total of 90 instances of false negatives were found, or 27 per 100,000 word count, with an estimated recall of 0.943. Only one full date and one age over 89 were missed. No patient names were missed in either corpus. Conclusion We have developed a pattern-matching de-identification system based on dictionary look-ups, regular expressions, and heuristics. Evaluation based on two different sets of nursing notes collected from a U.S. hospital suggests that, in terms of recall, the software out-performs a single human de-identifier (0.81) and performs at least as well as a consensus of two human de-identifiers (0.94). The system is currently tuned to de-identify PHI in nursing notes and discharge summaries but is sufficiently generalized and can be customized to handle text files of any format. Although the accuracy of the algorithm is high, it is probably insufficient to be used to publicly disseminate medical data. The open-source de-identification software and the gold standard re-identified corpus of medical records have therefore been made available to researchers via the PhysioNet website to encourage improvements in the algorithm. PMID:18652655

Neamatullah, Ishna; Douglass, Margaret M; Lehman, Li-wei H; Reisner, Andrew; Villarroel, Mauricio; Long, William J; Szolovits, Peter; Moody, George B; Mark, Roger G; Clifford, Gari D

2008-01-01

164

[Research on information extraction of electronic medical records in Chinese].  

PubMed

This is a research to enhance the application of natural language understanding and ontology in the Chinese medical text semantic annotation and content analysis, and so to provide technology support for the computer-readable electronic medical records (EMR). The Chinese EMR information extraction and statistical analysis of related subjects in accordance to the user's demands were performed through building the named entity rules, the classified word list and field ontology by using GATE platform on the basis of EMR text set's construction and pre-processing. The automatic and artificial semantic annotation of EMR text set was implemented. The situation of drugs used in medicinal treatment and the distribution of patients' age and sex were obtained. The ontology-based semantic information extraction can improve the function of computer for text understanding, and the discovery of knowledge in EMR through field ontology is feasible. PMID:20842840

Li, Yi; Bao, Pengfei; Xue, Wanguo

2010-08-01

165

The University of Washington electronic medical record experience.  

PubMed

The Health Sciences Library at the University of Washington initiated and continues to develop a role in the electronic medical record, starting with the development of the first integrated web-based interface, called MINDscape. An Integrated Academic Information Management System (IAIMS) grant in 1992 began the process, which also led to the development of a clinical medical librarian position. Over the years, the librarian's role in the clinical environment became more established, and with the advent of clinical online resources, it offered further opportunities for librarians to provide the expertise needed to incorporate the appropriate resources. The collaborative journey continues as librarians, now able to directly access the EMRs, provide information about what resources to use and where best to place them and design how best to provide notes or feedback to clinicians. PMID:20648254

Welton, Nanette J

2010-07-01

166

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

Code of Federal Regulations, 2012 CFR

41 Public Contracts and Property Management...requirements for medical/psychological records. 51-9...303-2 Public Contracts and Property Management...Relating to Public Contracts COMMITTEE FOR PURCHASE...requirements for medical/psychological records....

2012-07-01

167

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

41 Public Contracts and Property Management...requirements for medical/psychological records. 51-9...303-2 Public Contracts and Property Management...Relating to Public Contracts COMMITTEE FOR PURCHASE...requirements for medical/psychological records....

2014-07-01

168

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

Code of Federal Regulations, 2013 CFR

41 Public Contracts and Property Management...requirements for medical/psychological records. 51-9...303-2 Public Contracts and Property Management...Relating to Public Contracts COMMITTEE FOR PURCHASE...requirements for medical/psychological records....

2013-07-01

169

41 CFR 51-9.303-2 - Special requirements for medical/psychological records.  

Code of Federal Regulations, 2010 CFR

41 Public Contracts and Property Management...requirements for medical/psychological records. 51-9...303-2 Public Contracts and Property Management...Relating to Public Contracts COMMITTEE FOR PURCHASE...requirements for medical/psychological records....

2010-07-01

170

32 CFR 806b.48 - Disclosing the medical records of minors.  

...state define the age of majority. (a) The Air Force must obey state laws protecting medical records of drug or alcohol abuse treatment, abortion, and birth control. If you manage medical records, learn the local laws and coordinate...

2014-07-01

171

Reflecting on the ethical administration of computerized medical records  

NASA Astrophysics Data System (ADS)

This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing staff system training. Administration should develop ways to monitor staff compliance with confidentiality policies and should assess diligence in maintaining patient record confidentiality as part of staff annual performance evaluations. Ethical management of IMAC systems is the business of all members of the health care team. Computerized patient records management (including IMAC) should be scrutinized as any other clinical medial ethical issue. If hospitals include these processes in their planning for RIS, IMACS, and HIS systems, they should have time to develop institutional expertise on these questions before and as systems are installed rather than only as ethical dilemmas develop during their use.

Collmann, Jeff R.

1995-05-01

172

Virtual medical record implementation for enhancing clinical decision support.  

PubMed

Development of clinical decision support systems (CDS) is a process which highly depends on the local databases, this resulting in low interoperability. To increase the interoperability of CDS a standard representation of clinical information is needed. The paper suggests a CDS architecture which integrates several HL7 standards and the new vMR (virtual Medical Record). The clinical information for the CDS systems (the vMR) is represented with Topic Maps technology. Beside the implementation of the vMR, the architecture integrates: a Data Manager, an interface, a decision making system (based on Egadss), a retrieving data module. Conclusions are issued. PMID:22874164

Gomoi, Valentin-Sergiu; Dragu, Daniel; Stoicu-Tivadar, Vasile

2012-01-01

173

Applying XDS for sharing CDA-based medical records  

NASA Astrophysics Data System (ADS)

Many countries have set long-term objectives for establishing an Electronic Healthcare Records system(EHRs). Various IT Strategies note that integration of EHR systems has a high priority. Because the EHR systems are based on different information models and different technology platforms, one of the key integration problems in the realization of the EHRs for the continuity of patient care, is the inability to share patient records between various institutions. Integrating the Healthcare Enterprise (IHE) committee has defined the detailed implementations of existing standards such as DICOM, HL7, in a publicly available document called the IHE technical framework (IHE-TF). Cross-enterprise document sharing (XDS), one of IHE technical frameworks, is describing how to apply the standards into the information systems for the sharing of medical documents among hospitals. This study aims to design Clinical Document Architecture (CDA) schema based on HL7, and to apply implementation strategies of XDS using this CDA schema.

Kim, Joong Il; Jang, Bong Mun; Han, Dong Hoon; Yang, Keon Ho; Kang, Won-Suk; Jung, Haijo; Kim, Hee-Joung

2006-03-01

174

Construction and Validation of Synthetic Electronic Medical Records  

PubMed Central

There is a current and pressing need for a test bed of electronic medical records (EMRs) to insure consistent development, validation and verification of public health related algorithms that operate on EMRs. However, access to full EMRs is limited and not generally available to the academic algorithm developers who support the public health community. This paper describes a set of algorithms that produce synthetic EMRs using real EMRs as a model. The algorithms were used to generate a pilot set of over 3000 synthetic EMRs that are currently available on CDC’s Public Health grid. The properties of the synthetic EMRs were validated, both in the entire aggregate data set and for individual (synthetic) patients. We describe how the algorithms can be extended to produce records beyond the initial pilot data set. PMID:23569572

Moniz, Linda; Buczak, Anna L.; Hung, Lang; Babin, Steven; Dorko, Michael; Lombardo, Joseph

2009-01-01

175

Patient Clustering with Uncoded Text in Electronic Medical Records  

PubMed Central

We propose a mixture model for text data designed to capture underlying structure in the history of present illness section of electronic medical records data. Additionally, we propose a method to induce bias that leads to more homogeneous sets of diagnoses for patients in each cluster. We apply our model to a collection of electronic records from an emergency department and compare our results to three other relevant models in order to assess performance. Results using standard metrics demonstrate that patient clusters from our model are more homogeneous when compared to others, and qualitative analyses suggest that our approach leads to interpretable patient sub-populations when applied to real data. Finally, we demonstrate an example of our patient clustering model to identify adverse drug events. PMID:24551361

Henao, Ricardo; Murray, Jared; Ginsburg, Geoffrey; Carin, Lawrence; Lucas, Joseph E.

2013-01-01

176

Patient clustering with uncoded text in electronic medical records.  

PubMed

We propose a mixture model for text data designed to capture underlying structure in the history of present illness section of electronic medical records data. Additionally, we propose a method to induce bias that leads to more homogeneous sets of diagnoses for patients in each cluster. We apply our model to a collection of electronic records from an emergency department and compare our results to three other relevant models in order to assess performance. Results using standard metrics demonstrate that patient clusters from our model are more homogeneous when compared to others, and qualitative analyses suggest that our approach leads to interpretable patient sub-populations when applied to real data. Finally, we demonstrate an example of our patient clustering model to identify adverse drug events. PMID:24551361

Henao, Ricardo; Murray, Jared; Ginsburg, Geoffrey; Carin, Lawrence; Lucas, Joseph E

2013-01-01

177

A flexible framework for deriving assertions from electronic medical records Corresponding Author: Kirk Roberts  

E-print Network

into two domains: biomedical literature (primarily medical journals and other scholarly researchA flexible framework for deriving assertions from electronic medical records Corresponding Author Technology Research Institute, University of Texas at Dallas, Richardson TX USA Keywords: Medical Informatics

Harabagiu, Sanda M.

178

The Design & Implementation of a Curriculum Ladder in Medical Record Administration 1970-1973.  

ERIC Educational Resources Information Center

Objectives of a 3-year articulation project were (1) to design and put into effect a curriculum for medical record personnel which would provide educational progression for associate arts degree medical record technicians to baccalaureate degree medical record administration programs, (2) to research, classify, and compare curriculum content of…

Waters, Kathleen A.; Hanken, Mary Alice

179

School Administration Handbook for Approved Schools for Medical Record Technicians. Revised April 66.  

ERIC Educational Resources Information Center

These guidelines are for the development and operation of approved programs to prepare medical record technicians. "School Approval" discusses the cooperative roles of the American Medical Association (AMA) Council on Medical Education and the American Association of Medical Record Librarians (AAMRL) in connection with program approval, and other…

American Association of Medical Record Librarians, Chicago, IL.

180

Job dynamics of veterinary professionals in an academic research institution. II. Veterinary technician attendance, absenteeism, and pay distribution.  

PubMed

To understand and better manage attendance and overtime for a team of veterinary technicians, a retrospective analysis of the attendance and time card records was done over a 2-y period. The findings show that veterinary technicians were in the workplace for a combination of straight time and overtime hours for approximately 89% of all compensated hours. The remainder of paid compensation was for vacation (4%), holidays (4%), and sick leave (3%). This team of veterinary technicians earned significantly more overtime hours, as much as 9% of total annual compensated hours, than the reported 3% standard for animal resources programs nationwide. The majority of overtime hours (61%) were for assigned weekend and holiday duty and after-hours veterinary medical emergencies. Veterinary technicians expended sick leave at 75% of the amount accrued and at a statistically significantly rate 65% higher than the national average for unscheduled absences for hourly personnel in animal resources programs. Because the direct cost of absenteeism may exceed 645 dollars per employee annually and because work inappropriately done at premium pay outside of business hours is a controllable expense, sound management of attendance and overtime is important in cost containment for animal resources programs. PMID:16995643

Huerkamp, Michael J

2006-09-01

181

Role Prediction using Electronic Medical Record System Audits  

PubMed Central

Electronic Medical Records (EMRs) provide convenient access to patient data for parties who should have it, but, unless managed properly, may also provide it to those who should not. Distinguishing the two is a core security challenge for EMRs. Strategies proposed to address these problems include Role Based Access Control (RBAC), which assigns collections of privileges called roles to users, and Experience Based Access Management (EBAM), which analyzes audit logs to determine access rights. In this paper, we integrate RBAC and EBAM through an algorithm, called Roll-Up, to manage roles effectively. In doing so, we introduce the concept of “role prediction” to identify roles from audit data. We apply the algorithm to three months of logs from Northwestern Memorial Hospital’s Cerner system with approximately 8000 users and 140 roles. We demonstrate that existing roles can be predicted with 50% accuracy and intelligent grouping of roles through Roll-Up can facilitate 65% accuracy. PMID:22195144

Zhang, Wen; Gunter, Carl A.; Liebovitz, David; Tian, Jian; Malin, Bradley

2011-01-01

182

Using electronic medical records for HIV care in rural Rwanda.  

PubMed

Partners In Health (PIH) implemented an electronic medical record (EMR) system in Rwanda in 2005 to support and improve HIV and TB patient care. The system holds detailed patient records, accessible to clinicians through printed reports or directly via a computer in the consultation rooms. Ongoing assessment of data quality and clinical data use has led multiple interventions to be put in place. One such evaluation cycle led to the implementation of a system which identified 15 previously undiagnosed pediatric patients with HIV. Another cycle led to an EMR intervention which helped to decrease the proportion of completed critical CD4 lab results that did not reach clinicians by 34.2% (p=.002). Additionally an automated data quality improvement system reduced known errors by 92% by providing local data officers a tool and training to allow them to easily access and correct data errors. Electronic systems can be used to support care in rural resource-poor settings, and frequent assessment of data quality and clinical use of data can be used to support that goal. PMID:20841704

Amoroso, Cheryl L; Akimana, Benjamin; Wise, Benjamin; Fraser, Hamish S F

2010-01-01

183

Paperless medical records: moving from plan to reality.  

PubMed

In 2002, North Shore Magnetic Imaging Center (NSMIC) decided that a major restructuring of the patient process was necessary to alleviate staff frustration and increase the level of patient care. An aggressive, 16-month timeline was established for the center to develop and implement a paperless environment. The project began by focusing on the center's existing radiology information system (RIS). Research showed that no "canned" system would perform the necessary tasks. The center's vendor, with whom senior management had developed a longstanding and trusting relationship, assured the center that, with the proper programming, the existing RIS could support the new paperless environment. Additional technology components were addressed. The first phase enabled staff to obtain physician orders and outside reports from the fax server. Once the patient medical record was fully electronic, these external documents were no longer printed. The transfer of billing information to the radiologist's billing office was achieved through a Health-Level 7 (HL7) interface between NSMIC's RIS and the information systems utilized by the billing office. Technologists were impacted when wireless personal computer (PC) tablets were implemented. Measuring 8.5" x 11" x 0.5", these tablets enable technologists to gather and record patient information while moving freely throughout the center. Forming the Reinvention Team--an internal team of NSMIC staff that would deal with the project's impact on staff, workflow, and patient care--was done in very deliberate fashion. During the recruitment phase of the project, each prospective team member was required to take 2 specific personality profile tests. The team was comprised of a combination of different personality profiles. A radiologist was later added to the team. Throughout the implementation of new processes at NSMIC, numerous breakdowns were encountered. The breakdowns could be classified into 2 categories: technical andpatient-related. Breakdowns were addressed during the Reinvention Team's weekly meetings. A patient's experience at NSMIC has changed dramatically with the implementation of electronic medical records. More patients are able to complete their exam without experiencing anxiety, or even at time claustrophobia, because they are more at ease. The rate for patients becoming claustrophobic has seen a decrease from 1.9% to 0.99% in the past 12 months. PMID:15377108

Tobey, Mary Ellen

2004-01-01

184

The Economic Impact of Veterinary Medicine on the  

E-print Network

of Missouri College of Veterinary Medicine and the Missouri Veterinary Medical Association Prepared.S. citizens from bio-terror attacks. Veterinary medicine touches everyone in the state. The most familiar the physical, psycho- logical, and emotional well being that accompanies companion animal ownership

Taylor, Jerry

185

A cost-benefit analysis of electronic medical records in primary care  

Microsoft Academic Search

PurposeElectronic medical record systems improve the quality of patient care and decrease medical errors, but their financial effects have not been as well documented. The purpose of this study was to estimate the net financial benefit or cost of implementing electronic medical record systems in primary care.

Samuel J. Wang; Blackford Middleton; Lisa A. Prosser; Christiana G. Bardon; Cynthia D. Spurr; Patricia J. Carchidi; Anne F. Kittler; Robert C. Goldszer; David G. Fairchild; Andrew J. Sussman; Gilad J. Kuperman; David W. Bates

2003-01-01

186

SPeciaL ToPic|inTroducTion Electronic Medical Records  

E-print Network

and nurses lead to increased medical errors. Designing effective medical records requires the full comple systems prevent user error, provide effective decision sup- port, and help clinicians interpret complexSPeciaL ToPic|inTroducTion Electronic Medical Records: Usability Challenges and Opportunities Harry

Shneiderman, Ben

187

75 FR 1446 - Rate of Payment for Medical Records Received Through Health Information Technology (IT) Necessary...  

Federal Register 2010, 2011, 2012, 2013

...SSA-2009-0088] Rate of Payment for Medical Records Received Through Health Information...uniform national rate of Federal payment for medical records received through health IT...reasonable reimbursement to non-Federal medical providers for their costs in...

2010-01-11

188

Using SAS to Make an Independent Assessment of Electronic Medical Records  

Microsoft Academic Search

There are many claims concerning the benefits of electronic medical records: reduction in medical errors, more accurate billing records, more timely treatment of patients. However, these claims are rarely validated through statistical analysis. Using different types of data in the electronic medical database, it is possible to investigate the validity of claims of improvement in the quality of patient care.

Patricia B. Cerrito

189

Veterinary Anatomical Illustrations  

NSDL National Science Digital Library

These remarkable illustrations were taken from the classic works of German veterinary anatomists, Wilhelm Ellenberger and Hermann Baum, along with medical illustrator, Hermann Dittrich. Originally published in texts from 1898 and 1911 through 1925, these works remain seminal for those studying various animals today. Animals covered here include the horse, cow, dog, lion, goat, and deer. Crafted as part of the University of Wisconsin Digital Collections initiative, these works will be of special interest to veterinarians, anatomists, comparative anatomists, and anyone else with an interest in the musculoskeletal systems of animals. All told there are eighty plates here, rendered in exquisite detail.

190

The adoption of electronic medical record technology in order to prevent medical errors: a matter for American public policy  

Microsoft Academic Search

This article argues that public policy should address the use of electronic medical records (EMRs) as a way to ensure patient safety in the United States. The article discusses the scope and nature of the medical error problem in the United States, causes of medical errors and the use of EMRs as a solution to the problem. Research has shown

Jacquelyn N. Crane; Frederick G. Crane

2008-01-01

191

The Feminization of Veterinary Medicine.  

ERIC Educational Resources Information Center

In little more than a generation, veterinary medical schools have gone from enrolling a token number of women to having a higher proportion of women than men in some cases. Developments in drugs to control large animals, relatively low pay for veterinarians, and options for part-time employment have served to change the balance of sexes in the…

Gose, Ben

1998-01-01

192

Veterinary Report Summer 2006 Retired Faculty  

E-print Network

at the Veterinary Medical Research Institute from the time he was an undergraduate through his third year West Nile virus outbreak. Its Zoological Pathology Program, which provides diagnostic services

Gilbert, Matthew

193

The Effects of Promoting Patient Access to Medical Records: A Review  

PubMed Central

The Health Insurance Privacy and Portability Act (HIPPA) stipulates that patients must be permitted to review and amend their medical records. As information technology makes medical records more accessible to patients, it may become more commonplace for patients to review their records routinely. This article analyzes the potential benefits and drawbacks of facilitating patient access to the medical record by reviewing previously published research. Previous research includes analysis of clinical notes, surveys of patients and practitioners, and studies of patient-accessible medical records. Overall, studies suggest the potential for modest benefits (for instance, in enhancing doctor-patient communication). Risks (for instance, increasing patient worry or confusion) appear to be minimal in medical patients. The studies, however, were of limited quality and low statistical power to detect the variety of outcomes that may result from implementation of a patient-accessible medical record. The data from these studies lay the foundation for future research. PMID:12595402

Ross, Stephen E.; Lin, Chen-Tan

2003-01-01

194

Electronic medical record use in pediatric primary care  

PubMed Central

Objectives To characterize patterns of electronic medical record (EMR) use at pediatric primary care acute visits. Design Direct observational study of 529 acute visits with 27 experienced pediatric clinician users. Measurements For each 20?s interval and at each stage of the visit according to the Davis Observation Code, we recorded whether the physician was communicating with the family only, using the computer while communicating, or using the computer without communication. Regression models assessed the impact of clinician, patient and visit characteristics on overall visit length, time spent interacting with families, and time spent using the computer while interacting. Results The mean overall visit length was 11:30 (min:sec) with 9:06 spent in the exam room. Clinicians used the EMR during 27% of exam room time and at all stages of the visit (interacting, chatting, and building rapport; history taking; formulation of the diagnosis and treatment plan; and discussing prevention) except the physical exam. Communication with the family accompanied 70% of EMR use. In regression models, computer documentation outside the exam room was associated with visits that were 11% longer (p=0.001), and female clinicians spent more time using the computer while communicating (p=0.003). Limitations The 12 study practices shared one EMR. Conclusions Among pediatric clinicians with EMR experience, conversation accompanies most EMR use. Our results suggest that efforts to improve EMR usability and clinician EMR training should focus on use in the context of doctor–patient communication. Further study of the impact of documentation inside versus outside the exam room on productivity is warranted. PMID:21134975

Alessandrini, Evaline A; Forrest, Christopher B; Khan, Saira; Localio, A Russell; Gerber, Andreas

2010-01-01

195

The Moral Domain of the Medical Record: The Routine Ethics Evaluation  

Microsoft Academic Search

The structure, content, and orientation of the contemporary medical record inadequately reflect the appropriate influence of patients' rights and bioethics on health care. Most tellingly, the medical chart reveals a remarkable absence of attention to medical ethics, except in the case of crisis management. But medical ethics informs both crisis decision-making and virtually all clinical interventions. Indeed, clinical care embodies

Alfred I. Tauber

2006-01-01

196

32 CFR 310.24 - Disclosures to the public from medical records.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 false Disclosures to the public from medical records...PROGRAM DOD PRIVACY PROGRAM Disclosure of Personal Information to Other...and Third Parties § 310.24 Disclosures to the public from medical...

2010-07-01

197

Development of Mobile Platform Integrated with Existing Electronic Medical Records  

PubMed Central

Objectives This paper describes a mobile Electronic Medical Record (EMR) platform designed to manage and utilize the existing EMR and mobile application with optimized resources. Methods We structured the mEMR to reuse services of retrieval and storage in mobile app environments that have already proven to have no problem working with EMRs. A new mobile architecture-based mobile solution was developed in four steps: the construction of a server and its architecture; screen layout and storyboard making; screen user interface design and development; and a pilot test and step-by-step deployment. This mobile architecture consists of two parts, the server-side area and the client-side area. In the server-side area, it performs the roles of service management for EMR and documents and for information exchange. Furthermore, it performs menu allocation depending on user permission and automatic clinical document architecture document conversion. Results Currently, Severance Hospital operates an iOS-compatible mobile solution based on this mobile architecture and provides stable service without additional resources, dealing with dynamic changes of EMR templates. Conclusions The proposed mobile solution should go hand in hand with the existing EMR system, and it can be a cost-effective solution if a quality EMR system is operated steadily with this solution. Thus, we expect this example to be shared with hospitals that currently plan to deploy mobile solutions. PMID:25152837

Kim, YoungAh; Kang, Simon; Kim, Kyungduk; Kim, Jun

2014-01-01

198

Configuration Challenges: Implementing Translational Research Policies in Electronic Medical Records  

PubMed Central

Prospective clinical trials are a key step in translating bench findings into bedside therapies. Electronic medical records (EMRs) are often cited as a significant new tool for advancing clinical trial capabilities into standard clinical practice. However, combining clinical research and clinical care activities into one unified electronic information system requires integrating a substantial body of regulatory requirements and institutional policies. Differing interpretations of external regulations and internal policies need to be reconciled so that the EMR configuration simultaneously conforms to all requirements. The authors describe how they used a detailed clinical vignette to help focus discussions about their institution's current research policies and how regulations and policies might be implemented in a commercial EMR. The vignette highlighted a number of inconsistencies in the institution's policies and in individual interpretations of regulatory intent. Attempts to implement potential policies in the EMR system also revealed a number of limitations and inconsistencies in the commercial system. The authors describe a set of compromises that will be implemented at The Children's Hospital until missing functionality is made available from the commercial vendor. Each institution that implements an EMR will need to resolve similar policy and configuration issues at its own facility. The authors highlight these configuration challenges by presenting a list of questions that must be answered unambiguously before implementing translational research capabilities into an operational EMR. PMID:17595562

Kahn, Michael G.; Kaplan, David; Sokol, Ronald J.; DiLaura, Robert P.

2013-01-01

199

Characterization of statin dose response in electronic medical records.  

PubMed

Efforts to define the genetic architecture underlying variable statin response have met with limited success, possibly because previous studies were limited to effect based on a single dose. We leveraged electronic medical records (EMRs) to extract potency (ED50) and efficacy (Emax) of statin dose-response curves and tested them for association with 144 preselected variants. Two large biobanks were used to construct dose-response curves for 2,026 and 2,252 subjects on simvastatin and atorvastatin, respectively. Atorvastatin was more efficacious, was more potent, and demonstrated less interindividual variability than simvastatin. A pharmacodynamic variant emerging from randomized trials (PRDM16) was associated with Emax for both. For atorvastatin, Emax was 51.7?mg/dl in subjects homozygous for the minor allele vs. 75.0?mg/dl for those homozygous for the major allele. We also identified several loci associated with ED50. The extraction of rigorously defined traits from EMRs for pharmacogenetic studies represents a promising approach to further understand the genetic factors contributing to drug response. PMID:24096969

Wei, W-Q; Feng, Q; Jiang, L; Waitara, M S; Iwuchukwu, O F; Roden, D M; Jiang, M; Xu, H; Krauss, R M; Rotter, J I; Nickerson, D A; Davis, R L; Berg, R L; Peissig, P L; McCarty, C A; Wilke, R A; Denny, J C

2014-03-01

200

49 CFR 382.409 - Medical review officer record retention for controlled substances.  

Code of Federal Regulations, 2012 CFR

...officer record retention for controlled substances. 382.409 Section 382.409 ...CARRIER SAFETY REGULATIONS CONTROLLED SUBSTANCES AND ALCOHOL USE AND TESTING Handling...officer record retention for controlled substances. (a) A medical review...

2012-10-01

201

49 CFR 382.409 - Medical review officer record retention for controlled substances.  

Code of Federal Regulations, 2010 CFR

...officer record retention for controlled substances. 382.409 Section 382.409 ...CARRIER SAFETY REGULATIONS CONTROLLED SUBSTANCES AND ALCOHOL USE AND TESTING Handling...officer record retention for controlled substances. (a) A medical review...

2010-10-01

202

49 CFR 382.409 - Medical review officer record retention for controlled substances.  

Code of Federal Regulations, 2011 CFR

...officer record retention for controlled substances. 382.409 Section 382.409 ...CARRIER SAFETY REGULATIONS CONTROLLED SUBSTANCES AND ALCOHOL USE AND TESTING Handling...officer record retention for controlled substances. (a) A medical review...

2011-10-01

203

49 CFR 382.409 - Medical review officer record retention for controlled substances.  

Code of Federal Regulations, 2013 CFR

...officer record retention for controlled substances. 382.409 Section 382.409 ...CARRIER SAFETY REGULATIONS CONTROLLED SUBSTANCES AND ALCOHOL USE AND TESTING Handling...officer record retention for controlled substances. (a) A medical review...

2013-10-01

204

Extracting medical information from narrative patient records: the case of medication-related information  

PubMed Central

Objective While essential for patient care, information related to medication is often written as free text in clinical records and, therefore, difficult to use in computerized systems. This paper describes an approach to automatically extract medication information from clinical records, which was developed to participate in the i2b2 2009 challenge, as well as different strategies to improve the extraction. Design Our approach relies on a semantic lexicon and extraction rules as a two-phase strategy: first, drug names are recognized and, then, the context of these names is explored to extract drug-related information (mode, dosage, etc) according to rules capturing the document structure and the syntax of each kind of information. Different configurations are tested to improve this baseline system along several dimensions, particularly drug name recognition—this step being a determining factor to extract drug-related information. Changes were tested at the level of the lexicons and of the extraction rules. Results The initial system participating in i2b2 achieved good results (global F-measure of 77%). Further testing of different configurations substantially improved the system (global F-measure of 81%), performing well for all types of information (eg, 84% for drug names and 88% for modes), except for durations and reasons, which remain problematic. Conclusion This study demonstrates that a simple rule-based system can achieve good performance on the medication extraction task. We also showed that controlled modifications (lexicon filtering and rule refinement) were the improvements that best raised the performance. PMID:20819863

Grouin, Cyril; Zweigenbaum, Pierre

2010-01-01

205

MR-byMIT-med-1011 Medical Records Service  

E-print Network

or personal representative) specify release of future records of a specific test, specific clinic appointment records. c. There is no fee for records released directly to other health care providers. However, if you record are requested for parties other than the patient or another health care provider (e.g., legal

Polz, Martin

206

A medication extraction framework for electronic health records  

E-print Network

This thesis addresses the problem of concept and relation extraction in medical documents. We present a medical concept and relation extraction system (medNERR) that incorporates hand-built rules and constrained conditional ...

Bodnari, Andreea

2012-01-01

207

Consumers' Perceptions of Patient-Accessible Electronic Medical Records  

PubMed Central

Background Electronic health information (eHealth) tools for patients, including patient-accessible electronic medical records (patient portals), are proliferating in health care delivery systems nationally. However, there has been very limited study of the perceived utility and functionality of portals, as well as limited assessment of these systems by vulnerable (low education level, racial/ethnic minority) consumers. Objective The objective of the study was to identify vulnerable consumers’ response to patient portals, their perceived utility and value, as well as their reactions to specific portal functions. Methods This qualitative study used 4 focus groups with 28 low education level, English-speaking consumers in June and July 2010, in New York City. Results Participants included 10 males and 18 females, ranging in age from 21-63 years; 19 non-Hispanic black, 7 Hispanic, 1 non-Hispanic White and 1 Other. None of the participants had higher than a high school level education, and 13 had less than a high school education. All participants had experience with computers and 26 used the Internet. Major themes were enhanced consumer engagement/patient empowerment, extending the doctor’s visit/enhancing communication with health care providers, literacy and health literacy factors, improved prevention and health maintenance, and privacy and security concerns. Consumers were also asked to comment on a number of key portal features. Consumers were most positive about features that increased convenience, such as making appointments and refilling prescriptions. Consumers raised concerns about a number of potential barriers to usage, such as complex language, complex visual layouts, and poor usability features. Conclusions Most consumers were enthusiastic about patient portals and perceived that they had great utility and value. Study findings suggest that for patient portals to be effective for all consumers, portals must be designed to be easy to read, visually engaging, and have user-friendly navigation. PMID:23978618

Vaughon, Wendy L; Czaja, Sara J; Levy, Joslyn; Rockoff, Maxine L

2013-01-01

208

Anonymization of DICOM electronic medical records for radiation therapy.  

PubMed

Electronic medical records (EMR) and treatment plans are used in research on patient outcomes and radiation effects. In many situations researchers must remove protected health information (PHI) from EMRs. The literature contains several studies describing the anonymization of generic Digital Imaging and Communication in Medicine (DICOM) files and DICOM image sets but no publications were found that discuss the anonymization of DICOM radiation therapy plans, a key component of an EMR in a cancer clinic. In addition to this we were unable to find a commercial software tool that met the minimum requirements for anonymization and preservation of data integrity for radiation therapy research. The purpose of this study was to develop a prototype software code to meet the requirements for the anonymization of radiation therapy treatment plans and to develop a way to validate that code and demonstrate that it properly anonymized treatment plans and preserved data integrity. We extended an open-source code to process all relevant PHI and to allow for the automatic anonymization of multiple EMRs. The prototype code successfully anonymized multiple treatment plans in less than 1min/patient. We also tested commercial optical character recognition (OCR) algorithms for the detection of burned-in text on the images, but they were unable to reliably recognize text. In addition, we developed and tested an image filtering algorithm that allowed us to isolate and redact alpha-numeric text from a test radiograph. Validation tests verified that PHI was anonymized and data integrity, such as the relationship between DICOM unique identifiers (UID) was preserved. PMID:25147130

Newhauser, Wayne; Jones, Timothy; Swerdloff, Stuart; Newhauser, Warren; Cilia, Mark; Carver, Robert; Halloran, Andy; Zhang, Rui

2014-10-01

209

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2010 CFR

...other home dialysis patients whose care is under the supervision of the facility...whether the patient has executed an advance directive. These records must be maintained...complete, maintain, and monitor home care patients' records, including...

2010-10-01

210

Department of Industrial Engineering Fall 2010 Electronic Medical Records at Jersey Shore Hospital  

E-print Network

Hospital Overview The Jersey Shore Hospital is currently in the process of transitioning from paper medical records to electronic medical records. The hospital requested that the current process be analyzed in order to identify any potential issues and allow for a streamlined implementation. The hospital was also

Demirel, Melik C.

211

AUTHORIZATION TO REQUEST MEDICAL RECORDS Federal statutes require a written request for personal health information (PHI).  

E-print Network

AUTHORIZATION TO REQUEST MEDICAL RECORDS Federal statutes require a written request for personal health information (PHI). Please release the following to: BYU STUDENT HEALTH CENTER MEDICAL RECORDS 1750: Information Requested Requesting Clinician's Name: I give permission to the BYU Student Health Center

Hart, Gus

212

Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study  

Microsoft Academic Search

Objective To describe the experiences of patients with type 2 diabetes in a web based disease management programme based on an interactive electronic medical record. Design Qualitative analysis of semistructured interviews with patients enrolled in a diabetes care module that included access to their electronic medical record, secure email, ability to upload blood glucose readings, an education site with endorsed

James D Ralston; Debra Revere; Lynne S Robins; Harold I Goldberg

2004-01-01

213

Improving the Quality of Nursing Home Care and Medical-Record Accuracy with Direct Observational Technologies  

ERIC Educational Resources Information Center

Nursing home medical-record documentation of daily-care occurrence may be inaccurate, and information is not documented about important quality-of-life domains. The inadequacy of medical record data creates a barrier to improving care quality, because it supports an illusion of care consistent with regulations, which reduces the motivation and…

Schnelle, John F.; Osterweil, Dan; Simmons, Sandra F.

2005-01-01

214

Congruence of Self-Reported Medications with Pharmacy Prescription Records in Low-Income Older Adults  

ERIC Educational Resources Information Center

Purpose: This study examined the congruence of self-reported medications with computerized pharmacy records. Design and Methods: Pharmacy records and self-reported medications were obtained for 294 members of a state pharmaceutical assistance program who also participated in ACTIVE, a clinical trial on cognitive training in nondemented elderly…

Caskie, Grace I. L.; Willis, Sherry L.

2004-01-01

215

Reliability and Validity of Estimating the NIH Stroke Scale Score from Medical Records  

Microsoft Academic Search

Background and Purpose—The aim of our study was to determine whether the National Institutes of Health Stroke Scale (NIHSS) can be estimated retrospectively from medical records. The NIHSS is a quantitative measure of stroke-related neurological deficit with established reliability and validity for use in prospective clinical research. Recently, retrospective observational studies have estimated NIHSS scores from medical records for quantitative

Scott E. Kasner; Julio A. Chalela; Jean M. Luciano; Brett L. Cucchiara; Eric C. Raps; Michael L. McGarvey; Molly B. Conroy; A. Russell Localio

216

Roles, Functions, Training, and Proficiency Tests for Medical Record Personnel: A Guide to Curriculum Management.  

ERIC Educational Resources Information Center

The curriculum management guide serves as an aid to medical record teachers and other medical record educators. It is designed to provide them with a useful tool to improve student performances by improved administration and management of programs. The guide documents one possible systematic approach to professional and vocational curriculum…

Clark, Fredric A.

217

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

ERIC Educational Resources Information Center

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…

Tiggle, Michele

2012-01-01

218

Remote access to medical records via the Internet: feasibility, security and multilingual considerations  

Microsoft Academic Search

This paper investigates the use of Internet technology to provide secure multilingual access to the medical records of a cardiology clinic. Information extracted from the medical record archive is used to create mini-Webs of interlinked pages that may be viewed using a standard browser. The main features of the reported project are its multilingual nature-of particular significance in Europe, the

P. J. Lees; C. E. Chronaki; E. N. Simantirakis; S. G. Kostomanolakis; S. C. Orphanoudakis; P. E. Vardas

1999-01-01

219

Linking human anatomy to knowledge bases: a visual front end for electronic medical records.  

PubMed

A new concept of a visual electronic medical record is presented based on developments ongoing in the Defense Advanced Research Projects Agency Virtual Soldier Project. This new concept is based on the holographic medical electronic representation (Holomer) and on data formats being developed to support this. The Holomer is being developed in two different visualization environments, one of which is suitable for prototyping the visual electronic medical record. The advantages of a visual approach as a front end for electronic medical records are discussed and specific implementations are presented. PMID:15718802

Dickson, Stewart; Pouchard, Line; Ward, Richard; Atkins, Gary; Cole, Martin; Lorensen, Bill; Ade, Alexander

2005-01-01

220

THE COLLEGE OF VETERINARY MEDICINE  

E-print Network

Professor, Veterinary Preventive Medicine "SCIENCE AND TECHNOLOGY HAVE CHANGED DRAMATICALLY SINCE THE DAWN biosciences, veterinary clinical sciences, and veterinary preventive medicine. We are the only veterinary some form of private practice, while the remainder choose fields such as preventive medicine

221

MEDATA: a new concept in medical records management  

Microsoft Academic Search

The potential applications for computers in expediting medical research and improving patient care are well recognized. However, in a medical environment full exploitation of the latent powers of available electronic devices depends on one vital factor. That is, giving the physicians, research scientists, or administrators direct control of the type of information acquired and stored, how it is related, and

Caroline Horton; Tate M. Minckler; Lee D. Cady Jr.

1967-01-01

222

Physician Interaction with Electronic Medical Records: A Qualitative Study  

ERIC Educational Resources Information Center

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…

Noteboom, Cherie Bakker

2010-01-01

223

21 CFR 870.2800 - Medical magnetic tape recorder.  

...Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES...example, physiological amplifiers, signal conditioners, or computers. (b) Classification. Class II (performance...

2014-04-01

224

The Merck Veterinary Manual  

NSDL National Science Digital Library

The Merck Veterinary Manual is the single most comprehensive electronic reference for animal care information. The site is funded in part by Merck & Co., Inc., which has been providing quality medical information on a not-for-profit basis for more than 100 years. Merial Limited, dedicated to producing a wide range of pharmaceuticals and vaccines to keep livestock and pets healthy and productive also funds the site. The online manual contains articles on a multitude of topics including (to name only a few), the digestive system, metabolic disorders, emergency care and management, and exotic and laboratory animals. Within each topic are subheadings for a more specific search for information. The manual is easily navigated for users and would be a valuable resource for students and instructors alike.

2007-02-13

225

Faculty Position Therapeutic Medical Physics  

E-print Network

at the assistant or associate professor level in the area of Therapeutic Medical Physics. ERHS of the ERHS department, located at the Veterinary Teaching Hospital. This program provides radiation therapy for companion animals utilizing a VarianTM Trilogy accelerator, EclipseTM treatment planning and AriaTM record

226

A descriptive exploratory study of how admissions caused by medication-related harm are documented within inpatients' medical records  

PubMed Central

Background Adverse drug reactions, poor patient adherence and errors, here collectively referred to as medication-related harm (MRH), cause around 2.7-8.0% of UK hospital admissions. Communication gaps between successive healthcare providers exist, but little is known about how MRH is recorded in inpatients’ medical records. We describe the presence and quality of MRH documentation for patients admitted to a London teaching hospital due to MRH. Additionally, the international classification of disease 10th revision (ICD-10) codes attributed to confirmed MRH-related admissions were studied to explore appropriateness of their use to identify these patients. Methods Clinical pharmacists working on an admissions ward in a UK hospital identified patients admitted due to suspected MRH. Six different data sources in each patient’s medical record, including the discharge summary, were subsequently examined for MRH-related information. Each data source was examined for statements describing the MRH: symptom and diagnosis, identification of the causative agent, and a statement of the action taken or considered. Statements were categorised as ‘explicit’ if unambiguous or ‘implicit’ if open to interpretation. ICD-10 codes attributed to confirmed MRH cases were recorded. Results Eighty-four patients were identified over 141 data collection days; 75 met our inclusion criteria. MRH documentation was generally present (855 of 1307 statements were identified; 65%), and usually explicit (705 of 855; 82%). The causative agent had the lowest proportion of explicit statements (139 of 201 statements were explicit; 69%). For two (3%) discharged patients, the causal agent was documented in their paper medical record but not on the discharge summary. Of 64 patients with a confirmed MRH diagnosis at discharge, only six (9%) had a MRH-related ICD-10 code. Conclusions Availability of information in the paper medical record needs improving and communication of MRH-related information could be enhanced by using explicit statements and documenting reasons for changing medications. ICD-10 codes underestimate the true occurrence of MRH. PMID:24935647

2014-01-01

227

Experiences Sharing of Implementing Template-Based Electronic Medical Record System (TEMRS) in a Hong Kong Medical Organization  

Microsoft Academic Search

This paper aims to investigate the efficacy and feasibility of Template-based Electronic Medical Record System (TEMRS) and\\u000a factors for its successful implementation. A TEMRS was designed and implemented in one core clinic of a Hong Kong professional\\u000a multi-disciplinary medical services provider with four core clinics located in different parts of Hong Kong. Eight doctors\\u000a participated in the study. Surveys and

S. L. Ting; S. K. Kwok; Albert H. C. Tsang; W. B. Lee; K. F. Yee

228

42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.  

Code of Federal Regulations, 2011 CFR

...medical record requirements for psychiatric hospitals. 482.61 Section 482.61 Public Health...CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.61 Condition of...

2011-10-01

229

42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.  

Code of Federal Regulations, 2013 CFR

...medical record requirements for psychiatric hospitals. 482.61 Section 482.61 Public Health...CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.61 Condition of...

2013-10-01

230

42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.  

Code of Federal Regulations, 2012 CFR

...medical record requirements for psychiatric hospitals. 482.61 Section 482.61 Public Health...CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.61 Condition of...

2012-10-01

231

Computerized Maternal and Child Health and Family Planning Problem Oriented Medical (Health) Record.  

National Technical Information Service (NTIS)

An automated health management system for maternal and child health based on patients' problem-oriented medical records is described. The goal of the system is to provide information rapidly for agency, program, and patient management. The system consists...

F. M. Crowder, R. W. Renick

1978-01-01

232

A de-identifier for electronic medical records based on a heterogeneous feature set  

E-print Network

In this thesis, I describe our effort to build an extended and specialized Named Entity Recognizer (NER) to detect instances of Protected Health Information (PHI) in electronic medical records (A de-identifier). The ...

Tafvizi, Arya (Tafvizi Zavareh)

2011-01-01

233

Does the HIPAA Privacy Rule Allow Parents the Right to See Their Children's Medical Records?  

MedlinePLUS

Does the HIPAA Privacy Rule allow parents the right to see their children’s medical records? Answer: Yes, ... other applicable law is silent on a parent’s right of access in these cases, the licensed health ...

234

Applying XDS for sharing CDA-based medical records  

Microsoft Academic Search

Many countries have set long-term objectives for establishing an Electronic Healthcare Records system(EHRs). Various IT Strategies note that integration of EHR systems has a high priority. Because the EHR systems are based on different information models and different technology platforms, one of the key integration problems in the realization of the EHRs for the continuity of patient care, is the

Joong Il Kim; Bong Mun Jang; Dong Hoon Han; Keon Ho Yang; Won-Suk Kang; Haijo Jung; Hee-Joung Kim

2006-01-01

235

An Ontology-Based Electronic Medical Record for Chronic Disease Management  

Microsoft Academic Search

Effective chronic disease management ensures better treatment and reduces medical costs. Representing knowledge through building an ontology for Electronic Medical Records (EMRs) is important to achieve semantic interoperability among healthcare information systems and to better execute decision support systems. In this paper, an ontology-based EMR focusing on Chronic Disease Management is proposed. The W3C Computer-based Patient Record ontology [7] is

Ashraf Mohammed Iqbal; Michael A. Shepherd; Syed Sibte Raza Abidi

2011-01-01

236

SecureMed-ID: memorable and private identifiers for off-site access to medical records  

Microsoft Academic Search

SecureMed-ID improves the memorability of identifiers used by electronic medical record systems. Making identifiers that are easier to remember should improve the privacy of the medical record system by preventing leaks due to human error. SecureMed-ID can easily transform the commonly-used Globally Unique Identifier (GUID) system into a human-friendly two-word alias. This system hides much of the complexity of information

Todd H. Stokes; Richard A. Moffitt; May D. Wang

2011-01-01

237

Research Paper: Prediction of Chronic Obstructive Pulmonary Disease (COPD) in Asthma Patients Using Electronic Medical Records  

Microsoft Academic Search

ObjectiveIdentify clinical factors that modulate the risk of progression to COPD among asthma patients using data extracted from electronic medical records.DesignDemographic information and comorbidities from adult asthma patients who were observed for at least 5 years with initial observation dates between 1988 and 1998, were extracted from electronic medical records of the Partners Healthcare System using tools of the National

Blanca E. Himes; Yi Dai; Isaac S. Kohane; Scott T. Weiss; Marco F Ramoni

2009-01-01

238

Research strategies that result in optimal data collection from the patient medical record  

PubMed Central

Data obtained from the patient medical record are often a component of clinical research led by nurse investigators. The rigor of the data collection methods correlates to the reliability of the data and, ultimately, the analytical outcome of the study. Research strategies for reliable data collection from the patient medical record include the development of a precise data collection tool, the use of a coding manual, and ongoing communication with research staff. PMID:20974093

Gregory, Katherine E.; Radovinsky, Lucy

2010-01-01

239

Evaluation of Usage of Virtual Microscopy for the Study of Histology in the Medical, Dental, and Veterinary Undergraduate Programs of a UK University  

ERIC Educational Resources Information Center

This article describes the introduction of a virtual microscope (VM) that has allowed preclinical histology teaching to be fashioned to better suit the needs of approximately 900 undergraduate students per year studying medicine, dentistry, or veterinary science at the University of Bristol, United Kingdom. Features of the VM implementation…

Gatumu, Margaret K.; MacMillan, Frances M.; Langton, Philip D.; Headley, P. Max; Harris, Judy R.

2014-01-01

240

The Effect of Educational Intervention on Medical Diagnosis Recording among Residents  

PubMed Central

Introduction: Studies indicate that using interventions including education may improve medical record documentation and decrease incomplete files. Since physicians play a crucial role in medical record documentation, the researchers intend to examine the effect of educational intervention on physicians’ performance and knowledge about principles of medical diagnosis recording among residents in Hormozgan University of Medical Sciences(HUMS). Methods: This quasi-experimental study was conducted in 2010 on 40 specialty residents (from internal medicine, obstetrics and gynecology, pediatrics, anesthesiology and surgery specialties) in Hormozgan University of Medical Sciences. During a workshop, guidelines for recording diagnostic information related to given specialty were taught. Before and after the intervention, five medical records from each resident were selected to assess physician performance about chart documentation. Using a questionnaire, physicians’ knowledge was investigated before and after intervention. Data were analyzed through one-way ANOVA test. Results: Change in physicians’ knowledge before and after education was not statistically significant (p = 0.15). Residents’ behavior did not have statistically significant changes during three phases of the study. Conclusion: Diversity of related factors which contributes to the quality of documentation compels portfolio of strategies to enhance medical charting. Employing combination of best practice efforts including educating physicians from the beginning of internship and applying targeted strategy focus on problematic areas and existing gap may enhance physicians’ behavior about chart documentation. PMID:24167386

Davaridolatabadi, Nasrin; Sadoughi, Farahnaz; Meidani, Zahra; Shahi, Mehraban

2013-01-01

241

A Process to Integrate a New Patient Care Plan into the Medical Record.  

National Technical Information Service (NTIS)

This study, carried out by the Veterans Administration (VA) Medical Center, Buffalo, New York, was done in an effort to develop and implement a new Nursing Care Plan to be integrated into the patient's medical record. A secondary purpose was to explore th...

E. J. Kass

1981-01-01

242

Towards an Evolvable Cyber Security Protection Profile for Electronic Medical Records to Ensure Privacy and Security  

Microsoft Academic Search

Electronic Medical Records (EMR) provide increased productivity and convenience for patients, doctors, nurses, pharmacists, lab technicians and other medical professionals. The added accessibility to patient information introduces a multitude of security risks at various levels. The communication infrastructure may be breached by intruders from disparate countries. Loosely protected data entry terminals are susceptible to insider threats. This paper characterizes EMR

Damian Watkins; Craig Scott

243

Authorization for Release of Medical Records Service Protected Health Information (PHI)  

E-print Network

for mental illness, alcohol or drug abuse/treatment, domestic/sexual assault, or AIDS testing or 3Authorization for Release of Medical Records Service Protected Health Information (PHI) 77 Massachusetts Ave., E23-023 by MIT Medical Cambridge, MA 02139-4307 Phone: 617-253-4906 Fax: 617

Polz, Martin

244

A Study to Delineate Roles and Functions of Medical Record Personnel: Final Report.  

ERIC Educational Resources Information Center

In order to be able to comply, and to be able to document their compliance, with federal legislation regarding health occupations education and discriminatory practices, the American Medical Record Association conducted a study to see if a data base could be built to validate proficiency tests for medical personnel. The report was prepared to…

American Medical Record Association, Chicago, IL.

245

Survival during and after hospitalization: a medical record linkage  

Microsoft Academic Search

In Sweden, hospital stays, deaths, sick- listings and censuses have long been stored on electronic media. The purpose of the study was to apply post-hospital survival measures to hospitals having differing degrees of specialization by linking existing data in censuses and in-patient registers. In-patient records totaling 3.6 million were collected. They were linked to the 1985 and 1990 censuses regarding

Boo Svartbo; Lars Olov Bygren; Thomas Gunnarsson; Lars Steen; Martin Ribe

1999-01-01

246

The Barriers to Electronic Medical Record Systems and How to Overcome Them  

Microsoft Academic Search

Institutions all want electronic medical record (EMR) systems. They want them to solve their record movement problems, to improve the quality and coherence of the care process, to automate guidelines and care pathways to assist clinical research, outcomes management, and process improvement. EMRs are very difficult to construct because the existing electronic data sources, e.g., laboratory systems, pharmacy systems, and

CLEMENT J. MCDONALD

1997-01-01

247

32 CFR 806b.48 - Disclosing the medical records of minors.  

Code of Federal Regulations, 2012 CFR

...obey state laws protecting medical records of drug or alcohol abuse treatment, abortion, and birth control. If you manage...records overseas when the minor sought or consented to treatment between the ages of 15 and 17 in a program where...

2012-07-01

248

32 CFR 806b.48 - Disclosing the medical records of minors.  

Code of Federal Regulations, 2013 CFR

...obey state laws protecting medical records of drug or alcohol abuse treatment, abortion, and birth control. If you manage...records overseas when the minor sought or consented to treatment between the ages of 15 and 17 in a program where...

2013-07-01

249

Veterinary Clinical Trials  

MedlinePLUS

... coronoid processes Spinal cord injuries Acute disc herniations Testing pancreatic function Searchable Clinical Trials Database For Cancer In Pet Animals sponsored by the Veterinary Cooperative Oncology Group (VCOG) ...

250

The electronic medical record: a definition and discussion.  

PubMed

The health care industry has had limited success in achieving some degree of an EMR in the past several years, and the industry has the potential to move even farther in the next decade. As standards begin to emerge and technologies conform to those standards, the industry will begin to see the evolution of a totally electronic patient record. Standard interfaces and hardware platforms, with software products designed to meet a standardized market need, will become more prevalent. Multifunction workstations, voice recognition, and other technological advancements will simplify the data-entry process for clinicians. Legal statutes that support automated records will be established and accepted by the courts, and optical disk image processing systems will take off as the storage medium of choice for the next generation. Because the EMR can provide the benefits outlined here, the health care industry must work together to ensure the success of this vision. As leaders in the health care information management arena, we need to participate in the realization of this ideal for the betterment of our patients, our health care organizations, and the entire health care delivery system. PMID:10124869

Miller, C

1993-02-01

251

Auditing medical records accesses via healthcare interaction networks.  

PubMed

Healthcare organizations are deploying increasingly complex clinical information systems to support patient care. Traditional information security practices (e.g., role-based access control) are embedded in enterprise-level systems, but are insufficient to ensure patient privacy. This is due, in part, to the dynamic nature of healthcare, which makes it difficult to predict which care providers need access to what and when. In this paper, we show that modeling operations at a higher level of granularity (e.g., the departmental level) are stable in the context of a relational network, which may enable more effective auditing strategies. We study three months of access logs from a large academic medical center to illustrate that departmental interaction networks exhibit certain invariants, such as the number, strength, and reciprocity of relationships. We further show that the relations extracted from the network can be leveraged to assess the extent to which a patient's care satisfies expected organizational behavior. PMID:23304277

Chen, You; Nyemba, Steve; Malin, Bradley

2012-01-01

252

Method and system for determining precursors of health abnormalities from processing medical records  

DOEpatents

Medical reports are converted to document vectors in computing apparatus and sampled by applying a maximum variation sampling function including a fitness function to the document vectors to reduce a number of medical records being processed and to increase the diversity of the medical records being processed. Linguistic phrases are extracted from the medical records and converted to s-grams. A Haar wavelet function is applied to the s-grams over the preselected time interval; and the coefficient results of the Haar wavelet function are examined for patterns representing the likelihood of health abnormalities. This confirms certain s-grams as precursors of the health abnormality and a parameter can be calculated in relation to the occurrence of such a health abnormality.

Patton, Robert M; Potok, Thomas E; Beckerman, Barbara G

2013-06-25

253

Collating of a Distributed XML Based Medical Records into a Relational Database  

E-print Network

Introduction We are currently developing the Personal Internetworked Notary and Guardian (PING) 1 whose main goal is to implement a secure, distributed and patientcontrolled repository of life-long medical information on the Web. The PING record differs substantially for institutionally-oriented medical information systems. First, it uses XML as a basic data format and virtual directory structure as data storage and does not employ a relational database management system. Second, it is a highly secure system under a patients' own control on the bases of authentication, authorization, and encryption technology. Third, PING records are distributed over the Internet and not confined to a single institution's database. Fourth, PING records may have multiple data sources including patients as well as several health care providers. PING records could therefore provide very extensive, comprehensive and valuable information that other medical information systems may not en

Do Hoon Oh; Oh Md; Alberto Riva Phd; Kenneth D. M; L Md; Isaac S. Kohane Md

254

Ancient Greek and Byzantine Writers on Veterinary Renal Problems  

Microsoft Academic Search

It has been correctly stated that, ‘although there is no lack of veterinary texts, both in Greek and Latin, the history of veterinary medicine (let alone nephrology) has not received the attention it deserves’ [1]. In this article we present the views of some Greek medical writers from antiquity to Late Byzantium concerning the anatomy, physiology and pathology of the

Athanasios Diamandopoulos; Andreas Skarpelos

2002-01-01

255

Comparing Four CAB Abstracts Platforms from a Veterinary Medicine Perspective  

Microsoft Academic Search

CAB Abstracts® is the premier database for the veterinary medical literature. This research evaluated search performance, using recall and precision, and compared interface features and of the CAB Direct®, EBSCOhost®, ISI, and OvidSP interfaces to CAB Abstracts. While differences were found in search formulation, there were no statistically significant differences in precision or recall for ten veterinary searches, and all

Robin R. Sewell

2011-01-01

256

C-B1-02: VDW Patient Medical Record Report -Detailed Information on Patient Utilization  

PubMed Central

Background/Aims Project teams often require itemized patient information for their research and often engage a medical record technician to help them understand the details of a patient’s utilization. The authors suggest that project teams can either supplant or augment their abstracting efforts by using this person-level VDW (Virtual Data Warehouse) patient medical record report. This report is an inexpensive, quick, and well-organized method to produce a patient medical record using VDW data. Another important benefit of this report is that it also has additional information (such as claims) not readily found in the electronic medical record. Methods Users of the VDW patient medical record report have access to a wide array of content: diagnosis; DRG and procedure codes and descriptions; outpatient dispenses described by generic name; lab test results; BMI; weight; height; blood pressure; provider department; inpatient admitting source; and discharge status. Users can also opt to include cancer site from the VDW tumor registry. More variables can be added over time. This report includes all encounter types (e.g., inpatient, outpatient, emergency, long-term care, telephone, e-mail) found in the VDW files. In addition, the header includes gender and birth/death year, and users specify a time period. Each data value adds an additional line. It is designed for local review as the report contains PHI. Results This report is easy to create. Because the layout follows chronological order, the reviewer can quickly understand the patient’s utilization over a specified time period. Analysts, investigators, and providers have used this report. Programmer analysts use this information to guide their coding. Providers and investigators like it because they can quickly review patient utilization. We also often give this report to abstractors as a supplement to the traditional electronic medical record. Caveats: The report only contains information from the VDW, so it is only as complete as a site’s VDW files. The electronic medical record contains much information that is not in the VDW patient medical record report. Conclusions The VDW patient medical record report is an efficient way for research teams to view and understand patient-level utilization found in the VDW.

Bachman, Donald

2011-01-01

257

The electronic medical record and Patient-centered care  

PubMed Central

Background: One goal in EMR development should be to facilitate a patient-centered clinical encounter. Much prior EMR development has focused on capturing objective data, such as laboratory values and medication lists. Less attention has been devoted to the more complex task of capturing and analyzing data that incorporates the patient’s concerns and preferences. Methods: A literature search supplemented the author’s own various experiences with one EMR (that used nationally by the Department of Veterans Affairs) from his various perspectives of a physician, an educator, and a Chief of Staff. This data was used to identify both opportunities and obstacles to promoting patient-centered care in an integrated care setting that relies heavily on an EMR. Qualitative analysis and suggestions are offered for how the EMR can individualize patient care, in support of a patient-centered approach. Result: Three promising target areas in efforts to develop a patient-centered EMR are: elicitation of the chief complaint, conduct of health screening activities, and evaluation of health literacy. A range of strategies were identified, some of which may require information technology development, such as to facilitate patient direct entry of data into their own EMR. Conclusion: EMR design can facilitate a more patient-centered clinical encounter. Beyond the benefits to the individual patient, patient-centric modifications to the EMR architecture may also facilitate quality improvement and research activities on patient centered care. In light of the widespread current discussions of a movement toward Accountable Care Organizations that use EMR, it will be especially important to ensure that the resulting care systems maintain a focus on the patient and not just on the system of care. PMID:23569603

Nusbaum, Neil J

2011-01-01

258

Semantic extraction and processing of medical records for patient-oriented visual index  

NASA Astrophysics Data System (ADS)

To have comprehensive and completed understanding healthcare status of a patient, doctors need to search patient medical records from different healthcare information systems, such as PACS, RIS, HIS, USIS, as a reference of diagnosis and treatment decisions for the patient. However, it is time-consuming and tedious to do these procedures. In order to solve this kind of problems, we developed a patient-oriented visual index system (VIS) to use the visual technology to show health status and to retrieve the patients' examination information stored in each system with a 3D human model. In this presentation, we present a new approach about how to extract the semantic and characteristic information from the medical record systems such as RIS/USIS to create the 3D Visual Index. This approach includes following steps: (1) Building a medical characteristic semantic knowledge base; (2) Developing natural language processing (NLP) engine to perform semantic analysis and logical judgment on text-based medical records; (3) Applying the knowledge base and NLP engine on medical records to extract medical characteristics (e.g., the positive focus information), and then mapping extracted information to related organ/parts of 3D human model to create the visual index. We performed the testing procedures on 559 samples of radiological reports which include 853 focuses, and achieved 828 focuses' information. The successful rate of focus extraction is about 97.1%.

Zheng, Weilin; Dong, Wenjie; Chen, Xiangjiao; Zhang, Jianguo

2012-02-01

259

Abstract Making a decision support system for cording on the electronic medical record  

E-print Network

We have done the development of the Electronic Medical Record System. I have done the construction of the data base by XML, for the purpose of that does information interchange especially. We need the standardization of the record is necessary for information interchange. The correspondence to the tag of XML was a subject in the record of SOAP. Thereupon, it made to construct the support system of the diagnosis process which makes the tag of the record. It is operating it as the support system of the diagnosis process of nursing this time.

Yoshinori Yamashita A

260

The mixed management of patients' medical records: responsibility sharing between the patient and the physician.  

PubMed

Through this article, we propose a mixed management of patients' medical records, so as to share responsibilities between the patient and the Medical Practitioner by making Patients responsible for the validation of their administrative information, and MPs responsible for the validation of their Patients' medical information. Our proposal can be considered a solution to the main problem faced by patients, health practitioners and the authorities, namely the gathering and updating of administrative and medical data belonging to the patient in order to accurately reconstitute a patient's medical history. This method is based on two processes. The aim of the first process is to provide a patient's administrative data, in order to know where and when the patient received care (name of the health structure or health practitioner, type of care: out patient or inpatient). The aim of the second process is to provide a patient's medical information and to validate it under the accountability of the Medical Practitioner with the help of the patient if needed. During these two processes, the patient's privacy will be ensured through cryptographic hash functions like the Secure Hash Algorithm, which allows pseudonymisation of a patient's identity. The proposed Medical Record Search Engines will be able to retrieve and to provide upon a request formulated by the Medical Practitioner all the available information concerning a patient who has received care in different health structures without divulging the patient's identity. Our method can lead to improved efficiency of personal medical record management under the mixed responsibilities of the patient and the MP. PMID:20543354

Quantin, Catherine; Fassa, Maniane; Benzenine, Eric; Jaquet-Chiffelle, David-Olivier; Coatrieux, Gouenou; Allaert, François-André

2010-01-01

261

The role of frontline RNs in the selection of an electronic medical record business partner.  

PubMed

Frontline RNs knowledgeable in the strategic objectives of their organization made a difference in the selection of an electronic medical record business partner for a large, complex healthcare system. Their impact was significant because of the chief nurse executive's personal articulation of the organization's strategic goals and of her investment in their education. These factors provided the frontline RNs with a foundational base of knowledge about a variety of electronic medical record systems. The preparation and exposure enabled the frontline RNs to make a valuable contribution to the selection of an electronic medical record business partner. The RNs were a major force in affecting philosophical change from the organization's original pursuit of "best-of-breed" interfaced systems to a fully integrated, "best-of-class" vendor business partner. The learning experiences of the frontline RNs are explored to answer the following question: Why must frontline RNs play a key role in this process? PMID:16849913

Wilhoit, Kathryn; Mustain, Jane; King, Marjorie

2006-01-01

262

21 CFR 510.112 - Antibiotics used in veterinary medicine and for nonmedical purposes; required data.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Antibiotics used in veterinary medicine and for...Rulings and Decisions § 510.112 Antibiotics used in veterinary medicine and for...Veterinary Medical and Nonmedical Uses of Antibiotics, was formed by the Food and Drug...

2012-04-01

263

21 CFR 510.112 - Antibiotics used in veterinary medicine and for nonmedical purposes; required data.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Antibiotics used in veterinary medicine and for...Rulings and Decisions § 510.112 Antibiotics used in veterinary medicine and for...Veterinary Medical and Nonmedical Uses of Antibiotics, was formed by the Food and Drug...

2013-04-01

264

21 CFR 510.112 - Antibiotics used in veterinary medicine and for nonmedical purposes; required data.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Antibiotics used in veterinary medicine and for...Rulings and Decisions § 510.112 Antibiotics used in veterinary medicine and for...Veterinary Medical and Nonmedical Uses of Antibiotics, was formed by the Food and Drug...

2011-04-01

265

21 CFR 510.112 - Antibiotics used in veterinary medicine and for nonmedical purposes; required data.  

...2014-04-01 2014-04-01 false Antibiotics used in veterinary medicine and for...Rulings and Decisions § 510.112 Antibiotics used in veterinary medicine and for...Veterinary Medical and Nonmedical Uses of Antibiotics, was formed by the Food and Drug...

2014-04-01

266

Design and Implementation of Web-Based Mobile Electronic Medication Administration Record  

Microsoft Academic Search

Patients’ safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In\\u000a order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System\\u000a (HIS) to facilitate patients’ safety and to improve the quality of medical care. During the medical care processing, all the\\u000a tasks are based

Sung-huai Hsieh; I-Ching Hou; Po-Hsun Cheng; Ching-Ting Tan; Po-Chao Shen; Kai-Ping Hsu; Sheau-Ling Hsieh; Feipei Lai

2010-01-01

267

University of Arkansas for Medical Sciences electronic health record and medical informatics training for undergraduate health professionals.  

PubMed

The University of Arkansas for Medical Sciences (UAMS) is planning interprofessional training in electronic health records (EHRs) and medical informatics. Training will be integrated throughout the curricula and will include seminars on broad concepts supplemented with online modules, didactic lectures, and hands-on experiences. Training will prepare future health professionals to use EHRs, evidence-based medicine, medical decision support, and point-of-care tools to reduce errors, improve standards of care, address Health Insurance Portability and Accountability Act requirements and accreditation standards, and promote appropriate documentation to enable data retrieval for clinical research. UAMS will ensure that graduates are ready for the rapidly evolving practice environment created by the HITECH Act. PMID:20648253

Hart, Jan K; Newton, Bruce W; Boone, Steven E

2010-07-01

268

Nursing leaders serving as a foundation for the electronic medical record.  

PubMed

Transitioning health care information to an electronic medical record is one of the newest policies to reach the health care agenda. Nursing leaders are at the forefront to affect the design, development, implementation, and reception of an electronic medical record. Because of their clinical workflow knowledge, decision-making capacity, and leadership role, nursing leaders are able to achieve high-quality EMRs. Being proactive in the reception, design, development, and implementation of an EMR plays a role in creating an organizational culture that allows for the flow of data efficiently and accurately. PMID:22673079

Edwards, Courtney

2012-01-01

269

School of Veterinary Medicine Bulletin  

E-print Network

School of Veterinary Medicine Bulletin 2010-2011 #12;2 School of Veterinary Medicine About of Veterinary Medicine. http://www.vetmed.lsu.edu/art_show.htm #12;2010­2011 Bulletin 22010­2011 Bulletin 1 2010, and other mail sent to­School of Veterinary Medicine, LSU, Baton Rouge, Louisiana 70803. Statement

270

School of Veterinary Medicine Bulletin  

E-print Network

School of Veterinary Medicine Bulletin 2009-2010 #12;2 School of Veterinary Medicine About at the Louisiana State University School of Veterinary Medicine, March 28-April 26, 2009. #12;2009­2010 Bulletin of address, undeliverable copies, and other mail sent to­School of Veterinary Medicine, LSU, Baton Rouge

271

A SWOT Analysis of the Various Backup Scenarios Used in Electronic Medical Record Systems  

PubMed Central

Objectives Electronic medical records (EMRs) are increasingly being used by health care services. Currently, if an EMR shutdown occurs, even for a moment, patient safety and care can be seriously impacted. Our goal was to determine the methodology needed to develop an effective and reliable EMR backup system. Methods Our "independent backup system by medical organizations" paradigm implies that individual medical organizations develop their own EMR backup systems within their organizations. A "personal independent backup system" is defined as an individual privately managing his/her own medical records, whereas in a "central backup system by the government" the government controls all the data. A "central backup system by private enterprises" implies that individual companies retain control over their own data. A "cooperative backup system among medical organizations" refers to a networked system established through mutual agreement. The "backup system based on mutual trust between an individual and an organization" means that the medical information backup system at the organizational level is established through mutual trust. Results Through the use of SWOT analysis it can be shown that cooperative backup among medical organizations is possible to be established through a network composed of various medical agencies and that it can be managed systematically. An owner of medical information only grants data access to the specific person who gave the authorization for backup based on the mutual trust between an individual and an organization. Conclusions By employing SWOT analysis, we concluded that a linkage among medical organizations or between an individual and an organization can provide an efficient backup system. PMID:22084811

Seo, Hwa Jeong; Kim, Hye Hyeon

2011-01-01

272

UNIVERSITY OF PITTSBURGH SUBJECT: Privacy of Medical Records Compliance with the Health Insurance Portability  

E-print Network

UNIVERSITY OF PITTSBURGH POLICY SUBJECT: Privacy of Medical Records ­ Compliance with the Health subject research. II. POLICY It is the policy of the University of Pittsburgh to comply with the Health of the University that are health care providers, health plans or health care clearinghouses which engage

Sibille, Etienne

273

The impact of service level on the acceptance of application service oriented medical records  

Microsoft Academic Search

Service level is considered to be the most important criterion in evaluating application services. In our study we empirically investigated how perceived service level (PSL) influenced healthcare workers' willingness to use application service oriented medical records. In particular, we extended the technology acceptance model (TAM) by embedding PSL as a causal antecedent. We found that PSL explained 61% of the

Liping Liu; Qingxiong Ma

2005-01-01

274

Reliability of Birth Certificate Data: A Multi-Hospital Comparison to Medical Records Information  

Microsoft Academic Search

Objective: To examine the reliability of birth certificate data and determine if reliability differs between teaching and nonteaching hospitals. Methods: We compared information from birth certificates and medical records in 33,616 women admitted for labor and delivery in 1993–95 to 20 hospitals in Northeast Ohio. Analyses determined the agreement for 36 common data elements, and the sensitivity, specificity, and positive

David L. DiGiuseppe; David C. Aron; Lorin Ranbom; Dwain L. Harper; Gary E. Rosenthal

2002-01-01

275

Automated extraction of clinical traits of multiple sclerosis in electronic medical records  

PubMed Central

Objectives The clinical course of multiple sclerosis (MS) is highly variable, and research data collection is costly and time consuming. We evaluated natural language processing techniques applied to electronic medical records (EMR) to identify MS patients and the key clinical traits of their disease course. Materials and methods We used four algorithms based on ICD-9 codes, text keywords, and medications to identify individuals with MS from a de-identified, research version of the EMR at Vanderbilt University. Using a training dataset of the records of 899 individuals, algorithms were constructed to identify and extract detailed information regarding the clinical course of MS from the text of the medical records, including clinical subtype, presence of oligoclonal bands, year of diagnosis, year and origin of first symptom, Expanded Disability Status Scale (EDSS) scores, timed 25-foot walk scores, and MS medications. Algorithms were evaluated on a test set validated by two independent reviewers. Results We identified 5789 individuals with MS. For all clinical traits extracted, precision was at least 87% and specificity was greater than 80%. Recall values for clinical subtype, EDSS scores, and timed 25-foot walk scores were greater than 80%. Discussion and conclusion This collection of clinical data represents one of the largest databases of detailed, clinical traits available for research on MS. This work demonstrates that detailed clinical information is recorded in the EMR and can be extracted for research purposes with high reliability. PMID:24148554

Davis, Mary F; Sriram, Subramaniam; Bush, William S; Denny, Joshua C; Haines, Jonathan L

2013-01-01

276

Organizational Leader Sensemaking in Healthcare Process Changes: The Development of the Electronic Medical Records Expectation Questionnaire  

ERIC Educational Resources Information Center

Physicians play a unique role in the adoption of electronic medical records (EMR) within the healthcare organization. As leaders, they are responsible for setting the standards for this new technology within their sphere of influence while concurrently being required to learn and integrate EMR into their own workflow and process as the recipients…

Riesenmy, Kelly Rouse

2011-01-01

277

Agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases  

PubMed Central

Background The main objective of the present study was to evaluate the agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases. Methods Cross-sectional sample of 100 poisoning cases consecutively admitted to the Hospital Pulau Pinang, Malaysia during the period from September 2003 to February 2004 were studied. Data on health and socioeconomic problems were collected both by self-administered questionnaire and from medical records. Agreement between the two sets of data was assessed by calculating the concordance rate, Kappa (k) and PABAK. McNemar statistic was used to test differences between categories. Results Data collected by questionnaire and medical records showed excellent agreement on the "marital status"; good agreements on "chronic illness", "psychiatric illness", and "previous history of poisoning"; and fair agreements on "at least one health problem", and "boy-girl friends problem". PABAK values suggest better agreements' measures. Conclusion There were excellent to good agreements between questionnaire and medical records on the marital status and most of the health problems and fair to poor agreements on the majority of socioeconomic problems. The implications of those findings were discussed. PMID:19751526

Fathelrahman, Ahmed I

2009-01-01

278

Querying Radiology Appropriateness Criteria from a virtual Medical Record using GELLO  

E-print Network

Querying Radiology Appropriateness Criteria from a virtual Medical Record using GELLO Mor Peleg1 are representing radiology appropriateness criteria in GELLO and interpreting them against patient data from a v of Radiology appropriateness criteria (AC) are evidence-based guidelines to assist referring physicians

Peleg, Mor

279

Privacy protection and authentication for medical images with record-based watermarking  

Microsoft Academic Search

In this paper, we propose a practical scheme for privacy protection and authentication of medical images with the aid of EXIF metadata and associated records of the patients. By using watermarking, the goals mentioned above can be reached. Application for robust watermarking is one of the major branches in digital rights management (DRM) systems. With robust watermarking, it generally alters

Hsiang-Cheh Huang; Wai-Chi Fang; Shin-Chang Chen

2009-01-01

280

[Research on linked list algorithm for fast generation of medical record report].  

PubMed

A new algorithm to generate the medical record report based on XML and linked list is proposed in this paper. It decomposes and abstracts the content of report. Reporter can search and reuse the resources quickly, when writing or modifying the report. The experiment results prove that the algorithm reduces the reporting time and standardizes the content of report. PMID:19166196

Wu, Guohua; He, Zhenhua; Yang, Shuzhen

2008-12-01

281

Veterinary Neurobiology Learning Objects  

NSDL National Science Digital Library

Provided by the University of Minnesota College of Veterinary Medicine, this page’s learning objects are available for veterinary students and faculty to enhance their understanding of animal neurobiology. Covering canine pain pathways, nociceptor response, and vestibular nerves, each individual Macromedia Flash file is available for use on the web or for download to the user’s desktop. The objects not only use interactive learning components, but also include specific, labeled diagrams of the anatomy being studied.

2007-01-05

282

Electronic medical records for genetic research: results of the eMERGE consortium.  

PubMed

Clinical data in electronic medical records (EMRs) are a potential source of longitudinal clinical data for research. The Electronic Medical Records and Genomics Network (eMERGE) investigates whether data captured through routine clinical care using EMRs can identify disease phenotypes with sufficient positive and negative predictive values for use in genome-wide association studies (GWAS). Using data from five different sets of EMRs, we have identified five disease phenotypes with positive predictive values of 73 to 98% and negative predictive values of 98 to 100%. Most EMRs captured key information (diagnoses, medications, laboratory tests) used to define phenotypes in a structured format. We identified natural language processing as an important tool to improve case identification rates. Efforts and incentives to increase the implementation of interoperable EMRs will markedly improve the availability of clinical data for genomics research. PMID:21508311

Kho, Abel N; Pacheco, Jennifer A; Peissig, Peggy L; Rasmussen, Luke; Newton, Katherine M; Weston, Noah; Crane, Paul K; Pathak, Jyotishman; Chute, Christopher G; Bielinski, Suzette J; Kullo, Iftikhar J; Li, Rongling; Manolio, Teri A; Chisholm, Rex L; Denny, Joshua C

2011-04-20

283

Telemedicine in veterinary practice.  

PubMed

Veterinary surgeons have a long tradition of consulting one another about problem cases and many have unwittingly practised telemedicine when discussing cases by telephone or by sending laboratory reports by telefax. Specific veterinary telemedicine applications have been in use since the early 1980s, but little research has been undertaken in this field. The Pubmed and CAB International databases were searched for the following Boolean logic-linked keywords; veterinary and telemedicine, veterinary and telecare, animal and telemedicine, animal and telecare and veterinary and e-mail and an additional search was made of the worldwide web, using Google Scholar. This returned 25 papers which were reviewed. Of these only 2 report research. Sixteen papers had no references and 1 author was associated with 13 papers. Several themes emerge in the papers reviewed. These include remarks about the use of telemedicine, the benefits that can and are derived from the use of telemedicine, areas of practice in which telemedicine is being used, ethical and legal issues around the practice of telemedicine, image standards required for telemedicine, the equipment that is required for the practice of telemedicine, advice on ways in which digital images can be obtained and educational aspects of telemedicine. These are discussed. Veterinary practice has lagged behind its human counterpart in producing research on the validity and efficacy of telemedicine. This is an important field which requires further research. PMID:17120623

Mars, M; Auer, R E J

2006-06-01

284

Patients want granular privacy control over health information in electronic medical records  

PubMed Central

Objective 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. Materials and methods 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. Results 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. Discussion 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. Conclusions 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. PMID:23184192

Caine, Kelly; Hanania, Rima

2013-01-01

285

Distribution of Problems, Medications and Lab Results in Electronic Health Records: The Pareto Principle at Work  

PubMed Central

Background Many natural phenomena demonstrate power-law distributions, where very common items predominate. Problems, medications and lab results represent some of the most important data elements in medicine, but their overall distribution has not been reported. Objective Our objective is to determine whether problems, medications and lab results demonstrate a power law distribution. Methods Retrospective review of electronic medical record data for 100,000 randomly selected patients seen at least twice in 2006 and 2007 at the Brigham and Women’s Hospital in Boston and its affiliated medical practices. Results All three data types exhibited a power law distribution. The 12.5% most frequently used problems account for 80% of all patient problems, the top 11.8% of medications account for 80% of all medication orders and the top 4.5% of lab result types account for all lab results. Conclusion These three data elements exhibited power law distributions with a small number of common items representing a substantial proportion of all orders and observations, which has implications for electronic health record design. PMID:21991298

Wright, Adam; Bates, David W.

2010-01-01

286

The Development of Medical Record Items: a User-centered, Bottom-up Approach  

PubMed Central

Objectives Clinical documents (CDs) have evolved from traditional paper documents containing narrative text information into the electronic record sheets composed of itemized records, where each record is expressed as an item with a specific value. We defined medical record (MR) items to be information entities with a specific value. These entities were then used to compile form-based clinical documents as part of an electronic health record system (EHR-s). Methods We took a reusable bottom-up developmental approach for the MR items, which provided three things: efficient incorporation of the local needs and requirements of the medical professionals from various departments in the hospital, comprehensive inclusion of the essential concepts of the basic elements required in clinical documents, and the provision of a structured means for meaningful data entry and retrieval. This paper delineates our experiences in developing and managing medical records at a large tertiary university hospital in Korea. Results We collected 63,232 MR items from paper records scanned into 962 CDs. The MR item database was constructed using 13,287 MR items after removing redundant items. During the first year of service users requested changes to be made to 235 (1.8%) attributes of the MR items and also requested the additional 9,572 new MR items. In the second year, the attributes of 70 (0.5%) of the existing MR items were changed and 3,704 new items were added. The number of registered MR items increased by 72.0% in the first year and 27.9% in the second year. Conclusions The MR item concept provides an easier and more structured means of data entry within an EHR-s. By using these MR items, various kinds of clinical documents can be easily constructed and allows for medical information to be reused and retrieved as data. The success of the use of MR items in a large tertiary university hospital system provides evidence that verifies our approach as being an efficient means of user-oriented and structured data entry, enabling the easy reuse of medical records. PMID:22509469

Kim, YoungAh; Park, Hangi; Kim, Hong-Gee

2012-01-01

287

New Advanced Technologies to Provide Decentralised and Secure Access to Medical Records: Case Studies in Oncology  

PubMed Central

The main problem for health professionals and patients in accessing information is that this information is very often distributed over many medical records and locations. This problem is particularly acute in cancerology because patients may be treated for many years and undergo a variety of examinations. Recent advances in technology make it feasible to gain access to medical records anywhere and anytime, allowing the physician or the patient to gather information from an “ephemeral electronic patient record”. However, this easy access to data is accompanied by the requirement for improved security (confidentiality, traceability, integrity, ...) and this issue needs to be addressed. In this paper we propose and discuss a decentralised approach based on recent advances in information sharing and protection: Grid technologies and watermarking methodologies. The potential impact of these technologies for oncology is illustrated by the examples of two experimental cases: a cancer surveillance network and a radiotherapy treatment plan. It is expected that the proposed approach will constitute the basis of a future secure “google-like” access to medical records. PMID:19718446

Quantin, Catherine; Coatrieux, Gouenou; Allaert, Francois Andre; Fassa, Maniane; Bourquard, Karima; Boire, Jean-Yves; de Vlieger, Paul; Maigne, Lydia; Breton, Vincent

2009-01-01

288

Improving the Effectiveness of Physiology Record Books as a Learning Tool for First-Year Medical Students in India  

ERIC Educational Resources Information Center

In compliance with the Medical Council of India, preclinical medical students maintain a record of their laboratory work in physiology. The physiology record books also contain a set of questions to be answered by the students. Faculty members and students had indicated that responding to these questions did not serve the intended purpose of being…

Vyas, Rashmi; Tharion, Elizabeth; Sathishkumar, Solomon

2009-01-01

289

Affidavit for Medical Records -Investigation of Child Abuse or Neglect.doc Rev: 11-09-2009  

E-print Network

Affidavit for Medical Records - Investigation of Child Abuse or Neglect.doc Rev: 11-09-2009 AFFIDAVIT FOR MEDICAL RECORDS INVESTIGATION OF CHILD ABUSE OR NEGLECT I, , (name) a , (title) in the case and Family Services, I am investigating allegations of child abuse or neglect and, as part

Feschotte, Cedric

290

[Past, present and prospects for African veterinary ethnomedicine].  

PubMed

The author outlines the history of traditional veterinary medicine in Africa, the origin and evolution of which depend on empirical findings. Contributions of traditional medicine to the health and production of animals are illustrated by examples. This is followed by an account of the present status of traditional veterinary medicine in Africa, the ways in which it can coexist with modern medicine, its achievements and limitations. Finally the author examines the prospects for traditional veterinary medicine, with reference to conditions and constraints governing its development. He concludes by suggesting that certain steps be taken to re-evaluation of the role of traditional veterinary medicine, particularly a reconsideration of the role of traditional practitioners by Veterinary Services, and conservation of medical plants. PMID:9376646

Bâ, A S

1996-09-01

291

What information is provided in transcripts and Medical Student Performance Records from Canadian Medical Schools? A retrospective cohort study  

PubMed Central

Background Resident selection committees must rely on information provided by medical schools in order to evaluate candidates. However, this information varies between institutions, limiting its value in comparing individuals and fairly assessing their quality. This study investigates what is included in candidates’ documentation, the heterogeneity therein, as well as its objective data. Methods Samples of recent transcripts and Medical Student Performance Records were anonymised prior to evaluation. Data were then extracted by two independent reviewers blinded to the submitting university, assessing for the presence of pre-selected criteria; disagreement was resolved through consensus. The data were subsequently analysed in multiple subgroups. Results Inter-rater agreement equalled 92%. Inclusion of important criteria varied by school, ranging from 22.2% inclusion to 70.4%; the mean equalled 47.4%. The frequency of specific criteria was highly variable as well. Only 17.7% of schools provided any basis for comparison of academic performance; the majority detailed only status regarding pass or fail, without any further qualification. Conclusions Considerable heterogeneity exists in the information provided in official medical school documentation, as well as markedly little objective data. Standardization may be necessary in order to facilitate fair comparison of graduates from different institutions. Implementation of objective data may allow more effective intra- and inter-scholastic comparison. PMID:25205043

Robins, Jason A.; McInnes, Matthew D. F.; Esmail, Kaisra

2014-01-01

292

Parent Satisfaction With the Electronic Medical Record in an Academic Pediatric Rheumatology Practice  

PubMed Central

Background Patient satisfaction has not been widely studied with respect to implementation of the electronic medical record (EMR). There are few reports of the impact of the EMR in pediatrics. Objective The objective of this study was to assess the impact of implementation of an electronic medical record system on families in an academic pediatric rheumatology practice. Methods Families were surveyed 1 month pre-EMR implementation and 3 months post-EMR implementation. Results Overall, EMR was well received by families. Compared with the paper chart, parents agreed the EMR improved the quality of doctor care (55% or 59/107 vs 26% or 26/99, P < .001). More parents indicated they would prefer their pediatric physicians to use an EMR (68% or 73/107 vs 51% or 50/99, P = .01). Conclusions Transitioning an academic pediatric rheumatology practice to an EMR can increase family satisfaction with the office visit. PMID:21622292

2011-01-01

293

Development of a clinical information tool for the electronic medical record: a case study*  

PubMed Central

Question: What is the process of developing a clinical information tool to be embedded in the electronic health record of a very large and diverse academic medical center? Setting: The development took place at the University of Pittsburgh Health Sciences Library System. Method: The clinical information tool developed is a search box with subject tabs to provide quick access to designated full-text information resources. Each subject tab offers a federated search of a different pool of resources. Search results are organized “on the fly” into meaningful categories using clustering technology and are directly accessible from the results page. Results: After more than a year of discussion and planning, a clinical information tool was embedded in the academic medical center's electronic health record. Conclusion: The library successfully developed a clinical information tool, called Clinical-e, for use at the point of care. Future development will refine the tool and evaluate its impact and effectiveness. PMID:20648256

Epstein, Barbara A; Wessel, Charles B; Yarger, Frances; LaDue, John; Fiorillo, Anthony B

2010-01-01

294

Effects of Scanning and Eliminating Paper-based Medical Records on Hospital Physicians' Clinical Work Practice  

PubMed Central

Objective: It is not automatically given that the paper-based medical record can be eliminated after the introduction of an electronic medical record (EMR) in a hospital. Many keep and update the paper-based counterpart, and this limits the use of the EMR system. The authors have evaluated the physicians' clinical work practices and attitudes toward a system in a hospital that has eliminated the paper-based counterpart using scanning technology. Design: Combined open-ended interviews (8 physicians) and cross-sectional survey (70 physicians) were conducted and compared with reference data from a previous national survey (69 physicians from six hospitals). The hospitals in the reference group were using the same EMR system without the scanning module. Measurements: The questionnaire (English translation available as an online data supplement at ) covered frequency of use of the EMR system for 19 defined tasks, ease of performing them, and user satisfaction. The interviews were open-ended. Results: The physicians routinely used the system for nine of 11 tasks regarding retrieval of patient data, which the majority of the physicians found more easily performed than before. However, 22% to 25% of the physicians found retrieval of patient data more difficult, particularly among internists (33%). Overall, the physicians were equally satisfied with the part of the system handling the regular electronic data as that of the physicians in the reference group. They were, however, much less satisfied with the use of scanned document images than that of regular electronic data, using the former less frequently than the latter. Conclusion: Scanning and elimination of the paper-based medical record is feasible, but the scanned document images should be considered an intermediate stage toward fully electronic medical records. To our knowledge, this is the first assessment from a hospital in the process of completing such a scanning project. PMID:12925550

Laerum, Hallvard; Karlsen, Tom H.; Faxvaag, Arild

2003-01-01

295

Reassessing the Methods of Medical Record Review Studies in Emergency Medicine Research  

Microsoft Academic Search

abstractor,blinding to hypothesis,(4%; 95% CI 1% to 11%). Interobserver agreement,for the 12 criteria ranged,from 57% to 95%. A comparison,of these results with those of 10 years ago revealed significant improvements in 3 of the 8 original criteria assessed: data abstraction forms, mentioning interobserver performance, and testing interobserver performance. Conclusion: Medical record review studies continue,to comprise,a substantial,proportion of original

Andrew Worster; R. Daniel Bledsoe; Paul Cleve; Christopher M. Fernandes; Suneel Upadhye; Kevin Eva

2005-01-01

296

A study of general practitioners' perspectives on electronic medical records systems in NHSScotland  

PubMed Central

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

2013-01-01

297

Patients' consent preferences for research uses of information in electronic medical records: interview and survey data  

PubMed Central

Objectives To assess patients' preferred method of consent for the use of information from electronic medical records for research. Design Interviews and a structured survey of patients in practices with electronic medical records. Setting Family practices in southern Ontario, Canada. Participants 123 patients: 17 were interviewed and 106 completed a survey. Main outcome measures Patients' opinions and concerns on use of information from their medical records for research and their preferences for method of consent. Results Most interviewees were willing to allow the use of their information for research purposes, although the majority preferred that consent was sought first. The seeking of consent was considered an important element of respect for the individual. Most interviewees made little distinction between identifiable and anonymised data. Research sponsored by private insurance firms generated the greatest concern, and research sponsored by foundation the least. Sponsorship by drug companies evoked negative responses during interview and positive responses in the survey. Conclusions Patients are willing to allow information from their medical records to be used for research, but most prefer to be asked for consent either verbally or in writing. What is already known on this topicLegislation is being introduced worldwide to restrict the circumstances under which personal information may be used for secondary purposes without consentLittle empirical information exists about patients' concerns over privacy and preferences for consent for use of such information for researchWhat this study addsPatients are willing to allow personal information to be used for research purposes but want to be actively consulted firstPatients make little distinction between identifiable and non-identifiable informationMost patients prefer a time limit for their consent PMID:12586673

Willison, Donald J; Keshavjee, Karim; Nair, Kalpana; Goldsmith, Charlie; Holbrook, Anne M

2003-01-01

298

Rewriting abortion: deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal.  

PubMed

Boundary work refers to the strategies deployed by professionals in the arenas of the public, the law and the workplace to define and defend jurisdictional authority. Little attention has been directed to the role of documents in negotiating professional claims. While boundary work over induced abortion has been extensively documented, few studies have examined jurisdictional disputes over the treatment of abortion complications, or post-abortion care (PAC). This study explores how medical providers deploy medical records in boundary work over the treatment of complications of spontaneous and induced abortion in Senegal, where induced abortion is prohibited under any circumstance. Findings are based on an institutional ethnography of Senegal's national PAC program over a period of 13 months between 2010 and 2011. Data collection methods included in-depth interviews with 36 health care professionals, observation of PAC services at three hospitals, a review of abortion records at each hospital, and a case review of illegal abortions prosecuted by the state. Findings show that health providers produce a particular account of the type of abortion treated through a series of practices such as the patient interview and the clinical exam. Providers obscure induced abortion in medical documents in three ways: the use of terminology that does not differentiate between induced and spontaneous abortion in PAC registers, the omission of data on the type of abortion altogether in PAC registers, and reporting the total number but not the type of abortions treated in hospital data transmitted to state health authorities. The obscuration of suspected induced abortion in the record permits providers to circumvent police inquiry at the hospital. PAC has been implemented in approximately 50 countries worldwide. This study demonstrates the need for additional research on how medical professionals negotiate conflicting medical and legal obligations in the daily practice of treating abortion complications. PMID:24608117

Suh, Siri

2014-05-01

299

The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future  

PubMed Central

The Electronic Medical Records and Genomics Network is a National Human Genome Research Institute–funded consortium engaged in the development of methods and best practices for using the electronic medical record as a tool for genomic research. Now in its sixth year and second funding cycle, and comprising nine research groups and a coordinating center, the network has played a major role in validating the concept that clinical data derived from electronic medical records can be used successfully for genomic research. Current work is advancing knowledge in multiple disciplines at the intersection of genomics and health-care informatics, particularly for electronic phenotyping, genome-wide association studies, genomic medicine implementation, and the ethical and regulatory issues associated with genomics research and returning results to study participants. Here, we describe the evolution, accomplishments, opportunities, and challenges of the network from its inception as a five-group consortium focused on genotype–phenotype associations for genomic discovery to its current form as a nine-group consortium pivoting toward the implementation of genomic medicine. Genet Med 15 10, 761–771. PMID:23743551

Gottesman, Omri; Kuivaniemi, Helena; Tromp, Gerard; Faucett, W. Andrew; Li, Rongling; Manolio, Teri A.; Sanderson, Saskia C.; Kannry, Joseph; Zinberg, Randi; Basford, Melissa A.; Brilliant, Murray; Carey, David J.; Chisholm, Rex L.; Chute, Christopher G.; Connolly, John J.; Crosslin, David; Denny, Joshua C.; Gallego, Carlos J.; Haines, Jonathan L.; Hakonarson, Hakon; Harley, John; Jarvik, Gail P.; Kohane, Isaac; Kullo, Iftikhar J.; Larson, Eric B.; McCarty, Catherine; Ritchie, Marylyn D.; Roden, Dan M.; Smith, Maureen E.; Bottinger, Erwin P.; Williams, Marc S.

2013-01-01

300

The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future.  

PubMed

The Electronic Medical Records and Genomics Network is a National Human Genome Research Institute-funded consortium engaged in the development of methods and best practices for using the electronic medical record as a tool for genomic research. Now in its sixth year and second funding cycle, and comprising nine research groups and a coordinating center, the network has played a major role in validating the concept that clinical data derived from electronic medical records can be used successfully for genomic research. Current work is advancing knowledge in multiple disciplines at the intersection of genomics and health-care informatics, particularly for electronic phenotyping, genome-wide association studies, genomic medicine implementation, and the ethical and regulatory issues associated with genomics research and returning results to study participants. Here, we describe the evolution, accomplishments, opportunities, and challenges of the network from its inception as a five-group consortium focused on genotype-phenotype associations for genomic discovery to its current form as a nine-group consortium pivoting toward the implementation of genomic medicine. PMID:23743551

Gottesman, Omri; Kuivaniemi, Helena; Tromp, Gerard; Faucett, W Andrew; Li, Rongling; Manolio, Teri A; Sanderson, Saskia C; Kannry, Joseph; Zinberg, Randi; Basford, Melissa A; Brilliant, Murray; Carey, David J; Chisholm, Rex L; Chute, Christopher G; Connolly, John J; Crosslin, David; Denny, Joshua C; Gallego, Carlos J; Haines, Jonathan L; Hakonarson, Hakon; Harley, John; Jarvik, Gail P; Kohane, Isaac; Kullo, Iftikhar J; Larson, Eric B; McCarty, Catherine; Ritchie, Marylyn D; Roden, Dan M; Smith, Maureen E; Böttinger, Erwin P; Williams, Marc S

2013-10-01

301

Avaliação da qualidade dos registros de enfermagem no prontuário por meio da auditoria Evaluation of the quality of nursing documentation though the review of patient medical records  

Microsoft Academic Search

Objective: To evaluate the quality of nursing documentation on medical records of patients from a university hospital in São Paulo, Brazil. Methods: A retrospective descriptive study was used to conduct the study. Four hundred and twenty four medical records of patients from medical and surgical units were reviewed from November 2006 to January 2007. The medical records were from patients

Vanessa Grespan Setz; Maria D'Innocenzo

2009-01-01

302

Does the Medical Record Cover the Symptoms Experienced by Cancer Patients Receiving Palliative Care? A Comparison of the Record and Patient Self-Rating  

Microsoft Academic Search

The aim of this study was to investigate the extent to which the symptoms experienced by advanced cancer patients were covered by the medical records. Fifty-eight patients participated in the study. On the day of first encounter with our palliative care department, a medical history was taken, and on this or the following day, the patients completed the EORTC Quality

Annette S Strömgren; Mogens Groenvold; Lise Pedersen; Alf K Olsen; Marianne Spile; Per Sjøgren

2001-01-01

303

A pragmatic method for electronic medical record-based observational studies: developing an electronic medical records retrieval system for clinical research  

PubMed Central

Objective The use of electronic medical record (EMR) data is necessary to improve clinical research efficiency. However, it is not easy to identify patients who meet research eligibility criteria and collect the necessary information from EMRs because the data collection process must integrate various techniques, including the development of a data warehouse and translation of eligibility criteria into computable criteria. This research aimed to demonstrate an electronic medical records retrieval system (ERS) and an example of a hospital-based cohort study that identified both patients and exposure with an ERS. We also evaluated the feasibility and usefulness of the method. Design The system was developed and evaluated. Participants In total, 800?000 cases of clinical information stored in EMRs at our hospital were used. Primary and secondary outcome measures The feasibility and usefulness of the ERS, the method to convert text from eligible criteria to computable criteria, and a confirmation method to increase research data accuracy. Results To comprehensively and efficiently collect information from patients participating in clinical research, we developed an ERS. To create the ERS database, we designed a multidimensional data model optimised for patient identification. We also devised practical methods to translate narrative eligibility criteria into computable parameters. We applied the system to an actual hospital-based cohort study performed at our hospital and converted the test results into computable criteria. Based on this information, we identified eligible patients and extracted data necessary for confirmation by our investigators and for statistical analyses with our ERS. Conclusions We propose a pragmatic methodology to identify patients from EMRs who meet clinical research eligibility criteria. Our ERS allowed for the efficient collection of information on the eligibility of a given patient, reduced the labour required from the investigators and improved the reliability of the results. PMID:23117567

Yamamoto, Keiichi; Sumi, Eriko; Yamazaki, Toru; Asai, Keita; Yamori, Masashi; Teramukai, Satoshi; Bessho, Kazuhisa; Yokode, Masayuki; Fukushima, Masanori

2012-01-01

304

Estimating the information gap between emergency department records of community medication compared to on-line access to the community-based pharmacy records  

PubMed Central

Objective Errors in community medication histories increase the risk of adverse events. The objectives of this study were to estimate the extent to which access to community-based pharmacy records provided more information about prescription drug use than conventional medication histories. Materials and methods A prospective cohort of patients with public drug insurance who visited the emergency departments (ED) in two teaching hospitals in Montreal, Quebec was recruited. Drug lists recorded in the patients’ ED charts were compared with pharmacy records of dispensed medications retrieved from the public drug insurer. Patient and drug-related predictors of discrepancies were estimated using general estimating equation multivariate logistic regression. Results 613 patients participated in the study (mean age 63.1?years, 59.2% women). Pharmacy records identified 41.5% more prescribed medications than were noted in the ED chart. Concordance was highest for anticoagulants, cardiovascular drugs and diuretics. Omissions in the ED chart were more common for drugs that may be taken episodically. Patients with more than 12 medications (OR 2.92, 95% CI 1.71 to 4.97) and more than one pharmacy (OR 3.85, 95% CI 1.80 to 6.59) were more likely to have omissions in the ED chart. Discussion The development of health information exchanges could improve the efficiency and accuracy of information about community medication histories if they enable automated access to dispensed medication records from community pharmacies, particularly for the most vulnerable populations with multiple morbidities. Conclusions Pharmacy records identified a substantial number of medications that were not in the ED chart. There is potential for greater safety and efficiency with automated access to pharmacy records. PMID:23956015

Tamblyn, Robyn; Poissant, Lise; Huang, Allen; Winslade, Nancy; Rochefort, Christian M; Moraga, Teresa; Doran, Pamela

2014-01-01

305

Veterinary Medicine (BVMS): Induction 2014  

E-print Network

Veterinary Medicine (BVMS): Induction 2014 Monday 15 September 2014 Health Screening 0930 onwards 2014 Welcome to the School of Veterinary Medicine Head of School, Professor Ewan Cameron Introduction � Part 1 Tour of the School of Veterinary Medicine Moodle/Mahara Induction/Task Assignment 0930 Mc

Glasgow, University of

306

Cross-Sectional Comparison of Electronic and Paper Medical Records on Medication Counseling in Primary Care Clinics: A Southern Primary-care Urban Research Network (SPUR-Net) Study  

Microsoft Academic Search

Introduction: This study compared the frequency of oral counseling and written information by primary care physicians at paper medical record (PMR) clinics and electronic medical record (EMR) clinics, and assessed relationships between medication counseling and medication outcomes (knowledge, questions, reported adherence and side effects, and medication fill). Methods: A cross-sectional study with two convenience samples of English-speaking adult patients receiving

Grace M. Kuo; Patricia Dolan Mullen; Amy McQueen; Paul R. Swank; John C. Rogers

2007-01-01

307

Evaluation of usage of virtual microscopy for the study of histology in the medical, dental, and veterinary undergraduate programs of a UK University.  

PubMed

This article describes the introduction of a virtual microscope (VM) that has allowed preclinical histology teaching to be fashioned to better suit the needs of approximately 900 undergraduate students per year studying medicine, dentistry, or veterinary science at the University of Bristol, United Kingdom. Features of the VM implementation include: (1) the facility for students and teachers to make annotations on the digital slides; (2) in-house development of VM-based quizzes that are used for both formative and summative assessments; (3) archiving of teaching materials generated each year, enabling students to access their personalized learning resources throughout their programs; and (4) retention of light microscopy capability alongside the VM. Student feedback on the VM is particularly positive about its ease of use, the value of the annotation tool, the quizzes, and the accessibility of all components off-campus. Analysis of login data indicates considerable, although variable, use of the VM by students outside timetabled teaching. The median number of annual logins per student account for every course exceeded the number of timetabled histology classes for that course (1.6–3.5 times). The total number of annual student logins across all cohorts increased from approximately 9,000 in the year 2007–2008 to 22,000 in the year 2010–2011. The implementation of the VM has improved teaching and learning in practical classes within the histology laboratory and facilitated consolidation and revision of material outside the laboratory. Discussion is provided of some novel strategies that capitalize on the benefits of introducing a VM, as well as strategies adopted to overcome some potential challenges. PMID:25317448

Gatumu, Margaret K; MacMillan, Frances M; Langton, Philip D; Headley, P Max; Harris, Judy R

2014-01-01

308

FDA regulation of invasive neural recording electrodes: a daunting task for medical innovators.  

PubMed

The U.S. Food and Drug Administration (FDA) is charged with assuring the safety and effectiveness of medical devices. Before any medical device can be brought to market, it must comply with all federal regulations regarding FDA processes for clearance or approval. Navigating the FDA regulatory process may seem like a daunting task to the innovator of a novel medical device who has little experience with the FDA regulatory process or device commercialization. This review introduces the basics of the FDA regulatory premarket process, with a focus on issues relating to chronically implanted recording devices in the central or peripheral nervous system. Topics of device classification and regulatory pathways, the use of standards and guidance documents, and optimal time lines for interaction with the FDA are discussed. Additionally, this article summarizes the regulatory research on neural implant safety and reliability conducted by the FDA's Office of Science and Engineering Laboratories (OSEL) in collaboration with Defense Advanced Research Projects Agency (DARPA) Reliable Neural Technology (RE-NET) Program. For a more detailed explanation of the medical device regulatory process, please refer to several excellent reviews of the FDA's regulatory pathways for medical devices [1]-[4]. PMID:22481744

Welle, Cristin; Krauthamer, Victor

2012-03-01

309

Engineering Veterinary Education.  

ERIC Educational Resources Information Center

Calls for a new model for veterinary education, drawn from engineering education, which imparts a strong core of fundamental biomedical knowledge and multi-species clinical experience to all students than allows a genuine opportunity for differentiation into strongly focused subject areas that provide in-depth education and training appropriate to…

Eyre, Peter

2002-01-01

310

Economic Value of Veterinary  

E-print Network

Economic Value of Veterinary Diagnostics Public Investment in Animal Health Testing Yields Economic Diagnostic Laboratory (TVMDL) works to protect animal and human health through diagnostic testing of samples of animals and products. In 2007, TVMDL performed 708,300 tests in support of $65.4 million in interstate

311

Automatic Prediction of Rheumatoid Arthritis Disease Activity from the Electronic Medical Records  

PubMed Central

Objective We aimed to mine the data in the Electronic Medical Record to automatically discover patients' Rheumatoid Arthritis disease activity at discrete rheumatology clinic visits. We cast the problem as a document classification task where the feature space includes concepts from the clinical narrative and lab values as stored in the Electronic Medical Record. Materials and Methods The Training Set consisted of 2792 clinical notes and associated lab values. Test Set 1 included 1749 clinical notes and associated lab values. Test Set 2 included 344 clinical notes for which there were no associated lab values. The Apache clinical Text Analysis and Knowledge Extraction System was used to analyze the text and transform it into informative features to be combined with relevant lab values. Results Experiments over a range of machine learning algorithms and features were conducted. The best performing combination was linear kernel Support Vector Machines with Unified Medical Language System Concept Unique Identifier features with feature selection and lab values. The Area Under the Receiver Operating Characteristic Curve (AUC) is 0.831 (??=?0.0317), statistically significant as compared to two baselines (AUC?=?0.758, ??=?0.0291). Algorithms demonstrated superior performance on cases clinically defined as extreme categories of disease activity (Remission and High) compared to those defined as intermediate categories (Moderate and Low) and included laboratory data on inflammatory markers. Conclusion Automatic Rheumatoid Arthritis disease activity discovery from Electronic Medical Record data is a learnable task approximating human performance. As a result, this approach might have several research applications, such as the identification of patients for genome-wide pharmacogenetic studies that require large sample sizes with precise definitions of disease activity and response to therapies. PMID:23976944

Lin, Chen; Karlson, Elizabeth W.; Canhao, Helena; Miller, Timothy A.; Dligach, Dmitriy; Chen, Pei Jun; Perez, Raul Natanael Guzman; Shen, Yuanyan; Weinblatt, Michael E.; Shadick, Nancy A.; Plenge, Robert M.; Savova, Guergana K.

2013-01-01

312

Use of and attitudes to a hospital information system by medical secretaries, nurses and physicians deprived of the paper-based medical record: a case report  

PubMed Central

Background Most hospitals keep and update their paper-based medical records after introducing an electronic medical record or a hospital information system (HIS). This case report describes a HIS in a hospital where the paper-based medical records are scanned and eliminated. To evaluate the HIS comprehensively, the perspectives of medical secretaries and nurses are described as well as that of physicians. Methods We have used questionnaires and interviews to assess and compare frequency of use of the HIS for essential tasks, task performance and user satisfaction among medical secretaries, nurses and physicians. Results The medical secretaries use the HIS much more than the nurses and the physicians, and they consider that the electronic HIS greatly has simplified their work. The work of nurses and physicians has also become simplified, but they find less satisfaction with the system, particularly with the use of scanned document images. Conclusions Although the basis for reference is limited, the results support the assertion that replacing the paper-based medical record primarily benefits the medical secretaries, and to a lesser degree the nurses and the physicians. The varying results in the different employee groups emphasize the need for a multidisciplinary approach when evaluating a HIS. PMID:15488150

Laerum, Hallvard; Karlsen, Tom H; Faxvaag, Arild

2004-01-01

313

Application of an optical memory card as a portable medical record  

NASA Astrophysics Data System (ADS)

The optical memory card manufactured and marketed by Drexier Technology Corporation under the LaserCard«trademark, is a credit card-sized optical data storage device presently configured to hold up to 4.11 Mbytes of WORM (Write Once Read Many) data. The availability of a portable storage medium with this data capacity has stirred the interest of applications developers in such diverse fields as security access/ID, database publishing and distribution, vehicle maintenance logs and consumer electronic coupons. The application of the LaserCard as a portable, personal medical record is currently the most fully developed and as such is being evaluated in numerous field trials worldwide. Before describing some of these field trials, it is worthwhile to discuss several contributing factors that have made these field trials possible. These factors include, 1) evolution of a manufacturing facility of high-quality LaserCards, 2) availability of production-level read/write drives from several sources, 3) emergence of standards for optical memory cards and read/write drives, and 4) perceived value of a portable medical record in the medical care field.

Bouldin, Eric W.; Haddock, Richard M.

1990-08-01

314

The VA Hypertension Primary Care Longitudinal Cohort: Electronic medical records in the post-genomic era  

PubMed Central

The Veterans Affairs Hypertension Primary Care Longitudinal Cohort (VAHC) was initiated in 2003 as a pilot study designed to link the VA electronic medical record system with individual genetic data. Between June 2003 and December 2004, 1,527 hypertensive participants were recruited. Protected health information (PHI) was extracted from the regional VA data warehouse. Differences between the clinic and mail recruits suggested that clinic recruitment resulted in an over-sampling of African Americans. A review of medical records in a random sample of study participants confirmed that the data warehouse accurately captured most selected diagnoses. Genomic DNA was acquired non-invasively from buccal cells in mouthwash; ~ 96.5 per cent of samples contained DNA suitable for genotyping, with an average DNA yield of 5.02 ± 0.12 micrograms, enough for several thousand genotypes. The coupling of detailed medical databases with genetic information has the potential to facilitate the genetic study of hypertension and other complex diseases. PMID:21216807

Salem, Rany M.; Pandey, Braj; Richard, Erin; Fung, Maple M.; Garcia, Erin P.; Brophy, Victoria H.; Schork, Nicholas J.; O'Connor, Daniel T.; Bhatnagar, Vibha

2011-01-01

315

Veterinary students' attitudes on One Health: implications for curriculum development at veterinary colleges.  

PubMed

One Health knowledge has been identified by the North American Veterinary Medical Education Consortium (NAVMEC) as a core competency for all graduating veterinarians. Many veterinary colleges, however, are still in the preliminary stages of exploring how best to incorporate One Health principles into their existing curricula. In February 2012, we conducted a survey among second to fourth-year Professional Veterinary Medicine (PVM) students at the Colorado State University College of Veterinary Medicine and Biomedical Sciences to assess One Health needs and attitudes. Out of 407 students, 93 (22.9%) completed the survey. Although 74.2% of respondents were very or somewhat familiar with the One Health Initiative, only 34.4% reported some level of involvement with One Health-related activities. Over 80% of respondents rated the One Health Initiative as very important for public health, wildlife health, and food-animal medicine or surgery; less than 30% rated the One Health Initiative as very important for equine medicine or surgery and small-animal medicine or surgery. The majority of respondents were very interested in educational activities involving inter-disciplinary interactions with both human and ecosystem health professionals. Our findings can help guide the development and implementation of One Health-focused curricula at veterinary colleges. PMID:23475413

Wong, David; Kogan, Lori R

2013-01-01

316

Detecting earlier indicators of homelessness in the free text of medical records.  

PubMed

Early warning indicators to identify US Veterans at risk of homelessness are currently only inferred from administrative data. References to indicators of risk or instances of homelessness in the free text of medical notes written by Department of Veterans Affairs (VA) providers may precede formal identification of Veterans as being homeless. This represents a potentially untapped resource for early identification. Using natural language processing (NLP), we investigated the idea that concepts related to homelessness written in the free text of the medical record precede the identification of homelessness by administrative data. We found that homeless Veterans were much higher utilizers of VA resources producing approximately 12 times as many documents as non-homeless Veterans. NLP detected mentions of either direct or indirect evidence of homelessness in a significant portion of Veterans earlier than structured data. PMID:25000039

Redd, Andrew; Carter, Marjorie; Divita, Guy; Shen, Shuying; Palmer, Miland; Samore, Matthew; Gundlapalli, Adi V

2014-01-01

317

Rapid deployment of electronic medical records for ARV rollout in rural Rwanda.  

PubMed

While most people with AIDS do not yet have access to anti-retroviral drugs (ARVs), large ARV treatment programs are being rolled out in many areas in Sub-Saharan Africa. ARV programs have substantial data management needs, which electronic medical record systems (EMRs) are helping to address. While most sophisticated EMRs in low-income regions are in large cities, where infrastructure and staffing needs are more easily met, Partners In Health (PIH) has pioneered web-based EMRs for HIV and TB treatment in rural areas. The HIV-EMR, developed in Haiti [1], was de-ployed in two Rwandan health districts starting in Au-gust 2005. The addition of new features and adaptation to local needs is happening concurrently with the rapid scale-up and evolution of the medical program itself. PMID:17238460

Allen, Christian; Manyika, Patrick; Jazayeri, Darius; Rich, Michael; Lesh, Neal; Fraser, Hamish

2006-01-01

318

Health care professionals' pain narratives in hospitalized children's medical records. Part 1: Pain descriptors  

PubMed Central

BACKGROUND: Although documentation of children’s pain by health care professionals is frequently undertaken, few studies have explored the nature of the language used to describe pain in the medical records of hospitalized children. OBJECTIVES: To describe health care professionals’ use of written language related to the quality and quantity of pain experienced by hospitalized children. METHODS: Free-text pain narratives documented during a 24 h period were collected from the medical records of 3822 children (0 to 18 years of age) hospitalized on 32 inpatient units in eight Canadian pediatric hospitals. A qualitative descriptive exploration using a content analysis approach was used. RESULTS: Pain narratives were documented a total of 5390 times in 1518 of the 3822 children’s medical records (40%). Overall, word choices represented objective and subjective descriptors. Two major categories were identified, with their respective subcategories of word indicators and associated cues: indicators of pain, including behavioural (eg, vocal, motor, facial and activities cues), affective and physiological cues, and children’s descriptors; and word qualifiers, including intensity, comparator and temporal qualifiers. CONCLUSIONS: The richness and complexity of vocabulary used by clinicians to document children’s pain lend support to the concept that the word ‘pain’ is a label that represents a myriad of different experiences. There is potential to refine pediatric pain assessment measures to be inclusive of other cues used to identify children’s pain. The results enhance the discussion concerning the development of standardized nomenclature. Further research is warranted to determine whether there is congruence in interpretation across time, place and individuals. PMID:24093122

Rashotte, Judy; Coburn, Geraldine; Harrison, Denise; Stevens, Bonnie J; Yamada, Janet; Abbott, Laura K

2013-01-01

319

The Colorado State University Veterinary Diagnostic Laboratory (CSUVDL) seeks to fill a Laboratory Technician position at the Western Slope Branch Laboratory in Grand Junction, Colorado. This is an entry level  

E-print Network

of an animal disease outbreak. Additionally, the CSUVDL contributes to the of the College of Veterinary identification, investigation, prevention and through education of professional veterinary medical, graduate. Effective English oral and written communication skills. Willingness to pursue Medical Technology

Collett Jr., Jeffrey L.

320

Discovering medical conditions associated with periodontitis using linked electronic health records  

PubMed Central

Aim To use linked electronic medical and dental records to discover associations between periodontitis and medical conditions independent of a priori hypotheses. Materials and Methods This case-control study included 2475 patients who underwent dental treatment at the College of Dental Medicine at Columbia University and medical treatment at NewYork-Presbyterian Hospital. Our cases are patients who received periodontal treatment and our controls are patients who received dental maintenance but no periodontal treatment. Chi-square analysis was performed for medical treatment codes and logistic regression was used to adjust for confounders. Results Our method replicated several important periodontitis associations in a largely Hispanic population, including diabetes mellitus type I (OR = 1.6, 95% CI 1.30–1.99, p < 0.001) and type II (OR = 1.4, 95% CI 1.22–1.67, p < 0.001), hypertension (OR = 1.2, 95% CI 1.10–1.37, p < 0.001), hypercholesterolaemia (OR = 1.2, 95% CI 1.07–1.38, p = 0.004), hyperlipidaemia (OR = 1.2, 95% CI 1.06–1.43, p = 0.008) and conditions pertaining to pregnancy and childbirth (OR = 2.9, 95% CI: 1.32–7.21, p = 0.014). We also found a previously unreported association with benign prostatic hyperplasia (OR = 1.5, 95% CI 1.05–2.10, p = 0.026) after adjusting for age, gender, ethnicity, hypertension, diabetes, obesity, lipid and circulatory system conditions, alcohol and tobacco abuse. Conclusions This study contributes a high-throughput method for associating periodontitis with systemic diseases using linked electronic records. PMID:23495669

Boland, Mary Regina; Hripcsak, George; Albers, David J.; Wei, Ying; Wilcox, Adam B.; Wei, Jin; Li, Jianhua; Lin, Steven; Breene, Michael; Myers, Ronnie; Zimmerman, John; Papapanou, Panos N.; Weng, Chunhua

2013-01-01

321

Texas A&M Veterinary Medical Diagnostic Laboratory Procedures 21.01.08.V0.03 Vehicle Use Reports: Automobiles/Trucks  

E-print Network

the use of the State of Texas Vehicle Use Report. Guidelines for the use, and retention of this report guidance to units on the completion and retention of Vehicle Use Reports and maintenance records.1 Maintain a State of Texas Vehicle Use Report in the vehicle at all times. 1.2 Obtain State of Texas Vehicle

322

Integrating animal welfare into veterinary teaching.  

PubMed

The third edition of the World Society for the Protection of Animals' (WSPA's) Concepts in Animal Welfare teaching tool was released recently. The tool is intended to help with the teaching of animal welfare science. Shortly after the launch, Ruth De Vere, head of education at WSPA, spoke to Veterinary Record about the tool and the efforts the charity is making to promote welfare. Georgina Mills reports. PMID:24272563

Mills, Georgina

2013-11-23

323

Beyond information retrieval and electronic health record use: competencies in clinical informatics for medical education  

PubMed Central

Physicians in the 21st century will increasingly interact in diverse ways with information systems, requiring competence in many aspects of clinical informatics. In recent years, many medical school curricula have added content in information retrieval (search) and basic use of the electronic health record. However, this omits the growing number of other ways that physicians are interacting with information that includes activities such as clinical decision support, quality measurement and improvement, personal health records, telemedicine, and personalized medicine. We describe a process whereby six faculty members representing different perspectives came together to define competencies in clinical informatics for a curriculum transformation process occurring at Oregon Health & Science University. From the broad competencies, we also developed specific learning objectives and milestones, an implementation schedule, and mapping to general competency domains. We present our work to encourage debate and refinement as well as facilitate evaluation in this area. PMID:25057246

Hersh, William R; Gorman, Paul N; Biagioli, Frances E; Mohan, Vishnu; Gold, Jeffrey A; Mejicano, George C

2014-01-01

324

Development of a character, line and point display system. [for medical records  

NASA Technical Reports Server (NTRS)

A compact graphics terminal for use as the input to a computerized medical records system is described. The principal mode of communication between the terminal and the records system is by checklists and menu selection. However, the terminal accepts short, handwritten messages as well as conventional alphanumeric input. The terminal consists of an electronic tablet, a display, a microcomputer controller, a character generator, and a refresh memory for the display. An Intel SBC 80/10 microcomputer controls the flow of information and a 16 kilobyte memory stores the point-by-point array of information to be displayed. A specially designed interface continuously generates the raster display without the intervention of the microcomputer.

Owen, E. W.

1977-01-01

325

Three Years Experience with the Implementation of a Networked Electronic Medical Record in Haiti  

PubMed Central

Since 2005 we have been developing and implementing an electronic medical record (EMR) that supports both individual and population health care of HIV-infected patients in Haiti. Unreliable electrical power and network infrastructure, cultural differences, variable levels of experience and computer literacy, and the geographic dispersion of the team remain challenges, but the system is now implemented in about 40 sites nationwide providing antiretroviral therapy, and includes records for about 18,600 patients. The need to support countrywide monitoring and evaluation drove early architectural decisions to support linking systems under conditions of network uncertainty. We have found surprising end user acceptance of the system, with the adoption of interactive EMR usage exceeding our expectations and timeline. PMID:18999283

Lober, William B.; Quiles, Christina; Wagner, Steve; Cassagnol, Rachelle; Lamothes, Roges; Alexis, Don Rock Pierre; Joseph, Patrice; Sutton, Perri; Puttkammer, Nancy; Kitahata, Mari M.

2008-01-01

326

Randomized trial showed requesting medical records with a survey produced a more representative sample than requesting separately  

Microsoft Academic Search

ObjectivesThe objective of the study was to compare the effect of two approaches to requesting medical records on survey response rates, sample representativeness, and the quality of self-reported screening.

Melissa R. Partin; Diana J. Burgess; Krysten Halek; Joseph Grill; Sally W. Vernon; Deborah A. Fisher; Joan M. Griffin; Maureen Murdoch

2008-01-01

327

What they fill in today, may not be useful tomorrow: Lessons learned from studying Medical Records at the Women hospital in Tabriz, Iran  

PubMed Central

Background The medical record is used to document patient's medical history, illnesses and treatment procedures. The information inside is useful when all needed information is documented properly. Medical care providers in Iran have complained of low quality of Medical Records. This study was designed to evaluate the quality of the Medical Records at the university hospital in Tabriz, Iran. Methods In order to get a background of the quality of documentation, 300 Medical Records were randomly selected among all hospitalized patient during September 23, 2003 and September 22, 2004. Documentation of all records was evaluated using checklists. Then, in order to combine objective data with subjective, 10 physicians and 10 nurses who were involved in documentation of Medical Records were randomly selected and interviewed using two semi structured guidelines. Results Almost all 300 Medical Records had problems in terms of quality of documentation. There was no record in which all information was documented correctly and compatible with the official format in Medical Records provided by Ministry of Health and Medical Education. Interviewees believed that poor handwriting, missing of sheets and imperfect documentation are major problems of the Paper-based Medical Records, and the main reason was believed to be high workload of both physicians and nurses. Conclusion The Medical Records are expected to be complete and accurate. Our study has unveiled that the Medical Records are not documented properly in the university hospital where the Medical Records are also used for educational purposes. Such incomplete Medical Records are not reliable resources for medical care too. Some influencing factors external to the structure of the Medical Records (i.e. human factors and work conditions) are involved. PMID:18439311

Pourasghar, Faramarz; Malekafzali, Hossein; Kazemi, Alireza; Ellenius, Johan; Fors, Uno

2008-01-01

328

Veterinary Anatomy Instruction  

NSDL National Science Digital Library

With one of the most well regarded veterinary schools in the United States, the University of Minnesota continues to break new ground in the training of new veterinarians on a regular basis. Of course, more and more of these training materials are finding their way to the web, and this site will be quite helpful to those persons with an interest in this particular field. Created by different faculty members, the materials here are categorized by the course they are most commonly associated with, such as gross anatomy or neurobiology. In the gross anatomy section, visitors will find materials that include a glossary of terms related to veterinary anatomy and dissections, animations that illustrate the major gaits of various quadrupeds, and the nervous system pathways of canines. The neurobiology section contains instructional materials that include information about brain dissection neuroanatomy and neurohistology.

2006-10-30

329

A practical approach to achieve private medical record linkage in light of public resources  

PubMed Central

Objective Integration of patients' records across resources enhances analytics. To address privacy concerns, emerging strategies such as Bloom filter encodings (BFEs), enable integration while obscuring identifiers. However, recent investigations demonstrate BFEs are, in theory, vulnerable to cryptanalysis when encoded identifiers are randomly selected from a public resource. This study investigates the extent to which cryptanalysis conditions hold for (1) real patient records and (2) a countermeasure that obscures the frequencies of the identifying values in encoded datasets. Design First, to investigate the strength of cryptanalysis for real patient records, we build BFEs from identifiers in an electronic medical record system and apply cryptanalysis using identifiers in a publicly available voter registry. Second, to investigate the countermeasure under ideal cryptanalysis conditions, we compose BFEs from the identifiers that are randomly selected from a public voter registry. Measurement We utilize precision (ie, rate of correct re-identified encodings) and computation efficiency (ie, time to complete cryptanalysis) to assess the performance of cryptanalysis in BFEs before and after application of the countermeasure. Results Cryptanalysis can achieve high precision when the encoded identifiers are composed of a random sample of a public resource (ie, a voter registry). However, we also find that the attack is less efficient and may not be practical for more realistic scenarios. By contrast, the proposed countermeasure made cryptanalysis impractical in terms of precision and efficiency. Conclusions Performance of cryptanalysis against BFEs based on patient data is significantly lower than theoretical estimates. The proposed countermeasure makes BFEs resistant to known practical attacks. PMID:22847304

Kuzu, Mehmet; Kantarcioglu, Murat; Durham, Elizabeth Ashley; Toth, Csaba

2013-01-01

330

The eMERGE Network: A consortium of biorepositories linked to electronic medical records data for conducting genomic studies  

Microsoft Academic Search

INTRODUCTION: The eMERGE (electronic MEdical Records and GEnomics) Network is an NHGRI-supported consortium of five institutions to explore the utility of DNA repositories coupled to Electronic Medical Record (EMR) systems for advancing discovery in genome science. eMERGE also includes a special emphasis on the ethical, legal and social issues related to these endeavors. ORGANIZATION: The five sites are supported by

Catherine A McCarty; Rex L Chisholm; Christopher G Chute; Iftikhar J Kullo; Gail P Jarvik; Eric B Larson; Rongling Li; Daniel R Masys; Marylyn D Ritchie; Dan M Roden; Jeffery P Struewing; Wendy A Wolf

2011-01-01

331

Patients' Rights to Access their Medical Records: An Argument for Uniform Recognition of a Right of Access in the United States and Australia  

Microsoft Academic Search

This Note addresses the issue of a patient's right to access her own medical records in the United States and Australia. Part I discusses the background of a right of patient access to medical records through case law in the United States. Part I gives a historical perspective on US and Australian legislation regarding access to medical records. Part II

Hayley Rosenman

1997-01-01

332

Novel open-source electronic medical records system for palliative care in low-resource settings  

PubMed Central

Background The need for palliative care in sub-Saharan Africa is staggering: this region shoulders over 67% of the global burden of HIV/AIDS and cancer. However, provisions for these essential services remain limited and poorly integrated with national health systems in most nations. Moreover, the evidence base for palliative care in the region remains scarce. This study chronicles the development and evaluation of DataPall, an open-source electronic medical records system that can be used to track patients, manage data, and generate reports for palliative care providers in these settings. DataPall was developed using design criteria encompassing both functional and technical objectives articulated by hospital leaders and palliative care staff at a leading palliative care center in Malawi. The database can be used with computers that run Windows XP SP 2 or newer, and does not require an internet connection for use. Subsequent to its development and implementation in two hospitals, DataPall was tested among both trained and untrained hospital staff populations on the basis of its usability with comparison to existing paper records systems as well as on the speed at which users could perform basic database functions. Additionally, all participants evaluated this program on a standard system usability scale. Results In a study of health professionals in a Malawian hospital, DataPall enabled palliative care providers to find patients’ appointments, on average, in less than half the time required to locate the same record in current paper records. Moreover, participants generated customizable reports documenting patient records and comprehensive reports on providers’ activities with little training necessary. Participants affirmed this ease of use on the system usability scale. Conclusions DataPall is a simple, effective electronic medical records system that can assist in developing an evidence base of clinical data for palliative care in low resource settings. The system is available at no cost, is specifically designed to chronicle care in the region, and is catered to meet the technical needs and user specifications of such facilities. PMID:23941694

2013-01-01

333

[Study on medical records of acupuncture-moxibustion in The Twenty-four Histories].  

PubMed

Through the combination of manual retrieval and computerized retrieval, medical records of acupuncture-moxibustion in The Twenty-Four Histories were collected. Acupuncture cases from the Spring and Autumn Period (770-476 B.C.) to the end of the Ming Dynasty (1368-1644)were retrieved. From the medical records of acupuncture-moxibustion in Chinese official history books, it can be found that systematic diseases or emergent and severe diseases were already treated by physicians with the combination of acupuncture and medicine as early as in the Spring and Autumn Period as well as the Warring States Period(475-221 B.C.). CANG Gong, a famous physician of the Western Han Dynasty (206 B. C.-A. D. 24), cured diseases by selecting points along the running courses of meridians where the illness inhabited, which indicates that the theory of meridians and collaterals was served as a guide for clinical practice as early as in the Western Han Dynasty. Blood letting therapy, which has surprising effect, was often adopted by physicians of various historical periods to treat diseases. And treatment of diseases with single point was approved to be easy and effective. PMID:22471150

Huang, Kai-Wen

2012-03-01

334

Health care professionals' pain narratives in hospitalized children's medical records. Part 2: Structure and content  

PubMed Central

BACKGROUND: Although clinical narratives – described as free-text notations – have been noted to be a source of patient information, no studies have examined the composition of pain narratives in hospitalized children’s medical records. OBJECTIVES: To describe the structure and content of health care professionals’ narratives related to hospitalized children’s acute pain. METHODS: All pain narratives documented during a 24 h period were collected from the medical records of 3822 children (0 to 18 years of age) hospitalized in 32 inpatient units in eight Canadian pediatric hospitals. A qualitative descriptive exploration using a content analysis approach was performed. RESULTS: Three major structural elements with their respective categories and subcategories were identified: information sources, including clinician, patient, parent, dual and unknown; compositional archetypes, including baseline pain status, intermittent pain updates, single events, pain summation and pain management plan; and content, including pain declaration, pain assessment, pain intervention and multidimensional elements of care. CONCLUSIONS: The present qualitative analysis revealed the multidimensionality of structure and content that was used to document hospitalized children’s acute pain. The findings have the potential to inform debate on whether the multidimensionality of pain narratives’ composition is a desirable feature of documentation and how narratives can be refined and improved. There is potential for further investigation into how health care professionals’ pain narratives could have a role in generating guidelines for best pain documentation practice beyond numerical representations of pain intensity. PMID:24093123

Rashotte, Judy; Harrison, Denise; Coburn, Geraldine; Yamada, Janet; Stevens, Bonnie J

2013-01-01

335

Managing the quality of health information using electronic medical records: an exploratory study among clinical physicians.  

PubMed

As technology is advancing in the healthcare field, ways of reducing costs and improving quality are key initiatives in the tedious processes of operations planning. There are several ways of reducing costs and improving quality management. One such way is the implementation of Electronic Health Records (HERs). A personally interviewed sample from a relatively large healthcare facility located in Pittsburgh, Pennsylvania, which is associated with the University of Pittsburgh Medical Center, netted a total of 44 physicians. There were no statistically significant relationships found based on 'clinicians' willingness to accept Electronic Medical Record (EMR)-embedded systems with gender', 'benefits outweigh risks for EMR-embedded implementation', 'EMR-embedded systems should be mandated', 'EMR-embedded systems should be administered by the federal government', 'EMR-embedded systems should be administered by regional systems', 'EMR applications are an invasion of privacy' and 'IT-related technologies pose an added threat to the healthcare environment'. It was only for the independent variable 'improves quality of care by EMR-embedded implementation' that most physicians felt that such a technology does positively impact patient care. PMID:19174363

Smith, Alan D

2008-01-01

336

Experience in implementing the OpenMRS medical record system to support HIV treatment in Rwanda.  

PubMed

The challenge of scaling up HIV treatment in Africa has led to a new emphasis on improving health systems in impoverished areas. One aspect of this is the development and deployment of electronic medical record systems to support HIV and TB treatment. In this paper we describe the design and implementation of a new medical record architecture to support an HIV treatment program in rural Rwanda. The architecture is called OpenMRS and it has been developed to address the problem of configuring EMR systems to suit new sites, languages and diseases. OpenMRS uses a data dictionary called the concept dictionary to represent all the possible data items that can be collected. This allows new items to be added to the system by non-programmers. In addition, there are form creation tools that use drag and drop web technologies to simplify form construction. The OpenMRS system was first implemented in Kenya in February 2006 and then in Rwanda in August 2006. The system is now functioning well and we are developing extensions to improve the support for the clinic. These include improved, easy to use reporting tools, support for additional clinical problems including nutrition and child health, better database synchronization tools, and modules to collect laboratory data and support the pharmacy. The system is also in use in South Africa and Lesotho and is being deployed in Tanzania and Uganda. PMID:17911744

Allen, Christian; Jazayeri, Darius; Miranda, Justin; Biondich, Paul G; Mamlin, Burke W; Wolfe, Ben A; Seebregts, Chris; Lesh, Neal; Tierney, William M; Fraser, Hamish S F

2007-01-01

337

76 FR 80878 - Solicitation of Veterinary Shortage Situation Nominations for the Veterinary Medicine Loan...  

Federal Register 2010, 2011, 2012, 2013

...Nominations for the Veterinary Medicine Loan Repayment Program (VMLRP...situations for the Veterinary Medicine Loan Repayment Program (VMLRP...studies published in 2007 in the Journal of the American Veterinary...the Food Supply Veterinary Medicine Coalition...

2011-12-27

338

Interview with Lawrence Weed, MD-- The Father of the Problem-Oriented Medical Record Looks Ahead  

PubMed Central

I first met Lawrence Weed, MD, in 1972 when I was a third-year medical student at the University of Vermont. To this day I remember his passion for a disciplined approach to medical record documentation to optimize the care provided to each individual patient. Now, 35 years later, I was privileged to meet with Dr Weed at his home in Vermont. We discussed when he first was alerted to the nonscientific approach clinicians use to make decisions on patients. The rest of the interview time was spent with Dr Weed teaching me about the solution that he has spent the last 30 years designing and implementing. This interview is published to complement the editorial in the most recent issue of The Permanente Journal (Spring 2009;13[2]:85-7). We believe that in the era of health care reform and quality improvement initiatives, it is important that the medical community take a close look at Dr Weed's total approach decision-making information support defined in this interview. — Lee Jacobs, MD PMID:20740095

Jacobs, Lee

2009-01-01

339

OZIS and the politics of safety: using ICT to create a regionally accessible patient medication record.  

PubMed

In studies on success and failure of ICT applications in health care, the 'context' is often used to explain the failure of a system and seldom to explain the success of a system. Science and Technology Studies (STS) have showed that for understanding success and failure of phenomena, one has to take a symmetrical approach and thus use the same concept for analyzing success and failure. In this article we analyze the success of OZIS, a communication protocol that makes it possible for pharmacists to exchange medication data by sharing a regionally accessible electronic medication record. Though OZIS serves a common goal - reducing medication errors - the stakeholders that are involved also have other, competing, interests. By focussing on the context and more specifically the interests of the stakeholders, we will show how the success of OZIS can be explained. By doing this, we will also show that this context is highly dynamic and that continuously changing incentives and constraints within the context lead to both facilitating and threatening the success of OZIS. PMID:16824793

Stoop, Arjen P; Bal, Roland; Berg, Marc

2007-06-01

340

An electronic medical record-linked biorepository to identify novel biomarkers for atherosclerotic cardiovascular disease  

PubMed Central

Background: Atherosclerotic vascular disease (AVD), a leading cause of morbidity and mortality, is increasing in prevalence in the developing world. We describe an approach to establish a biorepository linked to medical records with the eventual goal of facilitating discovery of biomarkers for AVD. Methods: The Vascular Disease Biorepository at Mayo Clinic was established to archive DNA, plasma, and serum from patients with suspected AVD. AVD phenotypes, relevant risk factors and comorbid conditions were ascertained by electronic medical record (EMR)-based electronic algorithms that included diagnosis and procedure codes, laboratory data and text searches to ascertain medication use. Results: Up to December 2012, 8800 patients referred for vascular ultrasound examination and non-invasive lower extremity arterial evaluation were approached, of whom 5268 consented. The mean age of the initial 2182 patients recruited was 70.4 ± 11.2 years, 62.6% were men and 97.6% were whites. The prevalences of AVD phenotypes were: carotid artery stenosis 48%, abdominal aortic aneurysm 21% and peripheral arterial disease 38%. Positive predictive values for electronic phenotyping algorithms were>0.90 for cases (and>0.95 for controls) for each AVD phenotype, using manual review of the EMR as the gold standard. The prevalences of risk factors and comorbidities were as follows: hypertension 78%, diabetes 29%, dyslipidemia 73%, smoking 70%, coronary heart disease 37%, heart failure 12%, cerebrovascular disease 20% and chronic kidney disease 19%. Conclusions: Our study demonstrates the feasibility of establishing a biorepository of plasma, serum and DNA, with relatively rapid annotation of clinical variables using EMR-based algorithms. PMID:24689004

Ye, Zi; Kalloo, Fara S; Dalenberg, Angela K.; Kullo, Iftikhar J

2013-01-01

341

The integration of medical images with the electronic patient record and their web-based distribution 1  

Microsoft Academic Search

Medical images are currently created digitally and stored in the radiology department’s picture archiving and communication system. Reports are usually stored in the electronic patient record of other information systems, such as the radiology information system (RIS) and the hospital information system (HIS). But high-quality services can only be provided if electronic patient record data is integrated with digital images

H. Münch; U. Engelmann; A. Schröter; H. P. Meinzer

2004-01-01

342

Job dynamics of veterinary professionals in an academic research institution. I. Retention and turnover of veterinary technicians.  

PubMed

The turnover of veterinary technicians within an animal resources program averaged 33% annually over 18 y, peaking at 67% in 1998 to 1999. Insufficient retention of veterinary technicians led to diversion of veterinarian effort to technical tasks and to increased allocation of administrative resources for supervising and managing an expanding team of veterinary technicians. To identify factors and trends related to poor retention, address any causes, and reduce turnover, a retrospective analysis of employment records was done. The retention of veterinary technicians was significantly greater for the 9 technicians hired from veterinary private practice rather than for any of 3 other general sources: promotions from the animal care staff, transfers from other research institutions, and miscellaneous sources. Veterinary technician turnover was reduced from a mean of 60% over 1995 to 1999 to an average of 26% during 2000 to 2004. Higher retention was associated with management practices that included renewed concentration on recruiting and interviewing strategies and emphasis on training and career development including merit raises for technician certification through the American Association for Laboratory Animal Science. Higher retention yielded correspondingly greater experience on the job as the mean tenure increased from 1.1 y in 2000 to 2.8 y in 2004. The most valued attributes related to employment by veterinary technicians as determined by survey were to do meaningful work, earn a good living, and have a committed team of coworkers. PMID:16995642

Huerkamp, Michael J

2006-09-01

343

History of the Rochester Epidemiology Project: Half a Century of Medical Records Linkage in a US Population  

PubMed Central

The Rochester Epidemiology Project (REP) has maintained a comprehensive medical records linkage system for nearly half a century for almost all persons residing in Olmsted County, Minnesota. Herein, we provide a brief history of the REP before and after 1966, the year in which the REP was officially established. The key protagonists before 1966 were Henry Plummer, Mabel Root, and Joseph Berkson, who developed a medical records linkage system at Mayo Clinic. In 1966, Leonard Kurland established collaborative agreements with other local health care providers (hospitals, physician groups, and clinics [primarily Olmsted Medical Center]) to develop a medical records linkage system that covered the entire population of Olmsted County, and he obtained funding from the National Institutes of Health to support the new system. In 1997, L. Joseph Melton III addressed emerging concerns about the confidentiality of medical record information by introducing a broad patient research authorization as per Minnesota state law. We describe how the key protagonists of the REP have responded to challenges posed by evolving medical knowledge, information technology, and public expectation and policy. In addition, we provide a general description of the system; discuss issues of data quality, reliability, and validity; describe the research team structure; provide information about funding; and compare the REP with other medical information systems. The REP can serve as a model for the development of similar research infrastructures in the United States and worldwide. PMID:23199802

Rocca, Walter A.; Yawn, Barbara P.; St. Sauver, Jennifer L.; Grossardt, Brandon R.; Melton, L. Joseph

2012-01-01

344

Veterinary Medicine 2 | Veterinary Medicine University of Saskatchewan  

E-print Network

of species including food-producing animals, horses, companion animals, exotic pets and wildlife. Veterinary? Veterinary medicine focuses on animal health and the study of diseases that affect all animal species their interests in animals, science and health. Besides providing primary and specialized health care to a wide

Saskatchewan, University of

345

The Internet, the electronic medical record, the pediatric intensive care unit, and everything.  

PubMed

This article details how computers have changed life for those of us in pediatric intensive care. A week of clinical activity is described, with a focus on the interactions with computer systems that have become an integral part of patient-care activities for many of us. It becomes clear that the boundaries between personal computers, hospital systems, and the Internet are often not sharply defined. Resources that are used every week may include those residing on a personal digital assistant, on the hospital's electronic medical record, or on a distant site on the World Wide Web. Key resources on the Internet (World Wide Web and e-mail) are identified. The technical underpinnings, particularly the network that provides the infrastructure for various resources, are described. PMID:11496039

Weigle, C G; Markovitz, B P; Pon, S

2001-08-01

346

A clinical rule editor in an electronic medical record setting: development, design, and implementation.  

PubMed

Clinical decision support (CDS) implemented as part of an electronic medical record (EMR) has a well-documented history of improving patient safety and quality of care; however, the difficulties of keeping CDS up to date have also been documented. At Partners HealthCare, we initially implemented CDS reminders in our 'homegrown' EMR system as 'hardcoded' rules. The challenges of updating existing rules and implementing new rules in the hard-coded state, however, soon made this model unsustainable. After evaluating our needs and requirements for rule creation and maintenance, we designed and created a browser-based rule editor that would decrease turnaround time for logic changes, allowing us to respond to CDS requests more efficiently. We have been able to maintain the older reminder rules with the rule editor, and have added a number of new reminders. Our work to date has confirmed the strengths of the editor, but has also identified a few limitations. PMID:20351913

Regier, Rachel; Gurjar, Rupali; Rocha, Roberto A

2009-01-01

347

Robust Replication of Genotype-Phenotype Associations across Multiple Diseases in an Electronic Medical Record  

PubMed Central

Large-scale DNA databanks linked to electronic medical record (EMR) systems have been proposed as an approach for rapidly generating large, diverse cohorts for discovery and replication of genotype-phenotype associations. However, the extent to which such resources are capable of delivering on this promise is unknown. We studied whether an EMR-linked DNA biorepository can be used to detect known genotype-phenotype associations for five diseases. Twenty-one SNPs previously implicated as common variants predisposing to atrial fibrillation, Crohn disease, multiple sclerosis, rheumatoid arthritis, or type 2 diabetes were successfully genotyped in 9483 samples accrued over 4 mo into BioVU, the Vanderbilt University Medical Center DNA biobank. Previously reported odds ratios (ORPR) ranged from 1.14 to 2.36. For each phenotype, natural language processing techniques and billing-code queries were used to identify cases (n = 70–698) and controls (n = 808–3818) from deidentified health records. Each of the 21 tests of association yielded point estimates in the expected direction. Previous genotype-phenotype associations were replicated (p < 0.05) in 8/14 cases when the ORPR was > 1.25, and in 0/7 with lower ORPR. Statistically significant associations were detected in all analyses that were adequately powered. In each of the five diseases studied, at least one previously reported association was replicated. These data demonstrate that phenotypes representing clinical diagnoses can be extracted from EMR systems, and they support the use of DNA resources coupled to EMR systems as tools for rapid generation of large data sets required for replication of associations found in research cohorts and for discovery in genome science. PMID:20362271

Ritchie, Marylyn D.; Denny, Joshua C.; Crawford, Dana C.; Ramirez, Andrea H.; Weiner, Justin B.; Pulley, Jill M.; Basford, Melissa A.; Brown-Gentry, Kristin; Balser, Jeffrey R.; Masys, Daniel R.; Haines, Jonathan L.; Roden, Dan M.

2010-01-01

348

Validation of psoriatic arthritis diagnoses in electronic medical records using natural language processing  

PubMed Central

Objectives To test whether data extracted from full text patient visit notes from an electronic medical record (EMR) would improve the classification of PsA compared to an algorithm based on codified data. Methods From the > 1,350,000 adults in a large academic EMR, all 2318 patients with a billing code for PsA were extracted and 550 were randomly selected for chart review and algorithm training. Using codified data and phrases extracted from narrative data using natural language processing, 31 predictors were extracted and three random forest algorithms trained using coded, narrative, and combined predictors. The receiver operator curve (ROC) was used to identify the optimal algorithm and a cut point was chosen to achieve the maximum sensitivity possible at a 90% positive predictive value (PPV). The algorithm was then used to classify the remaining 1768 charts and finally validated in a random sample of 300 cases predicted to have PsA. Results The PPV of a single PsA code was 57% (95%CI 55%–58%). Using a combination of coded data and NLP the random forest algorithm reached a PPV of 90% (95%CI 86%–93%) at sensitivity of 87% (95% CI 83% – 91%) in the training data. The PPV was 93% (95%CI 89%–96%) in the validation set. Adding NLP predictors to codified data increased the area under the ROC (p < 0.001). Conclusions Using NLP with text notes from electronic medical records improved the performance of the prediction algorithm significantly. Random forests were a useful tool to accurately classify psoriatic arthritis cases to enable epidemiological research. PMID:20701955

Cai, Tianxi; Karlson, Elizabeth W.

2013-01-01

349

Veterinary Technology College of Veterinary Medicine  

E-print Network

) VCS 22100 Vet Nursing Techniques for Normal Animal (SA & LA) ______ (1) VM 24100 Safety, Prevention ______ (0.5) VCS 22200 Dentistry ______ (1) VCS 22300 Surgical Nursing/OR Protocols ______ (0.5) VM 25100 Medical Math & Terminology ______ (2) VCS 22400 Small Animal Nursing I ______ (2) VCS 22500 Large Animal

Ginzel, Matthew

350

Validation of a Bovine Rectal Palpation Simulator for Training Veterinary Students  

E-print Network

issues currently restrict the amount of training available to students in this procedure. Here we present if simulators are to become widely adopted in medical and veterinary training. Without it, the benefitsValidation of a Bovine Rectal Palpation Simulator for Training Veterinary Students Sarah BAILLIE 1

Williamson, John

351

Pet Insurance Veterinary Pet Insurance  

E-print Network

29 Pet Insurance Veterinary Pet Insurance® Veterinary Pet Insurance® is the nation's oldest, largest and number one veterinarian-recommended pet health insurance provider. With comprehensive plans designed to protect you financially when the unexpected occurs, affordable coverage from VPI® Pet Insurance

Pilyugin, Sergei S.

352

Use of Web-based Shared Medical Records among Patients with HIV  

PubMed Central

Background Patient websites with secure access to shared electronic medical records (SMR) may support care of patients with HIV, particularly during heightened need. However, groups disproportionately affected by HIV may be less likely to use them. Objective & Design We performed an observational cohort study to compare use of seven SMR features by adult patients with HIV. Automated data from the 36 months following SMR implementation were assessed in two integrated delivery systems. Participants, Main Measures, Key Results Most (3888/7398) patients used the SMR at least once. Users were most likely to view medical test results (49%), use secure messaging (43%), or request appointments (31%) or medication refills (30%). Initial use was associated with a new prescription for antiretroviral therapy [rate ratio (RR) 1.65, p <0.001], a recent change to CD4+ count <200 cells/?L (RR 1.34, p <0.02), a new HIV RNA ?75 copies/mL (RR 1.63, p <0.001), or a recent increase in non-HIV comorbidity score (RR 1.49, p = 0.0001). In age-, sex-, and comorbidity-adjusted analyses, users were less likely to be women (RR 0.49, p=0.0001), injection drug users (RR 0.59, p = 0.0001), or from lower-socioeconomic neighborhoods (RR 0.68, p = 0.0001). Compared with nonusers, users were less likely to be Black (RR 0.38, p = 0.0001), Hispanic (RR 0.52, p = 0.0001) or Asian/Pacific Islander (RR 0.59, p = 0.001). Conclusions SMR use was higher among those with HIV who had indicators of recent increases in health care need and lower among several vulnerable populations. Health care providers and systems should support SMR use among patients with HIV as part of broader efforts to improve overall access to care. PMID:23725449

Ralston, James D.; Silverberg, Michael J.; Grothaus, Louis; Leyden, Wendy A.; Ross, Tyler; Stewart, Christine; Carzasty, Steven; Horberg, Michael; Catz, Sheryl L.

2014-01-01

353

From Osler to Olafson. The evolution of veterinary pathology in North America.  

PubMed Central

Most branches of biological science in North America developed first in the United States, and later were taught and practiced in Canada. An exception was veterinary pathology, which as a discipline taught in veterinary colleges and as a field of research, developed first in Canada, and from there crossed the border to the United States. Pathology was first taught at the Montreal Veterinary College, founded in 1866 by Duncan McEachran, a graduate of the Edinburgh Veterinary College. From the outset, he formed a close association with the medical faculty of McGill University, permitting his students to attend the same classes in the basic subjects with the medical students. Eventually, the Montreal Veterinary College became formally affiliated with McGill University, as the Faculty of Comparative Medicine and Veterinary Science. The McGill veterinary faculty was forced to close for economic reasons in 1903, but it left an enduring legacy, particularly in the field of veterinary pathology. The legacy, a novel concept in the 1870's, was that pathology was the cornerstone of a veterinary education; the place where anatomy, physiology, chemistry and botany met with the clinical subjects, and gave the latter meaning. This tradition was formed at the Montreal Veterinary College by the world renowned physician William Osler, North America's leading medical teacher, whom McEachran had invited to teach at the College in 1876 in addition to his duties in the faculty of medicine. Osler had studied with Virchow in Berlin and applied his methods of autopsy technique and of scientific inquiry to his teaching of both human and veterinary pathology at McGill. Osler also undertook investigations into various diseases of domestic animals, at the request of McEachran, who doubled as Chief Veterinary Inspector for the Dominion Department of Agriculture. Osler left McGill University in 1884. Only after that year did other North American veterinary schools adopt pathology as a discipline of instruction. However, by 1884, Osler had already left his indelible imprint on the students (both medical and veterinary) he had taught in Montreal, one of whom took over the teaching of pathology in the veterinary college. Another, who followed Osler's example and also studied in Berlin with Virchow, wrote the first book in the English language on veterinary post mortem technique in 1889.(ABSTRACT TRUNCATED AT 400 WORDS) Images Fig. 1. Fig. 2. Fig. 4. Fig. 6. Fig. 8. Fig. 9. Fig. 10. Fig. 11. Fig. 12. Fig. 13. Fig. 14. Fig. 15. PMID:3552167

Saunders, L Z

1987-01-01

354

Combining Information from Cancer Registry and Medical Records Data to Improve Analyses of Adjuvant Cancer Therapies  

PubMed Central

SUMMARY Cancer registry records contain valuable data on provision of adjuvant therapies for cancer patients. Previous studies, however, have shown that these therapies are underreported in registry systems. Hence direct use of the registry data may lead to invalid analysis results. We propose first to impute correct treatment status, borrowing information from an additional source such as medical records data collected in a validation sample, and then to analyze the multiply imputed data, as in Yucel and Zaslavsky (2005). We extend their models to multiple therapies using multivariate probit models with random effects. Our model takes into account the associations among different therapies in both administration and probability of reporting, as well as the multilevel structure (patients clustered within hospitals) of registry data. We use Gibbs sampling to estimate model parameters and impute treatment status. The proposed methodology is applied to the data from the Quality of Cancer Care project, in which stage II or III colorectal cancer patients were eligible to receive adjuvant chemotherapy and radiation therapy. PMID:19210743

2009-01-01

355

Discovering knowledge on pediatric fluid therapy and dysnatremias from quantitative data found in electronic medical records.  

PubMed

It is accepted that intravenous fluid (IVF) therapy can result in hospital-acquired dysnatremias in pediatric patients, with associated morbidity and mortality. There is interest in improving IVF therapy to prevent dysnatremias, but the optimal approach is controversial. In this study, we develop Natremia Deviation and Intravenous Renderer (NaDIR), a tool that preprocesses large volumes of electronic medical record data obtained from an academic pediatric hospital in order to analyze (1) IVF therapy, (2) the epidemiology of dysnatremias, and (3) the impact of IVFs on changes in serum sodium (?S(Na)). We then applied NaDIR to 3,256 inpatient records over a 3 month period, which revealed (1) a 19.9% incidence of dysnatremias, (2) a significant increase in lengths of stay associated with dysnatremias, and (3) a novel linear relationship between ?S(Na) and IVF tonicity. This demonstrates that EMR data that can be readily analyzed to discover epidemiologic and predictive knowledge. PMID:21347059

Pham, Steve L; Bickel, Jonathan P; Moritz, Michael L; Levin, James E

2010-01-01

356

Statement on access to relevant medical and other health records and relevant legal records for forensic medical evaluations of alleged torture and other cruel, inhuman or degrading treatment or punishment.  

PubMed

In some jurisdictions attempts have been made to limit or deny access to medical records for victims of torture seeking remedy or reparations or for individuals who have been accused of crimes based on confessions allegedly extracted under torture. The following article describes the importance of full disclosure of all medical and other health records, as well as legal documents, in any case in which an individual alleges that they have been subjected to torture or other forms of cruel, inhuman or degrading treatment of punishment. A broad definition of what must be included in the terms medical and health records is put forward, and an overview of why their full disclosure is an integral part of international standards for the investigation and documentation of torture (the Istanbul Protocol). The fact that medical records may reveal the complicity or direct participation of healthcare professionals in acts of torture and other ill-treatment is discussed. A summary of international law and medical ethics surrounding the right of access to personal information, especially health information in connection with allegations of torture is also given. PMID:23472795

Alempijevic, D; Beriashvili, R; Beynon, J; Duque, M; Duterte, P; Fernando, R; Fincanci, S; Hansen, S; Hardi, L; Hougen, H; Iacopino, V; Mendonça, M; Modvig, J; Mendez, M; Özkalipci, Ö; Payne-James, J; Peel, M; Rasmussen, O; Reyes, H; Rogde, S; Sajantila, A; Treue, F; Vanezis, P; Vieira, D

2013-04-01

357

An Exploration of Heterogeneity in Electronic Medical Record Use: Information Technology Use as Emergent and Driven by Values and Expertise  

Microsoft Academic Search

We explore heterogeneity in the use of an organization-wide information technology (IT) by both individuals and groups in a professional organization. We study electronic medical record use by physicians and clinic work groups in two medical practices operating within one multi-specialty health care clinic. Data collection methods include interviews, non-participant observations, and questionnaires. Drawing on theories of professional organizations and

Holly Jordan Lanham; McDaniel Jr. Reuben R

2008-01-01

358

Improving the effectiveness of physiology record books as a learning tool for first-year medical students in India  

NSDL National Science Digital Library

In compliance with the Medical Council of India, preclinical medical students maintain a record of their laboratory work in physiology. The physiology record books also contain a set of questions to be answered by the students. Faculty members and students had indicated that responding to these questions did not serve the intended purpose of being an effective learning tool. The purpose of this study was to obtain the views of the medical students and faculty members at our institution concerning the usefulness of responding to the questions and to gather suggestions for possible improvement. Data were collected through focus groups and questionnaires to first-year medical students and faculty members in physiology and were analyzed using qualitative and quantitative methods. The students and faculty members viewed the physiology record books as a potentially useful learning aid, but lack of time led the students to write the answers without understanding the topic rather than generating their own responses to the questions. Faculty members and students recommended that the students should write the responses to the questions on site during the practical classes, using relevant on-site resources and interacting with faculty members. The findings of the present study may be of value to other medical colleges in India and outside India with modifications based on their specific needs to improve the effectiveness of physiology record books as a learning tool.

Rashmi Vyas (Christian Medical College Physiology); Elizabeth Tharion (Christian Medical College x); Solomon Sathishkumar (Christian Medical College)

2009-12-01

359

Occupational per-patient radiation dose from a conservative protocol for veterinary (18) F-fluorodeoxyglucose positron emission tomography.  

PubMed

The occupational external radiation dose to human medical personnel from positron emission tomography (PET) radiopharmaceuticals has been documented, but to date no corresponding veterinary staff dose data are available. Electronic personal dosimeters (EPDs) were used in this study to measure the per-patient external radiation doses to veterinary staff using a PET/CT (PET combined with computed tomography) protocol in which the patient radiopharmaceutical dose was injected after anesthetic induction. Radiation doses were recorded for the nuclear medicine technologists, the on-duty anesthesiology technologist, and an occasional observer from 19 veterinary (18) F-fluorodeoxyglucose PET/CT studies. Patient mass range was 2.8 to 61.0 kg (22.3 kg mean) and injected activity averaged 6 MBq kg(-1) . The dose range received by nuclear medicine technologists per procedure was 0-30 ?Sv (9.1 ?Sv mean), by anesthetists 1-22 ?Sv (8.2 ?Sv mean), and by the observer 0-2 ?Sv (0.5 ?Sv mean). In both feline and canine studies, placement of the EPD on staff was a significant predictor of radiation dose. Additional significant predictors of staff radiation dose from canine studies included job position and injected activity. The per-patient occupational radiation doses to veterinary PET/CT technologists were slightly greater than those reported for human nuclear medicine PET/CT technologists, but were comparable to estimated radiation doses for nurses caring for nonambulatory human PET/CT patients. Efforts toward maintaining staff radiation doses as low as reasonably achievable (ALARA) will be important as veterinary PET/CT caseload increases. PMID:22703227

Martinez, Nicole E; Kraft, Susan L; Gibbons, Debra S; Arceneaux, Billie K; Stewart, Jeffrey A; Mama, Khursheed R; Johnson, Thomas E

2012-01-01

360

UNIVERSITY OF CALIFORNIA, SANTA CRUZ STUDENT HEALTH CENTER MEDICAL RECORDS 1156 HIGH STREET, SANTA CRUZ, CA 95064 TEL: (831) 459-3063 FAX: (831) 459-3546  

E-print Network

UNIVERSITY OF CALIFORNIA, SANTA CRUZ STUDENT HEALTH CENTER MEDICAL RECORDS 1156 HIGH STREET, SANTA: ___________________________________________________________________ Purpose: Personal Records Continuity of care Billing/Insurance iPledge Other specify;UNIVERSITY OF CALIFORNIA, SANTA CRUZ STUDENT HEALTH CENTER MEDICAL RECORDS 1156 HIGH STREET, SANTA CRUZ, CA

California at Santa Cruz, University of

361

[Local communalization of clinical records between the municipal community hospital and local medical institutes by using information technology].  

PubMed

We introduced the electronic health record system in 2002. We produced a community medical network system to consolidate all medical treatment information from the local institute in 2010. Here, we report on the present status of this system that has been in use for the previous 2 years. We obtained a private server, set up a virtual private network(VPN)in our hospital, and installed dedicated terminals to issue an electronic certificate in 50 local institutions. The local institute applies for patient agreement in the community hospital(hospital designation style). They are then entitled to access the information of the designated patient via this local network server for one year. They can access each original medical record, sorted on the basis of the medical attendant and the chief physician; a summary of hospital stay; records of medication prescription; and the results of clinical examinations. Currently, there are approximately 80 new registrations and accesses per month. Information is provided in real time allowing up to date information, helping prescribe the medical treatment at the local institute. However, this information sharing system is read-only, and there is no cooperative clinical pass system. Therefore, this system has a limit to meet the demand for cooperation with the local clinics. PMID:23268886

Iijima, Shohei; Shinoki, Keiji; Ibata, Takeshi; Nakashita, Chisako; Doi, Seiko; Hidaka, Kumi; Hata, Akiko; Matsuoka, Mio; Waguchi, Hideko; Mito, Saori; Komuro, Ryutaro

2012-12-01

362

Confidentiality of the medical records of HIV-positive patients in the United Kingdom - a medicolegal and ethical perspective  

PubMed Central

This article examines the legal and ethical issues that surround the confidentiality of medical records, particularly in relation to patients who are HIV positive. It records some historical background of the HIV epidemic, and considers the relative risks of transmission of HIV from individual to individual. It explains the law as it pertains to confidentiality, and reports the professional guidance in these matters. It then considers how these relate to HIV-positive individuals in particular. PMID:22312224

Williams, Mike

2011-01-01

363

Expanding an electronic medical record to support community health worker and nutritional support programs in rural Rwanda.  

PubMed

Scaling up HIV and TB treatment rapidly in a resource poor setting is greatly facilitated when community health workers can monitor patient well-being and ensure that patients adhere to medication. In addition, it is almost essential that patients receive a food package while being treated for HIV and TB, since medication can be ineffective if patient is undernourished. However,a community health worker program and food program can add significant administrative overhead,particularly if reporting or evaluation is required. By expanding an Electronic Medical Record to cover these programs in addition to treatment programs, it becomes easier to administer them and combine interesting data from different sources. PMID:18693962

Allen, Christian; Manyika, Patrick; Ufitamahoro, Emmanuel; Musabende, Ancille; Rich, Michael; Jazayeri, Darius; Fraser, Hamish

2007-01-01

364

Improving the power of genetic association tests with imperfect phenotype derived from electronic medical records.  

PubMed

To reduce costs and improve clinical relevance of genetic studies, there has been increasing interest in performing such studies in hospital-based cohorts by linking phenotypes extracted from electronic medical records (EMRs) to genotypes assessed in routinely collected medical samples. A fundamental difficulty in implementing such studies is extracting accurate information about disease outcomes and important clinical covariates from large numbers of EMRs. Recently, numerous algorithms have been developed to infer phenotypes by combining information from multiple structured and unstructured variables extracted from EMRs. Although these algorithms are quite accurate, they typically do not provide perfect classification due to the difficulty in inferring meaning from the text. Some algorithms can produce for each patient a probability that the patient is a disease case. This probability can be thresholded to define case-control status, and this estimated case-control status has been used to replicate known genetic associations in EMR-based studies. However, using the estimated disease status in place of true disease status results in outcome misclassification, which can diminish test power and bias odds ratio estimates. We propose to instead directly model the algorithm-derived probability of being a case. We demonstrate how our approach improves test power and effect estimation in simulation studies, and we describe its performance in a study of rheumatoid arthritis. Our work provides an easily implemented solution to a major practical challenge that arises in the use of EMR data, which can facilitate the use of EMR infrastructure for more powerful, cost-effective, and diverse genetic studies. PMID:25062868

Sinnott, Jennifer A; Dai, Wei; Liao, Katherine P; Shaw, Stanley Y; Ananthakrishnan, Ashwin N; Gainer, Vivian S; Karlson, Elizabeth W; Churchill, Susanne; Szolovits, Peter; Murphy, Shawn; Kohane, Isaac; Plenge, Robert; Cai, Tianxi

2014-11-01

365

Cost Effectiveness of an Electronic Medical Record Based Clinical Decision Support System  

PubMed Central

Objective Medical groups have invested billions of dollars in Electronic Medical Records (EMRs), but few studies have examined the cost-effectiveness of EMR-based clinical decision support (CDS). This study examined the cost-effectiveness of EMR-based CDS for adults with diabetes from the perspective of the health care system. Data Sources/Setting Clinical outcome and cost data from a randomized clinical trial of EMR-based CDS were used as inputs into a diabetes simulation model. The simulation cohort included 1,092 patients with diabetes with A1c above goal at baseline. Study Design The UKPDS Outcomes Model, a validated simulation model of diabetes, was used to evaluate remaining life years, quality adjusted life years (QALYs), and health care costs over patient lifetimes (40-year time horizon) from the health system perspective. Principal Findings Patients in the intervention group had significantly lowered A1c (.26%, p=.014) relative to patients in the control arm. Intervention costs were $120 (SE=45) per patient in the first year and $76 (SE=45) per patient in the following years. In the base case analysis, EMR-based CDS increased lifetime QALYs by 0.04 (SE=.01) and increased lifetime costs by $112 (SE=660), resulting in an incremental cost effectiveness ratio of $3,017 per QALY. The cost-effectiveness of EMR-based CDS persisted in one-way, two way, and probabilistic sensitivity analyses. Conclusions Widespread adoption of sophisticated EMR-based CDS has the potential to modestly improve the quality of care for patients with chronic conditions without substantially increasing costs to the health care system. PMID:22578085

O'Connor, Patrick J.; Sperl-Hillen, JoAnn M.; Rush, William A.; Johnson, Paul E.; Amundson, Gerald H.; Asche, Stephen E.; Ekstrom, Heidi L.

2012-01-01

366

Use of an electronic medical record to create the marshfield clinic twin/multiple birth cohort.  

PubMed

Population-based genetic analyses, such as the Genome-Wide Association Study (GWAS), have proven powerful for describing the genetic complexities of common disease in epidemiologic research. However, the significant challenges faced by population-based study designs have resulted in revitalization of family-based approaches, including twin studies. Twin studies are unique in their ability to ascertain both heritable and environmental contributions to human disease. Several regional and national twin registries have been constructed using a variety of methods to identify potential twins. A significant challenge in constructing these large twin registries includes the substantial resources required to recruit participants, collect phenotypic data, and update the registries as time progresses. Here we describe the use of the Marshfield Clinic electronic medical record (EMR) to identify a cohort of 19,226 patients enriched for twins or multiples. This cohort defines the Marshfield Clinic Twin/Multiple Birth Cohort (MCTC). An EMR system provides both a mechanism to identify potential twins and a source of detailed phenotypic data in near real time without the need for patient contact outside standard medical care. To demonstrate that the MCTC can be used for genetic-based epidemiologic research, concordance rates for muscular dystrophy (MD) and fragile-X syndrome-two highly heritable diseases-were assessed. Observations indicate that both MD and fragile-X syndrome are highly correlated among affected twins in the MCTC (P ? 3.7 × 10(-6) and 1.1 × 10(-4) , respectively). These findings suggest that EMR systems may not only be an effective resource for predicting families of twins, but can also be rapidly applied to epidemiologic research. PMID:25250975

Mayer, John; Kitchner, Terrie; Ye, Zhan; Zhou, Zhiyi; He, Min; Schrodi, Steven J; Hebbring, Scott J

2014-12-01

367

A Comprehensive Project to Develop a Complete Curriculum in the Area of Medical Records Technician, Including Guidelines for the Development of a Two-Year Collegiate Curriculum for Medical Record Technicians. Final Report.  

ERIC Educational Resources Information Center

The objectives of the project were to determine the quantitative need of medical record technicians, to develop a curriculum, and to explore hospitals to be used for clinical experience. Five hundred and three hospitals assumed to be representative of the 7,127 listed by the American Hospital Association responded to a questionnaire. Projected…

Love, Robert L.

368

World Veterinary Year 2011: 250 Years of Improving Animal and  

E-print Network

Health Evolving and advancing veterinary medical education Leaders Champions and Heroes #12;FOOD SECURITY under and over nutrition, poverty, climate change, ecosystem health, animal welfare Use of antibiotics Livestock/Poultry Reduce Poverty Health, Development, and Poverty #12;Millenium Development Goals Goal 8

Straight, Aaron

369

Development of a peer review system using patient records for outcome evaluation of medical education: reliability analysis.  

PubMed

In addition to input evaluation (education delivered at school) and output evaluation (students' capability at graduation), the methods for outcome evaluation (performance after graduation) of medical education need to be established. One approach is a review of medical records, which, however, has been met with difficulties because of poor inter-rater reliability. Here, we attempted to develop a peer review system of medical records with high inter-rater reliability. We randomly selected 112 patients (and finally selected 110 after removing two ineligible patients) who visited (and were hospitalized in) one of the four general hospitals in the Tohoku region of Japan between 2008 and 2012. Four reviewers, who were well-trained general internists from outside the Tohoku region, visited the hospitals independently and evaluated outpatient medical records based on an evaluation sheet that consisted of 14 items (3-point scale) for record keeping and 15 items (5-point scale) for quality of care. The mean total score was 84.1 ± 7.7. Cronbach's alpha for these items was 0.798. Single measure and average measure intraclass correlations for the reviewers were 0.733 (95% confidence interval: 0.720-0.745) and 0.917 (95% confidence interval: 0.912-0.921), respectively. An exploratory factor analysis revealed six factors: history taking, physical examination, clinical reasoning, management and outcome, rhetoric, and patient relationship. In conclusion, we have developed a peer review system of medical records with high inter-rater reliability, which may enable us, with further validity analysis, to measure quality of patient care as an outcome evaluation of medical education in the future. PMID:25008553

Kameoka, Junichi; Okubo, Tomoya; Koguma, Emi; Takahashi, Fumie; Ishii, Seiichi; Kanatsuka, Hiroshi

2014-01-01

370

The Computerized Medical Record as a Tool for Clinical Governance in Australian Primary Care  

PubMed Central

Background Computerized medical records (CMR) are used in most Australian general practices. Although CMRs have the capacity to amalgamate and provide data to the clinician about their standard of care, there is little research on the way in which they may be used to support clinical governance: the process of ensuring quality and accountability that incorporates the obligation that patients are treated according to best evidence. Objective The objective of this study was to explore the capability, capacity, and acceptability of CMRs to support clinical governance. Methods We conducted a realist review of the role of seven CMR systems in implementing clinical governance, developing a four-level maturity model for the CMR. We took Australian primary care as the context, CMR to be the mechanism, and looked at outcomes for individual patients, localities, and for the population in terms of known evidence-based surrogates or true outcome measures. Results The lack of standardization of CMRs makes national and international benchmarking challenging. The use of the CMR was largely at level two of our maturity model, indicating a relatively simple system in which most of the process takes place outside of the CMR, and which has little capacity to support benchmarking, practice comparisons, and population-level activities. Although national standards for coding and projects for record access are proposed, they are not operationalized. Conclusions The current CMR systems can support clinical governance activities; however, unless the standardization and data quality issues are addressed, it will not be possible for current systems to work at higher levels. PMID:23939340

Phillips, Christine; Hall, Sally; Travaglia, Joanne

2013-01-01

371

Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions  

PubMed Central

Background The main objective of this research is to identify, categorize, and analyze barriers perceived by physicians to the adoption of Electronic Medical Records (EMRs) in order to provide implementers with beneficial intervention options. Methods A systematic literature review, based on research papers from 1998 to 2009, concerning barriers to the acceptance of EMRs by physicians was conducted. Four databases, "Science", "EBSCO", "PubMed" and "The Cochrane Library", were used in the literature search. Studies were included in the analysis if they reported on physicians' perceived barriers to implementing and using electronic medical records. Electronic medical records are defined as computerized medical information systems that collect, store and display patient information. Results The study includes twenty-two articles that have considered barriers to EMR as perceived by physicians. Eight main categories of barriers, including a total of 31 sub-categories, were identified. These eight categories are: A) Financial, B) Technical, C) Time, D) Psychological, E) Social, F) Legal, G) Organizational, and H) Change Process. All these categories are interrelated with each other. In particular, Categories G (Organizational) and H (Change Process) seem to be mediating factors on other barriers. By adopting a change management perspective, we develop some barrier-related interventions that could overcome the identified barriers. Conclusions Despite the positive effects of EMR usage in medical practices, the adoption rate of such systems is still low and meets resistance from physicians. This systematic review reveals that physicians may face a range of barriers when they approach EMR implementation. We conclude that the process of EMR implementation should be treated as a change project, and led by implementers or change managers, in medical practices. The quality of change management plays an important role in the success of EMR implementation. The barriers and suggested interventions highlighted in this study are intended to act as a reference for implementers of Electronic Medical Records. A careful diagnosis of the specific situation is required before relevant interventions can be determined. PMID:20691097

2010-01-01

372

Veterinary vaccine development from an industrial perspective  

Microsoft Academic Search

Veterinary vaccines currently available in Europe and in other parts of the world are developed by the veterinary pharmaceutical industry. The development of a vaccine for veterinary use is an economic endeavour that takes many years. There are many obstacles along the path to the successful development and launch of a vaccine. The industrial development of a vaccine for veterinary

J. G. M. Heldens; J. R. Patel; N. Chanter; G. J. ten Thij; M. Gravendijck; V. E. J. C. Schijns; A. Langen; Th. P. M. Schetters

2008-01-01

373

VETERINARY TEACHING HOSPITAL 1602 Campus Delivery  

E-print Network

VETERINARY TEACHING HOSPITAL 1602 Campus Delivery Fort Collins, Colorado 80523-1602 Phone: 970.297.1269 On-call Anesthesia Post-Doc Post-Doctoral Veterinary Teaching Hospital College of Veterinary Medicine and Biomedical Sciences Position Summary: The Veterinary Teaching Hospital (VTH) at Colorado State University

374

Veterinary Medical Scholars Program Admission Application  

E-print Network

for the in-state tuition? (Residency requirements are found at http relevant to your VMSP application Please use no more than approximately 2000 words in your personal statement. A Word or PDF file containing your resume/CV may be attached to the email. #12;GRE SCORES Score

Gilbert, Matthew

375

Veterinary Adverse Event Voluntary Reporting: How to Report an Adverse Drug Experience  

MedlinePLUS

... Home Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Animal & ... to the top Reporting Information About Animal Biologics: Vaccines, Bacterins and Diagnostic Kits Contact the U.S. Department ...

376

Confidentiality in preclinical Alzheimer disease studies: when research and medical records meet.  

PubMed

Clinical trials to advance the diagnosis and treatment of Alzheimer disease (AD) may expose research subjects to discrimination risks. An individual enrolled in a research study that uses positive test results from amyloid PET imaging or CSF measures of ?-amyloid 42 as inclusion criteria has biomarkers indicative of AD pathology. If insurers and employers learn this information, it could expose subjects to discrimination. Unfortunately, current legal and regulatory mechanisms are not sufficient to protect against harms that have significant consequences for subjects. Existing law that prohibits employment and insurance discrimination based on genetic status does not apply to amyloid biomarkers or any other biomarkers for neurodegenerative diseases. Gaps in legal protections fail to protect research subjects from discrimination by long-term care and disability insurers. This risk is particularly concerning because individuals with AD dementia ultimately need long-term care services. To maximize subject protections and advance valuable research, policymakers, investigators, and research institutions must address shortcomings in the design of the electronic medical record, revise laws to limit discrimination, and develop practices that inform research participants of risks associated with loss of confidentiality. PMID:24477112

Arias, Jalayne J; Karlawish, Jason

2014-02-25

377

Despite regulatory changes, hospitals cautious in helping physicians purchase electronic medical records.  

PubMed

While hospitals are evaluating strategies to help physicians purchase electronic medical records (EMRs) following recent federal regulatory changes, they are proceeding cautiously, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. Hospital strategies to aid physician EMR adoption include offering direct financial subsidies, extending the hospital's ambulatory EMR vendor discounts and providing technical support. Two key factors driving hospital interest in supporting physician EMR adoption are improving the quality and efficiency of care and aligning physicians more closely with the hospital. A few hospitals have begun small-scale, phased rollouts of subsidized EMRs, but the burden of other hospital information technology projects, budget limitations and lack of physician interest are among the factors impeding hospital action. While it is too early to assess whether the regulatory changes will spur greater physician EMR adoption, the outcome will depend both on hospitals' willingness to provide support and physicians' acceptance of hospital assistance. PMID:18807282

Grossman, Joy M; Cohen, Genna

2008-09-01

378

Improving gestational weight gain counseling through meaningful use of an electronic medical record.  

PubMed

The purpose of this study was to test the effectiveness of an intervention to improve the consistency and accuracy of antenatal gestational weight gain counseling through introduction of a "best practice alert" into an electronic medical record (EMR) system. A best practice alert was designed and implemented in the EMR. Based on each patient's pre-gravid body mass index (BMI), fetal number, and 2009 Institute of Medicine (IOM) guidelines, the alert provides an individualized total gestational weight gain goal, the weight gain goal per week of gestation, a template for scripted provider counseling and documentation, and a patient handout containing personalized gestational weight gain information. Retrospective chart reviews of 388 pre-intervention patients and 345 post-intervention patients were used to evaluate effectiveness. Introduction of a gestational weight gain best practice alert into the EMR improved the rate of antenatal gestational weight gain counseling that was consistent with current IOM guidelines (p < 0.001). Improvement in IOM-consistent gestational weight gain counseling was seen across all provider types, including obstetricians, family practice physicians, and certified nurse midwives. The intervention also resulted in significant improvement in documentation of pre-gravid weights and BMIs within the EMR. The EMR is an effective tool for improving the consistency and accuracy of antenatal gestational weight gain counseling in accord with 2009 IOM guidelines. PMID:24627233

Lindberg, Sara M; Anderson, Cynthie K

2014-11-01

379

Overview of laboratory data tools available in a single electronic medical record  

PubMed Central

Background: Laboratory data account for the bulk of data stored in any given electronic medical record (EMR). To best serve the user, electronic laboratory data needs to be flexible and customizable. Our aim was to determine the various ways in which laboratory data get utilized by clinicians in our health system's EMR. Method: All electronic menus, tabs, flowsheets, notes and subsections within the EMR (Millennium v2007.13, Cerner Corporation, Kansas City, MO, US) were explored to determine how clinicians utilize discrete laboratory data. Results: Laboratory data in the EMR were utilized by clinicians in five distinct ways: within flowsheets, their personal inbox (EMR messaging), with decision support tools, in the health maintenance tool, and when incorporating laboratory data into their clinical notes and letters. Conclusions: Flexible electronic laboratory data in the EMR hava many advantages. Users can view, sort, pool, and appropriately route laboratory information to better support trend analyses, clinical decision making, and clinical charting. Laboratory data in the EMR can also be utilized to develop clinical decision support tools. Pathologists need to participate in the creation of these EMR tools in order to better support the appropriate utilization of laboratory information in the EMR. PMID:20805960

Kudler, Neil R.; Pantanowitz, Liron

2010-01-01

380

Satisfaction and Perceived Quality of an Electronic Medical Record System in a Tertiary Hospital in Oman  

PubMed Central

Objective To evaluate the knowledge, attitude and practice (KAP) of physicians towards the Electronic Medical Record (EMR) system. Methods A cross-sectional survey including physicians from various clinical specialties was conducted. An existing questionnaire was adapted to assess the KAP of physicians towards the EMR system. Information was analyzed using Statistical Package for Social Sciences (SPSS) software. Results Out of 200 distributed questionnaires, 141 (70.5%) responses were received. Overall, only 22 physicians (15.6%) rated the current EMR system as an effective tool. A substantial proportion (29.4%) of respondents considered EMR not worth the time and effort required to use it. The majority (67.4%) reported increasing difficulty with the performance of work after applying the EMR system. The overall quality of work was perceived not to have changed (41.2% of the respondents) or declined (27.4% of the respondents). The low satisfaction and underperformance was found to be associated with younger age (p=0.032), junior designation (p=0.041), and low familiarity with computers (p=0.047). Conclusion We report low satisfaction and perceived quality of work among physicians in our institution with the current EMR system. Inappropriate and inadequate usage of the system was found to be the main cause of the underlying poor satisfaction. PMID:22125726

Al-Mujaini, Abdullah; Al-Farsi, Yahya; Al-Maniri, Abdulla; Ganesh, Anuradha

2011-01-01

381

Electronic Discovery and Electronic Medical Records: Does the Threat of Litigation aect Firm Decisions to Adopt Technology?  

Microsoft Academic Search

Firms' decision-making is increasingly leaving an electronic trail. We ask how the threat of litigation aects decisions to adopt technologies that leave more of an elec- tronic trail, like electronic medical records (EMR). On the one hand, firms may embrace a technology that allows them to easily document that their actions were appropriate if they have to defend them in

Amalia R. Miller; Catherine E. Tucker

382

INFORMATION SYSTEMS AND HEALTHCARE XVI: PHYSICIAN ADOPTION OF ELECTRONIC MEDICAL RECORDS: APPLYING THE UTAUT MODEL IN A HEALTHCARE CONTEXT  

Microsoft Academic Search

This study applies the Unified Theory of Acceptance and Use of Technology (UTAUT) to the phenomenon of physician adoption of electronic medical records (EMR) technology. UTAUT integrates eight theories of individual acceptance into one comprehensive model designed to assist in understanding what factors either enable or hinder technology adoption and use. As such, it provides a useful lens through which

Amy H. Hennington; Brian D. Janz

383

Evaluation of organizational maturity based on people capacity maturity model in medical record wards of Iranian hospitals  

PubMed Central

Context: People capacity maturity model (PCMM) is one of the models which focus on improving organizational human capabilities. Aims: The aim of this model's application is to increase people ability to attract, develop, motivate, organize and retain the talents needed to organizational continuous improvement. Settings and Design: In this study, we used the PCMM for investigation of organizational maturity level in medical record departments of governmental hospitals and determination strengths and weaknesses of their staff capabilities. Materials and Methods: This is an applied research and cross sectional study in which data were collected by questionnaires to investigation of PCMM model needs in medical record staff of governmental hospitals at Isfahan, Iran. We used the questionnaire which has been extracted from PCMM model and approved its reliability with Cronbach's Alpha 0.96. Statistical Analysis Used: Data collected by the questionnaire was analyzed based on the research objectives using SPSS software and in accordance with research questions descriptive statistics were used. Results: Our findings showed that the mean score of medical record practitioners, skill and capability in governmental hospitals was 35 (62.5%) from maximum 56 (100%). There is no significant relevance between organizational maturity and medical record practitioners, attributes. Conclusions: Applying PCMM model is caused increasing staff and manager attention in identifying the weaknesses in the current activities and practices, so it will result in improvement and developing processes. PMID:25077147

Yarmohammadian, Mohammad H.; Tavakoli, Nahid; Shams, Assadollah; Hatampour, Farzaneh

2014-01-01

384

Longitudinal Prescribing Patterns for Psychoactive Medications in Community-Based Individuals with Developmental Disabilities: Utilization of Pharmacy Records  

ERIC Educational Resources Information Center

Little is known about longitudinal prescribing practices for psychoactive medications for individuals with intellectual disabilities and developmental disabilities (IDDD) who are living in community settings. Computerized pharmacy records were accessed for 2344 community-based individuals with IDDD for whom a total of 3421 prescriptions were…

Lott, I. T.; McGregor, M.; Engelman, L.; Touchette, P.; Tournay, A.; Sandman, C.; Fernandez, G.; Plon, L.; Walsh, D.

2004-01-01

385

A Qualitative Study to Evaluate the Effectiveness of Simulation as a Training Method in Implementation of Electronic Medical Records  

ERIC Educational Resources Information Center

Background: Adoption of electronic medical records has been gradual in part due to physician concerns that its use in the exam room will interfere with the physician-patient relationship. Studies demonstrate their concern to be loss of eye contact with the patient and that entering information into the computer in the presence of the patient will…

Chelton, Barbara S.

2009-01-01

386

Bringing science to medicine: an interview with Larry Weed, inventor of the problem-oriented medical record.  

PubMed

Larry Weed, MD is widely known as the father of the problem-oriented medical record and inventor of the now-ubiquitous SOAP (subjective/objective/assessment/plan) note, for developing an electronic health record system (Problem-Oriented Medical Information System, PROMIS), and for founding a company (since acquired), which developed problem-knowledge couplers. However, Dr Weed's vision for medicine goes far beyond software-over the course of his storied career, he has relentlessly sought to bring the scientific method to medical practice and, where necessary, to point out shortcomings in the system and advocate for change. In this oral history, Dr Weed describes, in his own words, the arcs of his long career and the work that remains to be done. PMID:24872343

Wright, Adam; Sittig, Dean F; McGowan, Julie; Ash, Joan S; Weed, Lawrence L

2014-11-01

387

Stem cells in veterinary medicine  

Microsoft Academic Search

The stem cell field in veterinary medicine continues to evolve rapidly both experimentally and clinically. Stem cells are\\u000a most commonly used in clinical veterinary medicine in therapeutic applications for the treatment of musculoskeletal injuries\\u000a in horses and dogs. New technologies of assisted reproduction are being developed to apply the properties of spermatogonial\\u000a stem cells to preserve endangered animal species. The

Lisa A Fortier; Alexander J Travis

2011-01-01

388

Computer-Assisted Management of Instruction in Veterinary Public Health  

ERIC Educational Resources Information Center

Reviews a course in Food Hygiene and Public Health at the University of Illinois College of Veterinary Medicine in which students are sequenced through a series of computer-based lessons or autotutorial slide-tape lessons, the computer also being used to route, test, and keep records. Since grades indicated mastery of the subject, the course will…

Holt, Elsbeth; And Others

1975-01-01

389

Validating the therapy prediction model through a breakdown analysis on ICU patient medical records  

E-print Network

With the rapid advancement of computational data analysis tools, medical informatics has emerged as a discipline that explores the use of medical information in clinical practice. It searches for ways to effectively integrate ...

You, Shu-Chyng

2006-01-01

390

29 CFR 1904.9 - Recording criteria for cases involving medical removal under OSHA standards.  

Code of Federal Regulations, 2010 CFR

...Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...is medically removed under the medical surveillance requirements of an OSHA standard, you...include, but are not limited to, lead, cadmium, methylene chloride,...

2010-07-01

391

NIMH Performance Improvement Program Audit Tool for (circle one) INPATIENT / OUTPATIENT Medical Record Documentation by Physicians  

E-print Network

strategy adequate (if applicable) 12. Diagnosis B. Follow-up arrangements B. Medication reconciliation form. Frequency 3X per week (Multi.Disc. note may count as one) F. Medication reconciliation form signed BNIMH Performance Improvement Program Audit Tool for (circle one) INPATIENT / OUTPATIENT Medical

Baker, Chris I.

392

Container Type Medication Monitor: Dispenser for Recording the Time of Pill Removal and Preventing Unauthorized Removal.  

National Technical Information Service (NTIS)

The Medication Monitor described in the material determines when an individual pill tablet or capsule 'Pill' is removed from a container of medication in which the medications are loose and not arranged in any order making the device as easy to load as fi...

T. S. Moulding

1988-01-01

393

Understanding Electronic Medical Record Adoption in the United States: Communication and Sociocultural Perspectives  

PubMed Central

Background This paper adopts a communication and sociocultural perspective to analyze the factors behind the lag in electronic medical record (EMR) adoption in the United States. Much of the extant research on this topic has emphasized economic factors, particularly, lack of economic incentives, as the primary cause of the delay in EMR adoption. This prompted the Health Information Technology on Economic and Clinical Health Act that allow financial incentives through the Centers of Medicare and Medicaid Services for many health care organizations planning to adopt EMR. However, financial incentives alone have not solved the problem; many new innovations do not diffuse even when offered for free. Thus, this paper underlines the need to consider communication and sociocultural factors to develop a better understanding of the impediments of EMR adoption. Objective The objective of this paper was to develop a holistic understanding of EMR adoption by identifying and analyzing the impact of communication and sociocultural factors that operate at 3 levels: macro (environmental), meso (organizational), and micro (individual). Methods We use the systems approach to focus on the 3 levels (macro, meso, and micro) and developed propositions at each level drawing on the communication and sociocultural perspectives. Results Our analysis resulted in 10 propositions that connect communication and sociocultural aspects with EMR adoption. Conclusions This paper brings perspectives from the social sciences that have largely been missing in the extant literature of health information technology (HIT) adoption. In doing so, it implies how communication and sociocultural factors may complement (and in some instances, reinforce) the impact of economic factors on HIT adoption. PMID:23612390

Kreps, Gary L; Polit, Stan

2013-01-01

394

Improving the work efficiency of healthcare-associated infection surveillance using electronic medical records.  

PubMed

In this study, we developed an integrated hospital-associated urinary tract infection (HAUTI) surveillance information system (called iHAUTISIS) based on existing electronic medical records (EMR) systems for improving the work efficiency of infection control professionals (ICPs) in a 730-bed, tertiary-care teaching hospital in Taiwan. The iHAUTISIS can automatically collect data relevant to HAUTI surveillance from the different EMR systems, and provides a visualization dashboard that helps ICPs make better surveillance plans and facilitates their surveillance work. In order to measure the system performance, we also created a generic model for comparing the ICPs' work efficiency when using existing electronic culture-based surveillance information system (eCBSIS) and iHAUTISIS, respectively. This model can demonstrate a patient's state (unsuspected, suspected, and confirmed) and corresponding time spent on surveillance tasks performed by ICPs for the patient in that state. The study results showed that the iHAUTISIS performed better than the eCBSIS in terms of ICPs' time cost. It reduced the time by 73.27s, when using iHAUTISIS (114.26s) and eCBSIS (187.53s), for each patient on average. With increased adoption of EMR systems, the development of the integrated HAI surveillance information systems would be more and more cost-effective. Moreover, the iHAUTISIS adopted web-based technology that enables ICPs to online access patient's surveillance information using laptops or mobile devices. Therefore, our system can further facilitate the HAI surveillance and reduce ICPs' surveillance workloads. PMID:25154644

Lo, Yu-Sheng; Lee, Wen-Sen; Chen, Guo-Bin; Liu, Chien-Tsai

2014-11-01

395

Using the Electronic Medical Record to Identify Community-Acquired Pneumonia: Toward a Replicable Automated Strategy  

PubMed Central

Background Timely information about disease severity can be central to the detection and management of outbreaks of acute respiratory infections (ARI), including influenza. We asked if two resources: 1) free text, and 2) structured data from an electronic medical record (EMR) could complement each other to identify patients with pneumonia, an ARI severity landmark. Methods A manual EMR review of 2747 outpatient ARI visits with associated chest imaging identified x-ray reports that could support the diagnosis of pneumonia (kappa score ?=?0.88 (95% CI 0.82?0.93)), along with attendant cases with Possible Pneumonia (adds either cough, sputum, fever/chills/night sweats, dyspnea or pleuritic chest pain) or with Pneumonia-in-Plan (adds pneumonia stated as a likely diagnosis by the provider). The x-ray reports served as a reference to develop a text classifier using machine-learning software that did not require custom coding. To identify pneumonia cases, the classifier was combined with EMR-based structured data and with text analyses aimed at ARI symptoms in clinical notes. Results 370 reference cases with Possible Pneumonia and 250 with Pneumonia-in-Plan were identified. The x-ray report text classifier increased the positive predictive value of otherwise identical EMR-based case-detection algorithms by 20–70%, while retaining sensitivities of 58–75%. These performance gains were independent of the case definitions and of whether patients were admitted to the hospital or sent home. Text analyses seeking ARI symptoms in clinical notes did not add further value. Conclusion Specialized software development is not required for automated text analyses to help identify pneumonia patients. These results begin to map an efficient, replicable strategy through which EMR data can be used to stratify ARI severity. PMID:23967138

DeLisle, Sylvain; Kim, Bernard; Deepak, Janaki; Siddiqui, Tariq; Gundlapalli, Adi; Samore, Matthew; D'Avolio, Leonard

2013-01-01

396

Risk stratification using data from electronic medical records better predicts suicide risks than clinician assessments  

PubMed Central

Background To date, our ability to accurately identify patients at high risk from suicidal behaviour, and thus to target interventions, has been fairly limited. This study examined a large pool of factors that are potentially associated with suicide risk from the comprehensive electronic medical record (EMR) and to derive a predictive model for 1–6 month risk. Methods 7,399 patients undergoing suicide risk assessment were followed up for 180 days. The dataset was divided into a derivation and validation cohorts of 4,911 and 2,488 respectively. Clinicians used an 18-point checklist of known risk factors to divide patients into low, medium, or high risk. Their predictive ability was compared with a risk stratification model derived from the EMR data. The model was based on the continuation-ratio ordinal regression method coupled with lasso (which stands for least absolute shrinkage and selection operator). Results In the year prior to suicide assessment, 66.8% of patients attended the emergency department (ED) and 41.8% had at least one hospital admission. Administrative and demographic data, along with information on prior self-harm episodes, as well as mental and physical health diagnoses were predictive of high-risk suicidal behaviour. Clinicians using the 18-point checklist were relatively poor in predicting patients at high-risk in 3 months (AUC 0.58, 95% CIs: 0.50 – 0.66). The model derived EMR was superior (AUC 0.79, 95% CIs: 0.72 – 0.84). At specificity of 0.72 (95% CIs: 0.70-0.73) the EMR model had sensitivity of 0.70 (95% CIs: 0.56-0.83). Conclusion Predictive models applied to data from the EMR could improve risk stratification of patients presenting with potential suicidal behaviour. The predictive factors include known risks for suicide, but also other information relating to general health and health service utilisation. PMID:24628849

2014-01-01

397

Administrative Codes Combined with Medical Records-based Criteria Accurately Identified Bacterial Infections among Rheumatoid Arthritis Patients  

PubMed Central

Objective To evaluate diagnostic properties of International Classification of Diseases, Version 9 (ICD-9) diagnosis codes and infection criteria to identify bacterial infections among rheumatoid arthritis (RA) patients. Study Design and Setting We performed a cross- sectional study of RA patients with and without ICD-9 codes for bacterial infections. Sixteen bacterial infection criteria were developed. Diagnostic properties of comprehensive and restrictive sets of ICD-9 codes and the infection criteria were tested against an adjudicated review of medical records. Results Records on 162 RA patients with and 50 without purported bacterial infections were reviewed. Positive (PPV) and negative predictive values (NPVs) of ICD-9 codes ranged from 54% – 85% and 84% – 100%, respectively. PPVs of the medical records-based criteria were: 84% and 89% for “definite” and “definite or empirically treated” infections, respectively. PPV of infection criteria increased by 50% as disease prevalence increased using ICD-9 codes to enhance infection likelihood. Conclusion ICD-9 codes alone may misclassify bacterial infections in hospitalized RA patients. Misclassification varies with the specificity of the codes used and strength of evidence required to confirm infections. Combining ICD-9 codes with infection criteria identified infections with greatest accuracy. Novel infection criteria may limit the requirement to review medical records. PMID:18834713

Patkar, Nivedita M.; Curtis, Jeffrey R.; Teng, Gim Gee; Allison, Jeroan J.; Saag, Michael; Martin, Carolyn; Saag, Kenneth G.

2009-01-01

398

FM 4-02.18 (FM 8-10-18) VETERINARY SERVICE  

E-print Network

-1 2-1. Medical Detachment, Veterinary Service, TOE 08440A000 ............... 2-1 2-2. Medical-5. Echelons Above Corps Army Veterinarian .................................... 2-11 2-6. Corps Medical Command and Supply System in the Theater.......... 3-2 3-7. Food Safety

US Army Corps of Engineers

399

Characteristics of personal health records: findings of the Medical Library Association/National Library of Medicine Joint Electronic Personal Health Record Task Force  

PubMed Central

Objectives: The Medical Library Association (MLA)/National Library of Medicine (NLM) Joint Electronic Personal Health Record Task Force examined the current state of personal health records (PHRs). Methods: A working definition of PHRs was formulated, and a database was built with fields for specified PHR characteristics. PHRs were identified and listed. Each task force member was assigned a portion of the list for data gathering. Findings were recorded in the database. Results: Of the 117 PHRs identified, 91 were viable. Almost half were standalone products. A number used national standards for nomenclature and/or record structure. Less than half were mobile device enabled. Some were publicly available, and others were offered only to enrollees of particular health plans or employees at particular institutions. A few were targeted to special health conditions. Conclusions: The PHR field is very dynamic. While most PHR products have some common elements, their features can vary. PHRs can link their users with librarians and information resources. MLA and NLM have taken an active role in making this connection and in encouraging librarians to assume this assistance role with PHRs. PMID:20648259

Shipman, Jean P; Plaut, Daphne A; Selden, Catherine R

2010-01-01

400

Recordings  

Microsoft Academic Search

The Radio Ballads, 8 CDs, Topic TSCD801–808, 1999. Ewan MacColl (song lyrics, music, script), Peggy Seeger (orchestration and music direction), Charles Parker (field recordings).The Ballad of John Axon is about the railwaymen of England, in particular the story of steam locomotive driver John Axon, who was posthumously awarded the George Cross for his heroic attempt to stop his train after

Carole Pegg

1999-01-01

401

Use of Simulated Physician Handoffs to Study Cross-cover Chart Biopsy in the Electronic Medical Record  

PubMed Central

Clinical handoffs involve the rapid transfer of patient information from one provider or team to another, through activities which may introduce errors and affect care delivery. “Cross-coverage” requires quickly familiarizing oneself with unfamiliar patients whose management plans were established by another provider or team. Through this work, we describe physicians’ information seeking approaches within an electronic medical record (EMR) during physician handoff and chart biopsy at a major academic medical center. We conducted simulated handoff sessions and interviews with 21 physicians using standardized patient cases and we analyzed screen capture data, and video and audio recordings of interactions with the EMR and handoff printouts. We found highly variable navigation of the EMR but greater similarity in physicians’ EMR navigation behavior when the chart review was prompted by simulated interruptions. Understanding how physicians seek and assimilate patient data can inform handoff tool design and suggest strategies for explicitly supporting EMR chart biopsies. PMID:24551374

Kendall, Logan; Klasnja, Predrag; Iwasaki, Justin; Best, Jennifer A.; White, Andrew A.; Khalaj, Sahar; Amdahl, Chris; Blondon, Katherine

2013-01-01

402

An Exploratory Comparison of Medication Lists at Hospital Admission with Administrative Database Records  

Microsoft Academic Search

BACKGROUND: Medication reconciliation is recognized as important, but no one method has been recommended. Research has shown that the most common medication reconciliation errors are attributable to omitted medi- cations and doses. The pharmacy claims aggregator used in this evaluation is a private company that gathers pharmacy claims data from disparate pharmacy benefit managers into a secure repository (hereafter referred

Terri L. Warholak; Matthew McCulloch; Alysson Baumgart

403

Cognitive performance-altering effects of electronic medical records: an application of the human factors paradigm for patient safety  

Microsoft Academic Search

According to the human factors paradigm for patient safety, health care work systems and innovations such as electronic medical\\u000a records do not have direct effects on patient safety. Instead, their effects are contingent on how the clinical work system,\\u000a whether computerized or not, shapes health care providers’ performance of cognitive work processes. An application of the\\u000a human factors paradigm to

Richard J. Holden

2011-01-01

404

Impact of electronic medical record integration of a handoff tool on sign-out in a newborn intensive care unit  

Microsoft Academic Search

Objective:Patient care handoffs represent an important transfer of information.1, 2, 3, 4 Stand-alone electronic sign-out systems (such as Microsoft Word documents and Microsoft Access databases) require significant manual data transcription, which is a potential source of error.2 Sign-out systems integrated within a hospital's electronic medical record (EMR) have the ability to automate the retrieval of patient information from the EMR,

J P Palma; P J Sharek; C A Longhurst

2011-01-01

405

Videoconferencing in a veterinary curriculum.  

PubMed

Videoconferencing is a powerful and versatile method for distance learning. Videoconferencing incorporates real-time video and audio into connections with distant sites and, when combined with simultaneous Internet transmission of high-resolution images, enables veterinary educators to expand the classroom to include students and faculty from remote sites. The University of Tennessee College of Veterinary Medicine (UTCVM) has used videoconferencing to deliver and receive entire courses, virtual rounds, seminars, journal clubs, and small meetings and for in-house transmission from one area of the campus to another. Responses from faculty and students at UTCVM indicate that videoconferencing technology will be a permanent part of the academic mission of the college for years to come. This article describes a number of veterinary school applications using distance-learning approaches that the authors hope will serve as examples upon which others can build. PMID:17673789

Sims, Michael H; Howell, Nancy; Harbison, Babbet

2007-01-01

406

Using Latent Class Analysis to Identify Sophistication Categories of Electronic Medical Record Systems in U.S. Acute Care Hospitals  

PubMed Central

Many believe that electronic medical record systems hold promise for improving the quality of health care services. The body of research on this topic is still in the early stages, however, in part because of the challenge of measuring the capabilities of electronic medical record systems. The purpose of this study was to identify classes of Electronic Medical Record (EMR) system sophistication in hospitals as well as hospital characteristics associated with the sophistication categories. The data used were from the American Hospital Association (AHA) and the Health Information Management and Systems Society (HIMSS). The sample included acute care hospitals in the United States with 50 beds or more. We used latent class analysis to identify the sophistication classes and logistic regression to identify relationships between these classes and hospital characteristics. Our study identifies cumulative categories of EMR sophistication: ancillary-based, ancillary/data aggregation, and ancillary-to-bedside. Rural hospital EMRs are likely to be ancillary-based, while hospitals in a network are likely to have either ancillary-based or ancillary-to-bedside EMRs. Future research should explore the effect of network membership on EMR system development. PMID:24244071

Shea, Christopher M.; Weiner, Bryan J.; Belden, Charles M.

2013-01-01

407

Giving rheumatology patients online home access to their electronic medical record (EMR): advantages, drawbacks and preconditions according to care providers.  

PubMed

Technology enables patients home access to their electronic medical record (EMR), via a patient portal. This study aims to analyse (dis)advantages, preconditions and suitable content for this service, according to rheumatology health professionals. A two-phase policy Delphi study was conducted. First, interviews were performed with nurses/nurse practitioners (n = 9) and rheumatologists (n = 13). Subsequently, collected responses were quantified, using a questionnaire among the interviewees. The following advantages of patient home access to the EMR were reported: (1) enhancement of patient participation in treatment, (2) increased knowledge and self-management, (3) improved patient-provider interaction, (4) increased patient safety, and (5) better communication with others. Foreseen disadvantages of the service included: (1) problems with interpretation of data, (2) extra workload, (3) a change in consultation content, and (4) disturbing the patient-provider interaction. Also, the following preconditions emerged from the data: (1) optimal security, (2) no extra record, but a patient-accessible section, (3) no access to clinical notes, and (4) a lag time on the release of lab data. Most respondents reported that data on diagnosis, medication, treatment plan and consultations could be released to patients. On releasing more complex data, such as bodily examinations, lab results and radiological images the opinions differed considerably. Providing patients home access to their medical record might be a valuable next step into patient empowerment and in service towards the patient, provided that security is optimal and content and presentation of data are carefully considered. PMID:22453527

van der Vaart, Rosalie; Drossaert, Constance H C; Taal, Erik; van de Laar, Mart A F J

2013-09-01

408

Template-based data entry for general description in medical records and data transfer to data warehouse for analysis.  

PubMed

General descriptions in medical records are so diverse that they are usually entered as free text into an electronic medical record, and the resulting data analysis is often difficult. We developed and implemented a template-based data entry module and data analyzing system for general descriptions. We developed a template with tree structure, whose content master and entered patient's data are simultaneously expressed by XML. The entered structured data is converted to narrative form for easy reading. This module was implemented in the EMR system, and is used in 35 hospitals as of October, 2006. So far, 3725 templates (3242 concepts) have been produced. The data in XML and narrative text data are stored in the EMR database. The XML data are retrieved, and then patient's data are extracted, to be stored in the data ware-house (DWH). We developed a search assisting system that enables users to find objective data from the DWH without requiring complicated SQL. By using this method, general descriptions in medical records can be structured and made available for clinical research. PMID:17911750

Matsumura, Yasushi; Kuwata, Shigeki; Yamamoto, Yuichiro; Izumi, Kazunori; Okada, Yasushi; Hazumi, Michihiro; Yoshimoto, Sachiko; Mineno, Takahiro; Nagahama, Munetoshi; Fujii, Ayumi; Takeda, Hiroshi

2007-01-01

409

Veterinary Medicine the Day after Tomorrow  

ERIC Educational Resources Information Center

Societal changes that will influence the veterinary profession are examined including: population, energy, and food; pet ownership and veterinary service; government regulation; numbers of veterinarians; and percentages of salaried veterinarians. (LBH)

Hooper, B. E.

1977-01-01

410

VETERINARY TEACHING HOSPITAL 1620 Campus Delivery  

E-print Network

.297.1269 EQUINE FIELD SERVICE VETERINARIAN Veterinary Teaching Hospital College of Veterinary Medicine an opening for a one-year postdoctoral fellowship as an Equine Field Service Veterinarian. Equine Field

Rutledge, Steven

411

DOCTOR OF VETERINARY MEDICINE (DVM) PROGRAM  

E-print Network

.................................................................................. 1 II. REGIONAL NATURE OF WCVM........................................................................................................................................ 4 V. ANIMALS AND VETERINARY EXPERIENCE of Veterinary Medicine program prepares students to meet the needs of animal health care in Western Canada

Saskatchewan, University of

412

Improving sensitivity of machine learning methods for automated case identification from free-text electronic medical records  

PubMed Central

Background Distinguishing cases from non-cases in free-text electronic medical records is an important initial step in observational epidemiological studies, but manual record validation is time-consuming and cumbersome. We compared different approaches to develop an automatic case identification system with high sensitivity to assist manual annotators. Methods We used four different machine-learning algorithms to build case identification systems for two data sets, one comprising hepatobiliary disease patients, the other acute renal failure patients. To improve the sensitivity of the systems, we varied the imbalance ratio between positive cases and negative cases using under- and over-sampling techniques, and applied cost-sensitive learning with various misclassification costs. Results For the hepatobiliary data set, we obtained a high sensitivity of 0.95 (on a par with manual annotators, as compared to 0.91 for a baseline classifier) with specificity 0.56. For the acute renal failure data set, sensitivity increased from 0.69 to 0.89, with specificity 0.59. Performance differences between the various machine-learning algorithms were not large. Classifiers performed best when trained on data sets with imbalance ratio below 10. Conclusions We were able to achieve high sensitivity with moderate specificity for automatic case identification on two data sets of electronic medical records. Such a high-sensitive case identification system can be used as a pre-filter to significantly reduce the burden of manual record validation. PMID:23452306

2013-01-01

413

Personal health records in the preclinical medical curriculum: modeling student responses in a simple educational environment utilizing Google Health  

PubMed Central

Background Various problems concerning the introduction of personal health records in everyday healthcare practice are reported to be associated with physicians’ unfamiliarity with systematic means of electronically collecting health information about their patients (e.g. electronic health records - EHRs). Such barriers may further prevent the role physicians have in their patient encounters and the influence they can have in accelerating and diffusing personal health records (PHRs) to the patient community. One way to address these problems is through medical education on PHRs in the context of EHR activities within the undergraduate medical curriculum and the medical informatics courses in specific. In this paper, the development of an educational PHR activity based on Google Health is reported. Moreover, student responses on PHR’s use and utility are collected and presented. The collected responses are then modelled to relate the satisfaction level of students in such a setting to the estimation about their attitude towards PHRs in the future. Methods The study was conducted by designing an educational scenario about PHRs, which consisted of student instruction on Google Health as a model PHR and followed the guidelines of a protocol that was constructed for this purpose. This scenario was applied to a sample of 338 first-year undergraduate medical students. A questionnaire was distributed to each one of them in order to obtain Likert-like scale data on the sample’s response with respect to the PHR that was used; the data were then further analysed descriptively and in terms of a regression analysis to model hypothesised correlations. Results Students displayed, in general, satisfaction about the core PHR functions they used and they were optimistic about using them in the future, as they evaluated quite high up the level of their utility. The aspect they valued most in the PHR was its main role as a record-keeping tool, while their main concern was related to the negative effect their own opinion might have on the use of PHRs by patients. Finally, the estimate of their future attitudes towards PHR integration was found positively dependent of the level of PHR satisfaction that they gained through their experience (rho?=?0.524, p <0.001). Conclusions The results indicate that students support PHRs as medical record keeping helpers and perceive them as beneficial to healthcare. They also underline the importance of achieving good educational experiences in improving PHR perspectives inside such educational activities. Further research is obviously needed to establish the relative long-term effect of education to other methods of exposing future physicians to PHRs. PMID:23009713

2012-01-01

414

[Veterinary herd health management in swine production].  

PubMed

The paper describes the current tendencies in the field of pork production since the EU single market has come into being. The challenges to the veterinary profession resulting from them are the development of quality assurance systems through the whole production chain and the idea of the Alternative Veterinary Mandatory Alternative Meat Inspection System. The "new" veterinary activities to meet the growing demands are explained with special regard to slaughter checks, preventive veterinary consultation and future herd health management. PMID:8591754

Blaha, T

1995-07-01

415

29 CFR 1910.1020 - Access to employee exposure and medical records.  

Code of Federal Regulations, 2010 CFR

...results of medical examinations (pre-employment, pre-assignment, periodic, or episodic...or physical stress (noise, heat, cold, vibration, repetitive motion...exposure levels; (C) To conduct pre-assignment or periodic...

2010-07-01

416

29 CFR 1910.1020 - Access to employee exposure and medical records.  

Code of Federal Regulations, 2011 CFR

...results of medical examinations (pre-employment, pre-assignment, periodic, or episodic...or physical stress (noise, heat, cold, vibration, repetitive motion...exposure levels; (C) To conduct pre-assignment or periodic...

2011-07-01

417

29 CFR 1910.1020 - Access to employee exposure and medical records.  

...results of medical examinations (pre-employment, pre-assignment, periodic, or episodic...or physical stress (noise, heat, cold, vibration, repetitive motion...exposure levels; (C) To conduct pre-assignment or periodic...

2014-07-01

418

Information Discovery on Electronic Medical Records1 Vagelis Hristidis* Fernando Farfn* Redmond P. Burke+  

E-print Network

paradigms for using medical data. The primary focus of the paper is the newest XML-based EMR standard different elements of a CDA document, and also synonyms or related terms like "mortality" can be used

Hristidis, Vagelis

419

Electronic Medical Records: A Case Study to Improve Patient Safety at Royal Victoria Teaching Hospital  

E-print Network

the professional distribution of participants. No Response represents people who did not include their profession. The five students, however, included final year medical and dentistry students, as well as nursing, and medical laboratory students. Professional... experience ranged between 1 and 20 years. Profession Number Surgeon 3 Pharmacist 2 Physician 3 Radiologist 2 Midwife 5 Nurse 6 Laboratory Technician 2 Student 5 No Response 2 Total 30 Table 2: List of Profess iona is, RVTH 2009 20 To analyze...

Bittaye, Annie

2009-05-15

420

Preparing students for careers in food-supply veterinary medicine: a review of educational programs in the United States.  

PubMed

The real and/or perceived shortage of veterinarians serving food-supply veterinary medicine has been a topic of considerable discussion for decades. Regardless of this debate, there are issues still facing colleges of veterinary medicine (CVMs) about the best process of educating future food-supply veterinarians. Over the past several years, there have been increasing concerns by some that the needs of food-supply veterinary medicine have not adequately been met through veterinary educational institutions. The food-supply veterinary medical curriculum offered by individual CVMs varies depending on individual curricular design, available resident animal population, available food-animal caseload, faculty, and individual teaching efforts of faculty. All of the institutional members of the Association of American Veterinary Medical Colleges (AAVMC) were requested to share their Food Animal Veterinary Career Incentives Programs. The AAVMC asked all member institutions what incentives they used to attract and educate students interested in, or possibly considering, a career in food-supply veterinary medicine (FSVM). The problem arises as to how we continue to educate veterinary students with ever shrinking budgets and how to recruit and retain faculty with expertise to address the needs of society. Several CVMs use innovative training initiatives to help build successful FSVM programs. This article focuses on dairy, beef, and swine food-animal education and does not characterize colleges' educational efforts in poultry and aquaculture. This review highlights the individual strategies used by the CVMs in the United States. PMID:22951460

Posey, R Daniel; Hoffsis, Glen F; Cullor, James S; Naylor, Jonathan M; Chaddock, Michael; Ames, Trevor R

2012-01-01

421

Veterinary Seizure Detector Report Number 1  

E-print Network

Veterinary Seizure Detector Report Number 1 Page 1 of 20 DISTRIBUTION STATEMENT: Distribution authorized to all. Veterinary Seizure Detector Report Number 1 Submitted by Nicolas Roy University) 393 8351 Email nroy@usc.edu Date: April 27, 2010 Work performed at USC #12;Veterinary Seizure Detector

Levi, Anthony F. J.

422

Current Status of Veterinary Vaccines  

PubMed Central

The major goals of veterinary vaccines are to improve the health and welfare of companion animals, increase production of livestock in a cost-effective manner, and prevent animal-to-human transmission from both domestic animals and wildlife. These diverse aims have led to different approaches to the development of veterinary vaccines from crude but effective whole-pathogen preparations to molecularly defined subunit vaccines, genetically engineered organisms or chimeras, vectored antigen formulations, and naked DNA injections. The final successful outcome of vaccine research and development is the generation of a product that will be available in the marketplace or that will be used in the field to achieve desired outcomes. As detailed in this review, successful veterinary vaccines have been produced against viral, bacterial, protozoal, and multicellular pathogens, which in many ways have led the field in the application and adaptation of novel technologies. These veterinary vaccines have had, and continue to have, a major impact not only on animal health and production but also on human health through increasing safe food supplies and preventing animal-to-human transmission of infectious diseases. The continued interaction between animals and human researchers and health professionals will be of major importance for adapting new technologies, providing animal models of disease, and confronting new and emerging infectious diseases. PMID:17630337

Meeusen, Els N. T.; Walker, John; Peters, Andrew; Pastoret, Paul-Pierre; Jungersen, Gregers

2007-01-01

423

Veterinary surgeons in zoological medicine  

Microsoft Academic Search

To be successful in zoo work veterinary surgeons must alter their approach and acquire a basic philosophy of concern for wild species. With proper motivation and background information and a good biological outlook, they would be in a unique position to solve problems essential to the continued existence of some species of wild animals and the betterment of human life.

ME Fowler

1976-01-01

424

Salvaging legacy data: mapping an obsolete medical nomenclature to a modern one.  

PubMed

The Veterinary Medical Database (VMDB) is a repository containing abstracts of over six million case records from 24 veterinary colleges throughout the U.S. and Canada. These case record abstracts, spanning almost 40 years, represent a valuable resource for outcomes analysis and hypothesis generation. Database records are currently encoded using the Standard Nomenclature of Veterinary Diseases and Operations (SNVDO), a precoordinated, hierarchical coding system. SNVDO has not been updated since 1977 and is outdated and inadequate to express the current state of medical knowledge. We undertook to manually map a subset of the SNVDO codes to a modern medical nomenclature, SNOMED-RT (Version 1.0), and to evaluate the quality of the resultant mappings and the acceptability of the mapping method used. We found that the distribution of frequency of use of the SNVDO codes in the VMDB records is highly skewed, with a small number of codes accounting for a large percentage of the records. We targeted our mapping efforts on that subset of codes. We found that our targeted manual mapping of the SNVDO codes to SNOMED-RT codes was feasible and produced good quality results, based on separate evaluations performed by two domain experts. However, a significant proportion of the SNVDO codes could not be mapped to a single SNOMED-RT concept, necessitating construction of multiple-code post-coordinated terms. Additionally, this manual mapping was very labor-intensive. PMID:12085640

Folk, L C; Hahn, A W; Patrick, T B; Allen, G K; Smith, A B; Wilcke, J R

2002-01-01

425

Medical school tuition fees reach record levels as MD incomes shrink.  

PubMed

At half the country's 16 faculties of medicine, 1996-97 tuition fees are a minimum 16% higher than last year, and more large increases loom on the horizon. Administrators increasingly support the idea that medical students and those in other professional degree programs should assume a greater proportion of the cost of their education because their future earning potential is higher than it is for graduates with other degrees. However, medical students say they are being saddled with huge debt loads. These debts may be harder to repay, because they are rising at the same time physicians' incomes are either stagnant or being cut. PMID:8837550

Thorne, S

1996-10-01

426

Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology.  

PubMed Central

BACKGROUND. Most US medical records lack socioeconomic data, hindering studies of social gradients in health and ascertainment of whether study samples are representative of the general population. This study assessed the validity of a census-based approach in addressing these problems. METHODS. Socioeconomic data from 1980 census tracts and block groups were matched to the 1985 membership records of a large prepaid health plan (n = 1.9 million), with the link provided by each individual's residential address. Among a subset of 14,420 Black and White members, comparisons were made of the association of individual, census tract, and census block-group socioeconomic measures with hypertension, height, smoking, and reproductive history. RESULTS. Census-level and individual-level socioeconomic measures were similarly associated with the selected health outcomes. Census data permitted assessing response bias due to missing individual-level socioeconomic data and also contextual effects involving the interaction of individual- and neighborhood-level socioeconomic traits. On the basis of block-group characteristics, health plan members generally were representative of the total population; persons in impoverished neighborhoods, however, were underrepresented. CONCLUSIONS. This census-based methodology offers a valid and useful approach to overcoming the absence of socioeconomic data in most US medical records. PMID:1566949

Krieger, N

1992-01-01

427

Overcoming barriers to electronic medical record (EMR) implementation in the US healthcare system: A comparative study  

Microsoft Academic Search

An EMR system implementation would significantly reduce clinician workload and medical errors while saving the US healthcare system major expense. Yet, compared to other developed nations, the US lags behind. This article examines EMR system efforts, benefits, and barriers, as well as steps needed to move the US closer to a nationwide EMR system. The analysis includes a blueprint for

Sameer Kumar; Krista Aldrich

2010-01-01

428

Integrating an enterprise image distribution system into an existing electronic medical record system  

Microsoft Academic Search

The enterprise distribution of radiology images should be integrated into the same application that physicians obtain other clinical information about their patients. Over the past year the Roudebush Veterans Affairs Medical Center has provided enterprise access to radiology images after integrating a commercial web-based image distribution system (Stentor, Brisbane, CA) with the Department of Veterans Affairs internally developed Computerized Patient

Robert M. Witt; Robert Morrow

2003-01-01

429

Are electronic medical records trustworthy? Observations on copying, pasting and duplication.  

PubMed

As routine use of on-line progress notes in US Department of Veterans Affairs facilities grew rapidly in the past decade, health information managers and clinicians began to notice that authors sometimes copied text from old notes into new notes. Other sources of duplication were document templates that inserted boilerplate text or patient data into notes. Word-processing and templates aided the transition to electronic notes, but enabled author copying and sometimes led to lengthy, hard-to-read records stuffed with data already available on-line. Investigators at a VA center recognized for pioneering a fully electronic record system analyzed author copying and template-generated duplication with adapted plagiarism-detection software. Nine percent of progress notes studied contained copied or duplicated text. Most copying and duplication was benign, but some introduced misleading errors into the record and some seemed possibly unethical or potentially unsafe. High-risk author copying occurred once for every 720 notes, but one in ten electronic charts contained an instance of high-risk copying. Careless copying threatens the integrity of on-line records. Clear policies, practitioner consciousness-raising and development of effective monitoring procedures are recommended to protect the value of electronic patient records. PMID:14728176

Hammond, Kenric W; Helbig, Susan T; Benson, Craig C; Brathwaite-Sketoe, Beverly M

2003-01-01

430

Evaluating the impact and costs of deploying an electronic medical record system to support TB treatment in Peru.  

PubMed

The PIH-EMR is a Web based electronic medical record that has been in operation for over four years in Peru supporting the treatment of drug resistant TB. We describe here the types of evaluations that have been performed on the EMR to assess its impact on patient care, reporting, logistics and observational research. Formal studies have been performed on components for drug order entry, drug requirements prediction tools and the use of PDAs to collect bacteriology data. In addition less formal data on the use of the EMR for reporting and research are reviewed. Experience and insights from porting the PIH-EMR to the Philippines, and modifying it to support HIV treatment in Haiti and Rwanda are discussed. We propose that additional data of this sort is valuable in assessing medical information systems especially in resource poor areas. PMID:17238344

Fraser, Hamish S F; Blaya, Joaquin; Choi, Sharon S; Bonilla, Cesar; Jazayeri, Darius

2006-01-01

431

Differences in baseline characteristics between patients prescribed sitagliptin versus exenatide based on a US electronic medical record database  

Microsoft Academic Search

Introduction  Sitagliptin, an oral dipeptidyl peptidase-4 inhibitor, and exenatide, an injectable glucagon-like peptide-1 receptor agonist,\\u000a are incretin-based therapies for the treatment of type 2 diabetes. This study examined differences in baseline characteristics\\u000a between patients with type 2 diabetes initiating sitagliptin vs. exenatide treatment in clinical practice settings in the\\u000a US.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The General Electric Healthcare’s Clinical Data Services electronic medical records database,

Qiaoyi Zhang; Srini Rajagopalan; Panagiotis Mavros; Samuel S. Engel; Michael J. Davies; Donald Yin; Larry Radican

2010-01-01

432

78 FR 55244 - Notice of Availability of Record of Decision for Medical Facilities Development and University...  

Federal Register 2010, 2011, 2012, 2013

...announces its decision to construct and...MFD) at Naval Support Activity (NSA...also announces its decision to construct and...Military Health System commitments to deliver...will enhance and support but not add to the...of the Record of Decision (ROD) is...

2013-09-10

433

EMR Electronic Signature Electronic Signature: Usage in Medical Records and Other Electronic Transactions  

E-print Network

The purpose of this policy is to confirm Washington University’s commitment to conducting business in compliance with all applicable laws, regulations and University Policies. This policy outlines the technical measures required to insure appropriate signatures are assigned to electronic information and related material and to protect from unauthorized use. In addition, the FDA requires that electronic records and signatures be maintained in accordance with the FDA regulations relevant to the safety and integrity of study data under regulation, 21 CRF Part 11. This regulation has an increasing impact on Washington University School of Medicine since the majority of our patient records are maintained electronically. POLICY: 1. The term electronic signature means a signature in electronic format, attached to or logically associated with an electronic record. 2. The University considers electronic signatures to be legally binding and the equivalent to a handwritten signature. University employees will only utilize electronic signatures for appropriate business purposes. In addition, employees are accountable for all actions initiated under their electronic signature. Falsification of records or signatures may be subject to disciplinary action. Employees are required to report any suspected or fraudulent use of signatures immediately. REFERENCES: Several legislative requirements impact the use of electronic signatures. Additional information can be found at

unknown authors

434

Probabilistic Case Detection for Disease Surveillance Using Data in Electronic Medical Records  

PubMed Central

This paper describes a probabilistic case detection system (CDS) that uses a Bayesian network model of medical diagnosis and natural language processing to compute the posterior probability of influenza and influenza-like illness from emergency department dictated notes and laboratory results. The diagnostic accuracy of CDS for these conditions, as measured by the area under the ROC curve, was 0.97, and the overall accuracy for NLP employed in CDS was 0.91. PMID:23569615

Tsui, Fuchiang; Wagner, Michael; Cooper, Gregory; Que, Jialan; Harkema, Hendrik; Dowling, John; Sriburadej, Thomsun; Li, Qi; Espino, Jeremy U.; Voorhees, Ronald

2011-01-01

435

Veterinary ethics and production diseases.  

PubMed

An animal's welfare should be governed by five freedoms, namely, freedom from hunger and thirst, freedom from discomfort, freedom from pain, injury or disease, freedom to express normal behavior and freedom from fear and distress. If the essence of veterinary medicine is to act like a physician for animals then the profession must be vocal in opposition to production diseases, which can be prevented by changing the system of production. PMID:20003648

Rollin, Bernard E

2009-12-01

436

Teaching and assessing veterinary professionalism.  

PubMed

The teaching and assessment of professional behaviors and attitudes are important components of veterinary curricula. This article aims to outline some important considerations and concepts which will be useful for veterinary educators reviewing or developing this topic. A definition or framework of veterinary professionalism must be decided upon before educators can develop relevant learning outcomes. The interface between ethics and professionalism should be considered, and both clinicians and ethicists should deliver professionalism teaching. The influence of the hidden curriculum on student development as professionals should also be discussed during curriculum planning because it has the potential to undermine a formal curriculum of professionalism. There are several learning theories that have relevance to the teaching and learning of professionalism; situated learning theory, social cognitive theory, adult learning theory, reflective practice and experiential learning, and social constructivism must all be considered as a curriculum is designed. Delivery methods to teach professionalism are diverse, but the teaching of reflective skills and the use of early clinical experience to deliver valid learning opportunities are essential. Curricula should be longitudinal and integrated with other aspects of teaching and learning. Professionalism should also be assessed, and a wide range of methods have the potential to do so, including multisource feedback and portfolios. Validity, reliability, and feasibility are all important considerations. The above outlined approach to the teaching and assessment of professionalism will help ensure that institutions produce graduates who are ready for the workplace. PMID:23975066

Mossop, Liz H; Cobb, Kate

2013-01-01

437

Liver scintigraphy in veterinary medicine.  

PubMed

The most common veterinary application of liver scintigraphy is for the diagnosis of portosystemic shunts (PSSs). There has been a continual evolution of nuclear medicine techniques for diagnosis of PSS, starting in the early 1980s. Currently, transplenic portal scintigraphy using pertechnetate or (99m)Tc-mebrofenin is the technique of choice. This technique provides both anatomical and functional information about the nature of the PSS, with high sensitivity and specificity. Hepatobiliary scintigraphy has also been used in veterinary medicine for the evaluation of liver function and biliary patency. Hepatobiliary scintigraphy provides information about biliary patency that complements finding in ultrasound, which may not be able to differentiate between biliary ductal dilation from previous obstruction vs current obstruction. Hepatocellular function can also be determined by deconvolutional analysis of hepatic uptake or by measuring the clearance of the radiopharmaceutical from the plasma. Plasma clearance of the radiopharmaceutical can be directly measured from serial plasma samples, as in the horse, or by measuring changes in cardiac blood pool activity by region of interest analysis of images. The objective of this paper is to present a summary of the reported applications of hepatobiliary scintigraphy in veterinary medicine. PMID:24314042

Morandi, Federica

2014-01-01

438

Validation of diabetes mellitus and hypertension diagnosis in computerized medical records in primary health care  

PubMed Central

Background Computerized Clinical Records, which are incorporated in primary health care practice, have great potential for research. In order to use this information, data quality and reliability must be assessed to prevent compromising the validity of the results. The aim of this study is to validate the diagnosis of hypertension and diabetes mellitus in the computerized clinical records of primary health care, taking the diagnosis criteria established in the most prominently used clinical guidelines as the gold standard against which what measure the sensitivity, specificity, and determine the predictive values. The gold standard for diabetes mellitus was the diagnostic criteria established in 2003 American Diabetes Association Consensus Statement for diabetic subjects. The gold standard for hypertension was the diagnostic criteria established in the Joint National Committee published in 2003. Methods A cross-sectional multicentre validation study of diabetes mellitus and hypertension diagnoses in computerized clinical records of primary health care was carried out. Diagnostic criteria from the most prominently clinical practice guidelines were considered for standard reference. Sensitivity, specificity, positive and negative predictive values, and global agreement (with kappa index), were calculated. Results were shown overall and stratified by sex and age groups. Results The agreement for diabetes mellitus with the reference standard as determined by the guideline was almost perfect (? = 0.990), with a sensitivity of 99.53%, a specificity of 99.49%, a positive predictive value of 91.23% and a negative predictive value of 99.98%. Hypertension diagnosis showed substantial agreement with the reference standard as determined by the guideline (? = 0.778), the sensitivity was 85.22%, the specificity 96.95%, the positive predictive value 85.24%, and the negative predictive value was 96.95%. Sensitivity results were worse in patients who also had diabetes and in those aged 70 years or over. Conclusions Our results substantiate the validity of using diagnoses of diabetes and hypertension found within the computerized clinical records for epidemiologic studies. PMID:22035202

2011-01-01

439

Nurses, medical records and the killing of sick persons before, during and after the Nazi regime in Germany.  

PubMed

During the Nazi regime (1933-1945), more than 300,000 psychiatric patients were killed. The well-calculated killing of chronic mentally 'ill' patients was part of a huge biopolitical program of well-established scientific, eugenic standards of the time. Among the medical personnel implicated in these assassinations were nurses, who carried out this program through their everyday practice. However, newer research raises suspicions that psychiatric patients were being assassinated before and after the Nazi regime, which, I hypothesize, implies that the motives for these killings must be investigated within psychiatric practice itself. An investigation of the impact of the interplay between the notes left by nurses and those by psychiatrists illustrates the active role of the psychiatric medical record in the killing of these patients. Using theoretical insights from Michel Foucault and philosopher Giorgio Agamben and analyzing one part of a particularly rich patient file found in the Langenhorn Psychiatric Asylum in the city of Hamburg, I demonstrate the role of the record in both constructing and deconstructing patient subjectivities. De-subjectifying patients condemned them to specific zones in the asylum within which they were reduced to their 'bare life'--a precondition for their physical assassination. PMID:22394360

Foth, Thomas

2013-06-01

440

High density GWAS for LDL cholesterol in African Americans using electronic medical records reveals a strong protective variant in APOE.  

PubMed

Only one low-density lipoprotein cholesterol (LDL-C) genome-wide association study (GWAS) has been previously reported in -African Americans. We performed a GWAS of LDL-C in African Americans using data extracted from electronic medical records (EMR) in the eMERGE network. African Americans were genotyped on the Illumina 1M chip. All LDL-C measurements, prescriptions, and diagnoses of concomitant disease were extracted from EMR. We created two analytic datasets; one dataset having median LDL-C calculated after the exclusion of some lab values based on comorbidities and medication (n= 618) and another dataset having median LDL-C calculated without any exclusions (n= 1,249). SNP rs7412 in APOE was strongly associated with LDL-C in both datasets (p < 5 × 10(-8) ). In the dataset with exclusions, a decrease of 20.0 mg/dL per minor allele was observed. The effect size was attenuated (12.3 mg/dL) in the dataset without any lab values excluded. Although other signals in APOE have been detected in previous GWAS, this large and important SNP association has not been well detected in large GWAS because rs7412 was not included on many genotyping arrays. Use of median LDL-C extracted from EMR after exclusions for medications and comorbidities increased the percentage of trait variance explained by genetic variation. PMID:23067351

Rasmussen-Torvik, Laura J; Pacheco, Jennifer A; Wilke, Russell A; Thompson, William K; Ritchie, Marylyn D; Kho, Abel N; Muthalagu, Arun; Hayes, M Geoff; Armstrong, Loren L; Scheftner, Douglas A; Wilkins, John T; Zuvich, Rebecca L; Crosslin, David; Roden, Dan M; Denny, Joshua C; Jarvik, Gail P; Carlson, Christopher S; Kullo, Iftikhar J; Bielinski, Suzette J; McCarty, Catherine A; Li, Rongling; Manolio, Teri A; Crawford, Dana C; Chisholm, Rex L

2012-10-01

441

Electronic medical records and genomics (eMERGE) network exploration in cataract: Several new potential susceptibility loci  

PubMed Central

Purpose Cataract is the leading cause of blindness in the world, and in the United States accounts for approximately 60% of Medicare costs related to vision. The purpose of this study was to identify genetic markers for age-related cataract through a genome-wide association study (GWAS). Methods In the electronic medical records and genomics (eMERGE) network, we ran an electronic phenotyping algorithm on individuals in each of five sites with electronic medical records linked to DNA biobanks. We performed a GWAS using 530,101 SNPs from the Illumina 660W-Quad in a total of 7,397 individuals (5,503 cases and 1,894 controls). We also performed an age-at-diagnosis case-only analysis. Results We identified several statistically significant associations with age-related cataract (45 SNPs) as well as age at diagnosis (44 SNPs). The 45 SNPs associated with cataract at p<1×10?5 are in several interesting genes, including ALDOB, MAP3K1, and MEF2C. All have potential biologic relationships with cataracts. Conclusions This is the first genome-wide association study of age-related cataract, and several regions of interest have been identified. The eMERGE network has pioneered the exploration of genomic associations in biobanks linked to electronic health records, and this study is another example of the utility of such resources. Explorations of age-related cataract including validation and replication of the association results identified herein are needed in future studies.

Verma, Shefali S.; Hall, Molly A.; Goodloe, Robert J.; Berg, Richard L.; Carrell, Dave S.; Carlson, Christopher S.; Chen, Lin; Crosslin, David R.; Denny, Joshua C.; Jarvik, Gail; Li, Rongling; Linneman, James G.; Pathak, Jyoti; Peissig, Peggy; Rasmussen, Luke V.; Ramirez, Andrea H.; Wang, Xiaoming; Wilke, Russell A.; Wolf, Wendy A.; Torstenson, Eric S.; Turner, Stephen D.; McCarty, Catherine A.

2014-01-01

442

2010 Howard Hughes Medical Institute 2010 Howard Hughes Medical Institute  

E-print Network

for a medical student doing research in a field related to Duchenne Muscular Dystrophy (DMD). · The purpose©2010 Howard Hughes Medical Institute #12;©2010 Howard Hughes Medical Institute ELIGIBILITY FOR THE PROGRAM · U.S. citizenship not required · In good standing at a medical, dental, or veterinary school

Bushman, Frederic

443

[The use of disinfectants in veterinary practice].  

PubMed

The use of chemical disinfectants within the veterinary practice is only permitted when the disinfectants are legally registered. A distinction has to be made between disinfectants to be used on the skin of men or animals and disinfectants to be used on surfaces like floors, walls, cages, stables and for veterinary instruments. For the first group, to be considered as (veterinary) medicines, the Act on (Veterinary) Medicines applies. For the second group, to be considered as veterinary biocides, the Pesticide Act applies. A small survey carried out by the Keuringsdienst van Waren shows that in veterinary practice disinfectants are applied in an inappropriate way. A lack of knowledge and the lack of hygienic protocols could be reasons for these misuses. In this article the Keuringsdienst van Waren gives information about the legal aspects of disinfectants that fall within the scope of the Pesticide Act. PMID:12625156

Reus, H R

2003-02-15

444

Advanced patient records: some ethical and legal considerations touching medical information space.  

PubMed

The application of advanced computer-based information technology to patient records presents an opportunity for expanding the informational resource base that is available to health-care providers at all levels. Consequently, it has the potential for fundamentally restructuring the ethics of the physician/patient relationship and the ethos of contemporary health-care delivery. At the same time, the technology raises several important ethical problems. This paper explores some of these implications. It suggests that the fundamental ethical issue at stake in these developments is the status of the electronic record which functions as the analog of the health-care consumer in health-care decision making. Matters such as control and patient dignity are implicated. Other important ethical issues requiring solution include data ownership, data liability, informed consent to use and retrieval, security and access. The paper suggests that the ethical problems that arise cannot be solved in piecemeal fashion and on a purely national basis. They should be addressed in a coordinated international fashion and receive appropriate legal expression in the relevant countries and be incorporated into appropriate codes of ethics. PMID:8321138

Kluge, E H

1993-04-01

445

DOCTOR OF VETERINARY MEDICINE (DVM) PROGRAM  

E-print Network

..................................................................................1 II. REGIONAL NATURE OF WCVM.......................................................................................................................................4 V. ANIMALS AND VETERINARY EXPERIENCE the needs of animal health care in Western Canada and beyond. · During

Saskatchewan, University of

446

Tufts Cummings School of Veterinary Medicine Name: __________________________________________________________  

E-print Network

Tufts Cummings School of Veterinary Medicine Name: __________________________________________________________ First Middle Last Tufts ID/Drivers License #/Passport # (choose one: _______________________________________________ Phone Number: ____________________________ Position At Tufts (check one only) Faculty (Full

Tufts University

447

Physician use of electronic medical records: Issues and successes with direct data entry and physician productivity  

PubMed Central

At Intermountain Health Care, we evaluated whether physicians in an ambulatory setting will voluntarily choose to enter data directly into an electronic health record (EHR). In this paper we describe the benefits of an EHR, as they exist in the current IHC application and the ways in which we have sought to minimize obstacles to physician data entry. Currently, of 472 IHC employed physicians, 321 (68%) routinely enter some data directly into the EHR without coercion. Twenty-five percent (80/321) of the physicians use voice recognition for some data entry. Twelve of our 95 ambulatory clinics have voluntarily adopted measures to eliminate paper charts. Of the 212 physicians who entered data in 2004, sixty-nine physicians (22%) increased their level of data entry, while 12 (6%) decreased. We conclude that physicians will voluntarily adopt an EHR system, and will continue and even increase use after implementation barriers are addressed. PMID:16779018

Clayton, Paul D.; Narus, Scott P.; Bowes, Watson A.; Madsen, Tammy S.; Wilcox, Adam B.; Orsmond, Garth; Rocha, Beatriz; Thornton, Sidney N.; Jones, Spencer; Jacobsen, Craig A.; Udall, Marc R.; Rhodes, Michael L.; Wallace, Brent E.; Cannon, Wayne; Gardner, Jerry; Huff, Stan M.; Leckman, Linda

2005-01-01

448

BioMedical Sciences BioMedical Sciences  

E-print Network

on to medical, dental, veterinary, pharmacy school, biomedical research or employment with pharmaceutical As a Cytotechnologist, you'll use high-tech methodology to study cells within the human body. You will prepare slides

Saldin, Dilano

449

Longitudinal analysis of pain in patients with metastatic prostate cancer using natural language processing of medical record text  

PubMed Central

Objectives To test the feasibility of using text mining to depict meaningfully the experience of pain in patients with metastatic prostate cancer, to identify novel pain phenotypes, and to propose methods for longitudinal visualization of pain status. Materials and methods Text from 4409 clinical encounters for 33 men enrolled in a 15-year longitudinal clinical/molecular autopsy study of metastatic prostate cancer (Project to ELIminate lethal CANcer) was subjected to natural language processing (NLP) using Unified Medical Language System-based terms. A four-tiered pain scale was developed, and logistic regression analysis identified factors that correlated with experience of severe pain during each month. Results NLP identified 6387 pain and 13?827 drug mentions in the text. Graphical displays revealed the pain ‘landscape’ described in the textual records and confirmed dramatically increasing levels of pain in the last years of life in all but two patients, all of whom died from metastatic cancer. Severe pain was associated with receipt of opioids (OR=6.6, p<0.0001) and palliative radiation (OR=3.4, p=0.0002). Surprisingly, no severe or controlled pain was detected in two of 33 subjects’ clinical records. Additionally, the NLP algorithm proved generalizable in an evaluation using a separate data source (889 Informatics for Integrating Biology and the Bedside (i2b2) discharge summaries). Discussion Patterns in the pain experience, undetectable without the use of NLP to mine the longitudinal clinical record, were consistent with clinical expectations, suggesting that meaningful NLP-based pain status monitoring is feasible. Findings in this initial cohort suggest that ‘outlier’ pain phenotypes useful for probing the molecular basis of cancer pain may exist. Limitations The results are limited by a small cohort size and use of proprietary NLP software. Conclusions We have established the feasibility of tracking longitudinal patterns of pain by text mining of free text clinical records. These methods may be useful for monitoring pain management and identifying novel cancer phenotypes. PMID:23144336

Heintzelman, Norris H; Taylor, Robert J; Simonsen, Lone; Lustig, Roger; Anderko, Doug; Haythornthwaite, Jennifer A; Childs, Lois C; Bova, George Steven

2013-01-01

450

[Veterinary treatment of pigeon flocks].  

PubMed

Veterinary treatment of pigeon flocks requires specific knowledge on the management of the various pigeon flocks as well as of common diseases in these birds and important diagnostic and therapeutic measures. In this context, it is important to differentiate between racing pigeons, thoroughbreds and pigeons kept for meat production, that is, between food-supplying and companion animals. The following article provides an overview of the species-specific characteristics of Columba livia f. domestica and frequently occurring diseases as well as common therapeutic and prophylactic measures. PMID:25323217

Krautwald-Junghanns, M-E; Hofstetter, S; Schmidt, V

2014-10-17

451

Study of the factors that promoted the implementation of Electronic Medical Record on iPads at Two Emergency Departments  

PubMed Central

The purpose of this study was to understand the factors which promoted the demand for iPads by physicians in two Emergency departments (ED) prior to a system wide implementation of an electronic medical record (EMR). A grounded theory design was employed and 14 semi-structured interviews conducted with ED physicians. Analysis of the interview transcripts was completed using Atlas.ti qualitative software, which revealed that physicians’ perceptions of iPad use in the ED stemmed from their personal use of iPads along with three perceived ease of use factors. Physicians perceived that improved patient physician interaction, improved workflow and structural iPad benefits promoted their demand. Physicians perceived the structural benefits of iPads would improve patient physician interaction and improve workflow in the ED. As interest in handheld devices such as iPads increases, these findings could direct and encourage other iPad implementations at other hospital EDs’. PMID:23304348

Rao, Akhil Sanjay; Adam, Terrence J.; Gensinger, Raymond; Westra, Bonnie L.

2012-01-01

452

2012 update on meaningful use of electronic health records: recommendations from the AAO-HNS Medical Informatics Committee.  

PubMed

In 2011, the US federal government implemented an oversight program to encourage the adoption and meaningful use of electronic health records (EHRs). Otolaryngologists may receive as much as $44,000 under Medicare or $63,750 under Medicaid as part of this law. To receive this full benefit, otolaryngologists must acquire a certified EHR and demonstrate stage 1 meaningful use requirements by the end of 2012. Furthermore, the Office of the National Coordinator for Health IT intends to advance meaningful use requirements to stage 2 (estimated to go in effect in 2014) and stage 3 requirements. This commentary discusses updated recommendations from the Academy of Otolaryngology-Head and Neck Surgery Medical Informatics Committee for implementing meaningful use of EHRs, receiving incentive payments, and preparing for potential stage 2 and stage 3 requirements. PMID:22241788

Sun, Gordon H; Eisenberg, Lee D; Ermini, Edward B; Lee, K J; Nielsen, David R; Rubin, Koryn Y; Das, Subinoy

2012-04-01

453

Agreement between hospitalized adolescents' self-reports of maltreatment and witnessed home violence and clinician reports and medical records.  

PubMed

Seventy-one consecutive psychiatrically hospitalized adolescents (34 males and 37 females) were systematically asked about their experiences of sexual abuse, physical abuse, and witnessing home violence using a reliable 46-item self-report measure of maltreatment, the Traumatic Events Questionnaire-Adolescent Version (TEQ-A). Subjects' responses were compared with a "best-estimate" source consisting of data from child protective service and police reports, medical records, and clinician interviews. Rates of agreement varied from 88% (kappa value [kappa] = .75) for sexual abuse, to 83% (kappa = .65) for physical abuse, to 75% (kappa = .49) for witnessing home violence. Disclosures of maltreatment were not significantly influenced by the gender, age, educational level, or ethnicity of the adolescent. Disclosures were highest for sexual abuse (86%) and lowest for witnessing home violence (68%). The results show that psychiatrically hospitalized adolescents' self-reports of maltreatment experiences generally concur very well with best-estimate sources. PMID:10509616

Winegar, R K; Lipschitz, D S

1999-01-01

454

Veterinary Preventive Medicine Curriculum Development at Louisiana State University  

ERIC Educational Resources Information Center

The program aims at training veterinarians, with interdepartmental faculty participation the rule rather than the exception. Included in the curriculum are: avian medicine, herd health management, veterinary public health, veterinary food hygiene, and regulatory veterinary medicine. (LBH)

Hubbert, William T.

1976-01-01

455

Importance of Testing for Usability When Selecting and Implementing an Electronic Health or Medical Record System  

PubMed Central

Purpose: An oncology electronic health record (EHR) was implemented without prior usability testing. Before expanding the system to new clinics, this study was initiated to examine the role of usability testing in the evaluation of an EHR product and whether novice users could identify issues with usability that resonated with more experienced users of the system. In addition, our study evaluated whether usability issues with an already implemented system affect efficiency and satisfaction of users. Methods: A general usability guide was developed by a group of five informaticists. Using this guide, four novice users evaluated an EHR product and identified issues. A panel of five experts reviewed the identified issues to determine agreement with and applicability to the already implemented system. A survey of 42 experienced users of the previously implemented EHR was also performed to assess efficiency and general satisfaction. Results: The novice users identified 110 usability issues. Our expert panel agreed with 90% of the issues and recommendations for correction identified by the novice users. Our survey had a 54% response rate. The majority of the experienced users of the previously implemented system, which did not benefit from upfront usability testing, had a high degree of dissatisfaction with efficiency and general functionality but higher overall satisfaction than expected. Conclusion: In addition to reviewing features and content of an EHR system, usability testing could improve the chances that the EHR design is integrated with existing workflow and business processes in a clear and efficient way. PMID:20808553

Corrao, Natalie J.; Robinson, Alan G.; Swiernik, Michael A.; Naeim, Arash

2010-01-01

456

Methods to Achieve High Interrater Reliability in Data Collection From Primary Care Medical Records  

PubMed Central

PURPOSE We assessed interrater reliability (IRR) of chart abstractors within a randomized trial of cardiovascular care in primary care. We report our findings, and outline issues and provide recommendations related to determining sample size, frequency of verification, and minimum thresholds for 2 measures of IRR: the ? statistic and percent agreement. METHODS We designed a data quality monitoring procedure having 4 parts: use of standardized protocols and forms, extensive training, continuous monitoring of IRR, and a quality improvement feedback mechanism. Four abstractors checked a 5% sample of charts at 3 time points for a predefined set of indicators of the quality of care. We set our quality threshold for IRR at a ? of 0.75, a percent agreement of 95%, or both. RESULTS Abstractors reabstracted a sample of charts in 16 of 27 primary care practices, checking a total of 132 charts with 38 indicators per chart. The overall ? across all items was 0.91 (95% confidence interval, 0.90–0.92) and the overall percent agreement was 94.3%, signifying excellent agreement between abstractors. We gave feedback to the abstractors to highlight items that had a ? of less than 0.70 or a percent agreement less than 95%. No practice had to have its charts abstracted again because of poor quality. CONCLUSIONS A 5% sampling of charts for quality control using IRR analysis yielded ? and agreement levels that met or exceeded our quality thresholds. Using 3 time points during the chart audit phase allows for early quality control as well as ongoing quality monitoring. Our results can be used as a guide and benchmark for other medical chart review studies in primary care. PMID:21242562

Liddy, Clare; Wiens, Miriam; Hogg, William

2011-01-01

457

Electronic Medical Record Cancer Incidence over Six Years Comparing New Users of Glargine with New Users of NPH Insulin  

PubMed Central

Background Recent studies suggested that insulin glargine use could be associated with increased risk of cancer. We compared the incidence of cancer in new users of glargine versus new users of NPH in a longitudinal clinical cohort with diabetes for up to 6 years. Methods and Findings From all patients who had been regularly followed at Massachusetts General Hospital from 1/01/2005 to 12/31/2010, 3,680 patients who had a medication record for glargine or NPH usage were obtained from the electronic medical record (EMR). From those we selected 539 new glargine users (age: 60.1±13.6 years, BMI: 32.7±7.5 kg/m2) and 343 new NPH users (61.5±14.1 years, 32.7±8.3 kg/m2) who had no prevalent cancer during 19 months prior to glargine or NPH initiation. All incident cancer cases were ascertained from the EMR requiring at least 2 ICD-9 codes within a 2 month period. Insulin exposure time and cumulative dose were validated. The statistical analysis compared the rates of cancer in new glargine vs. new NPH users while on treatment, adjusted for the propensity to receive one or the other insulin. There were 26 and 28 new cancer cases in new glargine and new NPH users for 1559 and 1126 person-years follow-up, respectively. There were no differences in the propensity-adjusted clinical characteristics between groups. The adjusted hazard ratio for the cancer incidence comparing glargine vs. NPH use was 0.65 (95% CI: 0.36–1.19). Conclusions Insulin glargine is not associated with development of cancers when compared with NPH in this longitudinal and carefully retrieved EMR data. PMID:25329887

He, Wei; Bianca, Porneala C.; Yelibi, Carine; Marquis, Alison; Sturmer, Til; Buse, John B.; Meigs, James B.

2014-01-01

458

Development and pilot of Case Manager: a virtual-patient experience for veterinary students.  

PubMed

There is an increasing demand in veterinary education to engage students, teach and reinforce clinical reasoning, and provide access anytime/anywhere to quality learning opportunities. In addition, accrediting bodies are asking for more concrete documentation of essential clinical-skills outcomes. Unfortunately, during the clinical year in a referral hospital setting, students are at the mercy of chance regarding the types of cases they will encounter and the opportunities they will have to participate. Patient- and case-simulation technology is becoming more popular as a way to achieve these objectives in human and veterinary medical education. Many of the current options available to the veterinary medical education community to develop virtual-patient cases are too time-consuming, cost prohibitive, or difficult for the instructor or learner to use. In response, we developed a learning tool, Case Manager, which is low-cost and user-friendly. Case Manager was designed to meet the demands of veterinary education by providing students with an opportunity to cultivate clinical reasoning skills and allowing for real-time student feedback. We launched a pilot test with 37 senior veterinary medical students as part of their Small Animal Internal Medicine clinical rotation. Students reported that Case Manager increased their engagement with the material, improved diagnostic and problem-solving skills, and broadened their exposure to a variety of cases. In addition, students felt that Case Manager was superior to a more traditional, less interactive case presentation format. PMID:24947678

Byron, Julie K; Johnson, Susan E; Allen, L Clare V; Brilmyer, Cheryl; Griffiths, Robert P

2014-01-01

459

Current distribution of Achatina fulica, in the state of São Paulo including records of Aelurostrongylus abstrusus (Nematoda) larvae infestation.  

PubMed

The currently known distribution range of Achatina fulica Bowdich, 1822, in the state of São Paulo, Brazil, is presented. The record of A. fulica naturally infested with Aelurostrongylus abstrusus larvae (Railliet, 1898) (Nematoda: Metastrongylidae) can be found in the city of Guaratinguetá. It was found A. fulica with Metastrongylidae larvae without known medical and veterinary importance in the cities of Carapicuíba, Embu-Guaçu, Itapevi, São Caetano do Sul, São Paulo and Taboão da Serra. PMID:21748230

Ohlweiler, Fernanda Pires; Guimarães, Marisa Cristina de Almeida; Takahashi, Fernanda Yoshika; Eduardo, Juliana Manas

2010-01-01

460

Development of a portable information system: connecting palmtop computers with medical records systems and clinical reference resources.  

PubMed Central

The portability of palmtop computers makes them an ideal platform to maintain communication between busy physicians and medical information systems. In our academic FHC (Family Health Center) we have developed software that runs on a palmtop computer allowing access to information in the HIS (Hospital Information System) and our FHC's AAMRS (Automated Ambulatory Medical Record System). The resident physicians who staff the hospital and the FHC are frequently at home or otherwise off-site where terminal access is not available. Using a Hewlett-Packard 95LX palmtop computer as the base platform, custom software has been developed to access summary data on in-patients and out-patients. Data is downloaded into a database on a palmtop computer memory card. ASCII data from Medical Information Systems (MIS), is transformed into a database format readable on the palmtop. Our hospital MIS department transmits information daily on our in-patient service (20-30 patients). We also download, weekly, a patient summary on all of our active out-patients in our MUMPS-based AAMRS (2500-3000 patients). Each morning the resident in the Family Practice program updates his palmtop memory card at a central workstation. Palmtop computers with downloaded databases, can be valuable in care of patients when the physical or on-line chart is not easily accessible. They are particularly useful in multi-physician groups when the on-call physician provides care for the patients of other physicians. We have made the palmtop computer even more valuable to physicians by providing an integrated software package.(ABSTRACT TRUNCATED AT 250 WORDS) Images Figure 1 PMID:8130447

Ram, R.; Block, B.

1993-01-01