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Patient navigation is designed to identify and address patients' needs throughout their cancer treatment. In the context of a clinical trial designed to deliver a standardized patient navigation protocol, a registry was needed to allow users from across multiple health systems to input patient data, track navigation outreach, and coordinate cancer care in real time. To design a registry to allow patient navigators (PNs) at 6 medical centers across 4 [...]

Federated network studies allow data to remain locally while the research is conducted through the sharing of analytical code and aggregated results across different health care settings and countries. A large number of databases have been mapped to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM), boosting the use of analytical pipelines for standardized observational research within this open science framework. Transparency, reproducibility, and robustness of results have [...]

Patient portals are increasingly used to support digital health engagement, but little is known about how caregivers used patient portals before, during, and after the coronavirus disease 2019 (COVID-19) pandemic.This study aimed to examine longitudinal changes in caregiver engagement with pediatric patient portals, focusing on logins, session duration, messaging behaviors, and provider response times across prepandemic, pandemic, and postpandemic periods.We conducted a retrospective cohort study using deidentified MyChart data from [...]

Overuse and misuse of antibiotics is an urgent health care problem and one of the key factors in antibiotic resistance. Validated clinical prediction rules have shown effectiveness in guiding providers to an appropriate diagnosis and identifying when antibiotics are the recommended choice for treatment.We aimed to study the relative ability of registered nurses using clinical prediction rules to guide the management of acute respiratory infections in a simulated environment compared [...]

Sepsis is a heterogeneous syndrome with high morbidity and mortality. Despite extensive clinical trials, therapeutic progress remains limited, in part due to the absence of actionable sepsis subtypes.This study aimed to evaluate the feasibility of using HL7 Fast Healthcare Interoperability Resources (FHIR) for prerandomization sepsis subtyping to support clinical trial enrichment across multiple health systems.Data from 765 encounters at two academic medical centers were analyzed. FHIR-based resources were extracted from [...]

Health information exchanges (HIE), tools that electronically share clinical data across healthcare organizations, provide the opportunity to improve patient care. While widely available, HIE is utilized in only 2%-10% of patient encounters. Few studies have explored current barriers to use. The goal of this study was to evaluate current clinician perspectives on HIE and barriers to use at the point of care.

Clinical decision support (CDS) systems have been widely adopted across clinical settings to promote evidence-based practice for clinicians. CDS malfunctions often affect the user experience and indirectly or directly interfere with patient care. To enhance optimal performance, it is critical to constantly monitor the performance of the tool and react promptly when malfunctions are identified.This study aimed to describe malfunctions identified in the development and implementation of a CDS alert [...]

Maternal harm, especially for Black women, is a significant health care issue. Unstructured clinical notes in electronic health records (EHRs) may reveal unsafe maternal care. Prior studies using natural language processing (NLP) have shown that tone and sentiment in notes contribute to preventable safety events.This study aimed to examine whether negative patient descriptors in EHR clinical notes are associated with adverse maternal outcomes and how their use varies by patient [...]

Our objective was to identify barriers to implementing a custom clinical decision support (CDS) alert to randomize individuals in a pragmatic study, specifically those with a positive antinuclear antibody (ANA) test.We integrated a validated logistic regression model into the electronic health record to predict the risk of developing autoimmune disease for individuals with a positive ANA (titer ≥ 1:80). A custom CDS alert was created to randomize eligible individuals into [...]