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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 [...]

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 [...]

To assess what practice-, provider-, and patient population-level predictors predict adoption of an ADHD ehealth technology in community pediatric settings, pediatric providers nationwide were recruited and offered free use of an evidence-based mental health-focused ehealth quality improvement intervention (mehealth for ADHD). Practice-, provider-, and patient population-level factors predicting provider's adoption of the intervention were studied. We hypothesized that providers who were younger, nearing recredentialing, having more patients with ADHD, working [...]

At a large quaternary health system, tissue specimens were frequently sent to the microbiology laboratory with an incorrect wound culture order meant for swab specimens due to poor electronic health record (EHR) menu design. Wound cultures were also requested in chronic wound cases with a low index of suspicion for acute infection.This study aimed to present a case report on specific changes to the design of the electronic test menu [...]

Effective postoperative care is crucial for the success of total joint arthroplasty (TJA) and prevention of unnecessary emergency department (ED) visits. We explore the feasibility and acceptability of utilizing an Interactive Voice Response System (IVRS) to enhance postoperative monitoring in primary TJA patients.This pilot study was conducted with 24 participants undergoing primary TJA randomly assigned to an intervention group receiving IVRS calls (n = 12) or a control group (n = 12) receiving standard [...]

Experiences sharing complex workflow-integrated clinical decision support (CDS) across health systems are sparse and not well reported. This case study presents the sharing of a hybrid electronic health record (EHR)-native and SMART-compatible CDS tool for automating provision of smoking cessation treatment for caregivers during pediatric visits.We conducted a comprehensive needs assessment using sociotechnical frameworks to identify workflow gaps and technical requirements. A multidisciplinary team of clinical informaticians, software developers, and [...]

Global efforts aimed at ending human immunodeficiency virus (HIV) incidence have adapted and evolved since the turn of the century. The utilization of machine learning incorporated into an electronic health record (EHR) can be refined into prediction models that identify when an individual is at greater HIV infection risk. This can create a novel and innovative approach to identifying patients eligible for preventative therapy.This study's aim was to evaluate the [...]

To review pediatric artificial intelligence (AI) implementation studies from 2010 to 2021 and analyze reported performance measures.We searched PubMed/Medline, Embase CINHAL, Cochrane Library CENTRAL, IEEE, and Web of Science with controlled vocabulary. Inclusion criteria: AI intervention in a pediatric clinical setting that learns from data (i.e., data-driven, as opposed to rule-based) and takes actions to make patient-specific recommendations; published between 01/2010 and 10/2021; must have agency (AI must provide guidance [...]

Cerebral aneurysms (CAs) affect 3 to 5% of the general population, with saccular aneurysms being the most common type. Despite advances in treatment, patient understanding of CAs and associated procedures remains limited, impacting informed consent and treatment outcomes.This pilot study aims to evaluate the effectiveness of mixed reality (MR) technology in enhancing patient education and understanding of cerebral angiograms and aneurysm treatment, thereby improving the patient-surgeon communication process.A nonrandomized single-center [...]

This study aimed to systematically evaluate the effectiveness and safety of telemedicine in improving the corresponding indicators in patients with rheumatoid arthritis (RA).Computer searches of PubMed, Embase, the Cochrane Library, and Web of Science were conducted to collect journal articles on randomized controlled trials and clinical trials of telemedicine interventions for RA. A meta-analysis was performed using the risk-of-bias assessment tool Reedman 5.4 software from the Cochrane Handbook.The systematic assessment [...]