William Tierney

..abstract:..

..We evaluated how well physicians' global estimates of disease severity correspond to more specific physician-rated disease variables as well as patients' self-rated health and other patient variables...

..We used an existing electronic medical record (EMR) system and personal data assistants (PDAs) to assess the characteristics and outcomes of patients with acute respiratory illnesses (ARIs) visiting a Kenyan rural health center...

..We evaluated the effect of a change in Indiana Medicaid's policy (effective October 1, 1993) requiring prior approval to pay transportation costs...

..To assess the current status and potential value of this resource, we surveyed US primary care PBRNs in operation from late 2003 to early 2004...

..To investigate peak expiratory flow rate (PEFR) and quality of life scores for their ability to predict exacerbations of asthma...

..Electronic information systems have been proposed as one means to reduce medical errors of commission (doing the wrong thing) and omission (not providing indicated care)...

..g., tracing patients who fail to return for appointments), strategic planning (e.g., hiring health care providers and staff), reports to national AIDS programs and funding agencies, and research...

..Hypertension is often uncontrolled. One reason might be physicians' reticence to modify therapy in response to single office measurements of vital signs...

..Several partnerships among academic institutions and public and private organizations, in areas such as sub-Saharan Africa, Haiti, and Peru, are leading the way...

..They also discuss the beneficial effects that cancer has had on their lives and end with suggestions for clinicians and outcomes researchers who seek to assess and improve quality of life among persons with cancer...

..The proposed minimum data set will evolve over time as funding increases, care protocols change, and additional tests and treatments become available for HIV-infected patients in developing countries...

..Public, private, and academic partnerships can facilitate the development and implementation of EHRs in resource-constrained settings...

..Prognosis of patients with heart failure (HF) has improved in recent years due to advances in therapy. Whether this is also true for diabetic subjects with HF in clinical practice has not been studied in a prospective manner...

..Diabetes prevalence is increasing in the population, both in the young and the elderly. We assessed the impact of increasing prevalence of diabetes on admissions for acute myocardial infarctions (MI) from 1990 through 1997...

..To assess the effects of evidence-based treatment suggestions for hypertension made to physicians and pharmacists using a comprehensive electronic medical record system...

..3 vs. 1.7 hospitalizations, P = 0.05). CONCLUSION: Adding symptom information to computer-generated care suggestions for patients with heart failure did not affect physician treatment decisions or improve patient outcomes...

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..Translation of evidence-based guidelines into clinical practice has been inconsistent. We performed a randomized, controlled trial of guideline-based care suggestions delivered to physicians when writing orders on computer workstations...

..To determine the clinical and immunological outcomes of a cohort of HIV-infected patients receiving antiretroviral therapy...

..We also examine structural, financial, policy-related, cultural, and organizational barriers to IT implementation for evidence-based practice and strategies to overcome them...

..The President's Emergency Plan for AIDS Relief committed $15 billion to addressing HIV in resource-poor settings...

..We evaluated trends in post-myocardial infarction mortality and morbidity in patients with and without diabetes over a 7-year period from 1990 through 1997, when substantial changes occurred in the management of coronary disease...

..It is not known whether patient outcomes are enhanced by effective pharmacist-patient interactions...

..Research in practice-based research networks (PBRNs) is hampered by difficulty managing, identifying, and enrolling potential subjects. Well-designed informatics applications can greatly improve these processes...

..Issues related to recruitment and protocol delivery, and attendance patterns and predictors of program attendance are described...

..004) and with pharmacy by 63% (p<0.001). Surveyed providers were highly satisfied with the EHRs and its support infrastructure. This model offers a viable approach for broadly implementing EHRs in resource-limited settings...

..We hypothesized that having access to VA care would ameliorate the excess stroke mortality rates in African-Americans (AA) reported in non-VA studies...

..Recent increases in mammography use have led to a decrease in mortality from breast cancer...

..Incidence numbers fell for all ages with greater decrease in younger age groups. Our data indicate that the burden of stroke among male veterans is decreasing. This appears to be true for both blacks and whites and across all age groups...

..The system generates data that can be used for epidemiological surveillance and injury prevention at the local level, and for assessment of impact of specific injuries on health care resources...

..However, the prognostic value of CHF-specific health status on long-term mortality has not been adequately evaluated. Our objective was to assess CHF-specific health status and 5-year mortality among outpatients with CHF...

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..We set out to provide patient-specific Electronic Medical Record (EMR)-based clinical summaries for providers taking care of HIV-positive adult patients in the resource-limited setting of Mbarara, Uganda...

..Information systems that improve communication among providers during these transitions have the potential to improve safety and reduce costs...

..We evaluated the effect of a self-management program for low-income primary care patients with acute low back pain (ALBP) from inner-city neighborhood health centers...

..7; 95% CI, 0.4 to 1.4; P=.4). CONCLUSIONS: Olanzapine and risperidone use was associated with gaining weight in the first year, but only olanzapine was associated with developing diabetes mellitus...

..Efficient use of health care resources in low-income countries by providers and local and national managers requires timely access to patient data...

..Determine outcome differences between orphaned and non-orphaned children receiving antiretroviral therapy (ART)...

..The system is also in use in South Africa and Lesotho and is being deployed in Tanzania and Uganda...

..We evaluated the effect of a self-management program (SMP) on primary care patients with acute low back pain (ALBP) from low income, inner city neighborhood health centers and an emergency department of a public teaching hospital...

..This simple electronic medical record system has bridged the "digital divide." Financial and technical sustainability by Kenyans will be key to its future use and development...

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..CONCLUSIONS: Providers agreed with less than half of computer-generated care suggestions from evidence-based CHF guidelines, most often because the suggestions were felt to be inapplicable to their patients or unlikely to be tolerated...

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..We describe the development and structure of this EMR and plans for future development that include wireless connections, tablet computers, and migration to a Web-based platform...

..To establish a link between the minimal important difference (MID) and the standard error of measurement (SEM) for all responsive dimensions of the Asthma Quality of Life Questionnaire (AQLQ)...

..Extensive testing of the EEMR system capabilities, especially the ability to interface with existing software programs, is essential before purchasing an EEMR system...

..No important difference standards for the SF-36 have been published for patients with heart disease. This development of CIDs would facilitate the use of health status measures in daily clinical decision-making...

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..The objective of this study was to establish clinically important difference standards from the physician's perspective for use of 2 HRQoL measures among patients with chronic obstructive pulmonary disease (COPD)...

..Pragmatic problems, although significant, can be successfully overcome...

..To use triangulation methodology to better understand clinically important differences (CIDs) in the health-related quality of life (HRQoL) of patients with heart disease...

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..This approach would not only save resources but result in better outcomes of patient satisfaction...

..Change in health-related quality of life (HRQoL) is an important outcome in asthma treatment. Patient and provider consensus on how to determine thresholds for identifying important improvements and declines, however, has not been achieved...

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..However, there is a lack of consensus regarding which HRQoL outcome measures are appropriate to assess, and how much change on those measures depict significant HRQoL improvement...

..If confirmed among patients with the relevant diseases and those patients' physicians, these disease-specific CIDs could assist both researchers and practicing clinicians in the use and interpretation of HRQL changes over time...

..Pneumocystis carinii is the leading opportunistic pulmonary infection in HIV-infected patients. Invasive diagnostic procedures might be avoided if available electronic data can accurately identify patients with Pneumocystis pneumonia (PCP)...

..Thus, this sense of control measure has acceptable test-retest reliability and is appropriate for use in longitudinal research...

..Although this approach may be preferred, the validity of the anchor-based approach is currently under scrutiny...

..Implementing electronic data capture and management in East Africa will enhance the outcomes of health rare and public health interventions. ..