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Worcester, MA, United States

Harris S.K.,Harvard University | Harris S.K.,Center for Adolescent Substance Abuse Research | Csemy L.,Center for Evaluation | Csemy L.,Prague Psychiatric Center | And 19 more authors.
Pediatrics | Year: 2012

OBJECTIVE: Primary care providers need effective strategies for substance use screening and brief counseling of adolescents. We examined the effects of a new computer-facilitated screening and provider brief advice (cSBA) system. METHODS: We used a quasi-experimental, asynchronous study design in which each site served as its own control. From 2005 to 2008, 12- to 18- year-olds arriving for routine care at 9 medical offices in New England (n = 2096, 58% females) and 10 in Prague, Czech Republic (n = 589, 47% females) were recruited. Patients completed measurements only during the initial treatment-as-usual study phase. We then conducted 1-hour provider training, and initiated the cSBA phase. Before seeing the provider, all cSBA participants completed a computerized screen, and then viewed screening results, scientific information, and true-life stories illustrating substance use harms. Providers received screening results and "talking points" designed to prompt 2 to 3 minutes of brief advice. We examined alcohol and cannabis use, initiation, and cessation rates over the past 90 days at 3-month follow-up, and over the past 12 months at 12-month follow-up. RESULTS: Compared with treatment as usual, cSBA patients reported less alcohol use at follow-up in New England (3-month rates 15.5% vs 22.9%, adjusted relative risk ratio [aRRR] = 0.54, 95% confidence interval 0.38-0.77; 12-month rates 29.3% vs 37.5%, aRRR = 0.73, 0.57-0.92), and less cannabis use in Prague (3-month rates 5.5% vs 9.8%, aRRR = 0.37, 0.17-0.77; 12-month rates 17.0% vs 28.7%, aRRR = 0.47, 0.32-0.71). CONCLUSIONS: Computer-facilitated screening and provider brief advice appears promising for reducing substance use among adolescent primary care patients. Copyright © 2012 by the American Academy of Pediatrics. Source

Reliant Medical Group Inc. | Date: 2013-01-25

In one arrangement of a system for automated health information exchange, each server is configured to receive patient encounter information from corresponding entities. The patient encounter information includes affiliation information that identifies a patients affiliation with one or more health care entities of a group of health care entities. Once received, the server reviews the affiliation information to identify other facilities that have provided, or are about to provide, care to the patient. The server establishes and maintains a link, such as a network link, with each of these other entities identified in the patient encounter information. Based upon the links and patient authorizations, the server can automatically retrieve the patients electronic patient records from the other facilities servers and forward the records to its corresponding entity, or automatically send the patients electronic patient records to the linked facilities servers.

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