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Objectives We characterized real-time patient portal test result viewing among emergency department (ED) patients and described patient characteristics overall and among those not enrolled in the portal at ED arrival. Methods Our observational study at an academic ED used portal log data to trend the proportion of adult patients who viewed results during their visit from 4/5/2021 - 4/4/2022. Correlation was assessed visually and with Kendall's . Covariate analysis using [...]

The patient portal allows patients to engage with their healthcare team beyond the clinical encounter. While portals can improve patient outcomes, there may be disparities in which patients access the portal by sociodemographic factors. Understanding the characteristics of patients who use the portal could help design future interventions to expand portal adoption.

Objectives Critical care services (CCS) documentation affects billing, operations, and research. No studies exist on documentation decision support (DDS) for CCS in the emergency department (ED). We describe the design, implementation, and evaluation of a DDS tool built to improve CCS documentation at an academic ED. Methods This quality improvement study reports the prospective design, implementation, and evaluation of a novel documentation decision support tool for CCS documentation at an [...]

One of the major challenges in pediatric intensive care is the detection of life-threatening health conditions under acute time constraints and performance pressure. This includes the assessment of pediatric organ dysfunction (OD) that demands extraordinary clinical expertise and the clinicians' ability to derive a decision based on multiple information and data sources. Clinical decision support systems (CDSS) offer a solution to support medical staff in stressful routine work. Simultaneously, detection [...]

Medication refill processing is a repetitive and predictable time-intensive task for ambulatory primary and specialty care. Refill protocols are a clinical decision support (CDS) tool that allow clinicians to quickly and safely determine appropriateness of a refill request. Our health system opted to improve the quality and breadth of EHR vendor-supplied protocols to consistently leverage best practices and emerging evidence and to create novel protocols that further support clinicians.

Objective Congress and Medicare have required real-time benefit tools (RTBT) to provide patient-specific medication price information during prescribing to decrease the cost of medications. We sought physicians' perspectives on how these tools might most effectively improve their selection of low-cost medication. Methods We conducted 15 semi-structured interviews of physicians from varied medical specialties and identified key themes across interviews during coding and analysis. Results Though physicians saw value in real-time [...]

Healthcare providers are now required to provide their patients access to their consultation and progress notes. Early research of this concept, known as "OpenNotes", showed promising results in terms of provider acceptability and patient adoption, yet objective evaluations relating to patients' interactions with the notes are limited.

Asthma affects approximately 10% of Australian children. Electronic medical record (EMR) systems and clinical decision support initiatives have been shown to improve the delivery of asthma care. Our institution implemented an EMR based asthma "hub", which collates asthma related information to a central location within a patient's record, provides a template to collect relevant clinical information, allows clinicians to evaluate a patient's history and presentation in a systematic manner and [...]

We describe a novel solution to the challenges of lengthy notes and poor note readability by creating an unobtrusive clinical decision support tool named "disappearing help text."

Background In response to surges in demand for intensive care unit (ICU) care related to the COVID-19 pandemic, health care systems have had to increase hospital capacity. One institution redeployed certified registered nurse anesthetists (CRNAs) as ICU clinicians, which necessitated training in ICU-specific electronic health record (EHR) workflows prior to redeployment. Under time- and resource-constrained settings, clinical informatics (CI) fellows could effectively be lead instructors for such training. Objective To [...]