Table Of ContentClinical Problem Lists in the Electronic Health Record
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has a PhD in Medical Informatics from the Oregon Health and Science University and a BS in c d
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www.appleacademicpress.com 9 781771 880916
CLINICAL PROBLEM LISTS
IN THE
ELECTRONIC HEALTH RECORD
CLINICAL PROBLEM LISTS
IN THE
ELECTRONIC HEALTH RECORD
Edited by
Adam Wright, PhD
Apple Academic Press
TORONTO NEW JERSEY
CRC Press Apple Academic Press, Inc
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Version Date: 20141104
International Standard Book Number-13: 978-1-4987-1206-4 (eBook - PDF)
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ABOUT THE EDITOR
ADAM WRIGHT, PhD
Adam Wright is an Assistant Professor of Medicine at Harvard Medical
School, whose research interests include electronic health records, clini-
cal decision support, and data mining. In addition to research, Dr. Wright
teaches introductory medical informatics at Harvard Medical School as
well as clinical epidemiology and healthcare policy to medical students.
He is also a member of the leadership team for the Agency for Health-
care Research and Quality-Funded Clinical Decision Support Consortium,
which is focused on developing methods for sharing clinical decision sup-
port content. Adam has a PhD in Medical Informatics from the Oregon
Health and Science University, and a BS in Mathematical and Computa-
tional Sciences from Stanford University.
CONTENTS
Acknowledgment and How to Cite ..................................................xi
List of Contributors .......................................................................xiii
Introduction ...................................................................................xvii
Part I: History and Importance
1. Bringing Science to Medicine: An Interview with Larry Weed,
Inventor of the Problem-Oriented Medical Record ................................3
Adam Wright, Dean F. Sittig, Julie McGowan, Joan S. Ash,
and Lawrence L. Weed
2. Medical Records That Guide and Teach ................................................19
Lawrence L. Weed
3. Clinical Implications of an Accurate Problem List
on Heart Failure Treatment .....................................................................45
Daniel M. Hartung, Jacquelyn Hunt, Joseph Siemienczuk,
Heather Miller, and Daniel R. Touchette
Part II: Attitudes and Use
4. Clinician Attitudes Toward and Use of Electronic Problem Lists:
A Thematic Analysis ................................................................................ 59
Adam Wright, Francine L. Maloney, and Joshua C. Feblowitz
5. Healthcare Provider Attitudes Towards the Problem List
in an Electronic Health Record: A Mixed-Methods
Qualitative Study ..................................................................................... 83
Casey Holmes, Michael Brown, Daniel St Hilaire,
and Adam Wright
6. Use of an Electronic Problem List by Primary Care Providers
and Specialists .........................................................................................121
Adam Wright, Joshua Feblowitz, Francine L. Maloney,
Stanislav Henkin, and David W. Bates
7. Distribution of Problems, Medications and Lab Results in
Electronic Health Records: The Pareto Principle at Work ................135
Adam Wright and David W. Bates
viii Clinical Problem Lists in the Electronic Health Record
Part III: Improving the Problem List
8. An Automated Technique for Identifying Associations Between
Medications, Laboratory Results and Problems .................................147
Adam Wright, Elizabeth S. Chen, and Francine L. Maloney
9. A Method and Knowledge Base for Automated Inference
of Patient Problems from Structured Data in an Electronic
Medical Record .......................................................................................183
Adam Wright, Justine Pang, Joshua C. Feblowitz,
Francine L. Maloney, Allison R. Wilcox, Harley Z. Ramelson,
Louise I. Schneider, and David W. Bates
10. Improving Completeness of Electronic Problem Lists Through
Clinical Decision Support: A Randomized, Controlled Trial .............209
Adam Wright, Justine Pang, Joshua C. Feblowitz,
Francine L. Maloney, Allison R. Wilcox, Karen Sax McLoughlin, Harley Ramelson,
Louise Schneider, and David W. Bates
11. Computerized Physician Order Entry of Medications
and Clinical Decision Support Can Improve Problem List
Documentation Compliance ..................................................................229
William L. Galanter, Daniel B. Hier, Chiang Jao, and David Sarne
12. Randomized Controlled Trial of an Automated Problem List With
Improved Sensitivity ...............................................................................245
Stéphane M. Meystre and Peter J. Haug
Part IV: Applications of the Problem List
13. Incomplete Care: On the Trail of Flaws in the System .......................273
Tejal K. Gandhi, Gianna Zuccotti, and Thomas H. Lee
14. Leveraging Electronic Health Records to Support Chronic Disease
Management: The Need for Temporal Data Views .............................279
Lipika Samal, Adam Wright, Bang Wong, Jeffrey Linder,
and David Bates
15. Indication-Based Prescribing Prevents Wrong-Patient Medication
Errors In Computerized Provider Order Entry (CPOE) ...................299
William Galanter, Suzanne Falck, Matthew Burns, Marci Laragh, and
Bruce L. Lambert
Author Notes ....................................................................................................313
Index .................................................................................................................321
ACKNOWLEDGMENT AND
HOW TO CITE
The editor and publisher thank each of the authors who contributed to this
book. All chapters were previously published in various places in various
formats; to cite the work contained in this book and to view the individual
permissions, please refer to the citation at the beginning of each chapter.
Each chapter was read individually and carefully selected by the editor;
the result is a book that examines the use of clinical problem lists in elec-
tronic health records from many different perspectives, including their im-
portance, history, possible improvements, and current applications.
