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There is limited literature on prefilled order sentences, a form of prescription prefilled with dosage, route, and frequency information, and none on their effect in a targeted setting for community-acquired pneumonia, for which reported compliance is poor.Prefilled orders incorporated within computerized provider order entry systems (CPOE) may facilitate compliance guidelines by acting as a form of clinical decision support (CDS), providing a default choice for prescribers. We aim to assess [...]

Maternal harm, especially for Black women, is a significant health care issue. Unstructured clinical notes in electronic health records (EHRs) may reveal unsafe maternal care. Prior studies using natural language processing (NLP) have shown that tone and sentiment in notes contribute to preventable safety events.This study aimed to examine whether negative patient descriptors in EHR clinical notes are associated with adverse maternal outcomes and how their use varies by patient [...]

Direct Secure Messaging (DSM) is a communication standard for exchanging information between health care entities and practitioners. It relies on access to an address directory. When directory entry is incomplete, health information exchange breaks down. There is an urgent need for standardized DSM address directory management and synchronization workflows that support universal access in a timely manner.Our objective was to develop best practices for maintenance of DSM address directories and [...]

Long COVID, characterized by persistent or recurring symptoms post-COVID-19 infection, poses challenges for pediatric care and research due to the lack of a standardized clinical definition. Adult-focused phenotypes do not translate well to children, given developmental and physiological differences, and pediatric-specific phenotypes have not been compared with chart review.This study introduces and evaluates a pediatric-specific rule-based computable phenotype (CP) to identify long COVID using electronic health record data. We compare [...]

To develop ECG-FM, an open-weight foundation model for electrocardiogram (ECG) analysis, rigorously evaluate its performance on clinically salient tasks, and openly release it alongside a public benchmark.

Joint recognition and ICD-10 linking of diagnoses in bilingual, non-standard Spanish and Catalan primary care notes is challenging. We evaluate parameter-efficient fine-tuning (PEFT) techniques as a resource-conscious alternative to full fine-tuning (FFT) for multi-label clinical text classification.

Clinical decision support (CDS) tools are critical for improving care delivery and guideline adherence but are associated with clinician burnout when inadequately designed and implemented. User-centered design (UCD) and implementation science (IS) methods are evidence-based approaches to optimizing CDS tools, but are infrequently used in part due to limited guidance on how to apply them within resource-constrained health systems.This paper focuses on pragmatic application of an integrated UCD-IS approach, demonstrating [...]

Accelerate adoption of clinical research technology that obtains electronic health record (EHR) data through HL7 Fast Healthcare Interoperability Resources (FHIR).

Acute chest pain is a common presentation in the emergency department, characterized by sudden onset with high morbidity and mortality. Traditional diagnostic methods, such as computed tomography (CT) and CT angiography (CTA), are often time-consuming and fail to meet the urgent need for rapid triage in emergency settings.

Covariate-adaptive randomization algorithms (CARAs) can reduce covariate imbalance in randomized controlled trials (RCTs), but a lack of integration into Research Electronic Data Capture (REDCap) has limited their use. We developed a software pipeline to seamlessly integrate CARAs into REDCap as part of the all2GETHER study, a 2-armed RCT concerning HIV prevention.