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Despite the proven usefulness of appropriate clinical decision support (CDS) alerts, many CDS systems fire excessive, clinically irrelevant alerts that are often ignored by clinicians. We have developed a method to suppress false-positive alerts based on prior drug tolerance but encountered substantial barriers to integrating the method into widely adopted commercial electronic health record (EHR) systems.This study aimed to describe the challenges faced while attempting to integrate our method into [...]

Effective postoperative care is crucial for the success of total joint arthroplasty (TJA) and prevention of unnecessary emergency department (ED) visits. We explore the feasibility and acceptability of utilizing an Interactive Voice Response System (IVRS) to enhance postoperative monitoring in primary TJA patients.This pilot study was conducted with 24 participants undergoing primary TJA randomly assigned to an intervention group receiving IVRS calls (n = 12) or a control group (n = 12) receiving standard [...]

Experiences sharing complex workflow-integrated clinical decision support (CDS) across health systems are sparse and not well reported. This case study presents the sharing of a hybrid electronic health record (EHR)-native and SMART-compatible CDS tool for automating provision of smoking cessation treatment for caregivers during pediatric visits.We conducted a comprehensive needs assessment using sociotechnical frameworks to identify workflow gaps and technical requirements. A multidisciplinary team of clinical informaticians, software developers, and [...]

Global efforts aimed at ending human immunodeficiency virus (HIV) incidence have adapted and evolved since the turn of the century. The utilization of machine learning incorporated into an electronic health record (EHR) can be refined into prediction models that identify when an individual is at greater HIV infection risk. This can create a novel and innovative approach to identifying patients eligible for preventative therapy.This study's aim was to evaluate the [...]

This article describes the challenges faced by the National Library of Medicine with the rise of artificial intelligence (AI) and access to human knowledge through large language models (LLMs).

At a large quaternary health system, tissue specimens were frequently sent to the microbiology laboratory with an incorrect wound culture order meant for swab specimens due to poor electronic health record (EHR) menu design. Wound cultures were also requested in chronic wound cases with a low index of suspicion for acute infection.This study aimed to present a case report on specific changes to the design of the electronic test menu [...]

Digital health equity, the opportunity for all to engage with digital health tools to support good health outcomes, is an emerging priority across the world. The field of digital health equity would benefit from a comprehensive and systematic understanding of digital health, digital equity, and health equity, with a focus on real-world applications. We conducted a scoping review to identify and describe published frameworks and concepts relevant to digital health [...]

Adoption of electronic health record (EHR)-based clinical decision support tools in community-based health centers might increase the provision of indicated cancer screening orders. We examined: (1) if the use of the care gaps smartset (CGS), an EHR tool that expedites ordering care, is associated with colorectal/cervical cancer (CRC/CVC) screening order rates; and (2) how selected implementation strategies, barriers, and facilitators impact CGS use.Within a sequential mixed methods design, we used [...]

The objective of this work is to demonstrate the value of simulation testing for rapidly evaluating artificial intelligence (AI) products.