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Objectives: To develop, validate and implement algorithms to identify diabetic retinopathy (DR) cases and controls from electronic health care records (EHR)s. : We developed and validated EHR-based algorithms to identify DR cases and individuals with type I or II diabetes without DR (controls) in three independent EHR systems: Vanderbilt University Medical Center Synthetic Derivative (VUMC), the VA Northeast Ohio Healthcare System (VANEOHS), and Massachusetts General Brigham (MGB). Cases were required to meet one of three criteria: 1) two or more dates with any DR ICD-9/10 code documented in the EHR, or 2) at least one affirmative health-factor or EPIC code for DR along with an ICD9/10 code for DR on a different day, or 3) at least one ICD-9/10 code for any DR occurring within 24 hours of an ophthalmology exam.
View Article and Find Full Text PDFSoc Sci Med
April 2023
Department of Population Health Sciences, Geisinger, 100 North Academy Ave., Danville, PA, 17822, USA. Electronic address:
Current policy efforts to reduce health disparities focus on integrating patients' social determinants of health (SDHs) into their electronic health records (EHRs), with the goal of addressing both clinical and social risks through the health system. Yet clinicians' documentation of and engagement with patients' social characteristics may, in certain circumstances, actually contribute to health disparities. This paper compares accounts of clinical encounters from in-depth interviews with forty-six non-college-educated women against their EHR's codes and free-text notes, which document the clinician's perspective of the encounter.
View Article and Find Full Text PDFRes Nurs Health
October 2021
Rory Myers College of Nursing, New York University, New York, New York, USA.
Over a decade following the nationwide push to implement electronic health records (EHRs), the focus has shifted to addressing the cognitive burden associated with their use. Most research and discourse about the EHR's impact on clinicians' cognitive work has focused on physicians rather than on nursing-specific issues. Labor and delivery nurses may encounter unique challenges when using EHRs because they also interact with an electronic fetal monitoring system, continuously managing and synthesizing both maternal and fetal data.
View Article and Find Full Text PDFThe wide-scale adoption of electronic health records (EHR)s has increased the availability of routinely collected clinical data in electronic form that can be used to improve the reporting of quality of care. However, the bulk of information in the EHR is in unstructured form (e.g.
View Article and Find Full Text PDFJt Comm J Qual Patient Saf
September 2016
Keene Family Medicine.
Background: Transitions in care create challenges for warfarin management, including dosing errors, medication nonadherence, and/or insufficient monitoring. Adverse drug events from warfarin following transitions have been found to have serious consequences. Before the intervention, at the time of hospital discharge, individual physicians identified warfarin management plans on paper forms on the basis of their personal practice preferences.
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