Martha Adams | Duke University (original) (raw)
Papers by Martha Adams
Applied clinical informatics, 2018
JMIR Medical Education, 2016
Http Dx Doi Org 10 1080 10401334 2014 910461, Jul 1, 2014
Healthcare technologies and patient care have evolved rapidly. Healthcare communication technique... more Healthcare technologies and patient care have evolved rapidly. Healthcare communication techniques and technologies have lagged. This pilot study was conducted at Duke University Hospital to investigate the benefits of using smartphones among healthcare team members to promote efficient and effective patient care. This study used a pre-post implementation survey with an educational intervention. Teams (physicians, patient resource managers, physician assistants, and nurses) from medicine and surgery were randomly assigned a smartphone. A validated 28-question survey was used to assess user experience (7-point Likert scale, with 7 indicating more reliable, strongly agree, and faster). Participants were encouraged to attend focus groups to provide feedback on survey content and overall experience. Facilitators used guiding questions and transcripts were used for qualitative analysis. Eighty-nine matched pre- and postsurveys were analyzed. Postimplementation data results declined for a majority of items, although remained favorable. This suggests the reality of smartphone use did not live up to expectations but was still considered an improvement over the current paging system. Differences by device and user were found, such as the iPhone being easier to use and the BlackBerry more professional; nonphysicians were more concerned about training and the sterility of the device. Themes elicited from focus groups included challenges of the current paging system, text message content, device ease of use and utility, service coverage, and professionalism. Participants in this study recognized the benefit of using smartphones to reach team members in a timely and convenient manner while having access to beneficial applications. Lessons were learned for future implementations with more favorable experiences for participants. Perhaps most striking was the shared acknowledgment that the current system doesn't work well and an understanding of why.
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2015
The health information technology (HIT) implementation listserv was conceived as a way to combine... more The health information technology (HIT) implementation listserv was conceived as a way to combine a substantial portion of American Medical Informatics Association (AMIA) members who belonged to four working groups (WGs): CIS, Evaluation, ELSI, and POI. Other AMIA members joined in significant numbers. It immediately became a major forum for discussing medical informatics, informatics policies, and discussion of the purpose of AMIA itself. The listserv membership approximates 25% of AMIA's members and has generated over 6,000 posts. We report on a survey of the listserv's members: what members think about the listserv; what participants want for medical informatics; how they think those goals should be achieved, and what AMIA's role should be in this process. The listserv provides vital signs about AMIA and hopes for informatics. We combine qualitative analysis of members' comments and responses about the listserv using ATLAS.ti qualitative text analysis tool and a w...
European Journal of Clinical Pharmacology, 2015
Studies in health technology and informatics, 2015
A survey of members of the American Medical Informatics Association (AMIA) listserv Forum on impl... more A survey of members of the American Medical Informatics Association (AMIA) listserv Forum on implementation and optimization asked how members perceived the Forum, and suggestions for improvement. Respondents appear to be remarkably engaged with the Forum's debates, information sharing, educational and practical teachings, comments, and immediacy.
Journal of genetic counseling, Jan 3, 2015
Telegenetics-genetic counseling via live videoconferencing-can improve access to cancer genetic c... more Telegenetics-genetic counseling via live videoconferencing-can improve access to cancer genetic counseling (CGC) in underserved areas, but studies on cancer telegenetics have not applied randomized methodology or assessed cost. We report cost, patient satisfaction and CGC attendance from a randomized trial comparing telegenetics with in-person CGC among individuals referred to CGC in four rural oncology clinics. Participants (n = 162) were randomized to receive CGC at their local oncology clinic in-person or via telegenetics. Cost analyses included telegenetics system; mileage; and personnel costs for genetic counselor, IT specialist, and clinic personnel. CGC attendance was tracked via study database. Patient satisfaction was assessed 1 week post-CGC via telephone survey using validated scales. Total costs were 106pertelegeneticspatientand106 per telegenetics patient and 106pertelegeneticspatientand244 per in-person patient. Patient satisfaction did not differ by group on either satisfaction scale. In-person patients were significantl...
Informatics in primary care, 2009
To determine whether participation in educational conferences utilising iPod technology enhances ... more To determine whether participation in educational conferences utilising iPod technology enhances both medical knowledge and accessibility to educational content among medical residents in training. In May 2007, the authors led a randomised controlled study involving 30 internal medicine residents who volunteered either to attend five midday educational conferences or to use an iPod audio/video recording of the same conferences, each followed by a five-question competency quiz. Primary outcomes included quantitative assessment of knowledge acquisition and qualitative assessment of resident perception of ease of use. Secondary outcomes included resident perception of self-directed learning. At baseline, residents reported attendance at 50% of educational conferences. Of iPod participants, 46.7% previously used an iPod. During the study, 46-60% of conference attendees were paged out of each conference, of whom between 6 and 33% missed more than half of the conference. The quiz completi...
American Journal of Hypertension, 2010
Teaching and Learning in Medicine, 2014
Healthcare technologies and patient care have evolved rapidly. Healthcare communication technique... more Healthcare technologies and patient care have evolved rapidly. Healthcare communication techniques and technologies have lagged. This pilot study was conducted at Duke University Hospital to investigate the benefits of using smartphones among healthcare team members to promote efficient and effective patient care. This study used a pre-post implementation survey with an educational intervention. Teams (physicians, patient resource managers, physician assistants, and nurses) from medicine and surgery were randomly assigned a smartphone. A validated 28-question survey was used to assess user experience (7-point Likert scale, with 7 indicating more reliable, strongly agree, and faster). Participants were encouraged to attend focus groups to provide feedback on survey content and overall experience. Facilitators used guiding questions and transcripts were used for qualitative analysis. Eighty-nine matched pre- and postsurveys were analyzed. Postimplementation data results declined for a majority of items, although remained favorable. This suggests the reality of smartphone use did not live up to expectations but was still considered an improvement over the current paging system. Differences by device and user were found, such as the iPhone being easier to use and the BlackBerry more professional; nonphysicians were more concerned about training and the sterility of the device. Themes elicited from focus groups included challenges of the current paging system, text message content, device ease of use and utility, service coverage, and professionalism. Participants in this study recognized the benefit of using smartphones to reach team members in a timely and convenient manner while having access to beneficial applications. Lessons were learned for future implementations with more favorable experiences for participants. Perhaps most striking was the shared acknowledgment that the current system doesn't work well and an understanding of why.
Journal of general internal medicine, 2005
Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Cli... more Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Clinical trials implement strict protocols, whereas clinical practices and studies that assess quality of care utilize a less rigorous protocol for BP measurement. To examine agreement between real-time clinic-based assessment of BP and the standard mercury assessment of BP. Prospective reliability study. One hundred patients with an International Classification of Diseases-9th edition code for hypertension were enrolled. Two BP measurements were obtained with the Hawksley random-zero mercury sphygmomanometer and averaged. The clinic-based BP was extracted from the computerized medical records. Agreement between the mercury and clinic-based systolic blood pressure (SBP) was good, intraclass correlation coefficient (ICC)=0.91 (95% confidence interval (CI): 0.83 to 0.94); the agreement for the mercury and clinic-based diastolic blood pressure (DBP) was satisfactory, ICC=0.77 (95% CI: 0.62 to ...
Journal of Medical Systems, 2014
Communication among medical informatics communities can suffer from fragmentation across multiple... more Communication among medical informatics communities can suffer from fragmentation across multiple forums, disciplines, and subdisciplines; variation among journals, vocabularies and ontologies; cost and distance. Online communities help overcome these obstacles, but may become onerous when listservs are flooded with cross-postings. Rich and relevant content may be ignored. The American Medical Informatics Association successfully addressed these problems when it created a virtual meeting place by merging the membership of four working groups into a single listserv known as the "Implementation and Optimization Forum." A communication explosion ensued, with thousands of interchanges, hundreds of topics, commentaries from "notables," neophytes, and students--many from different disciplines, countries, traditions. We discuss the listserv's creation, illustrate its benefits, and examine its lessons for others. We use examples from the lively, creative, deep, and occasionally conflicting discussions of user experiences--interchanges about medication reconciliation, open source strategies, nursing, ethics, system integration, and patient photos in the EMR--all enhancing knowledge, collegiality, and collaboration.
Patient Education and Counseling, 2008
Journal of the Medical Library Association : JMLA, 2013
Journal of General Internal Medicine, 2005
Contemporary Clinical Trials, 2007
Among the 65 million Americans with hypertension, only approximately 31% have their blood pressur... more Among the 65 million Americans with hypertension, only approximately 31% have their blood pressure under control (<140/90 mm/Hg). Despite the damaging impact of hypertension and the availability of evidence-based target values for blood pressure, interventions to improve blood pressure control have had limited success. A randomized controlled health services intervention trial with a two by two design is being conducted to improve blood pressure control. This five-year trial evaluates two patient-directed interventions designed to improve blood pressure control among patients diagnosed with hypertension in a community-based primary care setting. Patients are randomized to one of four groups: usual care, home blood pressure monitoring, tailored behavioral self-management intervention that is administered via telephone by a nurse, or a combination of the home blood pressure monitoring and tailored behavioral intervention. Patients receiving the home blood pressure monitoring are trained in the use of an electronic blood pressure measurement device, are asked to measure their blood pressure 3 times/week, and send in two-month blood pressure recordings throughout the 24-month study duration. The behavioral intervention incorporates patients' need assessments and involves tailored behavioral and education modules to promote medication adherence and improve specific health behaviors. A nurse delivers all behavioral self-management modules over the telephone bi-monthly for 24 months. The primary outcome is the proportion of patients who achieve control of their blood pressure based on evidence-based guidelines (for patients without diabetes <140/90 mm/Hg, for patients with diabetes <130/80 mm/Hg) evaluated at six-month intervals over 24 months (five measurements) using a random-zero sphygmomanometer. Despite the known risk of poor blood pressure control, and the wide availability of effective treatment strategies, a majority of adults still do not have their blood pressure controlled. This study will be an important step in defining two explicit interventions to improve blood pressure control. To our knowledge, this study is the first to combine both a tailored behavioral self-management intervention and self-monitoring home blood pressure intervention to improve blood pressure control among patients in a primary care setting.
Circulation: Cardiovascular Quality and Outcomes, 2011
BMC Medical Informatics and Decision Making, 2007
Background Supporting 21st century health care and the practice of evidence-based medicine (EBM) ... more Background Supporting 21st century health care and the practice of evidence-based medicine (EBM) requires ubiquitous access to clinical information and to knowledge-based resources to answer clinical questions. Many questions go unanswered, however, due to lack of skills in formulating questions, crafting effective search strategies, and accessing databases to identify best levels of evidence. Methods This randomized trial was designed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system. Two of the search interfaces utilized a specific framework called PICO, which was designed to focus clinical questions and to prompt for publication type or type of question asked. The third interface was the standard PubMed interface readily available on the Web. Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US. Thirty-one subjects were rand...
Annals of Pharmacotherapy, 2005
Annals of Internal Medicine, 2009
Applied clinical informatics, 2018
JMIR Medical Education, 2016
Http Dx Doi Org 10 1080 10401334 2014 910461, Jul 1, 2014
Healthcare technologies and patient care have evolved rapidly. Healthcare communication technique... more Healthcare technologies and patient care have evolved rapidly. Healthcare communication techniques and technologies have lagged. This pilot study was conducted at Duke University Hospital to investigate the benefits of using smartphones among healthcare team members to promote efficient and effective patient care. This study used a pre-post implementation survey with an educational intervention. Teams (physicians, patient resource managers, physician assistants, and nurses) from medicine and surgery were randomly assigned a smartphone. A validated 28-question survey was used to assess user experience (7-point Likert scale, with 7 indicating more reliable, strongly agree, and faster). Participants were encouraged to attend focus groups to provide feedback on survey content and overall experience. Facilitators used guiding questions and transcripts were used for qualitative analysis. Eighty-nine matched pre- and postsurveys were analyzed. Postimplementation data results declined for a majority of items, although remained favorable. This suggests the reality of smartphone use did not live up to expectations but was still considered an improvement over the current paging system. Differences by device and user were found, such as the iPhone being easier to use and the BlackBerry more professional; nonphysicians were more concerned about training and the sterility of the device. Themes elicited from focus groups included challenges of the current paging system, text message content, device ease of use and utility, service coverage, and professionalism. Participants in this study recognized the benefit of using smartphones to reach team members in a timely and convenient manner while having access to beneficial applications. Lessons were learned for future implementations with more favorable experiences for participants. Perhaps most striking was the shared acknowledgment that the current system doesn't work well and an understanding of why.
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2015
The health information technology (HIT) implementation listserv was conceived as a way to combine... more The health information technology (HIT) implementation listserv was conceived as a way to combine a substantial portion of American Medical Informatics Association (AMIA) members who belonged to four working groups (WGs): CIS, Evaluation, ELSI, and POI. Other AMIA members joined in significant numbers. It immediately became a major forum for discussing medical informatics, informatics policies, and discussion of the purpose of AMIA itself. The listserv membership approximates 25% of AMIA's members and has generated over 6,000 posts. We report on a survey of the listserv's members: what members think about the listserv; what participants want for medical informatics; how they think those goals should be achieved, and what AMIA's role should be in this process. The listserv provides vital signs about AMIA and hopes for informatics. We combine qualitative analysis of members' comments and responses about the listserv using ATLAS.ti qualitative text analysis tool and a w...
European Journal of Clinical Pharmacology, 2015
Studies in health technology and informatics, 2015
A survey of members of the American Medical Informatics Association (AMIA) listserv Forum on impl... more A survey of members of the American Medical Informatics Association (AMIA) listserv Forum on implementation and optimization asked how members perceived the Forum, and suggestions for improvement. Respondents appear to be remarkably engaged with the Forum's debates, information sharing, educational and practical teachings, comments, and immediacy.
Journal of genetic counseling, Jan 3, 2015
Telegenetics-genetic counseling via live videoconferencing-can improve access to cancer genetic c... more Telegenetics-genetic counseling via live videoconferencing-can improve access to cancer genetic counseling (CGC) in underserved areas, but studies on cancer telegenetics have not applied randomized methodology or assessed cost. We report cost, patient satisfaction and CGC attendance from a randomized trial comparing telegenetics with in-person CGC among individuals referred to CGC in four rural oncology clinics. Participants (n = 162) were randomized to receive CGC at their local oncology clinic in-person or via telegenetics. Cost analyses included telegenetics system; mileage; and personnel costs for genetic counselor, IT specialist, and clinic personnel. CGC attendance was tracked via study database. Patient satisfaction was assessed 1 week post-CGC via telephone survey using validated scales. Total costs were 106pertelegeneticspatientand106 per telegenetics patient and 106pertelegeneticspatientand244 per in-person patient. Patient satisfaction did not differ by group on either satisfaction scale. In-person patients were significantl...
Informatics in primary care, 2009
To determine whether participation in educational conferences utilising iPod technology enhances ... more To determine whether participation in educational conferences utilising iPod technology enhances both medical knowledge and accessibility to educational content among medical residents in training. In May 2007, the authors led a randomised controlled study involving 30 internal medicine residents who volunteered either to attend five midday educational conferences or to use an iPod audio/video recording of the same conferences, each followed by a five-question competency quiz. Primary outcomes included quantitative assessment of knowledge acquisition and qualitative assessment of resident perception of ease of use. Secondary outcomes included resident perception of self-directed learning. At baseline, residents reported attendance at 50% of educational conferences. Of iPod participants, 46.7% previously used an iPod. During the study, 46-60% of conference attendees were paged out of each conference, of whom between 6 and 33% missed more than half of the conference. The quiz completi...
American Journal of Hypertension, 2010
Teaching and Learning in Medicine, 2014
Healthcare technologies and patient care have evolved rapidly. Healthcare communication technique... more Healthcare technologies and patient care have evolved rapidly. Healthcare communication techniques and technologies have lagged. This pilot study was conducted at Duke University Hospital to investigate the benefits of using smartphones among healthcare team members to promote efficient and effective patient care. This study used a pre-post implementation survey with an educational intervention. Teams (physicians, patient resource managers, physician assistants, and nurses) from medicine and surgery were randomly assigned a smartphone. A validated 28-question survey was used to assess user experience (7-point Likert scale, with 7 indicating more reliable, strongly agree, and faster). Participants were encouraged to attend focus groups to provide feedback on survey content and overall experience. Facilitators used guiding questions and transcripts were used for qualitative analysis. Eighty-nine matched pre- and postsurveys were analyzed. Postimplementation data results declined for a majority of items, although remained favorable. This suggests the reality of smartphone use did not live up to expectations but was still considered an improvement over the current paging system. Differences by device and user were found, such as the iPhone being easier to use and the BlackBerry more professional; nonphysicians were more concerned about training and the sterility of the device. Themes elicited from focus groups included challenges of the current paging system, text message content, device ease of use and utility, service coverage, and professionalism. Participants in this study recognized the benefit of using smartphones to reach team members in a timely and convenient manner while having access to beneficial applications. Lessons were learned for future implementations with more favorable experiences for participants. Perhaps most striking was the shared acknowledgment that the current system doesn't work well and an understanding of why.
Journal of general internal medicine, 2005
Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Cli... more Obtaining accurate blood pressure (BP) readings is a challenge faced by health professionals. Clinical trials implement strict protocols, whereas clinical practices and studies that assess quality of care utilize a less rigorous protocol for BP measurement. To examine agreement between real-time clinic-based assessment of BP and the standard mercury assessment of BP. Prospective reliability study. One hundred patients with an International Classification of Diseases-9th edition code for hypertension were enrolled. Two BP measurements were obtained with the Hawksley random-zero mercury sphygmomanometer and averaged. The clinic-based BP was extracted from the computerized medical records. Agreement between the mercury and clinic-based systolic blood pressure (SBP) was good, intraclass correlation coefficient (ICC)=0.91 (95% confidence interval (CI): 0.83 to 0.94); the agreement for the mercury and clinic-based diastolic blood pressure (DBP) was satisfactory, ICC=0.77 (95% CI: 0.62 to ...
Journal of Medical Systems, 2014
Communication among medical informatics communities can suffer from fragmentation across multiple... more Communication among medical informatics communities can suffer from fragmentation across multiple forums, disciplines, and subdisciplines; variation among journals, vocabularies and ontologies; cost and distance. Online communities help overcome these obstacles, but may become onerous when listservs are flooded with cross-postings. Rich and relevant content may be ignored. The American Medical Informatics Association successfully addressed these problems when it created a virtual meeting place by merging the membership of four working groups into a single listserv known as the "Implementation and Optimization Forum." A communication explosion ensued, with thousands of interchanges, hundreds of topics, commentaries from "notables," neophytes, and students--many from different disciplines, countries, traditions. We discuss the listserv's creation, illustrate its benefits, and examine its lessons for others. We use examples from the lively, creative, deep, and occasionally conflicting discussions of user experiences--interchanges about medication reconciliation, open source strategies, nursing, ethics, system integration, and patient photos in the EMR--all enhancing knowledge, collegiality, and collaboration.
Patient Education and Counseling, 2008
Journal of the Medical Library Association : JMLA, 2013
Journal of General Internal Medicine, 2005
Contemporary Clinical Trials, 2007
Among the 65 million Americans with hypertension, only approximately 31% have their blood pressur... more Among the 65 million Americans with hypertension, only approximately 31% have their blood pressure under control (<140/90 mm/Hg). Despite the damaging impact of hypertension and the availability of evidence-based target values for blood pressure, interventions to improve blood pressure control have had limited success. A randomized controlled health services intervention trial with a two by two design is being conducted to improve blood pressure control. This five-year trial evaluates two patient-directed interventions designed to improve blood pressure control among patients diagnosed with hypertension in a community-based primary care setting. Patients are randomized to one of four groups: usual care, home blood pressure monitoring, tailored behavioral self-management intervention that is administered via telephone by a nurse, or a combination of the home blood pressure monitoring and tailored behavioral intervention. Patients receiving the home blood pressure monitoring are trained in the use of an electronic blood pressure measurement device, are asked to measure their blood pressure 3 times/week, and send in two-month blood pressure recordings throughout the 24-month study duration. The behavioral intervention incorporates patients' need assessments and involves tailored behavioral and education modules to promote medication adherence and improve specific health behaviors. A nurse delivers all behavioral self-management modules over the telephone bi-monthly for 24 months. The primary outcome is the proportion of patients who achieve control of their blood pressure based on evidence-based guidelines (for patients without diabetes <140/90 mm/Hg, for patients with diabetes <130/80 mm/Hg) evaluated at six-month intervals over 24 months (five measurements) using a random-zero sphygmomanometer. Despite the known risk of poor blood pressure control, and the wide availability of effective treatment strategies, a majority of adults still do not have their blood pressure controlled. This study will be an important step in defining two explicit interventions to improve blood pressure control. To our knowledge, this study is the first to combine both a tailored behavioral self-management intervention and self-monitoring home blood pressure intervention to improve blood pressure control among patients in a primary care setting.
Circulation: Cardiovascular Quality and Outcomes, 2011
BMC Medical Informatics and Decision Making, 2007
Background Supporting 21st century health care and the practice of evidence-based medicine (EBM) ... more Background Supporting 21st century health care and the practice of evidence-based medicine (EBM) requires ubiquitous access to clinical information and to knowledge-based resources to answer clinical questions. Many questions go unanswered, however, due to lack of skills in formulating questions, crafting effective search strategies, and accessing databases to identify best levels of evidence. Methods This randomized trial was designed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system. Two of the search interfaces utilized a specific framework called PICO, which was designed to focus clinical questions and to prompt for publication type or type of question asked. The third interface was the standard PubMed interface readily available on the Web. Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US. Thirty-one subjects were rand...
Annals of Pharmacotherapy, 2005
Annals of Internal Medicine, 2009