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Quantify the effect of ambient artificial intelligence (AI) scribe technology on work experience, clinical operations, and patient experience in pediatric primary care.We conducted a 12-week study of 39 clinicians within a large pediatric primary care network. Clinician experience was measured using a custom survey instrument which included a combination of discrete and free-text responses. Qualitative analysis of free-text responses provided additional context and identified key facilitators and barriers to optimal [...]

In recent years, there has been an expansion in the literature on the effects of computerized alerts on prescribing and patient outcomes. The aim of our study was to examine the impact of these systems on clinician prescribing and patient outcomes.We searched three databases (Medline, Embase, and PsychINFO) for studies that had been conducted since 2009 and included studies that examined the effects of alerts at the point of prescribing [...]

Health professionals (HPs) trainee burnout is hard to capture. A lack of rigorous review and systematic methodological consideration hinders the development of qualitative methodological tools that can elicit rich and trustworthy qualitative data on HPs trainee burnout.This study aimed to report the process, results, and lessons learned while developing and pilot testing a qualitative tool to assess HPs' trainee experiences of burnout to complement quantitative tools.We developed a set of [...]

Clinical decision support systems (CDSS) are central to modern health care, but their effectiveness is compromised during system downtimes, which affect 96% of health care organizations. During these failures, clinicians lose access to critical decision-making tools like order sets, increasing the risk of medical errors. Traditional downtime solutions, such as paper-based protocols, are often impractical and difficult to maintain.This study introduces and evaluates Offsite Repository for Clinical Assets (ORCA), a [...]

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 [...]

Electronic health record (EHR) systems have become integral to hospital-based care, with studies showing physicians spending significant time interfacing with these systems. While EHR interactions are necessary for patient care, understanding usage patterns can identify opportunities for system optimization and workflow improvement. Previous studies have focused on outpatient settings, making this study among the first to comprehensively analyze inpatient EHR interaction patterns.This study aims to characterize EHR utilization patterns among [...]

While nursing summaries in electronic health records are used for initial orientation to a patient's status, research on nurses' use of these summaries remains scarce. This case study conducted an eye-tracking simulation to identify (1) key information types (orders, vital signs, etc.), (2) frequently paired information types, and (3) common sequential patterns of information types within nursing summaries as nurses review simulated patient cases.We recruited 33 medical-surgical nurses from a [...]

Hypertension is a significant contributor to cardiovascular disease, yet evidence-based blood pressure (BP) control practices are inconsistently applied. The Collaboration Oriented Approach to Controlling High Blood Pressure (COACH) is a digital clinical decision support tool designed to improve BP self-management and support clinician workflows. While the patient perspective on COACH has been evaluated in a separate study, this study evaluates organizational readiness for COACH implementation across three health systems using [...]

The Health Level 7 (HL7) Electronic Health Record Workgroup identified home medication list reconciliation as a prime opportunity to improve patient safety and reduce clinician burden. We developed a platform-neutral, Fast Healthcare Interoperability Resources (FHIR)-enabled reference model and demonstration wireframe to articulate the concepts of an interoperable, patient-centric home medication list management ecosystem.Four principal artifacts describe the reference model: (1) a conceptual (high-level) model, (2) a data architecture (detailed) model [...]

Hypertension is a chronic condition defined by persistent high blood pressure (BP) that contribute to significant morbidity and mortality. Evidence-based clinical guidelines provide recommendations for the diagnosis and management of hypertension. These recommendations are frequently incorporated into clinical decision support (CDS) tools used by clinicians. CDS tools can also be oriented toward patients but careful attention to the development process is required to make a useful, usable, and engaging digital [...]