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The widespread adoption of health information technology (HIT) has deepened hospitals' reliance on electronic health records (EHR). However, EHR downtime events, which refer to partial or complete system failures, can disrupt hospital operations and threaten patient safety. Systematic research on HIT downtime events in China remains limited.This study aims to identify and classify reported EHR downtime events in a Chinese hospital, assess their frequency and severity, and propose improvement recommendations [...]

The adoption of electronic health records (EHRs) into clinical practice has changed clinical workflows and, in some cases, increased documentation burden and clinician burnout. Identifying factors associated with perceived EHR usability after the implementation of a new EHR may guide efforts to reduce burden and burnout.This study measured: (1) group-level perceptions of EHR usability pre- and postimplementation of a new EHR; (2) adaptation to the new EHR; and (3) the [...]

To assess whether HL7 Fast Healthcare Interoperability Resources (FHIR) can underpin a fully standards-based, end-to-end digital research architecture, demonstrate it in a live study, and quantify its benefits for interoperability and development efficiency.

Gaps in transportation, particularly public transit, are a significant barrier to accessible, high-quality healthcare. Health systems, payors, and regulatory bodies recognize the need to identify and address these gaps. However, clinical research examining public transportation accessibility and its impacts on healthcare utilization, outcomes, and costs remains limited. Existing tools used for studying public transit are generally non-HIPAA compliant, expensive, proprietary, and/or difficult to use. A tool addressing these concerns is [...]

While timely interventions can improve medication adherence, it is challenging to identify which patients are at risk of nonadherence at point-of-care. We aim to develop and validate flexible machine learning (ML) models to predict a continuous measure of adherence to guideline-directed medication therapies (GDMTs) for heart failure (HF).

To evaluate the efficacy of digital twins developed using a large language model (LLaMA-3), fine-tuned with Low-Rank Adapters (LoRA) on intensive care units (ICU) physician notes, and to determine whether specialty-specific training enhances treatment recommendation accuracy compared to other ICU specialties or zero-shot baselines.

Demonstrate the ability to encapsulate clinical-grade genomics data normalization algorithms within a FHIR Genomics reference implementation.

Overuse and misuse of antibiotics is an urgent health care problem and one of the key factors in antibiotic resistance. Validated clinical prediction rules have shown effectiveness in guiding providers to an appropriate diagnosis and identifying when antibiotics are the recommended choice for treatment.We aimed to study the relative ability of registered nurses using clinical prediction rules to guide the management of acute respiratory infections in a simulated environment compared [...]

Time spent in the electronic health record (EHR) is an important measure of clinical activity. Vendor-derived EHR use metrics may not correspond to actual EHR experience. Raw EHR audit logs enable customized EHR use metrics, but translating discrete timestamps to time intervals is challenging. There are insufficient data available to quantify inactivity between audit log timestamps.This study aimed to develop and validate a computer vision-based model that (1) classifies EHR [...]