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Push notifications are a common method of clinical communication in inpatient settings, yet their volume and delivery patterns have not been described. Alert fatigue has been well-described in health care, and push notifications may be a new contributor.This study aimed to characterize the volume, type, and temporal distribution of push notifications received by hospitalists across distinct clinical roles in a large academic health system.We conducted a cross-sectional analysis of electronic [...]

Getting patients out of intensive care units (ICUs) is a major goal for acute care clinicians, as prolonged stays increase the risk of complications and strain critical resources such as staff, equipment, and beds. The ICU Liberation Bundle, or the ABCDEF (A-F) care bundle, is an evidence-based framework for improving outcomes in critically ill patients by addressing pain, sedation, delirium, mobility, and family engagement. However, variability in documentation and a [...]

Drive to Zero is a mobile health application (app) designed to identify and retain people with HIV (PWH) who have experienced challenges with achieving or maintaining viral suppression. The app targets PWH who have lacked documented HIV care in the past months and are experiencing medication adherence barriers. Features include an interactive chat for communicating with the study team and access to educational resources to support care engagement and health [...]

Abandoned medication orders-those initiated but not signed-represent a potential safety risk and an indicator of electronic health record (EHR) inefficiency. This study explores inpatient medication abandonment across two large tertiary healthcare systems using different EHRs.Silent alerts were deployed to identify abandoned orders at Site 1 (June 2018-May 2019) and Site 2 (July 2020-May 2023). At Site 1, alerts triggered on all inpatient medication orders. At Site 2, alerts were part [...]

Identifying patient portals (PP) activation disparities, especially in electronic health record (EHR) activation workflows, can help facilitate equitable health care access.Our study aimed to assess whether the parent/guardian's preferred language was associated with being offered, activating, and using the PP and the methods used to offer activation codes.This retrospective cohort study examined PP offer, activation, and usage rates at a large freestanding children's hospital. Patients <12 years old with ambulatory visits from July 1, 2022, to June 30, 2023, without prior active proxy PP accounts were included. The primary independent variable was the self-reported parent/guardian preferred language (English/Spanish). Outcomes included the probability of being offered, overall and by specific offer methods, activation, and usage. Zou's modified multivariate Poisson regression models examined the association between preferred language and offer/activate/use status.Among 39,578 patients, 85.1% were patients with English as preferred language (PEPL) and 14.9% had Spanish as preferred language (PSPL). PSPL had a lower probability of being offered (adjusted relative risk ratio [aRR]: 0.65, 95% confidence interval [CI]: 0.63-0.67), activated (aRR: 0.72, 95% CI: 0.70-0.75), and used (aRR: 0.68, 95% CI: 0.65-0.72) a PP compared to PEPL. Specifically, PSPL had a lower probability of activating if ever offered via instant activation (aRR: 0.72, 95% CI: 0.69-0.75), parent/guardian with existing account (aRR: 0.73, 95% CI: 0.69-0.76), and had equal probability of activating if ever offered via letter (aRR: 0.42, 95% CI: 0.19-0.94) and clinician-assisted method (aRR: 0.99, 95% CI: 0.86-1.16), compared to PEPL.PSPL at a large, free-standing pediatric health system had a lower probability of PP offer, activation, and usage than PEPL. Activation methods were not universally effective across language groups, emphasizing the need for equitable workflow optimization. This study highlights an approach to analyzing health disparities in activation workflows to inform targeted interventions to improve equitable PP access.

The digital transformation of healthcare is reshaping care delivery among healthcare professionals, requiring nurses to develop digital competencies. These competencies are essential but often underdeveloped due to limited training and resources. Global initiatives emphasize integrating these competencies into nursing education, necessitating valid instruments to assess them.This systematic review aims to identify instruments measuring digital competence in nursing and to assess their measurement properties.This review was registered in PROSPERO (identifier: CRD42024522349) [...]

Interruptive clinical decision support (CDS) alerts are intended to standardize patient care and prevent harm. However, failures can occur even in organizations with mature CDS governance and advanced analytics. These breakdowns, marked by excessive firings, workflow disruption, and clinician dissatisfaction, can provide insights into systemic weaknesses in CDS design, testing, and monitoring processes.This study aimed to examine a CDS alert malfunction as a lens for identifying system-level gaps and propose [...]

This study addresses the significant challenges posed by emerging SARS-CoV-2 variants, particularly in developing diagnostics and therapeutics. Drug repurposing is investigated by identifying critical regulatory proteins impacted by the virus, providing rapid and effective therapeutic solutions for better disease management.

Report the development of the patient-centered myAURA application and suite of methods designed to aid epilepsy patients, caregivers, and clinicians in making decisions about self-management and care.