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Time spent in the electronic health record (EHR) is an important measure of clinical activity. Vendor-derived EHR use metrics may not correspond to actual EHR experience. Raw EHR audit logs enable customized EHR use metrics, but translating discrete timestamps to time intervals is challenging. There are insufficient data available to quantify inactivity between audit log timestamps.

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

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 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 [...]

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 [...]

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.

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 [...]

Hospitals are looking to AI and other innovative applications to help alleviate provider burden and dissatisfaction associated with clinical documentation in oncology. Ambient artificial intelligence (AI) scribes are a promising technology to address these issues. However, they generally have not been optimized for oncology. This study aimed to evaluate an ambient AI scribe application with oncology providers to determine opportunities and potential challenges.This prospective pilot study of a scribe application [...]