Thomas Beale, Woland's Cat
“In his recent blog post, Eric Browne highlights what may be a problem in the design of the Australian PCEHR, due to the well-known CDA feature allowing dual forms of content – text and structured, supposedly equivalent – to be stored in the one document.
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Schuemie MJ et al, Pharmacoepidemiology and Drug Safety, 2012
PURPOSE:
Increasingly, patient information is stored in electronic medical records, which could be reused for research. Often these records comprise unstructured narrative data, which are cumbersome to analyze. The authors investigated whether text mining can make these data suitable for epidemiological studies and compared a concept recognition approach and a range of machine learning techniques that require a manually annotated training set. The authors show how this training set can be created with minimal effort by using a broad database query.
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Ryan BL et al, Canadian Family Physician, 57(12)
Inputting information into your EMR requires a balance between being efficient and being complete and accurate. Both goals are critical for patient care. When you intend to conduct research using data from your EMR, there is an additional goal of being able to retrieve the data in a reliable and consistent manner.
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Roni Zeiger, e-patients.net
“Three months ago, at the age of 40, I had a small bleed in my brain. My story is no more special than any of your stories, but I learned something important from it and I want to share it with you. I learned firsthand the difference between what a patient tells his doctors and what he tells his loved ones, and why it matters.
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Bos L. Future Visions on Biomedicine and Bioinformatics 1, 2011
This chapter is based on my keynote during the Estonian e-Health Conference in Tallinn, october 2010.
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Katherine Harmon, Scientific American
“It doesn’t take much imagination to think of ways in which all of the data being recorded into electronic health records (EHRs) could be used study diseases and map trends. One of the problems in putting this data to work, however, is that these forms are not uniformly maintained—and the more structured sections with standardized codes lack nuance and might even be misleading, according to some researchers.
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Janet Dillione, Huffington Post
“First, do no harm” is a fundamental precept to medical ethics and a guiding light for the delivery of care. Physicians take on the laudable act of healing — a superhuman undertaking that unfortunately cannot be done with a wand or wiggle of the nose.
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Bob Mitchell, CMIO
“Although natural language processing (NLP) research in the clinical setting has occurred since the 1960s, progress in developing NLP applications for clinical text has been slow and lags behind progress made in the general NLP domain, according to an editorial in the September issue of Journal of the American Medical Informatics Association.
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Chapman WW et al, J Am Med Inform Assoc, 18(5)
This issue of JAMIA focuses on natural language processing (NLP) techniques for clinical-text information extraction. Several articles are offshoots of the yearly ‘Informatics for Integrating Biology and the Bedside’ (i2b2) (http://www.i2b2.org) NLP shared-task challenge, introduced by Uzuner et al (see page 552) and co-sponsored by the Veteran’s Administration for the last 2 years. This shared task follows long-running challenge evaluations in other fields, such as the Message Understanding Conference (MUC) for information extraction, TREC for text information retrieval, and CASP for protein structure prediction. Shared tasks in the clinical domain are recent and include annual i2b2 Challenges that began in 2006, a challenge for multi-label classification of radiology reports sponsored by Cincinnati Children’s Hospital in 2007, a 2011 Cincinnati Children’s Hospital challenge on suicide notes, and the 2011 TREC information retrieval shared task involving retrieval of clinical cases from narrative records.
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Kelly Mehler, Healthcare IT News
“The idea of a nationwide electronic health record system is brilliant. Patients could use their own personal health record to request prescription refills, schedule future appointments and evaluate their own test results. The record could live on thumb drives, mobile devices, personal computers, or in the cloud.
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J. Scott Litton, Physicians Practice
“The passage of last year’s healthcare reform bill continues to have significant impacts on physician practices. More and more medical practices are transitioning away from the traditional paper chart and moving to a full featured electronic health record software package. As physicians embrace the EHR and the flow of information changes from the traditional physician narrative to a computer generated note, it is becoming increasingly difficult to add a narrative report to each patient note. There are several ways to modify this and allow physician notes to be easily modified to incorporate the all important narrative.
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Jeff Rowe, Healthcare IT HITECHWatch
“One of the less noted impacts of EHRs concerns how they have changed the way providers capture and store patient information.
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Lynn Kosegi, Advance
“Physicians have long used narrative documentation as an effective means of information capture. Dictation in particular is a widely used method to create clinical reports such as history and physical documents, operative reports, consultation reports, discharge summaries, and progress notes. In addition to serving as important communication tools, these documents are an excellent source of the information used by providers for HIM, medico-legal, and administrative functions.
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Zheng K et al, J Am Med Inform Assoc, 18(3)
Objective
A full-text search engine can be a useful tool for augmenting the reuse value of unstructured narrative data stored in electronic health records (EHR). A prominent barrier to the effective utilization of such tools originates from users’ lack of search expertise and/or medical-domain knowledge. To mitigate the issue, the authors experimented with a ‘collaborative search’ feature through a homegrown EHR search engine that allows users to preserve their search knowledge and share it with others. This feature was inspired by the success of many social information-foraging techniques used on the web that leverage users’ collective wisdom to improve the quality and efficiency of information retrieval.
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Kelly Young, RA Warrior
“That story happened to me. That’s why I loved that Tweet from Kelly Kunik during last night’s Twitter HCSM (Healthcare communications social media) discussion. A doctor had questioned whether e-patient bloggers are credible sources.
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EMR Daily News
“The Clinical Documentation Industry Association, or the CDIA, has announced the launch of a new industry trade association dedicated to ensuring the accuracy, consistency and security of clinical documentation contained within all patient health records.
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Häyrinen K, Saranto K. MEDINFO 2010
The purpose of this study is to describe and discuss physicians’ and nurses’ documentation of the patient’s needs assessment in electronic health records (EHR) in the neurological care setting. Both physicians and nurses collect, record and interpret data during patient care episodes. Assessment of patient’s need for care and treatment is an important part of the care process. Planning, implementation and outcome assessment of the care process are based on needs assessment data. The data of this study consist of 48 neurological medical narratives and nursing care plans. The data were analyzed using descriptive statistics and content analysis.
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Deléger L et al, J Am Med Inform Assoc, 17(5)
Objective
While essential for patient care, information related to medication is often written as free text in clinical records and, therefore, difficult to use in computerized systems. This paper describes an approach to automatically extract medication information from clinical records, which was developed to participate in the i2b2 2009 challenge, as well as different strategies to improve the extraction.
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Richard L. Reece, medinnovationblog
“Yet, despite obstacles and slowness in adopting, a combination of things – widespread “free” or inexpensive EHR systems, speech recognition programs enabling doctors to easily incorporate their thoughts and the patient narrative into EHRs, advances in wireless “touch” technologies, social pressures from patients, and financial assistance from payers – will help make the “inevitable” more “evitable.”
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Ken Congdon, Healthcare Technology Online
“A few weeks ago, I wrote an article titled Save The Clinical Narrative that emphasized the importance of preserving the medical narrative to aid in clinical decision making. I received a great deal of feedback on this article from physicians, healthcare IT personnel, and the vendor community alike.
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