Informatics in Primary Care最新文献

{"title":"Managing and exploiting routinely collected NHS data for research.","authors":"Vasa Curcin,&nbsp;Michael Soljak,&nbsp;Azeem Majeed","doi":"10.14236/jhi.v20i4.1","DOIUrl":"https://doi.org/10.14236/jhi.v20i4.1","url":null,"abstract":"<p><strong>Introduction: </strong>Health research using routinely collected National Health Service (NHS) data derived from electronic health records (EHRs) and health service information systems has been growing in both importance and quantity. Wide population coverage and detailed patient-level information allow this data to be applied to a variety of research questions. However, the sensitivity, complexity and scale of such data also hamper researchers from fully exploiting this potential.</p><p><strong>Objective: </strong>Here, we establish the current challenges preventing researchers from making optimal use of the data sets at their disposal, on both the legislative and practical levels, and give recommendations as to how these challenges can be overcome.</p><p><strong>Method: </strong>A number of projects has recently been launched in the UK to address poor research data-management practices. Rapid Organisation of Healthcare Research Data (ROHRD) at Imperial College, London produced a useful prototype that provides local researchers with a one-stop index of available data sets together with relevant metadata.</p><p><strong>Findings: </strong>Increased transparency of data sets' availability and their provenance leads to better utilisation and facilitates compliance with regulatory requirements.</p><p><strong>Discussion: </strong>Research data resulting from NHS data is often not utilised fully, or is handled in a haphazard manner that prevents full auditability of the research. Furthermore, lack of informatics and data management skills in research teams act as a barrier to implementing more advanced practices, such as provenance capture and detailed, regularly updated, data management strategies. Only by a concerted effort at the levels of research organisations, funding bodies and publishers, can we achieve full transparency and reproducibility of the research.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 4","pages":"225-31"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31611293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication and the electronic health record training: a comparison of three healthcare systems.","authors":"Michelle H Lynott,&nbsp;Sarah A Kooienga,&nbsp;Valerie T Stewart","doi":"10.14236/jhi.v20i1.43","DOIUrl":"https://doi.org/10.14236/jhi.v20i1.43","url":null,"abstract":"<p><strong>Background: </strong>The electronic health record (EHR) used in the examination room, is becoming the primary method of medical data storage in primary care practice in the USA. One of the challenges in using EHRs is maintaining effective patient-provider communication. Many studies have focused on communication in the examination room.</p><p><strong>Purpose: </strong>Scant research exists on the best methods in educating nurse practitioners and other primary care providers (clinicians). The purpose of this study was to explore various health record training programmes for clinicians.</p><p><strong>Methods: </strong>One researcher participated in and observed three health systems' EHR training programmes for ambulatory care providers in the Pacific Northwest. A focused ethnographic approach was used, emphasising patient-provider communication.</p><p><strong>Results: </strong>Only one system had formalised communication training in their class, the other two systems emphasised only the software and data aspects of the EHR.</p><p><strong>Conclusions: </strong>The fact that clinicians are expected to use EHRs in the examination room necessitates the inclusion of communication training in EHR training programmes and/or as a part of primary care nurse practitioner education programmes.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 1","pages":"7-12"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31177450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interpretation of the reasons for encounter 'cough' and 'sadness' in four international family medicine populations.","authors":"Jean K Soler,&nbsp;Inge Okkes,&nbsp;Sibo Oskam,&nbsp;Kees Van Boven,&nbsp;Predrag Zivotic,&nbsp;Milan Jevtic,&nbsp;Frank Dobbs,&nbsp;Henk Lamberts","doi":"10.14236/jhi.v20i1.45","DOIUrl":"https://doi.org/10.14236/jhi.v20i1.45","url":null,"abstract":"<p><strong>Background: </strong>This is a study of the relationships between common reasons for encounter (RfEs) and common diagnoses (episode titles) within episodes of care (EoCs) in family practice populations in four countries.</p><p><strong>Method: </strong>Participating family doctors (FDs) recorded details of all their patient contacts in an EoC structure using the International Classification of Primary Care (ICPC), including RfEs presented by the patient, and the FDs' diagnostic labels. The relationships between RfEs and episode titles were studied using Bayesian methods.</p><p><strong>Results: </strong>The RfE 'cough' is a strong, reliable predictor for the diagnoses 'cough' (a symptom diagnosis), 'acute bronchitis', 'URTI' and 'acute laryngitis/tracheitis' and a less strong, but reliable predictor for 'sinusitis', 'pneumonia', 'influenza', 'asthma', 'other viral diseases (NOS)', 'whooping cough', 'chronic bronchitis', 'wheezing' and 'phlegm'. The absence of cough is a weak but reliable predictor to exclude a diagnosis of 'cough', 'acute bronchitis' and 'tracheitis'. Its presence allows strong and reliable exclusion of the diagnoses 'gastroenteritis', 'no disease' and 'health promotion/prevention', and less strong exclusion of 'adverse effects of medication'. The RfE 'sadness' is a strong, reliable predictor for the diagnoses 'feeling sad/depressed' and 'depressive disorder'. It is a less strong, but reliable predictor of a diagnosis of 'acute stress reaction'. The absence of sadness (as a symptom) is a weak but reliable predictor to exclude the symptom diagnosis 'feeling sad/depressed'. Its presence does not support the exclusion of any diagnosis.</p><p><strong>Conclusions: </strong>We describe clinically and statistically significant diagnostic associations observed between the RfEs 'cough' and 'sadness', presenting as a new problem in family practice, and all the episode titles in ICPC.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 1","pages":"25-39"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31177452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a survey instrument to assess the readiness of primary care data, genetic and disease registries to conduct linked research: TRANSFoRm International Research Readiness (TIRRE) survey instrument.","authors":"Emily Leppenwell,&nbsp;Simon de Lusignan,&nbsp;Marilia Tristan Vicente,&nbsp;Georgios Michalakidis,&nbsp;Paul Krause,&nbsp;Steve Thompson,&nbsp;Mark McGilchrist,&nbsp;Frank Sullivan,&nbsp;Terry Desombre,&nbsp;Adel Taweel,&nbsp;Brendan Delaney","doi":"10.14236/jhi.v20i3.26","DOIUrl":"https://doi.org/10.14236/jhi.v20i3.26","url":null,"abstract":"<p><strong>Background: </strong>Clinical data are collected for routine care in family practice; there are also a growing number of genetic and cancer registry data repositories. The Translational Research and Patient Safety in Europe (TRANSFoRm) project seeks to facilitate research using linked data from more than one source. We performed a requirements analysis which identified a wide range of data and business process requirements that need to be met before linking primary care and either genetic or disease registry data.</p><p><strong>Objectives: </strong>To develop a survey to assess the readiness of data repositories to participate in linked research - the Transform International Research Readiness (TIRRE) survey.</p><p><strong>Method: </strong>We develop the questionnaire based on our requirement analysis; with questions at micro-, meso- and macro levels of granularity, study-specific questions about diabetes and gastro-oesophageal reflux disease (GORD), and research track record. The scope of the data required was extensive. We piloted this instrument, conducting ten preliminary telephone interviews to evaluate the response to the questionnaire.</p><p><strong>Results: </strong>Using feedback gained from these interviews we revised the questionnaire; clarifying questions that were difficult to answer and utilising skip logic to create different series of questions for the various types of data repository. We simplified the questionnaire replacing free-text responses with yes/no or picking list options, wherever possible. We placed the final questionnaire online and encouraged its use (www.clininf.eu/jointirre/info.html).</p><p><strong>Conclusion: </strong>Limited field testing suggests that TIRRE is capable of collecting comprehensive and relevant data about the suitability and readiness of data repositories to participate in linked data research.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 3","pages":"207-16"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31460686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computerised decision support systems for healthcare professionals: an interpretative review.","authors":"Kathrin Cresswell,&nbsp;Azeem Majeed,&nbsp;David W Bates,&nbsp;Aziz Sheikh","doi":"10.14236/jhi.v20i2.32","DOIUrl":"https://doi.org/10.14236/jhi.v20i2.32","url":null,"abstract":"<p><strong>Purpose: </strong>Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.</p><p><strong>Methods: </strong>We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.</p><p><strong>Results: </strong>Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.</p><p><strong>Conclusions: </strong>Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may also introduce new risks resulting not only from technical challenges (such as data inaccuracies) but also from disruption of clinical workflows. Moving forward, there is a need for system development, procurement and implementation to be characterised by a user 'pull' and then tailor systems to the needs of users.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 2","pages":"115-28"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31460677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the empirical evidence of the value of structuring and coding of clinical information within electronic health records for direct patient care.","authors":"Dipak Kalra,&nbsp;Bernard Fernando,&nbsp;Zoe Morrison,&nbsp;Aziz Sheikh","doi":"10.14236/jhi.v20i3.22","DOIUrl":"https://doi.org/10.14236/jhi.v20i3.22","url":null,"abstract":"<p><strong>Background: </strong>The case has historically been presented that structured and/or coded electronic health records (EHRs) benefit direct patient care, but the evidence base for this is not well documented.</p><p><strong>Methods: </strong>We searched for evidence of direct patient care value from the use of structured and/or coded information within EHRs. We interrogated nine international databases from 1990 to 2011. Value was defined using the Institute of Medicine's six areas for improvement for healthcare systems: effectiveness, safety, patient-centredness, timeliness, efficiency and equitability. We included studies satisfying the Cochrane Effective Practice and Organisation of Care (EPOC) group criteria.</p><p><strong>Results: </strong>Of 5016 potentially eligible papers, 13 studies satisfied our criteria: 10 focused on effectiveness, with eight demonstrating potential for improved proxy and actual clinical outcomes if a structured and/or coded EHR was combined with alerting or advisory systems in a focused clinical domain. Three studies demonstrated improvement in safety outcomes. No studies were found reporting value in relation to patient-centredness, timeliness, efficiency or equitability.</p><p><strong>Conclusions: </strong>We conclude that, to date, there has been patchy effort to investigate empirically the value from structuring and coding EHRs for direct patient care. Future investments in structuring and coding of EHRs should be informed by robust evidence as to the clinical scenarios in which patient care benefits may be realised.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 3","pages":"171-80"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31460682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The provision and impact of online patient access to their electronic health records (EHR) and transactional services on the quality and safety of health care: systematic review protocol.","authors":"Freda Mold,&nbsp;Beverley Ellis,&nbsp;Simon de Lusignan,&nbsp;Aziz Sheikh,&nbsp;Jeremy C Wyatt,&nbsp;Mary Cavill,&nbsp;Georgios Michalakidis,&nbsp;Fiona Barker,&nbsp;Azeem Majeed,&nbsp;Tom Quinn,&nbsp;Phil Koczan,&nbsp;Theo Avanitis,&nbsp;Toto Anne Gronlund,&nbsp;Christina Franco,&nbsp;Mary McCarthy,&nbsp;Zoë Renton,&nbsp;Umesh Chauhan,&nbsp;Hannah Blakey,&nbsp;Neha Kataria,&nbsp;Simon Jones,&nbsp;Imran Rafi","doi":"10.14236/jhi.v20i4.17","DOIUrl":"https://doi.org/10.14236/jhi.v20i4.17","url":null,"abstract":"<p><strong>Background: </strong>Innovators have piloted improvements in communication, changed patterns of practice and patient empowerment from online access to electronic health records (EHR). International studies of online services, such as prescription ordering, online appointment booking and secure communications with primary care, show good uptake of email consultations, accessing test results and booking appointments; when technologies and business process are in place. Online access and transactional services are due to be rolled out across England by 2015; this review seeks to explore the impact of online access to health records and other online services on the quality and safety of primary health care.</p><p><strong>Objective: </strong>To assess the factors that may affect the provision of online patient access to their EHR and transactional services, and the impact of such access on the quality and safety of health care.</p><p><strong>Method: </strong>Two reviewers independently searched 11 international databases during the period 1999-2012. A range of papers including descriptive studies using qualitative or quantitative methods, hypothesis-testing studies and systematic reviews were included. A detailed eligibility criterion will be used to shape study inclusion. A team of experts will review these papers for eligibility, extract data using a customised extraction form and use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument to determine the quality of the evidence and the strengths of any recommendation. Data will then be descriptively summarised and thematically synthesised. Where feasible, we will perform a quantitative meta-analysis. Prospero (International Prospective Register of Systematic Reviews) registration number: crd42012003091.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 4","pages":"271-82"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31610627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can data extraction from general practitioners' electronic records be used to predict clinical outcomes for patients with type 2 diabetes?","authors":"Michael Staff","doi":"10.14236/jhi.v20i2.30","DOIUrl":"https://doi.org/10.14236/jhi.v20i2.30","url":null,"abstract":"<p><strong>Background: </strong>The review of clinical data extraction from electronic records is increasingly being used as a tool to assist general practitioners (GPs) manage their patients in Australia. Type 2 diabetes (T2DM) is a chronic condition cared for primarily in the general practice setting that lends itself to the application of tools in this area.</p><p><strong>Objective: </strong>To assess the feasibility of extracting data from a general practice medical record software package to predict clinically significant outcomes for patients with T2DM.</p><p><strong>Methods: </strong>A pilot study was conducted involving two large practices where routinely collected clinical data were extracted and inputted into the United Kingdom Prospective Diabetes Study Outcomes Model to predict life expectancy. An initial assessment of the completeness of data available was performed and then for those patients aged between 45 and 64 years with adequate data life expectancies estimated.</p><p><strong>Results: </strong>A total of 1019 patients were identified as current patients with T2DM. There were sufficient data available on 40% of patients from one practice and 49% from the other to provide inputs into the UKPDS Outcomes Model. Predicted life expectancy was similar across the practices with women having longer life expectancies than men. Improved compliance with current management guidelines for glycaemic, lipid and blood pressure control was demonstrated to increase life expectancy between 1.0 and 2.4 years dependent on gender and age group.</p><p><strong>Conclusion: </strong>This pilot demonstrated that clinical data extraction from electronic records is feasible although there are several limitations chiefly caused by the incompleteness of data for patients with T2DM.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 2","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31460675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploratory study of the personal health records adoption model in the older adult with chronic illness.","authors":"Melanie D Logue,&nbsp;Judith A Effken","doi":"10.14236/jhi.v20i3.21","DOIUrl":"https://doi.org/10.14236/jhi.v20i3.21","url":null,"abstract":"<p><strong>Background: </strong>Despite international efforts moving toward integrated care using health information technologies and the potential of electronic PHRs to help us better coordinate patient-centered care, PHR adoption in the United States remains low among patients who have been offered free access to them from private-sector companies. If older adult stand to benefit from the use of PHRs for its usefulness in self-managing chronic illness, why have they not been more readily adopted? Since the chronically ill older adult has unique circumstances that impact their decision to participate in self-directed care, a theoretical framework to help understand factors that influence the adoption of PHRs is important. Here we describe the results of an exploratory study that provided an initial test of such a framework.</p><p><strong>Methods: </strong>The study used a descriptive survey methodology with 38 older adults. The survey questionnaire asked about the personal barriers and facilitators associated with personal health record adoption and included items measuring each of the PHRAM's four interacting factors (environmental factors, personal factors, technology factors, and self-management), and the resulting behavioral outcome.</p><p><strong>Results: </strong>Younger seniors had a more positive attitude toward computers, knew what health resources were available on the internet, agreed that they had the resources in place to use PHRs, and would be more influenced by a family member than a healthcare provider to use them. Conversely, older seniors reported less confidence in their ability to use Internet-based PHRs and did not perceive that they had the resources in place to use them.</p><p><strong>Conclusions: </strong>The results of this study indicated that personal, environmental, technology, chronic illness, and behavioral factors operated concurrently as personal barriers and/or facilitators to the adoption of PHRs among the older adult with chronic illness. These factors cannot be isolated because the person commonly weighs risk with benefit and determines the personal value of adopting PHRs.</p>","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 3","pages":"151-69"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31460681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coding the present problem.","authors":"Simon de Lusignan","doi":"10.14236/jhi.v20i3.20","DOIUrl":"https://doi.org/10.14236/jhi.v20i3.20","url":null,"abstract":"Coding of the ‘problem’ in computerised medical records is sine qua non in the informatics community. The ‘problem’ should be formulation of what the clinician thought was the underlying pathological process, ideally not simply a symptom, or procedure (Box 1). Many in informatics take it for granted that coding clinical data is a good thing; without considering if there is an evidence base for this activity. Whilst much of what we know about health and disease comes from routinely recorded computer data, the quality of that data and our ability to extract it without loss in its fidelity limit its usefulness. The informatics community has focused on data quality rather than developing an evidence base about the value and utility of the data collected. Data quality is defined in terms of its completeness and accuracy, currency (i.e. how up-to-date it is), and in terms of its positive predictive value and sensitivity that someone identified by routine data actually has that condition. Data quality has also been described functionally in terms of its ‘fitness for purpose.’ Kalra et al., in their review of the empirical evidence wakes us up to how there is little high-quality evidence for the benefits of clinical coding. There is no evidence of harm, but a dearth of studies providing positive evidence of benefit from coding data. The principal benefit, in terms of outcomes arising from the use of coded data, is in the management of longterm conditions in which prevention or therapeutic intervention reminders are linked to coded data. This same type of linkage is also used to improve patient safety by providing relevant prescribing alerts.","PeriodicalId":30591,"journal":{"name":"Informatics in Primary Care","volume":"20 3","pages":"147-9"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31465980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}