Running head: ANNOTATED BIBLIOGRAPHY 1

Annotated Bibliography

Students Name

Institutional Affiliation
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Annotated Bibliography

Are, U. S. (2018). Physician burnout in the electronic health record era: are we ignoring the real

cause?. Ann Intern Med, 169, 50-51. Most researchers in the HIT field concentrate on the

systems and fail to look out for the people who use them. Are seeks to investigate the

cause of physician burnout in relation to the use of electronic health records. His findings

indicate that the physicians are incredibly exhausted after working on both face-to-face

appointments and ‘desktop appointments.’ The author recommends some platform

improvements that allow physicians to work in teams. For instance, he recommends

patients to get involved in filling information in the EHR systems. However, the

limitation of this study is the provided recommendations might not be enough to solve the

looming issue. The programs should include value-based reimbursement programs which

ensure physicians are not overhead by administrative duties. Are addresses a vital issue in

the implemented value-based healthcare system that if not addressed, can lead to the loss

of many physicians. Overworked physicians mean ineffective healthcare provision and

should be looked into with caution.

Bucholc, M., Ding, X., Wang, H., Glass, D. H., Wang, H., Prasad, G., ... & Finn, D. P. (2019). A

practical computerized decision support system for predicting the severity of Alzheimer's

disease of an individual. Expert Systems with Applications, 130, 157-171. Considering

current research are mainly based on group analysis, discrete classification of disease

stages, or expensive and not readily accessible biomarkers, there is a need to develop a

system that relies on cognitive and functional assessment. Buncholc et al. used machine

learning tools to develop a computational framework using key markers to analyze the

severity of Alzheimer's disease. The project had several limitations which include lack of
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a mechanism to take care of data that was missing and the absence of a system to predict

the accuracy of an interactive model. The integration of an effective cost-friendly offers a

platform to standardize the diagnosis of Alzheimer's disease. This is advantageous

because it streamlines the workflow and helps in clinical decision making. Nonetheless, it

requires the active involvement of the entire medical community to certify that the

system is fully integrated into the healthcare system. Despite the few limitations, the

system works well in improving Alzheimer's diagnosis and general healthcare.

Chatzakis, I., Vassilakis, K., Lionis, C., & Germanakis, I. (2018). Electronic health record with

computerized decision support tools for a pediatric cardiovascular heart disease screening

program in Crete. Computer methods and programs in biomedicine, 159, 159-166. The

study aimed to elaborate on the development of an EHR system that incorporates a

computerized decision support tool. The tool was to be customized to support the

screening of cardiovascular heart diseases. Evidence-based knowledge from kids and

youth athletes was used as a basis for designing the software. Early detection through

screening is vital in the management and care of cardiovascular disease patients; this

research goes a long way in helping achieve this. The fact that it enables early detection

of the disease in children and young adults is the main advantage of this study. A

preliminary validation using data entered from 53 patients showed it was functional.

However, the researchers should have implemented other forms of primary data

collection to certify its accuracy. Other than that, the system will be crucial in the early

detection of cardiovascular diseases and risk factors in the younger population. In

addition, the system incorporates both electronic health records and computerized disease

registries, making it more efficient.

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Cowie, M. R., Blomster, J. I., Curtis, L. H., Duclaux, S., Ford, I., Fritz, F., ... & Michel, A.

(2017). Electronic health records to facilitate clinical research. Clinical Research in

Cardiology, 106(1), 1-9. The research was conducted to investigate the steps required to

advance the mandate of electronic health records in cardiovascular research. This is

regarding the increased concerns regarding the recruitment challenges in research, abuse

of collected data, and the obstructive and uncertain generalization of results. The method

used in the research is advantageous as it seeks to advance the approach of randomized

clinical trials and consequently accessing feasibility studies that streamline data

collection and facilitate patient recruitment. This can only be achieved by combining data

from academia, regulation bodies, patients, among others, something that electronic

health records can achieve. However, the use of electronic health records is limiting as it

is suitable for pragmatic studies in which its form of data collection is similar to that of

clinical trials. Additionally, its effectiveness is highly dependent on the regulatory

acceptance and whether it supports the researchers use. In general, electronic health

records are vital not only in storing data but also in registration clinical trials, which

consequently promotes general healthcare.

Fronczek, A. E., Rouhana, N. A., & Kitchin, J. M. (2017). Enhancing telehealth education in

nursing: Applying King’s conceptual framework and theory of goal attainment. Nursing

science quarterly, 30(3), 209-213. The authors of the article investigate a nursing school

that has integrated telehealth content into its undergraduate and postgraduate learning

system by utilizing King’s conceptual system. The reason for this is because nurses play

the primary role in providing care to all patients. Therefore, when they learn and

understand telehealth as a tool for improving healthcare, they can easily use the
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technologies in their day to day activities as they care for patients. The main advantage of

this research is the option of investigating the King’s conceptual approach as a learning

tool. The system provides a strong framework to meet the educational goals of nurses.

However, the authors investigated the effectiveness of the framework for a short period

hence not accurate. They should have taken their time or taken a sample population to

observe throughout their learning program and once they start work. Nonetheless, the

research provides a guideline on telehealth and its incorporation to nursing, which is the

backbone of healthcare.

Krishna, V. N., Managadi, K., Smith, M., & Wallace, E. (2017). Telehealth is the delivery of

home dialysis care: Catching up with technology. Advances in chronic kidney

disease, 24(1), 12-16. The authors seek solutions to the challenges that are faced when

delivering homecare dialysis, especially in low underserved backgrounds. The objective

of the paper is to understand how telehealth can be used to improve healthcare delivery in

these circumstances. Some of the services that can be achieved through this are

physician-patient communication, general monitoring, nursing, and nutrition education,

among others. The main advantage of this study is it provides a solution to rather

deteriorated system where effective care is crucial in keeping the patients alive.

Considering how sensitive these patients are, a noncontact form of communication

between patient and physician may not be effective. This is because the patient needs

close observation to certify that the dialysis is working. However, despite having its

limitation, telehealth might be the only solution for patients, especially in sparsely

populated areas as it eliminates geographical barriers.

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Nanji, K. C., Seger, D. L., Slight, S. P., Amato, M. G., Beeler, P. E., Her, Q. L., ... & Swerdloff,

M. (2017). Medication-related clinical decision support alert overrides in

inpatients. Journal of the American Medical Informatics Association, 25(5), 476-481.

Nanji et al. propose a privacy-preserving framework for the clinical support system that

uses lightweight data mining to observe patients’ health in real-time. These data are sent

to a cloud server for prediction while conserving privacy. This feature research work is

vital to general healthcare as any other is. It stands out because the researchers are

developing a new form of HIT that incorporates clinical decision support. The framework

not only mines light data about the patient but also preserves the data is a private cloud.

For that reason, privacy is its main advantage. However, because the data is mined

without the patient’s consent, the system breaks a number of privacy regulations. This is

controversial in itself because the data is illegally obtained. Hence, even though effective,

the system might not work in an ideal world. The researchers should, therefore, aim to

reconstruct their system to get data in a more accepted and legal manner.

Raza, M., Le, M. H., Aslam, N., Le, C. H., Le, N. T., & Le, T. L. (2017, June). Telehealth

technology: Potentials, challenges, and research directions for developing countries.

In International Conference on the Development of Biomedical Engineering in

Vietnam (pp. 523-528). Springer, Singapore. Raza et al. provide an overview of the

telehealth system while addressing the various technologies that exist in telehealth and

how they can be used to improve healthcare. The research is mainly focused on the

benefits it can have on developing countries. Some of these technologies include the

Internet of Things(IoT), cloud computing, medical imaging, among others. Developing

countries have limited access to reasonable healthcare; this research provides a view that
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could be beneficial in improving this. However, the main limitation of this research is its

focus on the developing countries and their challenges and ignoring the developed

countries that still have challenges when it comes to universal healthcare limits the

research’s findings to some areas of the world. Nonetheless, the conclusion dawn can go

a long way in helping people in developing countries who struggle with basic healthcare.

Tai-Seale, M., Olson, C. W., Li, J., Chan, A. S., Morikawa, C., Durbin, M., ... & Luft, H. S.

(2017). Electronic health record logs indicate that physicians split time evenly between

seeing patients and desktop medicine. Health Affairs, 36(4), 655-662. The study seeks to

address concerns that have been raised that physicians who use electronic health records

spend more time on screens that accessing the patients. The researchers used the time

stamp functionality data to capture the physicians work effort. The data of 471 physicians

between the period of 2011 and 2014 were looked into. This included but was not limited

to the time spent responding to patients, ordering tests, sending staff messages,

prescribing refills a reviewing test results. The results showed that despite a decline in

face-to-face visits by patients, the amount of ‘desktop time’ increased drastically. This is

something that most researchers fail to consider. The findings from the research are more

accurate because they use primary data instead of secondary. On the other hand, the

researchers used data collected for four years, further improving accuracy. However, the

timestamps might have been tampered with, or the physician might have been doing

something else other than what was expected. Therefore, there is room for error in the

results and findings. Despite the limitations, the research’s findings clear EHR systems

from the allegations made by patients and other physicians. Additionally, it improves

healthcare access to people despite their geographic location.

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Zheng, T., Xie, W., Xu, L., He, X., Zhang, Y., You, M., ... & Chen, Y. (2017). A machine

learning-based framework to identify type 2 diabetes through electronic health

records. International journal of medical informatics, 97, 120-127. Zheng et al. aim to

come up with a semi-automated framework that libelizes are filtering learning and

improve recall rate regarding the low flow rate of type II diabetes. The machine learning

system used is electronic health records in comparison to type 2 diabetes mellitus. From

their findings, the algorithm based identification system for type 2 diabetes from

electronic health systems is regularly hampered by high missing rates due to the systems

conservative nature. They recommend leveraging machine learning and machine learning

to improve the prospects for better results. This research paper is advantageous because it

provides a unique view of Electronic Health Records (EHR) that others do not look into.

It looks into the weakness of EHR and what can be done to improve it and healthcare in

general by improving the number of available samples. Nonetheless, the use of secondary

data rather than primary data limits the accuracy of the research. EHRs are crucial in

improving healthcare, but they are not perfect. The study gives insight into the

shortcomings and the viable solution.