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We present a model of applied clinical informatics in the context of medical informatics in general, across the domain of health sciences and the continuum of information technology development and its adoption into workflow. The distinct challenges of applied clinical informatics present an opportunity to improve efforts through collaboration of the growing number of physicians, health institutional leaders and other health workers in successfully implementing working systems. This journal will [...]

Electronic Health Records (EHRs) have been quickly implemented for meaningful use incentives; however these implementations have been associated with provider dissatisfaction and burnout. There are no previously reported instances of a comprehensive EHR educational program designed to engage providers and assist in improving efficiency and understanding of the EHR. Utilizing adult learning theory as a framework, Stanford Children's Health designed a tailored provider efficiency program with various inputs from: (1) [...]

Twenty-four hour ambulatory electrocardiograms ("Holter" monitors) are a key diagnostic test in cardiology. Commercial electronic medical record (EMR) tools have not been designed for pediatric Holter monitor reporting and paper-based methods are inefficient.

Recently there have been several high-profile ransomware attacks involving hospitals around the world. Ransomware is intended to damage or disable a user's computer unless the user makes a payment. Once the attack has been launched, users have three options: 1) try to restore their data from backup; 2) pay the ransom; or 3) lose their data. In this manuscript, we discuss a socio-technical approach to address ransomware and outline four [...]

Big data or population-based information has the potential to reduce uncertainty in medicine by informing clinicians about individual patient care. The objectives of this study were: 1) to explore the feasibility of extracting and displaying population-based information from an actual clinical population's database records, 2) to explore specific design features for improving population display, 3) to explore perceptions of population information displays, and 4) to explore the impact of population [...]

The role of extracorporeal membrane oxygenation (ECMO) in refractory cardiorespiratory failure is gaining momentum with recent advancements in technology. However, the need for dialysis modes such as continuous renal replacement therapy (CRRT) has also increased in the management for acute kidney injury. Establishing the exact timing of CRRT initiation in these patients from the electronic medical record is vital for automated data extraction for research and quality improvement efforts.

After implementation of a system-wide EMR within our university system, e-prescribing is now commonplace.

Prevention and management of chronic conditions is a priority for many healthcare systems. Personal health records have been suggested to facilitate implementation of chronic care programs. However, patients' attitude towards personal health records (PHRs) can significantly affect the adoption rates and use of PHRs.

Increasing use of EHRs has generated interest in the potential of computerized clinical decision support to improve treatment of sepsis. Electronic sepsis alerts have had mixed results due to poor test characteristics, the inability to detect sepsis in a timely fashion and the use of outside software limiting widespread adoption. We describe the development, evaluation and validation of an accurate and timely severe sepsis alert with the potential to impact [...]