This study contributes to the understanding of early Blue Button adoption and use of this feature for patient-initiated sharing of health information. Educational efforts are needed to raise awareness of the Blue Button and to address usability issues that hinder adoption.
Veterans' primary motivation for use of the pilot Web site was the ability to access their own personal health information from the EHR. With patients viewing such access as beneficial to their health and care, PHRs with access to EHR data are positioned to improve health care quality. Making additional information accessible to patients is crucial to meet their needs and preferences.
Objectives. We describe electronic health data use by the Department of Veterans Affairs (VA) in the month after Katrina, including supporting technologies, the extent and nature of information accessed, and lessons learned.Methods. We conducted a retrospective study using cross-sectional panels of data collected sequentially over time.Results. By September 30, 2005, clinical data were accessed electronically for at least 38% (14 941 of 39 910) of patients cared for prior to Hurricane Katrina by New Orleans-area VA medical facilities. Approximately 1000 patients per day had data accessed during the month following Hurricane Katrina, a rate approximately two thirds of pre-Katrina values. Health care data were transmitted to more than 200 sites in 48 states and to at least 2300 users.Conclusions. The VA electronic health records supported continuity of care for evacuated veterans after Katrina. Our findings suggest that pharmacy and laboratory computerization alone will not be sufficient for future disaster support systems. (Am J Public Health.
Introduction:Over the last few years, hypnotic and anxiolytic medications have had their clinical efficacy questioned in the context of concerns regarding dependence, tolerance alongside other adverse effects. It remains unclear how these concerns have impacted clinical prescribing practice.Materials and Methods:This is a study reviewing community-dispensed prescribing data for patients on the East Practice Medical Center list in Arbroath, Scotland, in 2007, 2011 and 2015. Anxiolytic and hypnotic medications were defined in accordance with the British National Formulary chapter 4.1.1 and chapter 4.1.2. All patients receiving a drug within this class in any of the study years were collated and anonymized using primary care prescribing data. The patients’ age, gender, name of the prescribed drug(s), and total number of prescriptions in this class over the year were extracted.Results:The proportion of patients prescribed a benzodiazepine medication decreased between 2007 and 2015: 83.8% (n = 109) in 2007, 70.5% (n = 122) in 2011, and 51.7% (n = 138) in 2015 (P = 0.006). The proportion of these patients prescribed a nonbenzodiazepine drug increased between 2007 and 2015: 30% (n = 39) in 2007, 46.2% (n = 80) in 2011, and 52.4% (n = 140) in 2015 (P = 0.001). There was a significant increase in the number of patients prescribed melatonin (P = 0.020).Discussion:This study reports a reduction in benzodiazepine prescriptions in primary care alongside increases in nonbenzodiazepine and melatonin prescribing, with an increase in prescribing rates of this drug class overall.Conclusion:Changes in this prescribing practice may reflect the medicalization of insomnia, local changes in prescribing practice and alongside national recommendations.
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