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1

MEDICAL AND VETERINARY SCIENCE Deselection of applicants  

E-print Network

MEDICAL AND VETERINARY SCIENCE Deselection of applicants (for medics and vets) Competition arrangements. Criminal Record Check (for medics and vets) All offers of a place on this course will be subject. Those of you being offered a place (conditional or unconditional) for Medical or Veterinary Sciences

Dixon, Peter

2

American Veterinary Medical Association  

MedlinePLUS

... Awards Veterinary Education Economics & Practice Economics & Finance Practice Management Client Materials Insurance Advocacy National Issues State & Local Issues Get Involved Meetings & Events AVMA Annual Convention Veterinary Leadership Conference Future AVMA Meeting Dates Meetings & CE Calendar ...

3

American Veterinary Medical Association (AVMA)  

NSDL National Science Digital Library

The American Veterinary Medical Association is a highly recognized not-for-profit organization specializing in animal-related issues. Whether you have questions about a pet, wild animal, or the latest animal vaccination news, you can find updated information at avma.org on these and various other topics. AVMA is divided into sections for the public, for members, and links to scientific resources. The research findings performed by AVMA are widely available to the public, and include both scientific and medical material. It includes access to the Journal of the American Veterinary Medicine Association and the American Journal of Veterinary Research. AVMA is an excellent resource for veterinary students, instructors and pet owners alike.

2007-02-22

4

American Veterinary Medical Association Media Library  

NSDL National Science Digital Library

The American Veterinary Medical Association's Media Library website is filled with free audio and video media on different topics. The categories under which the topics are organized are "Podcasts", "Timely Audio News", "PSAs", and "Latest Videos". The topics range from highly technical to suitability for a layperson, from livestock concerns to "America's Top Ten Cat Cities". Visitors can see a lengthier list of each of the categories by clicking on "More Podcasts", "More News", etc. at the bottom of the page. In the "Timely Audio News" category are several Spanish Language versions of basic pet care articles, such as "The Benefits of Spaying or Neutering Your Pets" and "Does Your Pet need a Rabies Shot?" At the bottom of the homepage is the section called "Audio Features" that contains over 50 audio files on topics that include equine, pet safety, dog bites, birds, and exotic pets.

5

The role of veterinary medical librarians in teaching information literacy.  

PubMed

This qualitative study seeks to determine the nature of the instruction librarians provide to veterinary medical students at all 28 United States veterinary colleges. A secondary goal of the study was to determine in what ways and to what extent librarians participated in other instructional activities at their colleges. Over half of the librarians formally taught in one or more courses, predominantly in the first two years of the veterinary curriculum. One presentation per course was most common. Over half of the librarians interviewed stated that evidence-based veterinary medicine was taught at their colleges, and about half of these librarians collaborated with veterinary faculty in this instruction. Many librarians participated in orientation for first-year veterinary students. The librarians also taught instructional sessions for residents, interns, faculty, graduate students, and practicing veterinarians. This study found that librarians teach information literacy skills both formally and informally, but, in general, instruction by librarians was not well integrated into the curriculum. This study advances several recommendations to help veterinary students develop information literacy skills. These include: encourage veterinary faculty and administrators to collaborate more closely with librarians, incorporate a broader array of information literacy skills into assignments, and add a literature evaluation course to the curriculum. PMID:22023922

Dinkelman, Andrea L; Viera, Ann R; Bickett-Weddle, Danelle A

2011-01-01

6

21 CFR 530.5 - Veterinary records.  

Code of Federal Regulations, 2010 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...

2010-04-01

7

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

8

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

9

21 CFR 530.5 - Veterinary records.  

Code of Federal Regulations, 2014 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...

2014-04-01

10

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

11

75 FR 77607 - Privacy Act of 1974; Proposed New System of Records; Veterinary Medicine Loan Repayment Program  

Federal Register 2010, 2011, 2012, 2013, 2014

...Proposed New System of Records; Veterinary Medicine Loan Repayment Program AGENCY: National...records notice titled, ``Veterinary Medicine Loan Repayment Program Records System...select applicants for the Veterinary Medicine Loan Repayment Program...

2010-12-13

12

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

13

USDA Center for Medical, Agricultural and Veterinary Entomology  

NSDL National Science Digital Library

A bibliography of publications from the USDA Center for Medical, Agricultural and Veterinary Entomology. Cataloged by year and searchable by peer-reviewed journal publications only or all publications. Links to each publication give reference details along with an interpretive summary as well as the technical abstract.

0000-00-00

14

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

15

Making medical records more resilient  

E-print Network

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

Rudin, Robert (Robert Samuel)

2007-01-01

16

Influence of a veterinary curriculum on the approaches and study skills of veterinary medical students.  

PubMed

The objectives of the present study were to evaluate first-, second-, third-, and fourth-year veterinary medical students' approaches to studying and learning as well as the factors within the curriculum that may influence these approaches. A questionnaire consisting of the short version of the Approaches and Study Skills Inventory for Students (ASSIST) was completed by 405 students, and it included questions relating to conceptions about learning, approaches to studying, and preferences for different types of courses and teaching. Descriptive statistics, factor analysis, Cronbach's alpha analysis, and log-linear analysis were performed on the data. Deep, strategic, and surface learning approaches emerged. There were a few differences between our findings and those presented in previous studies in terms of the correlation of the subscale monitoring effectiveness, which showed loading with both the deep and strategic learning approaches. In addition, the subscale alertness to assessment demands showed correlation with the surface learning approach. The perception of high workloads, the use of previous test files as a method for studying, and examinations that are based only on material provided in lecture notes were positively associated with the surface learning approach. Focusing on improving specific teaching and assessment methods that enhance deep learning is anticipated to enhance students' positive learning experience. These teaching methods include instructors who encourage students to be critical thinkers, the integration of course material in other disciplines, courses that encourage thinking and reading about the learning material, and books and articles that challenge students while providing explanations beyond lecture material. PMID:22130414

Chigerwe, Munashe; Ilkiw, Jan E; Boudreaux, Karen A

2011-01-01

17

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

18

Illegible handwriting in medical records.  

PubMed

In clinical records many items are handwritten and difficult to read. We examined clinical histories in a representative sample of case notes from a Spanish general hospital. Two independent observers assigned legibility scores, and a third adjudicated in case of disagreement. Defects of legibility such that the whole was unclear were present in 18 (15%) of 117 reports, and were particularly frequent in records from surgical departments. Through poor handwriting, much information in medical records is inaccessible to auditors, to researchers, and to other clinicians involved in the patient's care. If clinicians cannot be persuaded to write legibly, the solution must be an accelerated switch to computer-based systems. PMID:12411618

Rodríguez-Vera, F Javier; Marín, Y; Sánchez, A; Borrachero, C; Pujol, E

2002-11-01

19

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

20

14 CFR 67.413 - Medical records.  

Code of Federal Regulations, 2012 CFR

...2012-01-01 2012-01-01 false Medical records. 67.413 Section 67...TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Certification Procedures § 67.413 Medical records. (a) Whenever the...

2012-01-01

21

14 CFR 67.413 - Medical records.  

Code of Federal Regulations, 2014 CFR

...2014-01-01 2014-01-01 false Medical records. 67.413 Section 67...TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Certification Procedures § 67.413 Medical records. (a) Whenever the...

2014-01-01

22

14 CFR 67.413 - Medical records.  

Code of Federal Regulations, 2013 CFR

...2013-01-01 2013-01-01 false Medical records. 67.413 Section 67...TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Certification Procedures § 67.413 Medical records. (a) Whenever the...

2013-01-01

23

Virtual Microscopy: A Useful Tool for Meeting Evolving Challenges in the Veterinary Medical Curriculum  

NASA Astrophysics Data System (ADS)

Veterinary schools, similar to many professional health programs, face a myriad of evolving challenges in delivering their professional curricula including expansion of class size, costs to maintain expensive laboratories, and increased demands on veterinary educators to use curricular time efficiently and creatively. Additionally, exponential expansion of the knowledge base through ongoing biomedical research, educational goals to increase student engagement and clinical reasoning earlier in the curriculum, and students' desire to access course materials and enhance their educational experience through the use of technology all support the need to reassess traditional microscope laboratories within Professional Veterinary Medical (PVM) educational programs. While there is clear justification for teaching veterinary students how to use a microscope for clinical evaluation of cytological preparations (i.e., complete blood count, urinalysis, fecal analysis, fine needle aspirates, etc.), virtual microscopy may be a viable alternative to using light microscopy for teaching and learning fundamental histological concepts. This article discusses results of a survey given to assess Professional Veterinary Medical students' perceptions of using virtual microscope for learning basic histology/microscopic anatomy and implications of these results for using virtual microscopy as a pedagogical tool in teaching first-year Professional Veterinary Medical students' basic histology.

Kogan, Lori R.; Dowers, Kristy L.; Cerda, Jacey R.; Schoenfeld-Tacher, Regina M.; Stewart, Sherry M.

2014-12-01

24

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

25

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

26

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 false Medical records. 701.122 Section 701.122 National...UNITED STATES NAVY REGULATIONS AND OFFICIAL RECORDS AVAILABILITY OF DEPARTMENT OF THE NAVY RECORDS AND PUBLICATION OF DEPARTMENT OF THE...

2010-07-01

27

Learning-style profiles of 150 veterinary medical students.  

PubMed

Awareness of student learning-style preferences is important for several reasons. Understanding differences in learning styles permits instructors to design course materials that allow all types of learners to absorb and process information. Students who know their own learning style are better able to help themselves in courses taught in a non-preferred method by developing study strategies in line with their preferred learning method. We used the Felder and Solomon Index of Learning Styles to assess the learning-style profiles of 150 veterinary students in three consecutive years. Students were predominantly active (56.7%), sensing (79.3%), visual (76.7%), and sequential (69.3%). Most were balanced on the active-reflective (59.3%) and global-sequential (50%) dimensions, and 61.3% and 54% were moderately to strongly sensing and visual, respectively. Small but significant numbers of students were moderately to strongly intuitive (8.7%), verbal (13%), and global (12%). The most common patterns were active-sensing-visual-sequential (26%), reflective-sensing-visual-sequential (19.3%), active-sensing-visual-global (8.7%), and active-sensing-verbal-sequential (8.7%). Although most students (65.3%) were balanced on one to two dimensions, 77.3% had one or more strong preferences. Our results show that although people have dominant learning-style preference and patterns, they have significant minor preferences and patterns across all dimensions with moderate to strong preferences on each scale. These results indicate that a balanced approach to teaching is essential to allow all students to learn optimally. PMID:21135401

Neel, Jennifer A; Grindem, Carol B

2010-01-01

28

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.

29

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2014 CFR

...protection to certain medical records (e.g., drug and alcohol abuse treatment and psychiatric records.) Even if the records are...time of the treatment or consultation was 15, 16, or 17 years old; the treatment or consultation was within a program...

2014-07-01

30

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2011 CFR

...protection to certain medical records (e.g., drug and alcohol abuse treatment and psychiatric records.) Even if the records are...time of the treatment or consultation was 15, 16, or 17 years old; the treatment or consultation was within a program...

2011-07-01

31

32 CFR 701.122 - Medical records.  

Code of Federal Regulations, 2012 CFR

...protection to certain medical records (e.g., drug and alcohol abuse treatment and psychiatric records.) Even if the records are...time of the treatment or consultation was 15, 16, or 17 years old; the treatment or consultation was within a program...

2012-07-01

32

Analyses and decreasing patterns of veterinary antianxiety medications in soils.  

PubMed

An ultrasonic-assisted extraction method was developed to detect 16 antianxiety medications in soil samples using liquid chromatography-high resolution mass spectrometry (LC-HRMS), Orbitrap mass spectrometer. The determination method resulted in satisfactory sensitivity, linearity, recovery, repeatability, and within-laboratory reproducibility. Acepromazine, azaperone, and xylazine were incubated in control, amended, and sterilized soils. The amendment with powdered blood meal affected the relatively fast dissipations of acepromazine, azaperone, and xylazine in the soils. Dissipation kinetics of acepromazine were consistent with bi-phasic kinetics (first-order multi compartment) and the other couples were fit to single first-order kinetics. A hydroxylated acepromazine was identified from soil samples using Orbitrap mass spectrometry. According to sorption batch experiments, the adsorption of acepromazine and azaperone was greatly high, whereas that of xylazine was relatively low. Xylazine was persistent in the incubated soils, and acepromazine demonstrated fast initial dissipation; hence, xylazine could have a potential harmful effect on the environment. To the best of our knowledge, this is the first report on the dissipation and adsorption-desorption patters of animal pharmaceutical tranquilizers and ?, ?-blockers. PMID:24857899

Choi, Jeong-Heui; Lamshöft, Marc; Zühlke, Sebastian; Abd El-Aty, A M; Rahman, Md Musfiqur; Kim, Sung Woo; Shim, Jae-Han; Spiteller, Michael

2014-06-30

33

Texas A&M Veterinary Medical Diagnostic Lab Rules 15.99.03.V1 Ethics in Research, Scholarship, and Creative Work  

E-print Network

Texas A&M Veterinary Medical Diagnostic Lab Rules 15.99.03.V1 Ethics in Research, Scholarship Medical Diagnostic Lab Rules 15.99.03.V1 Ethics in Research, Scholarship, and Creative Work Page 1 of 2&M Veterinary Medical Diagnostic Lab Rules 15.99.03.V1 Ethics in Research, Scholarship, and Creative Work Page

34

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

35

MEDRIS: The Problem Oriented Electronic Medical Record in Medical Education  

PubMed Central

MEDRIS (The Medical Record Interface System) is an object oriented HyperCard interface designed to help physicians enter patient information as comfortably and naturally as possible. It can function as a stand alone system producing its own reports or serve as an interface to a medical expert system (e.g., MEDAS). MEDRIS plays an important role in the clinical education of medical students at the Chicago Medical School. MEDRIS portrays an intuitive, graphically oriented system that will provide a learning environment for the problem oriented medical record (POMR) that forms the basis of the structure of the history and physical exam. The enthusiasm shown by the medical students for this project has garnered support for including MEDRIS in the curriculum of the Introduction to Clinical Medicine course this semester. MEDRIS, developed using HyperCard, can be used as a tool not only for teaching POMR and physical diagnosis, but also computer literacy.

Rifat, Sami F.; Robert, Shanthi; Trace, David; Prakash, Sanjeev; Naeymi-Rad, Frank; Barnett, David; Pannicia, Gregory; Hammergren, David; Carmony, Lowell; Evens, Martha

1990-01-01

36

TITLE: RESEARCH AND HIPAA CLINICAL AND MEDICAL RECORDS Columbia University Medical Center will administer and conduct medical records research  

E-print Network

TITLE: RESEARCH AND HIPAA CLINICAL AND MEDICAL RECORDS POLICY: Columbia University Medical Center will administer and conduct medical records research activities in accordance with city, state, and federal laws Individuals conducting or assisting with research activities will follow existing Columbia University Medical

Columbia University

37

A review of student evaluation of teaching: applications to veterinary medical education.  

PubMed

Student evaluation of teaching is ubiquitous to teaching in colleges and universities around the world. Since the implementation of student evaluations in the 1970s in the US, considerable research has been devoted to their appropriate use as a means of judging the effectiveness of teaching. The present article aims to (1) examine the evidence for the reliability, validity, and utility of student ratings; (2) provide seven guidelines for ways to identify effective instruction, given that the purpose of student evaluation is to assess effective teaching; and (3) conclude with recommendations for the integration of student ratings into the continuous evaluation of veterinary medical education. PMID:22433742

Beran, Tanya N; Donnon, Tyrone; Hecker, Kent

2012-01-01

38

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

39

5 CFR 2504.6 - Special procedures for medical records.  

Code of Federal Regulations, 2010 CFR

...procedures for medical records. (a) When the...those official medical records which belong to the Office of Personnel Management and are described in...Federal Personnel Manual (medical records about entrance...

2010-01-01

40

Privacy, confidentiality, and electronic medical records.  

PubMed Central

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

Barrows, R C; Clayton, P D

1996-01-01

41

[Theo van Gogh's medical record].  

PubMed

In the final months of his life Theo van Gogh was admitted to the 'Geneeskundig Gesticht voor Krankzinnigen te Utrecht'. In November 1990 from the archives of the Willem Arntsz Huis, psychiatric centre in Utrecht, the medical files from this period were made available and a transcription was made by Han van Crimpen and Sjraar van Heugten, scientific collaborators of the Van Gogh Museum. From these data it is acceptable to conclude that Theo van Gogh had dementia paralytica and suffered a fast deterioration of his situation in these last few months. It is, however, probable that at least as early as 1886 Theo showed the first symptoms of this disease when he was in Paris, and that he was treated for this reason by dr. Rivet and dr. Gruby. There are insufficient indications that in Vincent van Gogh's case the same diagnosis can be put forward. It is most probable that during Vincent's visit to Theo in Paris in July 1890 in Theo's case symptoms of his medical deterioration were to be seen and this may have influenced the considerations finally leading to Vincent van Gogh's suicide. PMID:1407128

Voskuil, P H

1992-09-01

42

Interprofessional initiatives between the human health professions and veterinary medical students: a scoping review.  

PubMed

This article presents the findings of a scoping review designed to identify the extent, nature and range of literature on interprofessional education (IPE) initiatives between the human health professions and veterinary medical students, which is particularly important to advance One Health education and research. Nine published articles were identified. The websites of six universities were searched in order to collect further information. Interventions vary widely with regards to their structure and delivery, their objectives, the participants involved, and outcome measures. Healthcare professional programmes focus upon interprofessional collaborative practice in the human healthcare setting. By contrast, postgraduate programmes focus upon topics under the One Health paradigm but make little mention of interprofessional collaboration. Evidence of the impact of interventions on team processes at the human, animal, and environmental interface is extremely limited. In order to enhance our understanding of what constitutes effective IPE between veterinary medical students and the human health professions, guide intervention development, and the development of outcome measures, there is a need to further explore, define, differentiate and validate some of the terms and concepts used to describe interprofessional interventions. PMID:24621114

Courtenay, Molly; Conrad, Pat; Wilkes, Michael; La Ragione, Roberto; Fitzpatrick, Noel

2014-07-01

43

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

44

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

45

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

46

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:25655541

2015-02-01

47

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:25573870

2015-01-10

48

Texas A&M Veterinary Medical Diagnostic Lab Procedures 25.99.09.V0.01 Cellular Communication Devices and Services  

E-print Network

&M Veterinary Medical Diagnostic Laboratory Procedures 25.99.09.V0.01 Cellular Communication DevicesTexas A&M Veterinary Medical Diagnostic Lab Procedures 25.99.09.V0.01 Cellular Communication Devices and Services Approved: December 28, 2012 Next Scheduled Review: December 28, 2014 Texas A

49

Texas A&M Veterinary Medical Diagnostic Laboratory Procedures 15.01.03.V1.01 Financial Conflict of Interest in Research  

E-print Network

of Interest in Research Page 1 of 3 PROCEDURE STATEMENT Texas A&M Veterinary Medical Diagnostic LaboratoryTexas A&M Veterinary Medical Diagnostic Laboratory Procedures 15.01.03.V1.01 Financial Conflict of Interest in Research Approved: February 2, 2012 Revised: August 1, 2012 Next Scheduled Review: August 1

50

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.

51

17 CFR 200.305 - Special procedure: Medical records.  

Code of Federal Regulations, 2014 CFR

...false Special procedure: Medical records. 200.305 Section... ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS...305 Special procedure: Medical records. (a) Statement...pertaining to him that include medical and/or...

2014-04-01

52

17 CFR 200.305 - Special procedure: Medical records.  

Code of Federal Regulations, 2012 CFR

...false Special procedure: Medical records. 200.305 Section... ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS...305 Special procedure: Medical records. (a) Statement...pertaining to him that include medical and/or...

2012-04-01

53

17 CFR 200.305 - Special procedure: Medical records.  

Code of Federal Regulations, 2013 CFR

...false Special procedure: Medical records. 200.305 Section... ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS...305 Special procedure: Medical records. (a) Statement...pertaining to him that include medical and/or...

2013-04-01

54

17 CFR 200.305 - Special procedure: Medical records.  

Code of Federal Regulations, 2011 CFR

...false Special procedure: Medical records. 200.305 Section... ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS...305 Special procedure: Medical records. (a) Statement...pertaining to him that include medical and/or...

2011-04-01

55

17 CFR 200.305 - Special procedure: Medical records.  

Code of Federal Regulations, 2010 CFR

...false Special procedure: Medical records. 200.305 Section... ORGANIZATION; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS...305 Special procedure: Medical records. (a) Statement...pertaining to him that include medical and/or...

2010-04-01

56

5 CFR 297.205 - Access to medical records.  

Code of Federal Regulations, 2011 CFR

...2011-01-01 false Access to medical records... OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS...RECORDS Request for Access § 297.205 Access... When a request for access involves medical...of the physician's identity, the records will...

2011-01-01

57

5 CFR 297.205 - Access to medical records.  

Code of Federal Regulations, 2010 CFR

...2010-01-01 false Access to medical records... OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS...RECORDS Request for Access § 297.205 Access... When a request for access involves medical...of the physician's identity, the records will...

2010-01-01

58

20 CFR 401.55 - Access to medical records.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Access to medical records. 401.55 Section 401.55 Employees... PRIVACY AND DISCLOSURE OF OFFICIAL RECORDS AND INFORMATION The Privacy Act § 401.55 Access to medical records. (a) General. You have a...

2010-04-01

59

21 CFR 870.2800 - Medical magnetic tape recorder.  

Code of Federal Regulations, 2014 CFR

...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Monitoring Devices § 870.2800 Medical magnetic tape recorder. (a) Identification....

2014-04-01

60

The CRABEL score--a method for auditing medical records.  

PubMed Central

Medical record keeping has become increasingly important particularly for research, audit and medico-legal purposes. The authors present a protocol, the CRABEL score, that is quick and easy to use for the assessment of the quality of medical record keeping with the purpose of standardizing the audit of medical records and improving their quality. PMID:11212456

Crawford, J. R.; Beresford, T. P.; Lafferty, K. L.

2001-01-01

61

Enhancing Large-Group Problem-Based Learning in Veterinary Medical Education.  

ERIC Educational Resources Information Center

This project for large-group, problem-based learning at Kansas State University College of Veterinary Medicine developed 47 case-based videotapes that are used to model clinical conditions and also involved veterinary practitioners to formulate true practice cases into student learning opportunities. Problem-oriented, computer-assisted diagnostic…

Pickrell, John A.

62

Virtual Microscopy: A Useful Tool for Meeting Evolving Challenges in the Veterinary Medical Curriculum  

ERIC Educational Resources Information Center

Veterinary schools, similar to many professional health programs, face a myriad of evolving challenges in delivering their professional curricula including expansion of class size, costs to maintain expensive laboratories, and increased demands on veterinary educators to use curricular time efficiently and creatively. Additionally, exponential…

Kogan, Lori R.; Dowers, Kristy L.; Cerda, Jacey R.; Schoenfeld-Tacher, Regina M.; Stewart, Sherry M.

2014-01-01

63

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

64

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

PubMed

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

George, David R; Finn, Robert D; Graham, Kirsty M; Sparagano, Olivier A E

2014-01-01

65

Prevalence of Disorders Recorded in Dogs Attending Primary-Care Veterinary Practices in England  

PubMed Central

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

66

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

67

A new breed of risk: Electronic medical records security  

Microsoft Academic Search

Technological advances have seen convergences in previously disparate disciplines, such as medicine, computer technology and communications. This convergence is particularly apparent in clinical record keeping. For medical practice this has seen the transition from a paper-based patient record system to an electronic medical record (EMR) system. Integrated patient records are seen as a method to improve quality, cost effectiveness and

Patricia Williams; Rachel Mahncke

2005-01-01

68

Shallow medication extraction from hospital patient records.  

PubMed

This paper presents methods for shallow Information Extraction (IE) from the free text zones of hospital Patient Records (PRs) in Bulgarian language in the Patient Safety through Intelligent Procedures in medication (PSIP) project. We extract automatically information about drug names, dosage, modes and frequency and assign the corresponding ATC code to each medication event. Using various modules for rule-based text analysis, our IE components in PSIP perform a significant amount of symbolic computations. We try to address negative statements, elliptical constructions, typical conjunctive phrases, and simple inferences concerning temporal constraints and finally aim at the assignment of the drug ACT code to the extracted medication events, which additionally complicates the extraction algorithm. The prototype of the system was used for experiments with a training corpus containing 1,300 PRs and the evaluation results are obtained using a test corpus containing 6,200 PRs. The extraction accuracy (f-score) for drug names is 98.42% and for dose 93.85%. PMID:21685617

Boytcheva, Svetla

2011-01-01

69

Assessment of burnout in veterinary medical students using the Maslach Burnout Inventory-Educational Survey: a survey during two semesters.  

PubMed

BackgroundBurnout among veterinary students can result from known stressors in the absence of a support system. The objectives of this study were to evaluate use of the Maslach Burnout Inventory-Educator Survey (MBI-ES) to assess burnout in veterinary students and evaluate the factors that predict the MBI-ES scores.MethodsThe MBI-ES was administered to first (Class of 2016) and second year (Class of 2015) veterinary medical students during the 2012-2013 academic year in the fall and spring semesters. Factor analysis and test reliability for the survey were determined. Mean scores for the subscales determining burnout namely emotional exhaustion (EE), depersonalization (DP) and lack of personal accomplishment (PA) were calculated for both classes in the 2 semesters. Multiple regression analysis was performed to evaluate other factors that predict the MBI-ES scores.ResultsA non-probability sampling method was implemented consisting of a voluntary sample of 170 and 123 students in the fall and spring semesters, respectively. Scores for EE, DP and PA were not different between the 2 classes within the same semester. Mean¿±¿SD scores for EE, DP and PA for the fall semester were 22.9¿±¿9.6, 5.0¿±¿4.8 and 32.3¿±¿6.7, respectively. Mean¿±¿SD scores for EE, DP and PA the spring semester were 27.8¿±¿10.7, 6.5¿±¿6.1and 31.7¿±¿6.8, respectively. The EE score was higher in spring compared to fall while DP and PA scores were not different between the 2 semesters. Living arrangements specifically as to whether or not a student lived with another veterinary medical students was the only variable significantly associated with the MBI-ES scores. Students in this study had moderate levels of burnout based on the MBI-ES scores.ConclusionsThe MBI-ES was an acceptable instrument for assessing burnout in veterinary medical students. The EE scores were higher in the spring semester as compared to the fall semester. Thus students in the first and second years of veterinary school under the current curriculum experience the greatest levels of emotional exhaustion during the spring semester. This has administrative implications for the school, when considering the allocation and use of resources for student support systems during each semester. PMID:25429983

Chigerwe, Munashe; Boudreaux, Karen A; Ilkiw, Jan E

2014-11-28

70

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

PubMed

The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors. PMID:25397724

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

2014-12-01

71

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

72

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

73

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

E-print Network

Food & Drug Administration Animal Feed and Pet Food Safety Cooperative Agreement with the FDA-Veterinary Laboratory Response Network $19,000 Bruce Akey USDA-APHIS Classical Swine Fever Surveillance $23,694 Bruce-Federal Formula Funds Population Dynamics, Habitat Selection, Feeding Behavior and Guano Analysis of Brown Bats

Manning, Sturt

74

10 CFR 35.2080 - Records of mobile medical services.  

Code of Federal Regulations, 2014 CFR

...Energy 1 2014-01-01 2014-01-01 false Records of mobile medical services. 35.2080 Section 35.2080 Energy...USE OF BYPRODUCT MATERIAL Records § 35.2080 Records of mobile medical services. (a) A licensee shall retain...

2014-01-01

75

Too Few Seniors Check Their Medical Records Online  

MedlinePLUS

... the benefits of electronic medical records. University of Michigan researchers analyzed data from the long-running Health ... professor of internal medicine at the University of Michigan Medical School and research investigator at the Center ...

76

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

77

NEW YORK STATE EQUINE MEDICAL DIRECTOR The New York State Gaming Commission and the Cornell University College of Veterinary Medicine are  

E-print Network

NEW YORK STATE EQUINE MEDICAL DIRECTOR The New York State Gaming Commission and the Cornell University College of Veterinary Medicine are seeking applications for the New York State Equine Medical Director. The new position will be established cooperatively between Cornell and the State Gaming

Rodriguez, Carlos

78

Medical Records and Health Information Technicians  

MedlinePLUS

... categorize patient information for insurance reimbursement purposes, for databases and registries, and to maintain patients’ medical and ... categorize patient information for insurance reimbursement purposes, for databases and registries, and to maintain patients’ medical and ...

79

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

80

PART 2, Authors: ? ?? BYCHKOV; Index-Catalogue of Medical and Veterinary Zoology  

E-print Network

State Veterinary College Library. Lib. Cram.?Library of Dr. Eloise Blaine Cram, National Institute of Health, United States Public Health Service, Treasury Department, Washington. D. C. Lib. Hall.?Library of Dr. Maurice C. Hall, Zoological... Division, U. S. Public Health Service, located at National Institute of Health, Washington, D. C. Lib. Price.?Library of Dr. Emmett W. Price, Zoological Division, United States Bureau of Animal Industry, Washington, D. C. Lib. Schwartz...

Hassall, Albert; Potter, Maggie; Doss, Mildred; Farr, Marion; Carson, Gertrude

1938-01-01

81

MEDICAL STATEMENT Participant Record (Confidential Information)  

E-print Network

, cigars or cigarettes · have a high cholesterol level · have a family history of heart attack or stroke this statement prior to signing it. You must complete this Medical Statement, which includes the medical signed by a parent or guardian. Diving is an exciting and demanding activity. When performed correctly

Kavanagh, Karen L.

82

Electronic medical record systems for developing countries: Review  

Microsoft Academic Search

The majority of the focus related to the modernization of medical records is placed on developed countries. However, developing countries are also progressing from paper-based records to electronic records. The requirements of their systems can be dramatically different from those of the developed world. This paper describes briefly the benefits of EMRs in developing countries. It focuses on the basic

Nicholas A. Kalogriopoulos; Jonathan Baran; Amit J. Nimunkar; John G. Webster

2009-01-01

83

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

84

Overview of Mosquito Research Programs at the United States Department of Agriculture - Agricultural Research Service, Center for Medical, Agricultural & Veterinary Entomology  

Technology Transfer Automated Retrieval System (TEKTRAN)

The Center for Medical, Agricultural, and Veterinary Entomology (CMAVE), a U.S. Department of Agriculture – Agricultural Research Service laboratory, was established in World War II to produce products to protect military personnel against insect vector of disease. Currently the mission of CMAVE is ...

85

Interior, middle wing, medical records storage. Notice roof trusses. ...  

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

Interior, middle wing, medical records storage. Notice roof trusses. - Fitzsimons General Hospital, Nurses' Mess & Kitchen, Nurses' Recreation, West McAfee Avenue, North of Building 507, Aurora, Adams County, CO

86

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

87

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2013 CFR

...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES Administration § 494.170 Condition: Medical records. The dialysis facility must...

2013-10-01

88

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2014 CFR

...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE RENAL DISEASE FACILITIES Administration § 494.170 Condition: Medical records. The dialysis facility must...

2014-10-01

89

[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

90

The Literature of Veterinary Medicine. CE 60.  

ERIC Educational Resources Information Center

This course guide outlines the objectives and content for a professional continuing education course on the literature of veterinary medicine. Topics covered include: (1) an introduction to veterinary medicine as a discipline, including comparison with other medical sciences, veterinary medicine education, licensure, animal models, veterinary

Kerker, Ann E.; Malamud, Judie

91

Reaping the benefits of electronic medical record systems.  

PubMed

An electronic medical record system can provide benefits beyond the obvious functions of efficient and less labor-intensive scanning, archiving, retrieving, and printing of patient care information. The less tangible benefit of providing record access to several users simultaneously is difficult to quantify, but can enhance operations and improve the quality of patient care throughout a healthcare facility. PMID:10145825

Davis, M W

1993-06-01

92

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...so they can supply OWCP with a history of the injury, a...

2011-04-01

93

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...they can supply OWCP with a history of the claimed...

2011-04-01

94

Veterinary medical considerations for the use of nonhuman primates in space research  

NASA Technical Reports Server (NTRS)

The validity of biomedical research using animal subjects is highly dependent on the use of 'normal' and healthy animals. The current costs of research programs dictate that a minimum number of animals and test replicates be used to obtain the desired data. The use of healthy and standardized animals increases the probability of obtaining valid data while also permitting greater economy by reducing the between-individual variation, thus allowing the use of fewer animals. Areas of concern when planning animal payloads include constraints of the flight on candidate species selection, screening for physiological and psychological normalcy, procedures for routine care and quarantine of new animals and those returning from space, ground-based studies to determine experimental protocol, selection of instrumentation, stress during transportation for flight operations, housing and care facilities at launch and recovery sites, and the overall veterinary program.

Simmonds, R. C.

1977-01-01

95

Medical Record Clerk Training Program, Course of Study; Student Manual: For Medical Record Personnel in Small Rural Hospitals in Colorado.  

ERIC Educational Resources Information Center

The manual provides major topics, objectives, activities and, procedures, references and materials, and assignments for the training program. The topics covered are hospital organization and community role, organization and management of a medical records department, international classification of diseases and operations, medical terminology,…

Community Health Service (DHEW/PHS), Arlington, VA. Div. of Health Resources.

96

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

97

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

98

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

99

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

100

Information integrity and privacy for computerized medical patient records  

SciTech Connect

Sandia National Laboratories and Oceania, Inc. entered into a Cooperative Research and Development Agreement (CRADA) in November 1993 to provide ``Information Integrity and Privacy for Computerized Medical Patient Records`` (CRADA No. SC93/01183). The main objective of the project was to develop information protection methods that are appropriate for databases of patient records in health information systems. This document describes the findings and alternative solutions that resulted from this CRADA.

Gallegos, J.; Hamilton, V.; Gaylor, T.; McCurley, K.; Meeks, T.

1996-09-01

101

Physicians' Use Of Electronic Medical Records: Barriers And Solutions  

Microsoft Academic Search

ABSTRACT: The electronic medical record (EMR) is an enabling technology,that allows phy- sician practices to pursue,more powerful quality improvement,programs,than is possible with paper-based records. However, achieving quality improvement through EMR use is nei- ther low-cost nor easy. Based on a qualitative study of physician practices that had imple- mented an EMR, we found that quality improvement depends heavily on physicians’

Robert H. Miller; Ida Sim

2004-01-01

102

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

Microsoft Academic Search

ObjectiveWhile 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.DesignOur approach relies

Louise Deléger; Cyril Grouin; Pierre Zweigenbaum

2010-01-01

103

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

104

NCI Community Cancer Centers Program - Electronic Medical Records  

Cancer.gov

Develop a national database of voluntarily-provided electronic medical records. Expanding the information available on people who have been screened for cancer, are at high risk, are actively being treated, and are cancer survivors will greatly contribute to the knowledge and treatment of cancer.

105

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.shand@cbcu.nhs.uk Jean M. Bacon University of Cambridge jean.bacon@cl.cam.ac.uk ABSTRACT In this paper we present a web

Cambridge, University of

106

A Curriculum Guide for Medical Record Technologist. Final Report.  

ERIC Educational Resources Information Center

This curriculum guide was developed as a result of a project conducted in Pennsylvania to review, update, and revise the vocational-technical manual on file in the Pennsylvania Department of Education and to develop sample curriculum for the preparation of a medical record technologist program using the skills developed in the manual. The guide is…

Garozzo, Joyce

107

Evaluation of a Lecture Recording System in a Medical Curriculum  

ERIC Educational Resources Information Center

Recently, the Medical University of South Carolina adopted a lecture recording system (LRS). A retrospective study of LRS was implemented to document the students' perceptions, pattern of usage, and impact on the students' grades in three basic sciences courses (Cell Biology/Histology, Physiology, and Neurosciences). The number of accesses and…

Bacro, Thierry R. H.; Gebregziabher, Mulugeta; Fitzharris, Timothy P.

2010-01-01

108

Privacy of Medical Records: From Law Principles to Practice  

Microsoft Academic Search

Regulating access to electronic health records has become a major social and technical challenge. Unfortunately, existing access control models fail in translating accurately basic law principles related to the safeguard of personal information (e.g., medical folder). This paper identifies the problem and proposes a solution in the EHR context.

Saïda Medjdoub; Philippe Pucheral

2005-01-01

109

UNIVERSITY OF PITTSBURGH SUBJECT: SECURITY OF ELECTRONIC MEDICAL RECORDS--  

E-print Network

- 1 - UNIVERSITY OF PITTSBURGH POLICY SUBJECT: SECURITY OF ELECTRONIC MEDICAL RECORDS-- COMPLIANCE components. EPHI includes any computer data relating to the past, present or future physical or mental health WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA) DATE: March 18, 2005 I. SCOPE

Sibille, Etienne

110

42 CFR 494.170 - Condition: Medical records.  

Code of Federal Regulations, 2010 CFR

... Condition: Medical records. The dialysis facility must maintain complete, accurate...including home patients who elect to receive dialysis supplies and equipment from a supplier...provider of ESRD services and all other home dialysis patients whose care is under the...

2010-10-01

111

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

112

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

113

Image-based document management systems for medical records.  

PubMed

Using image scanning as a document capture mechanism at time of treatment or on day of discharge automates the medical record to achieve the larger objectives of simultaneous concurrent access to an electronic chart. This form of keyless document capture, although appearing labor intensive, is justified for improving business management and quality of care. Coupled with optical character recognition or barcode recognition for keyless data capture, medical information may be more easily made available for clinical research. Not merely a microfilm alternative, a medical record management system accelerates chart completion. Labor reduction is realized by eliminating filing and retrieval of active charts, loose sheet handling, photocopying, chart assembly, and chart location control. By reducing the reasons for chart completion delays, accelerated billing of Medicare accounts will occur, resulting in a reduction in receivables. Image-based document management systems accomplish the three things required of a senior manager in health care: (1) solve problems, (2) save money, and (3) make money. PMID:10116256

Massengill, S P

1992-03-01

114

Privacy preserving index for encrypted electronic medical records.  

PubMed

With the development of electronic systems, privacy has become an important security issue in real-life. In medical systems, privacy of patients' electronic medical records (EMRs) must be fully protected. However, to combine the efficiency and privacy, privacy preserving index is introduced to preserve the privacy, where the EMR can be efficiently accessed by this patient or specific doctor. In the literature, Goh first proposed a secure index scheme with keyword search over encrypted data based on a well-known primitive, Bloom filter. In this paper, we propose a new privacy preserving index scheme, called position index (P-index), with keyword search over the encrypted data. The proposed index scheme is semantically secure against the adaptive chosen keyword attack, and it also provides flexible space, lower false positive rate, and search privacy. Moreover, it does not rely on pairing, a complicate computation, and thus can search over encrypted electronic medical records from the cloud server efficiently. PMID:24158427

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

2013-12-01

115

Pursuing integration of performance measures into electronic medical records: beta-adrenergic receptor antagonist medications  

PubMed Central

Objective: Electronic medical records seldom integrate performance indicators into daily operations. Assessing quality indicators traditionally requires resource intensive chart reviews of small samples. We sought to use an electronic medical record to assess use of ß-adrenergic antagonist medications (ß-blockers) following myocardial infarction, to compare a standardized manual assessment with assessment using electronic medical records, and to discuss potential for future integration of performance indicators into electronic records. Design: Cross-sectional data analysis. Setting: An urban academic medical center. Participants: US Medicare beneficiaries 65 years of age or older, admitted to hospital with myocardial infarction between 1995 and 1999. Measurements and main results: Manual chart review was compared with a computer driven assessment of electronic records. Administration of ß-blockers and cases excluded from use of ß-blockers were measured, based on Medicare criteria. Among 4490 older adults, 391 (4%) of 9018 hospital admissions contained codes for myocardial infarction. In 323 (83%) of the 391 hospital admissions, criteria for excluding ß-blockers were met; 235 (60%) were excluded due to heart failure. Of 68 hospital admissions for myocardial infarction that did not meet exclusion criteria, physicians prescribed ß-blockers in 49 (72%) on admission and 42 (62%) at discharge. Compared with manual chart review, electronic review had a sensitivity of 83–100% and led to fewer false negative findings. Conclusions: An electronic medical records system can be used instead of chart review to measure use of ß-blockers after myocardial infarction. This should lead to integration of real time automated performance measurement into electronic medical records. PMID:15805454

Weiner, M; Stump, T; Callahan, C; Lewis, J; McDonald, C

2005-01-01

116

[Three new records of medical plant in Hubei, China].  

PubMed

In order to have a better understanding of the species diversity of medical plants in Enshi, Hubei of China, extensive field investigations and specimen collections were conducted in Enshi and adjacent regions. Based on field observations of plants in their living habitats and comparative morphological studies on specimens in herbarium of Hubei minzu University and other available herbaria as well, three new records of medical plants in Hubei, Scutellaria yunnanensis, Alangium faberi var. heterophyllum, and Drymaria diandra, were reported in this paper. PMID:25272511

Li, Hou-Cong; Yuan, De-Pei; Liu, Yuan

2014-07-01

117

Integrating all medical records to an enterprise viewer.  

PubMed

The idea behind hospital information systems is to make all of a patient's medical reports, lab results, and images electronically available to clinicians, instantaneously, wherever they are. But the higgledy-piggledy evolution of most hospital computer systems makes it hard to integrate all these clinical records. Although several integration standards had been proposed to meet this challenger, none of them is fit to Chinese hospitals. In this paper, we introduce our work of implementing a three-tiered architecture enterprise viewer in Huzhou Central Hospital to integration all existing medical information systems using limited resource. PMID:17282239

Li, Haomin; Duan, Huilong; Lu, Xudong; Zhao, Chenhui; An, Jiye

2005-01-01

118

National electronic medical records integration on cloud computing system.  

PubMed

Few Healthcare providers have an advanced level of Electronic Medical Record (EMR) adoption. Others have a low level and most have no EMR at all. Cloud computing technology is a new emerging technology that has been used in other industry and showed a great success. Despite the great features of Cloud computing, they haven't been utilized fairly yet in healthcare industry. This study presents an innovative Healthcare Cloud Computing system for Integrating Electronic Health Record (EHR). The proposed Cloud system applies the Cloud Computing technology on EHR system, to present a comprehensive EHR integrated environment. PMID:23920993

Mirza, Hebah; El-Masri, Samir

2013-01-01

119

Web-based electronic patient records for collaborative medical applications.  

PubMed

We developed a web-based system to interactively display electronic patient records (EPR), such as DICOM images, graphics, and structure reports and therapy records, for intranet and internet collaborative medical applications. This system has three major components, a C/S (client/server) architecture for EPR data acquisition and authoring, and a Web B/S architecture for data delivering. The Web viewer of this system integrates multi-media display modules and remote control module together to provide interactive EPR display and manipulation functions for collaborative applications. We have successfully used this system two times to provide teleconsultation for severe acute respiratory syndrome (SARS) patients in Shanghai Infection Hospital and Xinhua Hospital. During the consultation, both the physicians in infection control area and the experts outside the control area could use this system interactively to manipulate and navigate the EPR objects of the SARS patients to facilitate a more precise diagnosis. This paper gives a new approach to create and manage image-based EPR from actual patient records, and also presents a novel method to use Web technology and DICOM standard to build an open architecture for collaborative medical applications. The system can be used for both intranet and internet medical applications such as tele-diagnosis, teleconsultation, and distant learning. PMID:15755531

Zhang, Jianguo; Sun, Jianyong; Yang, Yuanyuan; Chen, Xiaomeng; Meng, Lili; Lian, Ping

2005-01-01

120

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

121

The Alcohol Treatment Unit Computerized Medical Record (ATU CMR): A Clinician-Entered Inpatient Record  

PubMed Central

Described is an Alcohol Treatment Unit Computerized Medical Record (ATU CMR) system developed at the Jerry L. Pettis Memorial Veterans' Hospital in Loma Linda, CA. The system is used by multiple providers for the administrative and clinical management of patients admitted to an inpatient Alcohol Treatment Unit. This clinician-entered computer-generated medical record system replaces the handwritten record, from patient intake to discharge. Multiple choice options allow for the standardization of language while free text capabilities provide expression of more detailed patient information; data output is formatted into natural English sentences. Savings of costly personnel time, increased communication between multiple care providers, improved patient care, and creation of a research database in ASCII format are among the benefits experienced by using this system. The ATU CMR is now an indispensable part of the Alcohol Treatment Unit.

Chang, M.M.; Gino, A.; Yahiku, P.Y.; King, C.A.; MacMurray, J.P.; Ferry, L.H.; Smith, L.; Young, R.; Bozzetti, L.

1988-01-01

122

Recommendations of the German Society for Medical Education and the German Association of Medical Faculties regarding university-specific assessments during the study of human, dental and veterinary medicine  

PubMed Central

The practice of assessing student performance in human, dental and veterinary medicine at universities in German-speaking countries has undergone significant changes in the past decade. Turning the focus to practical requirements regarding medical practice during undergraduate study away from an often theory-dominated curriculum, the academic scrutiny of the basics of teaching medical knowledge and skills, and amendments to legislation, all require ongoing adjustments to curricula and the ways in which assessments are done during undergraduate medical education. To establish quality standards, the Gesellschaft für medizinische Ausbildung (GMA German Society for Medical Education) reached a consensus in 2008 on recommendations for administering medical school-specific exams which have now been updated and approved by the GMA assessments committee, together with the Medizinischer Fakultätentag (MFT German Association of Medical Faculties), as recommendations for the administration of high-quality assessments. PMID:25228936

Jünger, Jana; Just, Ingo

2014-01-01

123

77 FR 55221 - Agency Information Collection Activities: Report of Medical Examination and Vaccination Record...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Collection Activities: Report of Medical Examination and Vaccination Record, Form I-693; Revision of a Currently Approved...the Form/Collection: Report of Medical Examination and Vaccination Record. (3) Agency form number, if any, and the...

2012-09-07

124

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

125

Biodosimetry medical recording-use of the Biodosimetry Assessment Tool.  

PubMed

Effective and dynamic recording of radiation exposure and medical diagnostic information for individuals suspected or known to have been exposed to ionizing radiation contributes to appropriate formulation of medical treatment strategies and radiation protection management. The objectives of this article are to report the database entry templates or screens, provide general use guidelines, and discuss the application to selected radiation exposure scenarios for the Armed Forces Radiobiology Research Institute's software application, Biodosimetry Assessment Tool (BAT). BAT data entry screens were developed based on consensus generic guidance and organized into discrete categories (i.e., physical dosimetry, contamination, prodromal symptoms, hematology, lymphocyte cytogenetics, erythema/wound, and infection) to facilitate its practical use during the early-phase response for radiological incidents. The summary report provides a concise output of information on radiation exposure, radionuclide contamination, dose assessment based on biological indicators (i.e., cytogenetic chromosome aberration bioassays, time to onset of vomiting, lymphocyte cell counts or depletion kinetics), and relevant clinical signs and symptoms. The BAT report template is compliant with NATO and international guidance for recording ionizing radiation exposures for medical purposes. PMID:20938228

Blakely, William F; Madrid, John P; Sandgren, David J

2010-11-01

126

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

PubMed

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 within the ambulatory EMR to the hospital discharge medication list, highlights all changes, and allows the EMR medication list to be easily updated. As might be expected for a novel tool intended for use in a minority of visits, use of the tool was low at first: 20% of applicable patient visits within 30 days of discharge. Clinician outreach, education, and a pop-up reminder succeeded in increasing use to 41% of applicable visits. Review of feedback identified several usability issues that will inform subsequent versions of the tool and provide generalizable lessons for how best to design medication reconciliation tools for this setting. PMID:21486889

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

2011-05-01

127

Physicians' perception and attitude toward electronic medical record.  

PubMed

Implementation of an electronic medical record (EMR) system increases efficiency of health services, quality of care and patient satisfaction. Successful implementation of EMRs depends on many factors. The path to quality improvement and financial gain with EMRs lies in getting the greatest number of Physicians to use the system. The main objective of this research is to explore physicians, attitude and perceptions of importance EMRs function, anticipated utilization of EMR functions and also issue impact EMRs. The cross-sectional study was conducted on 133 specialist physicians of three teaching hospitals of Hormozgan Medical Sciences University. The most important finding in this study was the Entry/Display of Diagnoses and Medications (96.3%) and Prescription Alerts drug-drug, allergy and dose checking and formulary management (96.2%) were of greatest importance to respondents. Nuclear medicine, Time trended Clinical Data Display, decision support capabilities, and medical management reporting generated percentage suggesting less than weekly usage. Only a small number of respondents addressed physicians' resistance in compare to another issues impact on EMRs. Understanding physician perceptions and attitude will allow for the development of targeted education to demonstrate the advantages and implementation of EMRs in further and improve physician perceptions of EMRs. PMID:24516790

Lakbala, Parvin; Dindarloo, Kavoos

2014-01-01

128

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

129

Application of an Electronic Medical Record in Space Medicine  

NASA Technical Reports Server (NTRS)

Electronic Medical Records (EMR) have been emerging over the past decade. Today, they are replacing the paper chart in clinics throughout the nation. Approximately three years ago, the NASA-JSC Flight Medicine Clinic initiated an assessment of the EMRs available on the market. This assessment included comparing these products with the particular scope of practice at JSC. In 1998, the Logician EMR from Medicalogic was selected for the JSC Flight Medicine Clinic. This presentation reviews the process of selection and implementation of the EMR into the unique practice of aerospace medicine at JSC.

McGinnis, Patrick J.

2000-01-01

130

Medical Record Documentation of Patients’ Hearing Loss by Physicians  

Microsoft Academic Search

BACKGROUND  Anecdotal evidence suggests that hearing loss, even when sufficient to prevent full access to spoken communication, often\\u000a is underreported by patients and not documented by physicians. No published studies have investigated this issue quantitatively.\\u000a \\u000a \\u000a \\u000a OBJECTIVE  To assess the documentation of hearing loss in comprehensive physician notes in cases where the patients are known to have\\u000a substantial binaural loss.\\u000a \\u000a \\u000a \\u000a DESIGN  Electronic medical record

Christopher F. Halpin; Lisa I. Iezzoni; Steven Rauch

2009-01-01

131

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

132

Efficient medical information retrieval in encrypted Electronic Health Records.  

PubMed

The recent development of eHealth platforms across the world, whose main objective is to centralize patient's healthcare information to ensure the best continuity of care, requires the development of advanced tools and techniques for supporting health professionals in retrieving relevant information in this vast quantity of data. However, for preserving patient's privacy, some countries decided to de-identify and encrypt data contained in the shared Electronic Health Records, which reinforces the complexity of proposing efficient medical information retrieval approach. In this paper, we describe an original approach exploiting standards metadata as well as knowledge organizing systems to overcome the barriers of data encryption for improving the results of medical information retrieval in centralized and encrypted Electronic Health Records. This is done through the exploitation of semantic properties provided by knowledge organizing systems, which enable query expansion. Furthermore, we provide an overview of the approach together with illustrating examples and a discussion on the advantages and limitations of the provided framework. PMID:22874185

Pruski, Cédric; Wisniewski, François

2012-01-01

133

Relevance of the electronic computer to hospital medical records*  

PubMed Central

During the past 30 years an “information explosion” has completely changed patterns of illness. Unit files of individual patients have become so large that they are increasingly difficult both to store physically and to assimilate mentally. We have reached a communications barriers which poses a major threat to the efficient practice of clinical medicine. At the same time a new kind of machine, the electronic digital computer, which was invented only 26 years ago, has already come to dominate large areas of military, scientific, commercial, and industrial activity. Its supremacy rests on its ability to perform any data procedure automatically and incredibly quickly. Computers are being employed in clinical medicine in hospitals for various purposes. They can act as arithmetic calculators, they can process and analyse output from recording devices, and they can make possible the automation of various machine systems. However, in the field of case records their role is much less well defined, for here the organization of data as a preliminary to computer input is the real stumbling-block. Data banks of retrospective selected clinical information have been in operation in some centres for a number of years. Attempts are now being made to design computerized “total information systems” to replace conventional paper records, and the possibility of automated diagnosis is being seriously discussed. In my view, however, the medical profession is in danger of being dazzled by optimistic claims about the usefulness of computers in case record processing. The solution to the present problems of record storage and handling is very simple, and does not involve computerization. PMID:4898564

Mitchell, J. H.

1969-01-01

134

A Study on Agent-Based Secure Scheme for Electronic Medical Record System  

Microsoft Academic Search

Patient records, including doctors’ diagnoses of diseases, trace of treatments and patients’ conditions, nursing actions,\\u000a and examination results from allied health profession departments, are the most important medical records of patients in medical\\u000a systems. With patient records, medical staff can instantly understand the entire medical information of a patient so that,\\u000a according to the patient’s conditions, more accurate diagnoses and

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

135

Change Management – Recommendations for Successful Electronic Medical Records Implementation  

PubMed Central

Summary Change is difficult and managing change even more so. With the advent of Electronic Medical Records (EMRs) and the difficulty of its acceptance, understanding physician’s attitudes and the psychology of change management is imperative. While many authors describe change management theories, one comes nearest to describing this particularly difficult transition. In 1969, Elizabeth Kübler-Ross wrote her seminal treatise, On Death and Dying, detailing the psychological changes terminally ill patients undergo. Her grieving model is a template to examine the impact of change. By following a physician through the EMR maze, understanding the difficulties he/she perceives and developing a plan other change agents are able to use, the paper gives practical recommendations to EMR change management. PMID:23616842

Shoolin, J.S.

2010-01-01

136

Forward secure digital signature for electronic medical records.  

PubMed

The Technology Safeguard in Health Insurance Portability and Accountability Act (HIPAA) Title II has addressed a way to maintain the integrity and non-repudiation of Electronic Medical Record (EMR). One of the important cryptographic technologies is mentioned in the ACT is digital signature; however, the ordinary digital signature (e.g. DSA, RSA, GQ...) has an inherent weakness: if the key (certificate) is updated, than all signatures, even the ones generated before the update, are no longer trustworthy. Unfortunately, the current most frequently used digital signature schemes are categorized into the ordinary digital signature scheme; therefore, the objective of this paper is to analyze the shortcoming of using ordinary digital signatures in EMR and to propose a method to use forward secure digital signature to sign EMR to ensure that the past EMR signatures remain trustworthy while the key (certificate) is updated. PMID:20703711

Yu, Yao-Chang; Huang, To-Yeh; Hou, Ting-Wei

2012-04-01

137

Role prediction using Electronic Medical Record system audits.  

PubMed

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

138

Training, Quality Assurance, and Assessment of Medical Record Abstraction in a Multisite Study  

Microsoft Academic Search

Clinical studies using medical record review should include careful training and quality assurance methods to enhance the reliability and validity of data obtained from the records. Because of time and budget constraints, comprehensive assessments of data quality and reliability, including masking of medical record abstractors, are not always possible. This paper describes the abstractor training and quality control methods and

Lisa M. Reisch; Jessica Scura Fosse; Kevin Beverly; Onchee Yu; William E. Barlow; Emily L. Harris; Sharon Rolnick; Mary B. Barton; Ann M. Geiger; Lisa J. Herrinton; Sarah M. Greene; Suzanne W. Fletcher; Joann G. Elmore

2003-01-01

139

Laser In Veterinary Medicine  

NASA Astrophysics Data System (ADS)

Lasers have been used for some time now on animals for experimental purposes prior to their use in human medical and surgical fields. However the use of lasers in veterinary medicine and surgery per se is a recent development. We describe the application of high and low intensity laser technology in a general overview of the current uses, some limitations to its use and future needs for future inquiry and development.

Newman, Carlton; Jaggar, David H.

1982-12-01

140

Automated electronic medical record sepsis detection in the emergency department  

PubMed Central

Background. While often first treated in the emergency department (ED), identification of sepsis is difficult. Electronic medical record (EMR) clinical decision tools offer a novel strategy for identifying patients with sepsis. The objective of this study was to test the accuracy of an EMR-based, automated sepsis identification system. Methods. We tested an EMR-based sepsis identification tool at a major academic, urban ED with 64,000 annual visits. The EMR system collected vital sign and laboratory test information on all ED patients, triggering a “sepsis alert” for those with ?2 SIRS (systemic inflammatory response syndrome) criteria (fever, tachycardia, tachypnea, leukocytosis) plus ?1 major organ dysfunction (SBP ? 90 mm Hg, lactic acid ?2.0 mg/dL). We confirmed the presence of sepsis through manual review of physician, nursing, and laboratory records. We also reviewed a random selection of ED cases that did not trigger a sepsis alert. We evaluated the diagnostic accuracy of the sepsis identification tool. Results. From January 1 through March 31, 2012, there were 795 automated sepsis alerts. We randomly selected 300 cases without a sepsis alert from the same period. The true prevalence of sepsis was 355/795 (44.7%) among alerts and 0/300 (0%) among non-alerts. The positive predictive value of the sepsis alert was 44.7% (95% CI [41.2–48.2%]). Pneumonia and respiratory infections (38%) and urinary tract infection (32.7%) were the most common infections among the 355 patients with true sepsis (true positives). Among false-positive sepsis alerts, the most common medical conditions were gastrointestinal (26.1%), traumatic (25.7%), and cardiovascular (20.0%) conditions. Rates of hospital admission were: true-positive sepsis alert 91.0%, false-positive alert 83.0%, no sepsis alert 5.7%. Conclusions. This ED EMR-based automated sepsis identification system was able to detect cases with sepsis. Automated EMR-based detection may provide a viable strategy for identifying sepsis in the ED. PMID:24765577

Nguyen, Su Q.; Mwakalindile, Edwin; Booth, James S.; Hogan, Vicki; Morgan, Jordan; Prickett, Charles T.; Donnelly, John P.

2014-01-01

141

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

142

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

143

The Electronic Medical Records and Genomics (eMERGE) Network Consent & Community Consultation Workgroup  

E-print Network

The Electronic Medical Records and Genomics (eMERGE) Network Consent & Community Consultation for future research, particularly those collections that have an electronic medical records component and an ethics review process--but your consent document should describe your particular review procedures

144

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

145

Notification of Abnormal Lab Test Results in an Electronic Medical Record: Do Any Safety Concerns Remain?  

Microsoft Academic Search

BackgroundFollow-up of abnormal outpatient laboratory test results is a major patient safety concern. Electronic medical records can potentially address this concern through automated notification. We examined whether automated notifications of abnormal laboratory results (alerts) in an integrated electronic medical record resulted in timely follow-up actions.

Hardeep Singh; Eric J. Thomas; Dean F. Sittig; Lindsey Wilson; Donna Espadas; Myrna M. Khan; Laura A. Petersen

2010-01-01

146

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

147

Department of Industrial Engineering Fall 2011 Electronic Medical Records at Jersey Shore Hospital's Physician Practice  

E-print Network

PENNSTATE Department of Industrial Engineering Fall 2011 Electronic Medical Records at Jersey Shore the support personnel's workflow. Transition to electronic communications to better support and aid JSH to create a database and replicate the forms electronically Simulated an Electronic Medical Records (EMR

Demirel, Melik C.

148

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

149

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

150

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

151

Veterinary Medicine Resources  

NSDL National Science Digital Library

Iowa State University's libraries have been compiling electronic subject guides for a number of years, and this is one such guide that users in the field of veterinary medicine will want to bookmark. Organized thematically, the resources are contained within one single list, and they are divided into categories such as websites, electronic journals, online abstracts, and basic pet care and health resources. Some of the gateway sites are quite helpful, particularly the link to the animal diseases database offered by the Karolinska Institutet in Sweden. Both potential veterinarian technicians and laypersons will appreciate the pet care links, which include links to the Healthy Pet site created by the American Animal Hospital Association and an overview to animal care created by the American Veterinary Medical Association.

152

Investigating barriers to electronic medical record use during collaborative information seeking activities  

Microsoft Academic Search

Collaborative information seeking (CIS) is an intrinsic part of medical work. Patient care teams increasingly rely upon various systems, such as Electronic Medical Records (EMRs), to support collaborative information seeking across hierarchical, functional and occupational boundaries of the organization in order to enhance the quality of medical care. However, despite their proven benefits, there still are several challenges to using

Arvind Karunakaran; Young Hee-Nam; Madhu Reddy

2012-01-01

153

AudioMine: Medical Data Mining in Heterogeneous Audiology Records  

Microsoft Academic Search

? Abstract— We report on the results of a pilot study in which a data-mining tool was developed for mining audiology records. The records were heterogeneous in that they contained numeric, category and textual data. The tools developed are designed to observe associations between any field in the records and any other field. The techniques employed were the statistical chi-squared

Shaun Cox; Michael P. Oakes; Stefan Wermter; Maurice Hawthorne

2004-01-01

154

Veterinary Technician Program Director Leadership Style and Program Success  

ERIC Educational Resources Information Center

Program directors of American Veterinary Medical Association (AVMA) accredited veterinary technician programs may have little or no training in leadership. The need for program directors of AVMA-accredited veterinary technician programs to understand how leadership traits may have an impact on student success is often overlooked. The purpose of…

Renda-Francis, Lori A.

2012-01-01

155

78 FR 55114 - Access to Employee Exposure and Medical Records; Extension of the Office of Management and Budget...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Employee Exposure and Medical Records; Extension of the Office of Management and Budget's (OMB...requirements for record access, record retention, worker information, trade secret management, and record transfer....

2013-09-09

156

Quality and correlates of medical record documentation in the ambulatory care setting  

PubMed Central

Background Documentation in the medical record facilitates the diagnosis and treatment of patients. Few studies have assessed the quality of outpatient medical record documentation, and to the authors' knowledge, none has conclusively determined the correlates of chart documentation. We therefore undertook the present study to measure the rates of documentation of quality of care measures in an outpatient primary care practice setting that utilizes an electronic medical record. Methods We reviewed electronic medical records from 834 patients receiving care from 167 physicians (117 internists and 50 pediatricians) at 14 sites of a multi-specialty medical group in Massachusetts. We abstracted information for five measures of medical record documentation quality: smoking history, medications, drug allergies, compliance with screening guidelines, and immunizations. From other sources we determined physicians' specialty, gender, year of medical school graduation, and self-reported time spent teaching and in patient care. Results Among internists, unadjusted rates of documentation were 96.2% for immunizations, 91.6% for medications, 88% for compliance with screening guidelines, 61.6% for drug allergies, 37.8% for smoking history. Among pediatricians, rates were 100% for immunizations, 84.8% for medications, 90.8% for compliance with screening guidelines, 50.4% for drug allergies, and 20.4% for smoking history. While certain physician and patient characteristics correlated with some measures of documentation quality, documentation varied depending on the measure. For example, female internists were more likely than male internists to document smoking history (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.27 – 2.83) but were less likely to document drug allergies (OR, 0.51; 95% CI, 0.35 – 0.75). Conclusions Medical record documentation varied depending on the measure, with room for improvement in most domains. A variety of characteristics correlated with medical record documentation, but no pattern emerged. Further study could lead to targeted interventions to improve documentation. PMID:12473161

Soto, Carlos M; Kleinman, Kenneth P; Simon, Steven R

2002-01-01

157

Medical Device Safety  

MedlinePLUS

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Medical Devices Print this page Share this page E-mail ... Medical Product Safety Network Emergency Situations (Medical Devices) Medical Device Safety Search the Medical Device Safety Section Medical ...

158

One world of veterinary medicine.  

PubMed

The veterinary profession finds itself in the midst of a new world order. Today veterinarians are part of a world that is exquisitely interconnected culturally, economically, socially, and professionally. As a consequence, societal needs and expectations of the profession are more demanding, critical and far-reaching. Veterinarians must play important roles in five intersecting domains of work: public health, bio-medical research, global food safety and security, ecosystem health and the more traditional role of caring for animals. To be successful in this broad and complex range of services and activities, veterinarians must possess an expanded knowledge base, acquire new skills, and develop a new mindset that will ensure their success and excellence in all these domains. The veterinary profession is becoming more fragmented and specialised, and it needs to be brought back together by a single sphere of knowledge or discipline that can serve as an intellectual foundation. The concept of One World of Veterinary Medicine can do just that. With this mindset veterinarians will become better connected to the world around and gain new public recognition and esteem. To achieve this, a special commitment by academic veterinary medicine is, of course, essential. Veterinary schools must lead an educational transformation that reaffirms the social contract of veterinarians and works to align diverse sectors, build a global community, find a common purpose and expand the 21st Century veterinary portfolio of services, activities, and new possibilities. PMID:20128453

King, L J

2009-08-01

159

44 CFR 6.31 - Special requirements for medical records.  

Code of Federal Regulations, 2010 CFR

...Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND...S. Office of Personnel Management and are described in Chapter...entrance qualifications or fitness for duty, or medical...to the Office of Personnel Management for determination....

2010-10-01

160

76 FR 53921 - Privacy Act of 1974; Department of Homeland Security ALL-034 Emergency Care Medical Records...  

Federal Register 2010, 2011, 2012, 2013, 2014

...of 1974; Department of Homeland Security ALL--034 Emergency Care Medical Records System...Department of Homeland Security/ ALL--034 Emergency Care Medical Records System...Washington, DC 20528. Instructions: All submissions received must include the...

2011-08-30

161

A software system to collect expert relevance ratings of medical record items for specific clinical tasks.  

PubMed

Development of task-specific electronic medical record (EMR) searches and user interfaces has the potential to improve the efficiency and safety of health care while curbing rising costs. The development of such tools must be data-driven and guided by a strong understanding of practitioner information requirements with respect to specific clinical tasks or scenarios. To acquire this important data, this paper describes a model by which expert practitioners are leveraged to identify which components of the medical record are most relevant to a specific clinical task. We also describe the computer system that was created to efficiently implement this model of data gathering. The system extracts medical record data from the EMR of patients matching a given clinical scenario, de-identifies the data, breaks the data up into separate medical record items (eg, radiology reports, operative notes, laboratory results, etc), presents each individual medical record item to experts under the hypothetical of the given clinical scenario, and records the experts' ratings regarding the relevance of each medical record item to that specific clinical scenario or task. After an iterative process of data collection, these expert relevance ratings can then be pooled and used to design point-of-care EMR searches and user interfaces tailored to the task-specific needs of practitioners. PMID:25600925

Harvey, H Benjamin; Krishnaraj, Arun; Alkasab, Tarik K

2014-01-01

162

A Software System to Collect Expert Relevance Ratings of Medical Record Items for Specific Clinical Tasks  

PubMed Central

Development of task-specific electronic medical record (EMR) searches and user interfaces has the potential to improve the efficiency and safety of health care while curbing rising costs. The development of such tools must be data-driven and guided by a strong understanding of practitioner information requirements with respect to specific clinical tasks or scenarios. To acquire this important data, this paper describes a model by which expert practitioners are leveraged to identify which components of the medical record are most relevant to a specific clinical task. We also describe the computer system that was created to efficiently implement this model of data gathering. The system extracts medical record data from the EMR of patients matching a given clinical scenario, de-identifies the data, breaks the data up into separate medical record items (eg, radiology reports, operative notes, laboratory results, etc), presents each individual medical record item to experts under the hypothetical of the given clinical scenario, and records the experts’ ratings regarding the relevance of each medical record item to that specific clinical scenario or task. After an iterative process of data collection, these expert relevance ratings can then be pooled and used to design point-of-care EMR searches and user interfaces tailored to the task-specific needs of practitioners.

Krishnaraj, Arun; Alkasab, Tarik K

2014-01-01

163

42 CFR 110.50 - Medical records necessary for the Secretary to determine whether a covered injury was sustained.  

Code of Federal Regulations, 2011 CFR

...covered countermeasure; and (3) All medical records for one year prior to administration...countermeasure recipient's pre-existing medical history. (b) A requester may submit additional medical documentation that he or she...

2011-10-01

164

Use of expert relevancy ratings to validate task-specific search strategies for electronic medical records.  

PubMed

As electronic medical records (EMRs) grow in size and complexity, there is increasing need for automated EMR tools that highlight the medical record items most germane to a practitioner's task-specific needs. The development of such tools would be aided by gold standards of information relevance for a series of different clinical scenarios. We have previously proposed a process in which exemplar medical record data are extracted from actual patients' EMRs, anonymized, and presented to clinical experts, who then score each medical record item for its relevance to a specific clinical scenario. In this paper, we present how that body of expert relevancy data can be used to create a test framework to validate new EMR search strategies. PMID:25601018

Harvey, Harlan; Krishnaraj, Arun; Alkasab, Tarik K

2014-01-01

165

Use of Expert Relevancy Ratings to Validate Task-Specific Search Strategies for Electronic Medical Records  

PubMed Central

As electronic medical records (EMRs) grow in size and complexity, there is increasing need for automated EMR tools that highlight the medical record items most germane to a practitioner’s task-specific needs. The development of such tools would be aided by gold standards of information relevance for a series of different clinical scenarios. We have previously proposed a process in which exemplar medical record data are extracted from actual patients’ EMRs, anonymized, and presented to clinical experts, who then score each medical record item for its relevance to a specific clinical scenario. In this paper, we present how that body of expert relevancy data can be used to create a test framework to validate new EMR search strategies.

Krishnaraj, Arun; Alkasab, Tarik K

2014-01-01

166

AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION Patient/Employee Name: ___________________________ Date of Birth: ___________Medical Record #: __________________  

E-print Network

AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION Patient/Employee Name: ___________________________ Date of Birth: ___________Medical Record #: __________________ I hereby authorize the following. Disclosure authorized to: __Employee Occupational Health Services Clinic University of New Mexico

New Mexico, University of

167

AUTHORIZATION TO REQUEST HEALTH INFORMATION Patient Name: __________________________ Date of Birth: ___________Medical Record #: __________________  

E-print Network

AUTHORIZATION TO REQUEST HEALTH INFORMATION Patient Name: __________________________ Date of Birth: ___________Medical Record #: __________________ I hereby authorize the Employee Occupational Health Services clinic) _____________________ from (date) ____________________ to (date) _____________________ 3. I further authorize

New Mexico, University of

168

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

169

75 FR 3697 - Solicitation of Nomination of Veterinary Shortage Situations for the Veterinary Medicine Loan...  

Federal Register 2010, 2011, 2012, 2013, 2014

...repayment and scholarship programs...represented the first time funds...for future years will be based...accredited college of veterinary...that in the first year, and perhaps...subsequent early years of program...Veterinary Medical Colleges (AAVMC...strategy. The first option...

2010-01-22

170

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

Federal Register 2010, 2011, 2012, 2013, 2014

...the next 10 years. While there...repayment and scholarship programs...represented the first time funds...and Full-Year Continuing...AVMA-accredited college of veterinary...as in the first two years of the program...Veterinary Medical Colleges...

2011-12-27

171

A computerized medical record with direct data entry for community clinics in Israel.  

PubMed Central

CLINIC is a computerized medical record system currently being used in two primary care clinics in Israel. Clinic features direct coded data-entry by the medical personnel via a system based on categories of problems and complaints with common signs and symptoms. PMID:1807725

Urkin, J.; Margolis, C. Z.; Warshawsky, S. S.

1991-01-01

172

Incorporation of clinical practice guidelines for glaucoma into an ophthalmology electronic medical record.  

PubMed

Clinical practice guidelines represent the best current thinking on the management of acute and chronic medical conditions. Unfortunately, the implementation of such guidelines in clinical practice has been difficult and problematic. Electronic medical records represent an opportunity to implement guidelines. We have designed a system for incorporating guidelines for the management of glaucoma into an ophthalmology EMR. PMID:16779402

Silverstone, David E; Paek, Hyung Min; Kogan, Yacov; Essaihi, Abdel; Shiffman, Richard N

2005-01-01

173

Organizational Learning and Large-Scale Change: Adoption of Electronic Medical Records  

ERIC Educational Resources Information Center

Despite implementation of electronic medical record (EMR) systems in the United States and other countries, there is no organizational development model that addresses medical professionals' attitudes toward technology adoption in a learning organization. The purpose of this study was to assess whether a model would change those attitudes toward…

Chavis, Virginia D.

2010-01-01

174

In memoriam: Janis Huston Audin, MSc, DVM, 1950-2009. Dynamic editor-in-chief of the Journal of the American Veterinary Medical Association and strong One Health advocate dies.  

PubMed

Dr Janis H. Audin (MSc Illinois 1975, DVM Illinois 1979), a champion of progressive veterinary medical journalism and 'One Health' died on 22 April 2009 following a long, courageous and difficult battle with pancreatic cancer. The world has lost a truly significant One Health leader and advocate. Under her guidance, the Journal of the American Veterinary Medical Association (JAVMA) implemented a 'one-health wonders' column that recognised and highlighted prominent One Health individuals among the medical and veterinary medical professions in the United States. The American Veterinary Medical Association (AVMA) has lost a dedicated and gifted editor-in-chief. Dr Audin joined the editorial staff of the AVMA in 1985, as an assistant editor and was promoted to associate editor in 1989 and editor in 1994. She became the editor-in-chief of both the JAVMA and the American Journal of Veterinary Research in 1995. Prior to that, Dr Audin practised as an associate veterinarian in Calumet City, Illinois, for four years. During her tenure, Dr Audin was noted for implementing procedural and technological changes in the journal to reduce costs, improve timeliness of publications and promote readership interest and awareness. New features in the News section introduced under her leadership have made the journals more practical and public health-relevant. For instance, Dr Audin fostered the United States Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) 'Inspection Insights' - a public health-oriented food safety monthly column related to meat, poultry and egg products - from 1996 through 1998. She also increased international manuscript submissions. On 23 March 2009 AVMA Executive Vice President Dr W. Ron DeHaven named Dr Audin as editor-in-chief emeritus of the Publications Division. Wisely, it also meant that Dr Audin could continue contributing to the staff effort to ensure the high quality of the AVMA scientific journals while the Association began a comprehensive search for her successor. Having observed the JAVMA editors-in-chief for 50 years, I consider her one of the best, if not the best of a most distinguished list. Janis was a special personal friend and my soul mate with respect to dealing with life-threatening cancer. I deeply mourn her loss and will miss her. PMID:20391410

Kaplan, Bruce

2009-01-01

175

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

176

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

Code of Federal Regulations, 2014 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...

2014-07-01

177

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

178

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

179

Recent Medical Device Recalls  

MedlinePLUS

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Medical Devices Print this page Share this page E-mail this page Home Medical Devices Medical Device Safety Medical Device Recalls Medical Device ...

180

Patient experiences with electronic medical records: Lessons learned  

PubMed Central

Purpose To describe the lived experience of patients communicating with their nurse practitioners and physicians while using paper health records (PHRs) and electronic health records (EHRs) in the examination rooms. The significance of the study lies in the salience of communication between the patient and provider in promoting optimal clinical outcomes and the highest level of patient satisfaction. Data sources The study used a qualitative, phenomenological design. Audio-taped focus group interviews were conducted with 21 patients from a diabetes clinic in Baltimore, Maryland. Patients had visits with the provider before and after implementation of EHRs in the clinic. Conclusions The four themes that emerged from the three focus groups included communication issues, patient preferences for electronic records, safety and security concerns, and transition problems with implementation of EHRs. Implications for practice Potential benefits for nurse practitioners implementing the recommendations in this study include enhanced communication between patients and providers while using EHRs, increased patient satisfaction, higher levels of nurse practitioner and physician satisfaction, and avoidance of communication issues during implementation of EHR systems. PMID:25234112

Rose, Dale; Richter, Louiseann T; Kapustin, Jane

2014-01-01

181

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

182

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

PubMed Central

Objectives To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. Design Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. Setting 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. Participants 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems. Main outcome measures Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar. Results Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems. Conclusions Doctors used electronic medical records systems for far fewer tasks than the systems supported. What is already known on this topicElectronic information systems in health care have not undergone systematic evaluation, and few comparisons between electronic medical records systems have been madeGiven the information intensive nature of clinical work, electronic medical records systems should be of help to doctors for most clinical tasksWhat this study addsDoctors in Norwegian hospitals reported a low level of use of all electronic medical records systemsThe systems were mainly used for reading patient data, and doctors used the systems for less than half of the tasks for which the systems were functionalAnalyses of actual use of electronic medical records provide more information than user satisfaction or functionality of such records systems PMID:11739222

Lærum, Hallvard; Ellingsen, Gunnar; Faxvaag, Arild

2001-01-01

183

Outpatients flow management and ophthalmic electronic medical records system in university hospital using Yahgee Document View.  

PubMed

General electronic medical records systems remain insufficient for ophthalmology outpatient clinics from the viewpoint of dealing with many ophthalmic examinations and images in a large number of patients. Filing systems for documents and images by Yahgee Document View (Yahgee, Inc.) were introduced on the platform of general electronic medical records system (Fujitsu, Inc.). Outpatients flow management system and electronic medical records system for ophthalmology were constructed. All images from ophthalmic appliances were transported to Yahgee Image by the MaxFile gateway system (P4 Medic, Inc.). The flow of outpatients going through examinations such as visual acuity testing were monitored by the list "Ophthalmology Outpatients List" by Yahgee Workflow in addition to the list "Patients Reception List" by Fujitsu. Patients' identification number was scanned with bar code readers attached to ophthalmic appliances. Dual monitors were placed in doctors' rooms to show Fujitsu Medical Records on the left-hand monitor and ophthalmic charts of Yahgee Document on the right-hand monitor. The data of manually-inputted visual acuity, automatically-exported autorefractometry and non-contact tonometry on a new template, MaxFile ED, were again automatically transported to designated boxes on ophthalmic charts of Yahgee Document. Images such as fundus photographs, fluorescein angiograms, optical coherence tomographic and ultrasound scans were viewed by Yahgee Image, and were copy-and-pasted to assigned boxes on the ophthalmic charts. Ordering such as appointments, drug prescription, fees and diagnoses input, central laboratory tests, surgical theater and ward room reservations were placed by functions of the Fujitsu electronic medical records system. The combination of the Fujitsu electronic medical records and Yahgee Document View systems enabled the University Hospital to examine the same number of outpatients as prior to the implementation of the computerized filing system. PMID:20703620

Matsuo, Toshihiko; Gochi, Akira; Hirakawa, Tsuyoshi; Ito, Tadashi; Kohno, Yoshihisa

2010-10-01

184

Workflow and Electronic Health Records in Small Medical Practices  

PubMed Central

This paper analyzes the workflow and implementation of electronic health record (EHR) systems across different functions in small physician offices. We characterize the differences in the offices based on the levels of computerization in terms of workflow, sources of time delay, and barriers to using EHR systems to support the entire workflow. The study was based on a combination of questionnaires, interviews, in situ observations, and data collection efforts. This study was not intended to be a full-scale time-and-motion study with precise measurements but was intended to provide an overview of the potential sources of delays while performing office tasks. The study follows an interpretive model of case studies rather than a large-sample statistical survey of practices. To identify time-consuming tasks, workflow maps were created based on the aggregated data from the offices. The results from the study show that specialty physicians are more favorable toward adopting EHR systems than primary care physicians are. The barriers to adoption of EHR systems by primary care physicians can be attributed to the complex workflows that exist in primary care physician offices, leading to nonstandardized workflow structures and practices. Also, primary care physicians would benefit more from EHR systems if the systems could interact with external entities. PMID:22737096

Ramaiah, Mala; Subrahmanian, Eswaran; Sriram, Ram D; Lide, Bettijoyce B

2012-01-01

185

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

186

Designing an Algorithm to Preserve Privacy for Medical Record Linkage With Error-Prone Data  

PubMed Central

Background Linking medical records across different medical service providers is important to the enhancement of health care quality and public health surveillance. In records linkage, protecting the patients’ privacy is a primary requirement. In real-world health care databases, records may well contain errors due to various reasons such as typos. Linking the error-prone data and preserving data privacy at the same time are very difficult. Existing privacy preserving solutions for this problem are only restricted to textual data. Objective To enable different medical service providers to link their error-prone data in a private way, our aim was to provide a holistic solution by designing and developing a medical record linkage system for medical service providers. Methods To initiate a record linkage, one provider selects one of its collaborators in the Connection Management Module, chooses some attributes of the database to be matched, and establishes the connection with the collaborator after the negotiation. In the Data Matching Module, for error-free data, our solution offered two different choices for cryptographic schemes. For error-prone numerical data, we proposed a newly designed privacy preserving linking algorithm named the Error-Tolerant Linking Algorithm, that allows the error-prone data to be correctly matched if the distance between the two records is below a threshold. Results We designed and developed a comprehensive and user-friendly software system that provides privacy preserving record linkage functions for medical service providers, which meets the regulation of Health Insurance Portability and Accountability Act. It does not require a third party and it is secure in that neither entity can learn the records in the other’s database. Moreover, our novel Error-Tolerant Linking Algorithm implemented in this software can work well with error-prone numerical data. We theoretically proved the correctness and security of our Error-Tolerant Linking Algorithm. We have also fully implemented the software. The experimental results showed that it is reliable and efficient. The design of our software is open so that the existing textual matching methods can be easily integrated into the system. Conclusions Designing algorithms to enable medical records linkage for error-prone numerical data and protect data privacy at the same time is difficult. Our proposed solution does not need a trusted third party and is secure in that in the linking process, neither entity can learn the records in the other’s database. PMID:25600786

Pal, Doyel; Chen, Tingting; Khethavath, Praveen

2014-01-01

187

Lasers in veterinary medicine: a review  

NASA Astrophysics Data System (ADS)

As in other facets of medical science, the use of lasers in veterinary medicine is a relatively new phenomenon. Economic aspects of the profession as well as questionable returns on investment have limited laser applications primarily to the academic community, research institutions, and specialty practices. As technology improves and efficacy is proven, costs should decrease and allow further introduction of laser surgical and diagnostic devices into the mainstream of clinical veterinary medicine.

Bartels, Kenneth E.

1994-09-01

188

Mining association rules between abnormal health examination results and outpatient medical records.  

PubMed

Currently, interpretation of health examination reports relies primarily on the physician's own experience. If health screening data could be integrated with outpatient medical records to uncover correlations between disease and abnormal test results, the physician could benefit from having additional reference resources for medical examination report interpretation and clinic diagnosis. This study used the medical database of a regional hospital in Taiwan to illustrate how association rules can be found between abnormal health examination results and outpatient illnesses. The rules can help to build up a disease-prevention knowledge database that assists healthcare providers in follow-up treatment and prevention. Furthermore, this study proposes a new algorithm, the data cutting and sorting method, or DCSM, in place of the traditional Apriori algorithm. DCSM significantly improves the mining performance of Apriori by reducing the time to scan health examination and outpatient medical records, both of which are databases of immense sizes. PMID:23736654

Chao Huang, Yi

2013-01-01

189

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

190

[Integrated medical records for surgical services: a new tool for a new hospital model].  

PubMed

According to a modern definition, the patient's medical record is a tool shared by health-care professionals whose purpose is to support the planning, providing and documenting of patient-centred care. The requirements and regulations of medical records, which date back to the sixties, need now be adapted to more recent organisational models based on different levels of care intensity and strongly integrated patient-oriented care approaches designed to create connectivity, alignment and collaboration within and between different professional fields. On this basis, the SS. Cosma and Damiano Hospital Chief Physician endorsed a multiprofessional project providing for the complete reorganisation of surgical activities according to the above-mentioned approach and, at the same time, for the elaboration of an "integrated" medical record, capable of overcoming the traditional separation between medical and nursing documents. This paper presents the results of a long period of complex teamwork consisting in revising and sharing a new medical record model based on principles of professional integration and patient-centredness in health-care provision. PMID:18360986

Terranova, Giuseppina; Cortesi, Elisabetta; Briani, Silvia; Giannini, Raffaella; Bartolomei, Marco; Corsale, Italo; Biscioni, Luca; Caffi, Tiziana; Paganelli, Ilaria; Frugoli, Patrizia; Ammazzini, Daniela

2007-01-01

191

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

192

FRR: fair remote retrieval of outsourced private medical records in electronic health networks.  

PubMed

Cloud computing is emerging as the next-generation IT architecture. However, cloud computing also raises security and privacy concerns since the users have no physical control over the outsourced data. This paper focuses on fairly retrieving encrypted private medical records outsourced to remote untrusted cloud servers in the case of medical accidents and disputes. Our goal is to enable an independent committee to fairly recover the original private medical records so that medical investigation can be carried out in a convincing way. We achieve this goal with a fair remote retrieval (FRR) model in which either t investigation committee members cooperatively retrieve the original medical data or none of them can get any information on the medical records. We realize the first FRR scheme by exploiting fair multi-member key exchange and homomorphic privately verifiable tags. Based on the standard computational Diffie-Hellman (CDH) assumption, our scheme is provably secure in the random oracle model (ROM). A detailed performance analysis and experimental results show that our scheme is efficient in terms of communication and computation. PMID:24560680

Wang, Huaqun; Wu, Qianhong; Qin, Bo; Domingo-Ferrer, Josep

2014-08-01

193

Design and implementation of web-based mobile electronic medication administration record.  

PubMed

Patients' safety is the most essential, critical issue, however, errors can hardly prevent, especially for human faults. In order to reduce the errors caused by human, we construct Electronic Health Records (EHR) in the Health Information System (HIS) to facilitate patients' safety and to improve the quality of medical care. During the medical care processing, all the tasks are based upon physicians' orders. In National Taiwan University Hospital (NTUH), the Electronic Health Record committee proposed a standard of order flows. There are objectives of the standard: first, to enhance medical procedures and enforce hospital policies; secondly, to improve the quality of medical care; third, to collect sufficient, adequate data for EHR in the near future. Among the proposed procedures, NTUH decides to establish a web-based mobile electronic medication administration record (ME-MAR) system. The system, build based on the service-oriented architecture (SOA) as well as embedded the HL7/XML standard, is installed in the Mobile Nursing Carts. It also implement accompany with the advanced techniques like Asynchronous JavaScript and XML (Ajax) or Web services to enhance the system usability. According to researches, it indicates that medication errors are highly proportion to total medical faults. Therefore, we expect the ME-MAR system can reduce medication errors. In addition, we evaluate ME-MAR can assist nurses or healthcare practitioners to administer, manage medication properly. This successful experience of developing the NTUH ME-MAR system can be easily applied to other related system. Meanwhile, the SOA architecture of the system can also be seamless integrated to NTUH or other HIS system. PMID:20703613

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

2010-10-01

194

Dual function seal: visualized digital signature for electronic medical record systems.  

PubMed

Digital signature is an important cryptography technology to be used to provide integrity and non-repudiation in electronic medical record systems (EMRS) and it is required by law. However, digital signatures normally appear in forms unrecognizable to medical staff, this may reduce the trust from medical staff that is used to the handwritten signatures or seals. Therefore, in this paper we propose a dual function seal to extend user trust from a traditional seal to a digital signature. The proposed dual function seal is a prototype that combines the traditional seal and digital seal. With this prototype, medical personnel are not just can put a seal on paper but also generate a visualized digital signature for electronic medical records. Medical Personnel can then look at the visualized digital signature and directly know which medical personnel generated it, just like with a traditional seal. Discrete wavelet transform (DWT) is used as an image processing method to generate a visualized digital signature, and the peak signal to noise ratio (PSNR) is calculated to verify that distortions of all converted images are beyond human recognition, and the results of our converted images are from 70 dB to 80 dB. The signature recoverability is also tested in this proposed paper to ensure that the visualized digital signature is verifiable. A simulated EMRS is implemented to show how the visualized digital signature can be integrity into EMRS. PMID:22048782

Yu, Yao-Chang; Hou, Ting-Wei; Chiang, Tzu-Chiang

2012-10-01

195

Barriers to Retrieving Patient Information from Electronic Health Record Data: Failure Analysis from the TREC Medical Records Track  

PubMed Central

Objective: Secondary use of electronic health record (EHR) data relies on the ability to retrieve accurate and complete information about desired patient populations. The Text Retrieval Conference (TREC) 2011 Medical Records Track was a challenge evaluation allowing comparison of systems and algorithms to retrieve patients eligible for clinical studies from a corpus of de-identified medical records, grouped by patient visit. Participants retrieved cohorts of patients relevant to 35 different clinical topics, and visits were judged for relevance to each topic. This study identified the most common barriers to identifying specific clinic populations in the test collection. Methods: Using the runs from track participants and judged visits, we analyzed the five non-relevant visits most often retrieved and the five relevant visits most often overlooked. Categories were developed iteratively to group the reasons for incorrect retrieval for each of the 35 topics. Results: Reasons fell into nine categories for non-relevant visits and five categories for relevant visits. Non-relevant visits were most often retrieved because they contained a non-relevant reference to the topic terms. Relevant visits were most often infrequently retrieved because they used a synonym for a topic term. Conclusions: This failure analysis provides insight into areas for future improvement in EHR-based retrieval with techniques such as more widespread and complete use of standardized terminology in retrieval and data entry systems. PMID:23304287

Edinger, Tracy; Cohen, Aaron M.; Bedrick, Steven; Ambert, Kyle; Hersh, William

2012-01-01

196

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

197

How accurate are medical record data in Afghanistan's maternal health facilities? An observational validity study  

PubMed Central

Objectives Improvement activities, surveillance and research in maternal and neonatal health in Afghanistan rely heavily on medical record data. This study investigates accuracy in delivery care records from three hospitals across workshifts. Design Observational cross-sectional study. Setting The study was conducted in one maternity hospital, one general hospital maternity department and one provincial hospital maternity department. Researchers observed vaginal deliveries and recorded observations to later check against data recorded in patient medical records and facility registers. Outcome measures We determined the sensitivity, specificity, area under the receiver operator characteristics curves (AUROCs), proportions correctly classified and the tendency to make performance seem better than it actually was. Results 600 observations across the three shifts and three hospitals showed high compliance with active management of the third stage of labour, measuring blood loss and uterine contraction at 30?min, cord care, drying and wrapping newborns and Apgar scores and low compliance with monitoring vital signs. Compliance with quality indicators was high and specificity was lower than sensitivity. For adverse outcomes in birth registries, specificity was higher than sensitivity. Overall AUROCs were between 0.5 and 0.6. Of 17 variables that showed biased errors, 12 made performance or outcomes seem better than they were, and five made them look worse (71% vs 29%, p=0.143). Compliance, sensitivity and specificity varied less among the three shifts than among hospitals. Conclusions Medical record accuracy was generally poor. Errors by clinicians did not appear to follow a pattern of self-enhancement of performance. Because successful improvement activities, surveillance and research in these settings are heavily reliant on collecting accurate data on processes and outcomes of care, substantial improvement is needed in medical record accuracy. PMID:23619087

Broughton, Edward I; Ikram, Abdul Naser; Sahak, Ihsanullah

2013-01-01

198

Electronic Medical Records Adoption and Usage among Osteopathic Physicians in New York State  

ERIC Educational Resources Information Center

In 2010, the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology reported a slow rate of adoption of electronic medical records. The present research sought to explore possible reasons for this situation by examining factors that distinguished between users and nonusers of electronic…

Rosenthal, Jon I.

2012-01-01

199

The impact of electronic medical records data sources on an adverse drug event quality measure  

Microsoft Academic Search

Objective To examine the impact of billing and clinical data extracted from an electronic medical record system on the calculation of an adverse drug event (ADE) quality measure approved for use in The Joint Commission's ORYX program, a mandatory national hospital quality reporting system. Design The Child Health Corporation of America's \\

Michael G. Kahn; Daksha Ranade

2010-01-01

200

42 CFR 102.50 - Medical records necessary to establish that a covered injury was sustained.  

Code of Federal Regulations, 2010 CFR

...on or after the date of the smallpox vaccination or exposure to vaccinia; and ...on or after the date of the smallpox vaccination or exposure to vaccinia. (b...medical records prior to the date of vaccination or accidental vaccinia exposure)...

2010-10-01

201

42 CFR 102.50 - Medical records necessary to establish that a covered injury was sustained.  

Code of Federal Regulations, 2011 CFR

...on or after the date of the smallpox vaccination or exposure to vaccinia; and ...on or after the date of the smallpox vaccination or exposure to vaccinia. (b...medical records prior to the date of vaccination or accidental vaccinia exposure)...

2011-10-01

202

42 CFR 102.50 - Medical records necessary to establish that a covered injury was sustained.  

Code of Federal Regulations, 2012 CFR

...on or after the date of the smallpox vaccination or exposure to vaccinia; and ...on or after the date of the smallpox vaccination or exposure to vaccinia. (b...medical records prior to the date of vaccination or accidental vaccinia exposure)...

2012-10-01

203

42 CFR 102.50 - Medical records necessary to establish that a covered injury was sustained.  

Code of Federal Regulations, 2014 CFR

...on or after the date of the smallpox vaccination or exposure to vaccinia; and ...on or after the date of the smallpox vaccination or exposure to vaccinia. (b...medical records prior to the date of vaccination or accidental vaccinia exposure)...

2014-10-01

204

42 CFR 102.50 - Medical records necessary to establish that a covered injury was sustained.  

Code of Federal Regulations, 2013 CFR

...on or after the date of the smallpox vaccination or exposure to vaccinia; and ...on or after the date of the smallpox vaccination or exposure to vaccinia. (b...medical records prior to the date of vaccination or accidental vaccinia exposure)...

2013-10-01

205

Developing a Systematic Architecture Approach for Designing an Enhanced Electronic Medical Record (EEMR) System  

ERIC Educational Resources Information Center

The Healthcare industry is characterized by its complexity in delivering care to the patients. Accordingly, healthcare organizations adopt and implement Information Technology (IT) solutions to manage complexity, improve quality of care, and transform to a fully integrated and digitized environment. Electronic Medical Records (EMR), which is…

Aldukheil, Maher A.

2013-01-01

206

The Role and Education of the Veterinary Pharmacist  

PubMed Central

Objective To define the role and education of the traditional pharmacist who supports the needs of the veterinarian (hereafter referred to as veterinary pharmacist) and a pharmacist who practices solely in veterinary pharmacy (here after referred to as veterinary pharmacy specialist). Methods The Delphi technique involving 7 panels of 143 experts was employed to reach consensus on the definition of the roles and education of the veterinary pharmacist and veterinary pharmacy specialist. Results The veterinary pharmacy specialist's role included dispensing medications, complying with regulations, advocating for quality therapeutic practices, and providing consultative services, research, and education. The perceived role of the veterinary pharmacist was viewed as being somewhat narrower. Compared to veterinary pharmacists, a more in-depth education in veterinary medicine was viewed as essential to the role development of veterinary pharmacy specialists. Conclusions The authors hope their research will promote widespread awareness of the emerging field of veterinary pharmacy and encourage schools to offer increased access to clinically relevant professional training programs. PMID:19513154

Fasser, Carl E.; Rush, John E.; Scheife, Richard T.; Orcutt, Connie J.; Michalski, Donald L.; Mazan, Melissa R.; Dorsey, Mary T.; Bernardi, Stephen P.

2009-01-01

207

Utilizing Electronic Health Record Information to Optimize Medication Infusion Devices: A Manual Data Integration Approach.  

PubMed

Health information technology is increasingly utilized within healthcare delivery systems today. Two examples of this type of technology include the capture of patient-specific information within an electronic health record and intravenous medication infusion devices equipped with dose error reduction software known as drug libraries. Automatic integration of these systems, termed intravenous (IV) interoperability, should serve as the goal toward which all healthcare systems work to maximize patient safety. For institutions lacking IV interoperability, we describe a manual approach of querying the electronic health record to incorporate medication administration information with data from infusion device software to optimize drug library settings. This approach serves to maximize utilization of available information to optimize medication safety provided by drug library software. PMID:24779473

Chuk, Amanda; Maloney, Robert; Gawron, Joyce; Skinner, Colin

2014-04-29

208

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

209

Formal representation of a conceptual data model for the patient-based medical record.  

PubMed Central

We present a general architecture for the patient-based medical record as it is being developed for the SAMS, a private social security system. The conceptual data model is described in a convenient formal notation, the entity-relationship diagram. Although following the original formulation of the problem-oriented medical record (POMR), the data model was designed with a level of generalization that, functionally, makes structural differences between conventional and POMR no longer apparent. The main features of this model are its adaptability to individual work practices and its problem-oriented structure, including the representation of problems' evolution. This structure will enable physicians to organize the data, mostly collected elsewhere, by explicitly relating the facts that constitute a particular patient record, which is a simple way to store context information and clinical knowledge that is not part of patient data. PMID:8130517

Gouveia-Oliveira, A.; Lopes, L.

1993-01-01

210

[A study of factors in medical insurance records associated with participation in health examinations].  

PubMed

Factors in medical insurance records of two groups classified as participants and nonparticipants in a multiphasic health examination (MHE) conducted in a rural town in Kyoto prefecture were compared. The purpose of this study was to clarify how the conditions of medical care influenced the participation in the MHE. The factors were days of consultation, total insurance points and days of consultation classified by specific disease and the area of the medical facility. Participants were examined at least once in 1987-1988 and nonparticipants were never examined in the corresponding period. The data were obtained from the medical insurance records of outpatients for the period from April 1986 thru March 1987. The medical care bills of 170 males and 201 females aged 30-69 were randomly sampled from National Health Insurance records (unit = family), and those of 55 males and 88 females aged 70 and over were from the Medical Service for the Aged (unit = person). These samples were about one forth of target population respectively. Both older participants and older nonparticipants of both sexes had more consultation days and more total insurance points than the corresponding younger subjects. Nonparticipants of both sexes aged 70 and over had more consultation days and more total insurance points than participants; female nonparticipants aged 50-69 had slightly more consultation days and those aged 30-49 also had more insurance points. Nonparticipants tended to have previous medical care for hypertension or ischemic heart disease, which the MHE is responsible for discovering.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2637378

Ozasa, K; Higashi, A; Watanabe, Y; Saito, A; Yan, S; Hayashi, K; Aoike, A; Kawai, K

1989-10-01

211

Identifying risk factors for healthcare-associated infections from electronic medical record home address data  

PubMed Central

Background Residential address is a common element in patient electronic medical records. Guidelines from the U.S. Centers for Disease Control and Prevention specify that residence in a nursing home, skilled nursing facility, or hospice within a year prior to a positive culture date is among the criteria for differentiating healthcare-acquired from community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections. Residential addresses may be useful for identifying patients residing in healthcare-associated settings, but methods for categorizing residence type based on electronic medical records have not been widely documented. The aim of this study was to develop a process to assist in differentiating healthcare-associated from community-associated MRSA infections by analyzing patient addresses to determine if residence reported at the time of positive culture was associated with a healthcare facility or other institutional location. Results We identified 1,232 of the patients (8.24% of the sample) with positive cultures as probable cases of healthcare-associated MRSA based on residential addresses contained in electronic medical records. Combining manual review with linking to institutional address databases improved geocoding rates from 11,870 records (79.37%) to 12,549 records (83.91%). Standardization of patient home address through geocoding increased the number of matches to institutional facilities from 545 (3.64%) to 1,379 (9.22%). Conclusions Linking patient home address data from electronic medical records to institutional residential databases provides useful information for epidemiologic researchers, infection control practitioners, and clinicians. This information, coupled with other clinical and laboratory data, can be used to inform differentiation of healthcare-acquired from community-acquired infections. The process presented should be extensible with little or no added data costs. PMID:20849635

2010-01-01

212

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, François André; Fassa, Maniane; Bourquard, Karima; Boire, Jean-Yves; de Vlieger, Paul; Maigne, Lydia; Breton, Vincent

2009-01-01

213

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

214

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

215

The intelligent use and clinical benefits of electronic medical records in multiple sclerosis.  

PubMed

Electronic medical records (EMRs) are being quickly adopted in clinics around the world. This advancement can greatly enhance the clinical care of patients with multiple sclerosis (MS) by providing formats that allow easier review of medical documents and more structured avenues to store relevant information. MS clinicians should be involved with implementing and updating EMRs at their institutions to ensure EMR formats that benefit MS clinics. EMRs also provide opportunities for research studies of MS to access detailed, longitudinal data of MS disease course that would otherwise be difficult to collect. PMID:25495075

Davis, Mary F; Haines, Jonathan L

2015-02-01

216

Mercer Veterinary Clinic for Pets of the Homeless All About Mercer Clinic  

E-print Network

Mercer Veterinary Clinic for Pets of the Homeless All About Mercer Clinic Mercer Veterinary Clinic for the Pets of the Homeless Mercer Veterinary Clinic for the Homeless is a 501(C)3 non-profit, student-operated organization providing free medical care for the animal companions of the homeless. The clinic meets the second

Schladow, S. Geoffrey

217

All-purpose veterinary education: a personal perspective.  

PubMed

The Recognition Lecture is an annual honor awarded by the Association of American Veterinary Medical Colleges (AAVMC) to an individual whose leadership and vision have made significant contributions to academic veterinary medicine and the veterinary profession. In 2011, this prestigious honor was awarded to Dr. Peter Eyre, Dean Emeritus of the Virginia-Maryland Regional College of Veterinary Medicine (VMRCVM). Dr. Eyre is a fierce advocate for veterinary medical education, with a clear vision of its value in ensuring that veterinarians are well positioned to meet societal needs. Dr. Eyre possesses an international perspective regarding the challenges and problems facing veterinary medical education and has a keen eye for getting to the heart of these challenges. He is known to ask hard questions and propose difficult choices. Dr. Eyre received his undergraduate veterinary degree (BVMS), bachelor of science degree, and PhD from the University of Edinburgh. He was Lecturer in Pharmacology at the Royal (Dick) School of Veterinary Studies for seven years before joining the faculty of the University of Guelph's Ontario Veterinary College, where he was Chair of the Department of Biomedical Sciences and Associate Director of the Canadian Centre for Toxicology. Dr. Eyre was appointed Dean of the VMRCVM in 1985, where he established the Center for Government and Corporate Veterinary Medicine in 1989. After retiring in 2003, he was named Interim Dean of the University of Calgary's new veterinary school. Among his many awards are the Norden Distinguished Teacher Award and the Sigma Psi Excellence in Research Award. In 2008 the American Veterinary Medical Association (AVMA) honored him with the President's Award, and in 2010 the University of Edinburgh awarded him the honorary degree of Doctor of Veterinary Medicine and Surgery. The Peter Eyre Student Leadership Award at the VMRCVM and the Peter Eyre Prize in Pharmacology at the University of Guelph are both named in his honor. He is a past president of the AAVMC, a fellow and former board member of the American Academy of Veterinary Pharmacology and Therapeutics, and a former member of the AVMA Legislative Advisory Committee. In the following article, Dr. Eyre offers his insights on the current debate about the future of veterinary medical education. PMID:22130408

Eyre, Peter

2011-01-01

218

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

219

Integrating Clinical Practice and Public Health Surveillance Using Electronic Medical Record Systems  

PubMed Central

Electronic medical record (EMR) systems have rich potential to improve integration between primary care and the public health system at the point of care. EMRs make it possible for clinicians to contribute timely, clinically detailed surveillance data to public health practitioners without changing their existing workflows or incurring extra work. New surveillance systems can extract raw data from providers’ EMRs, analyze them for conditions of public health interest, and automatically communicate results to health departments. We describe a model EMR-based public health surveillance platform called Electronic Medical Record Support for Public Health (ESP). The ESP platform provides live, automated surveillance for notifiable diseases, influenza-like illness, and diabetes prevalence, care, and complications. Results are automatically transmitted to state health departments. PMID:22690967

McVetta, Jason; Lazarus, Ross; Eggleston, Emma; Haney, Gillian; Kruskal, Benjamin A.; Yih, W. Katherine; Daly, Patricia; Oppedisano, Paul; Beagan, Brianne; Lee, Michael; Kirby, Chaim; Heisey-Grove, Dawn; DeMaria, Alfred; Platt, Richard

2012-01-01

220

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) ...

221

Image-Based Electronic Patient Records for Secured Collaborative Medical Applications  

Microsoft Academic Search

We developed a Web-based system to interactively display image-based electronic patient records (EPR) for secured intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), image-based EPR repository server (EPR-Server), Web server and EPR DICOM viewer (EPR-Viewer). In the EPR-GW and EPR-Viewer, the security modules of digital signature and authentication are integrated to

Jianguo Zhang; Jianyong Sun; Yuanyuan Yang; Chenwen Liang; Yihong Yao; Jin Jin; Weihua Cai; Kun Sun; Guozhen Zhang

2005-01-01

222

Data resource profile: the Rochester Epidemiology Project (REP) medical records-linkage system.  

PubMed

The Rochester Epidemiology Project (REP) medical records-linkage system was established in 1966 to capture health care information for the entire population of Olmsted County, MN, USA. The REP includes a dynamic cohort of 502 820 unique individuals who resided in Olmsted County at some point between 1966 and 2010, and received health care for any reason at a health care provider within the system. The data available electronically (electronic REP indexes) include demographic characteristics, medical diagnostic codes, surgical procedure codes and death information (including causes of death). In addition, for each resident, the system keeps a complete list of all paper records, electronic records and scanned documents that are available in full text for in-depth review and abstraction. The REP serves as the research infrastructure for studies of virtually all diseases that come to medical attention, and has supported over 2000 peer-reviewed publications since 1966. The system covers residents of all ages and both sexes, regardless of socio-economic status, ethnicity or insurance status. For further information regarding the use of the REP for a specific study, please visit our website at www.rochesterproject.org or contact us at info@rochesterproject.org. Our website also provides access to an introductory video in English and Spanish. PMID:23159830

St Sauver, Jennifer L; Grossardt, Brandon R; Yawn, Barbara P; Melton, L Joseph; Pankratz, Joshua J; Brue, Scott M; Rocca, Walter A

2012-12-01

223

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.; Böttinger, Erwin P.; Williams, Marc S.

2013-01-01

224

Continuous 24-hour ocular dimensional profile recording in medically treated normal-tension glaucoma  

PubMed Central

Purpose To analyze the 24-hour ocular dimensional profile in normal-tension glaucoma (NTG) patients on medical treatment. Methods Consecutive, medically treated NTG subjects were recruited from a university eye center. Subjects were on a mean of 1.7±0.7 types of antiglaucoma medications and 56.6% were on a prostaglandin analog. A contact lens-based sensor device was worn in one eye of NTG patients to record the intraocular pressure (IOP)-related profile for 24 hours, recording the following: variability from mean over 24 hours, nocturnally and diurnally, as well as the number of peaks and troughs diurnally and nocturnally. Results In 18 NTG subjects, the nocturnal variability around the mean contact lens-based sensor device signal was 48.9% less than the diurnal variability around the mean. The number of peaks was 54.7% less during the nocturnal period than during the diurnal period. The rate of increase in the ocular dimensional profile when going to sleep was significantly greater than the rate of decrease upon waking (P<0.001). Conclusion In medically treated NTG subjects, there was more variability in the IOP-related pattern during the daytime and there were fewer peaks during sleep.

Lee, Jacky WY; Fu, Lin; Shum, Jennifer WH; Chan, Jonathan CH; Lai, Jimmy SM

2015-01-01

225

De-identifying an EHR database - anonymity, correctness and readability of the medical record.  

PubMed

Electronic health records (EHR) contain a large amount of structured data and free text. Exploring and sharing clinical data can improve healthcare and facilitate the development of medical software. However, revealing confidential information is against ethical principles and laws. We de-identified a Danish EHR database with 437,164 patients. The goal was to generate a version with real medical records, but related to artificial persons. We developed a de-identification algorithm that uses lists of named entities, simple language analysis, and special rules. Our algorithm consists of 3 steps: collect lists of identifiers from the database and external resources, define a replacement for each identifier, and replace identifiers in structured data and free text. Some patient records could not be safely de-identified, so the de-identified database has 323,122 patient records with an acceptable degree of anonymity, readability and correctness (F-measure of 95%). The algorithm has to be adjusted for each culture, language and database. PMID:21893869

Pantazos, Kostas; Lauesen, Soren; Lippert, Soren

2011-01-01

226

From papyrus to the electronic tablet: a brief history of the clinical medical record with lessons for the digital age.  

PubMed

A major transition is underway in documentation of patient-related data in clinical settings with rapidly accelerating adoption of the electronic health record and electronic medical record. This article examines the history of the development of medical records in the West in order to suggest lessons applicable to the current transition. The first documented major transition in the evolution of the clinical medical record occurred in antiquity, with the development of written case history reports for didactic purposes. Benefiting from Classical and Hellenistic models earlier than physicians in the West, medieval Islamic physicians continued the development of case histories for didactic use. A forerunner of modern medical records first appeared in Paris and Berlin by the early 19th century. Development of the clinical record in America was pioneered in the 19th century in major teaching hospitals. However, a clinical medical record useful for direct patient care in hospital and ambulatory settings was not developed until the 20th century. Several lessons are drawn from the 4000-year history of the medical record that may help physicians improve patient care in the digital age. PMID:24054954

Gillum, Richard F

2013-10-01

227

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

228

Veterinary practice marketeer.  

PubMed

Justin Phillips is marketing manager at White Cross Vets and the Veterinary Marketing Association's (VMA's) Young Veterinary Marketeer of the Year. Here, he describes what he does and why he believes other practices should embrace marketing to improve their quality and client care. PMID:25614552

Phillips, Justin

2015-01-24

229

150th anniversary of veterinary education and the veterinary profession in North America: part 3, 1970-2000.  

PubMed

This is one of a series of articles in the Journal of Veterinary Medical Education (JVME). These articles are abridged versions of six lectures that make up an elective course on the history of the veterinary profession in North America offered at Cornell University's College of Veterinary Medicine. This third article in the series of six describes the development of the nine new colleges that opened between 1974 and 1981. The three colleges on or near campuses that also had medical schools are contrasted with those that focused predominantly on their agriculture base. Data are presented by species on the current employment patterns of veterinary graduates from colleges in the US and Ross University. Programs in public health, public policy, and corporate veterinary medicine are also described. This article closes with a description of the factors that led to the curriculum reform instituted at Cornell University in 1993. PMID:22023973

Smith, Donald F

2011-01-01

230

Reprocessing of Reusable Medical Devices  

MedlinePLUS

... Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Medical Devices Print this page Share this page E-mail ... Reusable Medical Devices or Reprocessing Reprocessing of Reusable Medical Devices Reusable medical devices are devices that health care ...

231

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

232

Veterinary Medicine 2 | Veterinary Medicine University of Saskatchewan  

E-print Network

Veterinary Medicine #12;2 | Veterinary Medicine University of Saskatchewan The Western College notices Mid-June #12;University of Saskatchewan Veterinary Medicine | 3 WHY VETERINARY MEDICINE of Saskatchewan -- the only Canadian university with a full complement of health sciences colleges and schools

Saskatchewan, University of

233

The history of the veterinary profession and education in Indonesia.  

PubMed

The beginning of the veterinary profession in Indonesia dates back to the middle of the 19th century. During the Dutch colonization period a development program for large ruminants was started by the 'Nederlandsch-Indië' government. In 1907 this government established a veterinary laboratory, planned by Dr. J.K.F. de Does. The laboratory was then merged with a veterinary training course for Indonesian (bumiputera) 'veterinarians' named 'Cursus tot Opleiding van Inlandsche Veeartsen'. In 1910 the name of the training course was changed to 'Inlandsche Veeartsenschool', and in 1914 the school was named 'Nederlandsch-Indische Veeartsenijschool' (NIVS). During the Japanese occupation (1942-1945) the veterinary school was named 'Bogor Semon Zui Gakko'. After the declaration of independence by Indonesia in August 1945, it became the High School of Veterinary Education. In 1946 the curriculum was extended from 4 to 5 years. Thereafter the school was closed and re-opened a few times due to the changing political circumstances. In 1947 the first Faculty of Veterinary Medicine ('Diergeneeskundige Faculteit') of the University of Indonesia was established in the former building of NIVS at Taman Kencana Campus in Bogor. Between 1948 and 1963, four more veterinary faculties were established in Indonesia: Gajah Mada, Syiahkuala, Airlangga and Udayana. The Indonesian Veterinary Medical Association (IVMA) was established on January 9, 1953. The membership now exceeds 20,000 veterinarians and the association has 15 special interest groups. Since 2008, five new faculties of veterinary medicine have been established, bringing the total to 10. PMID:25029757

Priosoeryanto, Bambang Pontjo; Arifiantini, Iis

2014-01-01

234

Attitudes towards, and utility of, an integrated medical-dental patient-held record in primary care.  

PubMed Central

BACKGROUND: The need for closer coordination between primary care medical and dental services has been recognized. AIM: To assess the attitudes of general medical practitioners (GMPs), general dental practitioners (GDPs), and patients to an integrated medical-dental patient-held record (integrated medical-dental PHR); to examine patients' use of these records, and the utility of the records for doctors and dentists. METHOD: A three-phase study was carried out: (1) postal survey of GMPs and GDPs; (2) randomized trial of patients, using postal questionnaires before and one year after the issue of integrated medical-dental PHRs to cases; (3) assessment by doctors and dentists of anonymized integrated medical-dental PHRs from this trial. The study was carried out in medical and dental practices in affluent and deprived areas in Greater Glasgow Health Board. Two hundred and thirteen GMPs, 183 GDPs, and 369 patients registered with GMPs and GDPs were surveyed. Eighteen GDPs and GMPs assessed the integrated medical-dental PHRs. RESULTS: Eighty per cent of dentists had contacted a doctor and 16% of doctors had contacted a dentist in the previous three months; 87% of dentists and 68% of doctors thought an integrated medical-dental PHR would be of some use. Twenty-one per cent of dentists and 85% of doctors had practice computers. Most patients wanted to be able to see and read their own records. Twenty-four per cent of patients said there were mistakes and 30% noticed omissions in the integrated medical-dental PHR issued. Experience of having an integrated medical-dental PHR made patients more positive towards the idea of having a patient-held record and being able to check the accuracy of records. Integrated medical-dental PHRs contained important information for half the GDPs and one-third of the GMPs. CONCLUSION: Both professionals and patients have reasonably positive attitudes towards the use of patient-held records. Among patients, the experience of having the integrated medical-dental PHR led to greater enthusiasm towards the idea. Dentists in particular would benefit from the transfer of information from doctors, but better methods are needed to ensure that patients take the integrated medical-dental PHR with them. Given the current lack of ability to easily produce an integrated medical-dental PHR, further examination of the routine issue of a copy of their medical summary, by GMPs, to all patients would be worthwhile. PMID:10736887

Jones, R; McConville, J; Mason, D; Macpherson, L; Naven, L; McEwen, J

1999-01-01

235

75 FR 1625 - Privacy Act of 1974; Report of Amended or Altered System; Medical, Health and Billing Records System  

Federal Register 2010, 2011, 2012, 2013, 2014

...Report of Amended or Altered System; Medical, Health and Billing Records System AGENCY: Indian Health Service...PURPOSES: The purposes of this system are: 1. To provide a description...arthritis, metabolism, and digestive diseases) for various...

2010-01-12

236

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

237

Derivation and Validation of Automated Electronic Search Strategies to Extract Charlson Comorbidities From Electronic Medical Records  

PubMed Central

Objective To develop and validate automated electronic note search strategies (automated digital algorithm) to identify Charlson comorbidities. Patients and Methods The automated digital algorithm was built by a series of programmatic queries applied to an institutional electronic medical record database. The automated digital algorithm was derived from secondary analysis of an observational cohort study of 1447 patients admitted to the intensive care unit from January 1 through December 31, 2006, and validated in an independent cohort of 240 patients. The sensitivity, specificity, and positive and negative predictive values of the automated digital algorithm and International Classification of Diseases, Ninth Revision (ICD-9) codes were compared with comprehensive medical record review (reference standard) for the Charlson comorbidities. Results In the derivation cohort, the automated digital algorithm achieved a median sensitivity of 100% (range, 99%-100%) and a median specificity of 99.7% (range, 99%-100%). In the validation cohort, the sensitivity of the automated digital algorithm ranged from 91% to 100%, and the specificity ranged from 98% to 100%. The sensitivity of the ICD-9 codes ranged from 8% for dementia to 100% for leukemia, whereas specificity ranged from 86% for congestive heart failure to 100% for leukemia, dementia, and AIDS. Conclusion Our results suggest that search strategies that use automated electronic search strategies to extract Charlson comorbidities from the clinical notes contained within the electronic medical record are feasible and reliable. Automated digital algorithm outperformed ICD-9 codes in all the Charlson variables except leukemia, with greater sensitivity, specificity, and positive and negative predictive values. PMID:22958988

Singh, Balwinder; Singh, Amandeep; Ahmed, Adil; Wilson, Gregory A.; Pickering, Brian W.; Herasevich, Vitaly; Gajic, Ognjen; Li, Guangxi

2012-01-01

238

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

239

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

240

Practices and beliefs of the traditional Dinka healer in relation to provision of modern medical and veterinary services for the Southern Sudan.  

PubMed

One class of traditional Dinka healers is a practical surgeon-bonesetter-obstetrician who practices (all but obstetrics) on both people and animals. His anatomical, physiological, and pathological knowledge and surmises, derived almost entirely from observations on cattle, are in some respects remarkable, especially those on the function of the kidney and nature of the circulatory system. He shares with ancient Egyptian healers the belief that sperm originate in the spinal cord and brain and performs a unique surgical operation on the horns of bulls that has been known in the Nile valley since the Egyptian 5th dynasty. With minimum training he might function effectively within the governmental health and veterinary services of the southern Sudan, an area populated mostly by transhumant cattle-culture peoples not easily reached through conventional health services. PMID:10252763

Schwabe, C W; Kuojok, I M

1981-01-01

241

Risk mitigation of shared electronic records system in campus institutions: medical social work practice in singapore.  

PubMed

In 2013, the Singapore General Hospital (SGH) Campus initiated a shared electronic system where patient records and documentations were standardized and shared across institutions within the Campus. The project was initiated to enhance quality of health care, improve accessibility, and ensure integrated (as opposed to fragmented) care for best outcomes in our patients. In mitigating the risks of ICT, it was found that familiarity with guiding ethical principles, and ensuring adherence to regulatory and technical competencies in medical social work were important. The need to negotiate and maneuver in a large environment within the Campus to ensure proactive integrative process helped. PMID:25321932

Ow Yong, Lai Meng; Tan, Amanda Wei Li; Loo, Cecilia Lay Keng; Lim, Esther Li Ping

2014-10-01

242

Clinical challenges associated with incorporation of nonradiology images into the electronic medical record  

NASA Astrophysics Data System (ADS)

To date, the majority of Picture Archival and Communication Systems (PACS) have been utilized only for capture, storage, and display of radiology and in some cases, nuclear medicine images. Medical images for other subspecialty areas are currently stored in local, independent systems, which typically are not accessible throughout the healthcare enterprise and do not communicate with other hospital information or image management systems. It is likely that during the next few years, healthcare centers will expand PAC system capability to incorporate these multimedia data or alternatively, hospital-wide electronic patient record systems will be able to provide this function.

Siegel, Eliot L.; Reiner, Bruce I.

2001-08-01

243

Object-orientated DBMS techniques for time-oriented medical record.  

PubMed

In implementing time-orientated medical record (TOMR) management systems, use of a relational model played a big role. Many applications have been developed to extend query and data manipulation languages to temporal aspects of information. Our experience in developing TOMR revealed some deficiencies inside the relational model, such as: (a) abstract data type definition; (b) unified view of data, at a programming level; (c) management of temporal data; (d) management of signals and images. We identified some first topics to face by an object-orientated approach to database design. This paper describes the first steps in designing and implementing a TOMR by an object-orientated DBMS. PMID:1305700

Pinciroli, F; Combi, C; Pozzi, G

1992-01-01

244

Primary Care Physicians’ Use of an Electronic Medical Record System: A Cognitive Task Analysis  

Microsoft Academic Search

OBJECTIVE  To describe physicians’ patterns of using an Electronic Medical Record (EMR) system; to reveal the underlying cognitive elements\\u000a involved in EMR use, possible resulting errors, and influences on patient–doctor communication; to gain insight into the role\\u000a of expertise in incorporating EMRs into clinical practice in general and communicative behavior in particular.\\u000a \\u000a \\u000a \\u000a DESIGN  Cognitive task analysis using semi-structured interviews and field observations.

Aviv Shachak; Michal Hadas-Dayagi; Amitai Ziv; Shmuel Reis

2009-01-01

245

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

246

Electronic medical records (EMRs), epidemiology, and epistemology: reflections on EMRs and future pediatric clinical research.  

PubMed

Electronic medical records (EMRs) are increasingly common in pediatric patient care. EMR data represent a relatively novel and rich resource for clinical research. The fact, however, that pediatric EMR data are collected for the purposes of clinical documentation and billing rather than research creates obstacles to their use in scientific investigation. Particular issues include accuracy, completeness, comparability between settings, ease of extraction, and context of recording. Although these problems can be addressed through standard strategies for dealing with partially accurate and incomplete data, a longer-term solution will involve work with pediatric clinicians to improve data quality. As research becomes one of the explicit purposes for which pediatricians collect EMR data, the pediatric clinician will play a central role in future pediatric clinical research. PMID:21622040

Wasserman, Richard C

2011-01-01

247

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

PubMed

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

248

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

249

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

250

Healthcare and Guidelines: A Population-Based Survey of Recorded Medical Problems and Health Surveillance for People with Down syndrome  

ERIC Educational Resources Information Center

Background: Medical problems are described in a population of persons with Down syndrome. Health surveillance is compared to the recommendations of national guidelines. Method: Case records from the specialised and primary healthcare and disability services were analysed. Results: A wide spectrum of age-specific medical and surgical problems was…

Maatta, Tuomo; Maatta, Joonas; Tervo-Maatta, Tuula; Taanila, Anja; Kaski, Markus; Iivanainen, Matti

2011-01-01

251

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

252

Veterinary Technologists and Technicians  

MedlinePLUS

... 37,190 Research and development in the physical, engineering, and life sciences 35,810 Veterinary services 29, ... samples and perform tests to analyze body fluids, tissue, and other substances. See How to Become One $ ...

253

Copy number variation analysis in the context of electronic medical records and large-scale genomics consortium efforts  

PubMed Central

The goal of this paper is to review recent research on copy number variations (CNVs) and their association with complex and rare diseases. In the latter part of this paper, we focus on how large biorepositories such as the electronic medical record and genomics (eMERGE) consortium may be best leveraged to systematically mine for potentially pathogenic CNVs, and we end with a discussion of how such variants might be reported back for inclusion in electronic medical records as part of medical history. PMID:24672537

Connolly, John J.; Glessner, Joseph T.; Almoguera, Berta; Crosslin, David R.; Jarvik, Gail P.; Sleiman, Patrick M.; Hakonarson, Hakon

2014-01-01

254

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

255

Specifying Design Criteria for Electronic Medical Record Interface Using Cognitive Framework  

PubMed Central

As the healthcare industry transitions from paper to electronic medical records (EMRs), medical informatics researchers face the task of ensuring that the electronic presentation of the information remains usable and effective while capitalizing on the ability of EMRs to tailor information to different users. In our research, we focus on utilizing formal cognitive science methodology to guide the conversion of paper-based narrative discharge summaries to a more dynamic, structured electronic version. In this paper, we present the results of a cognitive analytic study (1) that determines a ‘core’ component in medical narratives and (2) that compares the use of structured and narrative texts by physicians with varying expertise. Specifically, we studied six psychiatrists at three levels of expertise— experts, intermediates, and novices. The subjects were given two clinical case scenarios with discharge summaries and asked to verbalize their thoughts as they read through the summaries. The interview transcripts were analyzed for recalls and inferences generated in the verbalization. Based on experts’ verbalizations, the discharge summaries were organized into a more structured form and used in the interview of other subjects. Novice-level subjects had more recall with the structured than with the narrative format. More errors were also made in recall with the narrative than with the structured text. We discuss how these results are valuable in designing an EMR interface to reduce errors and to support users of different expertise. PMID:14728242

Sharda, Pallav; Das, Amar K.; Patel, Vimla

2003-01-01

256

Assessment of Medical Records Module of Health Information System According to ISO 9241-10  

PubMed Central

Introduction Hospital managers and personnel need to Hospital Information System (HIS) to increase the efficiency and effectiveness in their organization. Accurate, appropriate, precise, timely, valid information, and Suitable Information system for their tasks is required and the basis for decision making in various levels of the hospital management, since, this study was conducted to Assess of Selected HIS in Isfahan University of Medical Science Hospitals According to ISO 9241-10. Methods This paper obtained from an applied, descriptive cross sectional study, in which the medical records module of IUMS selected HIS in Isfahan University of Medical Science affiliated seven hospitals were assessed with ISO 9241-10 questionnaire contained 7 principles and 74 items. The obtained data were analyzed with SPSS software and descriptive statistics were used to examine measures of central tendencies. Results The analysis of data revealed the following about the software: Suitability for user tasks, self descriptiveness, controllability by user, Conformity with user expectations, error tolerance, suitability for individualization, and suitability for user learning, respectively, was 68, 67, 70, 74, 69, 53, and 68 percent. Total compliance with ISO 9241-10 was 67 percent. Conclusion Information is the basis for policy and decision making in various levels of the hospital management. Consequently, it seems that HIS developers should decrease HIS errors and increase its suitability for tasks, self descriptiveness, controllability, conformity with user expectations, error tolerance, suitability for individualization, suitability for user learning. PMID:23572860

Ehteshami, Asghar; Sadoughi, Farahnaz; Saeedbakhsh, Saeed; Isfahani, Mahtab Kasaei

2013-01-01

257

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

258

Assessing the safety features of electronic patient medication record systems used in community pharmacies in England  

PubMed Central

Aims To evaluate the ability of electronic patient medication record (ePMR) systems used in community pharmacies in England to detect and alert users about clinical hazards, errors and other safety problems. Methods Between September 2012 and November 2012, direct on-site observational data about the performance of ePMR systems were collected from nine sites. Twenty-eight scenarios were developed by consensus agreement between a general practitioner and two community pharmacists. Each scenario was entered into the ePMR system, and the results obtained from the assessment of six unique systems in nine sites, in terms of the presence or absence of an alert, were recorded onto a prespecified form. Results None of the systems produced the correct responses for all of the 28 scenarios tested. Only two systems provided an alert to penicillin sensitivity. No dose or frequency check was observed when processing a prescription for methotrexate. One system did not warn about nonsuitability of aspirin prescribed to a child of 14 years of age. In another system, it was not possible to record a patient's pregnancy status. None of the six systems provided any warning for diclofenac overdose, high initiation dose of morphine sulfate or significant dose increase. Only one of the systems did not produce any spurious alerts. Conclusions The performance of the ePMR systems tested was variable and suboptimal. The findings suggest the need for minimum specifications and standards for ePMR systems to ensure consistency of performance. PMID:24528252

Ojeleye, Oluwagbemileke; Avery, Anthony J; Boyd, Matthew J

2014-01-01

259

Meeting the security requirements of electronic medical records in the ERA of high-speed computing.  

PubMed

This study has two objectives. First, it aims to develop a system with a highly secured approach to transmitting electronic medical records (EMRs), and second, it aims to identify entities that transmit private patient information without permission. The NTRU and the Advanced Encryption Standard (AES) cryptosystems are secured encryption methods. The AES is a tested technology that has already been utilized in several systems to secure sensitive data. The United States government has been using AES since June 2003 to protect sensitive and essential information. Meanwhile, NTRU protects sensitive data against attacks through the use of quantum computers, which can break the RSA cryptosystem and elliptic curve cryptography algorithms. A hybrid of AES and NTRU is developed in this work to improve EMR security. The proposed hybrid cryptography technique is implemented to secure the data transmission process of EMRs. The proposed security solution can provide protection for over 40 years and is resistant to quantum computers. Moreover, the technique provides the necessary evidence required by law to identify disclosure or misuse of patient records. The proposed solution can effectively secure EMR transmission and protect patient rights. It also identifies the source responsible for disclosing confidential patient records. The proposed hybrid technique for securing data managed by institutional websites must be improved in the future. PMID:25481568

Alanazi, H O; Zaidan, A A; Zaidan, B B; Kiah, M L Mat; Al-Bakri, S H

2015-01-01

260

Agreement Between Self-Report and Medical Record Prevalence of 16 Chronic Conditions in the Alaska EARTH Study.  

PubMed

The gold standard for health information is the health record. Hospitalization and outpatient diagnoses provide health systems with data on which to project health costs and plan programmatic changes. Although health record information may be reliable and perceived as accurate, it may not include population-specific information and may exclude care provided outside a specific health care facility. Sole reliance on medical record information may lead to underutilization of health care services and inadequate assessment of population health status. In this study, we analyzed agreement, without assuming a gold standard, between self-reported and recorded chronic conditions in an American Indian/Alaska Native cohort. Self-reported health history was collected from 3821 adult participants of the Alaska EARTH study during 2004-2006. Participant medical records were electronically accessed and reviewed. Self-reported chronic conditions were underreported in relation to the medical record and both information sources reported the absence more reliably than the presence of conditions (across conditions, median positive predictive value = 64%, median negative predictive value = 94%). Agreement was affected by age, gender, and education. Differences between participant- and provider-based prevalence of chronic conditions demonstrate why health care administrators and policy makers should not rely exclusively on medical record-based administrative data for a comprehensive evaluation of population health. PMID:24399443

Koller, Kathryn R; Wilson, Amy S; Asay, Elvin D; Metzger, Jesse S; Neal, Diane E

2014-01-01

261

Global veterinary leadership.  

PubMed

The public needs no reminder that deadly infectious diseases such as FMD could emerge in any country at any moment, or that national food security could be compromised by Salmonella or Listeria infections. Protections against these risks include the knowledge that appropriate and equivalent veterinary education will enable detection and characterization of emerging disease agents, as well as an appropriate response, wherever they occur. Global veterinary leadership is needed to reduce the global threat of infectious diseases of major food animal and public health importance. We believe that the co-curriculum is an excellent way to prepare and train veterinarians and future leaders who understand and can deal with global issues. The key to the success of the program is the veterinarian's understanding that there is a cultural basis to the practice of veterinary medicine in any country. The result will be a cadre of veterinarians, faculty, and other professionals who are better able (language and culture) to understand the effects of change brought about by free trade and the importance of interdisciplinary and institutional relationships to deal effectively with national and regional issues of food safety and security. New global veterinary leadership programs will build on interests, experience, ideas, and ambitions. A college that wishes to take advantage of this diversity must offer opportunities that interest veterinarians throughout their careers and that preferably connect academic study with intensive experiential training in another country. At its best, the global veterinary leadership program would include a partnership between veterinarians and several international learning centers, a responsiveness to the identified international outreach needs of the profession, and attention to critical thinking and reflection. The global veterinary leadership program we have described is intended to be a set of ideas meant to promote collaboration, coalitions, and discussion among veterinarians and veterinary educators who may be intrigued by the concept. The impact of the program can be summarized as follows: Outreach Programs: The global veterinary leadership program will establish new partnerships between veterinarians and veterinary college faculty as they supervise the international internships and see a relationship between their goals and the value of food safety to this country. Strategic Opportunity: The program will build on the critical role that US veterinarians and veterinary colleges already play in strengthening the safety of free trade in this hemisphere. Diversity in an Age of Specialization: The program will combine a global orientation, language ability, and access to comprehensive, research- and economic-related work/study opportunities to expose veterinarians to the expanding world market for veterinary expertise. New Linkages Through Corporate Partners: Through the success and high visibility of current research and education programs, most veterinary colleges are well positioned to engage industry, government, and university leaders in ways to use the proposed program to increase the flow of new ideas and talent into the world food enterprise. International Funding: A new partnership among veterinarians, industry, government, and university leaders can coordinate strong multilateral requests for funding from national and international sources. An Interdisciplinary Strategy that Benefits Veterinary Medicine: The program will combine the diverse veterinary research and education system with our strong national and international network of collaborators to provide globally competent veterinarians who will be needed for the corporate and public opportunities of the future. PMID:12442573

Wagner, G Gale; Brown, Corrie C

2002-11-01

262

Experience implementing a point-of-care electronic medical record system for primary care in Malawi.  

PubMed

Due to the fact that health care professionals in Malawi are often overstretched, the use and quality of health data can be compromised. The Malawi Health Management Information System (HMIS) has streamlined data collection and reporting and increased the use of data to improve care. Obstacles remain, including incomplete reporting and low staff morale. With the Baobab Health Trust and the Malawi Ministry of Health, Partners In Health piloted an innovative point-of-care data system for primary care that functions alongside OpenMRS, an open source medical record platform. The system has given access to a patient-level primary care dataset in real time. Initial results highlight some of the benefits of a point-of-care system such as improved data quality, emphasize the importance of sharing data with clinical practitioners, and shed light on how this approach could strengthen HMIS. PMID:20841657

Waters, Evan; Rafter, Jeff; Douglas, Gerald P; Bwanali, Mwatha; Jazayeri, Darius; Fraser, Hamish S F

2010-01-01

263

Building national electronic medical record systems via the World Wide Web.  

PubMed Central

Electronic medical record systems (EMRSs) currently do not lend themselves easily to cross-institutional clinical care and research. Unique system designs coupled with a lack of standards have led to this difficulty. The authors have designed a preliminary EMRS architecture (W3-EMRS) that exploits the multiplatform, multiprotocol, client-server technology of the World Wide Web. The architecture abstracts the clinical information model and the visual presentation away from the underlying EMRS. As a result, computation upon data elements of the EMRS and their presentation are no longer tied to the underlying EMRS structures. The architecture is intended to enable implementation of programs that provide uniform access to multiple, heterogeneous legacy EMRSs. The authors have implemented an initial prototype of W3-EMRS that accesses the database of the Boston Children's Hospital Clinician's Workstation. PMID:8723610

Kohane, I S; Greenspun, P; Fackler, J; Cimino, C; Szolovits, P

1996-01-01

264

Trigger factors and outcomes of falls among korean hospitalized patients: analysis of electronic medical records.  

PubMed

This retrospective case-control study investigated risk factors for falls in hospitalized patients and the influence of falls on patient outcomes, using electronic medical records (EMRs) in a South Korean tertiary university hospital. Data were obtained from 868 patients who had experienced a fall and 3,472 patients who had not. Potential risk factors were obtained from EMR data and analyzed using hierarchical logistic regression analysis. Multiple logistic and linear regressions were used to analyze the influence of falls on patient outcomes. Results showed that introducing a fall prevention reinforcement policy contributed to reducing fall risk. Hospital inpatient falls contribute to negative patient outcomes (mortality, readmission, emergency room visits after discharge, length of stay, and costs). PMID:24615824

Hong, Hyun-Ja; Kim, Nam-Cho; Jin, Yinji; Piao, Jinshi; Lee, Sun-Mi

2015-02-01

265

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

266

Are You Taking Medication as Prescribed?  

MedlinePLUS

... Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Print this page Share ... Consumer Updates Consumer Updates Animal & Veterinary Children's Health Cosmetics Dietary Supplements Drugs Food Medical Devices Nutrition Radiation- ...

267

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

268

Disease Risk Factors Identified through Shared Genetic Architecture and Electronic Medical Records  

PubMed Central

Genome-Wide Association Studies (GWAS) have identified genetic variants for thousands of diseases and traits. In this study, we evaluated the relationships between specific risk factors (for example, blood cholesterol level) and diseases on the basis of their shared genetic architecture in a comprehensive human disease-SNP association database (VARIMED), analyzing the findings from 8,962 published association studies. Similarity between traits and diseases was statistically evaluated based on their association with shared gene variants. We identified 120 disease-trait pairs that were statistically similar, and of these we tested and validated five previously unknown disease-trait associations by searching electronic medical records (EMR) from 3 independent medical centers for evidence of the trait appearing in patients within one year of first diagnosis of the disease. We validated that mean corpuscular volume is elevated before diagnosis of acute lymphoblastic leukemia; both have associated variants in the gene IKZF1. Platelet count is decreased before diagnosis of alcohol dependence; both are associated with variants in the gene C12orf51. Alkaline phosphatase level is elevated in patients with venous thromboembolism; both share variants in ABO. Similarly, we found prostate specific antigen and serum magnesium levels were altered before the diagnosis of lung cancer and gastric cancer, respectively. Disease-trait associations identifies traits that can potentially serve a prognostic function clinically; validating disease-trait associations through EMR can whether these candidates are risk factors for complex diseases. PMID:24786325

Li, Li; Ruau, David J.; Patel, Chirag J.; Weber, Susan C.; Chen, Rong; Tatonetti, Nicholas P.; Dudley, Joel T.; Butte, Atul J.

2015-01-01

269

Interconnection of electronic medical record with clinical data management system by CDISC ODM.  

PubMed

EDC system has been used in the field of clinical research. The current EDC system does not connect with electronic medical record system (EMR), thus a medical staff has to transcribe the data in EMR to EDC system manually. This redundant process causes not only inefficiency but also human error. We developed an EDC system cooperating with EMR, in which the data required for a clinical research form (CRF) is transcribed automatically from EMR to electronic CRF (eCRF) and is sent via network. We call this system as "eCRF reporter". The interface module of eCRF reporter can retrieves the data in EMR database including patient biography data, laboratory test data, prescription data and data entered by template in progress notes. The eCRF reporter also enables users to enter data directly to eCRF. The eCRF reporter generates CDISC ODM file and PDF which is a translated form of Clinical data in ODM. After storing eCRF in EMR, it is transferred via VPN to a clinical data management system (CDMS) which can receive the eCRF files and parse ODM. We started some clinical research by using this system. This system is expected to promote clinical research efficiency and strictness. PMID:25160311

Matsumura, Yasushi; Hattori, Atsushi; Manabe, Shiro; Takeda, Toshihiro; Takahashi, Daiyo; Yamamoto, Yuichiro; Murata, Taizo; Mihara, Naoki

2014-01-01

270

Use of electronic medical records differs by specialty and office settings  

PubMed Central

Objective To assess differences in the use of electronic medical records (EMRs) among medical specialties and practice settings. Methods A cross-sectional retrospective study using nationally representative data from the National Ambulatory Medical Care Survey for the period 2003–2010 was performed. Bivariate and multivariate analyzes compared EMR use among physicians of 14 specialties and assessed variation by practice setting. Differences in EMR use by geographic region, patient characteristics, and physician office settings were also assessed. Results Bivariate and multivariate analysis demonstrated increased EMR use from 2003 to 2010, with 16% reporting at least partial use in 2003, rising to 52% in 2010 (p<0.001). Cardiologists, orthopedic surgeons, urologists, and family/general practitioners had higher frequencies of EMR use whereas psychiatrists, ophthalmologists, and dermatologists had the lowest EMR use. Employed physicians had higher EMR uptake than physicians who owned their practice (48% vs 31%, p<0.001). EMR uptake was lower among solo practitioners (23%) than non-solo practitioners (42%, p<0.001). Practices owned by Health Maintenance Organizations had higher frequencies of EMR use (83%) than practices owned by physicians, community health centers, or academic centers (all <45%, p<0.001). Patient demographics did not affect EMR use (p>0.05). Conclusions Uptake of EMR is increasing, although it is significantly slower in dermatology, ophthalmology, and psychiatry. Solo practitioners and owners of a practice have low frequencies of EMR use compared with non-solo practitioners and those who do not own their practice. Despite incentives for EMR adoption, physicians should carefully weigh which, if any, EMR to adopt in their practices. PMID:23538721

Kokkonen, Erik W J; Davis, Scott A; Lin, Hsien-Chang; Dabade, Tushar S; Feldman, Steven R; Fleischer, Alan B

2013-01-01

271

Enhancing the Power of Genetic Association Studies through the Use of Silver Standard Cases Derived from Electronic Medical Records  

PubMed Central

The feasibility of using imperfectly phenotyped “silver standard” samples identified from electronic medical record diagnoses is considered in genetic association studies when these samples might be combined with an existing set of samples phenotyped with a gold standard technique. An analytic expression is derived for the power of a chi-square test of independence using either research-quality case/control samples alone, or augmented with silver standard data. The subset of the parameter space where inclusion of silver standard samples increases statistical power is identified. A case study of dementia subjects identified from electronic medical records from the Electronic Medical Records and Genomics (eMERGE) network, combined with subjects from two studies specifically targeting dementia, verifies these results. PMID:23762230

McDavid, Andrew; Crane, Paul K.; Newton, Katherine M.; Crosslin, David R.; McCormick, Wayne; Weston, Noah; Ehrlich, Kelly; Hart, Eugene; Harrison, Robert; Kukull, Walter A.; Rottscheit, Carla; Peissig, Peggy; Stefanski, Elisha; McCarty, Catherine A.; Zuvich, Rebecca Lynn; Ritchie, Marylyn D.; Haines, Jonathan L.; Denny, Joshua C.; Schellenberg, Gerard D.; de Andrade, Mariza; Kullo, Iftikhar; Li, Rongling; Mirel, Daniel; Crenshaw, Andrew; Bowen, James D.; Li, Ge; Tsuang, Debby; McCurry, Susan; Teri, Linda; Larson, Eric B.; Jarvik, Gail P.; Carlson, Chris S.

2013-01-01

272

Food systems veterinary medicine.  

PubMed

The objectives of this review are to suggest the use of the systems thinking framework to improve how veterinary medicine is applied to food production. It applies the eight essential skills of systems thinking to a few selected veterinary examples. Two of the skills determine how we approach or define a problem, and are (i) dynamic thinking (taking a longer term perspective) and (ii) the 30,000 foot view (expanding the boundary of analysis beyond the animal, farm, or even country). The other skills are (iii) system-as-cause, (iv) operational thinking, (v) closed-loop (feedback) thinking, (vi) non-linear thinking, (vii) scientific thinking and (viii) generic thinking. The challenge is to adopt and apply this systems framework to veterinary medicine and food production. The result will be a rigorous new approach to solving the complex food and health problems of the 21st century. PMID:22124228

Hurd, H Scott

2011-12-01

273

Lessons of history in veterinary medicine.  

PubMed

The future of veterinary medicine is best understood in the context of history. What began as a profession rooted in urban centers in proximity to horses, physicians, and medical schools, was transformed into a land grant-based agricultural profession with the arrival of the internal combustion engine in the early twentieth century. Most of the United States' current veterinary colleges are still located in towns or small cities in the middle section of the country, outside the largest metropolitan areas where most veterinarians practice companion-animal medicine. Throughout veterinarian history, substantial numbers of US students have been educated in foreign colleges and this continues today, creating an even greater geographic imbalance between the veterinary educational process and US population centers and major medical schools. Three themes deserve special attention as we celebrate the profession's 150th anniversary. We must first move beyond the land-grant culture and develop a more geographically balanced approach to establishing new veterinary colleges that are also in closer association with schools of medicine and public health. We must also facilitate more opportunities for women leadership in organized veterinary medicine, in practice ownership, in academia, and in the corporate structures that educate, hire, and interface with veterinarians. Finally, we need to expand our understanding of One Health to include the concept of zooeyia (the role of animals in promoting human health), as well as continue to emphasize veterinarians' special roles in the control and management of zoonotic diseases and in advancing comparative medicine in the age of the genome. PMID:23470241

Smith, Donald F

2013-01-01

274

Veterinary practice internal controls.  

PubMed

This chapter explores the responsive management requirements critical for effective internal controls. Internal control techniques offered include the application of segregation of function, goal-orientation, performance planning, and training objectives in five veterinary practice areas. These areas are client controls, cash controls, inventory controls, purchase controls, and stock controls. Because only trusted staff members are given access to practice assets, the veterinary leadership must have a responsive management plan to protect the life of the practice while building the practice team. Methods are shared for controlling opportunities that can lead to employee fraud while concurrently building a team approach to internal controls. PMID:8778946

Catanzaro, T E

1996-02-01

275

10 CFR 35.2063 - Records of dosages of unsealed byproduct material for medical use.  

Code of Federal Regulations, 2013 CFR

...unsealed byproduct material for medical use. 35.2063 Section...NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL...unsealed byproduct material for medical use. (a) A licensee...2) The patient's or human research subject's name, or...

2013-01-01

276

10 CFR 35.2063 - Records of dosages of unsealed byproduct material for medical use.  

Code of Federal Regulations, 2012 CFR

...unsealed byproduct material for medical use. 35.2063 Section...NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL...unsealed byproduct material for medical use. (a) A licensee...2) The patient's or human research subject's name, or...

2012-01-01

277

10 CFR 35.2063 - Records of dosages of unsealed byproduct material for medical use.  

Code of Federal Regulations, 2011 CFR

...unsealed byproduct material for medical use. 35.2063 Section...NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL...unsealed byproduct material for medical use. (a) A licensee...2) The patient's or human research subject's name, or...

2011-01-01

278

10 CFR 35.2063 - Records of dosages of unsealed byproduct material for medical use.  

Code of Federal Regulations, 2014 CFR

...unsealed byproduct material for medical use. 35.2063 Section...NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL...unsealed byproduct material for medical use. (a) A licensee...2) The patient's or human research subject's name, or...

2014-01-01

279

10 CFR 35.2063 - Records of dosages of unsealed byproduct material for medical use.  

Code of Federal Regulations, 2010 CFR

...unsealed byproduct material for medical use. 35.2063 Section...NUCLEAR REGULATORY COMMISSION MEDICAL USE OF BYPRODUCT MATERIAL...unsealed byproduct material for medical use. (a) A licensee...2) The patient's or human research subject's name, or...

2010-01-01

280

Accuracy of Reported Family History and Effectiveness of Medical Record Requests in Genetic Counseling for Alzheimer Disease  

Microsoft Academic Search

The University of British Columbia Hospital Clinic for Alzheimer Disease and Related Disorders (UBCH-CARD) invests significant\\u000a effort to obtain medical records for the confirmation of patient–reported family histories of dementia. The effectiveness\\u000a of requesting these records was assessed through a review of the 275 requests made by UBCH-CARD genetic counselors during\\u000a the 24-month period of January 1, 2005–December 31, 2006.

Emily L. R. Alexander; Rachel K. Butler; Colleen Guimond; Blair Butler; A. Dessa Sadovnick

2011-01-01

281

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.

282

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

283

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

284

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

285

Gastrointestinal Disease Outbreak Detection Using Multiple Data Streams from Electronic Medical Records  

PubMed Central

Abstract Background: Passive reporting and laboratory testing delays may limit gastrointestinal (GI) disease outbreak detection. Healthcare systems routinely collect clinical data in electronic medical records (EMRs) that could be used for surveillance. This study's primary objective was to identify data streams from EMRs that may perform well for GI outbreak detection. Methods: Zip code-specific daily episode counts in 2009 were generated for 22 syndromic and laboratory-based data streams from Kaiser Permanente Northern California EMRs, covering 3.3 million members. Data streams included outpatient and inpatient diagnosis codes, antidiarrheal medication dispensings, stool culture orders, and positive microbiology tests for six GI pathogens. Prospective daily surveillance was mimicked using the space-time permutation scan statistic in single and multi-stream analyses, and space-time clusters were identified. Serotype relatedness was assessed for isolates in two Salmonella clusters. Results: Potential outbreaks included a cluster of 18 stool cultures ordered over 5 days in one zip code and a Salmonella cluster in three zip codes over 9 days, in which at least five of six cases had the same rare serotype. In all, 28 potential outbreaks were identified using single stream analyses, with signals in outpatient diagnosis codes most common. Multi-stream analyses identified additional potential outbreaks and in one example, improved the timeliness of detection. Conclusions: GI disease-related data streams can be used to identify potential outbreaks when generated from EMRs with extensive regional coverage. This process can supplement traditional GI outbreak reports to health departments, which frequently consist of outbreaks in well-defined settings (e.g., day care centers and restaurants) with no laboratory-confirmed pathogen. Data streams most promising for surveillance included microbiology test results, stool culture orders, and outpatient diagnoses. In particular, clusters of microbiology tests positive for specific pathogens could be identified in EMRs and used to prioritize further testing at state health departments, potentially improving outbreak detection. PMID:22429155

Huang, Jie; Abrams, Allyson M.; Gilliss, Debra; Reed, Mary; Platt, Richard; Huang, Susan S.; Kulldorff, Martin

2012-01-01

286

The potential of electronic medical record systems to support quality improvement work and research in Norwegian general practice  

Microsoft Academic Search

BACKGROUND: Electronic medical record (EMR) systems are used for many purposes including patient care, administration, research, quality improvement and reimbursement. This study aimed to test a data extraction tool (QTools) and to provide information to support the interpretation of EMR data. METHODS: Comparison of aggregated practice data for selected EMR fields and interviews with practice staff. Practices received summaries of

Shaun Treweek

2003-01-01

287

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

Microsoft Academic Search

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,

Albert Boonstra; Manda Broekhuis

2010-01-01

288

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

289

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

290

Prevalence and usage of printed and electronic drug references and patient medication records in community pharmacies in Malaysia.  

PubMed

This study aimed to determine the availability and usage of printed and electronic references and Patient Medication Record in community pharmacy. It was conducted for over 3 months from 15 January to 30 April 2007. Ninety-three pharmacies participated. Structured questionnaires were mailed to community pharmacies. Six weeks later a reminder was sent to all non responders, who were given another six weeks to return the completed questionnaire. Outcomes were analyzed using descriptive statistics and chi-square test of independence. Almost all the pharmacies (96.8%) have at least Monthly Index of Medical Specialties (MIMS) while 78.5% have at least MIMS ANNUAL in their stores. Only about a third (31.2%) of the pharmacies were equipped with online facilities of which the majority referred to medical websites (88.9%) with only a minority (11.1%) referring to electronic journals. More than half (59.1%) of the pharmacists kept Patient Medication Record profiles with 49.1% storing it in paper, 41.8% electronically and 9.1% in both printed and electronic versions. In general, prevalence and usage of electronic references in community pharmacies were rather low. Efforts should be increased to encourage wider usage of electronic references and Patient Medication Records in community pharmacies to facilitate pharmaceutical care. PMID:22551563

Usir, Ezlina; Lua, Pei Lin; Majeed, Abu Bakar Abdul

2012-06-01

291

Integration of multiple DICOM Web servers into an enterprise-wide Web-based electronic medical record  

NASA Astrophysics Data System (ADS)

The purpose of this paper is to integrate multiple DICOM image webservers into the currently existing enterprises- wide web-browsable electronic medical record. Over the last six years the University of Washington has created a clinical data repository combining in a distributed relational database information from multiple departmental databases (MIND). A character cell-based view of this data called the Mini Medical Record (MMR) has been available for four years, MINDscape, unlike the text-based MMR. provides a platform independent, dynamic, web browser view of the MIND database that can be easily linked with medical knowledge resources on the network, like PubMed and the Federated Drug Reference. There are over 10,000 MINDscape user accounts at the University of Washington Academic Medical Centers. The weekday average number of hits to MINDscape is 35,302 and weekday average number of individual users is 1252. DICOM images from multiple webservers are now being viewed through the MINDscape electronic medical record.

Stewart, Brent K.; Langer, Steven G.; Martin, Kelly P.

1999-07-01

292

Risk adjusting cesarean delivery rates: a comparison of hospital profiles based on medical record and birth certificate data.  

PubMed Central

OBJECTIVES: Compare the discrimination of risk-adjustment models for primary cesarean delivery derived from medical record data and birth certificate data and determine if the two types of models yield similar hospital profiles of risk-adjusted cesarean delivery rates. DATA SOURCES/STUDY SETTING: The study involved 29,234 women without prior cesarean delivery admitted for labor and delivery in 1993-95 to 20 hospitals in northeast Ohio for whom data abstracted from patient medical records and data from birth certificates could be linked. STUDY DESIGN: Three pairs of multivariate models of the risk of cesarean delivery were developed using (1) the full complement of variables in medical records or birth certificates; (2) variables that were common to the two sources; and (3) variables for which agreement between the two data sources was high. Using each of the six models, predicted rates of cesarean delivery were determined for each hospital. Hospitals were classified as outliers if observed and predicted rates of cesarean delivery differed (p < .05). PRINCIPAL FINDINGS: Discrimination of the full medical record and birth certificate models was higher (p < .001) than the discrimination of the more limited common and reliable variable models. Based on the full medical record model, six hospitals were classified as statistical (p < .01) outliers (three high and three low). In contrast, the full birth certificate model identified five low and four high outliers, and classifications differed for seven of the 20 hospitals. Even so, the correlation between adjusted hospital rates was substantial (r = .71). Interestingly, correlations between the full medical record model and the more limited common (r = .84) and reliable (r = .88) variable birth certificate models were higher, and differences in classification of hospital outlier status were fewer. CONCLUSION: Birth certificates can be used to develop cesarean delivery risk-adjustment models that have excellent discrimination. However, using the full complement of birth certificate variables may lead to biased hospital comparisons. In contrast, limiting models to data elements with known reliability may yield rankings that are more similar to rankings based on medical record data. PMID:11666112

DiGiuseppe, D L; Aron, D C; Payne, S M; Snow, R J; Dierker, L; Rosenthal, G E

2001-01-01

293

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

2014-01-01

294

Java-based framework for the secure distribution of electronic medical records.  

PubMed

In this paper, we present a Java-based framework for the processing, storage and delivery of Electronic Medical Records (EMR). The choice of Java as a developmental and operational environment ensures operability over a wide-range of client-side platforms, with our on-going work emphasising migration towards Extensible Markup Language (XML) capable Web browser clients. Telemedicine in support of womb-to-tomb healthcare as articulated by the Multimedia Supercorridor (MSC) Telemedicine initiative--which motivated this project--will require high-volume data exchange over an insecure public-access Wide Area Network (WAN), thereby requiring a hybrid cryptosystem with both symmetric and asymmetric components. Our prototype framework features a pre-transaction authentication and key negotiation sequence which can be readily modified for client-side environments ranging from Web browsers without local storage capability to workstations with serial connectivity to a tamper-proof device, and also for point-to-multipoint transaction processes. PMID:10724956

Goh, A

1999-01-01

295

[Explore ideal of establishing ischemic stroke drugs group modules based on electronic medical records].  

PubMed

Ischemic stroke is a kind of common and frequently-occurring disease in clinic. It has high morbidity and high mortality and high morbidity characteristics. It was treated may also use a variety of Chinese and western medicine in the acute phase in the large general hospital in clinical practice. According to the "modularity theory" from biology, different patients using different drugs, and with combination of drugs for the treatment of this disease may have a variety of topological structure characteristics. This study proposed in the national 15 large general hospital electronic medical records of database, the complex network constructed by acute ischemic stroke disease using drugs, adopting to the complex network analysis and data mining methods to build for different ischemic stroke patients who are many of Chinese and western medicine group modules. These modules can be explained structure and function characteristics, and to explore the appropriate crowd and evaluate drug group module efficacy and safety in use in clinic. It provide direction to optimize the clinical treatment for ischemic stroke, provide new method for the research on combination, also provide the basis for drug combination of Chinese and western solution into the guide. PMID:25532373

Yang, Wei; Xie, Yan-ming

2014-09-01

296

The medical ethics of Dr J Marion Sims: a fresh look at the historical record  

PubMed Central

Vesicovaginal fistula was a catastrophic complication of childbirth among 19th century American women. The first consistently successful operation for this condition was developed by Dr J Marion Sims, an Alabama surgeon who carried out a series of experimental operations on black slave women between 1845 and 1849. Numerous modern authors have attacked Sims's medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. This article reviews these allegations using primary historical source material and concludes that the charges that have been made against Sims are largely without merit. Sims's modern critics have discounted the enormous suffering experienced by fistula victims, have ignored the controversies that surrounded the introduction of anaesthesia into surgical practice in the middle of the 19th century, and have consistently misrepresented the historical record in their attacks on Sims. Although enslaved African American women certainly represented a “vulnerable population” in the 19th century American South, the evidence suggests that Sims's original patients were willing participants in his surgical attempts to cure their affliction—a condition for which no other viable therapy existed at that time. PMID:16731734

Wall, L L

2006-01-01

297

The Adoption of Electronic Medical Records and Decision Support Systems in Korea  

PubMed Central

Objectives To examine the current status of hospital information systems (HIS), analyze the effects of Electronic Medical Records (EMR) and Clinical Decision Support Systems (CDSS) have upon hospital performance, and examine how management issues change over time according to various growth stages. Methods Data taken from the 2010 survey on the HIS status and management issues for 44 tertiary hospitals and 2009 survey on hospital performance appraisal were used. A chi-square test was used to analyze the association between the EMR and CDSS characteristics. A t-test was used to analyze the effects of EMR and CDSS on hospital performance. Results Hospital size and top management support were significantly associated with the adoption of EMR. Unlike the EMR results, however, only the standardization characteristic was significantly associated with CDSS adoption. Both EMR and CDSS were associated with the improvement of hospital performance. The EMR adoption rates and outsourcing consistently increased as the growth stage increased. The CDSS, Knowledge Management System, standardization, and user training adoption rates for Stage 3 hospitals were higher than those found for Stage 2 hospitals. Conclusions Both EMR and CDSS influenced the improvement of hospital performance. As hospitals advanced to Stage 3, i.e. have more experience with information systems, they adopted EMRs and realized the importance of each management issue. PMID:22084812

Yoo, Ki Bong; Kim, Eun Sook; Chae, Hogene

2011-01-01

298

Epidemic Surveillance Using an Electronic Medical Record: An Empiric Approach to Performance Improvement  

PubMed Central

Backgrounds Electronic medical records (EMR) form a rich repository of information that could benefit public health. We asked how structured and free-text narrative EMR data should be combined to improve epidemic surveillance for acute respiratory infections (ARI). Methods Eight previously characterized ARI case detection algorithms (CDA) were applied to historical EMR entries to create authentic time series of daily ARI case counts (background). An epidemic model simulated influenza cases (injection). From the time of the injection, cluster-detection statistics were applied daily on paired background+injection (combined) and background-only time series. This cycle was then repeated with the injection shifted to each week of the evaluation year. We computed: a) the time from injection to the first statistical alarm uniquely found in the combined dataset (Detection Delay); b) how often alarms originated in the background-only dataset (false-alarm rate, or FAR); and c) the number of cases found within these false alarms (Caseload). For each CDA, we plotted the Detection Delay as a function of FAR or Caseload, over a broad range of alarm thresholds. Results CDAs that combined text analyses seeking ARI symptoms in clinical notes with provider-assigned diagnostic codes in order to maximize the precision rather than the sensitivity of case-detection lowered Detection Delay at any given FAR or Caseload. Conclusion An empiric approach can guide the integration of EMR data into case-detection methods that improve both the timeliness and efficiency of epidemic detection. PMID:25006878

Zheng, Hongzhang; Gaff, Holly; Smith, Gary; DeLisle, Sylvain

2014-01-01

299

A Retrospective Analysis of the Clinical Impact of 939 Chest Radiographs Using the Medical Records  

PubMed Central

Objective. Between one-third and half of all radiology examinations worldwide are probably chest studies. The aim of the current study was to retrospectively evaluate the clinical influence of chest radiography. Methods. In a tertiary referral hospital, 939 consecutive daytime chest radiography examinations were evaluated. The outcome was classified as normal, incidental, or pathologic. The referring physician's reaction to radiologic outcome was classified as highly expected, moderately expected, or unexpected. The influence on the patients' treatment was divided into four groups from major to no influence. Results. In all, 71.6% of the studies had a highly expected outcome. Moderately expected or unexpected outcomes were noted in 36.6% of 500 pathologic examinations. Unexpected outcome was noted in 11.6% of all studies. The radiologic outcome influenced treatment in 65.4% of patients where pathology was demonstrated. Patients with normal or incidental findings had treatment influenced in 1/3 of the cases. Unexpected findings influenced treatment more than moderately expected findings. When radiological findings were highly expected, treatment was influenced in less than half of the cases. Surprisingly few chest radiology examinations were commented upon in the medical records. PMID:23316358

Ivarsson, Liz; Göthlin, Jan H.

2012-01-01

300

Knowledge Retrieval from PubMed Abstracts and Electronic Medical Records with the Multiple Sclerosis Ontology  

PubMed Central

Background In order to retrieve useful information from scientific literature and electronic medical records (EMR) we developed an ontology specific for Multiple Sclerosis (MS). Methods The MS Ontology was created using scientific literature and expert review under the Protégé OWL environment. We developed a dictionary with semantic synonyms and translations to different languages for mining EMR. The MS Ontology was integrated with other ontologies and dictionaries (diseases/comorbidities, gene/protein, pathways, drug) into the text-mining tool SCAIView. We analyzed the EMRs from 624 patients with MS using the MS ontology dictionary in order to identify drug usage and comorbidities in MS. Testing competency questions and functional evaluation using F statistics further validated the usefulness of MS ontology. Results Validation of the lexicalized ontology by means of named entity recognition-based methods showed an adequate performance (F score = 0.73). The MS Ontology retrieved 80% of the genes associated with MS from scientific abstracts and identified additional pathways targeted by approved disease-modifying drugs (e.g. apoptosis pathways associated with mitoxantrone, rituximab and fingolimod). The analysis of the EMR from patients with MS identified current usage of disease modifying drugs and symptomatic therapy as well as comorbidities, which are in agreement with recent reports. Conclusion The MS Ontology provides a semantic framework that is able to automatically extract information from both scientific literature and EMR from patients with MS, revealing new pathogenesis insights as well as new clinical information. PMID:25665127

Malhotra, Ashutosh; Gündel, Michaela; Rajput, Abdul Mateen; Mevissen, Heinz-Theodor; Saiz, Albert; Pastor, Xavier; Lozano-Rubi, Raimundo; Martinez-Lapsicina, Elena H.; Zubizarreta, Irati; Mueller, Bernd; Kotelnikova, Ekaterina; Toldo, Luca; Hofmann-Apitius, Martin; Villoslada, Pablo

2015-01-01

301

Veterinary students and non-academic stressors.  

PubMed

Students in veterinary schools can experience stress in balancing the different demands on them-academic, interpersonal, intrapersonal, and professional or work related-as well as managing potential conflict between animal and human interests. Practicing veterinarians report many similar stressors and reactions. Stressful stimuli produce stress reactions that can be inimical to physical and psychological well-being, and students' performance in veterinary programs can be adversely affected if they do not have coping resources. While there has been some research into stress among university students in general, and among medical students in particular, there is little on the experience of veterinary students. This article describes a study by the School of Psychology, commissioned by the Department of Veterinary Clinical Sciences, at Murdoch University in Western Australia. It was designed to investigate the levels and causes of stress among, and the frequency and type of coping strategies used by, fourth- and fifth-year students. Results indicate that the students in this cohort faced frequent stressors and felt at least moderately stressed but did not routinely and systematically use a range of coping strategies. Academic stressors and perceived responsibilities attached to moving into practical or professional areas figured strongly and were associated with higher levels of stress in the students, in particular physical sequelae. Though the numbers were small, it is of concern that some students were using measures that were potentially harmful. Some recommendations are made here about measures that veterinary programs may be able to incorporate to address stress in their students. Information is included on current strategies within the curriculum to manage potential stressful situations as part of students' professional development. PMID:16078171

Kogan, Lori R; McConnell, Sherry L; Schoenfeld-Tacher, Regina

2005-01-01

302

2012-2018 Strategic Plan for the Virginia-Maryland Regional College of Veterinary  

E-print Network

of the future. One of these studies utilized foresight technology and it clearly indicated the need for change, economical, environmental, and technological influences that in turn are impacting the future of veterinary in veterinary medical education (1). The Foresight report engendered two more studies and consequent reports

Buehrer, R. Michael

303

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.

304

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

305

Electronic medical records and physician stress in primary care: results from the MEMO Study  

PubMed Central

Background Little has been written about physician stress that may be associated with electronic medical records (EMR). Objective We assessed relationships between the number of EMR functions, primary care work conditions, and physician satisfaction, stress and burnout. Design and participants 379 primary care physicians and 92 managers at 92 clinics from New York City and the upper Midwest participating in the 2001–5 Minimizing Error, Maximizing Outcome (MEMO) Study. A latent class analysis identified clusters of physicians within clinics with low, medium and high EMR functions. Main measures We assessed physician-reported stress, burnout, satisfaction, and intent to leave the practice, and predictors including time pressure during visits. We used a two-level regression model to estimate the mean response for each physician cluster to each outcome, adjusting for physician age, sex, specialty, work hours and years using the EMR. Effect sizes (ES) of these relationships were considered small (0.14), moderate (0.39), and large (0.61). Key results Compared to the low EMR cluster, physicians in the moderate EMR cluster reported more stress (ES 0.35, p=0.03) and lower satisfaction (ES ?0.45, p=0.006). Physicians in the high EMR cluster indicated lower satisfaction than low EMR cluster physicians (ES ?0.39, p=0.01). Time pressure was associated with significantly more burnout, dissatisfaction and intent to leave only within the high EMR cluster. Conclusions Stress may rise for physicians with a moderate number of EMR functions. Time pressure was associated with poor physician outcomes mainly in the high EMR cluster. Work redesign may address these stressors. PMID:24005796

Babbott, Stewart; Manwell, Linda Baier; Brown, Roger; Montague, Enid; Williams, Eric; Schwartz, Mark; Hess, Erik; Linzer, Mark

2014-01-01

306

QT variability during initial exposure to sotalol: experience based on a large electronic medical record  

PubMed Central

Aims A prolonged QT interval is associated with increased risk of Torsades de pointes (TdP) and may be fatal. We sought to investigate the extent to which clinical covariates affect the change in QT interval among ‘real-world’ patients treated with sotalol and followed in an electronic medical record (EMR) system. Methods and results We used clinical alerts in our EMR system to identify all patients in whom a new prescription for sotalol was written (2001–11). Rate-corrected QT (QTc) was calculated by Bazett's formula. Correlates of sotalol-induced change in the QTc interval and sotalol discontinuation were examined using linear and logistic regression, respectively. Overall, 541 sotalol-exposed patients were identified (n = 200 women, 37%). The mean first sotalol dose was 86 ± 39 mg, age 64 ± 13 years, and BMI 30 ± 7 kg/m2. Atrial fibrillation/flutter was the predominant indication (92.2%). After initial exposure, the change in the QTc interval from baseline was highly variable: ?QTc after 2 h = 3 ± 42 ms (P = 0.17) and 11 ± 37 ms after ?48 h (P < 0.001). Multivariable linear regression analysis identified female gender and age, reduced left ventricular ejection fraction, high sotalol dose, hypertrophic cardiomyopathy, and loop diuretic co-administration as correlates of increased ?QTc at ?48 h (P < 0.05 for all). Within 3 days of initiation, 12% discontinued sotalol of which 31% were because of exaggerated QTc prolongation. One percent developed TdP. Conclusion In this EMR-based cohort, the increase in QTc with sotalol initiation was highly variable, and multiple clinical factors contributed. These data represent an important step in ongoing work to identify real-world patients likely to tolerate long-term therapy and reinforces the utility of EMR-based cohorts as research tools. PMID:23787903

Weeke, Peter; Delaney, Jessica; Mosley, Jonathan D.; Wells, Quinn; Van Driest, Sara; Norris, Kris; Kucera, Gayle; Stubblefield, Tanya; Roden, Dan M.

2013-01-01

307

Modeling return on investment for an electronic medical record system in Lilongwe, Malawi  

PubMed Central

Objective To model the financial effects of implementing a hospital-wide electronic medical record (EMR) system in a tertiary facility in Malawi. Materials and Methods We evaluated three areas of impact: length of stay, transcription time, and laboratory use. We collected data on expenditures in these categories under the paper-based (pre-EMR) system, and then estimated reductions in each category based on findings from EMR systems in the USA and backed by ambulatory data from low-income settings. We compared these potential savings accrued over a period of 5?years with the costs of implementing the touchscreen point-of-care EMR system at that site. Results Estimated cost savings in length of stay, transcription time, and laboratory use totaled US$284?395 annually. When compared with the costs of installing and sustaining the EMR system, there is a net financial gain by the third year of operation. Over 5?years the estimated net benefit was US$613?681. Discussion Despite considering only three categories of savings, this analysis demonstrates the potential financial benefits of EMR systems in low-income settings. The results are robust to higher discount rates, and a net benefit is realized even under more conservative assumptions. Conclusions This model demonstrates that financial benefits could be realized with an EMR system in a low-income setting. Further studies will examine these and other categories in greater detail, study the financial effects at different levels of organization, and benefit from post-implementation data. This model will be further improved by substituting its assumptions for evidence as we conduct more detailed studies. PMID:23144335

Driessen, Julia; Cioffi, Marco; Alide, Noor; Landis-Lewis, Zach; Gamadzi, Gervase; Gadabu, Oliver Jintha; Douglas, Gerald

2013-01-01

308

Physicians' perception about electronic medical record system in Makkah Region, Saudi Arabia  

PubMed Central

Objectives: The study was done to determine the physicians' perception about electronic medical record system (EMRS) in the context of its productivity in order to improve its functionality and advantages. Materials and Methods: This cross-sectional survey was performed from July to August 2009 with structured questionnaire of 15 closed-ended questions with five points Likert scaling starting from strongly disagree to strongly agree as 1–5, reflecting the perception of physicians about EMRS. The physicians of the Makkah region working in six different hospitals were selected. “Positive” response means if percent of responses were rated 4 or 5 (agree/strongly agree), “neutral” if rated 3, and negative if rated 1 or 2 (strongly disagree/disagree). Descriptive data analysis techniques were used. Results: We selected 317 completed questionnaires. Majority of subjects were from King Fahd Hospital, Jeddah (83, 26.3%), residents (147, 46.4%), male (200,63.1%), expatriates (207, 65%), and age group 36–45 years (133, 42%) were dominant. The stem regarding importance of computers for practicing medicine and EMRS to improve quality of practice was appreciated by majority, that is, 77.7 and 71.2%, respectively. However, “It does not disrupt the workflow” (35.1%) and “EMRS is comfortable while entering the data instead of writing” (34.8%) were appreciated negatively. Consultants (53.9%), male (53.4%), expatriates (56.7%), physicians of King Abdul Aziz Hospital, Ta'if (56.9%), and age group of 46–55 years (53.8%) appreciated EMRS positively. Overall perception of EMRS was found positive by 52.8%. Conclusion: Majority appreciated the EMRS, but specific concerns about its usage easiness and workflow disturbance were opposed by them also. PMID:25625082

Shaker, Hani Abdulsattar; Farooq, Mian Usman; Dhafar, Khalid Obeid

2015-01-01

309

September 4, 2010 | Veterinary Record Short Communications  

E-print Network

(CISA)-INIA,CarreteraAlgete-El Casars/n,28130Valdeolmos,Spain R.Soriguer,PhD, J.Figuerola,PhD, EstaciónBiológicadeDoñana,Calle Americo in horses in Doñana, Spain, 2005 to 2008 M. A. Jiménez-Clavero, F. Llorente, E. Sotelo, R. Soriguer, C

Figuerola, Jordi

310

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

Code of Federal Regulations, 2010 CFR

...record within 24 hours after admission or registration, but prior to surgery or a procedure requiring...record within 24 hours after admission or registration, but prior to surgery or a procedure requiring...hospital acquired infections, and...

2010-10-01

311

Validation of electronic medical record-based phenotyping algorithms: results and lessons learned from the eMERGE network  

PubMed Central

Background Genetic studies require precise phenotype definitions, but electronic medical record (EMR) phenotype data are recorded inconsistently and in a variety of formats. Objective To present lessons learned about validation of EMR-based phenotypes from the Electronic Medical Records and Genomics (eMERGE) studies. Materials and methods The eMERGE network created and validated 13 EMR-derived phenotype algorithms. Network sites are Group Health, Marshfield Clinic, Mayo Clinic, Northwestern University, and Vanderbilt University. Results By validating EMR-derived phenotypes we learned that: (1) multisite validation improves phenotype algorithm accuracy; (2) targets for validation should be carefully considered and defined; (3) specifying time frames for review of variables eases validation time and improves accuracy; (4) using repeated measures requires defining the relevant time period and specifying the most meaningful value to be studied; (5) patient movement in and out of the health plan (transience) can result in incomplete or fragmented data; (6) the review scope should be defined carefully; (7) particular care is required in combining EMR and research data; (8) medication data can be assessed using claims, medications dispensed, or medications prescribed; (9) algorithm development and validation work best as an iterative process; and (10) validation by content experts or structured chart review can provide accurate results. Conclusions Despite the diverse structure of the five EMRs of the eMERGE sites, we developed, validated, and successfully deployed 13 electronic phenotype algorithms. Validation is a worthwhile process that not only measures phenotype performance but also strengthens phenotype algorithm definitions and enhances their inter-institutional sharing. PMID:23531748

Newton, Katherine M; Peissig, Peggy L; Kho, Abel Ngo; Bielinski, Suzette J; Berg, Richard L; Choudhary, Vidhu; Basford, Melissa; Chute, Christopher G; Kullo, Iftikhar J; Li, Rongling; Pacheco, Jennifer A; Rasmussen, Luke V; Spangler, Leslie; Denny, Joshua C

2013-01-01

312

78 FR 55244 - Notice of Availability of Record of Decision for Medical Facilities Development and University...  

Federal Register 2010, 2011, 2012, 2013, 2014

...provide adequate education and research space to meet Military Health...level education to the military medical community and enable USU to serve as the core academic health research center at WRNMMC. The proposed...missions of the installation, medical center, or the USU....

2013-09-10

313

Peri-Abortion Contraceptive Choices of Migrant Chinese Women: A Retrospective Review of Medical Records  

PubMed Central

Background Migrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether Chinese women were over-represented among abortion clinic attendees. Methods Retrospective review of medical records at a public hospital abortion clinic involving 305 Chinese women. Previously collected data for European (n?=?277) and Maori women (n?=?128) were used for comparative analyses. Regression analyses explored correlates of contraceptive method choice. Population census data were used to calculate rates of clinic attendance across ethnic groups. Results Chinese women were not over-represented among clinic attendees, and had similar rates of contraceptive non-use pre-abortion as women in comparison groups. Use of the oral contraceptive pill by Chinese was lower pre-abortion than for other ethnic groups, but choice of this method post-abortion was similar for Chinese (46.9%, 95% CI 41–52.7) and European women (43.7%, 95% CI 37.8–49.7). Post-abortion choice of an intrauterine device did not differ significantly between Chinese (28.9%, 95% CI 23.8–34.3) and Maori women (37%, 95% CI 28.4–45.7), but was higher than uptake of this method by European women (21.7%, 95% CI 17–27.0). Age, parity and previous abortion were significant predictors of post-abortion method choice by Chinese women (p<0.05). Conclusions Following contraceptive counseling at the clinic, Chinese women chose more effective contraceptive methods for use post-abortion than they had used previously. As the population of migrant Chinese in New Zealand continues to increase, strategies are urgently needed to provide new arrivals with appropriate information and advice about contraception and where to access it, so women can be better prepared to avoid unplanned pregnancy. PMID:22768231

Rose, Sally B.; Wei, Zhang; Cooper, Annette J.; Lawton, Beverley A.

2012-01-01

314

[Implementation and use of an electronic medical record in a department of cardiology: ten-year experience].  

PubMed

The rising of healthcare and hospital efficiency has underlined the necessity of clinical information systems. Hospitals represent complex organizations requiring control of different types of data for the management of patients and resources. A project was developed at the CNR Institute of Clinical Physiology of Pisa to produce an integration system to manage healthcare in its technological, administrative and clinical aspects, in respect of high quality in healthcare and cost-effectiveness evaluation. A networked computer-based information system was implemented to integrate different heterogeneous sources of patient data, both administrative and clinical (texts, signals, images), reaching a total integration. Data are stored into a relational database, processed and presented to healthcare personnel by network-connected clinical workstations. Epidemiological components are integrated to continuously offer evaluation processes to clinical components. From 1998 to August 2007 more than 300 stations were connected. The electronic medical records of more than 20 000 patients were recorded; more than 100 000 procedures were digitally integrated and the entire health file record and cost calculation could be obtained for each patient. In conclusion, the use of electronic medical records allowed a complete clinical data integration with improvement of overall structure efficiency and healthcare quality. PMID:18780552

Carpeggiani, Clara; Macerata, Alberto; Taddei, Alessandro; Benassi, Antonio; Donato, Luigi

2008-08-01

315

Surgical Lasers In Veterinary Medicine  

NASA Astrophysics Data System (ADS)

Veterinary medicine is a latecomer in benefiting from the advent of surgical lasers. It is ironic that although most of the basic work in lasers is carried out in animal species with which we are most conversant, veterinary medicine as a profession has not been very extensively involved.

Newman, H. C.

1987-03-01

316

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

317

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

Code of Federal Regulations, 2010 CFR

...there will be exposure to toxic substances...5) Employee exposure record means...methodologies, calculations, and other background...occupational exposures), (B) The...health nurse, industrial hygienist,...

2010-07-01

318

Two Postitions Open: Veterinary Pathology Resident Oregon State University, College of Veterinary Medicine, Department of Biomedical Sciences invites applications  

E-print Network

Two Postitions Open: Veterinary Pathology Resident Oregon State University, College of Veterinary Medicine, Department of Biomedical Sciences invites applications for a Veterinary Anatomic Pathology Resident and a Veterinary Clinical Pathology Resident (one position each). Veterinary Pathology Residents

Escher, Christine

319

Software engineering risk factors in the implementation of a small electronic medical record system: the problem of scalability.  

PubMed Central

The successful implementation of clinical information systems is difficult. In examining the reasons and potential solutions for this problem, the medical informatics community may benefit from the lessons of a rich body of software engineering and management literature about the failure of software projects. Based on previous studies, we present a conceptual framework for understanding the risk factors associated with large-scale projects. However, the vast majority of existing literature is based on large, enterprise-wide systems, and it unclear whether those results may be scaled down and applied to smaller projects such as departmental medical information systems. To examine this issue, we discuss the case study of a delayed electronic medical record implementation project in a small specialty practice at Columbia-Presbyterian Medical Center. While the factors contributing to the delay of this small project share some attributes with those found in larger organizations, there are important differences. The significance of these differences for groups implementing small medical information systems is discussed. PMID:12463804

Chiang, Michael F.; Starren, Justin B.

2002-01-01

320

MR-toMIT-med-4-11 Medical Records Service  

E-print Network

# ______________________________ for further medical care. 4. RELEASE OF PRIVILEGED INFORMATION Mental health Alcoholism Substance abuse not have to sign the authorization in order to receive treatment or payment, or to enroll or be eligible

Polz, Martin

321

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

care and strong communication with clients. Responsibilities/Duties: Conduct equine ambulatory will service existing clients and develop new clientele in the region. The successful candidate must be able appointments with clients in the Northern Colorado region Teach 4th year veterinary students about

322

DEVELOPMENT OF A DATA-MINING ALGORITHM TO IDENTIFY AGES AT REPRODUCTIVE MILESTONES IN ELECTRONIC MEDICAL RECORDS  

PubMed Central

Electronic medical records (EMRs) are becoming more widely implemented following directives from the federal government and incentives for supplemental reimbursements for Medicare and Medicaid claims. Replete with rich phenotypic data, EMRs offer a unique opportunity for clinicians and researchers to identify potential research cohorts and perform epidemiologic studies. Notable limitations to the traditional epidemiologic study include cost, time to complete the study, and limited ancestral diversity; EMR-based epidemiologic studies offer an alternative. The Epidemiologic Architecture for Genes Linked to Environment (EAGLE) Study, as part of the Population Architecture using Genomics and Epidemiology (PAGE) I Study, has genotyped more than 15,000 patients of diverse ancestry in BioVU, the Vanderbilt University Medical Center’s biorepository linked to the EMR (EAGLE BioVU). We report here the development and performance of data-mining techniques used to identify the age at menarche (AM) and age at menopause (AAM), important milestones in the reproductive lifespan, in women from EAGLE BioVU for genetic association studies. In addition, we demonstrate the ability to discriminate age at naturally-occurring menopause (ANM) from medically-induced menopause. Unusual timing of these events may indicate underlying pathologies and increased risk for some complex diseases and cancer; however, they are not consistently recorded in the EMR. Our algorithm offers a mechanism by which to extract these data for clinical and research goals. PMID:24297563

MALINOWSKI, JENNIFER; FARBER-EGER, ERIC; CRAWFORD, DANA C.

2014-01-01

323

Practical considerations to guide development of access controls and decision support for genetic information in electronic medical records  

PubMed Central

Background Genetic testing is increasingly used as a tool throughout the health care system. In 2011 the number of clinically available genetic tests is approaching 2,000, and wide variation exists between these tests in their sensitivity, specificity, and clinical implications, as well as the potential for discrimination based on the results. Discussion As health care systems increasingly implement electronic medical record systems (EMRs) they must carefully consider how to use information from this wide spectrum of genetic tests, with whom to share information, and how to provide decision support for clinicians to properly interpret the information. Although some characteristics of genetic tests overlap with other medical test results, there are reasons to make genetic test results widely available to health care providers and counterbalancing reasons to restrict access to these test results to honor patient preferences, and avoid distracting or confusing clinicians with irrelevant but complex information. Electronic medical records can facilitate and provide reasonable restrictions on access to genetic test results and deliver education and decision support tools to guide appropriate interpretation and use. Summary This paper will serve to review some of the key characteristics of genetic tests as they relate to design of access control and decision support of genetic test information in the EMR, emphasizing the clear need for health information technology (HIT) to be part of optimal implementation of genetic medicine, and the importance of understanding key characteristics of genetic tests when designing HIT applications. PMID:22047175

2011-01-01

324

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

Code of Federal Regulations, 2010 CFR

...significantly involved. (4) The social service records, including...resource contacts as well as a social history. (5) When indicated...5) Describe attitudes and behavior; (6) Estimate intellectual...482.12(c), nurse, social worker and, when...

2010-10-01

325

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

Code of Federal Regulations, 2011 CFR

...significantly involved. (4) The social service records, including...resource contacts as well as a social history. (5) When indicated...5) Describe attitudes and behavior; (6) Estimate intellectual...482.12(c), nurse, social worker and, when...

2011-10-01

326

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

Code of Federal Regulations, 2012 CFR

...significantly involved. (4) The social service records, including...resource contacts as well as a social history. (5) When indicated...5) Describe attitudes and behavior; (6) Estimate intellectual...482.12(c), nurse, social worker and, when...

2012-10-01

327

Veterinary Nursing We provide training and undertake research in veterinary nursing.  

E-print Network

Veterinary Nursing We provide training and undertake research in veterinary nursing. The veterinary nursing programme is a three-year course which leads to a Bachelor's degree and to a professional qualification in veterinary nursing. We also provide a course which gives veterinary surgeons who have graduated

328

Validation of the treatment identification strategy of the HEDIS addiction quality measures: concordance with medical record review  

PubMed Central

Background Strategies to accurately identify the occurrence of specific health care events in administrative data is central to many quality improvement and research efforts. Many health care quality measures have treatment identification strategies based on diagnosis and procedure codes - an approach that is inexpensive and feasible but usually of unknown validity. In this study, we examined if the diagnosis/procedure code combinations used in the 2006 HEDIS Initiation and Engagement quality measures to identify instances of addiction treatment have high concordance with documentation of addiction treatment in clinical progress notes. Methods Four type of records were randomly sampled from VHA electronic medical data: (a) Outpatient records from a substance use disorder (SUD) specialty clinic with a HEDIS-qualified substance use disorder (SUD) diagnosis/CPT code combination (n = 700), (b) Outpatient records from a non-SUD setting with a HEDIS-qualified SUD diagnosis/CPT code combination (n = 592), (c) Specialty SUD Inpatient/residential records that included a SUD diagnosis (n = 700), and (d) Non-SUD specialty Inpatient/residential records that included a SUD diagnosis (n = 700). Clinical progress notes for the sampled records were extracted and two raters classified each as documenting or not documenting addiction treatment. Rates of concordance between the HEDIS addiction treatment identification strategy and the raters' judgments were calculated for each record type. Results Within SUD outpatient clinics and SUD inpatient specialty units, 92% and 98% of sampled records had chart evidence of addiction treatment. Of outpatient encounters with a qualifying diagnosis/procedure code combination outside of SUD clinics, 63% had chart evidence of addiction treatment. Within non-SUD specialty inpatient units, only 46% of sampled records had chart evidence of addiction treatment. Conclusions For records generated in SUD specialty settings, the HEDIS strategy of identifying SUD treatment with diagnosis and procedure codes has a high concordance with chart review. The concordance rate outside of SUD specialty settings is much lower and highly variable between facilities. Therefore, some patients may be counted as meeting the 2006 HEDIS Initiation and Engagement criteria without having received the specified amount (or any) addiction treatment. PMID:21481264

2011-01-01

329

A Proposal for Electronic Medical Records in U.S. Primary Care  

Microsoft Academic Search

Delivery of excellent primary care—central to overall medical care—demands that providers have the necessary information when they give care. This paper, developed by the National Alliance for Primary Care Informatics, a collaborative group sponsored by a number of primary care societies, argues that providers’ and patients’ information and decision support needs can be satisfied only if primary care providers use

David W Bates; Mark Ebell; Edward Gotlieb; John Zapp; H. C. Mullins

2003-01-01

330

Update on Veterinary Tuberculosis Vaccines  

Technology Transfer Automated Retrieval System (TEKTRAN)

Educational Objective: At the conclusion of this presentation, the participant will know the current status of veterinary tuberculosis vaccine research and development, and understand the challenges which remain for the future introduction of tuberculosis vaccines intended for wildlife and livestock...

331

Saving Patient Ryan--Can Advanced Electronic Medical Records Make Patient Care Safer?  

E-print Network

, Carnegie Mellon University, rtelang@andrew.cmu.edu William M. Marella Pennsylvania Patient Safety Authority, WMarella@ecri.org Patient safety is one of the foremost problems in US healthcare, affecting hundreds records (EMRs) are widely expected to improve patient safety, but the evidence of advanced EMRs' impact

Sadeh, Norman M.

332

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

333

Application of thrombelastography/thromboelastometry to veterinary medicine.  

PubMed

Thrombelastograph analyzers are point-of-care hemostatic analyzers that provide global assessment of the hemostatic process. Thrombelastography (TEG) detects and provides a continuous recording of the changes in the viscoelastic properties of whole blood from initial clot formation through fibinolysis. TEG has been validated for use in dogs, horses, and cats. Hemostasis research using TEG has focused on test validation, alterations of TEG tracings in animals with naturally occurring diseases, and the use of TEG for monitoring various therapeutic modalities. This article reviews TEG methodology and terminology, including potential sources of preanalytical and analytical errors, the correlation between TEG and other routine hemostatic assays, and current clinical applications of TEG, with emphasis on veterinary medical practice. Data suggest that TEG may be a sensitive and useful adjunctive tool for evaluating an animal with an underlying coagulopathy, including hypercoagulability and hypocoagulability. Additional prospective studies are needed to (1) correlate TEG tracing patterns with a clinical predisposition for bleeding or thrombosis in various disease states and (2) determine whether monitoring and treating hemostatic disorders based on TEG tracings improve clinical outcome. PMID:20969608

Kol, Amir; Borjesson, Dori L

2010-12-01

334

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

PubMed Central

According to the human factors paradigm for patient safety, health care work systems and innovations such as electronic medical records do not have direct effects on patient safety. Instead, their effects are contingent on how the clinical work system, whether computerized or not, shapes health care providers' performance of cognitive work processes. An application of the human factors paradigm to interview data from two hospitals in the Midwest United States yielded numerous examples of the performance-altering effects of electronic medical records, electronic clinical documentation, and computerized provider order entry. Findings describe both improvements and decrements in the ease and quality of cognitive performance, both for interviewed clinicians and for their colleagues and patients. Changes in cognitive performance appear to have desirable and undesirable implications for patient safety as well as for quality of care and other important outcomes. Cognitive performance can also be traced to interactions between work system elements, including new technology, allowing for the discovery of problems with “fit” to be addressed through design interventions. PMID:21479125

Holden, Richard J.

2010-01-01

335

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

336

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

337

The history of veterinary cardiology.  

PubMed

Throughout civilization, animals have played a pivotal role in the advancement of science and medicine. From as early as 400 BC when Hippocrates recognized that diseases had natural causes, the steadfast advances made by biologists, scientists, physicians and scholars were fueled by timely and important facts and information- much of it gained through animal observations that contributed importantly to understanding anatomy, physiology, and pathology. There have been many breakthroughs and historic developments. For example, William Harvey in the 16th and 17th centuries clarified the importance of the circulatory system, aided by observations in dogs and pigs, which helped to clarify and confirm his concepts. The nineteenth century witnessed advances in physical examination techniques including auscultation and percussion. These helped create the basis for enhanced proficiency in clinical cardiology. An explosion of technologic advances that followed in the 20th century have made possible sophisticated, accurate, and non-invasive diagnostics. This permitted rapid patient assessment, effective monitoring, the development of new cardiotonic drugs, clinical trials to assess efficacy, and multi-therapy strategies. The latter 20th century has marshaled a dizzying array of advances in medical genetics and molecular science, expanding the frontiers of etiologies and disease mechanisms in man, with important implications for animal health. Veterinary medicine has evolved during the last half century, from a trade designed to serve agrarian cultures, to a diverse profession supporting an array of career opportunities ranging from private, specialty practice, to highly organized, specialized medicine and subspecialty academic training programs in cardiology and allied disciplines. PMID:23453139

Buchanan, James W

2013-03-01

338

Electronic Medical Records, Nurse Staffing, and Nurse-Sensitive Patient Outcomes: Evidence from California Hospitals, 1998–2007  

PubMed Central

Objective To estimate the effects of electronic medical records (EMR) implementation on medical-surgical acute unit costs, length of stay, nurse staffing levels, nursing skill mix, nurse cost per hour, and nurse-sensitive patient outcomes. Data Sources Data on EMR implementation came from the 1998–2007 HIMSS Analytics Databases. Data on nurse staffing and patient outcomes came from the 1998–2007 Annual Financial Disclosure Reports and Patient Discharge Databases of the California Office of Statewide Health Planning and Development (OSHPD). Methods Longitudinal analysis of an unbalanced panel of 326 short-term, general acute care hospitals in California. Marginal effects estimated using fixed effects (within-hospital) OLS regression. Principal Findings EMR implementation was associated with 6–10 percent higher cost per discharge in medical-surgical acute units. EMR stage 2 increased registered nurse hours per patient day by 15–26 percent and reduced licensed vocational nurse cost per hour by 2–4 percent. EMR stage 3 was associated with 3–4 percent lower rates of in-hospital mortality for conditions. Conclusions Our results suggest that advanced EMR applications may increase hospital costs and nurse staffing levels, as well as increase complications and decrease mortality for some conditions. Contrary to expectation, we found no support for the proposition that EMR reduced length of stay or decreased the demand for nurses. PMID:20403065

Furukawa, Michael F; Raghu, T S; Shao, Benjamin B M

2010-01-01

339

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. PMID:25352737

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

340

NIH Medical Research Scholars Program  

E-print Network

NIH Medical Research Scholars Program The National Institutes of Health (NIH) Medical Research creative, research-oriented medical, dental, and veterinary students to the intramural campus of the NIH and provides the opportunity for future clinician-scientists and medical researchers to carry out research

Bushman, Frederic

341

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

342

Relationships Among Neurocognitive Status, Medication Adherence Measured by Pharmacy Refill Records, and Virologic Suppression in HIV-infected Persons  

PubMed Central

Background Optimal antiretroviral therapy (ART) effectiveness depends upon medication adherence, which is a complex behavior with many contributing factors including neurocognitive function. Pharmacy refill records offer a promising and practical tool to assess adherence. Methods A substudy of the CHARTER (CNS HIV Anti-Retroviral Therapy Effects Research) study was conducted at the Johns Hopkins University (JHU) and the University of Washington (UW). Pharmacy refill records were the primary method to measure ART adherence, indexed to a “sentinel” drug with the highest central nervous system penetration effectiveness score. Standardized neuromedical, neuropsychological, psychiatric and substance use assessments were performed at enrollment and at 6 months. Regression models were used to determine factors associated with adherence and the relationships between adherence and change in plasma and cerebrospinal fluid HIV RNA concentrations between visits. Results Among 80 (33 JHU, 47 UW) participants, the mean adherence score was 86.4% with no difference by site. In the final multivariable model, better neurocognitive function was associated with better adherence, especially among participants who were at JHU, male, and HIV-infected for a longer time-period. Worse performance on working memory tests was associated with worse adherence. Better adherence predicted greater decreases in cerebrospinal fluid HIV RNA between visits. Conclusion Poorer global neurocognitive functioning and deficits in working memory were associated with lower adherence defined by a pharmacy refill record measure, suggesting that assessments of cognitive function, and working memory in particular, may identify patients at risk for poor ART adherence who would benefit from adherence support. PMID:23202813

Andrade, Adriana S.A.; Deutsch, Reena; Celano, Shivaun; Duarte, Nichole A.; Marcotte, Thomas D.; Umlauf, Anya; Atkinson, J. Hampton; McCutchan, J. Allen; Franklin, Donald; Alexander, Terry J.; McArthur, Justin; Marra, Christina; Grant, Igor; Collier, Ann C

2013-01-01

343

Basic Science and Clinical Application of Stem Cells in Veterinary Medicine  

NASA Astrophysics Data System (ADS)

Stem cells play an important role in veterinary medicine in different ways. Currently several stem cell therapies for animal patients are being developed and some, like the treatment of equine tendinopathies with mesenchymal stem cells (MSCs), have already successfully entered the market. Moreover, animal models are widely used to study the properties and potential of stem cells for possible future applications in human medicine. Therefore, in the young and emerging field of stem cell research, human and veterinary medicine are intrinsically tied to one another. Many of the pioneering innovations in the field of stem cell research are achieved by cooperating teams of human and veterinary medical scientists.

Ribitsch, I.; Burk, J.; Delling, U.; Geißler, C.; Gittel, C.; Jülke, H.; Brehm, W.

344

Utilizing SELinux to mandate ultra-secure access control of medical records.  

PubMed

Ongoing concerns have been raised over the effectiveness of information technology products and systems in maintaining privacy protection for sensitive data. The aim is to ensure that sensitive health information can be adequately protected yet still be accessible only to those that "need-to-know". To achieve this and ensure sustainability over the longer term, it is advocated that an alternative, stable and secure system architecture is required. This paper considers the adoption of a model targeted at health information that provides much higher degrees of protection. A purpose built demonstrator that was developed based on enterprise-level systems software products is detailed. The long term aim is to provide a viable solution by utilizing contemporary, commercially supported operating system and allied software. The advantages and limitations in its application with a medical database are discussed. The future needs in terms of research, software development and changes in organizational policy for healthcare providers, are outlined. PMID:17911767

Croll, Peter R; Henricksen, Matt; Caelli, Bill; Liu, Vicky

2007-01-01

345

Stem cells in veterinary medicine.  

PubMed

The stem cell field in veterinary medicine continues to evolve rapidly both experimentally and clinically. Stem cells are most commonly used in clinical veterinary medicine in therapeutic applications for the treatment of musculoskeletal injuries in horses and dogs. New technologies of assisted reproduction are being developed to apply the properties of spermatogonial stem cells to preserve endangered animal species. The same methods can be used to generate transgenic animals for production of pharmaceuticals or for use as biomedical models. Small and large animal species serve as valuable models for preclinical evaluation of stem cell applications in human beings and in veterinary patients in areas such as spinal cord injury and myocardial infarction. However, these applications have not been implemented in the clinical treatment of veterinary patients. Reviews on the use of animal models for stem cell research have been published recently. Therefore, in this review, animal model research will be reviewed only in the context of supporting the current clinical application of stem cells in veterinary medicine. PMID:21371354

Fortier, Lisa A; Travis, Alexander J

2011-01-01

346

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

347

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; Stürmer, Til; Buse, John B.; Meigs, James B.

2014-01-01

348

Effects of different once-a-day medications on 24-hour blood pressure recordings in hypertensives.  

PubMed

Compliance with antihypertensive treatment can be increased by using medications that are taken only once daily. There is, however, concern as to whether the efficacy of such drugs is sufficient to cover 24 h. Ambulatory blood pressure monitoring (ABPM) is an ideal technique to assess the effect of this kind of drug and to determine over- or undertreatment. In this study three drugs were examined as once-a-day preparations. Thirty-six patients were treated with three different doses of bisoprolol, as an example of the beta 1-selective beta-blockers; 12 patients were treated with a combination of the AChE-inhibitor enalapril and hydrochlorothiazide; eight patients were treated with nifedipine once per day, a new galenic form of nifedipine, as an example of the calcium-channel blockers. In each group we saw a significant downward shift over the entire 24-h curve. Our results also show that using 24-h blood pressure monitoring devices can help establish an appropriate dose, avoid over- and undertreatment, and control the total burden of the patient. PMID:1799929

Höfling, B; von Hoyningen-Huene, K

1991-01-01

349

An enhanced security solution for electronic medical records based on AES hybrid technique with SOAP/XML and SHA-1.  

PubMed

This study aims to provide security solutions for implementing electronic medical records (EMRs). E-Health organizations could utilize the proposed method and implement recommended solutions in medical/health systems. Majority of the required security features of EMRs were noted. The methods used were tested against each of these security features. In implementing the system, the combination that satisfied all of the security features of EMRs was selected. Secure implementation and management of EMRs facilitate the safeguarding of the confidentiality, integrity, and availability of e-health organization systems. Health practitioners, patients, and visitors can use the information system facilities safely and with confidence anytime and anywhere. After critically reviewing security and data transmission methods, a new hybrid method was proposed to be implemented on EMR systems. This method will enhance the robustness, security, and integration of EMR systems. The hybrid of simple object access protocol/extensible markup language (XML) with advanced encryption standard and secure hash algorithm version 1 has achieved the security requirements of an EMR system with the capability of integrating with other systems through the design of XML messages. PMID:24037086

Kiah, M L Mat; Nabi, Mohamed S; Zaidan, B B; Zaidan, A A

2013-10-01

350

Biofilms and Role to Infection and Disease in Veterinary Medicine  

Microsoft Academic Search

\\u000a Biofilms play an increasing role within the medical and veterinary community. Due to the increased resistance of a biofilm,\\u000a they can have direct and indirect effects upon a range of infections and diseases including chronic non-healing wounds, implant\\/prosthesis\\u000a infection and mastitis. These problems can have significant effects on other industries, for example mastitis can have a detrimental\\u000a effect on milk

Alice J. Gardner; Steven L. Percival; Christine A. Cochrane

351

The potential of electronic medical record systems to support quality improvement work and research in Norwegian general practice  

PubMed Central

Background Electronic medical record (EMR) systems are used for many purposes including patient care, administration, research, quality improvement and reimbursement. This study aimed to test a data extraction tool (QTools) and to provide information to support the interpretation of EMR data. Methods Comparison of aggregated practice data for selected EMR fields and interviews with practice staff. Practices received summaries of their data and aggregated data for other practices. Summaries were discussed in interviews. Results Fourteen general practices in the Oslo area using the Winmed EMR participated. QTools ran successfully at all 14 practices. Nine practices agreed to interviews. Apart from age and sex, general patient information was poorly recorded. Face-to-face consultations account for 59% of contacts but differences in coding led to variations between practices. Psychiatric problems accounted for 13% of diagnoses, other diagnosis groups rarely accounted for more than 5%. Over 90% of diabetics and 75% of patients with heart disease were identified by diagnosis code alone. Conclusion Some variation seen in EMR data is due to differences in the way staff use their EMR. These data can support quality improvement work but this requires an awareness of how the EMR is actually used by practice staff. PMID:12793909

Treweek, Shaun

2003-01-01

352

A common data model to assess cardiovascular hospitalization and mortality in atrial fibrillation patients using administrative claims and medical records  

PubMed Central

Purpose Atrial fibrillation/flutter (AF) is frequently associated with cardiovascular comorbidities. Observational health care databases are commonly used for research purposes in studies of quality of care, health economics, outcomes research, drug safety, and epidemiology. This retrospective cohort study applied a common data model to administrative claims data (Truven Health Analytics MarketScan® claims databases [MS-Claims]) and electronic medical records data (Geisinger Health System’s MedMining electronic medical record database [MG-EMR]) to examine the risk of cardiovascular hospitalization and all-cause mortality in relation to clinical risk factors in recent-onset AF and to assess the consistency of analyses for each data source. Methods Cohorts of patients with newly diagnosed AF (n=105,262 [MS-Claims] and n=3,919 [MG-EMR]) and demographically similar patients without AF (n=105,262 [MS-Claims] and n=3,872 [MG-EMR]) were followed from the qualifying AF diagnosis until cardiovascular hospitalization, death, database disenrollment, or study completion. A common data model standardized the data in structure, format, content, and nomenclature to allow for systematic assessment and comparison of outcomes from two disparate data sets. Results In both databases, AF patients had greater overall baseline comorbidity and higher incidence rates of cardiovascular hospitalization (threefold higher) and all-cause mortality (46% higher) than non-AF patients. For AF patients, incidence rates of cardiovascular hospitalization and all-cause mortality were increased by the concomitant presence of coronary disease, chronic obstructive pulmonary disease, and stroke at baseline. Overall, the pattern of cardiovascular hospitalization in the MS-Claims database was similar to that in the MG-EMR database. Compared with the MS-Claims database, the use of cardiovascular medications and the capture of certain comorbidities among AF patients appeared to be higher in the MG-EMR data set. Conclusion Similar standardized analyses across EMR and Claims databases were consistent in the association of AF with acute morbidity and an increased risk of all-cause mortality. Areas of inconsistency were due to differences in underlying population demographics and cardiovascular risks and completeness of certain data fields.

Panaccio, Mary P; Cummins, Gordon; Wentworth, Charles; Lanes, Stephan; Reynolds, Shannon L; Reynolds, Matthew W; Miao, Raymond; Koren, Andrew

2015-01-01

353

Confronting Zoonoses, Linking Human and Veterinary Medicine  

PubMed Central

Many of the emerging infectious diseases, including those caused by bioterrorist agents, are zoonoses. Since zoonoses can infect both animals and humans, the medical and veterinary communities should work closely together in clinical, public health, and research settings. In the clinical setting, input from both professions would improve assessments of the risk-benefit ratios of pet ownership, particularly for pet owners who are immunocompromised. In public health, human and animal disease surveillance systems are important in tracking and controlling zoonoses such as avian influenza virus, West Nile virus, and foodborne pathogens. Comparative medicine is the study of disease processes across species, including humans. Physician and veterinarian comparative medicine research teams should be promoted and encouraged to study zoonotic agent-host interactions. These efforts would increase our understanding of how zoonoses expand their host range and would, ultimately, improve prevention and control strategies. PMID:16704801

2006-01-01

354

Veterinary medicines in the environment.  

PubMed

The impact of veterinary medicines on the environment will depend on a number of factors including physicochemical properties, amount used and method of administration, treatment type and dose, animal husbandry practices, manure storage and handling practices, metabolism within the animal, and degradation rates in manure and slurry. Once released to the environment, other factors such as soil type, climate, and ecotoxicity also determine the environmental impact of the compound. The importance of individual routes into the environment for different types of veterinary medicines varies according to the type of treatment and livestock category. Treatments used in aquaculture have a high potential to reach the aquatic environment. The main routes of entry to the terrestrial environment are from the use of veterinary medicines in intensively reared livestock, via the application of slurry and manure to land, and by the use of veterinary medicines in pasture-reared animals where pharmaceutical residues are excreted directly into the environment. Veterinary medicines applied to land via spreading of slurry may also enter the aquatic environment indirectly via surface runoff or leaching to groundwater. It is likely that topical treatments have greater potential to be released to the environment than treatments administered orally or by injection. Inputs from the manufacturing process, companion animal treatments, and disposal are likely to be minimal in comparison. Monitoring studies demonstrate that veterinary medicines do enter the environment, with sheep dip chemicals, antibiotics, sealice treatments, and anthelmintics being measured in soils, groundwater, surface waters, sediment, or biota. Maximum concentrations vary across chemical classes, with very high concentrations being reported for the sheep dip chemicals. The degree to which veterinary medicines may adsorb to particulates varies widely. Partition coefficients (K(d)) range from low (0.61 L kg(-1)) to high (6000 L kg(-1)). The variation in partitioning for many of the compounds in different soils was significant (up to a factor of 30), but these differences could be not be explained by normalization to the organic carbon content of the soils. Thus, to arrive at a realistic assessment of the availability of veterinary medicines for transport through the soil and uptake into soil organisms, the K(oc) (which is used in many of the exposure models) may not be an appropriate measure. Transport of particle-associated substances from soil to surface waters has also been demonstrated. Veterinary medicines can persist in soils for days to years, and half-lives are influenced by a range of factors including temperature, pH, and the presence of manure. The persistence of major groups of veterinary medicines in soil, manure, slurry, and water varies across and within classes. Ecotoxicity data were available for a wide range of veterinary medicines. The acute and chronic effects of avermectins and sheep dip chemicals on aquatic organisms are well documented, and these substances are known to be toxic to many organisms at low concentrations (ng L(-1) to microg L(-1)). Concerns have also been raised about the possibility of indirect effects of these substances on predatory species (e.g., birds and bats). Data for other groups indicate that toxicity values are generally in the mg L(-1) range. For the antibiotics, toxicity is greater for certain species of algae and marine bacteria. Generally, toxicity values for antibacterial agents were significantly higher than reported environmental concentrations. However, because of a lack of appropriate toxicity data, it is difficult to assess the environmental significance of these observations with regard to subtle long-term effects. PMID:14561076

Boxall, A B A; Fogg, L A; Blackwell, P A; Kay, P; Pemberton, E J; Croxford, A

2004-01-01

355

Medical Records in the Greater Los Angeles State Veterans Home: A Unique Opportunity to Improve Quality of Care  

E-print Network

in Facilitating Medication Errors”, Journal of the Americanby human error, such as wrong medication administration. 7errors as they commonly suffer from multiple chronic illnesses, take more medications and

Allison Townsend; Galena Kolchugina

2006-01-01

356

US Veterinary Immune Reagents Network  

Technology Transfer Automated Retrieval System (TEKTRAN)

A major obstacle to advances in veterinary immunology and disease control is the lack of sufficient immunological reagents specific for ruminants, swine, poultry, equine and aquaculture species". Sets of reagents, i.e., monoclonal (mAb) and polyclonal antibodies, that can identify the major leukocy...

357

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

358

Veterinary cytogenetics: past and perspective.  

PubMed

Cytogenetics was conceived in the late 1800s and nurtured through the early 1900s by discoveries pointing to the chromosomal basis of inheritance. The relevance of chromosomes to human health and disease was realized more than half a century later when improvements in techniques facilitated unequivocal chromosome delineation. Veterinary cytogenetics has benefited from the information generated in human cytogenetics which, in turn, owes its theoretical and technical advancement to data gathered from plants, insects and laboratory mammals. The scope of this science has moved from the structure and number of chromosomes to molecular cytogenetics for use in research or for diagnostic and prognostic purposes including comparative genomic hybridization arrays, single nucleotide polymorphism array-based karyotyping and automated systems for counting the results of standard FISH preparations. Even though the counterparts to a variety of human diseases and disorders are seen in domestic animals, clinical applications of veterinary cytogenetics will be less well exploited mainly because of the cost-driven nature of demand on diagnosis and treatment which often out-weigh emotional and sentimental attachments. An area where the potential of veterinary cytogenetics will be fully exploited is reproduction since an inherited aberration that impacts on reproductive efficiency can compromise the success achieved over the years in animal breeding. It is gratifying to note that such aberrations can now be tracked and tackled using sophisticated cytogenetic tools already commercially available for RNA expression analysis, chromatin immunoprecipitation, or comparative genomic hybridization using custom-made microarray platforms that allow the construction of microarrays that match veterinary cytogenetic needs, be it for research or for clinical applications. Judging from the technical refinements already accomplished in veterinary cytogenetics since the 1960s, it is clear that the importance of the achievements to date are bound to be matched or out-weighed by what awaits to be accomplished in the not-too-far future. PMID:18467822

Basrur, P K; Stranzinger, G

2008-01-01

359

Genetic and ElectroNic medIcal records to predict oUtcomeS in Heart Failure patients (GENIUS-HF) - design and rationale  

PubMed Central

Background Studies adopting electronic medical records and genomic information are becoming widespread. Through this new modality in research, it is possible to study how genetic variants influence susceptibility towards chronic conditions and can improve patient care. Our aim is to develop a biobank with 2,000 heart failure patients treated in a tertiary cardiology hospital containing electronic medical records data and biologic samples for performing genome-wide association studies for validation and development of medical decision routines aimed at helping the clinical management of patients. Methods/Design Patients between 18 and 80 years old with heart failure diagnosis of different etiologies and left ventricular ejection fraction???50% in the past 2 years will be eligible for enrollment on the cohort. After consent, patients will be submitted to clinical baseline, echocardiography, cardiograph impedance and biochemical evaluation. Study data will be collected and managed using Research Electronic Data Capture tools. The follow up will take place every 6 months to assess cardiovascular outcomes (all-cause mortality, cardiovascular mortality, hospitalization for worsening heart failure and current medication use). Initial analytical strategy will focus on the establishment of the accuracy of electronic medical records extraction protocols for main predictor factors of morbidity and mortality in heart failure. Discussion Building a biobank with biologic samples and clinical data of 2,000 heart failure patients we will perform genome-wide association studies. By this way, we pretend to study how genetic variants influence susceptibility towards chronic conditions. Besides, it will be created a working group focused on the development and implementation of algorithms for validation and application of medical routines using the electronic medical records of the Heart Institute (InCor - HCFMUSP). Trial registration Current Controlled Trials NTC02043431. PMID:24592820

2014-01-01

360

NIH Medical Research Scholars Program  

E-print Network

1 NIH Medical Research Scholars Program · A comprehensive, year-long residential research enrichment program for medical, dental, and veterinary students · NIH Intramural Research Program in Bethesda' personal interests and career goals NIH Medical Research Scholars Program -1 · Blends elements of two

Bushman, Frederic

361

Physician user satisfaction with an electronic medical records system in primary healthcare centres in Al Ain: a qualitative study  

PubMed Central

Objectives To explore physician satisfaction with an electronic medical records (EMR) system, to identify and explore the main limitations of the system and finally to submit recommendations to address these limitations. Design A descriptive qualitative study that entailed three focus group interviews was performed among physicians using open-ended questions. The interviews were audiotaped, documented and transcribed verbatim. The themes were explored and analysed in different categories. Setting The study was conducted in primary healthcare centres (PHC) in Al Ain, United Arab Emirates (UAE). Participants A total of 23 physicians, all using the same EMR system, attended one of three focus groups held in PHC in Al Ain Medical District. Each focus group consisted of 7–9 physicians working in PHC as family medicine specialists, residents or general practitioners. Primary outcome measure Physician satisfaction with the EMR system. Results Key themes emerged and were categorised as physician-dependent, patient-related and system-related factors. In general, physicians were satisfied with the EMR system in spite of initial difficulties with implementation. Most participants identified that the long time required to do the documentation affected their practice and patient communication. Many physicians expressed satisfaction with the orders and results of laboratory and radiology functions and they emphasised that this was the strongest point in the EMR. They were also satisfied with the electronic prescription function, stating that it reduced errors and saved time. Conclusions Physicians are satisfied with the EMR and have a positive perception regarding the application of the system. Several themes emerged during this study that need to be considered to enhance the EMR system. Further studies need to be conducted among other healthcare practitioners and patients to explore their attitude and perception about the EMR. PMID:25377010

Al Alawi, Shamma; Al Dhaheri, Aysha; Al Baloushi, Durra; Al Dhaheri, Mouza; Prinsloo, Engela A M

2014-01-01

362

The Use of the Academic Electronic Medical Record (EMR) to Develop Critical Thinking Skills in an Associate Degree Nursing Mobility Program  

ERIC Educational Resources Information Center

In an attempt to prepare new graduate nurses to meet the demands of health care delivery systems, the use of computer-based clinical information systems that combine hands-on experience with computer based information systems was explored. Since the introduction of Electronic Medical Records (EMR) nearly two decades ago, the demand for nurses to…

Wlodyga, Linda J.

2010-01-01

363

Managing the Challenges of Adopting Electronic Medical Records: An Exploratory Study of the Challenges Faced by African American Health Care Professionals  

ERIC Educational Resources Information Center

The implementation of technology within the health care industry is viewed as a possible solution for lowering costs and improving health care delivery to patients. Electronic medical record system(s) (EMRS) are information technology tools viewed within the health care industry as a possible solution for aiding improvements in health care…

Riddick, William P.

2013-01-01

364

Necessity is the mother of invention: video recording firsthand perspectives of critical medical procedures to make simulated training more effective.  

PubMed

The traditional apprenticeship model for training doctors requires ample opportunities in the clinic for trainees to learn core procedures under the supervision of skilled doctors. In this issue, Kyser and colleagues document that the learning opportunities for residents to master certain core procedures, such as forceps and vacuum deliveries, are insufficient in many teaching hospitals. To address this serious problem, this author argues that learning techniques (i.e., deliberate practice and simulator use) from other domains of expertise, such as chess, music, and sports, must be adapted for use in medicine. For example, medical procedures should be videotaped and indexed for access over the Internet. Trainees then could view recordings of rare emergency procedures and complications and practice their decision-making skills. Evidence suggests that training outside the constraints of the clinic could be more effective in improving performance because trainees are able to engage in deliberate practice and focus on their individual weaknesses in executing procedures and making decisions. For example, with video and simulator training, trainees have the opportunity to repeatedly perform only the parts of a procedure that they find challenging until they have attained a level of acceptable speed and control. More generally, training could be structured around the particular needs of individual learners and scheduled when the learners are rested and able to concentrate fully on learning. Training also should include opportunities for learners to practice repeatedly with different patient descriptions requiring the same or different, yet related, procedures to teach trainees effective discrimination and execution. PMID:24280862

Ericsson, K Anders

2014-01-01

365

Supporting the "clinic without walls" with an event-directed messaging system integrated into an electronic medical record.  

PubMed Central

To facilitate the communication of ideas, orders and treatment plans among providers practicing in a multidisciplinary ambulatory care setting, we have created an event-directed messaging system integrated into our larger Ambulatory Care Information System (ACIS). ACIS has been operational since 1992 and currently supports an average of 350 patient visits per day. The new messaging system permits a provider to send a message to the next provider who will be caring for a patient. The messages can be sent to any provider offering care in the future, or they can be directed to future visits with a particular clinical service. In contrast to traditional electronic mail systems, messages are not directed to specific providers or groups of provider. Messages are instead directed to a specific clinical event, namely a patient's visit to an appropriate clinic. Messages are displayed when a patient returns for a designated visit, both as part of a pre-printed progress note upon which a provider documents the visit and as part of a hypertext-based general information display in an electronic medical record. The messaging system helps providers ensure that subsequent providers caring for their patients will be alerted to pertinent aspects of a patient's care. It also similarly helps providers quickly gain familiarity with those issues prior providers had felt were important to highlight or did not want to risk being overlooked. PMID:8947746

Rappaport, S. H.

1996-01-01

366

Reducing emergency department charting and ordering errors with a room number watermark on the electronic medical record display.  

PubMed

A survey of Emergency Department (ED) clinicians (ie, physicians, nurses and clinical assistants) at a single hospital in Honolulu, Hawai'i was conducted to assess the frequency of errors in charting, and entering orders on the wrong patient's chart in the electronic medical record (EMR), and clinician opinion was sought on whether a simple watermark of the patient's room number might help reduce the number of these EMR "wrong patient errors." ED clinicians (68 total surveys) were asked if and how often they charted in the wrong patient's chart or entered an order (physicians only) in the wrong patient's chart. Physicians had a combined self-reported average error rate of 1.3%. Mean rate of patient charting errors occurred at 0.5 errors and 0.4 errors per 100 hours, for nurses and clinical assistants, respectively. The majority (81%) of the 68 clinicians surveyed felt that a room number watermark would eliminate most of the wrong patient errors. In conclusion, charting on the wrong patient and order entry on the wrong patient type errors occur with varying frequencies amongst ED clinicians. Nearly all the clinicians believe that a room number watermark might be an effective strategy to reduce these errors. PMID:25337450

Yamamoto, Loren G

2014-10-01

367

ClinicalCodes: An Online Clinical Codes Repository to Improve the Validity and Reproducibility of Research Using Electronic Medical Records  

PubMed Central

Lists of clinical codes are the foundation for research undertaken using electronic medical records (EMRs). If clinical code lists are not available, reviewers are unable to determine the validity of research, full study replication is impossible, researchers are unable to make effective comparisons between studies, and the construction of new code lists is subject to much duplication of effort. Despite this, the publication of clinical codes is rarely if ever a requirement for obtaining grants, validating protocols, or publishing research. In a representative sample of 450 EMR primary research articles indexed on PubMed, we found that only 19 (5.1%) were accompanied by a full set of published clinical codes and 32 (8.6%) stated that code lists were available on request. To help address these problems, we have built an online repository where researchers using EMRs can upload and download lists of clinical codes. The repository will enable clinical researchers to better validate EMR studies, build on previous code lists and compare disease definitions across studies. It will also assist health informaticians in replicating database studies, tracking changes in disease definitions or clinical coding practice through time and sharing clinical code information across platforms and data sources as research objects. PMID:24941260

Springate, David A.; Kontopantelis, Evangelos; Ashcroft, Darren M.; Olier, Ivan; Parisi, Rosa; Chamapiwa, Edmore; Reeves, David

2014-01-01

368

Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review  

PubMed Central

Myelofibrosis (MF) is a clonal hematopoietic malignancy characterized by constitutional and localized symptoms, progressive splenomegaly, bone marrow fibrosis, and cytopenias. Although MF is well studied, few studies exist regarding its symptomatic burden in routine clinical practice. This study aimed to characterize symptoms and other clinical features of MF among patients in the United States. We conducted a retrospective medical record review of adult patients with an MF diagnosis between 1 January 2005 and 31 March 2010, stratified by the presence of palpable splenomegaly. Eligible patients had 12 months or more of follow-up after diagnosis (or after detection of splenomegaly, if present) unless death occurred. Demographic and clinical characteristics, MF-related symptoms, and treatments were reported by treating physicians. We report on 180 MF patients: 102 with splenomegaly, 78 without. Median age was 66 years, 63% were male, and 82% had intermediate-2 or high-risk MF (International Prognostic Scoring System). Fatigue was reported by ?85% of patients; weight loss, night sweats, and fever (any grade) were each reported by 50% or more of patients. Generalized abdominal pain, left subcostal pain, and early satiety occurred more frequently among patients with splenomegaly. Multiple symptoms were reported by 95% of patients. Common comorbidities were hypertension, diabetes, and chronic pulmonary disease. Symptoms are common in MF patients, regardless of the presence of palpable splenomegaly. Careful assessment of symptom burden is an important aspect of the clinical evaluation of patients with MF. PMID:24403262

Mitra, Debanjali; Kaye, James A; Piecoro, Lance T; Brown, Jennifer; Reith, Kelly; Mughal, Tariq I; Sarlis, Nicholas J

2013-01-01

369

“Smart Forms” in an Electronic Medical Record: Documentation-based Clinical Decision Support to Improve Disease Management  

PubMed Central

Clinical decision support systems (CDSS) integrated within Electronic Medical Records (EMR) hold the promise of improving healthcare quality. To date the effectiveness of CDSS has been less than expected, especially concerning the ambulatory management of chronic diseases. This is due, in part, to the fact that clinicians do not use CDSS fully. Barriers to clinicians' use of CDSS have included lack of integration into workflow, software usability issues, and relevance of the content to the patient at hand. At Partners HealthCare, we are developing “Smart Forms” to facilitate documentation-based clinical decision support. Rather than being interruptive in nature, the Smart Form enables writing a multi-problem visit note while capturing coded information and providing sophisticated decision support in the form of tailored recommendations for care. The current version of the Smart Form is designed around two chronic diseases: coronary artery disease and diabetes mellitus. The Smart Form has potential to improve the care of patients with both acute and chronic conditions. PMID:18436911

Schnipper, Jeffrey L.; Linder, Jeffrey A.; Palchuk, Matvey B.; Einbinder, Jonathan S.; Li, Qi; Postilnik, Anatoly; Middleton, Blackford

2008-01-01

370

The accuracy and trends of smoking history documentation in electronic medical records in a large managed care organization.  

PubMed

The accuracy of smoking history documentation in the electronic medical records was examined at a large managed care organization among 36,494 male members who self-reported smoking history in mailed surveys. The sensitivity of electronic smoking history documentation for ever-smoking status was 0.19 in years 2003-2005 (using ICD-9/CPT code only), 0.80 in 2006-2008 and 0.84 in 2009-2010 (combination of ICD-9/CPT codes and risk factor module used after 2006). The positive predictive value was 0.96, 0.90, and 0.95 in these periods, respectively. Among self-reported ever-smokers, increased healthcare utilization and smoking intensity/duration were associated with higher likelihood of having electronic smoking history documentation, while Asian race and Spanish language preference were associated with lower likelihood. These data suggest that enhanced efforts may be needed to screen for and document smoking among racial/ethnic minorities. PMID:23621678

Chen, Lie-Hong; Quinn, Virginia; Xu, Lanfang; Gould, Michael K; Jacobsen, Steven J; Koebnick, Corinna; Reynolds, Kristi; Hechter, Rulin C; Chao, Chun R

2013-06-01

371

Reducing Emergency Department Charting and Ordering Errors with a Room Number Watermark on the Electronic Medical Record Display  

PubMed Central

A survey of Emergency Department (ED) clinicians (ie, physicians, nurses and clinical assistants) at a single hospital in Honolulu, Hawai‘i was conducted to assess the frequency of errors in charting, and entering orders on the wrong patient's chart in the electronic medical record (EMR), and clinician opinion was sought on whether a simple watermark of the patient's room number might help reduce the number of these EMR “wrong patient errors.” ED clinicians (68 total surveys) were asked if and how often they charted in the wrong patient's chart or entered an order (physicians only) in the wrong patient's chart. Physicians had a combined self-reported average error rate of 1.3%. Mean rate of patient charting errors occurred at 0.5 errors and 0.4 errors per 100 hours, for nurses and clinical assistants, respectively. The majority (81%) of the 68 clinicians surveyed felt that a room number watermark would eliminate most of the wrong patient errors. In conclusion, charting on the wrong patient and order entry on the wrong patient type errors occur with varying frequencies amongst ED clinicians. Nearly all the clinicians believe that a room number watermark might be an effective strategy to reduce these errors. PMID:25337450

2014-01-01

372

Systematic comparison of phenome-wide association study of electronic medical record data and genome-wide association study data  

PubMed Central

Candidate gene and genome-wide association studies (GWAS) have identified genetic variants that modulate risk for human disease; many of these associations require further study to replicate the results. Here we report the first large-scale application of the phenome-wide association study (PheWAS) paradigm within electronic medical records (EMRs), an unbiased approach to replication and discovery that interrogates relationships between targeted genotypes and multiple phenotypes. We scanned for associations between 3,144 single-nucleotide polymorphisms (previously implicated by GWAS as mediators of human traits) and 1,358 EMR-derived phenotypes in 13,835 individuals of European ancestry. This PheWAS replicated 66% (51/77) of sufficiently powered prior GWAS associations and revealed 63 potentially pleiotropic associations with P < 4.6 × 10?6 (false discovery rate < 0.1); the strongest of these novel associations were replicated in an independent cohort (n = 7,406). These findings validate PheWAS as a tool to allow unbiased interrogation across multiple phenotypes in EMR-based cohorts and to enhance analysis of the genomic basis of human disease. PMID:24270849

Denny, Joshua C; Bastarache, Lisa; Ritchie, Marylyn D; Carroll, Robert J; Zink, Raquel; Mosley, Jonathan D; Field, Julie R; Pulley, Jill M; Ramirez, Andrea H; Bowton, Erica; Basford, Melissa A; Carrell, David S; Peissig, Peggy L; Kho, Abel N; Pacheco, Jennifer A; Rasmussen, Luke V; Crosslin, David R; Crane, Paul K; Pathak, Jyotishman; Bielinski, Suzette J; Pendergrass, Sarah A; Xu, Hua; Hindorff, Lucia A; Li, Rongling; Manolio, Teri A; Chute, Christopher G; Chisholm, Rex L; Larson, Eric B; Jarvik, Gail P; Brilliant, Murray H; McCarty, Catherine A; Kullo, Iftikhar J; Haines, Jonathan L; Crawford, Dana C; Masys, Daniel R; Roden, Dan M

2014-01-01

373

Veterinary Medicine Extension: A Vital Link National partners and regional outreachVeterinary Medicine Extension faculty members provide the vital link  

E-print Network

-world problems. Faculty based in Davis and Tulare travel frequently to solve problems first-hand, host workshops in veterinary and public health. Extension specialists alert university researchers about emerging health such risks · Wildfires, Smoke and Livestock, one of the first publications to explore the medical issues

Schladow, S. Geoffrey

374

An Automated Model Using Electronic Medical Record Data Identifies Patients With Cirrhosis at High Risk for Readmission  

PubMed Central

BACKGROUND & AIMS Patients with cirrhosis have 1-month rates of readmission as high as 35%. Early identification of high-risk patients could permit interventions to reduce readmission. The aim of our study was to construct an automated 30-day readmission risk model for cirrhotic patients using electronic medical record (EMR) data available early during hospitalization. METHODS We identified patients with cirrhosis admitted to a large safety-net hospital from January 2008 through December 2009. A multiple logistic regression model for 30-day rehospitalization was developed using medical and socioeconomic factors available within 48 hours of admission and tested on a validation cohort. Discrimination was assessed using receiver operator characteristic curve analysis. RESULTS We identified 836 cirrhotic patients with 1291 unique admission encounters. Rehospitalization occurred within 30 days for 27% of patients. Significant predictors of 30-day readmission included the number of address changes in the prior year (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.05–1.21), number of admissions in the prior year (OR, 1.14; 95% CI, 1.05–1.24), Medicaid insurance (OR, 1.53; 95% CI, 1.10 –2.13), thrombocytopenia (OR, 0.50; 95% CI, 0.35– 0.72), low level of alanine aminotransferase (OR, 2.56; 95% CI, 1.09 – 6.00), anemia (OR, 1.63; 95% CI, 1.17–2.27), hyponatremia (OR, 1.78; 95% CI, 1.14 –2.80), and Model for End-stage Liver Disease score (OR, 1.04; 95% CI, 1.01–1.06). The risk model predicted 30-day readmission, with c-statistics of 0.68 (95% CI, 0.64 – 0.72) and 0.66 (95% CI, 0.59 – 0.73) in the derivation and validation cohorts, respectively. CONCLUSIONS Clinical and social factors available early during admission and extractable from an EMR predicted 30-day readmission in cirrhotic patients with moderate accuracy. Decision support tools that use EMR-automated data are useful for risk stratification of patients with cirrhosis early during hospitalization. PMID:23591286

SINGAL, AMIT G.; RAHIMI, ROBERT S.; CLARK, CHRISTOPHER; MA, YING; CUTHBERT, JENNIFER A.; ROCKEY, DON C.; AMARASINGHAM, RUBEN

2013-01-01

375

A Comparison of Physician Pre-Adoption and Adoption Views on Electronic Health Records in Canadian Medical Practices  

PubMed Central

Background There is a major campaign involving large expenditures of public money to increase the adoption rate of electronic health record (EHR) systems in Canada. To maximize the chances of success in this effort, physician views on EHRs must be addressed, since user perceptions are key to successful implementation of technology innovations. Objective We propose a theoretical model comprising behavioral factors either favoring or against EHR adoption and use in Canadian medical practices, from the physicians’ point of view. EHR perceptions of physicians already using EHR systems are compared with those not using one, through the lens of this model. Methods We conducted an online cross-sectional survey in both English and French among medical practitioners across Canada. Data were collected both from physicians using EHRs and those not using EHRs, and analyzed with structural equation modeling (SEM) techniques. Results We collected 119 responses from EHR users and 100 from nonusers, resulting in 2 valid samples of 102 and 83 participants, respectively. The theoretical adoption model explained 55.8% of the variance in behavioral intention to continue using EHRs for physicians already using them, and 66.8% of the variance in nonuser intention to adopt such systems. Perception of ease of use was found to be the strongest motivator for EHR users (total effect .525), while perceptions of usefulness and of ease of use were the key determinants for nonusers (total effect .538 and .519, respectively) to adopt the system. Users see perceived overall risk associated with EHR adoption as a major obstacle (total effect –.371), while nonusers perceive risk only as a weak indirect demotivator. Of the 13 paths of the SEM model, 5 showed significant differences between the 2 samples (at the .05 level): general doubts about using the system (P = .02), the necessity for the system to be relevant for their job (P < .001), and the necessity for the system to be useful (P = .049) are more important for EHR nonusers than for users, while perceptions of overall obstacles to adoption (P = .03) and system ease of use (P = .042) count more for EHR users than for nonusers. Conclusions Relatively few differences in perceptions about EHR system adoption and use exist between physicians already using such systems and those not yet using the systems. To maximize the chances of success for new EHR implementations from a behavioral point of view, general doubts about the rationale for such systems must be mitigated through improving design, stressing how EHRs are relevant to physician jobs, and providing substantiating evidence that EHRs are easier to use and more effective than nonusers might expect. PMID:21840835

Cocosila, Mihail

2011-01-01

376

This article was downloaded by:[Danish Veterinary and Agricultural Library] [Danish Veterinary and Agricultural Library  

E-print Network

This article was downloaded by:[Danish Veterinary and Agricultural Library] [Danish Veterinary. © Taylor and Francis 2007 #12;DownloadedBy:[DanishVeterinaryandAgriculturalLibrary]At:14:2025April2007 162

Nielsen, Rasmus

377

An investigation of the effect of nurses’ technology readiness on the acceptance of mobile electronic medical record systems  

PubMed Central

Background Adopting mobile electronic medical record (MEMR) systems is expected to be one of the superior approaches for improving nurses’ bedside and point of care services. However, nurses may use the functions for far fewer tasks than the MEMR supports. This may depend on their technological personality associated to MEMR acceptance. The purpose of this study is to investigate nurses’ personality traits in regard to technology readiness toward MEMR acceptance. Methods The study used a self-administered questionnaire to collect 665 valid responses from a large hospital in Taiwan. Structural Equation modeling was utilized to analyze the collected data. Results Of the four personality traits of the technology readiness, the results posit that nurses are optimistic, innovative, secure but uncomfortable about technology. Furthermore, these four personality traits were all proven to have a significant impact on the perceived ease of use of MEMR while the perceived usefulness of MEMR was significantly influenced by the optimism trait only. The results also confirmed the relationships between the perceived components of ease of use, usefulness, and behavioral intention in the Technology Acceptance Model toward MEMR usage. Conclusions Continuous educational programs can be provided for nurses to enhance their information technology literacy, minimizing their stress and discomfort about information technology. Further, hospital should recruit, either internally or externally, more optimistic nurses as champions of MEMR by leveraging the instrument proposed in this study. Besides, nurses’ requirements must be fully understood during the development of MEMR to ensure that MEMR can meet the real needs of nurses. The friendliness of user interfaces of MEMR and the compatibility of nurses’ work practices as these will also greatly enhance nurses’ willingness to use MEMR. Finally, the effects of technology personality should not be ignored, indicating that hospitals should also include more employees’ characteristics beyond socio-demographic profiles in their personnel databases. PMID:23938040

2013-01-01

378

Users’ acceptance and attitude in regarding electronic medical record at central polyclinic of oil industry in Isfahan, Iran  

PubMed Central

Introduction: Simultaneous with the rapid changes in the technology and information systems, hospitals interest in using them. One of the most common systems in hospitals is electronic medical record (EMR) whose one of uses is providing better health care quality via health information technology. Prior to its use, attempts should be put to identifying factors affecting the acceptance, attitude and utilizing of this technology. The current article aimed to study the effective factors of EMR acceptance by technology acceptance model (TAM) at central polyclinic of Oil Industry in Isfahan. Materials and Methods: This was a practical, descriptive and regression study. The population research were all EMR users at polyclinic of Oil Industry in 2012 and its sampling was simple random with 62 users. The tool of data collection was a research-made questionnaire based on TAM. The validity of questionnaire has been assigned through the strategy of content validity and health information technology experts’ views and its reliability by test-retest. Findings: The system users have positive attitude toward using EMR (56.6%). Also, users are not very satisfied with effective external (38.14%) and behavioral factors (47.8%) upon using the system. Perceived ease-of-use (PEU) and perceived usefulness (PU) were at a good level. Conclusion: Lack of relative satisfaction with using of EMR derives from factors such as appearance, screen, data and information quality and terminology. In this study, it is suggested to improve the system and the efficiency of the users through software’ external factors development. So that PEU and users’ attitude to be changed and moved in positive manner. PMID:24524089

Tavakoli, Nahid; Shahin, Arash; Jahanbakhsh, Maryam; Mokhtari, Habibollah; Rafiei, Maryam

2013-01-01

379

Electronic Medical Record in Central Polyclinic of Isfahan Oil Industry: A Case Study Based on Technology Acceptance Model  

PubMed Central

Introduction Today, health information technologies are base of health services and Electronic Medical Record is one of them. The purpose of this paper is to investigate the Technology Acceptance Model (TAM) on EMR at Central Polyclinic Oil Industry that is a pioneer in implementation of EMR in Isfahan. Methods This study was an applied and analytical survey that it was done at the Central Polyclinic Oil Industry. Because statistical population were limited, sampling bas been done by conducting the census and the sample was according to the population. The data was collected by a researcher-made questionnaire that it was validated by experts and its reliability was confirmed by test retest. The questionnaire was developed in 5 scopes including external factors (data quality and user interface), perceived usefulness, perceived ease of usefulness, attitude toward using, and behavioral intention to use. The Results analyzed by SPSS. Results There was a significant relationship between data quality with PU(r=/295, p/005). Discussion The survey of the scopes in the polyclinic showed that there is relationship among user interface, perceived usefulness, perceived ease of usefulness, attitude toward using, and behavioral intention to use, but data quality has no relationship with attitude. It seems the system designers didn’t consider to data quality characteristics. It is proposed that they consult with health information management professionals for improvement the existing system. PMID:23572857

Tavakoli, Nahid; Jahanbakhsh, Maryam; Shahin, Arash; Mokhtari, Habibollah; Rafiei, Maryam

2013-01-01

380

Development of an Electronic Medical Record Based Alert for Risk of HIV Treatment Failure in a Low-Resource Setting  

PubMed Central

Background The adoption of electronic medical record systems in resource-limited settings can help clinicians monitor patients' adherence to HIV antiretroviral therapy (ART) and identify patients at risk of future ART failure, allowing resources to be targeted to those most at risk. Methods Among adult patients enrolled on ART from 2005–2013 at two large, public-sector hospitals in Haiti, ART failure was assessed after 6–12 months on treatment, based on the World Health Organization's immunologic and clinical criteria. We identified models for predicting ART failure based on ART adherence measures and other patient characteristics. We assessed performance of candidate models using area under the receiver operating curve, and validated results using a randomly-split data sample. The selected prediction model was used to generate a risk score, and its ability to differentiate ART failure risk over a 42-month follow-up period was tested using stratified Kaplan Meier survival curves. Results Among 923 patients with CD4 results available during the period 6–12 months after ART initiation, 196 (21.2%) met ART failure criteria. The pharmacy-based proportion of days covered (PDC) measure performed best among five possible ART adherence measures at predicting ART failure. Average PDC during the first 6 months on ART was 79.0% among cases of ART failure and 88.6% among cases of non-failure (p<0.01). When additional information including sex, baseline CD4, and duration of enrollment in HIV care prior to ART initiation were added to PDC, the risk score differentiated between those who did and did not meet failure criteria over 42 months following ART initiation. Conclusions Pharmacy data are most useful for new ART adherence alerts within iSanté. Such alerts offer potential to help clinicians identify patients at high risk of ART failure so that they can be targeted with adherence support interventions, before ART failure occurs. PMID:25390044

Puttkammer, Nancy; Zeliadt, Steven; Balan, Jean Gabriel; Baseman, Janet; Destiné, Rodney; Domerçant, Jean Wysler; France, Garilus; Hyppolite, Nathaelf; Pelletier, Valérie; Raphael, Nernst Atwood; Sherr, Kenneth; Yuhas, Krista; Barnhart, Scott

2014-01-01

381

Students preparing for a career in medicine, dentistry, veterinary medicine, or other health-related professions should visit the Preprofessional Advising Office at the College of Arts & Sciences, 725 Commonwealth Ave., Room B-2 (moving to  

E-print Network

by the American Dental Education Association, 1625 Massachusetts Ave., N.W., Washington, DC 20036 (www, you should consult the text entitled, Medical School Admission Requirements (Association of American Admission Requirements is published by the Association of American Veterinary Medic

Goldberg, Bennett

382

78 FR 69991 - Advisory Committee; Veterinary Medicine Advisory Committee; Termination  

Federal Register 2010, 2011, 2012, 2013, 2014

...FDA-2013-N-1380] Advisory Committee; Veterinary Medicine Advisory Committee; Termination AGENCY...announcing the termination of the Veterinary Medicine Advisory Committee. This document removes...SUPPLEMENTARY INFORMATION: The Veterinary Medicine Committee was established on April...

2013-11-22

383

Electronic health record training in undergraduate medical education: bridging theory to practice with curricula for empowering patient- and relationship-centered care in the computerized setting.  

PubMed

While electronic health record (EHR) use is becoming state-of-the-art, deliberate teaching of health care information technology (HCIT) competencies is not keeping pace with burgeoning use. Medical students require training to become skilled users of HCIT, but formal pedagogy within undergraduate medical education (UME) is sparse. How can medical educators best meet the needs of learners while integrating EHRs into medical education and practice? How can they help learners preserve and foster effective communication skills within the computerized setting? In general, how can UME curricula be devised for skilled use of EHRs to enhance rather than hinder provision of effective, humanistic health care?Within this Perspective, the authors build on recent publications that "set the stage" for next steps: EHR curricula innovation and implementation as concrete embodiments of theoretical underpinnings. They elaborate on previous calls for maximizing benefits and minimizing risks of EHR use with sufficient focus on physician-patient communication skills and for developing core competencies within medical education. The authors describe bridging theory into practice with systematic longitudinal curriculum development for EHR training in UME at their institution, informed by Kern and colleagues' curriculum development framework, narrative medicine, and reflective practice. They consider this innovation within a broader perspective-the overarching goal of empowering undergraduate medical students' patient- and relationship-centered skills while effectively demonstrating HCIT-related skills. PMID:24448045

Wald, Hedy S; George, Paul; Reis, Shmuel P; Taylor, Julie Scott

2014-03-01

384

[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

2014-01-01

385

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

MedlinePLUS

... Food and Drug Administration Protecting and Promoting Your Health A to Z Index Follow FDA En Español Search FDA Submit search Popular Content Home Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & ... & Veterinary Safety & Health Report a Problem Safety & Health Report a Problem ...

386

The ninth international veterinary immunology symposium  

Technology Transfer Automated Retrieval System (TEKTRAN)

This Introduction to the special issue of Veterinary Immunology and Immunopathology summarizes the Proceedings of the 9th International Veterinary Immunology Symposium (9th IVIS) held August, 2010, in Tokyo, Japan. Over 340 delegates from 30 countries discussed research progress analyzing the immune...

387

Veterinary Report Spring 2005 Dr. Daniel Rock,  

E-print Network

Veterinary Report · Spring 2005 q Dr. Daniel Rock, an expert in viral disease research, came aboard as head of the Department of Veterinary Pathobi- ology on March 28. Dr. Rock was formerly research leader biomedi- cal science." Dr. Rock believes the College is well posi- tioned to lead in the area

Gilbert, Matthew

388

Integrating veterinary pathology into basic research  

E-print Network

Integrating veterinary pathology into basic research Tuesday 17 April 2012 University of Surrey in veterinary pathology, to develop an integrated approach to the study of pathology. The seminar will focus on advances in basic pathology techniques including tissue sampling,morphometric imaging

Doran, Simon J.

389

Bioavailability of veterinary antibiotics in surface water  

Technology Transfer Automated Retrieval System (TEKTRAN)

Veterinary antibiotics are commonly used as feed additives in livestock production for growth promotion and disease prevention. These pharmaceuticals are often excreted by the livestock in urine and feces, and enter the environment via manure application. Little is known about the fate of veterinary...

390

VETERINARY TEACHING HOSPITAL 1602 Campus Delivery  

E-print Network

.297.1269 On-call Anesthesia Post-Doc Post-Doctoral Veterinary Teaching Hospital College of Veterinary Medicine (CSU) seeks to fill a flexible after hours position for the Anesthesia service. The individual in this position will be dedicated to providing after hours/ weekend anesthesia coverage. The primary

391

29 CFR 1913.10 - Rules of agency practice and procedure concerning OSHA access to employee medical records.  

Code of Federal Regulations, 2014 CFR

...purposes for which the information was obtained. (4) The protective measures established by this section apply to all worksheets, duplicate copies, or other agency documents containing personally identifiable employee medical information....

2014-07-01

392

29 CFR 1913.10 - Rules of agency practice and procedure concerning OSHA access to employee medical records.  

Code of Federal Regulations, 2011 CFR

...purposes for which the information was obtained. (4) The protective measures established by this section apply to all worksheets, duplicate copies, or other agency documents containing personally identifiable employee medical information....

2011-07-01

393

29 CFR 1913.10 - Rules of agency practice and procedure concerning OSHA access to employee medical records.  

Code of Federal Regulations, 2013 CFR

...purposes for which the information was obtained. (4) The protective measures established by this section apply to all worksheets, duplicate copies, or other agency documents containing personally identifiable employee medical information....

2013-07-01

394

20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...  

Code of Federal Regulations, 2014 CFR

...COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing Claims; Evidence and Burden of Proof; Special Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for written medical documentation,...

2014-04-01

395

20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...  

Code of Federal Regulations, 2011 CFR

...COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing Claims; Evidence and Burden of Proof; Special Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for written medical documentation,...

2011-04-01

396

20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...  

Code of Federal Regulations, 2012 CFR

...COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing Claims; Evidence and Burden of Proof; Special Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for written medical documentation,...

2012-04-01

397

20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...  

Code of Federal Regulations, 2010 CFR

...COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing Claims; Evidence and Burden of Proof; Special Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for written medical documentation,...

2010-04-01

398

20 CFR 30.113 - What are the requirements for written medical documentation, contemporaneous records, and other...  

Code of Federal Regulations, 2013 CFR

...COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Filing Claims; Evidence and Burden of Proof; Special Procedures for Certain Cancer Claims Evidence and Burden of Proof § 30.113 What are the requirements for written medical documentation,...

2013-04-01

399

Several methods and apparatus of low-energy laser therapy in veterinary practice  

NASA Astrophysics Data System (ADS)

During same years various medical effect of low-energy laser therapy in veterinary were tested. We established that the laser low-energy therapy can be very effective for treatment such animal's diseases as mastitis and demodekose when certain combinations of laser beam parameters are used. This combinations were taken as the principle of a number of laser veterinary apparatus, which we started to produce at `POLUS'. It is our series of apparatus `VEGA-MB' and `VETLAS-3', which is real used today for dogs and cows treatment in Russia.

Svirin, Vaytcheslav N.; Rogatkin, Dmitrii A.; Barybin, Vitalii F.

1998-12-01

400

University teaching hospital and private clinic collaboration to enhance veterinary educational opportunities at Mississippi State University.  

PubMed

The College of Veterinary Medicine at Mississippi State University established a not-for-profit corporation (MSU-CVM-COS) to develop and manage private specialty clinics that would enhance teaching and student learning, increase caseload, and generate revenue. The corporation currently operates the Animal Emergency and Referral Center (AERC) and the Veterinary Specialty Center (VSC) as affiliates of Mississippi State University. These privately managed facilities provide access to advanced medical equipment, enhance clinical service and teaching, and promote the College's One Health initiative. PMID:24384387

Tyner, C Lee; Harkness, John; Hoblet, Kent; Zumwalt, Lauren; Templeton, Karen; McLaughlin, Ron

2014-01-01

401

Information technology in veterinary pharmacology instruction.  

PubMed

Veterinary clinical pharmacology encompasses all interactions between drugs and animals and applies basic and clinical knowledge to improve rational drug use and patient outcomes. Veterinary pharmacology instructors set educational goals and objectives that, when mastered by students, lead to improved animal health. The special needs of pharmacology instruction include establishing a functional interface between basic and clinical knowledge, managing a large quantity of information, and mastering quantitative skills essential to successful drug administration and analysis of drug action. In the present study, a survey was conducted to determine the extent to which veterinary pharmacology instructors utilize information technology (IT) in their teaching. Several IT categories were investigated, including Web-based instructional aids, stand-alone pharmacology software, interactive videoconferencing, databases, personal digital assistants (PDAs), and e-book applications. Currently IT plays a largely ancillary role in pharmacology instruction. IT use is being expanded primarily through the efforts of two veterinary professional pharmacology groups, the American College of Veterinary Clinical Pharmacology (ACVCP) and the American Academy of Veterinary Pharmacology and Therapeutics (AAVPT). The long-term outcome of improved IT use in pharmacology instruction should be to support the larger educational mission of active learning and problem solving. Creation of high-quality IT resources that promote this goal has the potential to improve veterinary pharmacology instruction within and across institutions. PMID:14976618

Kochevar, Deborah T

2003-01-01

402

The European system of veterinary specialization.  

PubMed

Veterinary specialist diplomas were available in many European countries during the second half of the 20th century. However, such an early recognition of the importance of veterinary specialization actually delayed the concept of the European veterinary specialist in Europe, compared with the United States, where the first specialist colleges were established in the 1960s, because it was felt that the national system was functioning properly and there was therefore no need for a new structure in the European countries. The European Board of Veterinary Specialisation (EBVS) was established in 1996, and currently there are 23 specialist colleges with more than 2,600 veterinarians officially listed in the EBVS register as European specialists. The Advisory Committee on Veterinary Training (ACVT) approved the establishment of EBVS but never implemented a supervising body (with ACVT representation). Such a body, the European Coordinating Committee on Veterinary Training, was later implemented by the profession itself, although it still lacked a political component. Each college depends on the EBVS, which has the function to define standards and criteria for monitoring the quality of college diplomates. To become a European Diplomate, veterinarians must have gone through an intensive period of training supervised by a diplomate, after which candidates must pass an examination. Although the term European veterinary specialist still does not have any legal recognition, national specialist qualifications are being phased out in many countries because of the inherent higher quality of EBVS specialist qualifications. PMID:21135399

Romagnoli, Stefano

2010-01-01

403

Veterinary and human vaccine evaluation methods  

PubMed Central

Despite the universal importance of vaccines, approaches to human and veterinary vaccine evaluation differ markedly. For human vaccines, vaccine efficacy is the proportion of vaccinated individuals protected by the vaccine against a defined outcome under ideal conditions, whereas for veterinary vaccines the term is used for a range of measures of vaccine protection. The evaluation of vaccine effectiveness, vaccine protection assessed under routine programme conditions, is largely limited to human vaccines. Challenge studies under controlled conditions and sero-conversion studies are widely used when evaluating veterinary vaccines, whereas human vaccines are generally evaluated in terms of protection against natural challenge assessed in trials or post-marketing observational studies. Although challenge studies provide a standardized platform on which to compare different vaccines, they do not capture the variation that occurs under field conditions. Field studies of vaccine effectiveness are needed to assess the performance of a vaccination programme. However, if vaccination is performed without central co-ordination, as is often the case for veterinary vaccines, evaluation will be limited. This paper reviews approaches to veterinary vaccine evaluation in comparison to evaluation methods used for human vaccines. Foot-and-mouth disease has been used to illustrate the veterinary approach. Recommendations are made for standardization of terminology and for rigorous evaluation of veterinary vaccines. PMID:24741009

Knight-Jones, T. J. D.; Edmond, K.; Gubbins, S.; Paton, D. J.

2014-01-01

404

Using informatics and the electronic medical record to describe antimicrobial use in the clinical management of diarrhea cases at 12 companion animal practices.  

PubMed

Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6%) of the target cases underwent diagnostic testing of which 36/88 (40.9%) had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4%) and specificity (85%, 95% confidence interval, 80.2%-89.1%). Overall, 7400/15,928 (46.5%) of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use. PMID:25057893

Anholt, R Michele; Berezowski, John; Ribble, Carl S; Russell, Margaret L; Stephen, Craig

2014-01-01

405

Online tools for teaching evidence-based veterinary medicine.  

PubMed

Evidence-based veterinary medicine (EBVM) is of interest and relevance to veterinary practitioners. Consequently, veterinary schools take responsibility for teaching students how to appraise scientific articles and for equipping them with the skills needed to obtain and evaluate the best evidence and to apply this approach to their own cases. As part of our farm animal clinical rotation, we train students in qualitative and quantitative EBVM methods using an e-learning environment, online teaching materials, a wiki (a Web site that allows its users to edit its content via a Web browser), and face-to-face tutorials that support learning. Students working in small groups use a wiki to record details of the history, clinical presentation, diagnostic tests, herd data, and management plans for their chosen farm animal clinical cases. Using a standardized patient, intervention, comparison, and outcome (PICO) format, each group formulates a patient question based on either a proposed intervention or diagnostic procedure for the case and conducts an online scientific literature database search. The students appraise the articles retrieved using EBVM approaches and record the information in the wiki. The summation of this body of work, the group's critically appraised topic (CAT), includes the original PICO, a standardized table of the scientific evidence for the effectiveness of the intervention or diagnostic procedure, a summary statement in the form of a clinical bottom line, and their reflections upon the CAT. At the end of the rotation, students take part in a structured "CAT Club" where they present and discuss their findings with fellow students and clinicians. PMID:23975071

Steele, Michael; Crabb, Nicholas P; Moore, Lynda J; Reyher, Kristen K; Baillie, Sarah; Eisler, Mark C

2013-01-01

406

of Veterinary Concurrent ranavirus and Batrachochytrium dendrobatidis  

E-print Network

Faculty of Veterinary Medicine Concurrent ranavirus and Batrachochytrium dendrobatidis infection Ranavirus and Batrachochytrium dendrobatidis infections have been associated with amphibian mass mortalities) of B. dendrobatidis in the stratum corneum (Fig. 1). . Fig. 1. E: empty sporangia. Multifocal

Gray, Matthew

407

Good veterinary governance: definition, measurement and challenges.  

PubMed

Good veterinary governance assumes the provision of veterinary services that are sustainably financed, universally available, and provided efficiently without waste or duplication, in a manner that is transparent and free of fraud or corruption. Good veterinary governance is a necessary condition for sustainable economic development insomuch as it promotes the effective delivery of services and improves the overall performance of animal health systems. This article defines governance in Veterinary Services and proposes a framework for its measurement. It also discusses the role of Veterinary Services and analyses the governance dimensions of the performance-assessment tools developed by the World Organisation for Animal Health (OIE). These tools (OIE PVS Tool and PVS Gap Analysis) track the performance of Veterinary Services across countries (a harmonised tool) and over time (the PVS Pathway). The article shows the usefulness of the OIE PVS Tool for measuring governance, but also points to two shortcomings, namely (i) the lack of clear outcome indicators, which is an impediment to a comprehensive assessment of the performance of Veterinary Services, and (ii) the lack of specific measures for assessing the extent of corruption within Veterinary Services and the extent to which demand for better governance is being strengthened within the animal health system. A discussion follows on the drivers of corruption and instruments for perception-based assessments of country governance and corruption. Similarly, the article introduces the concept of social accountability, which is an approach to enhancing government transparency and accountability, and shows how supply-side and demand-side mechanisms complement each other in improving the governance of service delivery. It further elaborates on two instruments--citizen report card surveys and grievance redress mechanisms--because of their wider relevance and their possible applications in many settings, including Veterinary Services. Also, central to improving transparency and accountability is access to information and a discussion on the appropriate level of decentralisation of Veterinary Services. Bringing Veterinary Services into compliance with OIE international standards would contribute to improving governance and providing economic benefits through increased animal productivity, the expansion of trade and improved food security. It would also help to increase public health benefits, through greater food safety and better prevention and control of zoonoses. PMID:23413724

Msellati, L; Commault, J; Dehove, A

2012-08-01

408

Building a portable data and information interoperability infrastructure - framework for a standard Taiwan Electronic Medical Record Template  

Microsoft Academic Search

Traditional electronic health record (EHR) data are produced from various hospital information systems. They could not have existed independently without an information system until the incarnation of XML technology. The interoperability of a healthcare system can be divided into two dimensions: functional interoperability and semantic interoperability. Currently, no single EHR standard exists that provides complete EHR interoperability. In order to

Wen-shan Jian; Chien-yeh Hsu; Te-hui Hao; Hsyien-chia Wen; Min-huei Hsu; Yen-liang Lee; Yu-chuan Li; Polun Chang

2007-01-01

409

Increasing the Meaningful Use of Electronic Medical Records: A Localized Health Level 7 Clinical Document Architecture System  

Microsoft Academic Search

\\u000a The health information systems of most medical institutions in China are isolated. Communications across these systems are\\u000a generally realized through point-to-point interfaces at the database level, which tend to lack interoperability, extensibility,\\u000a and security. In the resent study, we developed localized, document-oriented and data-focused clinical document architecture\\u000a (CDA) templates based on health level 7 (HL7) CDA. Then, by combining these

Jun Liang; Mei Fang Xu; Lan Juan Li; Sheng Li Yang; Bao Luo Li; De Ren Cheng; Ou Jin; Li Zhong Zhang; Long Wei Yang; Jun Xiang Sun

2010-01-01

410

Dynamic consent: a possible solution to improve patient confidence and trust in how electronic patient records are used in medical research.  

PubMed

With one million people treated every 36 hours, routinely collected UK National Health Service (NHS) health data has huge potential for medical research. Advances in data acquisition from electronic patient records (EPRs) means such data are increasingly digital and can be anonymised for research purposes. NHS England's care.data initiative recently sought to increase the amount and availability of such data. However, controversy and uncertainty following the care.data public awareness campaign led to a delay in rollout, indicating that the success of EPR data for medical research may be threatened by a loss of patient and public trust. The sharing of sensitive health care data can only be done through maintaining such trust in a constantly evolving ethicolegal and political landscape. We propose that a dynamic consent model, whereby patients can electronically control consent through time and receive information about the uses of their data, provides a transparent, flexible, and user-friendly means to maintain public trust. This could leverage the huge potential of the EPR for medical research and, ultimately, patient and societal benefit. PMID:25586934

Williams, Hawys; Spencer, Karen; Sanders, Caroline; Lund, David; Whitley, Edgar A; Kaye, Jane; Dixon, William G

2015-01-01

411

Dynamic Consent: A Possible Solution to Improve Patient Confidence and Trust in How Electronic Patient Records Are Used in Medical Research  

PubMed Central

With one million people treated every 36 hours, routinely collected UK National Health Service (NHS) health data has huge potential for medical research. Advances in data acquisition from electronic patient records (EPRs) means such data are increasingly digital and can be anonymised for research purposes. NHS England’s care.data initiative recently sought to increase the amount and availability of such data. However, controversy and uncertainty following the care.data public awareness campaign led to a delay in rollout, indicating that the success of EPR data for medical research may be threatened by a loss of patient and public trust. The sharing of sensitive health care data can only be done through maintaining such trust in a constantly evolving ethicolegal and political landscape. We propose that a dynamic consent model, whereby patients can electronically control consent through time and receive information about the uses of their data, provides a transparent, flexible, and user-friendly means to maintain public trust. This could leverage the huge potential of the EPR for medical research and, ultimately, patient and societal benefit. PMID:25586934

Williams, Hawys; Spencer, Karen; Sanders, Caroline; Lund, David; Whitley, Edgar A; Kaye, Jane

2015-01-01

412

Development and implementation of a secure, integrated management system for medical images and electronic clinical records for small hospitals.  

PubMed

The field of Medical Informatics is currently experiencing increasing demands for new models of the Picture Archiving and Communication Systems (PACS) and Digital Imaging and Communications in Medicine (DICOM) protocols. Despite of the considerable advantages of current systems, implementation in hospitals is remarkably slow, due primarily to difficulties in integration and relatively high costs. Even though the success of DICOM standards has greatly contributed to the development of PACS, many hospitals remain unable to support it or to make full use of its potential because various imaging modalities in use at these sites generate images that cannot be stored in the PACS and cannot be managed in a centralized manner without DICOM standardization modules. Furthermore, the imaging modalities being used in such smaller centers are expensive and unlikely to be replaced, making DICOM compliance untenable. With this in mind, this paper describes the design, development, and implementation of a management system for medical diagnostic imaging, based on the DICOM standard and adapted to the needs of a small hospital. The system is currently being implemented in the San Rafael Hospital at A Coruna in Spain, and integrated with the existing hospital information system (HIS). We have studied the networking infrastructure of the hospital and its available image generation devices, and have subsequently carried out a series of measurements including transmission times, image file size, compression ratios, and many others that allow us to analyze the behavior of the system. Results obtained from these investigations demonstrate both the flexibility of using such a "small-hospital" DICOM-based framework as well as the relative cost-effectiveness of the system. In this regard, the approach, described herein, might serve as a model for other small, and possibly mid-sized, medical centers. PMID:17603833

Pereira, Javier; Castro, Antonio F; Perez, Juan L; Novoa, Francisco J; Vázquez, Jose M; Teijeiro, Jorge; Pazos, Alejandro; Ezquerra, Norberto

2007-06-01

413

No paper, but the same routines: a qualitative exploration of experiences in two Norwegian hospitals deprived of the paper based medical record  

PubMed Central

Background It has been shown that implementation of electronic medical records (EMR) and withdrawal of the paper-based medical record is feasible, but represents a drastic change in the information environment of hospital physicians. Previous investigations have revealed considerable inter-hospital variations in EMR system use and user satisfaction. The aim of this study was to further explore changes of clinicians' work after the EMR system implementation process and how they experienced working in a paper-deprived information environment. Methods Qualitative study based on 18 semi-structured interviews with physicians in two Norwegian hospitals. Results Ten different but related characteristics of work within the EMR-based practice were identified; (1) there was closer clinical and administrative cooperation during the implementation processes; (2) there were greater benefits when everybody used the system; (3) systems supported freshmen better than experienced physicians; (4) the EMR was useful in regard to professional learning; (5) new users were given an introduction to the system by experienced; (6) younger clinicians reported different attitudes than senior clinicians, but this might be related to more than age and previous experience with computers; (7) the EMR made it easier to generate free-text notes, but this also created a potential for information overflow; (8) there is little or no support for mobile work; (9) instances of downtime are still experienced, and this influenced the attitude towards the system and (10) clinicians preferred EMR-only compared to combined paper and electronic systems. Conclusion Despite the removal of paper-based records from clinical workflow (a change that hospital clinicians perceived as highly useful), many of the old routines remained unchanged, limiting the potential of the EMR system. Thus, there is a need to not only remove paper in the physical sense, but also to established routines to fully achieve the benefits of an EMR system. PMID:18186935

Lium, Jan-Tore; Tjora, Aksel; Faxvaag, Arild

2008-01-01

414

Reptiles with dermatological lesions: a retrospective study of 301 cases at two university veterinary teaching hospitals (1992-2008).  

PubMed

This retrospective study reviews the medical records of 301 reptiles with dermatological lesions that were examined at the Veterinary Medical Teaching Hospital, University of California at Davis (VMTH-UCD) and the Unité de Dermatologie-Parasitologie-Mycologie, Ecole Nationale Vétérinaire de Nantes (UDPM-ENVN) from 1 January 1992 to 1 July 2008. The most common reptile groups differed between the two hospitals, with lizards being the most common at the VMTH-UCD and chelonians at the UDPM-ENVN. At the VMTH-UCD, boa constrictors (Boa constrictor), ball pythons (Python regius) and other Python species were over-represented, and box turtles (Terrapene carolina) were under-represented in the dermatological lesion caseload. When institutional data were combined, 47% of all reptiles at both institutions with confirmed or suspected cases of sepsis had petechiae, with the highest association seen in chelonians at 82%. Dependent on institution and reptile group, from 29% to 64% of the cases had underlying husbandry issues. Sixty-two per cent of all cases were alive at final status. Veterinarians treating reptiles with skin disease should be aware of the following: (i) that boa constrictors and Python species may be predisposed to dermatological lesions; (ii) that client education is important for proper husbandry; and (iii) that there is a possible association between petechiae and sepsis, especially in chelonians. The conjectural association between certain skin lesions and sepsis remains to be confirmed by systematically derived data that demonstrate a causal relationship between the two. PMID:20887405

White, Stephen D; Bourdeau, Patrick; Bruet, Vincent; Kass, Philip H; Tell, Lisa; Hawkins, Michelle G

2011-04-01

415

Evaluation of Electronic Health Record Implementation in Ophthalmology at an Academic Medical Center (An American Ophthalmological Society Thesis)  

PubMed Central

Purpose: To evaluate three measures related to electronic health record (EHR) implementation: clinical volume, time requirements, and nature of clinical documentation. Comparison is made to baseline paper documentation. Methods: An academic ophthalmology department implemented an EHR in 2006. A study population was defined of faculty providers who worked the 5 months before and after implementation. Clinical volumes, as well as time length for each patient encounter, were collected from the EHR reporting system. To directly compare time requirements, two faculty providers who utilized both paper and EHR systems completed time-motion logs to record the number of patients, clinic time, and nonclinic time to complete documentation. Faculty providers and databases were queried to identify patient records containing both paper and EHR notes, from which three cases were identified to illustrate representative documentation differences. Results: Twenty-three faculty providers completed 120,490 clinical encounters during a 3-year study period. Compared to baseline clinical volume from 3 months pre-implementation, the post-implementation volume was 88% in quarter 1, 93% in year 1, 97% in year 2, and 97% in year 3. Among all encounters, 75% were completed within 1.7 days after beginning documentation. The mean total time per patient was 6.8 minutes longer with EHR than paper (P<.01). EHR documentation involved greater reliance on textual interpretation of clinical findings, whereas paper notes used more graphical representations, and EHR notes were longer and included automatically generated text. Conclusion: This EHR implementation was associated with increased documentation time, little or no increase in clinical volume, and changes in the nature of ophthalmic documentation. PMID:24167326

Chiang, Michael F.; Read-Brown, Sarah; Tu, Daniel C.; Choi, Dongseok; Sanders, David S.; Hwang, Thomas S.; Bailey, Steven; Karr, Daniel J.; Cottle, Elizabeth; Morrison, John C.; Wilson, David J.; Yackel, Thomas R.

2013-01-01

416

Veterinary pharmacovigilance in the European context.  

PubMed

Pharmacovigilance (or pharmaco-surveillance) is the surveillance of adverse drug reactions (ADRs) which are noxious and of unintended reactions which occur at doses normally used in animals in accordance with the terms of the marketing authorization. From this definition, the scope of veterinary pharmacovigilance should be clearly defined, especially with regard to associated problems of lack of efficacy, resistance, effects in man, residues, etc. Priorities should be established concerning adverse effects in animals in order to set up an operational system. Methodological tools are being developed such as causality assessment, thesaurus, data banks, alert systems. The situation of veterinary pharmacovigilance in countries is very different. The existing systems are based on two different conceptions: a pharmacovigilance of the administrative type, made by authorities; a pharmacovigilace of the interactive type, made in veterinary universities, linked with the authorities. In industry, the importance of pharmacovigilance is increasing; collaborations have been set up but should certainly be developed. Finally, the sensitization of the veterinary practitioners, which play a key-role in the system of spontaneous reporting of ADRs, is to be developed in many ways: interaction during or after the report, publication of data, concrete actions, improvement of side-effect warnings and prevention, etc. Veterinary pharmacovigilance should be a very interesting area of cooperation between the field, universities, industry and regulation authorities. PMID:1303032

Keck, G

1992-01-01

417

DEPARTMENT OF PATHOLOGY, MICROBIOLOGY & IMMUNOLOGY SCHOOL OF VETERINARY MEDICINE  

E-print Network

DEPARTMENT OF PATHOLOGY, MICROBIOLOGY & IMMUNOLOGY SCHOOL OF VETERINARY MEDICINE UNIVERSITY that integrate well with the research strengths in the Department of Pathology, Microbiology and Immunology microbiology, host-pathogen interactions, immunology and disease pathogenesis. The School of Veterinary

Ishida, Yuko

418

Graduate Training in Toxicology in Colleges of Veterinary Medicine.  

ERIC Educational Resources Information Center

Presented are an American Board of Veterinary Toxicology survey and evaluation of the training resources available in graduate programs in toxicology located in colleges of veterinary medicine. Regulatory toxicology, number of toxicologists needed, and curriculum are also discussed. (JMD)

Robens, J. F.; Buck, W. B.

1979-01-01

419

Chapter 5. Assessing the Aquatic Hazards of Veterinary Medicines  

EPA Science Inventory

In recent years, there has been increasing awareness of the widespread distribution of low concentrations of veterinary medicine products and other pharmaceuticals in the aquatic environment. While aquatic hazard for a select group of veterinary medicines has received previous s...

420

Thirtieth Annual Congress on Veterinary Acupuncture: IVAS Report  

PubMed Central

More than 155 participants from 25 countries attended the 30th Annual IVAS Congress, September 8–11, 2004 in Oostende, Belgium. The focus was on veterinary acupuncture (AP) and immunology, and the event was sponsored by the International Veterinary Acupuncture Society (IVAS). IVAS is a non-profit organization dedicated to promoting excellence in the practice of veterinary AP as an integral part of the total veterinary health care delivery system. The Society endeavors to establish uniformly high standards of veterinary AP through its educational programs and accreditation examination. IVAS seeks to integrate veterinary AP and the practice of Western veterinary science, while also noting that the science of veterinary AP does not overlook allied health systems, such as homeopathy, herbology, nutrition, chiropractic, kinesiology, etc. ().

2005-01-01

421

Medical Math applications (Solving Equations)  

NSDL National Science Digital Library

Students use a formula to solve equations, for problems with a medical slant provided by Mesa Collegeâs Veterinary Program. This requires the use of subscript notation and the multiplication property of equality to solve. The equations are the simplest of linear equations however the application makes them more interesting.

2010-01-01

422

Mitigating the health effects of disasters for medically underserved populations: electronic health records, telemedicine, research, screening, and surveillance.  

PubMed

The Regional Coordinating Center for Hurricane Response (RCC) collaborated with the EXPORT Centers (Centers of Excellence in Partnerships for Community Outreach, Research on Health Disparities and Training) to rebuild, revitalize, and improve the health care infrastructure in the Gulf Coast states damaged by Hurricanes Katrina and Rita. This initiative aims to enhance the provision of health care by installing Electronic Health Records and Telepsychiatry systems throughout the Gulf Coast. Through the EXPORT Centers, the RCC plans to perform screening and surveillance projects within the communities and develop research projects focused on eliminating health disparities affecting underserved populations in the region. Another goal is to establish partnerships with EXPORT Centers, Community Health Centers, and other essential primary care practices in hurricane-ravaged communities. Through these partnerships, the overarching goal is to create a balanced health care system model that academic institutions can integrate into preventive care for emergency planning and research. PMID:17483570

Mack, Dominic; Brantley, Katrina M; Bell, Kimberly G

2007-05-01

423

Brain activity and medical diagnosis: an EEG study  

PubMed Central

Background Despite new brain imaging techniques that have improved the study of the underlying processes of human decision-making, to the best of our knowledge, there have been very few studies that have attempted to investigate brain activity during medical diagnostic processing. We investigated brain electroencephalography (EEG) activity associated with diagnostic decision-making in the realm of veterinary medicine using X-rays as a fundamental auxiliary test. EEG signals were analysed using Principal Components (PCA) and Logistic Regression Analysis Results The principal component analysis revealed three patterns that accounted for 85% of the total variance in the EEG activity recorded while veterinary doctors read a clinical history, examined an X-ray image pertinent to a medical case, and selected among alternative diagnostic hypotheses. Two of these patterns are proposed to be associated with visual processing and the executive control of the task. The other two patterns are proposed to be related to the reasoning process that occurs during diagnostic decision-making. Conclusions PCA analysis was successful in disclosing the different patterns of brain activity associated with hypothesis triggering and handling (pattern P1); identification uncertainty and prevalence assessment (pattern P3), and hypothesis plausibility calculation (pattern P2); Logistic regression analysis was successful in disclosing the brain activity associated with clinical reasoning success, and together with regression analysis showed that clinical practice reorganizes the neural circuits supporting clinical reasoning. PMID:24083668

2013-01-01

424

Adaptation of a web-based, open source electronic medical record system platform to support a large study of tuberculosis epidemiology  

PubMed Central

Background In 2006, we were funded by the US National Institutes of Health to implement a study of tuberculosis epidemiology in Peru. The study required a secure information system to manage data from a target goal of 16,000 subjects who needed to be followed for at least one year. With previous experience in the development and deployment of web-based medical record systems for TB treatment in Peru, we chose to use the OpenMRS open source electronic medical record system platform to develop the study information system. Supported by a core technical and management team and a large and growing worldwide community, OpenMRS is now being used in more than 40 developing countries. We adapted the OpenMRS platform to better support foreign languages. We added a new module to support double data entry, linkage to an existing laboratory information system, automatic upload of GPS data from handheld devices, and better security and auditing of data changes. We added new reports for study managers, and developed data extraction tools for research staff and statisticians. Further adaptation to handle direct entry of laboratory data occurred after the study was launched. Results Data collection in the OpenMRS system began in September 2009. By August 2011 a total of 9,256 participants had been enrolled, 102,274 forms and 13,829 laboratory results had been entered, and there were 208 users. The system is now entirely supported by the Peruvian study staff and programmers. Conclusions The information system served the study objectives well despite requiring some significant adaptations mid-stream. OpenMRS has more tools and capabilities than it did in 2008, and requires less adaptations for future projects. OpenMRS can be an effective research data system in resource poor environments, especially for organizations using or considering it for clinical care as well as research. PMID:23131180

2012-01-01

425

Improving Case Definition of Crohn’s Disease and Ulcerative Colitis in Electronic Medical Records Using Natural Language Processing: A Novel Informatics Approach  

PubMed Central

Introduction Prior studies identifying patients with inflammatory bowel disease (IBD) utilizing administrative codes have yielded inconsistent results. Our objective was to develop a robust electronic medical record (EMR) based model for classification of IBD leveraging the combination of codified data and information from clinical text notes using natural language processing (NLP). Methods Using the EMR of 2 large academic centers, we created data marts for Crohn’s disease (CD) and ulcerative colitis (UC) comprising patients with ? 1 ICD-9 code for each disease. We utilized codified (i.e. ICD9 codes, electronic prescriptions) and narrative data from clinical notes to develop our classification model. Model development and validation was performed in a training set of 600 randomly selected patients for each disease with medical record review as the gold standard. Logistic regression with the adaptive LASSO penalty was used to select informative variables. Results We confirmed 399 (67%) CD cases in the CD training set and 378 (63%) UC cases in the UC training set. For both, a combined model including narrative and codified data had better accuracy (area under the curve (AUC) for CD 0.95; UC 0.94) than models utilizing only disease ICD-9 codes (AUC 0.89 for CD; 0.86 for UC). Addition of NLP narrative terms to our final model resulted in classification of 6–12% more subjects with the same accuracy. Conclusion Inclusion of narrative concepts identified using NLP improves the accuracy of EMR case-definition for CD and UC while simultaneously identifying more subjects compared to models using codified data alone. PMID:23567779

Ananthakrishnan, Ashwin N.; Cai, Tianxi; Savova, Guergana; Cheng, Su-Chun; Chen, Pei; Perez, Raul Guzman; Gainer, Vivian S.; Murphy, Shawn N.; Szolovits, Peter; Xia, Zongqi; Shaw, Stanley; Churchill, Susanne; Karlson, Elizabeth W.; Kohane, Isaac; Plenge, Robert M.; Liao, Katherine P.

2013-01-01

426

Evaluation of a Nutrition Care Process-based audit instrument, the Diet-NCP-Audit, for documentation of dietetic care in medical records.  

PubMed

Adequate documentation in medical records is important for high-quality health care. Documentation quality is widely studied within nursing, but studies are lacking within dietetic care. The aim of this study was to translate, elaborate and evaluate an audit instrument, based on the four-step Nutrition Care Process model, for documentation of dietetic care in medical records. The audit instrument includes 14 items focused on essential parts of dietetic care and the documentation's clarity and structure. Each item is to be rated 0-1 or 0-2 points, with a maximum total instrument score of 26. A detailed manual was added to facilitate the interpretation and increase the reliability of the instrument. The instrument is based on a similar tool initiated 9 years ago in the United States, which in this study was translated to Swedish and further elaborated. The translated and further elaborated instrument was named Diet-NCP-Audit. Firstly, the content validity of the Diet-NCP-Audit instrument was tested by five experienced dietitians. They rated the relevance and clarity of the included items. After a first rating, minor improvements were made. After the second rating, the Content Validity Indexes were 1.0, and the Clarity Index was 0.98. Secondly, to test the reliability, four dietitians reviewed 20 systematically collected dietetic notes independently using the audit instrument. Before the review, a calibration process was performed. A comparison of the reviews was performed, which resulted in a moderate inter-rater agreement with Krippendorff's ? = 0.65-0.67. Grouping the audit results in three levels: lower, medium or higher range, a Krippendorff's ? of 0.74 was considered high reliability. Also, an intra-rater reliability test-retest with a 9 weeks interval, performed by one dietitian, showed strong agreement. To conclude, the evaluated audit instrument had high content validity and moderate to high reliability and can be used in auditing documentation of dietetic care. PMID:23647427

Lövestam, Elin; Orrevall, Ylva; Koochek, Afsaneh; Karlström, Brita; Andersson, Agneta

2014-06-01

427

Distinctions The School of Veterinary Medicine team has shaped the field of veterinary medicine, developing dynamic veterinary  

E-print Network

disease, autism and other disorders. · The Veterinary Genetics Laboratory, established in the 1950s veterinarians developed the J-5 vaccine, which prevents mastitis infections in dairy cattle, saving producers invented a genetically engineered vaccine for rinderpest and an inexpensive diagnostic kit designed

Schladow, S. Geoffrey

428

Medical and Veterinary Entomology (2007) 21, 370376 2007 The Authors  

E-print Network

© 2007 The Royal Entomological Society Introduction Dengue fever (DF) is the world's most important arboviral dis- ease. Its symptoms range from general malaise to the potentially lethal dengue haemorrhagic fever (DHF) and dengue shock syn- drome (DSS). Over 2.5 billion people live in high-risk areas

Severson, David

429

Personal Health Records  

MedlinePLUS

... chart there, too. These charts are your medical records. They may be on paper or electronic. To ... good idea to keep your own personal health record. What kind of information would you put in ...

430

Comparison of an expanded ataxia interactome with patient medical records reveals a relationship between macular degeneration and ataxia  

PubMed Central

Spinocerebellar ataxias 6 and 7 (SCA6 and SCA7) are neurodegenerative disorders caused by expansion of CAG repeats encoding polyglutamine (polyQ) tracts in CACNA1A, the alpha1A subunit of the P/Q-type calcium channel, and ataxin-7 (ATXN7), a component of a chromatin-remodeling complex, respectively. We hypothesized that finding new protein partners for ATXN7 and CACNA1A would provide insight into the biology of their respective diseases and their relationship to other ataxia-causing proteins. We identified 118 protein interactions for CACNA1A and ATXN7 linking them to other ataxia-causing proteins and the ataxia network. To begin to understand the biological relevance of these protein interactions within the ataxia network, we used OMIM to identify diseases associated with the expanded ataxia network. We then used Medicare patient records to determine if any of these diseases co-occur with hereditary ataxia. We found that patients with ataxia are at 3.03-fold greater risk of these diseases than Medicare patients overall. One of the diseases comorbid with ataxia is macular degeneration (MD). The ataxia network is significantly (P= 7.37 × 10?5) enriched for proteins that interact with known MD-causing proteins, forming a MD subnetwork. We found that at least two of the proteins in the MD subnetwork have altered expression in the retina of Ataxin-7266Q/+ mice suggesting an in vivo functional relationship with ATXN7. Together these data reveal novel protein interactions and suggest potential pathways that can contribute to the pathophysiology of ataxia, MD, and diseases comorbid with ataxia. PMID:21078624

Kahle, Juliette J.; Gulbahce, Natali; Shaw, Chad A.; Lim, Janghoo; Hill, David E.; Barabási, Albert-László; Zoghbi, Huda Y.

2011-01-01

431

75 FR 52505 - Fiscal Year 2011 Veterinary Import/Export Services, Veterinary Diagnostic Services, and Export...  

Federal Register 2010, 2011, 2012, 2013, 2014

...DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2010-0073...Veterinary Diagnostic Services, and Export Certification for Plants and Plant Products User Fees AGENCY: Animal and Plant Health...

2010-08-26

432

A1-4: Pragmatic and Adaptive Methods of Electronic Medical Record (EMR) Cohort Identification for Comparative Effectiveness Research  

PubMed Central

Background/Aims Accurate EMR-based cohort identification is crucial in the conduct of comparative effectiveness research. CheCS is a longitudinal study of chronic hepatitis B (CHB) and C (CHC) infection being conducted at 4 HMORN sites. Subjects are identified using automated EMR-based ICD-9 diagnosis and laboratory inclusion criteria, and about 12,000 patients were identified in the initial cohort selection. After confirmation of CHB/ CHC status through chart abstraction, we found false discovery rates (FDR) were 13.6% for CHB and 11.3% for CHC. An adaptive approach was proposed to optimize the EMR-based cohort selection. Methods Classification and Regression Tree (CART) was performed to identify a set of electronic variables (or variable combinations) for CHB and CHC. The variables/classifiers that were considered included not only all the initial cohort identificaton criteria, but also HIV status, any outpatient order or pharmacy claim for CHB/CHC antiviral medication, and 41 other liver disease-related procedures/diagnoses. The analysis began with CART model building using one set of data (learning), followed by model validation using the other set of data (testing). Results Of the 12,144 patients identified for the initial CHeCS cohort, 2518 met initial CHB criteria and 9844 met initial CHC criteria, including 218 who met criteria for both. Of these, 10,825 (2176 CHB and 8724 CHC, including 75 co-infected) patients’ diagnoses were confirmed through chart abstraction and the remaining were excluded. CART model FDRs were 8.5% on learning data and 7.1% on testing data for CHB, and 4.9% and 5.7% for CHC, yielding sensitivities and specificities >91% for CHB and >84% for CHC. Overall, FDRs were significantly lower (7.8% for CHB, 5.3% for CHC) than those yielded from the initial inclusion criteria alone (P <0.001). Conclusions Our adaptive approach to using electronic data for prediction of CHB/CHC status is feasible, can be used for sequential CHeCS cohort identification, and may be useful in other studies to identify patients diagnosed with CHB/CHC.

Lu, Mei; Li, Jia; Rupp, Lora; Lamerato, Lois; Vijayadeva, Vinutha; Boscarino, Joseph; Schmidt, Mark; Nerenz, David; Gordon, Stuart

2013-01-01

433

Notes FINDING EBOOKS in Veterinary Medicine  

E-print Network

by copyright Internet Archive: Digital Library of Free Books, Movies, Music, etc. http, title, or subject keyword Follow links to publisher/vendor web site Note: Some links connect to online and view chapter pdfs Wiley Online Library http://onlinelibrary.wiley.com/ Browse "Veterinary

Chen, Tsuhan

434

Women as veterinary leaders and entrepreneurs.  

PubMed

Despite making up an increasing proportion of the veterinary profession, women continue to be significantly underrepresented in leadership roles. Is this imbalance a problem? And what opportunities are there to address it? A debate at the BVA Congress at the London Vet Show last month sought to provide some answers, as Laura Honey reports. PMID:25501518

2014-12-13

435

IMPACT OF ANTIMICROBIC USE IN VETERINARY MEDICINE  

Technology Transfer Automated Retrieval System (TEKTRAN)

Antimicrobial resistance has become a concern for both humans and animal health on a global scale. In addition to concerns about treatment failures in veterinary medicine and human medicine related to resistant organisms, there is a concern about the potential transfer of resistant organisms from an...

436

VETERINARY TEACHING HOSPITAL 1620 Campus Delivery  

E-print Network

services to clientele in northern Colorado. This position will service existing clients and develop new for 4th year veterinary students while providing excellent equine care and strong communication with clients. Responsibilities/Duties: Conduct equine ambulatory appointments with clients in the Northern

Rutledge, Steven

437

Applying games technology to veterinary teaching.  

PubMed

Veterinarian Márton Balogh has been interested in computers, gaming and programming since he was eight years old. Here, he explains how he is using software that is more often associated with the creation of 3D computer games to develop an immersive, virtual consultation room, complete with patient, to help train veterinary students in clinical examination techniques. PMID:24443465

Balogh, Márton

2014-01-18

438

COLLEGE OF VETERINARY MEDICINE UNIVERSITY OF TENNESSEE  

E-print Network

COLLEGE OF VETERINARY MEDICINE UNIVERSITY OF TENNESSEE The University of Tennessee, founded in 1794, established in 1974, is located in Knoxville on the University's Agricultural Campus along the Tennessee River. The city, the cultural center of East Tennessee, is situated in the Appalachian foothills of east central

Tennessee, University of

439

Distribution of veterinary drug residues among muscles  

Technology Transfer Automated Retrieval System (TEKTRAN)

The U.S. Food and Drug Administration sets tolerances for veterinary drug residues in muscle, but does not specify which muscle should be sampled for analysis. The goal of this research was to determine if antibiotic residue levels are dependent on muscle type. In this study, penicillin G (Pen G) d...

440

Veterinary education: a basis for good governance leading to effective veterinary services.  

PubMed

Veterinary education serves as the foundation on which a country can build effective Veterinary Services (VS). In addition, an appropriately well-educated animal health workforce will be better poised to actively participate in and advance good governance practices. Good governance, in turn, will lead to improved animal and veterinary public heath infrastructures and help advance economic development across the globe. A crucial first step in establishing a strong educational foundation is to define minimum competencies for both public- and private-practice veterinarians to perform veterinary service tasks. Defining minimum competencies will also assist veterinary education establishments (VEEs) in developing and implementing curricula to allow graduates to achieve those competencies. Incorporating veterinary educational prerequisites and requirements into governance documents that regulate VS will help to ensure that those who deliver VS have an adequate knowledge and skills base to do so. Public-private partnerships may be particularly effective in designing and implementing curricula that address defined minimum competencies and assure the quality of VEEs. Through these partnerships, a system of continuous quality improvement is established that embodies the qualities essential to good governance practices. Such practices will ultimately strengthen national VS, better protect animal and public health, and ensure food security. PMID:23413731

Sabin, E A; DeHaven, W R

2012-08-01

441

The analysis of 8-year data (2002-2010) of the tumor cases based on the pathology records of Abant Izzet Baysal University medical faculty department  

PubMed Central

Aim: Cancer is one of the most significant health problems throughout the world. An important aspect of measures against cancer is to determinate the extension and prevalence of the cancer. Understanding characteristics and behavior of cancer is the key issue in providing preventive steps and developing proper strategies in the concept of early diagnosis and treatment. The objective of this study was to determine the regional cancer incidence and cancer types based on the pathology records of Department of Pathology, Medical School, Abant Izzet Baysal University. Secondly. The aim was to discuss the properties of these cases with other similar reports both from Turkey and the world. Materials and methods: All pathology records of the cases were evaluated who diagnosed at The Department of Pathology, Medical School, Abant Izzet Baysal University between December 20, 2002 and December 31, 2010. The results were classified according to year, age, sex and organ systems. Statistical analyses were carried out using Open Office version 3.1 and PSPP 0.7.2. The duplication of data was particularly prevented by excluding the multiple records in the case of more than one biopsies of the same cancer in the same patient. Results: Totally 18654 pathology records were analyzed. The ratio of positive cases was 24.18% (4510/18654) of including all benign and malignant tumors. Among them 1984 (43.99%) were male and 2526 (56.01%) were female. On the other hand, malignant tumors constituted 33.35 % (1504/18654) of all cases and the percentage of male and female patients were 67.81 % (1020/1504) and 32.19 % (484/1504) respectively. The occurrence of malignant tumors was mostly seen between 60 and 69 age group, while the predominant age period was between 50 and 59 when considering both benign and malignant patients. Male patients had cancers mostly after 60 age group and the predominant period was between 60 and 69 ages. Considering the female patients only, they had more cancers between 10 and 60 age group than males, and the most prevalent period was between 40 and 49 years. The prevalence of both benign and malignant tumors with respect to their origin were skin( 30.15%), female genital tract (21.57%) and gastrointestinal system (12.92%). Considering only the malignant tumors, the distribution was as skin (21.07%), male genital tract (17.82%) and gastrointestinal tract (14.96%). On the other hand, the order of cancers was skin (31.29%), gastrointestinal tract (17.69%), male genital tract (14.81%) in male patients, while it was as female genital tract (38.50%), skin (29.30%), gastrointestinal tract (9.20%) for the female patients. Conclusion: Due to our datas, our results are similar to the results in Turkey and the World. The reason of the lower incidence of some tumors such as lung tumors which are much higher in Turkey and the world may depend on technical inadequacy due to our faculty’s being a newly established one. PMID:25232420

Yanik, Serdar; Yilmaz, Fahri; Özdemir, Zeynep Tuba; Akkoca, Ay?e Neslin; Alkoy, Seval; Aydin, Ali; Sözütek, Didem

2014-01-01

442

Application of clinical pathway using electronic medical record system in pediatric patients with supracondylar fracture of the humerus: a before and after comparative study  

PubMed Central

Background This study was performed to investigate the usefulness of clinical pathway (CP) using an electronic medical record (EMR) in pediatric patients undergoing closed pinning for supracondylar fracture of the humerus, by analyzing the length of hospital stay, hospital cost and satisfaction of the medical teams. Methods This before and after comparative study included consecutive children who underwent closed pinning for supracondylar fracture of the humerus since 2009. The pre-CP group consists of 90 patients with the mean age of 5.7 years, and the post-CP group consists of 32 patients with the mean age of 6.2 years. Multidisciplinary work-team developed CP using an EMR system in March 2011. The length of hospital stay was the primary outcome variable, and hospital cost and medical team’s satisfaction score were secondary outcome variables. The non-inferiority test was used to demonstrate the efficiency of the pathway. Results The length of hospital stay decreased from 2.9?±?0.7 days to 2.4?±?0.7 days by 15.0%, after the implementation of CP, and the lower bound of the 95% CI of the difference (0.14 day) was within the non-inferiority margin of ?0.3 days. The hospital cost decreased from 1162.2?±?236.7 US$ to 1139.8?±?291.1 US$ by 1.9% and the lower bound of the 95% CI of the difference was ?81.3 US$, which did not exceed the non-inferiority margin of ?116.2 US$. Therefore, the post-CP group was not inferior compared with the pre-CP group in term of the length of hospital stay and total hospital cost. There was significant increase in the satisfaction score for doctors after implementation of CP (p?

2013-01-01

443

Ethics teaching in European veterinary schools: a qualitative case study.  

PubMed

Veterinary ethics is recognised as a relevant topic in the undergraduate veterinary curriculum. However, there appears to be no widely agreed view on which contents are best suited for veterinary ethics teaching and there is limited information on the teaching approaches adopted by veterinary schools. This paper provides an inside perspective on the diversity of veterinary ethics teaching topics, based on an in-depth analysis of three European veterinary schools: Copenhagen, Lisbon and Nottingham. The case study approach integrated information from the analysis of syllabi contents and interviews with educators (curricular year 2010-2011). These results show that the curriculum of veterinary ethics is multidimensional and can combine a wide range of scientific, regulatory, professional and philosophical subjects, some of which may not be explicitly set out in the course descriptors. A conceptual model for veterinary ethics teaching is proposed comprising prominent topics included within four overarching concepts: animal welfare science, laws/regulations, professionalism, and theories/concepts. It is intended that this work should inform future curriculum development of veterinary ethics in European schools and assist ethical deliberation in veterinary practice. PMID:25185106

Magalhães-Sant'Ana, M

2014-12-13

444

Expressing Observations from Electronic Medical Record Flowsheets in an i2b2 based Clinical Data Repository to Support Research and Quality Improvement  

PubMed Central

While nursing documentation in electronic medical record (EMR) flowsheets may represent the largest investment of clinician time with information systems, organizations lack tools to visualize and repurpose this data for research and quality improvement. Incorporating flowsheet documentation into a clinical data repository and methods to reduce the flowsheet ontology’s redundancy are described. 411 million flowsheet observations, derived from an EMR predominantly used in inpatient, outpatient oncology, and emergency room settings, were incorporated into a repository using the i2b2 framework. The local flowsheet ontology contained 720 “templates” employing 5,379 groups (2,678 distinct), 37,836 measures (13,659 distinct) containing 226,666 choices for a total size of 270,641. Aggressive pruning and clustering resulted in 150 templates, 743 groups (615 distinct), 6,950 measures (4,066 distinct) with 22,497 choices, and size of 30,371. Making nursing data accessible within i2b2 provides a new perspective for contributing clinical organizations and heightens collaboration between the academic and clinical activities. PMID:22195209

Waitman, Lemuel R.; Warren, Judith J.; Manos, E. LaVerne; Connolly, Daniel W.

2011-01-01

445

Extraction of echocardiographic data from the electronic medical record is a rapid and efficient method for study of cardiac structure and function  

PubMed Central

Background Measures of cardiac structure and function are important human phenotypes that are associated with a range of clinical outcomes. Studying these traits in large populations can be time consuming and costly. Utilizing data from large electronic medical records (EMRs) is one possible solution to this problem. We describe the extraction and filtering of quantitative transthoracic echocardiographic data from the Epidemiologic Architecture for Genes Linked to Environment (EAGLE) study, a large, racially diverse, EMR-based cohort (n?=?15,863). Results There were 6,076 echocardiography reports for 2,834 unique adult subjects. Missing data were uncommon with over 90% of data points present. Data irregularities are primarily related to inconsistent use of measurement units and transcriptional errors. The reported filtering method requires manual review of very few data points (<1%), and filtered echocardiographic parameters are similar to published data from epidemiologic populations of similar ethnicity. Moreover, the cohort is comparable in size, and in some cases larger than community-based cohorts of similar race/ethnicity. Conclusions These results demonstrate that echocardiographic data can be efficiently extracted from EMRs, and suggest that EMR-based cohorts have the potential to make major contributions toward the study of epidemiologic and genotype-phenotype associations for cardiac structure and function in diverse populations. PMID:25276338

2014-01-01

446

Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records  

PubMed Central

Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP) and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patients, 62% were male and the average age was 50.20 years. Ninety percent of patients presented with LBP and 67% with sciatica. Eighty-four percent were diagnosed with herniated nucleus pulposus at time of surgery. Of these patients, 70% had pain recurrence 6 months or later, but 19% experienced no relief or immediate aggravation of pain after surgery. Many patients selected traditional Korean medicine treatment as primary means of postsurgery care (47%). When time to pain recurrence was short or pain persisted after surgery, return of symptoms at the same disc level and side was frequent. Conclusion. An integrative treatment model focusing on Korean medicine and used in conjunction with radiological diagnostics and conventional medicine is currently used as a treatment option for patients with pain after lumbar spine surgery.

Chi, Eun Hya; Lee, Jinho; Shin, Joon-Shik; Ha, In-Hyuk

2014-01-01

447

Rinderpest: the veterinary perspective on eradication  

PubMed Central

Rinderpest was a devastating disease of livestock responsible for continent-wide famine and poverty. Centuries of veterinary advances culminated in 2011 with the UN Food and Agriculture Organization and the World Organization for Animal Health declaring global eradication of rinderpest; only the second disease to be eradicated and the greatest veterinary achievement of our time. Conventional control measures, principally mass vaccination combined with zoosanitary procedures, led to substantial declines in the incidence of rinderpest. However, during the past decades, innovative strategies were deployed for the last mile to overcome diagnostic and surveillance challenges, unanticipated variations in virus pathogenicity, circulation of disease in wildlife populations and to service remote and nomadic communities in often-unstable states. This review provides an overview of these challenges, describes how they were overcome and identifies key factors for this success. PMID:23798687

Roeder, Peter; Mariner, Jeffrey; Kock, Richard

2013-01-01

448

Laser and radiosurgery in veterinary dentistry.  

PubMed

Lasers and radiosurgery frequently used in human dentistry are rapidly entering veterinary dental use. The carbon dioxide, diode, and low-level therapy lasers have features including hemostasis control, access to difficult to reach areas, and decreased pain, that make them useful for oral surgery. Periodontal pocket surgery, gingivectomy, gingivoplasty, gingival hyperplasia, operculectomy, tongue surgery, oropharyngeal inflammation therapy, oral mass surgery, crown, and frenectomy laser surgeries are described, including images. PMID:23643025

Bellows, Jan

2013-05-01

449

Practical acid-base in veterinary patients.  

PubMed

Acid-base abnormalities are common in critically ill veterinary patients. Rapid recognition of disturbances can be helpful in identifying the underlying cause o