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Applied Clinical Informatics

Daniel J Lee, Robert Cronin, Jamie Robinson, Shilo Anders, Kim Unertl, Katherine Kelly, Heather Hankins, Ryan Skeens, Gretchen P Jackson
BACKGROUND:  Informed and engaged parents may influence outcomes for childhood illness. Understanding the needs of the caregivers of pediatric patients is a critical first step in promoting engagement in their child's care. In 2014, we developed an Engagement Consultation Service at the Monroe Carell Jr. Children's Hospital at Vanderbilt. This service determines the health-related needs of the caregivers of hospitalized children and makes educational or technology recommendations to meet those needs and support engagement...
July 2018: Applied Clinical Informatics
Megan Sweeney, Kaavya Paruchuri, Saul N Weingart
BACKGROUND: There are few published studies of the use of portable or handheld computers in health care, but these devices have the potential to transform multiple aspects of clinical teaching and practice. OBJECTIVE:  This article assesses resident physicians' perceptions and experiences with tablet computers before and after the introduction of these devices. METHODS:  We surveyed 49 resident physicians from 8 neurology, surgery, and internal medicine clinical services before and after the introduction of tablet computers at a 415-bed Boston teaching hospital...
July 2018: Applied Clinical Informatics
Eric Shelov, Naveen Muthu, Heather Wolfe, Danielle Traynor, Nancy Craig, Christopher Bonafide, Vinay Nadkarni, Daniela Davis, Maya Dewan
BACKGROUND AND OBJECTIVE:  Pediatric in-hospital cardiac arrest most commonly occurs in the pediatric intensive care unit (PICU) and is frequently preceded by early warning signs of clinical deterioration. In this study, we describe the implementation and evaluation of criteria to identify high-risk patients from a paper-based checklist into a clinical decision support (CDS) tool in the electronic health record (EHR). MATERIALS AND METHODS:  The validated paper-based tool was first adapted by PICU clinicians and clinical informaticians and then integrated into clinical workflow following best practices for CDS design...
July 2018: Applied Clinical Informatics
Lisa V Grossman, Steven K Feiner, Elliot G Mitchell, Ruth M Masterson Creber
BACKGROUND:  Health care organizations increasingly use patient-reported outcomes (PROs) to capture patients' health status. Although federal policy mandates PRO collection, the challenge remains to better engage patients in PRO surveys, and ensure patients comprehend the surveys and their results. OBJECTIVE:  This article identifies the design requirements for an interface that assists patients with PRO survey completion and interpretation, and then builds and evaluates the interface...
July 2018: Applied Clinical Informatics
Jennifer L Hefner, Cynthia J Sieck, Ann Scheck McAlearney
BACKGROUND:  Inpatient portals are an emerging technology that can facilitate collaborative interactions between patients and care teams, but little is known about how organizations attempt to implement and facilitate inpatient portal use for their providers. METHODS:  We held in-person, semistructured interviews with care team members and information technology (IT) staff and conducted rigorous thematic analysis of transcripts. RESULTS:  Interviews with 220 care team members and 4 IT staff identified 3 new areas of training needed to optimize inpatient portal implementation and use that extend beyond training to use other technologies: (1) teaching staff to train patients about tool use; (2) training about how to promote tool use to patients; and (3) training about optimal use of secure messaging...
July 2018: Applied Clinical Informatics
Mollie R Cummins, Pallavi Ranade-Kharkar, Cody Johansen, Heather Bennett, Shelley Gabriel, Barbara I Crouch, Guilherme Del Fiol, Matt Hoffman
BACKGROUND:  U.S. poison control centers pose a special case for patient identity matching because they collect only minimal patient identifying information. METHODS:  In early 2017, the Utah Poison Control Center (Utah PCC) initiated participation in regional health information exchange by sending Health Level Seven Consolidated Clinical Document Architecture (C-CDA) documents to the Utah Health Information Network and Intermountain Healthcare. To increase the documentation of patient identifiers by the Utah PCC, we (1) adapted documentation practices to enable more complete and consistent documentation, and (2) implemented staff training to improve collection of identifiers...
July 2018: Applied Clinical Informatics
Yaa A Kumah-Crystal, Claude J Pirtle, Harrison M Whyte, Edward S Goode, Shilo H Anders, Christoph U Lehmann
BACKGROUND:  Usability problems in the electronic health record (EHR) lead to workflow inefficiencies when navigating charts and entering or retrieving data using standard keyboard and mouse interfaces. Voice input technology has been used to overcome some of the challenges associated with conventional interfaces and continues to evolve as a promising way to interact with the EHR. OBJECTIVE:  This article reviews the literature and evidence on voice input technology used to facilitate work in the EHR...
July 2018: Applied Clinical Informatics
Agnes S Sundaresan, Gargi Schneider, Joy Reynolds, H Lester Kirchner
BACKGROUND:  Asthma exacerbation leading to emergency department (ED) visit is prevalent, an indicator of poor control of asthma, and is a potentially preventable clinical outcome. OBJECTIVE:  We propose to utilize multiple data elements available in electronic medical records (EMRs) and claims database to create separate algorithms with high validity for clinical and research purposes to identify asthma exacerbation-related ED visit among the general population...
July 2018: Applied Clinical Informatics
Danielle E Kurant, Jason M Baron, Genti Strazimiri, Kent B Lewandrowski, Joseph W Rudolf, Anand S Dighe
OBJECTIVES:  Laboratory-based utilization management programs typically rely primarily on data derived from the laboratory information system to analyze testing volumes for trends and utilization concerns. We wished to examine the ability of an electronic health record (EHR) laboratory orders database to improve a laboratory utilization program. METHODS:  We obtained a daily file from our EHR containing data related to laboratory test ordering. We then used an automated process to import this file into a database to facilitate self-service queries and analysis...
July 2018: Applied Clinical Informatics
Dawn Dowding, Jacqueline A Merrill
BACKGROUND:  Heuristic evaluation is used in human-computer interaction studies to assess the usability of information systems. Nielsen's widely used heuristics, first developed in 1990, are appropriate for general usability but do not specifically address usability in systems that produce information visualizations. OBJECTIVE:  This article develops a heuristic evaluation checklist that can be used to evaluate systems that produce information visualizations...
July 2018: Applied Clinical Informatics
Catherine K Craven, Martha Adams
No abstract text is available yet for this article.
July 2018: Applied Clinical Informatics
Anthony Solomonides
No abstract text is available yet for this article.
July 2018: Applied Clinical Informatics
Paul R DeMuro, Laurie L Novak, Carolyn Petersen
No abstract text is available yet for this article.
July 2018: Applied Clinical Informatics
Laurie L Novak, Craig Kuziemsky, Bonnie Kaplan
No abstract text is available yet for this article.
July 2018: Applied Clinical Informatics
Jos Aarts
No abstract text is available yet for this article.
July 2018: Applied Clinical Informatics
Robin L Pierce, Anna Berti Suman, Bert-Jaap Koops, Ronald Leenes
No abstract text is available yet for this article.
July 2018: Applied Clinical Informatics
Michael W Smith, Charnetta Brown, Salim S Virani, Charlene R Weir, Laura A Petersen, Natalie Kelly, Julia Akeroyd, Jennifer H Garvin
BACKGROUND:  The recognition of and response to undertreatment of heart failure (HF) patients can be complicated. A clinical reminder can facilitate use of guideline-concordant β-blocker titration for HF patients with depressed ejection fraction. However, the design must consider the cognitive demands on the providers and the context of the work. OBJECTIVE:  This study's purpose is to develop requirements for a clinical decision support tool (a clinical reminder) by analyzing the cognitive demands of the task along with the factors in the Cabana framework of physician adherence to guidelines, the health information technology (HIT) sociotechnical framework, and the Promoting Action on Research Implementation in Health Services (PARIHS) framework of health services implementation...
April 2018: Applied Clinical Informatics
Michelle A Jahn, Brian W Porter, Himalaya Patel, Alan J Zillich, Steven R Simon, Alissa L Russ
BACKGROUND:  Web-based patient portals feature secure messaging systems that enable health care providers and patients to communicate information. However, little is known about the usability of these systems for clinical document sharing. OBJECTIVE:  This article evaluates the usability of a secure messaging system for providers and patients in terms of its ability to support sharing of electronic clinical documents. METHODS:  We conducted usability testing with providers and patients in a human-computer interaction laboratory at a Midwestern U...
April 2018: Applied Clinical Informatics
Yuri Quintana, Eduardo A Gonzalez Martorell, Darren Fahy, Charles Safran
OBJECTIVE:  Adherence to antiretroviral therapy (ART) is paramount to successful long-term suppression of human immunodeficiency virus (HIV). For poorly adherent patients with HIV, barriers to remaining adherent may be overcome by the implementation of targeted interventions delivered via mobile devices. This systematic review is focused specifically on mobile phone technologies to deliver adherence interventions in HIV/acquired immunodeficiency syndrome (AIDS) populations. METHODS:  This review (PROSPERO #CRD42017065131) systematically extracted data from published literature from five databases on mobile phone interventions to improve adherence to ART for HIV...
April 2018: Applied Clinical Informatics
Danielle Groat, Hiral Soni, Maria Adela Grando, Bithika Thompson, David Kaufman, Curtiss B Cook
BACKGROUND:  Type 1 diabetes (T1D) care requires multiple daily self-management behaviors (SMBs). Preliminary studies on SMBs rely mainly on self-reported survey and interview data. There is little information on adult T1D SMBs, along with corresponding compensation techniques (CTs), gathered in real-time. OBJECTIVE:  The article aims to use a patient-centered approach to design iDECIDE, a smartphone application that gathers daily diabetes SMBs and CTs related to meal and alcohol intake and exercise in real-time, and contrast patients' actual behaviors against those self-reported with the app...
April 2018: Applied Clinical Informatics
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