The Growing Gap in Electronic Medical Record Satisfaction Between Clinicians and Information Technology Professionals: Issues of Most Concern and Suggested Remediations.

Background: With the alarming statistics concerning the quality of national health care, it is hoped that electronic health records (EHRs) will reduce inefficiencies associated with medical delivery and improve patient safety. This study reports the results of a survey that demonstrates a pattern in EHR system implementation that indicates that health-care information technology decisions are based more on the preferences of information technology professionals (ITPs) and hospital administrators than clinicians.

Methods: We present survey data highlighting the growing discrepancy in EHR-related satisfaction between clinicians and ITPs.

Managing Diabetes in Pregnancy Using Cell Phone/Internet Technology.

In Brief For pregnant women with diabetes, using cell phone/Internet technology to track and report self-monitoring of blood glucose results improves compliance and satisfaction compared to using the more traditional methods of log books, telephone calls, and voicemail messages.

Guiding health care transformation: A next-generation, diagnostic remediation tool for leveraging polarities.

Background: Health care reform is optimized through the Polarity Thinking Model to achieve and sustain improvements in cost, safety, quality, and efficiency. Traditional problem-solving "fix-it" approaches have histories of inadequacy and failure in addressing the multiple polarities inherent in health care transformation. The Polarity Thinking Model is reviewed followed by a study conducted to establish validity and reliability for diagnostic assessment and remediation through leveraging polarities.

Utility of computed tomography arthrograms in evaluating osteochondral allograft transplants of the distal femur.

Postsurgical evaluation of osteochondral allograft transplant surgery (OATS) of the distal femur most commonly utilizes radiographs or magnetic resonance imaging. This article proposes the utilization of computed tomography (CT) arthrography as an additional option, which allows clear assessment of articular congruity and osseous integration. A retrospective review was performed of 18 patients who underwent an OATS for distal femoral chondral lesions and obtained CT arthrograms postoperatively.

Complications Associated With High-dose Corticosteroid Administration in Children With Spinal Cord Injury.

Background: Complications with high-dose steroid administration for spinal cord injury are documented in adult patients. Our purpose was to determine the incidence of early complications of this therapy in pediatric patients with spinal cord injuries.

Methods: An IRB-approved retrospective review was performed for patients treated for spinal cord injury at a level 1 pediatric trauma center between 2003 and 2011.

High frequency of posterior and combined shoulder instability in young active patients.

Objective: The purpose of this study was to describe the epidemiology and demographics of surgically treated shoulder instability stratified by direction. We hypothesized that there would be an increased frequency of posterior and combined shoulder instability in our population compared with published literature. Secondarily, we assessed preoperative magnetic resonance imaging (MRI) reports to determine how accurately they detected the pathology addressed at surgery.

Rates of bacteriuria in laboring women with epidural analgesia: continuous vs intermittent bladder catheterization.

Objective: The purpose of this study was to compare the rates of bacteriuria in laboring women with epidural analgesia with the use of intermittent bladder catheterization (IC) vs continuous indwelling Foley catheterization (CIF).

Study Design: We conducted a randomized, nonblinded trial in which 160 laboring women received IC or CIF. An initial catheterized urine culture was taken at the time of epidural placement.

Physician adoption of personal digital assistants (PDA): testing its determinants within a structural equation model.

Research has begun to explore the determinants of personal digital assistant (PDA) adoption in health care. Much of this research has, however, been inconsistent in its treatment of key constructs and its methodological approaches. The current study takes a stricter approach and tracks the pre- and postadoption beliefs of physicians provided with an actual PDA within a single health care facility in the United States.

Patterns and changes in prescriber attitudes toward PDA prescription-assistive technology.

Context: Medication error prevention is a priority for the U.S. healthcare system in the 21st century.

A search for the "Holy Grail" of health care: a correlation between quality and profitability.

In a study by CHRISTUS Health, data from 18 acute care facilities revealed that numerous indicators of clinical quality were significantly correlated with measures of business success. Results suggest that timely and appropriate interventions, coupled with timely and complete documentation, are correlated with improved business performance. The correlations between quality and financial performance make intuitive sense based on the observation that diligence in clinical processes can produce better information to support financial processes.

Antepartum seafood consumption and mercury levels in newborn cord blood.

Objective: The purpose of this study was to determine the level of fetal mercury exposure by measuring mercury levels in newborn cord blood and to analyze the association with fish consumption during pregnancy.

Study Design: A total of 308 women who met the eligibility criteria were enrolled in the study. Of these, 275 women completed a dietary survey; after delivery, cord blood was collected and analyzed for mercury levels.

Duration of patency of laser-assisted tympanic membrane fenestration.

Background: Laser-assisted tympanic membrane fenestration (LTMF) provides intermediate-duration middle ear ventilation, which benefits selected children with acute otitis media (AOM) and otitis media with effusion (OME).

Objective: To evaluate clinical and technical factors that may affect duration of LTMF patency.

Design: Prospective clinical cohort effectiveness trial.