Publications by authors named "Jon E Puro"
Prevalence of Select New Symptoms and Conditions Among Persons Aged Younger Than 20 Years and 20 Years or Older at 31 to 150 Days After Testing Positive or Negative for SARS-CoV-2.
JAMA Netw Open
February 2022
Importance: New symptoms and conditions can develop following SARS-CoV-2 infection. Whether they occur more frequently among persons with SARS-CoV-2 infection compared with those without is unclear.
Objective: To compare the prevalence of new diagnoses of select symptoms and conditions between 31 and 150 days after testing among persons who tested positive vs negative for SARS-CoV-2.
Objective: To describe PCORnet, a clinical research network developed for patient-centered outcomes research on a national scale.
Study Design And Setting: Descriptive study of the current state and future directions for PCORnet. We conducted cross-sectional analyses of the health systems and patient populations of the 9 Clinical Research Networks and 2 Health Plan Research Networks that are part of PCORnet.
Introduction: Brief smoking-cessation interventions in primary care settings are effective, but delivery of these services remains low. The Centers for Medicare and Medicaid Services' Meaningful Use (MU) of Electronic Health Record (EHR) Incentive Program could increase rates of smoking assessment and cessation assistance among vulnerable populations. This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 MU implementation.
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- The CER Hub is a web-based platform designed for comparative effectiveness research that enables the integration of electronic health data from various organizations with different EHR systems.
- It processes both free-text and coded clinical data, while offering standardized access and a library of tools for researchers to develop specific applications.
- The platform is currently utilized in studies assessing asthma medication effectiveness and smoking cessation services in diverse healthcare settings, demonstrating its capability to handle complex, multi-institutional clinical data.
Article Synopsis
- This study tracked changes in tobacco use over 4 years among patients in six diverse health care organizations, using electronic medical records.
- Out of 34,393 smokers identified in 2007, 38.6% quit smoking at least once, with 15.4% remaining smoke-free for over a year by the end of the fourth year.
- Factors that increased long-term quitting included being older, or having certain health diagnoses, while female gender and being black or non-Hispanic were linked to lower quitting rates.
Article Synopsis
- Comparative effectiveness research (CER) requires high-quality data from diverse electronic health record (EHR) systems, and uniformity in this data is critical for accurate study outcomes.
- The CER Hub developed a quality assurance (QA) process using the 'emrAdapter' tool, which conducts quality checks on primary care encounter records and reports data issues for local fixes.
- After implementing the QA process across six health systems, data quality significantly improved over three iterations, addressing issues such as incomplete mapping of local EHR data to a standardized framework.
Article Synopsis
- The study evaluates how well physicians provide smoking cessation services, specifically using the 5 As approach, to current smokers across different health systems, gender, and age groups.
- About half of the smokers received advice to quit, while fewer were assessed for readiness or provided with follow-up support, indicating gaps in smoking cessation efforts.
- Results showed significant differences in how the 5 As were documented depending on the health system, while no notable differences were found based on gender, suggesting a need for improved protocols for better patient support.*
Objectives: To assess the performance of a health information technology platform that enables automated measurement of asthma care quality using comprehensive electronic medical record (EMR) data, including providers' free-text notes.
Study Design: Retrospective data study of outpatient asthma care in Kaiser Permanente Northwest (KPNW), a midsized health maintenance organization (HMO), and OCHIN, Inc, a group of Federally Qualified Health Centers.
Methods: We created 22 automated quality measures addressing guideline-recommended outpatient asthma care.
Background: Patients receive care in safety net clinics regardless of insurance status; however, receipt of diabetes preventive care might vary among patients with differing levels of insurance continuity.
Methods: In a retrospective cohort study, using electronic health record data from adults with diabetes who were receiving care in 50 safety net clinics in Oregon in 2005 to 2007, we conducted adjusted logistic regressions to model the associations between amount of time with insurance and rates of receipt of lipid screening, influenza vaccination, nephropathy screening (urine microalbumin), and HbA1c (glycohemoglobin) screening.
Results: Of 3384 adults with diabetes, 711 were partially insured (covered 1% to 99% of the 3-year study period), 909 had no coverage, and 1764 were continuously insured.