Biomedical subjects

Sidney N Thornton

Publications and source records attributed to Sidney N Thornton.

6 recordsLinked to original sources

PubMed2005

Physician use of electronic medical records: issues and successes with direct data entry and physician productivity.

At Intermountain Health Care, we evaluated whether physicians in an ambulatory setting will voluntarily choose to enter data directly into an electronic health record (EHR). In this paper we describe the benefits of an EHR, as they exist in the current IHC application and the ways in which we have sought to minimize obstacles to physician data entry. Currently, of 472 IHC employed physicians, 321 (68%) routinely enter some data directly into the EHR without coercion. Twenty-five percent (80/321) of the physicians use voice recognition for some data entry. Twelve of our 95 ambulatory clinics have voluntarily adopted measures to eliminate paper charts. Of the 212 physicians who entered data in 2004, sixty-nine physicians (22%) increased their level of data entry, while 12 (6%) decreased. We conclude that physicians will voluntarily adopt an EHR system, and will continue and even increase use after implementation barriers are addressed.

Ambulatory Care Information Systems↗

PubMed2005

Use and impact of a computer-generated patient summary worksheet for primary care.

Advanced clinical information systems have been proposed to improve patient care in terms of safety, effectiveness, and efficiency. In order to be effective, such systems require detailed patient-specific clinical information in a form easily reviewed by clinicians. We have developed a patient summary worksheet for use in outpatient clinics, which presents a structured overview of patient health information. The worksheet provides patient demographic information, specific problems and conditions, the patient's current medication profile, laboratory test results pertinent to patient problems, and disease-specific or preventive care actionable advisories. Usage has grown from a few hundred to over 25,000 unique patients per month during a two-year period. Diabetic patients for whom the worksheet is accessed are significantly more likely to be in compliance with accepted testing regimens for glycosolated hemoglobin (OR 1.47, 95% CI 1.28, 1.61).

Ambulatory Care Facilities↗

PubMed2005

Aiding clinicians through summarization of perinatal data.

Exploratory analysis has focused on developing summarized views of monitor-captured perinatal data to support adherence to established clinical protocols. In addition to facilitating rapid access to significant clinical trends and reducing subjective interpretation of monitor-captured data, combining data summaries with traditional monitor review may assist in the anticipation of complications.

Cardiotocography↗

PubMed2005

Reducing duplicate patient creation using a probabilistic matching algorithm in an open-access community data sharing environment.

In an open-access community data sharing environment, Intermountain Health Care (IHC) is managing the creation of duplicate patient records through a probabilistic matching algorithm that allows the threshold limits for the returned set to be dynamically assigned to the source system. For internal hospital systems, the rate of duplicate creation was cut 30% in the first 6 months. For IHC's first community data sharing partner, the rate of duplicate creation has been maintained below the acceptable range for the internal Health Plans rate.

Algorithms↗

PubMed2004

Integration challenges of clinical information systems developed without a shared data dictionary.

Legacy systems have proven to be long-term integration challenges for Intermountain Health Care (IHC) despite commitment and attention to share clinical information across settings and among clinicians. This study measures the extent of the disparity of data elements across three independent data systems in current use. A sample of relevant data elements was selected across systems covering prenatal, labor and delivery, and newborn intensive care units (NICU). The findings revealed only 17% of these sample data elements had compatible structure across all three systems. The implications from differences in granularity, missing data, and duplicate data entry, include diminished data quality, greater risk for medical error, increased costs of integration and inefficient use of clinician time. Retrospective guidelines for managing conceptual context and granularity are given to assist in designing an integrated longitudinal patient electronic medical record.

Delivery of Health Care, Integrated↗

PubMed2002

Using point of service clinical documentation to reduce variability in charge capture.

Data collected at bedside to document patient care can also be used to generate an itemized summary of charges including activity-based clinician charges. This approach becomes advantageous when the charge capture operation is transparent to the clinician who would otherwise have to review the care documentation, recall the appropriate charging rules, and exercise discretion in capturing charges. Documented procedures and supplies convert directly into patient charge rules. Documented patient care is more difficult to translate into activity-based charges because nursing care can vary in intensity and duration depending on the patient's needs. The problem can be overcome by embedding time or data-driven logic into the charging rules. Using this approach in the labor and delivery units of 7 IHC hospitals (114 beds), we generated consistent charge summaries. We improved the accuracy of patient charges from 65% to over 98% of our charge summaries having no missed charges.

Algorithms↗