Search PubMed⌕ Search

Biomedical subjects

Gary H Brandeis

Publications and source records attributed to Gary H Brandeis.

4 recordsLinked to original sources
PubMed2007

Electronic health record implementation in community nursing homes.

INTRODUCTION: The Electronic Health Record (EHR) is being advocated as a tool to improve patient care. Nationwide initiatives are under way to determine how to implement EHR. To date, community nursing homes have not been involved in that effort. Many reasons, including multiple providers in a home, physical structure of a facility, multiple facilities, high costs of implementation, and maintenance of an EHR, hinder efforts to establish such a record in a nursing home. Convinced that an EHR would improve resident care, we undertook a project to establish an EHR in 11 community nursing homes. METHODS: Boston University Geriatric Services and Boston Medical Center partnered with 11 community nursing homes in the Boston, MA, area to introduce GE Centricity as the medical provider's medical record for the residents under the care of this medical practice. This effort included allowing the software to be used at various sites, providing hardware, and establishing Internet connectivity. RESULTS: All 11 of the nursing homes served by Boston University Geriatric Services have been connected to the system. DISCUSSION: It is possible to establish an EHR in a diverse, unrelated group of nursing homes. This has allowed for improved communication between providers, consultants, hospital, and nursing home staff.

Academic Medical Centers↗
PubMed2002

Profiling nursing homes using Bayesian hierarchical modeling.

OBJECTIVES: New methods developed to improve the statistical basis of provider profiling may be particularly applicable to nursing homes. We examine the use of Bayesian hierarchical modeling in profiling nursing homes on their rate of pressure ulcer development. DESIGN: Observational study using Minimum Data Set data from 1997 and 1998. SETTING: A for-profit nursing home chain. PARTICIPANTS: Residents of 108 nursing homes who were without a pressure ulcer on an index assessment. MEASUREMENTS: Nursing homes were compared on their performance on risk-adjusted rates of pressure ulcer development calculated using standard statistical techniques and Bayesian hierarchical modeling. RESULTS: Bayesian estimates of nursing home performance differed considerably from rates calculated using standard statistical techniques. The range of risk-adjusted rates among nursing homes was 0% to 14.3% using standard methods and 1.0% to 4.8% using Bayesian analysis. Fifteen nursing homes were designated as outliers based on their z scores, and two were outliers using Bayesian modeling. Only one nursing home had greater than a 50% probability of having a true rate of ulcer development exceeding 4%. CONCLUSIONS: Bayesian hierarchical modeling can be successfully applied to the problem of profiling nursing homes. Results obtained from Bayesian modeling are different from those obtained using standard statistical techniques. The continued evaluation and application of this new methodology in nursing homes may ensure that consumers and providers have the most accurate information regarding performance.

Bayes Theorem↗