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This Viewpoint paper has grown out of a presentation at the American College of Medical Informatics 2007 Winter Symposium, the resulting discussion, and several activities that have coalesced around an issue that most informaticians accept as true but is not commonly considered during the implementation of Electronic Health Records (EHR) outside of academia or research institutions. Successful EHR implementation is facilitated and sometimes determined by formative evaluation, usually focusing on [...]

Diverse stakeholders--clinicians, researchers, business leaders, policy makers, and the public--have good reason to believe that the effective use of electronic health care records (EHRs) is essential to meaningful advances in health care quality and patient safety. However, several reports have documented the potential of EHRs to contribute to health care system flaws and patient harm. As organizations (including small hospitals and physician practices) with limited resources for care-process transformation, human-factors [...]

Partners Healthcare, and its affiliated hospitals, have a long track record of accomplishments in clinical information systems implementations and research. Seven ideas have shaped the information systems strategies and tactics at Partners; centrality of processes, organizational partnerships, progressive incrementalism, agility, architecture, embedded research, and engage the field. This article reviews the ideas and discusses the rationale and steps taken to put the ideas into practice.

To determine the effectiveness of providing synthesized research evidence to inform patient care practices via an evidence based informatics program, the Clinical Informatics Consult Service (CICS).

The Tailored Interventions for management of DEpressive Symptoms (TIDES) program was designed based on social cognitive theory to provide tailored, computer-based education on key elements and self-care strategies for depressive symptoms in persons living with HIV/AIDS (PLWHAs).

To investigate the agreement among clinical experts in their judgments of monitoring data with respect to artifacts, and to examine the effect of reference standards that consist of individual and joint expert judgments on the performance of artifact filters.

The Biomedical Research Integrated Domain Group (BRIDG) project is a collaborative initiative between the National Cancer Institute (NCI), the Clinical Data Interchange Standards Consortium (CDISC), the Regulated Clinical Research Information Management Technical Committee (RCRIM TC) of Health Level 7 (HL7), and the Food and Drug Administration (FDA) to develop a model of the shared understanding of the semantics of clinical research.

There has been major progress both in description logics and ontology design since SNOMED was originally developed. The emergence of the standard Web Ontology language in its latest revision, OWL 1.1 is leading to a rapid proliferation of tools. Combined with the increase in computing power in the past two decades, these developments mean that many of the restrictions that limited SNOMED's original formulation no longer need apply. We argue [...]

Statistical aberrancy-detection algorithms play a central role in automated public health systems, analyzing large volumes of clinical and administrative data in real-time with the goal of detecting disease outbreaks rapidly and accurately. Not all algorithms perform equally well in terms of sensitivity, specificity, and timeliness in detecting disease outbreaks and the evidence describing the relative performance of different methods is fragmented and mainly qualitative.