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Brassil E.,Baystate Health | Gunn B.,Baystate Health | Shenoy A.M.,Baystate Health | Blanchard R.,University of Massachusetts Medical School
Journal of the Medical Library Association | Year: 2017

Objective: With the myriad of cases presented to clinicians every day at our integrated academic health system, clinical questions are bound to arise. Clinicians need to recognize these knowledge gaps and act on them. However, for many reasons, clinicians might not seek answers to these questions. Our goal was to investigate the rationale and process behind these unanswered clinical questions. Subsequently, we explored the use of biomedical information resources among specialists and primary care providers and identified ways to promote more informed clinical decision making. Methods: We conducted a survey to assess how practitioners identify and respond to information gaps, their background knowledge of search tools and strategies, and their usage of and comfort level with technology. Results: Most of the 292 respondents encountered clinical questions at least a few times per week. While the vast majority often or always pursued answers, time was the biggest barrier for not following through on questions. Most respondents did not have any formal training in searching databases, were unaware of many digital resources, and indicated a need for resources and services that could be provided at the point of care. Conclusions: While the reasons for unanswered clinical questions varied, thoughtful review of the responses suggested that a combination of educational strategies, embedded librarian services, and technology applications could help providers pursue answers to their clinical questions, enhance patient safety, and contribute to patient-based, self-directed learning. © 2017, Medical Library Association. All rights reserved.

News Article | December 13, 2016
Site: www.prweb.com

Brightbox, Inc., the American B2B kiosk technology company and leading global provider of secure cell phone charging products, today announced the deployment of its platform-supported charging solution in partnership with a host of American collegiate properties and Frontier Communications Corporation. Fans can now stay powered up and connected during their stadium and arena sports experiences by charging their mobile devices in Brightbox’s highly secure charging stations. Frontier Communications branded Brightbox mobile device charging kiosks are now available for refreshing recharging experiences in football stadiums and basketball arenas across the nation, including: IMG facilitated the three-year partnership between Frontier Communications, a leading national provider of high-speed-internet, phone & TV, and Brightbox. Frontier’s branded Brightbox charging stations will now be in numerous college football and basketball facilities encouraging customers to “Charge While You Cheer.” “We are thrilled to support these great institutions of higher learning and meet the mobile power needs of their fans and students,” said Billy Gridley, CEO of Brightbox. “In a world where nearly everyone is always on-line, particularly students using mobile devices as a “second screen”, and there is no off-line, Brightbox secure charging is critical physical infrastructure and in-stadium technology that fulfills customer need, while providing global organizations with a powerful branding and marketing tool.” Brightbox is unique because it offers organizations and marketers a trifecta solution: secure mobile re-charging, digital signage and interactive features, such as data surveys, SMS messaging and product coupon delivery. Unlike other providers in the market, the Brightbox platform is open for management of a network of connected, out-of-home charging kiosks. Partners and clients can access the Brightbox platform to directly manage their own video content and messaging, download reporting data and analytics, remotely support their fleet, and conduct marketing and lead capture campaigns. As the global technology leader in the field, Brightbox offers a breadth of locker key choices: secure masked on-screen pin code, mag stripe cards (financial, customized and loyalty) and RFID. Brightbox was the first secure charging solution on the market to offer USB-C charging support for the latest generation of smartphones. Brightbox is committed to delivering secure, safe and reliable power for mobile users when they need it most, with a hardened LINUX-based connected platform solution and kiosk product offerings that are the most innovative and sophisticated in the marketplace. About Brightbox Brightbox® is a B2B kiosk technology company providing venues with a best-in-class mobile device recharging and digital marketing platform. Founded in 2011, Brightbox delivers advanced and innovative solutions, and has deployed over 800 secure recharging kiosks in 10 countries and 22 American states and 4 Canadian Provinces in a variety of vertical markets including retail, entertainment, hospitality, events, healthcare, transport and government. Enterprise customers include AOL, American Airlines, Baystate Health, Cadillac Fairview, Caesars Entertainment, Christie’s, Citibank, Comcast, Coca-Coca Company, Columbia University, CUNY, Dream, Fifth Third Bank, Grand Bazaar Shops, HBO, Hilton, Honda, Hyatt, IBM, IMG College, Intel, JC Penney, MGM, Memorial City Mall, Mount Sinai Health, New York Red Bulls, Newad, Omni, Orlando Regional Medical Center, Phoenix Suns, Planet Hollywood, Samsung, SeaWorld, Sheraton, Spectrum, Statue of Liberty, T-Mobile, Wells Fargo, Westfield Malls, Wynn Resorts and Yale New Haven Health. Brightbox has technology and operator partners in the US, Brazil, Canada, Chile, Europe, Mexico, Panama, South Africa, Sweden and the United Kingdom. Learn more at https://brightboxcharge.com/  @brightboxcharge About Frontier Communications Corporation Frontier Communications Corporation is a leader in providing communications services to urban, suburban, and rural communities in 29 states. Frontier offers a variety of services to residential customers over its fiber-optic and copper networks, including video, high-speed internet, advanced voice, and Frontier Secure ® digital protection solutions. Frontier Business Edge™ offers communications solutions to small, medium, and enterprise businesses.

Grimm E.,University of Washington | Friedberg R.C.,Baystate Health | Wilkinson D.S.,Virginia Commonwealth University | AuBuchon J.P.,University of Washington | And 3 more authors.
Archives of Pathology and Laboratory Medicine | Year: 2010

Context: Although a rare occurrence, ABO incompatible transfusions can cause patient morbidity and mortality. Up to 20% of all mistransfusions are traced to patient misidentification and/or sample mislabeling errors that occur before a sample arrives in the laboratory. Laboratories play a significant role in preventing mistransfusion by identifying wrong blood in tube and rejecting mislabeled samples. Objectives:To determine the rates of mislabeled samples and wrong blood in tube for samples submitted for ABO typing and to survey patient identification and sample labeling practices and sample acceptance policies for ABO typing samples across a variety of US institutions. Design:One hundred twenty-two institutions prospectively reviewed inpatient and outpatient samples submitted for ABO typing for 30 days. Labeling error rates were calculated for each participant and tested for associations with institutional demographic and practice variable information. Wrong-blood-in-tube rates were calculated for the 30-day period and for a retrospective 12-month period. A concurrent survey collected institution-specific sample labeling requirements and institutional policies regarding the fate of mislabeled samples. Results:For all institutions combined, the aggregate mislabeled sample rate was 1.12%. The annual and 30-day wrong-blood-in-tube aggregate rates were both 0.04%. Patient first name, last name, and unique identification number were required on the sample by more than 90% of participating institutions; however, other requirements varied more widely. Conclusions:The rates of mislabeled samples and wrong blood in tube for US participants in this study were comparable to those reported for most European countries. The survey of patient identification and sample labeling practices and sample acceptance policies for ABO typing samples revealed both practice uniformity and variability as well as significant opportunity for improvement.

Liptzin B.,Baystate Health | Peisah C.,University of New South Wales | Shulman K.,University of Toronto | Finkel S.,University of Chicago
International Psychogeriatrics | Year: 2010

Background: With the aging of the population there will be a substantial transfer of wealth in the next 25 years. The presence of delirium can complicate the evaluation of an older person's testamentary capacity and susceptibility to undue influence but has not been well examined in the existing literature. Methods: A subcommittee of the IPA Task Force on Testamentary Capacity and Undue Influence undertook to review how to assess prospectively and retrospectively testamentary capacity and susceptibility to undue influence in patients with delirium. Results: The subcommittee identified questions that should be asked in cases where someone changes their will or estate plan towards the end of their life in the presence of delirium. These questions include: was there consistency in the patient's wishes over time? Were these wishes expressed during a lucid interval when the person was less confused? Were the patient's wishes clearly expressed in response to open-ended questions? Is there clear documentation of the patient's mental status at the time of the discussion? Conclusions: This review with some case examples provides guidance on how to consider the question of testamentary capacity or susceptibility to undue influence in someone undergoing an episode of delirium. Copyright © 2010 International Psychogeriatric Association.

Cervinski M.A.,Dartmouth Hitchcock Medical Center | Schwab M.C.,Dartmouth Hitchcock Medical Center | Lefferts J.A.,Dartmouth Hitchcock Medical Center | Lewis L.D.,Section of Clinical Pharmacology | And 4 more authors.
American Journal of Clinical Pathology | Year: 2013

Conversion of clopidogrel (Plavix) to its active metabolite is catalyzed largely by the P450 enzyme 2C19 (CYP2C19). Numerous allelic variants of CYP2C19 exist. The 1 allele is considered wild type, whereas the *2 and 3 alleles have no in vivo enzymatic activity. Conversely, the 17 allele has increased expression, resulting in increased clopidogrel activation. Poor metabolizers (*2/*2 and *2/3 genotypes) experience higher rates of therapeutic failure. For this reason, we have validated a CYP2C19 genotyping assay for the 1, *2, 3, and 17 alleles. Genomic DNA extracted from 30 deidentified EDTA whole-blood samples from patients was analyzed at 2 independent facilities using specific TaqMan realtime polymerase chain reaction primers and probes. Concordant genotypes were generated on all samples tested. Of the 30 samples, 15 were CYP2C191/1, 8 were CYP2C191/17, 5 were CYP2C191/2, and 2 were CYP2C19*2/17. There were no CYP2C193 alleles or *2/*2 homozygous genotypes detected. This CYP2C19 genotyping assay is appropriate for clinical testing, demonstrating excellent interlaboratory concordance, enabling the selection of the most effective clopidogrel treatment regimen for patients undergoing percutaneous coronary intervention. © American Society for Clinical Pathology.

Culler S.D.,Emory University | Kugelmass A.D.,Baystate Health | Brown P.P.,HealthTrust Purchasing Group L.P. | Reynolds M.R.,Lahey Hospital and Medical Center | Simon A.W.,HealthTrust Purchasing Group L.P.
Circulation | Year: 2015

Background-This study reports on the trends in the volume and outcomes of coronary revascularization procedures performed on Medicare beneficiaries between 2008 and 2012. Methods and Results-This retrospective study identifies all Medicare beneficiaries undergoing a coronary revascularization procedure: coronary artery bypass graft surgery or percutaneous coronary intervention (PCI) performed in either the nonadmission or inpatient setting. International Classification of Diseases, 9th Revision, Clinical Modification procedure codes (inpatient setting) and Current Procedural Terminology and Ambulatory Payment Classification codes (nonadmission) were used to identify revascularizations. The study population consists of 2 768 007 records. This study finds that the rapid growth in nonadmission PCIs performed on Medicare beneficiaries (60 405-106 495) has been more than offset by the decrease in PCI admissions (363 384-295 434) during the study period. There also were >18 000 fewer coronary artery bypass graft admissions in 2012 than in 2008. This study finds lower observed mortality rates (3.7%-3.2%) among Medicare beneficiaries undergoing any coronary artery bypass graft surgery and higher observed mortality rates (1.7%-1.9%) for Medicare beneficiaries undergoing any PCI encounter. This study also finds a growth in the number of facilities performing revascularization procedures during the study period: 268 (20.2%) more sites were performing nonadmission PCIs; 136 (8.2%) more sites were performing inpatient PCIs; and 19 (1.6%) more sites were performing coronary artery bypass graft surgery. Conclusions-The total number of revascularization procedures performed on Medicare beneficiaries peaked in 2010 and declined by >4% per year in 2011 and 2012. Observed mortality rates among all Medicare beneficiaries undergoing any coronary revascularization remained between 2.1% and 2.2% annually during the study period. © 2014 American Heart Association, Inc.

Nichols J.H.,Tufts University | Nichols J.H.,Baystate Health
Journal of Diabetes Science and Technology | Year: 2011

Glucose testing in the hospital with point-of-care devices presents multiple opportunities for error. Any device can fail under the right conditions. For glucose monitoring in the hospital, with thousands of operators, hundreds of devices, and dozens of locations involved, there is ample opportunity for errors that can impact the quality of test results. Errors can occur in any phase of the testing process: preanalytic, analytic, or postanalytic. Common sources of meter error include patient or methodology interferences, operator mistakes, environmental exposure, and device malfunction. Early models of glucose meters had few internal checks or capability to warn the operator of meter problems. The latest generation of glucose monitors has a number of internal checks and controls engineered into the testing process to prevent serious errors or warn the operator by suppressing test results. Some of these control processes are built into the software and data management system of the meters, others require the hospital to do something, such as regularly clean the meter or analyze control samples of known glucose concentration, to verify meter performance. Hospitals need to be aware of the potential for errors by understanding weaknesses in the testing process that could lead to erroneous results and take steps to prevent errors from occurring or to minimize the harm to patients when errors do occur. The reliability of a glucose result will depend on the balance of internal control features available from manufacturers in conjunction with the liquid control analysis and other control processes (operator training, device validation, and maintenance) utilized by the hospitals. © Diabetes Technology Society.

Artenstein A.W.,Baystate Health
In the Blink of an Eye: The Deadly Story of Epidemic Meningitis | Year: 2013

This book is an account of a major historical event, in the world of medicine. As the son of one of the lead scientists who developed the vaccine for meningococcal meningitis, Andrew Artenstein has a unique perspective on the story. In the Blink of an Eye shares his experience. © Springer Science+Business Media New York 2013. All rights are reserved.

Hunter S.B.,RAND Health | Schwartz R.P.,Friends Research Institute | Friedmann P.D.,Baystate Health
Journal of Substance Abuse Treatment | Year: 2016

National efforts are underway to integrate medical care and behavioral health treatment. This special issue of the Journal of Substance Abuse Treatment presents 13 papers that examine the integration of substance use interventions and medical care. In this introduction, the guest editors first describe the need to examine the integration of substance use treatment into medical care settings. Next, an overview of the emerging field of implementation science and its applicability to substance use intervention integration is presented. Preview summaries of each of the articles included in this special issue are given. Articles include empirical studies of various integration models, study protocol papers that describe currently funded implementation research, and one review/commentary piece that discusses federal research priorities, integration support activities and remaining research gaps. These articles provide important information about how to guide future health system integration efforts to treat the millions of medical patients with substance use problems. © 2015 Elsevier Inc.

Penn H.J.,Mayo Medical School | Langman L.J.,Mayo Medical School | Unold D.,Baystate Health | Shields J.,Baystate Health | Nichols J.H.,Baystate Health
Clinical Biochemistry | Year: 2011

Objective: We investigated the ability of clinical drug of abuse tests to detect synthetic cannabinoids. Results: A broad class GC/MS drug screening method detected JWH-018 and JWH-073 in methanolic extracts and teas steeped from herbal incense products in three of four products tested. Conclusions: Synthetic cannabinoids are present in herbal incense purchased over the internet. © 2011 The Canadian Society of Clinical Chemists.

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