RESUMEN
Medical data and information are ubiquitous due to internet availability. However, most people persist in using and trusting their healthcare professionals for health information. They are increasingly flooded with health information from diverse sources such as the internet, community-based organizations, and family or friends. It is crucial to understand where stroke patients vary in the use and trust of health information to improve their conditions. This pilot study aimed to better understand the nature of the problems confronted by stroke patients, such as the source of reliable health information, trust in the healthcare system, and technology trend awareness. African American and Afro-Caribbean stroke patients (n=64) residing in Central Brooklyn, New York, participated in a survey. The results showed that physicians remained the most highly trusted information sources for stroke patients, particularly among patients with higher education, irrespective of the available communication sources.
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Grupos Minoritarios , Accidente Cerebrovascular , Humanos , Proyectos Piloto , Etnicidad , Accidente Cerebrovascular/terapia , SobrevivientesRESUMEN
This poster describes the findings from a study that attempts to characterize an underserved Black stroke cohort who are at risk for discontinuities of care using electronic health record (EHR). Preliminary analysis revealed that 90.1% of the patients were Black. After being diagnosed with a stroke, 57% of the population did not return for follow-up. The objective is to understand the factors contributing to discontinuity of care in Black stroke patients.
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Registros Electrónicos de Salud , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular/terapiaRESUMEN
The purpose of the study is to evaluate whether clinician's acknowledgement and adherence to Clinical Best Practice Advisories (BPA) system's alerts improves the outcome of patients with chronic diabetes. We used deidentified clinical data of elderly (65 or older) diabetes patients with hemoglobin A1C (HbA1C) >= 6.5 that were extracted from the clinical database of a multi-specialty outpatient clinic that also provides primary care services. We performed paired ttest to evaluate whether clinician's acknowledgement and adherence to BPA system's alert has any impact on patients' HbA1C management. Our findings showed that the average HbA1C values improved for patients whose alerts were acknowledged by their clinicians. For the group of patients whose BPA alerts were ignored by their clinicians, we found clinicians' acknowledgement and adherence to BPA alerts for chronic diabetes patient management did not have a significant negative effect on improvement in patient outcome.
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Sistemas de Apoyo a Decisiones Clínicas , Diabetes Mellitus , Sistemas de Entrada de Órdenes Médicas , Médicos , Humanos , Anciano , Hemoglobina Glucada , Errores de Medicación , Atención Primaria de Salud , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/terapiaRESUMEN
OBJECTIVE: To explore a 5-year comparison of disparities in intravenous t-PA (IV t-PA) use among acute ischemic stroke (AIS) patients based on race, gender, age, ethnic origin, hospital status, and geographic location. METHODS: We extracted patients' demographic information and hospital characteristics for 2010 and 2014 from the New York Statewide Planning and Research Cooperative System (SPARCS). We compared disparities in IV t-PA use among AIS patients in 2010 to that in 2014 to estimate temporal trends. Multiple logistic regression was performed to compare disparities based on demographic variables, hospital designation, and geographic location. RESULTS: Overall, there was approximately a 2% increase in IV t-PA from 2010 to 2014. Blacks were 15% less likely to receive IV t-PA compared to Whites in 2014, but in 2010, there was no difference. Patients aged 62-73 had lower odds of receiving IV t-PA than age group ≤61 in both 2010 and 2014. Designated stroke centers in the Lower New York State region were associated with reduced odds of IV t-PA use in 2010 while those located in the Upper New York State region were associated with increased odds of IV t-PA use in both 2010 and 2014, compared to their respective nondesignated counterparts. Gender, ethnic origin, and insurance status were not associated with IV t-PA utilization in both 2010 and 2014. CONCLUSION: Overall IV t-PA utilization among AIS patients increased between 2010 and 2014. However, there are evident disparities in IV t-PA use based on patient's race, age, hospital geography, and stroke designation status.
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Isquemia Encefálica/tratamiento farmacológico , Fibrinolíticos/administración & dosificación , Accesibilidad a los Servicios de Salud/tendencias , Disparidades en Atención de Salud/tendencias , Evaluación de Procesos, Atención de Salud/tendencias , Accidente Cerebrovascular/tratamiento farmacológico , Terapia Trombolítica/tendencias , Administración Intravenosa , Factores de Edad , Anciano , Anciano de 80 o más Años , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/etnología , Bases de Datos Factuales , Femenino , Disparidades en Atención de Salud/etnología , Humanos , Masculino , Persona de Mediana Edad , New York/epidemiología , Grupos Raciales , Factores Sexuales , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/etnología , Factores de Tiempo , Resultado del TratamientoRESUMEN
Most of the cyber security systems use simulated data in evaluating their detection capabilities. The proposed cyber security system utilizes real hospital network connections. It uses a probabilistic data mining algorithm to detect anomalous events and takes appropriate response in real-time. On an evaluation using real-world hospital network data consisting of incoming network connections collected for a 24-hour period, the proposed system detected 15 unusual connections which were undetected by a commercial intrusion prevention system for the same network connections. Evaluation of the proposed system shows a potential to secure protected patient health information on a hospital network.