Madison L. Gates, PhD & Anthony Q. Baxter, PhD
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1 Madison L. Gates, PhD & Anthony Q. Baxter, PhD
2 Primary care medicine Public & Private partnership Kentucky Department of Corrections (Decisionmaker) University of Kentucky Correctional Health Services Network (Administrator) CorrectCare Integrated Health (Health manager & service provider) Services provided much like managed care
3 Evidence-based medicine Cost effective care Balance security issues Continuous improvements Practice-based research (specifics findings to general conclusions)
4 Does this research duplicate randomized controlled trials? Is corrections a unique population? Does this type of research constitute evidence? Who has time to design a rigorous study? Who is the audience? What to do with the findings?
5 Systematic, not always consistent Comprehensive and integrated Documentation Order management Communication Reporting and analysis Flexible workflows Structured data Controlled vocabulary Structuring unstructured data Decisional support
6 Documentation standards Clinical Decision Support Cross-sectional studies eprescribing & emar Workflows Remote Consult Telehealth econtacts
7 Strength Central nervous system Tool for delivery, practice, and analysis of care Efficient and cost effective Standards to an extent Weaknesses Not the panacea for all health management problems Limited adoptions Standards to an extent Opportunities Improved workflows Sharing data Standardizations Threats Perceived as limiting clinicians discretion Past experiences Changes to workflows
8 Wellness (health and fitness) Disease management Diabetes Hyperlipidemia Hypertension Polypharmacy Medication adherence
9 Collaboration with others Practice & community partners Academic Health Centers Research design Purpose/Problem, Research Questions/Specific Aims, Hypothesis, Methodology, Patterns and themes
10 Data collection Data entry Representative sample Chart reviews Inconsistencies Timely & costly Results and analyses Conclusions
11 What do you really want to learn? Research must be collaborative and participatory. Factor in detailed policy and health implications. Manage expectations. Data alone is not the answer. Results pertain to process (EHR/data) and product (outcomes).
12 An EHR is more than Standardization Legible and accurate documentation Storage and retrieval Organizational tools An EHR should Integrate data Incorporate evidence-based medicine Provide decisional support Support/facilitate health management
13 MADISON L GATES, PHD mgates@ .uky.edu University of Kentucky Family & Community Medicine KY Corrections Health Services Network (KCHSN) 2355 Huguenard Dr., Suite 100 Lexington, KY ANTHONY Q BAXTER, PHD [email protected] University of Kentucky College of Engineering Department of Computer Science 763D Anderson Hall Lexington, KY 40506
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