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Nurses are the largest group of electronic health record (EHR) users in Canada, yet their experiences with documentation burden remain underexplored. While EHR-generated usage data, such as audit logs and time-motion metrics, have been used to quantify documentation time, they are rarely used to better understand EHR inefficiencies and identify potential changes for nursing documentation and workflows. This approach may help address instances of documentation demands detracting from direct patient [...]

Achieving digital health equity and proper use of identity credentials is crucial as reliance on electronic modalities increases. Proxy access-now increasingly referred to as shared access-is a widely available functionality that offers identity credentials to care partners who assist loved ones in navigating the electronic care delivery demands of patients with complex care needs. However, adoption of these tools has been hindered by complicated user interfaces and low awareness.Drawing on [...]

This study aimed to evaluate the effect of optimizing the ambulatory medication preference list on provider efficiency in medication ordering.Using electronic health record (EHR) vendor data, a multidisciplinary informatics team optimized the general ambulatory medication preference list to better align with providers' ordering patterns. We conducted a pre-postintervention analysis assessing time-in-orders per encounter and number of manual changes per order.Postintervention, average manual changes per order decreased from 4.12 to 3.00 [...]

For every 30 minutes a provider spends seeing a patient, they spend 36 minutes charting in the electronic health record (EHR). Clinical documentation burden in U.S. health care is driven by increasing administrative tasks associated with EHRs, regulatory demands, and workflow inefficiencies. This burden contributes to increased cognitive load, fragmented care, and staff burnout. No comprehensive conceptual framework guides researchers addressing these challenges.This study aimed to develop a conceptual framework clarifying the [...]

Completion of Family and Medical Leave Act (FMLA) paperwork is a necessary but time-intensive task that contributes to clinician administrative burden.This study aimed to implement and evaluate an electronic health record (EHR)-integrated FMLA tool designed to reduce documentation time and improve workflow efficiency.An EHR-embedded FMLA form was deployed at a large academic medical center, piloted in July 2024 in primary care, and expanded to all ambulatory practices in September 2024 [...]

Problem lists are intended to support high-quality care, but are often long and outdated. Despite policy efforts to encourage their upkeep-such as the "Problem List Reviewed" attestation checkbox in electronic health records (EHRs)-many diagnoses remain on lists far longer than clinically appropriate. Clinicians often check the attestation box that problem lists have been reviewed to comply with performance measures without reviewing and modifying the list.This study aimed to assess whether [...]

Malnutrition remains a critical global health challenge among hospitalized patients, necessitating effective nutrition support systems.This study aims to construct and evaluate a cross-professional, cross-sectoral nutrition health care information system (CPCS-NHIS) to optimize clinical nutrition management.The system integrates modified medical systems to unify information flows, knowledge, and clinical roles. In addition, a 20-item across six dimensions electronic questionnaire based on the revised DeLone and McLean IS Success model was developed to [...]

Enhancing the efficiency of family-centered rounds (FCRs) while ensuring timely patient care has been a focus of study over the past decade. We employed an Operations Research technique (i.e., simulation) to identify opportunities for improving rounding efficiency on our inpatient cardiology unit at Nationwide Children's Hospital (NCH).Through simulation of schedule-based rounds, our aims were to reduce the length of stay (LOS) and subsequent healthcare costs via (1) prioritizing rounds for [...]

Patient decompensation necessitating rapid response team (RRT) care in the hospital setting involves complex medical decision making, strong leadership skills, and precise communication where every second matters. However, RRT outcomes can vary based on leader training, knowledge, and experience. We designed five digital, condition-specific, guided algorithms to improve RRT care and compared user survey data among three physician cohorts across the clinical training spectrum to assess the practicality of real-world [...]

Clinical decision support systems (CDSS) have been suggested to be helpful in detecting and preventing drug-related problems such as adverse drug events (ADEs). However, patient participation systems monitoring self-reported data, such as symptoms, are still sparsely described in the literature.This study aimed to investigate if the use of a patient participating CDSS (PCDSS) can facilitate early detection of ADEs, thereby contributing to safer drug treatment in older adults.A 1-year prospective [...]