Democratizing information creation from health care data for quality improvement, research, and education-the Montefiore Medical Center Experience.

The National Research Council recently reviewed the capabilities of health care software implemented in the United States and described a health care information technology chasm that is threatening the medical community's ability to meet the health care quality goals enumerated in Institute of Medicine reports. Among the critical gaps is the inability of health care software systems to allow users to convert data into meaningful information supporting quality improvement, analysis, and research. In this article, the authors describe the Montefiore Medical Center's decade-long experience developing software for the purpose of converting data into useful information and integrating software use into the clinical culture. The program at Montefiore could serve as a potential national model.

[1]  H. Billett,et al.  Efficacy of inferior vena cava filters in anticoagulated patients , 2007, Journal of thrombosis and haemostasis : JTH.

[2]  C. Patterson.  Joint Commission on Accreditation of Healthcare Organizations , 1995, Infection Control & Hospital Epidemiology.

[3]  Adam B. Keene,et al.  Increased bleeding risk associated with the use of recombinant human activated protein C in patients with advanced liver disease , 2008, Critical Care.

[4]  C. Putterman,et al.  Necrotizing fasciitis in systemic lupus erythematosus. , 2008, Seminars in arthritis and rheumatism.

[5]  Don E. Detmer,et al.  White Paper: Advancing the Framework: Use of Health Data - A Report of a Working Conference of the American Medical Informatics Association , 2008, J. Am. Medical Informatics Assoc..

[6]  Adam B. Keene,et al.  Mortality before and after initiation of a computerized physician order entry system in a critically ill pediatric population* , 2007, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[7]  K. Bonuck,et al.  Randomized controlled trial of a prenatal and postnatal lactation consultant intervention on infant health care use. , 2006, Archives of pediatrics & adolescent medicine.

[8]  William W. Stead,et al.  Committee on Engaging the Computer Science Research Community in Health Care Informatics , 2009 .

[9]  Herbert S. Lin,et al.  Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions , 2009 .

[10]  H. Billett,et al.  A comparison of direct thrombin inhibitors in the treatment of heparin-induced thrombocytopenia: a single institution experience , 2008, Journal of Thrombosis and Thrombolysis.

[11]  Richard D Moore,et al.  Interval and clinical cohort studies: epidemiological issues. , 2007, AIDS research and human retroviruses.

[12]  Paul C Tang,et al.  Research Paper: Comparison of Methodologies for Calculating Quality Measures Based on Administrative Data versus Clinical Data from an Electronic Health Record System: Implications for Performance Measures , 2007, J. Am. Medical Informatics Assoc..

[13]  S. Hailpern,et al.  Predictors of Early Hospital Readmission for Asthma Among Inner-City Children , 2006, The Journal of asthma : official journal of the Association for the Care of Asthma.

[14]  Patricia Gauthier,et al.  Integrating feedback from a clinical data warehouse into practice organisation , 2006, Int. J. Medical Informatics.

[15]  Amy R Ehrlich,et al.  Risk Factors for Fires and Burns in Homebound, Urban Elderly , 2008, Journal of burn care & research : official publication of the American Burn Association.

[16]  M. Surks,et al.  Reference limits of serum TSH and free T4 are significantly influenced by race and age in an urban outpatient medical practice , 2009, Clinical endocrinology.

[17]  D Koo,et al.  Public health 101 for informaticians. , 2001, Journal of the American Medical Informatics Association : JAMIA.

[18]  J. Arnsten,et al.  The effect of race on provider decisions to test for illicit drug use in the peripartum setting. , 2007, Journal of women's health.

[19]  K. Bonuck,et al.  Breastfeeding and Infant Illness in Low-Income, Minority Women: A Prospective Cohort Study of the Dose-Response Relationship , 2008, Journal of human lactation : official journal of International Lactation Consultant Association.

[20]  P. Chountas,et al.  Development of a clinical data warehouse , 2004, 2004 IDEAS Workshop on Medical Information Systems: The Digital Hospital (IDEAS-DH'04).

[21]  T. Aldrich,et al.  The oxygen affinity of sickle hemoglobin , 2008, Respiratory Physiology & Neurobiology.

[22]  Alexander Kopp,et al.  Outpatient gatifloxacin therapy and dysglycemia in older adults. , 2006, The New England journal of medicine.

[23]  J. Gurwitz.  Serious adverse drug effects--seeing the trees through the forest. , 2006, The New England journal of medicine.

[24]  Nhan Do,et al.  Application of Information Technology: Exchange of Computable Patient Data between the Department of Veterans Affairs (VA) and the Department of Defense (DoD): Terminology Mediation Strategy , 2008, J. Am. Medical Informatics Assoc..

[25]  Joseph L. Kannry,et al.  Research Paper: Portability Issues for a Structured Clinical Vocabulary: Mapping from Yale to the Columbia Medical Entities Dictionary , 1996, J. Am. Medical Informatics Assoc..

[26]  Karen Frush,et al.  Handoffs in the era of duty hours reform: a focused review and strategy to address changes in the Accreditation Council for Graduate Medical Education Common Program Requirements. , 2012, Academic medicine : journal of the Association of American Medical Colleges.

[27]  N. Dubler,et al.  The quality improvement-research divide and the need for external oversight. , 2001, American journal of public health.

[28]  Matthew A. Berger,et al.  Hospitalist care and length of stay in patients requiring complex discharge planning and close clinical monitoring. , 2007, Archives of internal medicine.

[29]  George W Gray.  Challenges of building clinical data analysis solutions. , 2004, Journal of critical care.

[30]  R. Dolin.  Modeling the temporal complexities of symptoms. , 1995, Journal of the American Medical Informatics Association : JAMIA.

[31]  Adeeba Kamarulzaman,et al.  AIDS Res Hum Retroviruses , 2006 .

[32]  J. Shuter,et al.  HIV-Infected Patients Receiving Lopinavir/Ritonavir-Based Antiretroviral Therapy Achieve High Rates of Virologic Suppression Despite Adherence Rates Less Than 95% , 2007, Journal of acquired immune deficiency syndromes.

[33]  J. Loeb,et al.  From the Joint Commission on Accreditation of Healthcare Organizations. , 1995, JAMA.

[34]  K. Bonuck,et al.  Randomized, Controlled Trial of a Prenatal and Postnatal Lactation Consultant Intervention on Duration and Intensity of Breastfeeding up to 12 Months , 2005, Pediatrics.

[35]  M. Segal,et al.  Medicare's New Restrictions on Rehabilitation Admissions: Impact on the Elderly , 2008, American journal of physical medicine & rehabilitation.