{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T22:54:20Z","timestamp":1773096860958,"version":"3.50.1"},"reference-count":55,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:00:00Z","timestamp":1687219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R01 HS027742"],"award-info":[{"award-number":["R01 HS027742"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Reducing Health Disparities through Informatics","award":["T32NR007969"],"award-info":[{"award-number":["T32NR007969"]}]},{"DOI":"10.13039\/100000056","name":"NINR","doi-asserted-by":"publisher","award":["T32NR007969"],"award-info":[{"award-number":["T32NR007969"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Care for At Risk Older Adults","award":["T32NR009356"],"award-info":[{"award-number":["T32NR009356"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to identify temporal risk factor patterns documented in home health care (HHC) clinical notes and examine their association with hospitalizations or emergency department (ED) visits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Data for 73\u00a0350 episodes of care from one large HHC organization were analyzed using dynamic time warping and hierarchical clustering analysis to identify the temporal patterns of risk factors documented in clinical notes. The Omaha System nursing terminology represented risk factors. First, clinical characteristics were compared between clusters. Next, multivariate logistic regression was used to examine the association between clusters and risk for hospitalizations or ED visits. Omaha System domains corresponding to risk factors were analyzed and described in each cluster.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Six temporal clusters emerged, showing different patterns in how risk factors were documented over time. Patients with a steep increase in documented risk factors over time had a 3 times higher likelihood of hospitalization or ED visit than patients with no documented risk factors. Most risk factors belonged to the physiological domain, and only a few were in the environmental domain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>An analysis of risk factor trajectories reflects a patient\u2019s evolving health status during a HHC episode. Using standardized nursing terminology, this study provided new insights into the complex temporal dynamics of HHC, which may lead to improved patient outcomes through better treatment and management plans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Incorporating temporal patterns in documented risk factors and their clusters into early warning systems may activate interventions to prevent hospitalizations or ED visits in HHC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocad101","type":"journal-article","created":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T04:25:59Z","timestamp":1687321559000},"page":"1801-1810","source":"Crossref","is-referenced-by-count":4,"title":["Uncovering hidden trends: identifying time trajectories in risk factors documented in clinical notes and predicting hospitalizations and emergency department visits during home health care"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0362-0670","authenticated-orcid":false,"given":"Jiyoun","family":"Song","sequence":"first","affiliation":[{"name":"Columbia University School of Nursing , New York City, New York, USA"}]},{"given":"Se Hee","family":"Min","sequence":"additional","affiliation":[{"name":"Columbia University School of Nursing , New York City, New York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9136-6176","authenticated-orcid":false,"given":"Sena","family":"Chae","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Iowa , Iowa City, Iowa, USA"}]},{"given":"Kathryn H","family":"Bowles","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania, USA"},{"name":"Center for Home Care Policy & Research, VNS Health , New York, New York, USA"}]},{"given":"Margaret V","family":"McDonald","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, VNS Health , New York, New York, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2852-4175","authenticated-orcid":false,"given":"Mollie","family":"Hobensack","sequence":"additional","affiliation":[{"name":"Columbia University School of Nursing , New York City, New York, USA"}]},{"given":"Yolanda","family":"Barr\u00f3n","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, VNS Health , New York, New York, USA"}]},{"given":"Sridevi","family":"Sridharan","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, VNS Health , New York, New York, USA"}]},{"given":"Anahita","family":"Davoudi","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, VNS Health , New York, New York, USA"}]},{"given":"Sungho","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of 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