Regenstrief Institute

About: Regenstrief Institute is a nonprofit organization based out in Indianapolis, Indiana, United States. It is known for research contribution in the topics: Health care & Population. The organization has 742 authors who have published 2042 publications receiving 96966 citations.

Development and Assessment of a Public Health Alert Delivered through a Community Health Information Exchange

Abstract: Timely communication of information to health care providers during a public health event can improve overall response to such events. However, current methods for sending information to providers are inefficient and costly. Local health departments have traditionally used labor-intensive, mail-based processes to send public health alerts to the provider community. This article describes a novel approach for delivering public health alerts to providers by leveraging an electronic clinical messaging system within the context of a health information exchange. Alerts included notifications related to the 2009 H1N1 flu epidemic, a syphilis outbreak, and local rabies exposure. We describe the process for sending electronic public health alerts and the estimated impact on efficiency and cost effectiveness. Keywords: public health alerts, health information exchange, syndromic surveillance, clinical messaging, H1N1 flu, broadcast alert

Impact of socio-demographic, socioeconomic, and water variables on dental fluorosis in adolescents growing up during the implementation of a fluoridated domestic salt program

Abstract: The objective of this study is to determine the impact of socio-demographic, socioeconomic, and other risk indicators on dental fluorosis (DF) among Mexican adolescents. A cross-sectional study was carried out in 1,538 adolescents 12 and 15 years of age in semi-rural communities located at high altitude (>2,000 m) and with high concentration of fluoride in water (1.38–3.07 ppm) in Hidalgo, Mexico. DF was determined by means of Dean’s Index and all teeth were examined. Remaining variables were collected using a questionnaire. The adjusted final model was performed using ordered logistic regression. After adjusting for sex, the variables associated with DF were (p < 0.05): being 12 years old (OR = 1.10) versus 15 years old; having lived the first 6 years of life in El Llano (3.07 F ppm) (OR = 3.19) or San Marcos (1.38 F ppm) (OR = 1.63) versus Tula (1.42 F ppm); having public (OR = 1.35) or private health insurance (OR = 1.36) versus those without insurance; belonging to the lower quartiles of socioeconomic position (SEP) [1st quartile (OR = 2.48), 2nd quartile (OR = 1.81), 3rd quartile (OR = 1.49)] versus the highest quartile; having drunk tap water (OR = 1.83) or from a well or spring (OR = 2.30) versus those who drank water purchased in large containers or bottles. Demographic and socioeconomic variables were associated with DF. While better SEP appeared to play an important role in DF, a pattern of water intake associated with water purchased in large containers or bottles (which have different connotations to the use of bottled water in industrialized Western countries) did reduce DF risk in these high fluoride content, high altitude communities.

Why is warfarin underused for stroke prevention in atrial fibrillation? A detailed review of electronic medical records.

Abstract: Objective:Automated electronic queries of structured data fields in electronic medical records (EMR) found no barriers to warfarin in 42% of patients with atrial fibrillation or atrial flutter (AF) with moderate or high risk of stroke and no warfarin. A thorough manual review of records (including text reports) from the same EMR may better identify physicians’ reasons for not using warfarin.Methods:This was a cross-sectional, retrospective, manual EMR review. Patients identified in a previous automated EMR study with a CHADS2 (Chronic heart failure, Hypertension, Age >75 years, Diabetes mellitus, Stroke) score ≥2, no record of warfarin, no barrier to warfarin use, and (in the present study) confirmation of AF diagnosis were included in the manual EMR review. A structured chart abstraction form was used to extract data visible in the clinicians’ EMR user interface. Reasons why warfarin had not been prescribed were reported using descriptive statistics.Results:Among 408 patients with ‘no barriers’ t...