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OBJECTIVE The majority of clinical symptoms are stored as free text in the clinical record, and this information can inform clinical decision support and automated surveillance efforts if it can be accurately processed into computer interpretable data. METHODS We developed rule-based algorithms and evaluated a natural language processing (NLP) system for(More)
CONTEXT Currently most automated methods to identify patient safety occurrences rely on administrative data codes; however, free-text searches of electronic medical records could represent an additional surveillance approach. OBJECTIVE To evaluate a natural language processing search-approach to identify postoperative surgical complications within a(More)
BACKGROUND The aim of this study was to build electronic algorithms using a combination of structured data and natural language processing (NLP) of text notes for potential safety surveillance of 9 postoperative complications. METHODS Postoperative complications from 6 medical centers in the Southeastern United States were obtained from the Veterans(More)
To facilitate the future implementation of an electronic prescribing system, this case study modeled prescription management processes in various primary care settings. The Vanderbilt e-prescribing design team conducted initial interviews with clinic managers, physicians and nurses, and then represented the sequences of steps carried out to complete(More)
Background Up to 38% of inpatient medication errors occur at the administration stage. Although they reduce prescribing errors, computerized provider order entry (CPOE) systems do not prevent administration errors or timing discrepancies. This study determined the degree to which CPOE medication orders matched actual dose administration times. METHODS At a(More)
The authors will demonstrate Quill (QUestions and Information Logically Linked), a comprehensive structured reporting environment for ambulatory care that was developed at the Vanderbilt University Medical Center. A notes capture tool was sought with the immediate hope of decreasing or eliminating transcription costs (currently around $6M/yr) and paper(More)
Physician order entry is difficult to implement, both in inpatient and outpatient settings. Such systems must integrate conveniently into clinical workflows, and provide sufficient benefit to offset the burden of system use. For outpatient order entry, significant advantages can accrue when systems incorporate medical necessity guidelines - improved billing(More)
PURPOSE This is a pilot study investigating the effect of healing touch (HT) on fatigue in breast cancer patients undergoing radiation therapy (RT). METHODS/DESIGN This study presents the results of a within-subjects design randomized clinical trial where the treatment group was treated with HT, whereas the control group experienced sham therapy. The(More)
With the Balanced Budget Act of 1997 mandating that the Health Care Financing Administration (HCFA) implement risk-adjusted payment mechanisms for Medicare managed care plans (Medicare + Choice) by January 2000, risk-adjustment tools will play an important role in future capitated reimbursement. This is because there is growing evidence that(More)
Microbiology results are reported in semi-structured formats and have a high content of useful patient information. We developed and validated a hybrid regular expression and natural language processing solution for processing blood culture microbiology reports. Multi-center Veterans Affairs training and testing data sets were randomly extracted and(More)