The impact of electronic health records on people with diabetes in three different emergency departments.

Objective: To evaluate if electronic health records (EHR) with prior clinical information have observable effects for patients with diabetes presenting to emergency departments (ED), we examined measures of quality and resource utilization.

Materials And Methods: Retrospective observational studies of patients in three ED (A=5510; B=4393; C=3324) were conducted comparing patients with prior information in the EHR to those without such information. Differences with respect to hospitalization, mortality, length of stay (LOS), and numbers of ED orders for tests, procedures and medications were examined after adjusting for age, gender, race, marital status, comorbidities and for acuity level within each ED.

The impact of electronic health records on care of heart failure patients in the emergency room.

Objective: To evaluate if electronic health records (EHR) have observable effects on care outcomes, we examined quality and efficiency measures for patients presenting to emergency departments (ED).

Materials And Methods: We conducted a retrospective study of 5166 adults with heart failure in three metropolitan EDs. Patients were termed internal if prior information was in the EHR upon ED presentation, otherwise external.

Impact of prior clinical information in an EHR on care outcomes of emergency patients.

A patient's prior clinical information available electronically can be helpful during the care process, particularly in the emergency department (ED). The effect of such information on quality and efficiency of ED patient care has not been adequately studied. This study uses secondary data to investigate its impact on surrogate measures of care quality and efficiency among 6,143 congestive heart failure, diabetic, and asthmatic patients in 3 EDs.

Emergency room providers' perceptions of MyChart's My Emergency Data: findings from a focus group study.

My Emergency Data (MED), a one-page clinical abstract, has been implemented as the first phase of a health information exchange (HIE) project across three healthcare systems. This study presents findings from one of a series of focus groups of emergency room (ER) providers' perceptions of MED. Barriers to using MED in the ER are identified and recommendations for improved utilization are provided.

Linking patients' records across organizations while maintaining anonymity.

In an health information exchange (HIE) project, linking patients' health records across organizations while maintaining appropriate patients anonymity is essential. Anonymous identifiers created from various combinations of personal identifiers using one way encryption function were evaluated for linkage quality between two synthesized databases. Preliminary results show that such anonymous identifiers (IDs) based on date of birth, zip code and last name or first name can link records with high specificity and sensitivity.

Synthesis of a database test bed for evaluating record linkage algorithms.

Record linkage algorithm development is a challenging task requiring large databases representative of a target population. As part of an evaluation of a health information exchange project we had the need for a linking algorithm that would not pass protected health information among organizations. We synthesized a test bed for this purpose employing a randomization process and incorporating conditions that represent the study population and possible error generating conditions in real world electronic record systems.

Personal digital assistant-enabled report content knowledgebase results in more complete pathology reports and enhances resident learning.

We developed a personal digital assistant-based knowledgebase of surgical pathology report content recommendations and performed an experimental trial to test if the knowledgebase improved report completeness. The 15 experimental group and 13 control group residents were given microscope slides and corresponding reports with the final diagnosis section blanked-out, and were asked to complete the final diagnosis section during 3 study episodes (T0, T1, and T2). At T0 (baseline), experimental group and control group produced reports of comparable completeness.

Optimization of laser capture microdissection and RNA amplification for gene expression profiling of prostate cancer.

Background: To discover prostate cancer biomarkers, we profiled gene expression in benign and malignant cells laser capture microdissected (LCM) from prostate tissues and metastatic prostatic adenocarcinomas. Here we present methods developed, optimized, and validated to obtain high quality gene expression data.

Results: RNase inhibitor was included in solutions used to stain frozen tissue sections for LCM, which improved RNA quality significantly.

Evaluation of the implementation of an electronic medical record.

University of Minnesota Physicians, the faculty clinical practice organization of the Medical School, is implementing an Electronic Medical Record (EMR). During this process, we anticipated the need for an evaluative study of the implementation to examine process and satisfaction. This was in order to monitor the ability of the physicians to use the EMR effectively.

Using Web technologies for implementing testing strategies.

Although the application of Web technologies to laboratory services is relatively new, it is evolving rapidly and presents both promises and challenges to those adopting it for test strategy deployment. Its application can be helpful in disseminating information about a testing strategy once it is formulated, but it's more important potential contribution is in facilitating clinicians' use of the strategy. There is an array of ways Web technologies can be used to facilitate both the initiation of a strategy at the point of order entry and ensuring optimal use of the laboratory results that emanate from a testing strategy.