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The Enhanced EHR-facilitated Cancer Symptom Control (E2C2) Trial is a pragmatic trial testing a collaborative care approach for managing common cancer symptoms. There were challenges in identifying cancer site and metastatic status.This study compares three different approaches to determine cancer site and six strategies for identifying the presence of metastasis using EHR and cancer registry data.The E2C2 cohort included 50,559 patients seen in the medical oncology clinics of a large [...]

Human immunodeficiency virus (HIV) remains a significant global health challenge, especially in Europe, including Italy, where it affects thousands. Antiretroviral therapy (ART) has turned HIV into a manageable chronic condition, improving the quality of life and life expectancy for people living with HIV (PLWH). Enhancing health-related quality of life (HRQoL) is essential, as it positively influences therapy adherence.The objective of the study was to evaluate the impact of the AURORA [...]

Adoption of electronic health record (EHR)-based clinical decision support tools in community-based health centers might increase the provision of indicated cancer screening orders. We examined: (1) if the use of the care gaps smartset (CGS), an EHR tool that expedites ordering care, is associated with colorectal/cervical cancer (CRC/CVC) screening order rates; and (2) how selected implementation strategies, barriers, and facilitators impact CGS use.Within a sequential mixed methods design, we used [...]

Interruptive alerts in clinical decision support (CDS) systems are intended to guide clinicians in making informed decisions and adhering to best practices. However, these alerts can often become a source of frustration, contributing to alert fatigue and clinician burnout. Traditionally, an alert's burden is often assessed by evaluating the total number of times it is seen by end-users, which can overlook the true impact of highly interruptive workflows. This study [...]

Patient portals bridge patient and provider communications but exacerbate physician and nursing burnout. Large language models (LLMs) can generate message responses that are viewed favorably by health care professionals/providers (HCPs); however, these studies have not included diverse message types or new prompt-engineering strategies.Our goal is to investigate and compare the quality and precision of GPT-generated message responses versus real doctor responses across the spectrum of message types within a patient [...]

Registered nurses increasingly work in remote care and digital interaction roles, offering flexibility and expansion of their scope of practice. These roles may expose nurses to digital compassion fatigue, a phenomenon proposed to be characterized by the negative psychological and emotional impact of caring for patients remotely through the use of technology.The first objective of this work is to propose the phenomenon of "digital compassion fatigue" as a potentially further [...]

While computerized provider order entry (CPOE) has become standard for medication, laboratory, referral, and imaging ordering, use in surgical case requests has not been well-described. At a large county hospital, many surgical clinics used a variety of workflows for case requests, leading to data duplication and data storage outside of the electronic health record (EHR).We hypothesized that a provider-entered order-based case request (OBCR) tool would improve data entry efficiency and [...]

Although many aspects of nursing documentation are considered an essential part of clinical communication and care coordination, other types of nursing documentation have been implemented to meet compliance and secondary uses. Adding required documentation without carefully assessing its association with patient outcomes adds excessive documentation burden on nurses. There is a gap in the evidence of the association between additional required nursing documentation and improvements in patient outcomes.This study aimed [...]

Electronic health record (EHR) systems are essential for modern healthcare but contribute to a significant documentation burden, affecting physician workflow and well-being. While previous studies have identified differences in EHR usage across demographics, systematic methods for identifying high-burden physician groups remain limited. This study applies cluster analysis to uncover distinct EHR usage profiles and provide a framework to inform the development of targeted interventions.This study investigated two research questions: (1) [...]