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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 [...]

This study compared the time efficiency of the hospital admission process using personal mobile devices to traditional walk-in methods, thereby assessing the effectiveness of the mobile admission process.This retrospective study was conducted at Chung-Ang University Gwangmyeong Hospital in South Korea (August 2022-January 2023). Turnaround times for the walk-in and mobile admission processes were compared. Patients were divided into mobile and walk-in groups based on their admission process. Collected timestamp data [...]

This study aims to evaluate the impact of using a large language model (LLM) for generating draft responses to patient messages in the electronic health record (EHR) system on clinicians and support staff workload and efficiency.We partnered with Epic Systems to implement OpenAI's ChatGPT 4.0 for responding to patient messages. A pilot study was conducted from August 2023 to July 2024 across 13 ambulatory specialties involving 323 participants, including clinicians [...]

This study sought to characterize how a population experienced health-related social needs (HRSNs) over time.We employed hidden Markov modeling using data extracted from a natural language processing state machine from 2018 to 2020 to examine whether a patient experienced any food, legal, transportation, employment, financial, or housing needs. Characteristics of patients transitioning into low/high-risk states were compared. We also identified the frequency at which patients transitioned according to their risk [...]

The Health Level 7 (HL7) Electronic Health Record Workgroup identified home medication list reconciliation as a prime opportunity to improve patient safety and reduce clinician burden. We developed a platform-neutral, Fast Healthcare Interoperability Resources (FHIR)-enabled reference model and demonstration wireframe to articulate the concepts of an interoperable, patient-centric home medication list management ecosystem.Four principal artifacts describe the reference model: (1) a conceptual (high-level) model, (2) a data architecture (detailed) model [...]

Globally, health information system (HIS) development projects face challenges regarding technology infrastructure, financing, user resistance, and interoperability. While these challenges are well-described in literature, most studies on HIS digitalization focus on the development of national and hospital HISs, with little focus on HISs in primary care. We described the HISs of two primary care clinics in Manila, Philippines in terms of data management procedures, governance, training and equipment, information culture [...]

This study aimed to describe human-centered design of clinical decision support (CDS) for children with metabolic diseases at high risk of rapid decompensation, assess the influence of CDS on care processes and patient outcomes, and share insights from the implementation.A CDS was designed in collaboration with pediatric genetics experts to provide accelerated triage and recommend dextrose-containing fluids for patients metabolic conditions. Formative usability testing was conducted with emergency department (ED) [...]

Hypertension is a chronic condition defined by persistent high blood pressure (BP) that contribute to significant morbidity and mortality. Evidence-based clinical guidelines provide recommendations for the diagnosis and management of hypertension. These recommendations are frequently incorporated into clinical decision support (CDS) tools used by clinicians. CDS tools can also be oriented toward patients but careful attention to the development process is required to make a useful, usable, and engaging digital [...]

Clinical decision support (CDS) tools in electronic health records (EHRs) often face low uptake due to limited usability, workflow integration, and other implementation issues. We recently designed and implemented the STRATIFY-CDS tool, which calculates a validated risk-prediction model and recommends disposition for emergency department (ED) patients with acute heart failure. Despite applying human-centered design and implementation science strategies, initial utilization in the first 3 months of the STRATIFY-CDS tool was [...]