Faculty Bibliography

Adoption of health information technology (HIT) is a key effort in improving care delivery, reducing costs of health care, and improving the quality of health care. Evidence from electronic health record (EHR) use suggests that HIT will play a significant role in transforming primary care practices and chronic disease management. This article shows that EHRs and HIT can be used effectively to manage chronic diseases, that HIT can facilitate communication and reduce efforts related to transitions in care, and that HIT can improve patient safety by increasing the information available to providers and patients, improving disease management and safety.

The Beacon Community Program is part of a federal strategy for using health information technology as a foundation to improve the nation's health care system. In particular, Beacon Communities seek to increase the quality and efficiency of health care, improve the health of individuals and communities, and inform similar initiatives in other parts of the country. Each Beacon Community has set quality, efficiency, and health-related goals, and each is deploying multiple technology-enabled interventions to achieve them. Yet achieving large-scale and sustainable health care improvement also requires an implementation framework that can foster innovation and continuous learning from results. Based on the early experiences of the seventeen diverse Beacon Communities, this paper describes program design features that characterize how these initiatives are organized.

BACKGROUND: The 'gold standard' for diagnosing allergic contact dermatitis is patch testing. Previous studies have not adequately addressed the validity and usefulness of the North American Contact Dermatitis Group (NACDG) Standard 65-allergen series alone as a screening tool in the evaluation of contact dermatitis. OBJECTIVE: The purpose of this study is to examine the usefulness of the NACDG series of 65 allergens as an exclusive screening method in the diagnosis of contact allergy. METHODS: A retrospective chart review of 794 patients referred for patch testing with the NACDG Screening Series with or without additional allergens was performed to determine the number of positive patch-test results. The study groups were analyzed to identify whether the positive reactions were to allergens in the NACDG Standard Series or to allergens in the supplementary group. RESULTS: Of the 794 patients patch-tested between July 1, 2004, and July 1, 2006, 590 (74.31%) had a positive reaction to either an NACDG patch-tested allergen or a supplemental allergen; 386 (65.42%) patients testing positive for an allergen were positive to an NACDG allergen only, and 534 (90.51%) of the total positive reactors were positive for at least one NACDG test allergen. CONCLUSION: As a screening tool, the NACDG Standard Series is substantially more efficacious than are more limited standard series when used exclusively in the evaluation of patients with allergic contact dermatitis. More extensive testing, including testing with suspected supplementary allergens determined by thorough history and physical examination, can improve upon the NACDG series as a means to investigate the full causes of contact dermatitis in any individual patient