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Despite the benefits of clinical decision support (CDS), concerns of potential risks arise amidst increasing reports of CDS malfunctions. Without objective and standardized methods to evaluate CDS in the post-live stage, CDS performance in a dynamic healthcare environment remains a black box from the user's perspective. In this study, we proposed a comprehensive framework to identify and evaluate post-live CDS malfunctions from the perspective of healthcare settings.We developed a two-phase [...]

Telemedicine use has surged since the COVID-19 pandemic, offering a convenient way for patients to access health care. Whereas digital literacy (general comfort with and ability to use digital tools) is necessary to utilize telemedicine, digital health literacy is a subset of this, focusing on the ability to use digital tools to seek out, understand, and utilize health information. Barriers such as the lack of high-speed internet and limited digital [...]

Appropriate Use Criteria Clinical Decision Support (AUC CDS) was legislatively mandated in the United States in 2014, and multiple CDS vendors were designated as qualified Clinical Decision Support Mechanisms by the Centers for Medicare and Medicaid Services. Little is known about the costs and benefits of these systems in real-world settings.We evaluated the effectiveness of an AUC CDS system and the time costs it imposes on clinicians at an academic [...]

Despite its morbidity, mortality, and financial burden, in-hospital malnutrition remains underdiagnosed and undertreated. Artificial intelligence (AI) offers a promising clinical informatics solution for identifying malnutrition risk and one that can be coupled with clinician-delivered patient care.The objectives of the study were to evaluate an AI-based hospital malnutrition screening model in a large and diverse inpatient population and to compare it to the currently used clinician-delivered malnutrition screening tool.We studied the [...]

This study aimed to evaluate and compare the diagnostic responses generated by two artificial intelligence (AI) models developed 54 years apart, and encourage physicians to explore the use of large language models (LLMs) like GPT-4o in clinical practice.A clinical case of metabolic acidosis was presented to GPT-4o, and the model's diagnostic reasoning, data interpretation, and management recommendations were recorded. These outputs were then compared with the responses from Schwartz's 1970 [...]

Health equity is greatly impacted by the systems and processes with which health systems deliver care. Given the minimal guidance on measurement and reporting of health inequities specific to key population health outcomes, a solution for measurement of health equity is proposed.The concept of a lens of equity was adopted to disaggregate common measures such as breast cancer screening rates to expose inequities across neighborhoods and races in populations served [...]

Quantify the effect of ambient artificial intelligence (AI) scribe technology on work experience, clinical operations, and patient experience in pediatric primary care.We conducted a 12-week study of 39 clinicians within a large pediatric primary care network. Clinician experience was measured using a custom survey instrument which included a combination of discrete and free-text responses. Qualitative analysis of free-text responses provided additional context and identified key facilitators and barriers to optimal [...]

Health professionals (HPs) trainee burnout is hard to capture. A lack of rigorous review and systematic methodological consideration hinders the development of qualitative methodological tools that can elicit rich and trustworthy qualitative data on HPs trainee burnout.This study aimed to report the process, results, and lessons learned while developing and pilot testing a qualitative tool to assess HPs' trainee experiences of burnout to complement quantitative tools.We developed a set of [...]

In recent years, there has been an expansion in the literature on the effects of computerized alerts on prescribing and patient outcomes. The aim of our study was to examine the impact of these systems on clinician prescribing and patient outcomes.We searched three databases (Medline, Embase, and PsychINFO) for studies that had been conducted since 2009 and included studies that examined the effects of alerts at the point of prescribing [...]

Clinical decision support systems (CDSS) are central to modern health care, but their effectiveness is compromised during system downtimes, which affect 96% of health care organizations. During these failures, clinicians lose access to critical decision-making tools like order sets, increasing the risk of medical errors. Traditional downtime solutions, such as paper-based protocols, are often impractical and difficult to maintain.This study introduces and evaluates Offsite Repository for Clinical Assets (ORCA), a [...]