000 03482nam a22003857a 4500
008 190823s20192019 xxu||||| |||| 00| 0 eng d
022 _a1869-0327
024 _a10.1055/s-0039-1693711 [doi]
024 _aPMC6669040 [pmc]
040 _aOvid MEDLINE(R)
099 _a31365941
245 _aDesign and Implementation of a Comprehensive Surveillance System for Venous Thromboembolism in a Defined Region Using Electronic and Manual Approaches.
251 _aApplied Clinical Informatics. 10(3):552-562, 2019 May.
252 _aAppl Clin Inform. 10(3):552-562, 2019 May.
253 _aApplied clinical informatics
260 _c2019
260 _fFY2019
265 _sppublish
266 _d2019-08-23
520 _aBACKGROUND: Systematic surveillance for venous thromboembolism (VTE) in the United States has been recommended by several organizations. Despite adoption of electronic medical records (EMRs) by most health care providers and facilities, however, systematic surveillance for VTE is not available.
520 _aCONCLUSION: We identified several challenges with implementing a comprehensive VTE surveillance program that could limit accuracy of the results. Improved electronic strategies are needed to cross-reference patients across multiple health systems and to minimize the need for manual review and confirmation of results.
520 _aCopyright Georg Thieme Verlag KG Stuttgart . New York.
520 _aMETHODS: The primary surveillance strategy combined computerized searches of the EMR with a manual review of imaging data at the Duke University Health System in Durham County, North Carolina, United States. Different strategies of searching the EMR were explored. Consolidation of results with autopsy reports (nonsearchable in the EMR) and with results from the Durham Veterans' Administration Medical Center was performed to provide a comprehensive report of new VTE from the defined region over a 2-year timeframe.
520 _aOBJECTIVES: This article develops a comprehensive, population-based surveillance strategy for VTE in a defined geographical region.
520 _aRESULTS: Monthly searches of the primary EMR missed a significant number of patients with new VTE who were identified by a separate manual search of radiology records, apparently related to delays in data entry and coding into the EMR. Comprehensive searches incorporating a location-restricted strategy were incomplete due to the assigned residence reflecting the current address and not the address at the time of event. The most comprehensive strategy omitted the geographic restriction step and identified all patients with VTE followed by manual review of individual records to remove incorrect entries (e.g., outside the surveillance time period or geographic location; no evidence for VTE). Consolidation of results from the EMR searches with results from autopsy reports and the separate facility identified additional patients not diagnosed within the Duke system.
546 _aEnglish
650 _aIN PROCESS -- NOT YET INDEXED
651 _aMedStar Washington Hospital Center
656 _aHematology and Oncology
657 _aJournal Article
700 _aSingh, Bhavana Pendurthi
790 _aArnold K, Beckman M, Brown A, Ortel TL, Reyes N, Saber I, Schulteis R, Singh BP, Sitlinger A, Thames EH
856 _uhttps://dx.doi.org/10.1055/s-0039-1693711
_zhttps://dx.doi.org/10.1055/s-0039-1693711
942 _cART
_dArticle
999 _c4512
_d4512