Browsing by Subject "EMR"

Now showing 1 - 4 of 4
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    Indianapolis Emergency Medical Service and the Indiana Network for Patient Care: Evaluating the Patient Match Process
    (2014-01-03) Park, Seong Cheol; Finnell, John T.; Jones, Josette F.; Kharrazi, Hadi
    In 2009, Indianapolis Emergency Medical Service (I-EMS, formerly Wishard Ambulance Service) launched an electronic medical record system within their ambulances and started to exchange patient data with the Indiana Network for Patient Care (INPC). This unique system allows EMS personnel in an ambulance to get important medical information prior to the patient’s arrival to the accepting hospital from incident scene. In this retrospective cohort study, we found EMS personnel made 3,021 patient data requests (14%) of 21,215 EMS transports during a one-year period, with a “success” match rate of 46%, and a match “failure” rate of 17%. The three major factors for causing match “failure” were (1) ZIP code 55%, (2) Patient Name 22%, and (3) Birth Date 12%. This study shows that the ZIP code is not a robust identifier in the patient identification process and Non-ZIP code identifiers may be a better choice due to inaccuracies and changes of the ZIP code in a patient’s record.
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    Leveraging electronic tablets for general pediatric care: a pilot study
    (Schattauer, 2015) Anand, V.; McKee, S.; Dugan, T. M.; Downs, S. M.; Department of Pediatrics, IU School of Medicine
    BACKGROUND: We have previously shown that a scan-able paper based interface linked to a computerized clinical decision support system (CDSS) can effectively screen patients in pediatric waiting rooms and support the physician using evidence based care guidelines at the time of clinical encounter. However, the use of scan-able paper based interface has many inherent limitations including lacking real time communication with the CDSS and being prone to human and system errors. An electronic tablet based user interface can not only overcome these limitations, but may also support advanced functionality for clinical and research use. However, use of such devices for pediatric care is not well studied in clinical settings. OBJECTIVE: In this pilot study, we enhance our pediatric CDSS with an electronic tablet based user interface and evaluate it for usability as well as for changes in patient questionnaire completion rates. METHODS: Child Health Improvement through Computers Leveraging Electronic Tablets or CHICLET is an electronic tablet based user interface. It is developed to augment the existing scan-able paper interface to our CDSS. For the purposes of this study, we deployed CHICLET in one outpatient pediatric clinic. Usability factors for CHICLET were evaluated via caregiver and staff surveys. RESULTS: When compared to the scan-able paper based interface, we observed an 18% increase or 30% relative increase in question completion rates using CHICLET. This difference was statistically significant. Caregivers and staff survey results were positive for using CHICLET in clinical environment. CONCLUSIONS: Electronic tablets are a viable interface for capturing patient self-report in pediatric waiting rooms. We further hypothesize that the use of electronic tablet based interfaces will drive advances in computerized clinical decision support and create opportunities for patient engagement.
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    OpenMRS as an emergency EMR—How we used a global good to create an emergency EMR in a week
    (Elsevier, 2021) Mamlin, Burke W.; Shivers, Jennifer E.; Glober, Nancy K.; Dick, Jonathan J.; Medicine, School of Medicine
    Background: As the coronavirus pandemic progressed through the United States, Indianapolis Emergency Medical Services (IEMS) identified a gap between the health system capacity and the projected need to support an overwhelmed health care system. In addressing emergencies or special cases, each medical institution in a metropolitan area typically has a siloed process for capturing emergency patient records. These approaches vary in technical capabilities and may include use of an electronic medical record system (EMR) or a hybrid paper/EMR process. Given the projected volume of patients for the COVID-19 pandemic and the proposed multi-institutional team approach needed in case of significant provider illness, IEMS sought a simple, efficient, consolidated EMR solution to support planning for the potential capacity gap. IEMS approached Regenstrief Institute (RI), an established partner with experience in supporting OpenMRS, a global good EMR platform that had been deployed in multiple settings globally. Objective: The purpose of this project was to determine if OpenMRS, a global good, could be used to quickly stand up a system that would meet the needs for health emergency data collection and reporting. Design and implementation methods: The team used an "all hands on deck" approach, bringing together technical and subject matter experts, and a human-centered and iterative process to ensure the system met the key needs of IEMS. The OpenMRS Reference Application was adapted to the specific need and deployed as Docker containers to servers within the Indiana Health Information Exchange. Project outcomes and lessons learned: In less than two weeks, the Regenstrief team was able to install, configure and set up a working version of OpenMRS to support the desired electronic record requirements for the IEMS disaster field clinics. Using a human-centered approach, the RI team developed, tested, and released a user-friendly, installation-ready solution complete with an end user manual and a base support plan. IEMS and RI are sharing this approach to demonstrate how a global good can quickly generate a solution for COVID-19 and other disaster responses. Conclusions: Open source global goods can rapidly be adapted to meet local needs in an emergency. OpenMRS can be adapted to meet the needs of basic emergency medical services registration, triage, and basic data collection.
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    Short cap technique to complete EMR of very flat colorectal laterally spreading tumors
    (Elsevier, 2017-07-18) Parsa, Nasim; Rex, Douglas K.; Medicine, School of Medicine
    We demonstrate the utility of a short cap placed over the colonoscope tip to facilitate EMR of very flat portions of laterally spreading tumors (LSTs) (Fig. 1A). Snare resection is preferred over ablative techniques for the removal of very flat portions that resist snaring. Snaring of very flat portions is often frustrating because even a stiff snare may slide over the very flat tissue.