-
A Comprehensive Multi-Functional Approach for Measuring Parkinson's Disease Severity. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-23 Morteza Rahimi,Zeina Al Masry,John Michael Templeton,Sandra Schneider,Christian Poellabauer
OBJECTIVES This research study aims to advance the staging of Parkinson's disease (PD) by incorporating machine learning to assess and include a broader multi-functional spectrum of neurocognitive symptoms in the staging schemes beyond motor-centric assessments. Specifically, we provide a novel framework to modernize and personalize PD staging more objectively by proposing a hybrid feature scoring
-
Imaging Informatics Education in Clinical Informatics Programs: Perspective from Imaging and Clinical Informatics Professionals Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-18 Nathan A. Bumbarger, Alexander J. Towbin, Pamela Garcia-Filion, James Whitfill, Tessa Cook, Les R. Folio
Background Imaging and Clinical Informatics are domains of biomedical informatics. Imaging Informatics topics are often not covered in depth in most Clinical Informatics fellowships. While dedicated Imaging Informatics fellowships exist, they may not have the same rigor as ACGME (Accreditation Council for Graduate Medical Education) accredited Clinical Informatics fellowships and they do not provide
-
Patient–Clinician Diagnostic Concordance upon Hospital Admission Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-18 Alyssa Lam, Savanna Plombon, Alison Garber, Pamela Garabedian, Ronen Rozenblum, Jacqueline A. Griffin, Jeffrey L. Schnipper, Stuart R. Lipsitz, David W. Bates, Anuj K. Dalal
Objectives This study aimed to pilot an application-based patient diagnostic questionnaire (PDQ) and assess the concordance of the admission diagnosis reported by the patient and entered by the clinician. Methods Eligible patients completed the PDQ assessing patients' understanding of and confidence in the diagnosis 24 hours into hospitalization either independently or with assistance. Demographic
-
Special Issue on Informatics Education: Exploring the Impact of GitHub Copilot on Health Informatics Education. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-13 Sanja Avramovic,Ivan Avramovic,Janusz Wojtusiak
BACKGROUND The use of artificial intelligence-driven code completion tools, particularly the integration of GitHub Copilot with Visual Studio, has potential implications for Health Informatics education, particularly for students learning SQL and Python. OBJECTIVES This study aims to evaluate the effectiveness of these tools in solving or assisting with the solution of problems found in Health Informatics
-
Clinical Decision Support Tool to Promote Adoption of New Neonatal Hyperbilirubinemia Guidelines Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-11 Lucia An, Paul J. Lukac, Deepa Kulkarni
Objective This study aimed to increase the adoption of revised newborn hyperbilirubinemia guidelines by building a clinical decision support (CDS) tool into templated notes. Methods We created a rule-based CDS tool that correctly populates the phototherapy threshold from more than 2,700 possible values directly into the note and guides clinicians to an appropriate follow-up plan consistent with the
-
Developing PRISM: A Pragmatic Institutional Survey and Bench Marking Tool to Measure Digital Research Maturity of Cancer Centers Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-11 Carlos Berenguer Albiñana, Matteo Pallocca, Hayley Fenton, Will Sopwith, Charlie Van Eden, Olof Akre, Annika Auranen, François Bocquet, Marina Borges, Emiliano Calvo, John Corkett, Serena Di Cosimo, Nicola Gentili, Julien Guérin, Sissel Jor, Tomas Kazda, Alenka Kolar, Tim Kuschel, Maria Julia Lostes, Chiara Paratore, Paolo Pedrazzoli, Marko Petrovic, Jarno Raid, Miriam Roche, Christoph Schatz, Joelle
Background Multicenter precision oncology real-world evidence requires a substantial long-term investment by hospitals to prepare their data and align on common Clinical Research processes and medical definitions. Our team has developed a self-assessment framework to support hospitals and hospital networks to measure their digital maturity and better plan and coordinate those investments. From that
-
Issue on Teaching and Training Future Health Informaticians:Partnering with Students to Develop a Capstone for a Graduate Health Informatics Program. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-10 Rita Jezrawi,Stephanie Zahorka Derka,Elizabeth Warnick,Jasmine Foley,Vritti Patel,Neethu Pavithran,Thérèse Bernier,Nicole Wagner,Neil G Barr,Vincent Maccio,Margaret Leyland,Cynthia Lokker
OBJECTIVE To assess the desirability, feasibility, and sustainability of integrating a project-based capstone course with the course-based curriculum of an interdisciplinary MSc health informatics program guided with a student-partnered steering committee and student-centered approach. METHODS We conducted an online cross-sectional survey (n=87) and three semi-structured focus groups (n=18) of health
-
Enhancing Suicide Risk Prediction Models with Temporal Clinical Note Features. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-09 Kevin Krause,Sharon Davis,Zhijun Yin,Katherine Schafer,Trent Rosenbloom,Colin Walsh
OBJECTIVE The objective of this study was to investigate the impact of enhancing a structured-data-based suicide attempt risk prediction model with temporal Concept Unique Identifiers (CUIs) derived from clinical notes. We aimed to examine how different temporal schemes, model types, and prediction ranges influenced the model's predictive performance. This research sought to improve our understanding
-
A Discount Approach to Reducing Nursing Alert Burden Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-04 Sarah A. Thompson, Swaminathan Kandaswamy, Evan Orenstein
Background Numerous programs have arisen to address interruptive clinical decision support (CDS) with the goals of reducing alert burden and alert fatigue. These programs often have standing committees with broad stakeholder representation, significant governance efforts, and substantial analyst hours to achieve reductions in alert burden which can be difficult for hospital systems to replicate. Objective This
-
Evaluation of Mobile Apps Used among Medical Students for Learning and Education: A Mixed-Method Concurrent Triangulation Approach Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-09-04 Jwaher A. Almulhem, Raniah N. Aldekhyyel, Samar Binkheder
Background The use of medical mobile applications (apps) to enhance learning is widespread in medical education. Despite the large number of medical apps used among medical students for learning, many apps have not been evaluated using validated instruments. Finding relevant and valuable apps for student learning might be difficult. Objective The objective is to evaluate four medical apps (AMBOSS,
-
Special Issue on Informatics Education: Teaching Data Science through an Interactive, Hands-On Workshop with Clinically-Relevant Case Studies. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-30 Alvin Dean Jeffery,Patricia Sengstack
BACKGROUND In this case report, we describe the development of an innovative workshop to bridge the gap in data science education for practicing clinicians (and particularly nurses). In the workshop, we emphasize the core concepts of machine learning and predictive modeling to increase understanding among clinicians. OBJECTIVE Addressing the limited exposure of healthcare providers to leverage and
-
Special Issue on Informatics Education: < Integrating Diversity, Equity, Inclusion, and Accessibility into a Data Storytelling Model for Health Informatics Education >. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-30 Grace Gao,Christie Martin,Alvin Dean Jeffery
BACKGROUND Health informatics education is pivotal in integrating diversity, equity, inclusion, and accessibility (DEIA) principles into curricula and leveraging data with equity considerations. Integrating clinically driven data with other datasets is crucial to comprehensive understanding of patient care demographics, experiences, and outcomes to create equity-minded data storytelling. Publicly available
-
Patients with Heart Failure: Internet Use and Mobile Health Perceptions Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-28 Albert Sohn, Anne M. Turner, William Speier, Gregg C. Fonarow, Michael K. Ong, Corey W. Arnold
Background Heart failure is a complex clinical syndrome noted on approximately one in eight death certificates in the United States. Vital to reducing complications of heart failure and preventing hospital readmissions is adherence to heart failure self-care routines. Mobile health offers promising opportunities for enhancing self-care behaviors by facilitating tracking and timely reminders. Objectives We
-
External Validation of an Electronic Phenotyping Algorithm Detecting Attention to High Body Mass Index in Pediatric Primary Care Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-28 Anya G. Barron, Ada M. Fenick, Kaitlin R. Maciejewski, Christy B. Turer, Mona Sharifi
Objectives The lack of feasible and meaningful measures of clinicians' behavior hinders efforts to assess and improve obesity management in pediatric primary care. In this study, we examined the external validity of a novel algorithm, previously validated in a single geographic region, using structured electronic health record (EHR) data to identify phenotypes of clinicians' attention to elevated body
-
Special Issue on Informatics Education: ChatGPT Performs Worse on USMLE-Style Ethics Questions Compared to Medical Knowledge Questions. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-29 Tessa Louise Danehy,Jessica Hecht,Sabrina Kentis,Clyde Schechter,Sunit Jariwala
OBJECTIVES The main objective of this study is to evaluate the ability of the Large Language Model ChatGPT to accurately answer USMLE board style medical ethics questions compared to medical knowledge based questions. This study has the additional objectives of comparing the overall accuracy of GPT-3.5 to GPT-4 and to assess the variability of responses given by each version. MATERIALS AND METHODS
-
Nudging Towards Sleep-Friendly Hospitalizations: A Multifaceted Approach on Reducing Unnecessary Overnight Interventions. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-27 Sullafa Kadura,Lauren Eisner,Samia Lopa,Alexander Poulakis,Hannah Mesmer,Nicole Willnow,Wilfred Pigeon
BACKGROUND Choice architecture refers to the design of decision environments, which can influence healthcare decision-making. Nudges are subtle adjustments in these environments that guide decisions toward desired outcomes. For example, Computerized Provider Order Entry (CPOE) within Electronic Health Records (EHR) recommends frequencies for interventions such as nursing assessments and medication
-
Realizing the Full Potential of Clinical Decision Support: Translating Usability Testing into Routine Practice in healthcare operations. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-27 Swaminathan Kandaswamy,Herb Williams,Sarah A Thompson,Thomas Dawson,Naveen Muthu,Evan Orenstein
BACKGROUND Clinical Decision Support (CDS) tools have a mixed record of effectiveness, often due to inadequate alignment with clinical workflows and poor usability. While there's a consensus that usability testing methods address these issues, in practice, usability testing is generally only used for selected projects (such as funded research studies). There is a critical need for CDS operations to
-
"It attracts your eyes and brain": Refining visualizations for shared decision-making with heart failure patients. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-23 Sabrina Mangal,Maryam Hyder,Kate Zarzuela,William McDonald,Ruth M Masterson Creber,Ian M Kronish,Stefan Konigorski,Mathew S Maurer,Monika M Safford,Mark S Lachs,Parag Goyal
BACKGROUND N-of-1 trials have emerged as a personalized approach to patient-centered care, where patients can compare evidence-based treatments using their own data. However, little is known about optimal methods to present individual-level data from medication-related N-of-1 trials to patients to promote decision-making. OBJECTIVES We conducted qualitative interviews with patients with heart failure
-
Sociodemographic Differences in Perspectives on Postpartum Symptom Reporting Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-21 Natalie C. Benda, Ruth M. Masterson Creber, Roberta Scheinmann, Stephanie Nino de Rivera, Eric Costa Pimentel, Robin B. Kalish, Laura E. Riley, Alison Hermann, Jessica S. Ancker
Objective The overall goal of this work is to create a patient-reported outcome (PRO) and decision support system to help postpartum patients determine when to seek care for concerning symptoms. In this case study, we assessed differences in perspectives for application design needs based on race, ethnicity, and preferred language. Methods A sample of 446 participants who reported giving birth in the
-
Coverage of physical therapy assessments in the Observational Medical Outcomes Partnership Model common data model. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-22 Margaret A French,Paul Hartman,Heather A Hayes,Leah Ling,John Magel,Anne Thackeray
BACKGROUND High-value care aims to enhance meaningful patient outcomes while reducing costs and is accelerated by curating data across healthcare systems through common data models (CDMs), such as Observational Medical Outcomes Partnership Model (OMOP). Meaningful patient outcomes, such as physical function, must be included in these CDMs. However, the extent that physical therapy assessments are covered
-
Successfully transitioning an interruptive alert into a non-interruptive alert for central line dressing changes in the Neonatal Intensive Care Unit. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-20 Lindsey A Knake,Rachel Asbury,Shannon Penisten,Nathan Meyer,Keith Burrell,Rebecca Chuffo Davila,Adam Wright,James M Blum
BACKGROUND Interruptive alerts are known to be associated with clinician alert fatigue, and poorly performing alerts should be evaluated for alternative solutions. An interruptive alert to remind clinicians about a required peripherally inserted central catheter (PICC) dressing change within the first 48-hours after placement resulted in 617 firings in a 6-month period with only 11 (1.7%) actions taken
-
Special Issue on Informatics Education: Developing and Implementing a Clinical Informatics Fellowship Curriculum. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-20 Lindsey Spiegelman,Scott Rudkin,Sonia Portillo,Ryan O'Connell
We developed and implemented a novel internal clinical informatics curriculum for the UCI Fellowship Program. We sought to innovate the program's educational approach by transitioning from an external to an internal curriculum in response to feedback and the evolving needs of the field. This case study outlines the rationale, design process, challenges, and outcomes of this curriculum development effort
-
A Structured Social-Media Health Support intervention Program after Bariatric Surgery. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-20 Orly Tamir,Hassan Kais,Moran Accos Carmel,Tatyana Kolobov,Gideon Matthews,Aviva Lipsitz,Yuval Shalev Many,Sigal Benton,Arriel Benis
BACKGROUND Social media networks have been found to provide emotional, instrumental, and social support, which may contribute to improved adherence to post-bariatric surgery care recommendations. OBJECTIVES To evaluate the impact of an online social media-based, healthcare professional-led, educational and support program on patients' long-term engagement with and adherence to follow-up guidelines
-
Training in Public Health Informatics and Technology Leveraging a Multi-institutional Partnership Model and Emphasizing Experiential Learning Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-14 Sripriya Rajamani, Kristie C. Waterfield, Robin Austin, Vivian Singletary, Yasmin Odowa, Stephanie Miles-Richardson, Tony Winters, Brenton Powers, Feather LaRoche, Sarah Trachet, Jennifer Fritz, Jonathon P. Leider, Rebecca Wurtz, Gulzar H. Shah
Background and Objective Though public health is an information-intense profession, there is a paucity of workforce with Public Health Informatics and Technology (PHIT) skills, which was evident during the coronavirus disease 2019 (COVID-19) pandemic. This need is addressed through the PHIT workforce program (2021–2025) by the Office of the National Coordinator for training and to increase racial and
-
Effects of a Pharmacist-Designed Clinical Decision Support System on Antimicrobial Stewardship Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-14 Miguel Ángel Amor-García, Esther Chamorro-de-Vega, Carmen Guadalupe Rodríguez-González, Irene Iglesias-Peinado, Raquel Moreno-Díaz
Background Clinical decision support systems (CDSSs) are computer applications, which can be applied to give guidance to practitioners in antimicrobial stewardship (AS) activities; however, further information is needed for their optimal use. Objectives Our objective was to analyze the implementation of a CDSS program in a second-level hospital, describing alerts, recommendations, and the effects on
-
Special Issue on Informatics Education: Pedagogical Principles in Implementing a Data Visualization Project in an Undergraduate Public Health Informatics Course. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-13 John Robert Bautista
Background The Applied Public Health Informatics Competency Model lists "data analysis, visualization, and reporting" as one of the eight competencies when teaching public health informatics. Thus, public health informatics students need to develop knowledge and skills in visualizing public health data. Unfortunately, there is limited work that discusses pedagogical principles that could guide the
-
Defining documentation burden (DocBurden) and excess DocBurden for all health professionals: A scoping review. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-13 Deborah R Levy,Jennifer Withall,Rebecca Grochow Mishuris,Vicky Tiase,Courtney J Diamond,Brian Douthit,Monika Grabowska,Rachel Lee,Amanda Moy,Patricia Sengstack,Julia Adler-Milstein,Don E Detmer,Kevin B Johnson,James J Cimino,Sarah T Corley,Judy Murphy,Trent Rosenbloom,Kenrick Cato,Sarah Collins Rossetti
OBJECTIVE Efforts to reduce documentation burden (DocBurden) for all health professionals (HP) are aligned with national initiatives to improve clinician wellness and patient safety. Yet DocBurden has not been precisely defined, limiting national conversations and rigorous, reproducible, and meaningful measures. Increasing attention to DocBurden motivated this work to establish a standard definition
-
Effect of Ambient Voice Technology, Natural Language Processing, and Artificial Intelligence on the Patient–Physician Relationship Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-07 Lance M. Owens, J Joshua Wilda, Ronald Grifka, Joan Westendorp, Jeffrey J. Fletcher
Background The method of documentation during a clinical encounter may affect the patient–physician relationship. Objectives Evaluate how the use of ambient voice recognition, coupled with natural language processing and artificial intelligence (DAX), affects the patient–physician relationship. Methods This was a prospective observational study with a primary aim of evaluating any difference in patient
-
Fellows of the American Medical Informatics Association (FAMIA): Looking Back and Looking Ahead Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-07 Laura Heermann Langford, Kate Fultz Hollis, Margo Edmunds, Allison B. McCoy, Eric S. Hall, Jeffrey A. Nielson, Sarah Collins Rosetti
Background Over the past 30 years, the American Medical Informatics Association (AMIA) has played a pivotal role in fostering a collaborative community for professionals in biomedical and health informatics. As an interdisciplinary association, AMIA brings together individuals with clinical, research, and computer expertise and emphasizes the use of data to enhance biomedical research and clinical
-
EHR Documentation and Referrals for Intimate Partner Violence and Sexual Assault. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-06 Joshua E Richardson,Jaclyn Houston-Kolnik,Stefany Ramos,Devin Oxner,Paige Presler-Jur
BACKGROUND Hospital settings provide a unique opportunity to screen for interpersonal violence (IPV) and sexual assault (SA) yet often lack health IT solutions for generating reliable and valid medico-legal documentation via forensic reports. OBJECTIVES The objective of the project was to evaluate a pilot, technology "tool" for documenting cases of IPV and SA that could support forensic nurse examiners
-
Multitasking during medication management in a nursing home: A time motion study. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-08-05 Yu Jin Kang,Christine Mueller,Joseph E Gaugler,Karen A Monsen
BACKGROUND Multitasking, defined as performing two or more interventions simultaneously, increases the cognitive burden of clinicians. This may, in turn, lead to higher risk of medication and procedural errors. Time motion study (TMS) data for nurses in nursing homes revealed an extensive amount of multitasking while managing medications. Further investigation of multitasked nursing interventions will
-
Interprofessional Evaluation of a Medication Clinical Decision Support System Prior to Implementation Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-31 Jacqueline Bauer, Marika Busse, Tanja Kopetzky, Christof Seggewies, Martin F. Fromm, Frank Dörje
Background Computerized physician order entry (CPOE) and clinical decision support systems (CDSS) are widespread due to increasing digitalization of hospitals. They can be associated with reduced medication errors and improved patient safety, but also with well-known risks (e.g., overalerting, nonadoption). Objectives Therefore, we aimed to evaluate a commonly used CDSS containing Medication-Safety-Validators
-
Leveraging Novel Clinical Decision Support to Improve Preferred Language Documentation in a Neonatal Intensive Care Unit Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-31 Osvaldo Mercado, Alex Ruan, Bolu Oluwalade, Matthew Devine, Kathleen Gibbs, Leah Carr
Background Recognition of the patient and family's diverse backgrounds and language preference is critical for communicating effectively. In our hospital's electronic health record, a patient or family's identified language for communication is documented in a discrete field known as “preferred language.” This field serves as an interdepartmental method to identify patients with a non-English preferred
-
Manual Evaluation of Record Linkage Algorithm Performance in Four Real-World Datasets Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-31 Agrayan K. Gupta, Huiping Xu, Xiaochun Li, Joshua R. Vest, Shaun J. Grannis
Objectives Patient data are fragmented across multiple repositories, yielding suboptimal and costly care. Record linkage algorithms are widely accepted solutions for improving completeness of patient records. However, studies often fail to fully describe their linkage techniques. Further, while many frameworks evaluate record linkage methods, few focus on producing gold standard datasets. This highlights
-
Contributors to Electronic Health Record-Integrated Secure Messaging Use: A Study of Over 33,000 Health Care Professionals Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-24 Laura R. Baratta, Daphne Lew, Thomas Kannampallil, Sunny S. Lou
Objectives Electronic health record (EHR)-integrated secure messaging is extensively used for communication between clinicians. We investigated the factors contributing to secure messaging use in a large health care system. Methods This was a cross-sectional study that included 14 hospitals and 263 outpatient clinic locations. Data on EHR-integrated secure messaging use over a 1-month period (February
-
Evaluation of a Digital Scribe: Conversation Summarization for Emergency Department Consultation Calls Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-24 Emre Sezgin, Joseph W. Sirrianni, Kelly Kranz
Objectives We present a proof-of-concept digital scribe system as an emergency department (ED) consultation call-based clinical conversation summarization pipeline to support clinical documentation and report its performance. Methods We use four pretrained large language models to establish the digital scribe system: T5-small, T5-base, PEGASUS-PubMed, and BART-Large-CNN via zero-shot and fine-tuning
-
Designing the User Interface of a Nitroglycerin Dose Titration Decision Support System: User-Centered Design Study Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-24 Navpreet Kamboj, Kelly Metcalfe, Charlene H. Chu, Aaron Conway
Background Nurses adjust intravenous nitroglycerin infusions to provide acute relief for angina by manually increasing or decreasing the dosage. However, titration can pose challenges, as excessively high doses can lead to hypotension, and low doses may result in inadequate pain relief. Clinical decision support systems (CDSSs) that predict changes in blood pressure for nitroglycerin dose adjustments
-
What Do We Mean by Sharing of Patient Data? DaSH - A Data Sharing Hierarchy of Privacy and Ethical Challenges. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-25 Richard Schreiber,Ross Koppel,Bonnie Kaplan
BACKGROUND Sharing of clinical data is common and necessary for patient care, research, public health, and innovation. The term "data sharing," however, is often ambiguous in its many facets and complexities-each of which involves ethical, legal, and social issues. To our knowledge there is no extant hierarchy of data sharing that assesses these issues. OBJECTIVE Develop a hierarchy explicating the
-
Special Issue on Teaching and Training Future Health Informaticians: Increasing generative artificial intelligence competency among students enrolled in doctoral nursing research coursework. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-25 Meghan Reading Turchioe,Liesbet Van Bulck,Sergey Kisselev,Suzanne Bakken
BACKGROUND Generative AI tools may soon be integrated into healthcare practice and research. Nurses in leadership roles, many of whom are doctorally prepared, will need to determine whether and how to integrate them in a safe and useful way. OBJECTIVE The objective of this study was to develop and evaluate a brief intervention to increase PhD nursing students' knowledge of appropriate applications
-
A Medical Student-Led Multi-Pronged Initiative to Close the Digital Divide in Outpatient Primary Care. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-22 Yilan Jiangliu,Hannah Tang Kim,Michelle Lazar,Eileen Liu,Saaz Mantri,Edwin Qiu,Megan Berube,Himani Sood,Anika S Walia,Breanne Biondi,Andres Miguel Mesias Gonzalez,Rebecca Grochow Mishuris,Pablo Buitron de la Vega
BACKGROUND The COVID-19 pandemic accelerated the use of telehealth. However, this also exacerbated healthcare disparities for vulnerable populations. OBJECTIVE To explore the feasibility and effectiveness of a medical student-led initiative to identify and address gaps in patient access to digital health resources in adult primary care clinics at a safety-net academic center. METHODS Medical students
-
Shared Access to Adults' Patient Portals: A Secret Shopper Exercise. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-22 Deborah Wachenheim,Isabel Hurwitz,Vadim Dukhanin,Jennifer Wolff,Catherine M DesRoches
BACKGROUND Millions of Americans manage their healthcare with the help of a trusted individual. Shared access to a patient's online patient portal is one tool that can assist their care partner(s) in gaining access to the patient's health information and allow for easy information exchange with the patient's care team. Shared access provides care partners with a validated and secure method for accessing
-
Special Issue on Informatics Education: Characteristics of U.S. Baccalaureate Health Informatics Programs. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-17 Katie A McCarthy,Christina Eldredge,Fatima Mercado,Anya Wong,Rohan Gajjar
BACKGROUND Health informatics (HI) is a growing field of study, yet sparse data is available on the characteristics of undergraduate health informatics programs in the United States (U.S.). The lack of a central location for U.S. HI undergraduate program data has led to a gap in information to support current efforts to promote academic standards in the field and attract potential students. OBJECTIVES
-
Effect of an Electronic Health Record-Based Intervention on Documentation Practices. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-17 Shreya Shah,Michael Bedgood,Anna Devon-Sand,Cathriona Dolphin-Dempsey,Venkata Cherukuri,Kirsti Weng,Steven Lin,Christopher Sharp
Please see title page and main document for latest version of abstract.
-
Human-Centered Design and Development of a Fall Prevention Exercise App for Older Adults in Primary Care Settings Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-10 Nichole K. Czuber, Pamela M. Garabedian, Hannah Rice, Christian J. Tejeda, Patricia C. Dykes, Nancy K. Latham
Background Falls in older adults are a serious public health problem that can lead to reduced quality of life or death. Patients often do not receive fall prevention guidance from primary care providers (PCPs), despite evidence that falls can be prevented. Mobile health technologies may help to address this disparity and promote evidence-based fall prevention. Objective Our main objective was to use
-
Machine Alarm Fatigue among Hemodialysis Nurses in 29 Tertiary Hospitals Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-10 Chaonan Sun, Meirong Bao, Congshan Pu, Xin Kang, Yiping Zhang, Xiaomei Kong, Rongzhi Zhang
Objectives To understand the status quo and related influencing factors of machine alarm fatigue of hemodialysis nurses in tertiary hospitals in Liaoning Province. Methods This cross-sectional study employed convenience sampling to select 460 nurses from 29 tertiary hospitals in Liaoning Province, who are involved in hemodialysis care. Surveys were conducted using the General Information Questionnaire
-
Predicting Provider Workload Using Predicted Patient Risk Score and Social Determinants of Health in Primary Care Setting Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-03 Yiqun Jiang, Yu-Li Huang, Alexandra Watral, Renaldo C. Blocker, David R. Rushlow
Background Provider burnout due to workload is a significant concern in primary care settings. Workload for primary care providers encompasses both scheduled visit care and non–visit care interactions. These interactions are highly influenced by patients' health conditions or acuity, which can be measured by the Adjusted Clinical Group (ACG) score. However, new patients typically have minimal health
-
Social Media's Lessons for Clinical Decision Support: Strategies to Improve Engagement and Acceptance. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-07-03 Christopher Sova,Eric Poon,Robert Clayton Musser,Anand Chowdhury
-
Implementation of a Real-Time Documentation Assistance Tool: Automated Diagnosis (AutoDx) Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-26 Matthew T. Cerasale, Ali Mansour, Ethan Molitch-Hou, Sean Bernstein, Tokhanh Nguyen, Cheng-Kai Kao
Background Clinical documentation improvement programs are utilized by most health care systems to enhance provider documentation. Suggestions are sent to providers in a variety of ways, and are commonly referred to as coding queries. Responding to these coding queries can require significant provider time and do not often align with workflows. To enhance provider documentation in a more consistent
-
Comparing Clinician Estimates versus a Statistical Tool for Predicting Risk of Death within 45 Days of Admission for Cancer Patients Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-26 Adrianna Z. Herskovits, Tiffanny Newman, Kevin Nicholas, Cesar F. Colorado-Jimenez, Claire E. Perry, Alisa Valentino, Isaac Wagner, Barbara Egan, Dmitriy Gorenshteyn, Andrew J. Vickers, Melissa S. Pessin
Objectives While clinical practice guidelines recommend that oncologists discuss goals of care with patients who have advanced cancer, it is estimated that less than 20% of individuals admitted to the hospital with high-risk cancers have end-of-life discussions with their providers. While there has been interest in developing models for mortality prediction to trigger such discussions, few studies
-
Avoiding Unintended Consequences of Pediatric Blood Order Set Updates through In Situ Usability Testing. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-25 Sarah A Thompson,Herb Williams,Daniel Rzewnicki,Evan Orenstein,Alexis Carter,Margo Rollins,Beverly Rogers,Swaminathan Kandaswamy
Background Blood product ordering is a complex process, and mistakes can lead to patient harm and poor outcomes. Orders and order sets can be designed to help mitigate errors, but major changes in design can unintentionally cause new errors. Objectives (1) Utilize formative in situ usability testing to iteratively improve the design of a redesigned blood product order set prior to go-live, (2) implement
-
SALUS—A Study on Self-Tonometry for Glaucoma Patients: Design and Implementation of the Electronic Case File Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-19 Sandra Geisler, Kristina Oldiges, Florim Hamiti, Jens J. Storp, M.A. Masud, Julian A. Zimmermann, Stefan Kreutter, Nicole Eter, Thomas Berlage
Background In times of omnipresent digitization and big data, telemedicine and electronic case files (ECFs) are gaining ground for networking between players in the health care sector. In the context of the SALUS study, this approach is applied in practice in the form of electronic platforms to display and process disease-relevant data of glaucoma patients. Objectives The SALUS ECF is designed and
-
A Neurosurgical Readmissions Reduction Program in an Academic Hospital Leveraging Machine Learning, Workflow Analysis, and Simulation Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-19 Tzu-Chun Wu, Abraham Kim, Ching-Tzu Tsai, Andy Gao, Taran Ghuman, Anne Paul, Alexandra Castillo, Joseph Cheng, Owoicho Adogwa, Laura B. Ngwenya, Brandon Foreman, Danny T.Y. Wu
Background Predicting 30-day hospital readmissions is crucial for improving patient outcomes, optimizing resource allocation, and achieving financial savings. Existing studies reporting the development of machine learning (ML) models predictive of neurosurgical readmissions do not report factors related to clinical implementation. Objectives Train individual predictive models with good performance
-
Looking Beyond Mortality Prediction: Primary Care Physician Views of Patients' Palliative Care Needs Predicted by a Machine Learning Tool Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-12 Lisa Rotenstein, Liqin Wang, Sophia N. Zupanc, Akhila Penumarthy, John Laurentiev, Jan Lamey, Subrina Farah, Stuart Lipsitz, Nina Jain, David W. Bates, Li Zhou, Joshua R. Lakin
Objectives To assess primary care physicians' (PCPs) perception of the need for serious illness conversations (SIC) or other palliative care interventions in patients flagged by a machine learning tool for high 1-year mortality risk. Methods We surveyed PCPs from four Brigham and Women's Hospital primary care practice sites. Multiple mortality prediction algorithms were ensembled to assess adult patients
-
The Need for Expanded Educational Opportunities in Clinical Informatics for Pediatric Trainees. Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-07 Adam P Yan,Julia Yarahuan,Jonathan D Hron
-
Preparing Future Pediatric Care Providers with a Clinical Informatics Elective Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-05 Tiranun Rungvivatjarus, Mario Bialostozky, Amy Z. Chong, Jeannie S. Huang, Cynthia L. Kuelbs
Background Clinical informatics (CI) has reshaped how medical information is shared, evaluated, and utilized in health care delivery. The widespread integration of electronic health records (EHRs) mandates proficiency among physicians and practitioners, yet medical trainees face a scarcity of opportunities for CI education. Objectives We developed a CI rotation at a tertiary pediatric care center to
-
Toward Alleviating Clinician Documentation Burden: A Scoping Review of Burden Reduction Efforts Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-06-05 Elizabeth A. Sloss, Shawna Abdul, Mayfair A. Aboagyewah, Alicia Beebe, Kathleen Kendle, Kyle Marshall, S. Trent Rosenbloom, Sarah Rossetti, Aaron Grigg, Kevin D. Smith, Rebecca G. Mishuris
Background Studies have shown that documentation burden experienced by clinicians may lead to less direct patient care, increased errors, and job dissatisfaction. Implementing effective strategies within health care systems to mitigate documentation burden can result in improved clinician satisfaction and more time spent with patients. However, there is a gap in the literature regarding evidence-based
-
Physicians' Perspectives with the E-prescribing System in Five Teaching Hospitals Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-05-29 Jahanpour Alipour, Abolfazl Payandeh, Aida Hashemi, Ali Aliabadi, Afsaneh Karimi
Objectives Despite the evidence suggesting the potential of electronic prescribing (e-prescribing), this system also faces challenges that can lead to inefficiency and even failure. This study aimed to evaluate physicians' perspectives on the efficiency, effectiveness, opportunities, and challenges associated with the e-prescribing system. Methods In 2023, a descriptive analytics cross-sectional study
-
Centralized Multipatient Dashboards' Impact on Intensive Care Unit Clinician Performance and Satisfaction: A Systematic Review Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-05-29 Inna Strechen, Svetlana Herasevich, Amelia Barwise, Juan Garcia-Mendez, Lucrezia Rovati, Brian Pickering, Daniel Diedrich, Vitaly Herasevich
Background Intensive care unit (ICU) clinicians encounter frequent challenges with managing vast amounts of fragmented data while caring for multiple critically ill patients simultaneously. This may lead to increased provider cognitive load that may jeopardize patient safety. Objectives This systematic review assesses the impact of centralized multipatient dashboards on ICU clinician performance, perceptions
-
Suicide Risk Screening for Head and Neck Cancer Patients: An Implementation Study Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-05-22 Bhargav Kansara, Ameer Basta, Marian Mikhael, Randa Perkins, Phillip Reisman, Julie Hallanger-Johnson, Dana E. Rollison, Oliver T. Nguyen, Sean Powell, Scott M. Gilbert, Kea Turner
Objectives There is limited research on suicide risk screening (SRS) among head and neck cancer (HNC) patients, a population at increased risk for suicide. To address this gap, this single-site mixed methods study assessed oncology professionals' perspectives about the feasibility, acceptability, and appropriateness of an electronic SRS program that was implemented as a part of routine care for HNC
-
Standardization of Emergency Department Clinical Note Templates: A Retrospective Analysis across an Integrated Health System Appl. Clin. Inform. (IF 2.1) Pub Date : 2024-05-22 Christopher S. Evans, Barry Bunn, Timothy Reeder, Leigh Patterson, Dustin Gertsch, Richard J. Medford
Background and Objective Clinical documentation is essential for conveying medical decision-making, communication between providers and patients, and capturing quality, billing, and regulatory measures during emergency department (ED) visits. Growing evidence suggests the benefits of note template standardization; however, variations in documentation practices are common. The primary objective of this