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Background and Objectives Disparities exist in patient portal use among non-English-speaking caregivers of pediatric patients. This study aims to evaluate the reasons behind Spanish-speaking caregivers' use of patient portals and identify facilitators and barriers, focusing on those caring for children with chronic conditions. Methods We conducted semi-structured interviews and surveys with Spanish-speaking caregivers of pediatric patients with chronic conditions at an academic pediatric health network in California. Data were transcribed [...]

In the EMergency department-initiated BuprenorphinE for opioid use Disorder (EMBED) trial, a clinical decision support (CDS) tool had no effect on rates of buprenorphine initiation in emergency department (ED) patients with opioid use disorder. The Agency for Healthcare Research and Quality (AHRQ) recently released a CDS Performance Measure Inventory to guide data-driven CDS development and evaluation. Through partner co-design, we tailored AHRQ inventory measures to evaluate EMBED CDS performance and [...]

Background Emergency Department (ED) handoff to inpatient teams is a potential source of error. Generative Artificial Intelligence (AI) has shown promise in succinctly summarizing large quantities of clinical data and may help improve Emergency Department (ED) handoff. Objectives Our objectives were to: 1) evaluate the accuracy, clinical utility, and safety of AI-generated ED-to-inpatient handoff summaries; 2) identify patient and visit characteristics influencing summary effectiveness; and 3) characterize potential error patterns [...]

Background Clinical Informatics (CI) is a dynamic field at the intersection of healthcare, technology, and information science, aimed at enhancing healthcare delivery and patient outcomes. CI fellowship programs prepare physicians to lead and apply health information technologies that drive improvements in clinical care, system efficiency, and innovation. Achieving Accreditation Council for Graduate Medical Education (ACGME) accreditation for such programs is crucial for standardizing training and ensuring the development of a [...]

This case series aims to evaluate several applications of inline disappearing text (DT) clinical decision support (CDS) tools within clinician documentation.

Clinicians' occupational fatigue can lead to suboptimal decisions that do not align with evidence-based guidelines or patient needs.

Major depression in adolescents is recognized as a serious psychiatric illness and a risk factor for suicide. It is important for providers to screen for depression and suicidality and have clinical decision support (CDS) for evaluation, risk assessment, and initial management. Our efforts focused on leveraging the electronic health record (EHR) to ensure that high-risk adolescents received appropriate interventions before leaving the office.This study aims to improve notification of positive [...]

Interruptive clinical decision support (CDS) alerts are intended to improve patient care, but can contribute to alert fatigue, diminishing their effectiveness. The alert demonstrated minimal clinical effect while contributing significantly to alert fatigue.This study aims to evaluate if transitioning a high-firing medication on hold alert from interruptive to noninterruptive would change provider practices.The alert was triggered when at least two medications were held for >48 hours. A pre-post intervention cohort study [...]

The purpose of this systematic literature review is to critically evaluate the use of mathematical and simulation models within emergency departments (EDs) and assess their potential to improve the quality of care. This review emphasizes the critical need for quality enhancement in health care systems, with a specific focus on EDs.This review incorporates studies that have investigated the quality of care provided in ED settings, employing assorted mathematical and simulation [...]

Nursing documentation burden is a growing point of concern in the United States health care system. Documentation in the electronic health record (EHR) is a contributor to perceptions of burden. Efficiency tools like flowsheet macros are one development intended to ease the burden of documentation.This study aimed to evaluate whether flowsheet macros, a documentation efficiency tool in the EHR that consolidates documentation into a single click, reduces the time spent [...]