Search AMIA.org

Ensuring clinician safety in health care settings is critical, particularly regarding exposure to hazardous drugs and bodily fluids, which can be carcinogenic, teratogenic, genotoxic, or cause organ toxicity at low doses. At SickKids a safety issue arose when a clinician was unknowingly exposed to hazardous bodily fluids due to inadequate communication of a patient's hazardous medication status.This clinical decision support (CDS) redesign aimed to reduce alert fatigue while ensuring timely [...]

Terminologies, such as Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) and Solor, assist with knowledge representation and management, data integration, and triggering clinical decision support (CDS) rules. Semantic relations in these terminologies provide explicit meaning in compositional expressions, which assist with many of the above-listed activities.The aims of this research are to: (1) identify semantic relations that are not fully present in SNOMED CT and Solor and (2) use [...]

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 [...]

This study aimed to explore: (1) how nurses in the acute care setting describe their experience(s) of excessive documentation burden (ExDocBurden); (2) what factors contribute to ExDocBurden for nurses in the inpatient setting; and (3) nurses' perspectives on solutions to mitigate ExDocBurden that support documentation practices that they deem essential to providing safe, high-quality care.Semistructured interviews were conducted with 18 acute care nurses. Transcribed interviews were analyzed using the constant [...]

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 [...]

Improving early recognition and treatment of sepsis is key to decreasing patient mortality. A large academic health system implemented several quality improvement initiatives, yet monthly compliance with sepsis best practices remained low.Develop and evaluate an electronic health record (EHR)-embedded microlearning intervention to address suboptimal adherence to sepsis care best practices.We conducted a randomized stepped-wedge trial of our microlearning intervention with randomization done at the nursing block level. Antibiotic delay and [...]

This study sought to characterize how a population experienced health-related social needs (HRSNs) over time.We employed hidden Markov modeling using data extracted from a natural language processing state machine from 2018 to 2020 to examine whether a patient experienced any food, legal, transportation, employment, financial, or housing needs. Characteristics of patients transitioning into low/high-risk states were compared. We also identified the frequency at which patients transitioned according to their risk [...]

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 [...]

Globally, health information system (HIS) development projects face challenges regarding technology infrastructure, financing, user resistance, and interoperability. While these challenges are well-described in literature, most studies on HIS digitalization focus on the development of national and hospital HISs, with little focus on HISs in primary care. We described the HISs of two primary care clinics in Manila, Philippines in terms of data management procedures, governance, training and equipment, information culture [...]