Documentation of care is at risk of overtaking the delivery of care in terms of time, clinician focus, and perceived importance. The medical record as currently used for documentation contributes to increased cognitive workload, strained clinician-patient relationships, and burnout. We posit that a near verbatim transcript of the clinical encounter is neither feasible nor desirable, and that attempts to produce this exact recording are harmful to patients, clinicians, and the health system. In this Viewpoint, we focus on the alternative constructions of the medical record to bring them back to their primary purpose-to aid cognition, communicate, create a succinct account of care, and support longitudinal comprehensive care-thereby to support the building of relationships and medical decision making while decreasing workload.
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http://dx.doi.org/10.1016/S0140-6736(16)00338-X | DOI Listing |
BMC Public Health
January 2025
Department of Psychology, Comillas Pontifical University, Comillas, 3-5, Madrid, 28049, Spain.
Background: This study qualitatively investigates retirement-age adults' perspectives on engaging in health behaviors such as physical activity or a healthy diet, distinguishing facilitators, barriers, goals, and motivations (the two later in line with Self-Determination Theory).
Methods: Two clinical psychologists conducted four focus groups with Spanish adults around retirement age. We conducted inductive and deductive content analysis.
BMC Med Inform Decis Mak
January 2025
Great Ormond Street Institute of Child Health, University College London, London, UK.
Introduction: Unsupervised feature learning methods inspired by natural language processing (NLP) models are capable of constructing patient-specific features from longitudinal Electronic Health Records (EHR).
Design: We applied document embedding algorithms to real-world paediatric intensive care (PICU) EHR data to extract patient-specific features from 1853 patients' PICU journeys using 647 unique lab tests and medication events. We evaluated the clinical utility of the patient features via a K-means clustering analysis.
BMC Public Health
January 2025
Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), Department of Veteran Affairs (VA) Greater Los Angeles, Los Angeles, CA, USA.
Background: Permanent supportive housing (PSH) is an evidence-based practice for reducing homelessness that subsidizes permanent, independent housing and provides case management-including linkages to health services. Substance use disorders (SUDs) are common contributing factors towards premature, unwanted ("negative") PSH exits; little is known about racial/ethnic differences in negative PSH exits among residents with SUDs. Within the nation's largest PSH program at the Department of Veterans Affairs (VA), we examined relationships among SUDs and negative PSH exits (for up to five years post-PSH move-in) across racial/ethnic subgroups.
View Article and Find Full Text PDFBackground: The proportion of people living with HIV (PLHIV) in Guangxi who are men who have sex with men (MSM) increased rapidly to nearly 10% in 2023; notably, over 95% of this particular population is currently receiving antiretroviral therapy (ART). This study aimed to describe the survival of MSM PLHIV, depict the characteristics and trends of changes in CD4 T cell counts, CD4/CD8 T cell ratio, and viral load, and explore immunological indicators that may be related to mortality during different stages of treatment.
Methods: Immunological indicators of MSM PLHIV receiving ART were extracted and categorized into baseline, mid-treatment, and last values.
BMC Cardiovasc Disord
January 2025
Nanhai Family Practice Hospital, Foshan, Guangdong, 528200, People's Republic of China.
Background: Heart failure (HF) patients admitted to the intensive care unit (ICU) often face high short-term mortality rates. This study aims to investigate the relationship between lactate dehydrogenase (LDH) levels and all-cause mortality in critically ill patients with HF.
Methods: Data from the MIMIC-IV database were extracted for subjects eligible for HF diagnosis.
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