Among adult patients receiving chronic PPI therapy, there is a significant decrease in hematologic indices from baseline.

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Our study highlights opportunities to improve clinical summaries for guiding patients' postdischarge care.

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Background: The after visit summary (AVS) is a paper or electronic document given to patients after a medical appointment, which is intended to summarize patients' health and guide future care, including self-management tasks. Objective: To describe experiences of health systems implementing a redesigned outpatient AVS in commercially available electronic health record (EHR) systems to inform future optimization. Materials and Methods: We conducted semi-structured interviews with information technology and clinical leaders at 12 hospital and community-based healthcare institutions across the continental United States focusing on the process of AVS redesign and implementation. We also report our experience implementing a redesigned AVS in the Epic EHR at the Mount Sinai Hospital in New York City, NY. Results: Health systems experienced many challenges implementing the redesigned AVS. While many IT leaders noted that the redesigned AVS is easier to understand and the document is better organized, they claim the effort is time-consuming, Epic system upgrades render AVS modifications non-functional, and primary care and specialty practices have different needs in *

Several monitoring techniques were evaluated for their effectiveness, based on the highest mean captures of cranberry tipworm, Dasineura oxycoccana (Johnson), in detecting D. oxycoccana in rabbiteye, Vaccinium ashei Reade, and southern highbush, V. corymbosum L. x V. darrowi Camp, blueberry plantings. There were no significant differences in captures of D. oxycoccana adults on unbaited sticky board traps, regardless of color (yellow, white, green, or blue). In a separate experiment, three monitoring techniques, yellow unbaited sticky boards, larval/adult emergence from infested buds, and bud dissection, were evaluated for detecting D. oxycoccana, eggs, larvae, and adults. In total, four bud types were examined, including rabbiteye floral, rabbiteye leaf, southern highbush floral, and southern highbush leaf. The emergence monitoring technique detected significantly more D. oxycoccana adults than the other techniques evaluated. Emergence and dissection techniques performed equally well for detecting D. oxycoccana larvae. Dissection was the only technique capable of detecting D. oxycoccana eggs. Overall, the highest numbers of D. oxycoccana eggs were detected in southern highbush leaf buds. However, larval infestation was lower for southern highbush leaf buds compared with other bud types sampled. Hypotheses to explain this phenomenon are discussed. The fewest number of eggs was recorded for southern highbush flower buds, potentially because these buds develop before peak emergence of D. oxycoccana. Managing D. oxycoccana in infested plantings can be improved by incorporating monitoring techniques, specifically bud dissection to search for eggs, that will aid growers in making timely insecticide applications.

Our medication management application PresRx OCR is innovative, acceptable for patient use, and accurately tracks medication adherence.

Nurses report significant gaps in communication among patients discharged from the hospital with home healthcare (HHC) services. The aim of this pilot study was to quantify the contents of HHC admission packets used to guide nurses' first home visit after hospital discharge. We evaluated 20 randomly selected charts of older adults admitted to HHC after a hospitalization for heart failure. Admission packets contained nearly 50 pages of material, which frequently included duplicate documents printed from the hospital-based electronic health record (EHR). Despite the plethora of documents, most packets omitted key information, such as patients' cognitive and functional status, and even discharge summaries, which would be relevant and actionable for HHC nurses. Moreover, admission packets contained multiple, often discordant, EHR-generated medication lists, which makes reconciliation challenging for nurses and puts vulnerable patients at risk for adverse drug events. Overall, there is an urgent need to improve health information exchange between hospitals and HHC agencies, which will simultaneously promote nurse efficiency and patient safety.