Publications

Scholarly Journals--Published

  • Patient and Provider Feedback for Radiology Reports: Implementation of a Quality Improvement Project in a Multi-Institutional Setting (07/2021) (link)
  • Deriving a patient de-identified clinical research database from an electronic health record system: A single center experience in determining the prognostic value of lactate, C-reactive protein, and procalcitonin J Transl Sci, 2020 doi: 10.15761/JTS.1000405 Mohan R1, Ho P2, Dalton L3, Chan F1 and Nguyen HB4* Abstract Objective: In this study, we demonstrate the derivation of a de-identified research database from the electronic health records (EHR) and then use it in determining the prognostic value of biomarkers lactate, C-reactive protein (CRP), and procalcitonin in hospitalized patients. Methods: The database was created through a series of data export, transform, load, and visualization. A database glossary was completed, including 650 data elements per patient encounter without personal identifiers. Data visualization and statistical analysis tools were provided to those utilizing the database. Results: From July 2012 to August 2019, the database contained 240,759 distinct hospital encounters, with 2,682 patients meeting criteria for analysis, age 54.5±18.6 years, lactate 1.9±1.7 mmol/L, CRP 10.7±10.0 μg/mL, procalcitonin 4.0±17.5 ng/mL, and mortality 8.7%. ROC area under the curve for lactate, CRP, and procalcitonin was 0.670, 0.553, and 0.672, respectively. Lactate, CRP, and procalcitonin had odds ratio for mortality of 1.111 (1.037-1.190), 1.015 (0.991-1.031), and 0.999 (0.991-1.007), respectively. Conclusions: Our efforts provide a framework for creating EHR-derived de-identified patient data for clinical research. Our analysis of the prognostic value of lactate, CRP, and procalcitonin showed these biomarkers to be less accurate than expected, highlighting the challenges of using existing data. (07/2020) (link)
  • Implementation of the Whole Child Assessment to Screen for Adverse Childhood Experiences AbstractPediatricians are encouraged to screen for adverse childhood experiences (ACEs). The current study developed andimplemented a tool to screen for Child-ACEs at a pediatric resident clinic in San Bernardino, California. Developmentof the tool, named the Whole Child Assessment (WCA), was based on an iterative process that incorporatedtriangulation of references, patient data, and physician feedback. Implementation of the WCA occurred over thecourse of 6 improvement cycles that involved obtaining and responding to stakeholder feedback, streamliningpaperwork and workflow, and providing physician education. Over the course of our study, we reviewed 1100charts from well-child visits. We demonstrated that use of the WCA increased identification of multiple Child-ACEscompared with no screening and that reports of multiple Child-ACEs increased with age. These results suggest thatuse of the WCA provides an acceptable and feasible way to screen for Child-ACEs during routine pediatric practice. (07/2019) (link)

Non-Scholarly Journals

  • Editor-in-Chief, Pediatric In-Patient libarary for Exitcare, Lake Elmo, Minnesota (2009)
  • Contributing Writer for approximately five articles on Pediatric topics to The Sun Newspaper, San Bernardino, CA. (2002 - 2005)
  • Contributing Writer for approximately 57 articles on Pediatric topics to Press-Enterprise Newspaper, Riverside, CA. (1999 - 2005)