965 results match your criteria Applied Clinical Informatics[Journal]


Applied Clinical Informatics Journal: A Brief History.

Appl Clin Inform 2022 Mar 18;13(2):516-520. Epub 2022 May 18.

Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, United States.

In 2009, Schattauer Verlag in Stuttgart, Germany first published the () Journal. has served since its inception as an official journal of the International Medical Informatics Association. Later, the American Medical Informatics Association and the European Federation for Medical Informatics named as an official journal. Read More

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Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients.

Appl Clin Inform 2022 Mar 18;13(2):504-515. Epub 2022 May 18.

Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States.

Background:  Helping parents quit smoking is a public health priority. However, parents are rarely, if ever, offered tobacco use treatment through pediatric settings. Clinical decision support (CDS) systems developed for the workflows of pediatric primary care may support consistent screening, treatment, and referral. Read More

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Displaying cost and completion time for reference laboratory test orders - a randomized controlled trial.

Appl Clin Inform 2022 May 17. Epub 2022 May 17.

Department of Pathology and Laboratory Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, United States.

Objectives Reduction in unnecessary services is one strategy for increasing the value of health care. Reference laboratory, or send-out, tests are associated with considerable costs. We investigated whether displaying cost and turnaround time (TAT), or time-to-result, for reference laboratory tests at the time of order entry in the electronic health record system (EHR) would impact provider ordering practices. Read More

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Reporting Outcomes of Pediatric Intensive Care Unit Patients to Referring Physicians via an Electronic Health Record-Based Feedback System.

Appl Clin Inform 2022 Mar 11;13(2):495-503. Epub 2022 May 11.

Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, United States.

Background:  Many critically ill children are initially evaluated in front-line settings by clinicians with variable pediatric training before they are transferred to a pediatric intensive care unit (PICU). Because clinicians learn from past performance, communicating outcomes of patients back to front-line clinicians who provide pediatric emergency care could be valuable; however, referring clinicians do not consistently receive this important feedback.

Objectives:  Our aim was to determine the feasibility, usability, and clinical relevance of a semiautomated electronic health record (EHR)-supported system developed at a single institution to deliver timely and relevant PICU patient outcome feedback to referring emergency department (ED) physicians. Read More

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25 × 5 Symposium to Reduce Documentation Burden: Report-out and Call for Action.

Appl Clin Inform 2022 Mar 11;13(2):439-446. Epub 2022 May 11.

Departments of Biomedical Informatics Internal Medicine and Pediatrics, Vanderbilt University, Nashville, Tennessee, United States.

Background:  The widespread adoption of electronic health records and a simultaneous increase in regulatory demands have led to an acceleration of documentation requirements among clinicians. The corresponding burden from documentation requirements is a central contributor to clinician burnout and can lead to an increased risk of suboptimal patient care.

Objective:  To address the problem of documentation burden, (Symposium) was organized to provide a forum for experts to discuss the current state of documentation burden and to identify specific actions aimed at dramatically reducing documentation burden for clinicians. Read More

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Generating and Reporting Electronic Clinical Quality Measures from Electronic Health Records: Strategies from EvidenceNOW Cooperatives.

Appl Clin Inform 2022 03 4;13(2):485-494. Epub 2022 May 4.

Center for Health Information Partnerships (CHiP), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States.

Background: Electronic clinical quality measures (eCQMs) from electronic health records (EHRs) are a key component of quality improvement (QI) initiatives in small-to-medium size primary care practices, but using eCQMs for QI can be challenging. Organizational strategies are needed to effectively operationalize eCQMs for QI in these practice settings.

Objective: This study aimed to characterize strategies that seven regional cooperatives participating in the EvidenceNOW initiative developed to generate and report EHR-based eCQMs for QI in small-to-medium size practices. Read More

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Monitoring Approaches for a Pediatric Chronic Kidney Disease Machine Learning Model.

Appl Clin Inform 2022 03 4;13(2):431-438. Epub 2022 May 4.

Division of Neonatology, Department of Pediatrics, Orlando Health, Orlando, Florida, United States.

Objective: The purpose of this study is to evaluate the ability of three metrics to monitor for a reduction in performance of a chronic kidney disease (CKD) model deployed at a pediatric hospital.

Methods: The CKD risk model estimates a patient's risk of developing CKD 3 to 12 months following an inpatient admission. The model was developed on a retrospective dataset of 4,879 admissions from 2014 to 2018, then run silently on 1,270 admissions from April to October, 2019. Read More

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Usability and Acceptability of Clinical Decision Support Based on the KIIDS-TBI Tool for Children with Mild Traumatic Brain Injuries and Intracranial Injuries.

Appl Clin Inform 2022 Mar 27;13(2):456-467. Epub 2022 Apr 27.

Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, United States.

Background:  The Kids Intracranial Injury Decision Support tool for Traumatic Brain Injury (KIIDS-TBI) tool is a validated risk prediction model for managing children with mild traumatic brain injuries (mTBI) and intracranial injuries. Electronic clinical decision support (CDS) may facilitate the clinical implementation of this evidence-based guidance.

Objective:  Our objective was to evaluate the acceptability and usability of an electronic CDS tool for managing children with mTBI and intracranial injuries. Read More

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Clinician Acceptance of Order Sets for Pain Management: A Survey in Two Urban Hospitals.

Appl Clin Inform 2022 Mar 27;13(2):447-455. Epub 2022 Apr 27.

Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States.

Background:  Order sets are a clinical decision support (CDS) tool in computerized provider order entry systems. Order set use has been associated with improved quality of care. Particularly related to opioids and pain management, order sets have been shown to standardize and reduce the prescription of opioids. Read More

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Impact of a Vendor-Developed Opioid Clinical Decision Support Intervention on Adherence to Prescribing Guidelines, Opioid Prescribing, and Rates of Opioid-Related Encounters.

Appl Clin Inform 2022 Mar 20;13(2):419-430. Epub 2022 Apr 20.

Department of Child Health, University of Missouri School of Medicine, Columbia, Missouri, United States.

Background:  Provider prescribing practices contribute to an excess of opioid-related deaths in the United States. Clinical guidelines exist to assist providers with improving prescribing practices and promoting patient safety. Clinical decision support systems (CDSS) may promote adherence to these guidelines and improve prescribing practices. Read More

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Improving COVID-19 Research of University Hospitals in Germany: Formative Usability Evaluation of the CODEX Feasibility Portal.

Appl Clin Inform 2022 Mar 20;13(2):400-409. Epub 2022 Apr 20.

Department of Medical Informatics, Biometrics and Epidemiology, Chair of Medical Informatics, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany.

Background:  Within the German "Network University Medicine," a portal is to be developed to enable researchers to query on novel coronavirus disease 2019 (COVID-19) data from university hospitals for assessing the feasibility of a clinical study.

Objectives:  The usability of a prototype for federated feasibility queries was evaluated to identify design strengths and weaknesses and derive improvement recommendations for further development.

Methods:  In the course of a remote usability test with the thinking-aloud method and posttask interviews, 15 clinical researchers evaluated the usability of a prototype of the Feasibility Portal. Read More

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Improving Provisioning of an Inpatient Portal: Perspectives from Nursing Staff.

Appl Clin Inform 2022 Mar 13;13(2):355-362. Epub 2022 Apr 13.

The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States.

Background:  Inpatient portals are recognized to provide benefits for both patients and providers, yet the process of provisioning tablets to patients by staff has been difficult for many hospitals.

Objective:  Our study aimed to identify and describe practices important for provisioning an inpatient portal from the perspectives of nursing staff and provide insight to enable hospitals to address challenges related to provisioning workflow for the inpatient portal accessible on a tablet.

Methods:  Qualitative interviews were conducted with 210 nursing staff members across 26 inpatient units in six hospitals within The Ohio State University Wexner Medical Center (OSUWMC) following the introduction of tablets providing access to an inpatient portal, MyChart Bedside (MCB). Read More

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Toward a Learning Health Care System: A Systematic Review and Evidence-Based Conceptual Framework for Implementation of Clinical Analytics in a Digital Hospital.

Appl Clin Inform 2022 Mar 6;13(2):339-354. Epub 2022 Apr 6.

Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Brisbane, Australia.

Objective:  A learning health care system (LHS) uses routinely collected data to continuously monitor and improve health care outcomes. Little is reported on the challenges and methods used to implement the analytics underpinning an LHS. Our aim was to systematically review the literature for reports of real-time clinical analytics implementation in digital hospitals and to use these findings to synthesize a conceptual framework for LHS implementation. Read More

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An Exploratory Study of Allied Health Students' Experiences of Electronic Medical Records During Placements.

Appl Clin Inform 2022 Mar 6;13(2):410-418. Epub 2022 Apr 6.

Work Integrated Learning, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.

Background:  Allowing students to access and document in electronic medical records (eMRs) during clinical placements is viewed as critical for ensuring that graduates have a high level of digital proficiency prior to entering the workforce. Limited studies have explored student access to eMRs in health disciplines outside of medicine and nursing.

Objective:  Our main objective was to examine allied health students' experiences and perceptions of the opportunity to develop eMR competencies during their placement, across a range of allied health disciplines and placement settings. Read More

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Searching of Clinical Trials Made Easier in cBioPortal Using Patients' Genetic and Clinical Profiles.

Appl Clin Inform 2022 Mar 30;13(2):363-369. Epub 2022 Mar 30.

Friedrich-Alexander University Erlangen-Nuremberg, Chair of Medical Informatics, Erlangen, Bayern, Germany.

Background:  Molecular tumor boards (MTBs) cope with the complexity of an increased usage of genome sequencing data in cancer treatment. As for most of these patients, guideline-based therapy options are exhausted, finding matching clinical trials is crucial. This search process is often performed manually and therefore time consuming and complex due to the heterogeneous and challenging dataset. Read More

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A Data-Driven Assessment of the U.S. Health Informatics Programs and Job Market.

Appl Clin Inform 2022 Mar 30;13(2):327-338. Epub 2022 Mar 30.

Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania, United States.

Background:  Health Informatics (HI) is an interdisciplinary field, integrating health sciences, computer science, information science, and cognitive science to assist health information management, analysis, and utilization. As the HI field is broad, it is impossible that a student will be able to master all the diverse HI topics. Thus, it is important to train the HI students based on the offering of the various HI programs and needs of the current market. Read More

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The Clinical Informatics Practice Pathway Should Be Maintained for Now but Transformed into an Alternative to In-Place Fellowships.

Authors:
William R Hersh

Appl Clin Inform 2022 03 23;13(2):398-399. Epub 2022 Mar 23.

Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health and Science University, Portland, Oregon, United States.

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Visualizing Opioid-Use Variation in a Pediatric Perioperative Dashboard.

Appl Clin Inform 2022 03 23;13(2):370-379. Epub 2022 Mar 23.

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, United States.

Background: Anesthesiologists integrate numerous variables to determine an opioid dose that manages patient nociception and pain while minimizing adverse effects. Clinical dashboards that enable physicians to compare themselves to their peers can reduce unnecessary variation in patient care and improve outcomes. However, due to the complexity of anesthetic dosing decisions, comparative visualizations of opioid-use patterns are complicated by case-mix differences between providers. Read More

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Qualitative Analysis of Team Communication with a Clinical Texting System at a Midwestern Academic Hospital.

Appl Clin Inform 2022 03 16;13(2):391-397. Epub 2022 Mar 16.

Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States.

Background: Hospitals are increasingly replacing pagers with clinical texting systems that allow users to use smartphones to send messages while maintaining compliance for privacy and security. As more institutions adopt such systems, the need to understand the impact of such transitions on team communication becomes ever more significant.

Methods: We conducted focus groups with hospitalists and individual interviews with nurses at one academic medical center in the Midwest. Read More

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Design, Usability, and Acceptability of a Needs-Based, Automated Dashboard to Provide Individualized Patient-Care Data to Pediatric Residents.

Appl Clin Inform 2022 03 16;13(2):380-390. Epub 2022 Mar 16.

Division of Pediatric Hospital Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States.

Background And Objectives: Pediatric residency programs are required by the Accreditation Council for Graduate Medical Education to provide residents with patient-care and quality metrics to facilitate self-identification of knowledge gaps to prioritize improvement efforts. Trainees are interested in receiving this data, but this is a largely unmet need. Our objectives were to (1) design and implement an automated dashboard providing individualized data to residents, and (2) examine the usability and acceptability of the dashboard among pediatric residents. Read More

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Thank You for a Successful 2021!

Appl Clin Inform 2022 01 9;13(1):304-314. Epub 2022 Mar 9.

Applied Clinical Informatics Editorial Office, Nashville, Tennessee, United States.

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January 2022

Barriers and Benefits of Information Communication Technologies Used by Health Care Aides.

Appl Clin Inform 2022 01 9;13(1):270-286. Epub 2022 Mar 9.

School of Publich Health Sciences, Faculty of Health, University of Waterloo, Waterloo (ON), Canada.

Background: Although information and communication technologies (ICT) are becoming more common among health care providers, there is little evidence on how ICT can support health care aides. Health care aides, also known as personal care workers, are unlicensed service providers who encompass the second largest workforce, next to nurses, that provide care to older adults in Canada.

Objective: The purpose of this literature review is to examine the range and extent of barriers and benefits of ICT used by health care workers to manage and coordinate the care-delivery workflow for their clients. Read More

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January 2022

Design and Evaluation of a Postpartum Depression Ontology.

Appl Clin Inform 2022 01 9;13(1):287-300. Epub 2022 Mar 9.

Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States.

Objective: Postpartum depression (PPD) remains an understudied research area despite its high prevalence. The goal of this study is to develop an ontology to aid in the identification of patients with PPD and to enable future analyses with electronic health record (EHR) data.

Methods: We used Protégé-OWL to construct a postpartum depression ontology (PDO) of relevant comorbidities, symptoms, treatments, and other items pertinent to the study and treatment of PPD. Read More

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January 2022

Agile, Easily Applicable, and Useful eHealth Usability Evaluations: Systematic Review and Expert-Validation.

Appl Clin Inform 2022 01 9;13(1):67-79. Epub 2022 Mar 9.

Department of Biomedical Computer Science and Mechatronics, Institute of Medical Informatics, UMIT, Private University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.

Background: Electronic health (eHealth) usability evaluations of rapidly developed eHealth systems are difficult to accomplish because traditional usability evaluation methods require substantial time in preparation and implementation. This illustrates the growing need for fast, flexible, and cost-effective methods to evaluate the usability of eHealth systems. To address this demand, the present study systematically identified and expert-validated rapidly deployable eHealth usability evaluation methods. Read More

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January 2022

A Student-Led Clinical Informatics Enrichment Course for Medical Students.

Appl Clin Inform 2022 01 2;13(1):322-326. Epub 2022 Mar 2.

Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States.

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January 2022

Building a Learning Health System: Creating an Analytical Workflow for Evidence Generation to Inform Institutional Clinical Care Guidelines.

Appl Clin Inform 2022 01 2;13(1):315-321. Epub 2022 Mar 2.

Stanford Center for Biomedical Informatics Research, Stanford University, Stanford, California, United States.

Background: One key aspect of a learning health system (LHS) is utilizing data generated during care delivery to inform clinical care. However, institutional guidelines that utilize observational data are rare and require months to create, making current processes impractical for more urgent scenarios such as those posed by the COVID-19 pandemic. There exists a need to rapidly analyze institutional data to drive guideline creation where evidence from randomized control trials are unavailable. Read More

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January 2022

Telehealth Education via WeChat Improves the Quality of Life of Parents of Children with Type-1 Diabetes Mellitus.

Appl Clin Inform 2022 01 2;13(1):263-269. Epub 2022 Mar 2.

Department of Pediatrics, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian Province, China.

Objective: The purpose of this study was to explore the effect of telehealth education and care guidance via WeChat (Tencent Ltd., Shenzhen, China; a popular smartphone-based social media application) on improving the quality of life of parents of children with type-1 diabetes mellitus.

Methods: A prospective randomized controlled study was conducted in our hospital from March 2019 to September 2020 to compare the quality of life of parents of children with type-1 diabetes mellitus in the intervention group and the control group. Read More

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January 2022

An Open Letter Arguing for Closure of the Practice Pathway for Clinical Informatics Medical Subspecialty Certification.

Appl Clin Inform 2022 01 26;13(1):301-303. Epub 2022 Feb 26.

Clinical Informatics Center, UTSouthwestern Medical Center, Dallas, Texas, United States.

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January 2022

Opportunities and Challenges of Integrating Food Practice into Clinical Decision-Making.

Appl Clin Inform 2022 01 23;13(1):252-262. Epub 2022 Feb 23.

College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United States.

Background: Food practice plays an important role in health. Food practice data collected in daily living settings can inform clinical decisions. However, integrating such data into clinical decision-making is burdensome for both clinicians and patients, resulting in poor adherence and limited utilization. Read More

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January 2022

Prevalence and Factors Associated with Patient-Requested Corrections to the Medical Record through Use of a Patient Portal: Findings from a National Survey.

Appl Clin Inform 2022 01 23;13(1):242-251. Epub 2022 Feb 23.

Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States.

Background: Providing patients with medical records access is one strategy that health systems can utilize to reduce medical errors. However, how often patients request corrections to their records on a national scale is unknown.

Objectives: We aimed to develop population-level estimates of patients who request corrections to their medical records using national-level data. Read More

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January 2022