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This study aimed to describe human-centered design of clinical decision support (CDS) for children with metabolic diseases at high risk of rapid decompensation, assess the influence of CDS on care processes and patient outcomes, and share insights from the implementation.A CDS was designed in collaboration with pediatric genetics experts to provide accelerated triage and recommend dextrose-containing fluids for patients metabolic conditions. Formative usability testing was conducted with emergency department (ED) [...]

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 [...]

Clinical decision support (CDS) tools in electronic health records (EHRs) often face low uptake due to limited usability, workflow integration, and other implementation issues. We recently designed and implemented the STRATIFY-CDS tool, which calculates a validated risk-prediction model and recommends disposition for emergency department (ED) patients with acute heart failure. Despite applying human-centered design and implementation science strategies, initial utilization in the first 3 months of the STRATIFY-CDS tool was [...]

Hospitals are looking to AI and other innovative applications to help alleviate provider burden and dissatisfaction associated with clinical documentation in oncology. Ambient artificial intelligence (AI) scribes are a promising technology to address these issues. However, they generally have not been optimized for oncology. This study aimed to evaluate an ambient AI scribe application with oncology providers to determine opportunities and potential challenges.This prospective pilot study of a scribe application [...]

The global aging population is rapidly increasing, and the prevalence of age-related cognitive conditions, such as mild cognitive impairment (MCI), is becoming more common. This condition, which represents intermediate stages between normal aging and dementia, underscores the importance of early detection and timely intervention to address the growing demand for health services. Traditional cognitive assessments have limitations, such as the consistency of results, prompting the need for innovative technology-based solutions.This [...]

Chemoprophylaxis reduces the risk of hospital-acquired venous thromboembolism (VTE), but is not reliably ordered. Our institution created a clinical decision support (CDS) interruptive alert to remind clinicians to order VTE chemoprophylaxis when it is missing for qualifying inpatients. Unfortunately, this alert has required repeated modifications to ensure accurate logic, and continues to generate negative feedback from users.This study aimed to describe multiple failures in the development and postdeployment optimization of [...]

The goal of national interoperability is to improve care quality and decrease administrative burden and costs. Patients, providers, and other stakeholders are increasingly concerned that indiscriminate sharing of data may have deleterious, permanent consequences, as well as fail to provide granular control over the sharing of individual health data. Data segmentation and consent standards to date have been limited in scope and implementation, which has hindered efforts to scale data [...]

Aging populations strain health care systems. Assisted Living Technologies (ALTs) emerge as a potential solution for promoting independent living among older adults. However, the real-world effect of ALTs remains unclear.This study explores benefits and challenges (anticipated and unanticipated) of ALTs for older adults and informal caregivers across three aged care settings (residential aged care facilities [RACFs], retirement villages [RVs], and home-dwelling communities [HDCs]) in Australia.Three ALTs (fall detection sensors, sleep [...]

Traditional early warning systems (EWS) have shown uncertain efficacy in real-world settings. More recently, machine learning models like the Epic Deterioration Index (DTI) have been developed, promising greater accuracy. Recognizing the potential of DTI, but also the pervasive issue of alert fatigue with interruptive (i.e., pop-up) EWS alerts, our institution implemented a DTI-enabled EWS with passive alerts (colored icons visible in prespecified locations within the electronic health record). We hypothesized [...]

As healthcare delivery becomes increasingly digital, nursing informatics knowledge has become essential for nurses to participate effectively in digitally enabled healthcare environments. The Canadian Association of Schools of Nursing (CASN) released updated nursing informatics entry-to-practice competencies in 2025 to inform nursing education in Canada. However, the integration of informatics knowledge and content into nursing curricula and professional practice education remains inconsistent. Mapping the teaching strategies used by nursing educators to [...]