Tag Archives: MEDICAL TESTS

Electronic health records: Quick access to patient’s records improves patient care

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When a patient gets transferred from a hospital to a nearby specialist or rehabilitation facility, it is often difficult for personnel at the new facility to access the patient’s electronic health records – which includes important patient-specific information such as their medication history and allergies. This lack of electronic compatibility often leads to wasteful and expensive duplication of tests, X-rays and paperwork that can interfere with the treatment of patients.

A recent study at the University of Missouri highlights how the use of electronic health records have resulted better quality of care – which can direct the next steps of government programs to ensure hospitals use electronic health records in a way that promotes interoperability, or the ability for various health care organizations to quickly access a patient’s records, reduce waste and speed up decision-making to improve patient health outcomes.

So far, the adoption and implementation of electronic health records has been a bumpy road, said Kate Trout, assistant professor in the MU School of Health Professions and lead author on the study. Electronic health records have widely been cited in research literature as the most cumbersome technology ever implemented in the health care industry.

“They have the potential to be very helpful, but in practice they tend to be very disruptive because it’s time consuming to train personnel how to use them. They’re expensive, and there’s always new complicated updates and new forms that come out, and there is often a lack of interoperability for the data to be shared among different health care organizations,” Trout said. “Given the massive national investments, we wanted to see if electronic health records are being utilized in a meaningful way to promote interoperability and ultimately improve quality of care.”

electronic health records/University of Missouri

More than $30 billion has been invested by the federal government in the adoption and use of electronic health records by health care organizations in an attempt to improve the quality of care delivered to patients.

In 2011, Centers for Medicare and Medicaid established the “Meaningful Use” program – now known as the “Promoting Interoperability Program” – which offers financial incentives to health care providers who effectively utilize electronic health records in a way that promotes information sharing, public health reporting and interoperability.

Trout analyzed the impact of electronic health records on mortality rates for patients with various medical procedures and conditions. More than 5 million patients in 300 U.S. hospitals were included in the study, which merged large datasets from the electronic health records, the American Hospital Association and Centers for Medicare and Medicaid.

Three main categories emerged:

  1. hospitals that meet the “Meaningful Use” requirements with their electronic health records,
  2. hospitals that fully implement electronic health records but not in a way that meets the “Meaningful Use” requirements, and
  3. hospitals that have either none or only partially implemented electronic health records.

Trout found that the hospitals that meet the “Meaningful Use” requirements were able to improve quality of care and reduce patient mortality rates to a greater extent than hospitals in the other two groups. While the results show some optimism, Trout cautions that more still needs to be done, including the need to analyze the impact of interoperability and advanced electronic health record functions on quality of care.

“This research highlights the importance of using electronic health records in a way that promotes interoperability to streamline processes, speed up decision-making, reduce wasted time and ultimately improve patient health outcomes,” Trout said. “Ideally, the United States could implement one standardized electronic health records system for everyone to ensure compatibility, so policy makers can hopefully benefit from this research.”

Trout added that with the use of data mining and analytics, electronic health records can be better used going forward to potentially identify patient characteristics that put them at higher risks for possible infections or other conditions.

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“With this information, are there alerts we can put in after a surgery to ensure we follow up at critical points in time?” Trout said. “Are there certain patient populations that we can use the data to catch them earlier and make sure we give them extra care and not just put them through the same routine protocols as everyone else? That is how we move away from only focusing on implementing the technology and progress toward encouraging innovative ideas that ultimately improve patient health outcomes.”

Trout said this research can be particularly useful for rural hospitals that historically have less resources and lag behind their urban counterparts in adopting health technology like telehealth and electronic health records. There have been many closures of rural hospitals, an issue that has been worsened by the COVID-19 pandemic, and rural patients tend to have more co-morbidities and worse health outcomes.

“I am passionate about helping vulnerable, underserved populations, and our personal health is often tied to where we live and various social determinants of health,” Trout said. “Those ideas are not incorporated into our clinical data yet, but they should be going forward. My overall goal is to harness the data in a way that we can hopefully start to spend less and get more.”

This tiny sensor detects medicine levels from sweat drop in 30 seconds

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Lithium can alleviate the symptoms of bipolar disorder and depression — if taken in just the right amount. Too little won’t work, while too much can bring on dangerous side effects. To precisely monitor the amount of this medication in the body, patients must undergo invasive blood tests. But today, scientists report the invention of a tiny sensor that detects lithium levels from sweat on the surface of a fingertip in as little as 30 seconds, without a trip to the clinic.

The researchers will present their results today at the fall meeting of the American Chemical Society (ACS). ACS Fall 2022 is a hybrid meeting being held virtually and in-person Aug. 21–25, with on-demand access available Aug. 26–Sept. 9. The meeting features nearly 11,000 presentations on a wide range of science topics.

Not only must lithium be taken at a certain dosage, but patients often struggle to take it as prescribed and may miss pills. So, when the medication doesn’t appear to be working, health care providers need to know how much medication the patient is actually swallowing. But current options for monitoring have significant drawbacks. For example, blood draws produce accurate results, but they are invasive and time consuming. Pill counters, meanwhile, don’t directly measure the intake of the medication. To address these limitations, the team turned to another body fluid.

“Although it may not be visible, the human body constantly produces sweat, often only in very small amounts,” says Shuyu Lin, Ph.D., a postgraduate student researcher who is co-presenting the work with graduate student Jialun Zhu at the meeting. “Small molecules derived from medication, including lithium, show up in that sweat. We recognized this as an opportunity to develop a new type of sensor that would detect these molecules.”

“Through a single touch, our new device can obtain clinically useful molecular-level information about what is circulating in the body,” says Sam Emaminejad, Ph.D., the project’s principal investigator, who is at the University of California, Los Angeles (UCLA). “We already interact with a lot of touch-based electronics, such as smart phones and keyboards, so this sensor could integrate seamlessly into daily life.”

Devising a sensor to detect lithium presented some technical challenges, however. Sweat is generally only present in minute amounts, but the electrochemical sensing needed to detect charged particles of lithium required an aqueous, or watery, environment. To provide it, the team engineered a water-based gel containing glycerol. This extra ingredient prevented the gel from drying out and created a controlled environment for the electronic portion of the sensor.

To trap the lithium ions after they traversed the gel, the team used an ion-selective electrode. The accumulating ions generate a difference in electrical potential compared with a reference electrode. The researchers used this difference to infer the concentration of lithium present in sweat. Together, these components comprise a tiny, rectangular sensor that is smaller than the head of a thumbtack and can detect lithium in about 30 seconds. The sensor is still in the preliminary testing phase, but ultimately, the researchers envision incorporating it into a larger, yet-to-be designed system that provides visual feedback to the provider or the patient.

After characterizing the sensor using an artificial fingertip, the team recruited real people to test it, including one person on a lithium treatment regimen. The researchers recorded this person’s lithium levels before and after taking the medication. They found that these measurements fell close to those derived from saliva, which prior research has shown to accurately measure lithium levels. In the future, the researchers plan to study the effects of lotion and other skin products on the sensor’s readings.

This technology also has applications beyond lithium. Emaminejad is developing similar touch-based sensors to monitor alcohol and acetaminophen, a painkiller also known as Tylenol®, while also exploring the possibility of detecting other substances. The complete sensing systems could include additional features, such as encryption secured by a fingerprint, or, for substances prone to abuse, a robotic dispensing system that releases medication only if the patient has a low level in their bloodstream.

The researchers acknowledge support and funding from the National Science Foundation, Brain and Behavior Foundation, Precise Advanced Technologies and Health Systems for Underserved Populations and the UCLA Henry Samueli School of Engineering and Applied Sciences.

ACS Fall 2022 will be a vaccination-required and mask-recommended event for all attendees, exhibitors, vendors and ACS staff who plan to participate in-person in Chicago. For detailed information about the requirement and all ACS safety measures, please visit the ACS website.

The American Chemical Society (ACS) is a nonprofit organization chartered by the U.S. Congress. ACS’ mission is to advance the broader chemistry enterprise and its practitioners for the benefit of Earth and all its people. The Society is a global leader in promoting excellence in science education and providing access to chemistry-related information and research through its multiple research solutions, peer-reviewed journals, scientific conferences, eBooks and weekly news periodical Chemical & Engineering News. ACS journals are among the most cited, most trusted and most read within the scientific literature; however, ACS itself does not conduct chemical research. As a leader in scientific information solutions, its CAS division partners with global innovators to accelerate breakthroughs by curating, connecting and analyzing the world’s scientific knowledge. ACS’ main offices are in Washington, D.C., and Columbus, Ohio.