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Mistri IU, Badge A, Shahu S. Enhancing Patient Safety Culture in Hospitals. Cureus 2023; 15:e51159. [PMID: 38283419 PMCID: PMC10811440 DOI: 10.7759/cureus.51159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Patient safety has become a top priority for healthcare organizations. A better patient safety environment is associated with a lower probability of significant complications. Training programmers is critical to promoting patient safety and minimizing misunderstandings. The quality, performance, and productivity of the healthcare industry can be dramatically improved by changing the patient safety atmosphere operating within the hospital sector. Hospitals can significantly reduce medical errors and adverse events by implementing the program and training programmers to prioritize patient safety. This will improve patient outcomes and increase efficiency and effectiveness. Creating a patient safety culture within hospitals will contribute to a higher standard of care and improved overall performance in the healthcare industry. Hospitals can identify systemic problems and implement proactive measures to prevent future incidents by creating an environment in which healthcare professionals feel comfortable reporting errors. A patient safety culture encourages collaboration and open communication among healthcare teams leading to more effective and coordinated care.
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Affiliation(s)
- Isha U Mistri
- Hospital Administration, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
| | - Ankit Badge
- Microbiology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
| | - Shivani Shahu
- Hospital Administration, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research (Deemed to Be University), Nagpur, IND
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Tolera A, Oljira L, Dingeta T, Abera A, Roba HS. Electronic medical record use and associated factors among healthcare professionals at public health facilities in Dire Dawa, eastern Ethiopia: A mixed-method study. Front Digit Health 2022; 4:935945. [DOI: 10.3389/fdgth.2022.935945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDespite the significant benefits of digital health technologies (ITs), developing countries are lagging behind their developed counterparts in the adoption of electronic medical records (EMRs) in a healthcare setting. EMRs have long been considered essential elements in improving the quality of healthcare. However, the rate of utilization of EMRs among healthcare providers still remains low, particularly in developing countries.ObjectiveThis study aimed at exploring EMR use and its determinants among healthcare providers at public health facilities in Dire Dawa, eastern Ethiopia.MethodsA quantitative cross-sectional study was conducted among 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive summary statistics and binary and multivariable logistic regression analysis were used to explore the determinant factors of EMR use, while qualitative data were thematically analyzed.ResultsOverall, about a quarter (26.6%) of health professionals were using electronic medical records. A work experience of 6 years or less [adjusted odds ratio (AOR) = 2.23; 95% confidence interval (CI): [1.15–4.31]], a discussion on EMR (AOR = 14.47; 95% CI: [5.58–7.57]), the presence of an EMR manual (AOR = 3.10; 95% CI: [1.28–7.38]), and a positive attitude toward the EMR system (AOR = 11.15; 95% CI: [4.90–25.36]) and service quality (AOR = 8.02; 95% CI: [4.09–15.72]) were independent determinants of EMR use. Poor collaboration among stakeholders and dependence on the software programs of NGOs were the main challenges cited by key informants.ConclusionThe findings of this study indicate that EMR use by health professionals in the study area is very low. Several organizational, technical, and behavioral factors were identified for this low utilization. Therefore, there is a need to leverage EMRs through continuous technical support and commitment to enhance its use, which has the potential to improve health service performance. Developing locally applicable EMR software should be considered.
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Hamadi HY, Niazi SK, Zhao M, Spaulding A. Single-Vendor Electronic Health Record Use Is Associated With Greater Opportunities for Organizational and Clinical Care Improvements. Mayo Clin Proc Innov Qual Outcomes 2022; 6:269-278. [PMID: 35669522 PMCID: PMC9163586 DOI: 10.1016/j.mayocpiqo.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To compare how hospitals that use single-vendor vs best-of-breed electronic health record (EHR) vendors utilize clinical and organizational evaluation capabilities. Methods Data from the 2018 (June 1, 2016, to December 31, 2017) American Hospital Association Information Technology Supplement Survey and Medicare Final Rule Standardizing File were used. Multinomial logistic regression analysis of hospitals (n=1902) was conducted to identify hospital characteristics associated with the use of EHRs for (1) clinical care evaluation capabilities and (2) organizational evaluation capabilities. Results Single-vendor EHR hospitals were more likely (relative risk ratio, 3.37; 95% confidence interval, 1.97-5.76) to use EHRs for clinical care and organizational evaluation capabilities. Not-for-profit hospitals were more likely to use EHRs for all organizational evaluation capabilities than government nonfederal hospitals. For-profit hospitals were less likely to use EHRs for organizational or clinical evaluation capabilities than government nonfederal hospitals. Conclusion Hospitals using the single-vendor EHR system were more likely to engage in clinical care and organizational evaluation than hospitals using best-of-breed EHR systems.
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Affiliation(s)
- Hanadi Y Hamadi
- Department of Health Administration, University of North Florida, Jacksonville, FL
| | - Shehzad K Niazi
- Department of Psychiatry and Psychology, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL
| | - Mei Zhao
- Department of Health Administration, University of North Florida, Jacksonville, FL
| | - Aaron Spaulding
- Division of Health Care Delivery, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL
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Alrahbi DA, Khan M, Gupta S, Modgil S, Chiappetta Jabbour CJ. Challenges for developing health-care knowledge in the digital age. JOURNAL OF KNOWLEDGE MANAGEMENT 2020. [DOI: 10.1108/jkm-03-2020-0224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose
Health-care knowledge is dispersed among different departments in a health care organization, which makes it difficult at times to provide quality care services to patients. Therefore, this study aims to identify the main challenges in adopting health information technology (HIT).
Design/methodology/approach
This study surveyed 148 stakeholders in 4 key categories [patients, health-care providers, United Arab Emirates (UAE) citizens and foresight experts] to identify the challenges they face in adopting health care technologies. Responses were analyzed using exploratory (EFA) and confirmatory factor analysis (CFA).
Findings
EFA revealed four key latent factors predicting resistance to HIT adoption, namely, organizational strategy (ORGS); technical barriers; readiness for big data and the internet of things (IoT); and orientation (ORI). ORGS accounted for the greatest amount of variance. CFA indicated that readiness for big data and the IoT was only moderately correlated with HIT adoption, but the other three factors were strongly correlated. Specific items relating to cost, the effectiveness and usability of the technology and the organization were strongly correlated with HIT adoption. These results indicate that, in addition to financial considerations, effective HIT adoption requires ensuring that technologies will be easy to implement to ensure their long-term use.
Research limitations/implications
The results indicate that readiness for big data and the IoT-related infrastructure poses a challenge to HIT adoption in the UAE context. Respondents believed that the infrastructure of big data can be helpful in more efficiently storing and sharing health-care information. On the technological side, respondents felt that they may experience a steep learning curve. Regarding ORI, stakeholders expected many more such initiatives from health-care providers to make it more knowledge-specific and proactive.
Practical implications
This study has implications for knowledge management in the health -care sector for information technologies. The HIT can help firms in creating a knowledge eco-system, which is not possible in a dispersed knowledge environment. The utilization of the knowledge base that emerged from the practices and data can help the health care sector to set new standards of information flow and other clinical services such as monitoring the self-health condition. The HIT can further influence the actions of the pharmaceutical and medical device industry.
Originality/value
This paper highlights the challenges in HIT adoption and the most prominent factors. The conceptual model was empirically tested after the collection of primary data from the UAE using stakeholder theory.
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Fuller TE, Garabedian PM, Lemonias DP, Joyce E, Schnipper JL, Harry EM, Bates DW, Dalal AK, Benneyan JC. Assessing the cognitive and work load of an inpatient safety dashboard in the context of opioid management. APPLIED ERGONOMICS 2020; 85:103047. [PMID: 32174343 DOI: 10.1016/j.apergo.2020.103047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 12/19/2019] [Accepted: 01/09/2020] [Indexed: 06/10/2023]
Abstract
For health information technology to realize its potential to improve flow, care, and patient safety, applications should be intuitive to use and burden neutral for frontline clinicians. We assessed the impact of a patient safety dashboard on clinician cognitive and work load within a simulated information-seeking task for safe inpatient opioid medication management. Compared to use of an electronic health record for the same task, the dashboard was associated with significantly reduced time on task, mouse clicks, and mouse movement (each p < 0.001), with no significant increases in cognitive load nor task inaccuracy. Cognitive burden was higher for users with less experience, possibly partly attributable to usability issues identified during this study. Findings underscore the importance of assessing the usability, cognitive, and work load analysis during the design and implementation of health information technology applications.
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Affiliation(s)
- Theresa E Fuller
- Healthcare Systems Engineering Institute, Northeastern University, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA
| | | | - Demetri P Lemonias
- Healthcare Systems Engineering Institute, Northeastern University, Boston, MA, USA
| | - Erin Joyce
- Healthcare Systems Engineering Institute, Northeastern University, Boston, MA, USA
| | - Jeffrey L Schnipper
- Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Elizabeth M Harry
- Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - David W Bates
- Brigham and Women's Hospital, Boston, MA, USA; Partners Healthcare, Incorporated, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Anuj K Dalal
- Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - James C Benneyan
- Healthcare Systems Engineering Institute, Northeastern University, Boston, MA, USA; College of Engineering, Northeastern University, Boston, MA, USA.
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Abstract
Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient. Thus, it poses special challenges for measurement. In this paper, we discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. We highlight challenges and opportunities for developing potential measures of "diagnostic safety" related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, we propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety and call for these to be studied and further refined. This would enable safe diagnosis to become an organizational priority and facilitate quality improvement. Health-care systems should consider measurement and evaluation of diagnostic performance as essential to timely and accurate diagnosis and to the reduction of preventable diagnostic harm.
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Affiliation(s)
- Hardeep Singh
- From the Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Mark L. Graber
- RTI International, Raleigh-Durham, North Carolina
- SUNY Stony Brook School of Medicine, Stony Brook
- Society to Improve Diagnosis in Medicine, New York, New York
| | - Timothy P. Hofer
- VA Center for Clinical Management Research
- Department of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, Michigan
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McLachlan S, Dube K, Johnson O, Buchanan D, Potts HW, Gallagher T, Fenton N. A framework for analysing learning health systems: Are we removing the most impactful barriers? Learn Health Syst 2019; 3:e10189. [PMID: 31641685 PMCID: PMC6802533 DOI: 10.1002/lrh2.10189] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/01/2019] [Accepted: 03/05/2019] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Learning health systems (LHS) are one of the major computing advances in health care. However, no prior research has systematically analysed barriers and facilitators for LHS. This paper presents an investigation into the barriers, benefits, and facilitating factors for LHS in order to create a basis for their successful implementation and adoption. METHODS First, the ITPOSMO-BBF framework was developed based on the established ITPOSMO (information, technology, processes, objectives, staffing, management, and other factors) framework, extending it for analysing barriers, benefits, and facilitators. Second, the new framework was applied to LHS. RESULTS We found that LHS shares similar barriers and facilitators with electronic health records (EHR); in particular, most facilitator effort in implementing EHR and LHS goes towards barriers categorised as human factors, even though they were seen to carry fewer benefits. Barriers whose resolution would bring significant benefits in safety, quality, and health outcomes remain.LHS envisage constant generation of new clinical knowledge and practice based on the central role of collections of EHR. Once LHS are constructed and operational, they trigger new data streams into the EHR. So LHS and EHR have a symbiotic relationship. The implementation and adoption of EHRs have proved and continues to prove challenging, and there are many lessons for LHS arising from these challenges. CONCLUSIONS Successful adoption of LHS should take account of the framework proposed in this paper, especially with respect to its focus on removing barriers that have the most impact.
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Affiliation(s)
- Scott McLachlan
- Electrical Engineering and Computer ScienceQueen Mary University of LondonLondonUK
| | - Kudakwashe Dube
- Fundamental SciencesMassey UniversityPalmerston NorthNew Zealand
| | | | - Derek Buchanan
- Fundamental SciencesMassey UniversityPalmerston NorthNew Zealand
| | - Henry W.W. Potts
- Institute of Health InformaticsUniversity College LondonLondonUK
| | | | - Norman Fenton
- Electrical Engineering and Computer ScienceQueen Mary University of LondonLondonUK
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Kirkendall ES, Ni Y, Lingren T, Leonard M, Hall ES, Melton K. Data Challenges With Real-Time Safety Event Detection And Clinical Decision Support. J Med Internet Res 2019; 21:e13047. [PMID: 31120022 PMCID: PMC6549472 DOI: 10.2196/13047] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 03/04/2019] [Accepted: 04/05/2019] [Indexed: 12/03/2022] Open
Abstract
Background The continued digitization and maturation of health care information technology has made access to real-time data easier and feasible for more health care organizations. With this increased availability, the promise of using data to algorithmically detect health care–related events in real-time has become more of a reality. However, as more researchers and clinicians utilize real-time data delivery capabilities, it has become apparent that simply gaining access to the data is not a panacea, and some unique data challenges have emerged to the forefront in the process. Objective The aim of this viewpoint was to highlight some of the challenges that are germane to real-time processing of health care system–generated data and the accurate interpretation of the results. Methods Distinct challenges related to the use and processing of real-time data for safety event detection were compiled and reported by several informatics and clinical experts at a quaternary pediatric academic institution. The challenges were collated from the experiences of the researchers implementing real-time event detection on more than half a dozen distinct projects. The challenges have been presented in a challenge category-specific challenge-example format. Results In total, 8 major types of challenge categories were reported, with 13 specific challenges and 9 specific examples detailed to provide a context for the challenges. The examples reported are anchored to a specific project using medication order, medication administration record, and smart infusion pump data to detect discrepancies and errors between the 3 datasets. Conclusions The use of real-time data to drive safety event detection and clinical decision support is extremely powerful, but it presents its own set of challenges that include data quality and technical complexity. These challenges must be recognized and accommodated for if the full promise of accurate, real-time safety event clinical decision support is to be realized.
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Affiliation(s)
- Eric Steven Kirkendall
- Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States.,Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,James M Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Yizhao Ni
- Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Todd Lingren
- Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Matthew Leonard
- Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Eric S Hall
- Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States.,Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Kristin Melton
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, United States.,Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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Larsen E, Hoffman D, Rivera C, Kleiner BM, Wernz C, Ratwani RM. Continuing Patient Care during Electronic Health Record Downtime. Appl Clin Inform 2019; 10:495-504. [PMID: 31291677 PMCID: PMC6620179 DOI: 10.1055/s-0039-1692678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Electronic health record (EHR) downtime is any period during which the EHR system is fully or partially unavailable. These periods are operationally disruptive and pose risks to patients. EHR downtime has not sufficiently been studied in the literature, and most hospitals are not adequately prepared. OBJECTIVE The objective of this study was to assess the operational implications of downtime with a focus on the clinical laboratory, and to derive recommendations for improved downtime contingency planning. METHODS A hybrid qualitative-quantitative study based on historic performance data and semistructured interviews was performed at two mid-Atlantic hospitals. In the quantitative analysis, paper records from downtime events were analyzed and compared with normal operations. To enrich this quantitative analysis, interviews were conducted with 17 hospital employees, who had experienced several downtime events, including a hospital-wide EHR shutdown. RESULTS During downtime, laboratory testing results were delayed by an average of 62% compared with normal operation. However, the archival data were incomplete due to inconsistencies in the downtime paper records. The qualitative interview data confirmed that delays in laboratory result reporting are significant, and further uncovered that the delays are often due to improper procedural execution, and incomplete or incorrect documentation. Interviewees provided a variety of perspectives on the operational implications of downtime, and how to best address them. Based on these insights, recommendations for improved downtime contingency planning were derived, which provide a foundation to enhance Safety Assurance Factors for EHR Resilience guides. CONCLUSION This study documents the extent to which downtime events are disruptive to hospital operations. It further highlights the challenge of quantitatively assessing the implication of downtimes events, due to a lack of otherwise EHR-recorded data. Organizations that seek to improve and evaluate their downtime contingency plans need to find more effective methods to collect data during these times.
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Affiliation(s)
- Ethan Larsen
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas, United States
| | - Daniel Hoffman
- National Center for Human Factors in Healthcare, MedStar Health, Washington, District of Columbia, United States
| | - Carlos Rivera
- Department of Health Administration, Virginia Commonwealth University, Richmond, Virginia, United States
| | - Brian M. Kleiner
- Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, United States
| | - Christian Wernz
- Department of Health Administration, Virginia Commonwealth University, Richmond, Virginia, United States
| | - Raj M. Ratwani
- National Center for Human Factors in Healthcare, MedStar Health, Washington, District of Columbia, United States
- Department of Emergency Medicine, Georgetown University School of Medicine, Washington, District of Columbia, United States
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Exploring mobile working in healthcare: Clinical perspectives on transitioning to a mobile first culture of work. Int J Med Inform 2019; 125:96-101. [DOI: 10.1016/j.ijmedinf.2019.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 03/03/2019] [Accepted: 03/06/2019] [Indexed: 12/21/2022]
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Murphy DR, Meyer AN, Sittig DF, Meeks DW, Thomas EJ, Singh H. Application of electronic trigger tools to identify targets for improving diagnostic safety. BMJ Qual Saf 2019; 28:151-159. [PMID: 30291180 PMCID: PMC6365920 DOI: 10.1136/bmjqs-2018-008086] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/20/2018] [Accepted: 08/14/2018] [Indexed: 02/05/2023]
Abstract
Progress in reducing diagnostic errors remains slow partly due to poorly defined methods to identify errors, high-risk situations, and adverse events. Electronic trigger (e-trigger) tools, which mine vast amounts of patient data to identify signals indicative of a likely error or adverse event, offer a promising method to efficiently identify errors. The increasing amounts of longitudinal electronic data and maturing data warehousing techniques and infrastructure offer an unprecedented opportunity to implement new types of e-trigger tools that use algorithms to identify risks and events related to the diagnostic process. We present a knowledge discovery framework, the Safer Dx Trigger Tools Framework, that enables health systems to develop and implement e-trigger tools to identify and measure diagnostic errors using comprehensive electronic health record (EHR) data. Safer Dx e-trigger tools detect potential diagnostic events, allowing health systems to monitor event rates, study contributory factors and identify targets for improving diagnostic safety. In addition to promoting organisational learning, some e-triggers can monitor data prospectively and help identify patients at high-risk for a future adverse event, enabling clinicians, patients or safety personnel to take preventive actions proactively. Successful application of electronic algorithms requires health systems to invest in clinical informaticists, information technology professionals, patient safety professionals and clinicians, all of who work closely together to overcome development and implementation challenges. We outline key future research, including advances in natural language processing and machine learning, needed to improve effectiveness of e-triggers. Integrating diagnostic safety e-triggers in institutional patient safety strategies can accelerate progress in reducing preventable harm from diagnostic errors.
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Affiliation(s)
- Daniel R Murphy
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Ashley Nd Meyer
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Dean F Sittig
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, Texas, USA
- Department of Medicine, University of Texas-Memorial Hermann Center for Healthcare Quality and Safety, Houston, Texas, USA
| | - Derek W Meeks
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Eric J Thomas
- Department of Medicine, University of Texas-Memorial Hermann Center for Healthcare Quality and Safety, Houston, Texas, USA
| | - Hardeep Singh
- Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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A Systematic Review of Open Source Clinical Software on GitHub for Improving Software Reuse in Smart Healthcare. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9010150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The plethora of open source clinical software offers great reuse opportunities for developers to build clinical tools at lower cost and at a faster pace. However, the lack of research on open source clinical software poses a challenge for software reuse in clinical software development. This paper aims to help clinical developers better understand open source clinical software by conducting a thorough investigation of open source clinical software hosted on GitHub. We first developed a data pipeline that automatically collected and preprocessed GitHub data. Then, a deep analysis with several methods, such as statistical analysis, hypothesis testing, and topic modeling, was conducted to reveal the overall status and various characteristics of open source clinical software. There were 14,971 clinical-related GitHub repositories created during the last 10 years, with an average annual growth rate of 55%. Among them, 12,919 are open source clinical software. Our analysis unveiled a number of interesting findings: Popular open source clinical software in terms of the number of stars, most productive countries that contribute to the community, important factors that make an open source clinical software popular, and 10 main groups of open source clinical software. The results can assist both researchers and practitioners, especially newcomers, in understanding open source clinical software.
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Kraus JM, Lausser L, Kuhn P, Jobst F, Bock M, Halanke C, Hummel M, Heuschmann P, Kestler HA. Big data and precision medicine: challenges and strategies with healthcare data. INTERNATIONAL JOURNAL OF DATA SCIENCE AND ANALYTICS 2018. [DOI: 10.1007/s41060-018-0095-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Leveraging the electronic health record to improve quality and safety in rheumatology. Rheumatol Int 2017; 37:1603-1610. [PMID: 28852846 DOI: 10.1007/s00296-017-3804-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/17/2017] [Indexed: 12/13/2022]
Abstract
During the last two decades, improving the quality and safety of healthcare has become a focus in rheumatology. Widespread use of electronic health records (EHRs) and the availability of digital data have the potential to drive quality improvement, improve patient outcomes, and prevent adverse events. In the coming years, developing and leveraging tools within the EHR will be the key to making the next big strides in improving the health of patients with rheumatoid arthritis and other rheumatic diseases, including building EHR infrastructure to capture patient outcomes and developing automated methods to retrieve information from free text of clinical notes.
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Improving Diagnostic Safety in Primary Care by Unlocking Digital Data. Jt Comm J Qual Patient Saf 2017; 43:29-31. [PMID: 28334582 DOI: 10.1016/j.jcjq.2016.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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16
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Garlid AO, Polson JS, Garlid KD, Hermjakob H, Ping P. Equipping Physiologists with an Informatics Tool Chest: Toward an Integerated Mitochondrial Phenome. Handb Exp Pharmacol 2017; 240:377-401. [PMID: 27995389 DOI: 10.1007/164_2016_93] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Understanding the complex involvement of mitochondrial biology in disease development often requires the acquisition, analysis, and integration of large-scale molecular and phenotypic data. An increasing number of bioinformatics tools are currently employed to aid in mitochondrial investigations, most notably in predicting or corroborating the spatial and temporal dynamics of mitochondrial molecules, in retrieving structural data of mitochondrial components, and in aggregating as well as transforming mitochondrial centric biomedical knowledge. With the increasing prevalence of complex Big Data from omics experiments and clinical cohorts, informatics tools have become indispensable in our quest to understand mitochondrial physiology and pathology. Here we present an overview of the various informatics resources that are helping researchers explore this vital organelle and gain insights into its form, function, and dynamics.
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Affiliation(s)
- Anders Olav Garlid
- The NIH BD2K Center of Excellence in Biomedical Computing at UCLA, Department of Physiology, University of California, Los Angeles, CA, 90095, USA.
| | - Jennifer S Polson
- The NIH BD2K Center of Excellence in Biomedical Computing at UCLA, Department of Physiology, University of California, Los Angeles, CA, 90095, USA.
| | - Keith D Garlid
- The NIH BD2K Center of Excellence in Biomedical Computing at UCLA, Department of Physiology, University of California, Los Angeles, CA, 90095, USA
| | - Henning Hermjakob
- The NIH BD2K Center of Excellence in Biomedical Computing at UCLA, Department of Physiology, University of California, Los Angeles, CA, 90095, USA
- Molecular Systems Cluster, European Molecular Biology Laboratory-European Bioinformatics Institute (EMBL-EBI), Cambridge, UK
| | - Peipei Ping
- The NIH BD2K Center of Excellence in Biomedical Computing at UCLA, Departments of Physiology, Medicine, and Bioinformatics, University of California, Los Angeles, CA, 90095, USA
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