Search AMIA.org

To evaluate the data quality of ventilator settings recorded by respiratory therapists using a computer charting application and assess the impact of incorrect data on computerized ventilator management protocols. DESIGN An analysis of 29,054 charting events gathered over 12 months from 678 ventilated patients (1,736 ventilator days) in four intensive care units at a tertiary care hospital.

The full impact of IT in health care has not been realized because of the failure to recognize that (1) the path from availability of applications to the anticipated benefits passes through a series of steps; and (2) progress can be stopped at any one of those steps. As a result, strategies for diffusion, adoption, and use have been incomplete and have produced disappointing results. In this paper, we present [...]

Negation is common in clinical documents and is an important source of poor precision in automated indexing systems. Previous research has shown that negated terms may be difficult to identify if the words implying negations (negation signals) are more than a few words away from them. We describe a novel hybrid approach, combining regular expression matching with grammatical parsing, to address the above limitation in automatically detecting negations in clinical [...]

This case study describes and analyzes a breach of the confidentiality and integrity of personally identified health information (e.g. appointment details, answers to patients' questions, medical advice) for over 800 Kaiser Permanente (KP) members through KP Online, a web-enabled health care portal. The authors obtained and analyzed multiple types of qualitative data about this incident including interviews with KP staff, incident reports, root cause analyses, and media reports. Reasons at [...]

Our goal is to assess how clinical information from previous visits is used in the emergency department. We used detailed user audit logs to measure access to different data types. We found that clinician-authored notes and laboratory and radiology data were used most often (common data types were used up to 5% to 20% of the time). Data were accessed less than half the time (up to 20% to 50%) [...]

To determine the prevalence and inaccessibility of Internet references in the bibliography of biomedical publications when first released in PubMed.

Despite their demonstrated effectiveness, clinical decision support (CDS) systems are not widely used within the U.S. The Roadmap for National Action on Clinical Decision Support, published in June 2006 by the American Medical Informatics Association, identifies six strategic objectives for achieving widespread adoption of effective CDS capabilities. In this manuscript, we propose a Service-Oriented Architecture (SOA) for CDS that facilitates achievement of these six objectives. Within the proposed framework, CDS [...]

This paper presents a model for analysis of chronic disease prescribing action over time in terms of transitions in status of therapy as indicated in electronic prescribing records. The quality of alerts derived from these therapeutic state transitions is assessed in the context of antihypertensive prescribing.

Despite emerging evidence that electronic health records (EHRs) can improve the efficiency and quality of medical care, most physicians in office practice in the United States do not currently use an EHR. We sought to measure the correlates of EHR adoption.