Difference between revisions of "Main Page"

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'''Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System'''
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=The Clinical Informatics Wiki -- Clinfowiki=
  
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The Clinical Informatics Wiki is an implementation of a [http://en.wikipedia.org/wiki/Wiki wiki] devoted to topics in clinical informatics. To begin a new article, or edit an existing article, you must first create an account and login to the ClinfoWiki.
  
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Based upon the report by Institute of Medicine and safety initiatives promoted by Leapfrog group, the Department of Critical care Medicine, University of Pittsburg School Of Medicine, Pittsburg, PA, implemented a commercially sold computerized physician order entry (CPOE) systems. Accordingly, the attempt was an effort to reduce medical errors and mortality rate. The idea behind the implementation was to test the hypothesis that CPOE results in the reduction of mortality rate among children who are transported for specialized care. The method employed was, gathering demographic, clinical, and mortality of all children that were admitted via interfacility transport to the authors’ children’s hospital for a period of 18 months. According to the authors, a commercially purchased CPOE was used during the time frame in general and medical-surgical operations. The implementation of the software was completed in six days. Retrospective analysis of pre-CPOE (15 months) and post-CPOE implementation was done on 1942 children.
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Please see [http://meta.wikipedia.org/wiki/MediaWiki_i18n documentation on customizing the interface]
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and the [http://meta.wikipedia.org/wiki/MediaWiki_User's_Guide User's Guide] for usage and configuration help.
  
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The authors claimed that 75 children, among the 1942 who were referred for specialized care during the study period, which result in 3.86%. Analysis revealed that the mortality rate increased significantly from 2.80 % (39 of 1394) before the CPOE implementation to 6.57% (36 of 548) after CPOE. With respect to the observations of the authors, they conclude that there the unexpected increase in mortality and the implementation of the CPOE seem to be coincidental. Accordingly, while the CPOE holds great promise, the authors advise that, when implementing CPOE, systems, institutions should continue to evaluate mortality effects, in addition to medical error rates for “children who are dependent on time-sensitive therapies.”
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You can test your edits as much as you want in the [http://en.wikipedia.org/wiki/Wikipedia:Sandbox Sandbox].
  
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''Comment: The authors did not totally disagree with the findings of those who were promoting the efficacy of CPOE in clinical settings. It appears that their observations could be prone to errors as well. Moreover, the environment in which the examination was made could not be representatives of the total environment in which CPOE systems have been implemented. The unexpected increase in the mortality rate of the patients could also be attributed to the time of the sickness or the degree of illness of the patients involved. Moreover, the authors did not indicate any demonstrable bias against or for the use of CPOE by the clinicians. And this could also be a factor in not using the systems efficiently, which could have had impact on the clinicians’ job performances. Are all these clinicians computer literate? That question was not answered. Therefore, further studies are needed to justify the efficacy of CPOE. –GB Abimbola''
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[[Special:Listusers|We]] are currently working on [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles, and we [[JFWiki:To Do|need your help]] to complete this study of Clinical Informatics. See [[Special:Statistics]] for more complete information on the site.
  
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Young Y. Han, Joseph A. Carcillo, Shekhar T. Venkataraman, Robert S.B. Clark, R. Scott Watson, Trung C. Nguyen, Hulya Bayir and Richard A.Orr
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==Electronic Medical Record (EMR) Systems== see [[EMR]]
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Pediatrics 2005;116;1506-1512
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DOI: 10.1542/peds.2005-1287
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==Computer-based Provider Order Entry -- CPOE== see [[CPOE]]
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==Clinical Decision Support -- CDS== see [[CDS]]
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==Personal Health Records -- PHRs== see [[PHR]]
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==Blueprint for a Comprehensive HIT System==
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*[http://wellness.wikispaces.com/Tactic+-+Use+Evolving+Health+Information+Technology+Tools Introducing new categories of HIT tools, which compliment the ones above]
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*[http://wellness.wikispaces.com/Blueprint+for+an+Integrated+HIT+system+-+The+Patient+Life-Cycle+Wellness+System Blueprint for an Integrated HIT system]
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==Biobanking -- a.k.a. Biorepositories or Tissue Banks == see [[BioBanking]]
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==Regional Health Information Organizations -- RHIOs== see [[RHIO]]
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==Evidence-Based Medicine -- EBM== see [[EBM]]
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==U.S. Federal Health Information Technology Initiatives==
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*'''[[Assistant Secretary for Planning & Evaluation]]'''
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*'''[[Office of the National Coordinator for Health Information Technology (ONC)]]'''
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*'''[[Council on the Application of Health Information Technology (CAHIT)]]'''
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*'''[[Agency for Healthcare Research and Quality (AHRQ)]]'''
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*'''[[Centers for Medicare and Medicaid Services (CMS)]]'''
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*'''[[U.S. Food and Drug Administration (FDA)]]'''
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*'''[[National Institutes of Health (NIH)]]'''
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*'''[[Indian Health Service (IHS)]]'''
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*'''[[Health Services and Resource Administration (HRSA)]]'''
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*'''[[Centers for Disease Control and Prevention (CDC)]]'''
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*'''[[U.S. Department of Commerce]]'''
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*'''[[Combined U.S. Department of Defense / Veterans Affairs Initiatives]]'''
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*'''[[U.S. Department of Defense (DoD) Initiatives]]'''
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*'''[[Department of Veterans Affairs Initiatives]]'''
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*'''[[U.S. Department of Homeland Security]]'''
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==The E-Patient-Provider Relationship==
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*'''[[SMS, Blogs and the Patient-Provider Relationship: Enhancing Communication, Improving Treatment Outcomes]]'''
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==International views==
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* '''[[Purpose and overview]]'''
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* '''[[UK]]'''
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==Blogposium, April 2006==
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The Blogposium, held from April 18-20, was an innovation in collaborative blogging and wiki building.
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The effort marshalled the expertise and energy of several dozen health bloggers and volunteers to expand and refine this Clinical Informatics Wiki. Bloggers posted their first drafts of entries as posts or links to this wiki and invited readers to provide comments and edit suggestions.
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*[[:Category:Blogposium|All articles resulting from the BlogPosium collaboration]]'''
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While many bloggers and readers contributed to this Web 2.0 innovation in collaborative work, key participants included the follow blogs. Please visit them and thank them for their contributions:
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* [http://thielst.typepad.com/my_weblog/Christina's Considerations] on Regional Health Information Organizations
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* [http://www.conmergence.com/ Conmergence] on Telehealth
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* [http://www.drugwonks.com/ Drugwonks] on FDA Critical Path Initiative
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* [http://www.bloglines.com/blog/eHealth eHealth] on Integration of Personal Health Records and Electronic Medical Records
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* [http://www.crashutah.com/emr/ EMR and HIPAA] on Electronic Medical Records and Biometric Integration
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* [http://fardj.prblogs.org/ Envisioning 2.0] on The E-Patient-Provider Relationship
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* [http://www. healthnex.org HealthNex] (two other topics: Biobanking and Genetic Privacy Issues
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* [http://www.hitsmit.com/ HITsmit] on e-MAR Systems
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* [http://blog.hittransition.com/ HIT Transition] on RHIO Startup Funding and Finance
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* [http://www.rodspace.co.uk/blog/blogger.html Informaticopia] on International Perspectives on Clinical Informatics
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* [http://marketplace.md/community/blogs/marketplace.md_blog/default.aspx Marketplace.MD] on the Consumer-Driven Health Care Movement
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* [http://medicalconnectivity.com/ Medical Connectivity] on Integrating Medical Devices into EMRs
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* [http://www.enochchoi.com/thoughts/ medmusings] on Mobile Access to EMR/EHR/PHR for Providers and Patients
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* [http://usemed.com/ Usemed]  on Ongoing and Completed EHR, CPOE and CDS Implementation Projects
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==Endowed Professorships and Chairs in Health / Medical / Nursing / Biomedical Informatics==
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see [[Endowed Professorships]]
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==External Links==
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*[http://www.cpoe.org Website of the Provider Order Entry Team from Oregon Health]
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*[http://hittransition.com/tools.htm Links to online tools for HIT/RHIO development]
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*[http://www.hitdashboard.com/unitedStates.aspx Health Information Technology Dashboard]
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*[http://wellness.wikispaces.com/Tactic+-+Use+Evolving+Health+Information+Technology+Tools Wellness Wiki: Use Evolving Health Information Technology Tools]

Revision as of 09:58, 4 May 2006

The Clinical Informatics Wiki -- Clinfowiki

The Clinical Informatics Wiki is an implementation of a wiki devoted to topics in clinical informatics. To begin a new article, or edit an existing article, you must first create an account and login to the ClinfoWiki.

Please see documentation on customizing the interface and the User's Guide for usage and configuration help.

You can test your edits as much as you want in the Sandbox.

We are currently working on 1,581 articles, and we need your help to complete this study of Clinical Informatics. See Special:Statistics for more complete information on the site.

==Electronic Medical Record (EMR) Systems== see EMR

==Computer-based Provider Order Entry -- CPOE== see CPOE

==Clinical Decision Support -- CDS== see CDS

==Personal Health Records -- PHRs== see PHR

Blueprint for a Comprehensive HIT System

==Biobanking -- a.k.a. Biorepositories or Tissue Banks == see BioBanking

==Regional Health Information Organizations -- RHIOs== see RHIO

==Evidence-Based Medicine -- EBM== see EBM

U.S. Federal Health Information Technology Initiatives

The E-Patient-Provider Relationship


International views

Blogposium, April 2006

The Blogposium, held from April 18-20, was an innovation in collaborative blogging and wiki building.

The effort marshalled the expertise and energy of several dozen health bloggers and volunteers to expand and refine this Clinical Informatics Wiki. Bloggers posted their first drafts of entries as posts or links to this wiki and invited readers to provide comments and edit suggestions.

While many bloggers and readers contributed to this Web 2.0 innovation in collaborative work, key participants included the follow blogs. Please visit them and thank them for their contributions:

Endowed Professorships and Chairs in Health / Medical / Nursing / Biomedical Informatics

see Endowed Professorships

External Links

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