Biomedical subjects
Publications and source records attributed to Daniel J Vreeman.
The investigators developed a 1-page chart abstraction tool to evaluate compliance with practice guidelines for attention deficit hyperactivity disorder. The tool had strong inter-rater reliability, with kappa of 0.81. Pilot testing for 57 children with attention deficit hyperactivity disorder showed only 12% documented full compliance with assessment guidelines and 44% with treatment guidelines.
With increasing pressures to better manage clinical information, we investigated the role of electronic health record (EHR) systems in physical therapist practice through a critical review of the literature. We reviewed studies that met our predefined criteria after independent review by 3 authors. The investigators in all of the reviewed studies reported benefits, including improved reporting, operational efficiency, interdepartmental communication, data accuracy, and capability for future research. In 7 studies, the investigators reported barriers, including challenges with behavior modification, equipment inadequacy, and training. The investigators in all studies reported key success factors, including end-user participation, adequate training, workflow analysis, and data standardization. This review suggests that EHRs have potential benefits for physical therapists. The authors formed the following recommendations based on the studies' themes: (1) incorporate workflow analysis into system design and implementation; (2) include end users, especially clinicians, in system development; (3) devote significant resources for training; (4) plan and test carefully to ensure adequate software and hardware performance; and (5) commit to data standards.
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We developed an automated tool, called the Intelligent Mapper (IM), to improve the efficiency and consistency of mapping local terms to LOINC. We evaluated IM's performance in mapping diagnostic radiology report terms from two hospitals to LOINC by comparing IM's term rankings to a manually established gold standard. Using a CPT-based restriction, for terms with a LOINC code match, IM ranked the correct LOINC code first in 90% of our development set terms, and in 87% of our test set terms. The CPT-based restriction significantly improved IM's ability to identify correct LOINC codes. We have made IM freely available, with the aim of reducing the effort required to integrate disparate systems and helping move us towards the goal of interoperable health information exchange.