Literature DB >> 21991298

Distribution of Problems, Medications and Lab Results in Electronic Health Records: The Pareto Principle at Work.

Adam Wright1, David W Bates.   

Abstract

BACKGROUND: Many natural phenomena demonstrate power-law distributions, where very common items predominate. Problems, medications and lab results represent some of the most important data elements in medicine, but their overall distribution has not been reported.
OBJECTIVE: Our objective is to determine whether problems, medications and lab results demonstrate a power law distribution.
METHODS: Retrospective review of electronic medical record data for 100,000 randomly selected patients seen at least twice in 2006 and 2007 at the Brigham and Women's Hospital in Boston and its affiliated medical practices.
RESULTS: All three data types exhibited a power law distribution. The 12.5% most frequently used problems account for 80% of all patient problems, the top 11.8% of medications account for 80% of all medication orders and the top 4.5% of lab result types account for all lab results.
CONCLUSION: These three data elements exhibited power law distributions with a small number of common items representing a substantial proportion of all orders and observations, which has implications for electronic health record design.

Entities:  

Year:  2010        PMID: 21991298      PMCID: PMC3189502          DOI: 10.4338/ACI-2009-12-RA-0023

Source DB:  PubMed          Journal:  Appl Clin Inform        ISSN: 1869-0327            Impact factor:   2.342


  6 in total

1.  Evaluation of a command-line parser-based order entry pathway for the Department of Veterans Affairs electronic patient record.

Authors:  C Lovis; M K Chapko; D P Martin; T H Payne; R H Baud; P J Hoey; S D Fihn
Journal:  J Am Med Inform Assoc       Date:  2001 Sep-Oct       Impact factor: 4.497

2.  Physicians and ambulatory electronic health records.

Authors:  David W Bates
Journal:  Health Aff (Millwood)       Date:  2005 Sep-Oct       Impact factor: 6.301

3.  Automated development of order sets and corollary orders by data mining in an ambulatory computerized physician order entry system.

Authors:  Adam Wright; Dean F Sittig
Journal:  AMIA Annu Symp Proc       Date:  2006

4.  The state of regional health information organizations: current activities and financing.

Authors:  Julia Adler-Milstein; Andrew P McAfee; David W Bates; Ashish K Jha
Journal:  Health Aff (Millwood)       Date:  2007-12-11       Impact factor: 6.301

5.  Expert consensus guidelines for stocking of antidotes in hospitals that provide emergency care.

Authors:  Richard C Dart; Stephen W Borron; E Martin Caravati; Daniel J Cobaugh; Steven C Curry; Jay L Falk; Lewis Goldfrank; Susan E Gorman; Stephen Groft; Kennon Heard; Ken Miller; Kent R Olson; Gerald O'Malley; Donna Seger; Steven A Seifert; Marco L A Sivilotti; Tammi Schaeffer; Anthony J Tomassoni; Robert Wise; Gregory M Bogdan; Mohammed Alhelail; Jennie Buchanan; Jason Hoppe; Eric Lavonas; Sara Mlynarchek; Dong-Haur Phua; Sean Rhyee; Shawn Varney; Amy Zosel
Journal:  Ann Emerg Med       Date:  2009-05-05       Impact factor: 5.721

6.  Electronic health records in ambulatory care--a national survey of physicians.

Authors:  Catherine M DesRoches; Eric G Campbell; Sowmya R Rao; Karen Donelan; Timothy G Ferris; Ashish Jha; Rainu Kaushal; Douglas E Levy; Sara Rosenbaum; Alexandra E Shields; David Blumenthal
Journal:  N Engl J Med       Date:  2008-06-18       Impact factor: 91.245

  6 in total
  19 in total

1.  Comparative analysis of the VA/Kaiser and NLM CORE problem subsets: an empirical study based on problem frequency.

Authors:  Adam Wright; Joshua Feblowitz; Allison B McCoy; Dean F Sittig
Journal:  AMIA Annu Symp Proc       Date:  2011-10-22

2.  DYNAMICALLY EVOLVING CLINICAL PRACTICES AND IMPLICATIONS FOR PREDICTING MEDICAL DECISIONS.

Authors:  Jonathan H Chen; Mary K Goldstein; Steven M Asch; Russ B Altman
Journal:  Pac Symp Biocomput       Date:  2016

3.  OrderRex: clinical order decision support and outcome predictions by data-mining electronic medical records.

Authors:  Jonathan H Chen; Tanya Podchiyska; Russ B Altman
Journal:  J Am Med Inform Assoc       Date:  2015-07-21       Impact factor: 4.497

4.  Use of order sets in inpatient computerized provider order entry systems: a comparative analysis of usage patterns at seven sites.

Authors:  Adam Wright; Joshua C Feblowitz; Justine E Pang; James D Carpenter; Michael A Krall; Blackford Middleton; Dean F Sittig
Journal:  Int J Med Inform       Date:  2012-07-18       Impact factor: 4.046

5.  An evaluation of clinical order patterns machine-learned from clinician cohorts stratified by patient mortality outcomes.

Authors:  Jason K Wang; Jason Hom; Santhosh Balasubramanian; Alejandro Schuler; Nigam H Shah; Mary K Goldstein; Michael T M Baiocchi; Jonathan H Chen
Journal:  J Biomed Inform       Date:  2018-09-07       Impact factor: 6.317

Review 6.  How to Diagnose Solutions to a Quality of Care Problem.

Authors:  Ziv Harel; Samuel A Silver; Rory F McQuillan; Adam V Weizman; Alison Thomas; Glenn M Chertow; Gihad Nesrallah; Christopher T Chan; Chaim M Bell
Journal:  Clin J Am Soc Nephrol       Date:  2016-03-25       Impact factor: 8.237

7.  Decaying relevance of clinical data towards future decisions in data-driven inpatient clinical order sets.

Authors:  Jonathan H Chen; Muthuraman Alagappan; Mary K Goldstein; Steven M Asch; Russ B Altman
Journal:  Int J Med Inform       Date:  2017-03-18       Impact factor: 4.046

8.  Data-Mining Electronic Medical Records for Clinical Order Recommendations: Wisdom of the Crowd or Tyranny of the Mob?

Authors:  Jonathan H Chen; Russ B Altman
Journal:  AMIA Jt Summits Transl Sci Proc       Date:  2015-03-25

9.  Health care transformation through collaboration on open-source informatics projects: integrating a medical applications platform, research data repository, and patient summarization.

Authors:  Jeffrey G Klann; Allison B McCoy; Adam Wright; Nich Wattanasin; Dean F Sittig; Shawn N Murphy
Journal:  Interact J Med Res       Date:  2013-05-30

10.  Integrating Multiple On-line Knowledge Bases for Disease-Lab Test Relation Extraction.

Authors:  Yaoyun Zhang; Ergin Soysal; Sungrim Moon; Jingqi Wang; Cui Tao; Hua Xu
Journal:  AMIA Jt Summits Transl Sci Proc       Date:  2015-03-25
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