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Background Clinical Informatics (CI) is a dynamic field at the intersection of healthcare, technology, and information science, aimed at enhancing healthcare delivery and patient outcomes. CI fellowship programs prepare physicians to lead and apply health information technologies that drive improvements in clinical care, system efficiency, and innovation. Achieving Accreditation Council for Graduate Medical Education (ACGME) accreditation for such programs is crucial for standardizing training and ensuring the development of a [...]

Background Emergency Department (ED) handoff to inpatient teams is a potential source of error. Generative Artificial Intelligence (AI) has shown promise in succinctly summarizing large quantities of clinical data and may help improve Emergency Department (ED) handoff. Objectives Our objectives were to: 1) evaluate the accuracy, clinical utility, and safety of AI-generated ED-to-inpatient handoff summaries; 2) identify patient and visit characteristics influencing summary effectiveness; and 3) characterize potential error patterns [...]

This case series aims to evaluate several applications of inline disappearing text (DT) clinical decision support (CDS) tools within clinician documentation.

Clinicians' occupational fatigue can lead to suboptimal decisions that do not align with evidence-based guidelines or patient needs.

Copy-paste (CP) and copy-forward (CF) are common electronic health record (EHR) documentation tools that purportedly improve provider efficiency, but they can also contribute to documentation burden while increasing note bloat and errors. Our understanding of provider perceptions of these tools remains limited.This study aimed to increase understanding of provider perceptions and self-reported usage patterns of CP and CF across different clinical environments and provider roles, including the impact of these [...]

Children with a difficult airway are at high risk of decompensation in the setting of respiratory distress. Situational awareness among all team members, and a shared plan in case of an emergency, can reduce the chance of catastrophic outcomes.This study aimed to improve difficult airway situational awareness while minimizing alert burden in a quaternary care pediatric healthcare system through the application of clinical decision support (CDS).Three iterative designs were developed [...]

The CONCERN Early Warning System (CONCERN EWS) is an artificial intelligence-based clinical decision support system (AI-CDSS) for the prediction of clinical deterioration, leveraging signals from nursing documentation patterns. While a recent multisite randomized controlled trial (RCT) demonstrated its effectiveness in reducing inpatient mortality and length of stay, evaluating implementation outcomes is essential to ensure equitable results across patient populations.This study aims to (1) assess whether clinicians' usage of the CONCERN [...]

Interruptive clinical decision support (CDS) alerts are intended to improve patient care, but can contribute to alert fatigue, diminishing their effectiveness. The alert demonstrated minimal clinical effect while contributing significantly to alert fatigue.This study aims to evaluate if transitioning a high-firing medication on hold alert from interruptive to noninterruptive would change provider practices.The alert was triggered when at least two medications were held for >48 hours. A pre-post intervention cohort study [...]

This study aims to evaluate the impact of using a large language model (LLM) for generating draft responses to patient messages in the electronic health record (EHR) system on clinicians and support staff workload and efficiency.We partnered with Epic Systems to implement OpenAI's ChatGPT 4.0 for responding to patient messages. A pilot study was conducted from August 2023 to July 2024 across 13 ambulatory specialties involving 323 participants, including clinicians [...]

Patient mobility during hospitalization is essential for high-quality healthcare as mobility is linked to physical function and quality of life. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale is a validated method to assess mobility in hospitalized patients. Although the JH-HLM is widely utilized, it has limitations including ceiling effects, unobserved mobility events going unrecorded, and the staff time needed to observe and document.We explored the feasibility of using [...]