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A sizable fraction of patients experiences adverse drug events or lack of drug efficacy. A part of this variability in drug response can be explained by genetic differences between patients. However, pharmacogenomic data as well as computational clinical decision support systems for interpreting such data are still unavailable in most healthcare settings. We address this problem by introducing the medicine safety code (MSC), which captures compressed pharmacogenomic data in a [...]

The clinical element model (CEM) is an information model designed for representing clinical information in electronic health records (EHR) systems across organizations. The current representation of CEMs does not support formal semantic definitions and therefore it is not possible to perform reasoning and consistency checking on derived models. This paper introduces our efforts to represent the CEM specification using the Web Ontology Language (OWL). The CEM-OWL representation connects the CEM [...]

Patient portal use has been associated with favorable outcomes, but we know less about how patients use and benefit from specific patient portal features.

To explore the applicability of a syndromic surveillance method to the early detection of health information technology (HIT) system failures.

To evaluate an online disease management system supporting patients with uncontrolled type 2 diabetes.

This paper describes our considerations and methods for implementing an open-source centralized research data repository (CRDR) and reports its impact on retrospective outcomes research capacity in the urology department at Columbia University. We performed retrospective pretest and post-test analyses of user acceptance, workflow efficiency, and publication quantity and quality (measured by journal impact factor) before and after the implementation. The CRDR transformed the research workflow and enabled a new research [...]

To adapt and automate the medication regimen complexity index (MRCI) within the structure of a commercial medication database in the post-acute home care setting.

Drug-drug interaction (DDI) alerting is an important form of clinical decision support, yet physicians often fail to attend to critical DDI warnings due to alert fatigue. We previously described a model for highlighting patients at high risk of a DDI by enhancing alerts with relevant laboratory data. We sought to evaluate the effect of this model on alert adherence in high-risk patients.

Data-mining algorithms that can produce accurate signals of potentially novel adverse drug reactions (ADRs) are a central component of pharmacovigilance. We propose a signal-detection strategy that combines the adverse event reporting system (AERS) of the Food and Drug Administration and electronic health records (EHRs) by requiring signaling in both sources. We claim that this approach leads to improved accuracy of signal detection when the goal is to produce a highly [...]