Browsing by Subject "Clinical documentation"

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    National Network of Depression Centers' Recommendations on Harmonizing Clinical Documentation of Electroconvulsive Therapy
    (Wolters Kluwer, 2022) Zandi, Peter P.; Morreale, Michael; Reti, Irving M.; Maixner, Daniel F.; McDonald, William M.; Patel, Paresh D.; Achtyes, Eric; Bhati, Mahendra T.; Carr, Brent R.; Conroy, Susan K.; Cristancho, Mario; Dubin, Marc J.; Francis, Andrew; Glazer, Kara; Ingram, Wendy; Khurshid, Khurshid; McClintock, Shawn M.; Pinjari, Omar F.; Reeves, Kevin; Rodriguez, Nelson F.; Sampson, Shirlene; Seiner, Stephen J.; Selek, Salih; Sheline, Yvette; Smetana, Roy W.; Soda, Takahiro; Trapp, Nicholas T.; Wright, Jesse H.; Husain, Mustafa; Weiner, Richard D.; Psychiatry, School of Medicine
    Electroconvulsive therapy (ECT) is a highly therapeutic and cost-effective treatment for severe and/or treatment-resistant major depression. However, because of the varied clinical practices, there is a great deal of heterogeneity in how ECT is delivered and documented. This represents both an opportunity to study how differences in implementation influence clinical outcomes and a challenge for carrying out coordinated quality improvement and research efforts across multiple ECT centers. The National Network of Depression Centers, a consortium of 26+ US academic medical centers of excellence providing care for patients with mood disorders, formed a task group with the goals of promoting best clinical practices for the delivery of ECT and to facilitate large-scale, multisite quality improvement and research to advance more effective and safe use of this treatment modality. The National Network of Depression Centers Task Group on ECT set out to define best practices for harmonizing the clinical documentation of ECT across treatment centers to promote clinical interoperability and facilitate a nationwide collaboration that would enable multisite quality improvement and longitudinal research in real-world settings. This article reports on the work of this effort. It focuses on the use of ECT for major depressive disorder, which accounts for the majority of ECT referrals in most countries. However, most of the recommendations on clinical documentation proposed herein will be applicable to the use of ECT for any of its indications.
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    You and me and the computer makes three: variations in exam room use of the electronic health record
    (Oxford University Press, 2014-02) Saleem, Jason J.; Flanagan, Mindy E.; Russ, Alissa L.; McMullen, Carmit K.; Elli, Leora; Russell, Scott A.; Bennett, Katelyn J.; Matthias, Marianne S.; Rehman, Shakaib U.; Schwartz, Mark D.; Frankel, Richard M.; Medicine, School of Medicine
    Challenges persist on how to effectively integrate the electronic health record (EHR) into patient visits and clinical workflow, while maintaining patient-centered care. Our goal was to identify variations in, barriers to, and facilitators of the use of the US Department of Veterans Affairs (VA) EHR in ambulatory care workflow in order better to understand how to integrate the EHR into clinical work. We observed and interviewed 20 ambulatory care providers across three geographically distinct VA medical centers. Analysis revealed several variations in, associated barriers to, and facilitators of EHR use corresponding to different units of analysis: computer interface, team coordination/workflow, and organizational. We discuss our findings in the context of different units of analysis and connect variations in EHR use to various barriers and facilitators. Findings from this study may help inform the design of the next generation of EHRs for the VA and other healthcare systems.