Richard Platt
Biographic Data
| ID | 1159628 |
|---|---|
| NAME | Richard Platt |
| GIVEN NAMES | Richard |
| FAMILY NAME | Platt |
| SIGNATURE | PLATT R |
| AFFILIATIONS | Harvard Pilgrim Health Care |
| ORCID | 0000-0002-3248-3583 |
| VERIFIED | Yes |
| TOTAL WORKS | 28 |
| TOTAL CITATIONS | 20 |
| AUTHOR COUNT | 27 |
| EDITOR COUNT | 1 |
| FIRST PUBLICATION YEAR | 1858 |
| LATEST PUBLICATION YEAR | 2019 |
| H-INDEX | 3 |
Bystander Ethics and Good Samaritanism
In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuou…
Surgical Site Infections
BACKGROUND: Surgical site infection (SSI) rates are publicly reported as quality metrics and increasingly used to determine financial reimbursement. OBJECTIVE: To evaluate the volume-outcome relationship as well as the year-to-year stability of performance rankings following coronary artery bypass graft (CABG) surgery and hip arthroplasty. RESEARCH DESIGN: We performed a retrospective cohort study of Medicare beneficiaries who underwent CABG surg…
MDPHnet
Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance. Clinical practices’ security, privacy, and proprietary concerns, however, have limited their willingness to share these data with public health agencies. We describe a novel distributed network for public health surveillance called MDPHnet. The system allows the Massachusetts Department o…
Medicare Claims Can Be Used to Identify US Hospitals With Higher Rates of Surgical Site Infection Following Vascular Surgery
BACKGROUND: Surgical site infections (SSIs) following vascular surgery have high morbidity and costs, and are increasingly tracked as hospital quality measures. OBJECTIVE: To assess the ability of Medicare claims to identify US hospitals with high SSI rates after vascular surgery. RESEARCH DESIGN: Using claims from fee-for-service Medicare enrollees of age 65 years and older who underwent vascular surgery from 2005 to 2008, we derived hospital ra…
Evaluation as Part of Operations
Understanding the components of clinical care that work best is a cornerstone of improving health care. And yet, the more we improve the quality of quality improvement and move to continuous learning about clinical care more broadly, the more we find ourselves in a regulatory environment that makes evaluation more difficult, expensive, and, in some situations, impossible. In their paper on the ethical underpinnings of the distinction between rese…
Integrating Clinical Practice and Public Health Surveillance Using Electronic Medical Record Systems
Electronic medical record (EMR) systems have rich potential to improve integration between primary care and the public health system at the point of care. EMRs make it possible for clinicians to contribute timely, clinically detailed surveillance data to public health practitioners without changing their existing workflows or incurring extra work. New surveillance systems can extract raw data from providers’ EMRs, analyze them for conditions of p…
Medication Exposure in Pregnancy Risk Evaluation Program
Social Network Analysis of Patient Sharing Among Hospitals in Orange County, California
Objectives. We applied social network analyses to determine how hospitals within Orange County, California, are interconnected by patient sharing, a system which may have numerous public health implications. Methods. Our analyses considered 2 general patient-sharing networks: uninterrupted patient sharing (UPS; i.e., direct interhospital transfers) and total patient sharing (TPS; i.e., all interhospital patient sharing, including patients with in…
Cluster Randomized Trials in Comparative Effectiveness Research
BACKGROUND: The need for evidence about the effectiveness of therapeutics and other medical practices has triggered new interest in methods for comparative effectiveness research. OBJECTIVE: Describe an approach to comparative effectiveness research involving cluster randomized trials in networks of hospitals, health plans, or medical practices with centralized administrative and informatics capabilities. RESEARCH DESIGN: We discuss the example o…
Distributed Health Data Networks
BACKGROUND: Comparative effectiveness research, medical product safety evaluation, and quality measurement will require the ability to use electronic health data held by multiple organizations. There is no consensus about whether to create regional or national combined (eg, "all payer") databases for these purposes, or distributed data networks that leave most Protected Health Information and proprietary data in the possession of the original dat…
Active Influenza Vaccine Safety Surveillance
BACKGROUND: Rapid safety assessment of novel vaccines, especially those targeted against pandemic influenza, is a public health priority. OBJECTIVES: Assess the feasibility of using healthcare claims data to rapidly detect influenza vaccine adverse events using sequential analytic methods. RESEARCH DESIGN: Retrospective pilot study simulating prospective surveillance using 6 cumulative monthly administrative claims data extracts. The first includ…
Academic Detailing to Improve Laboratory Testing Among Outpatient Medication Users
PURPOSE: To determine whether group academic detailing with performance feedback increases recommended laboratory monitoring among outpatients dispensed medications. METHODS: Thirty-eight primary care practices in 3 states were randomized to group academic detailing with physician-level performance feedback (intervention) or a control group. Adjusted differences in creatinine and potassium testing between intervention and control group patients w…
Cluster Randomized Trials
BACKGROUND: Cluster randomized trials (CRTs) offer unique advantages over standard randomized controlled clinical trials (RCTs) and observational methodologies, and may provide a cost-efficient alternative for answering questions about the best treatments for common conditions. OBJECTIVES: To describe health plan leaders' views on CRTs, identify barriers to conducting CRTs, and solicit recommendations for increasing the acceptability of CRTs. RES…
Real-Time Vaccine Safety Surveillance for the Early Detection of Adverse Events
BACKGROUND: Rare but serious adverse events associated with vaccines or drugs are often nearly impossible to detect in prelicensure studies and require monitoring after introduction of the agent in large populations. Sequential testing procedures are needed to detect vaccine or drug safety problems as soon as possible after introduction. OBJECTIVE: To develop and evaluate a new real-time surveillance system that uses dynamic data files and sequen…
Distributed data processing for public health surveillance
For well-defined surveillance requirements, the model can be successfully deployed with very low risk of inadvertent disclosure of PHI--a feature that may make participation in surveillance systems more feasible for organizations and more appealing to the individuals whose PHI they hold. It is possible to design and implement distributed systems to support non-routine public health needs if required
Potential Drug–Drug Interactions in the Outpatient Setting
BACKGROUND: Although medication safety research has tended to focus on inpatients, the safety of drug use among outpatients is also a concern. OBJECTIVE: We estimate the frequency of potentially interacting concomitant medication dispensing among outpatients. RESEARCH DESIGN: We report the number and percent of patients annually dispensed an object drug of interest (ie, warfarin, digoxin, cyclosporine, or lovastatin/simvastatin) with a potentiall…
Effect of Increased Cost-Sharing on Oral Hypoglycemic Use in Five Managed Care Organizations
BACKGROUND: For patients with a chronic disease, increased cost-sharing for medications may lead to unintended consequences, including reduced use of medications essential for control of their disease. OBJECTIVE: The objective of this study was to estimate the effects of small ($1-6 per 30-day supply), moderate ($7-10), and large (>$10) increases in medication cost-sharing on 12-month trends in oral hypoglycemic (OH) use among adults with type 2 …
Attitudes of healthcare workers in U.S. hospitals regarding smallpox vaccination
The success of smallpox vaccination efforts will ultimately depend on the relative weight in people's minds of the risk of vaccine adverse events compared with the risk of being exposed to the disease. Although more than half of the respondents thought the likelihood of a bioterrorist smallpox attack was intermediate or high, less than 10% of the group slated for vaccination has actually accepted it at this time. Unless new information about the …
Syndromic surveillance using minimum transfer of identifiable data
The Local Correspondence of the Royal African Company of England, 1681–1699, Vol. 2
Prelleur, Peter
Roseingrave family
Roseingrave, Thomas
Using automated medical records for rapid identification of illness syndromes (syndromic surveillance)
This information complements existing surveillance programs by assessing the large majority of episodes of illness for which no etiologic agents are identified. Additional advantages include: a) sensitivity, uniformity and efficiency, since detection of events does not depend on clinicians' to actively report diagnoses, b) timeliness, the data are available within a day of the clinical event; and c) ease of integration into automated surveillance…
Validation of Patient Reports, Automated Pharmacy Records, and Pill Counts With Electronic Monitoring of Adherence to Antihypertensive Therapy
OBJECTIVES: To evaluate the validity of patient report, pharmacy dispensing records, and pill counts as measures of antihypertensive adherence using electronic monitoring as the validation standard. METHODS: The study was conducted among 286 members of Harvard Pilgrim Health Care, a managed care organization, who were at least 18 years of age, on monotherapy for hypertension, and had prescription drug coverage. Prescription refill adherence durin…
Social Network Analysis of Patient Sharing Among Hospitals in Orange County, California
Objectives. We applied social network analyses to determine how hospitals within Orange County, California, are interconnected by patient sharing, a system which may have numerous public health implications. Methods. Our analyses considered 2 general patient-sharing networks: uninterrupted patient sharing (UPS; i.e., direct interhospital transfers) and total patient sharing (TPS; i.e., all interhospital patient sharing, including patients with in…
Integrating Clinical Practice and Public Health Surveillance Using Electronic Medical Record Systems
Electronic medical record (EMR) systems have rich potential to improve integration between primary care and the public health system at the point of care. EMRs make it possible for clinicians to contribute timely, clinically detailed surveillance data to public health practitioners without changing their existing workflows or incurring extra work. New surveillance systems can extract raw data from providers’ EMRs, analyze them for conditions of p…
MDPHnet
Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance. Clinical practices’ security, privacy, and proprietary concerns, however, have limited their willingness to share these data with public health agencies. We describe a novel distributed network for public health surveillance called MDPHnet. The system allows the Massachusetts Department o…
Syndromic surveillance using minimum transfer of identifiable data
Addition to the Seals of Free Grammar Schools
The Eight Symphonies
Symphonies Nos. 1-8
Validation of Patient Reports, Automated Pharmacy Records, and Pill Counts With Electronic Monitoring of Adherence to Antihypertensive Therapy
OBJECTIVES: To evaluate the validity of patient report, pharmacy dispensing records, and pill counts as measures of antihypertensive adherence using electronic monitoring as the validation standard. METHODS: The study was conducted among 286 members of Harvard Pilgrim Health Care, a managed care organization, who were at least 18 years of age, on monotherapy for hypertension, and had prescription drug coverage. Prescription refill adherence durin…
The Local Correspondence of the Royal African Company of England, 1681–1699, Vol. 2
Prelleur, Peter
Roseingrave family
Roseingrave, Thomas
Using automated medical records for rapid identification of illness syndromes (syndromic surveillance)
This information complements existing surveillance programs by assessing the large majority of episodes of illness for which no etiologic agents are identified. Additional advantages include: a) sensitivity, uniformity and efficiency, since detection of events does not depend on clinicians' to actively report diagnoses, b) timeliness, the data are available within a day of the clinical event; and c) ease of integration into automated surveillance…
Attitudes of healthcare workers in U.S. hospitals regarding smallpox vaccination
The success of smallpox vaccination efforts will ultimately depend on the relative weight in people's minds of the risk of vaccine adverse events compared with the risk of being exposed to the disease. Although more than half of the respondents thought the likelihood of a bioterrorist smallpox attack was intermediate or high, less than 10% of the group slated for vaccination has actually accepted it at this time. Unless new information about the …
Syndromic surveillance using minimum transfer of identifiable data
Effect of Increased Cost-Sharing on Oral Hypoglycemic Use in Five Managed Care Organizations
BACKGROUND: For patients with a chronic disease, increased cost-sharing for medications may lead to unintended consequences, including reduced use of medications essential for control of their disease. OBJECTIVE: The objective of this study was to estimate the effects of small ($1-6 per 30-day supply), moderate ($7-10), and large (>$10) increases in medication cost-sharing on 12-month trends in oral hypoglycemic (OH) use among adults with type 2 …
Distributed data processing for public health surveillance
For well-defined surveillance requirements, the model can be successfully deployed with very low risk of inadvertent disclosure of PHI--a feature that may make participation in surveillance systems more feasible for organizations and more appealing to the individuals whose PHI they hold. It is possible to design and implement distributed systems to support non-routine public health needs if required
Potential Drug–Drug Interactions in the Outpatient Setting
BACKGROUND: Although medication safety research has tended to focus on inpatients, the safety of drug use among outpatients is also a concern. OBJECTIVE: We estimate the frequency of potentially interacting concomitant medication dispensing among outpatients. RESEARCH DESIGN: We report the number and percent of patients annually dispensed an object drug of interest (ie, warfarin, digoxin, cyclosporine, or lovastatin/simvastatin) with a potentiall…
Academic Detailing to Improve Laboratory Testing Among Outpatient Medication Users
PURPOSE: To determine whether group academic detailing with performance feedback increases recommended laboratory monitoring among outpatients dispensed medications. METHODS: Thirty-eight primary care practices in 3 states were randomized to group academic detailing with physician-level performance feedback (intervention) or a control group. Adjusted differences in creatinine and potassium testing between intervention and control group patients w…
Cluster Randomized Trials
BACKGROUND: Cluster randomized trials (CRTs) offer unique advantages over standard randomized controlled clinical trials (RCTs) and observational methodologies, and may provide a cost-efficient alternative for answering questions about the best treatments for common conditions. OBJECTIVES: To describe health plan leaders' views on CRTs, identify barriers to conducting CRTs, and solicit recommendations for increasing the acceptability of CRTs. RES…
Real-Time Vaccine Safety Surveillance for the Early Detection of Adverse Events
BACKGROUND: Rare but serious adverse events associated with vaccines or drugs are often nearly impossible to detect in prelicensure studies and require monitoring after introduction of the agent in large populations. Sequential testing procedures are needed to detect vaccine or drug safety problems as soon as possible after introduction. OBJECTIVE: To develop and evaluate a new real-time surveillance system that uses dynamic data files and sequen…
Active Influenza Vaccine Safety Surveillance
BACKGROUND: Rapid safety assessment of novel vaccines, especially those targeted against pandemic influenza, is a public health priority. OBJECTIVES: Assess the feasibility of using healthcare claims data to rapidly detect influenza vaccine adverse events using sequential analytic methods. RESEARCH DESIGN: Retrospective pilot study simulating prospective surveillance using 6 cumulative monthly administrative claims data extracts. The first includ…
Cluster Randomized Trials in Comparative Effectiveness Research
BACKGROUND: The need for evidence about the effectiveness of therapeutics and other medical practices has triggered new interest in methods for comparative effectiveness research. OBJECTIVE: Describe an approach to comparative effectiveness research involving cluster randomized trials in networks of hospitals, health plans, or medical practices with centralized administrative and informatics capabilities. RESEARCH DESIGN: We discuss the example o…
Distributed Health Data Networks
BACKGROUND: Comparative effectiveness research, medical product safety evaluation, and quality measurement will require the ability to use electronic health data held by multiple organizations. There is no consensus about whether to create regional or national combined (eg, "all payer") databases for these purposes, or distributed data networks that leave most Protected Health Information and proprietary data in the possession of the original dat…
Medication Exposure in Pregnancy Risk Evaluation Program
Social Network Analysis of Patient Sharing Among Hospitals in Orange County, California
Objectives. We applied social network analyses to determine how hospitals within Orange County, California, are interconnected by patient sharing, a system which may have numerous public health implications. Methods. Our analyses considered 2 general patient-sharing networks: uninterrupted patient sharing (UPS; i.e., direct interhospital transfers) and total patient sharing (TPS; i.e., all interhospital patient sharing, including patients with in…
Integrating Clinical Practice and Public Health Surveillance Using Electronic Medical Record Systems
Electronic medical record (EMR) systems have rich potential to improve integration between primary care and the public health system at the point of care. EMRs make it possible for clinicians to contribute timely, clinically detailed surveillance data to public health practitioners without changing their existing workflows or incurring extra work. New surveillance systems can extract raw data from providers’ EMRs, analyze them for conditions of p…
Evaluation as Part of Operations
Understanding the components of clinical care that work best is a cornerstone of improving health care. And yet, the more we improve the quality of quality improvement and move to continuous learning about clinical care more broadly, the more we find ourselves in a regulatory environment that makes evaluation more difficult, expensive, and, in some situations, impossible. In their paper on the ethical underpinnings of the distinction between rese…
MDPHnet
Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance. Clinical practices’ security, privacy, and proprietary concerns, however, have limited their willingness to share these data with public health agencies. We describe a novel distributed network for public health surveillance called MDPHnet. The system allows the Massachusetts Department o…
Medicine (19 works) · Computer Science (11 works) · Health care (11 works) · Medical emergency (9 works) · Nursing (9 works) · Internal Medicine (8 works) · Public health (8 works) · Family medicine (7 works) · Data-Driven Disease Surveillance (6 works) · Environmental health (6 works)