The impact of real-time alerting on appropriate prescribing in kidney disease: a cluster randomized controlled trial
Background Patients with kidney disease are at risk for adverse events due to improper medication prescribing. Few randomized controlled trials of clinical decision support (CDS) utilizing dynamic assessment of patients’ kidney function to improve prescribing for patients with kidney disease have been published.Methods We developed a CDS tool for 20 medications within a commercial electronic health record. Our system detected scenarios in which drug discontinuation or dosage adjustment was recommended for adult patients with impaired renal function in the ambulatory and acute settings – both at the time of the ...
Source: Journal of the American Medical Informatics Association - November 27, 2015 Category: Information Technology Authors: Awdishu, L., Coates, C. R., Lyddane, A., Tran, K., Daniels, C. E., Lee, J., El-Kareh, R. Tags: Research and Applications Source Type: research

A data-driven approach for quality assessment of radiologic interpretations
Given the increasing emphasis on delivering high-quality, cost-efficient healthcare, improved methodologies are needed to measure the accuracy and utility of ordered diagnostic examinations in achieving the appropriate diagnosis. Here, we present a data-driven approach for performing automated quality assessment of radiologic interpretations using other clinical information (e.g., pathology) as a reference standard for individual radiologists, subspecialty sections, imaging modalities, and entire departments. Downstream diagnostic conclusions from the electronic medical record are utilized as "truth" to which ups...
Source: Journal of the American Medical Informatics Association - November 25, 2015 Category: Information Technology Authors: Hsu, W., Han, S. X., Arnold, C. W., Bui, A. A., Enzmann, D. R. Tags: Brief Communication Source Type: research

Rising drug allergy alert overrides in electronic health records: an observational retrospective study of a decade of experience
Objective There have been growing concerns about the impact of drug allergy alerts on patient safety and provider alert fatigue. The authors aimed to explore the common drug allergy alerts over the last 10 years and the reasons why providers tend to override these alerts.Design: Retrospective observational cross-sectional study (2004–2013).Materials and Methods Drug allergy alert data (n = 611,192) were collected from two large academic hospitals in Boston, MA (USA).Results Overall, the authors found an increase in the rate of drug allergy alert overrides, from 83.3% in 2004 to 87.6% in 2013 (P
Source: Journal of the American Medical Informatics Association - November 17, 2015 Category: Information Technology Authors: Topaz, M., Seger, D. L., Slight, S. P., Goss, F., Lai, K., Wickner, P. G., Blumenthal, K., Dhopeshwarkar, N., Chang, F., Bates, D. W., Zhou, L. Tags: Research and Applications Source Type: research

Risks and benefits of speech recognition for clinical documentation: a systematic review
Conclusions SR is steadily maturing and offers some advantages for clinical documentation. However, evidence supporting the use of SR is weak, and further investigation is required to assess the impact of SR on documentation error types, rates, and clinical outcomes. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 17, 2015 Category: Information Technology Authors: Hodgson, T., Coiera, E. Tags: Review Source Type: research

Improving health care proxy documentation using a web-based interview through a patient portal
Conclusions Patients found our online interview convenient and helpful in facilitating selection and documentation of an HCP. Our study demonstrates that a web-based interview to collect and share a patient’s HCP information is both feasible and useful. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Bajracharya, A. S., Crotty, B. H., Kowaloff, H. B., Safran, C., Slack, W. V. Tags: Research and Applications Source Type: research

Clinical element models in the SHARPn consortium
Conclusions The SHARPn effort demonstrated the normalization and secondary use of EHR data. CEMs proved capable of capturing data originating from a variety of sources within the normalization pipeline and serving as suitable normalization targets. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Oniki, T. A., Zhuo, N., Beebe, C. E., Liu, H., Coyle, J. F., Parker, C. G., Solbrig, H. R., Marchant, K., Kaggal, V. C., Chute, C. G., Huff, S. M. Tags: Research and Applications Source Type: research

The vulnerabilities of computerized physician order entry systems: a qualitative study
Conclusion The authors found high variability in ordering approaches between different CPOE systems, with major deficiencies identified in some systems. It is important that developers reflect on these findings and build in safeguards to ensure safer prescribing for patients. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Slight, S. P., Eguale, T., Amato, M. G., Seger, A. C., Whitney, D. L., Bates, D. W., Schiff, G. D. Tags: Research and Applications Source Type: research

Effects of health information technology on patient outcomes: a systematic review
Conclusion Many areas of health IT application remain understudied and the majority of studies have non-significant or mixed findings. Our study suggests that larger, higher quality studies need to be conducted, particularly in the long-term care and ambulatory care settings. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Brenner, S. K., Kaushal, R., Grinspan, Z., Joyce, C., Kim, I., Allard, R. J., Delgado, D., Abramson, E. L. Tags: Review Source Type: research

Strategizing EHR use to achieve patient-centered care in exam rooms: a qualitative study on primary care providers
Conclusion This study has uncovered the challenges that primary care providers face in integrating the EHR into their work practice, and the strategies they use to overcome these challenges in order to maintain patient-centered care. These findings illuminate the importance of developing "best" practices to improve patient-centered care in today’s highly "wired" health environment. These findings also show that more user-centered EHR design is needed to improve system usability. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Zhang, J., Chen, Y., Ashfaq, S., Bell, K., Calvitti, A., Farber, N. J., Gabuzda, M. T., Gray, B., Liu, L., Rick, S., Street, R. L., Zheng, K., Zuest, D., Agha, Z. Tags: Research and Applications Source Type: research

Meaningful use care coordination criteria: Perceived barriers and benefits among primary care providers
Conclusion The survey results suggest the need to enhance policy approaches and organizational strategies to address the key barriers identified by providers and practices in order to realize important care coordination benefits. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Cohen, G. R., Adler-Milstein, J. Tags: Brief Communication Source Type: research

Experience with decision support system and comfort with topic predict clinicians' responses to alerts and reminders
Conclusion This study highlights several factors associated with clinician prompt response rates that could be generalized to other health information technology applications, including the clinician’s length of exposure to the CDSS, the prompt’s position on the page, and the clinician’s comfort with the prompt topic. Incorporating continuous quality improvement efforts when designing and implementing health information technology may ensure that its use is optimized. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Bauer, N. S., Carroll, A. E., Saha, C., Downs, S. M. Tags: Research and Applications Source Type: research

An information model for automated assessment of concordance between advance care preferences and care delivered near the end of life
Conclusion An information model for automating the assessment of the concordance between patients’ advance care planning preferences and the end-of-life care they received was effective in a small population and has the potential to assess population-level preference-concordance on an ongoing basis. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Turley, M., Wang, S., Meng, D., Kanter, M. H., Garrido, T. Tags: Research and Applications Source Type: research

A multi-institution evaluation of clinical profile anonymization
Conclusions: Sharing large volumes of clinical data in support of phenome-wide association studies is possible while safeguarding privacy to the underlying individuals. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Heatherly, R., Rasmussen, L. V., Peissig, P. L., Pacheco, J. A., Harris, P., Denny, J. C., Malin, B. A. Tags: Case Report Source Type: research

Classification of radiology reports for falls in an HIV study cohort
Conclusion Machine learning is an effective method of identifying patients who have suffered a fall. The development of this classifier supplements the clinical researcher’s toolkit and reduces dependence on under-coded structured electronic health record data. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 13, 2015 Category: Information Technology Authors: Bates, J., Fodeh, S. J., Brandt, C. A., Womack, J. A. Tags: Research and Applications Source Type: research

Identifying opportunities in EHR to improve the quality of antibiotic allergy data
Conclusions Findings suggest that current EHR documentation practices among the health centers reviewed do not provide enough information on allergic reactions to allow providers to discern between true allergies and common, but anticipated, drug side effects. Improved EHR documentation guidance, training that reinforces the use of standardized data and more detailed recording of allergic reactions, combined with initiatives to address patient barriers including health literacy, may help to improve the accuracy of drug allergies in patients’ records. These initiatives, combined with antimicrobial stewardship programs...
Source: Journal of the American Medical Informatics Association - November 9, 2015 Category: Information Technology Authors: Moskow, J. M., Cook, N., Champion-Lippmann, C., Amofah, S. A., Garcia, A. S. Tags: Research and Applications Source Type: research

VERTIcal Grid lOgistic regression (VERTIGO)
Conclusion The proposed VERTIGO algorithm can generate accurate global models to support federated data analysis of vertically partitioned data. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 9, 2015 Category: Information Technology Authors: Li, Y., Jiang, X., Wang, S., Xiong, H., Ohno-Machado, L. Tags: Research and Applications Source Type: research

Dispatch from the non-HITECH-incented Health IT world: electronic medication history adoption and utilization
Objective To document national trends of electronic medication history use in the ambulatory setting and describe the characteristics and predicting factors of providers who regularly use medication history transaction capabilities through their e-prescribing systems.Materials and Methods The study used provider-initiated medication history data requests, electronically sent over an e-prescribing network from all 50 states and the District of Columbia. Data from 138,000 prescribers were evaluated using multivariate analyses from 2007 to 2013.Results Medication history use showed significant growth, increasing from 8 to 850...
Source: Journal of the American Medical Informatics Association - November 9, 2015 Category: Information Technology Authors: Gabriel, M. H., Smith, J. Y., Sow, M., Charles, D., Joseph, S., Wilkins, T. L. Tags: Research and Applications Source Type: research

Multilayered temporal modeling for the clinical domain
Conclusion Presented here is the first open-source clinical temporal relation discovery system. It was built using a multilayered temporal modeling strategy and achieved top performance in 2 major shared tasks. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 31, 2015 Category: Information Technology Authors: Lin, C., Dligach, D., Miller, T. A., Bethard, S., Savova, G. K. Tags: Research and Applications Source Type: research

Identifying unmet informational needs in the inpatient setting to increase patient and caregiver engagement in the context of pediatric hematopoietic stem cell transplantation
Conclusion Pediatric HSCT caregivers and patients have multiple informational needs that could be met with a health information technology system that integrates data from several sources, including electronic health records. Meeting these needs could reduce patients’ and caregivers’ anxiety surrounding the care process; reduce information asymmetry between caregivers/patients and providers; empower patients/caregivers to participate in the care process; and, ultimately, increase patient/caregiver engagement in the care process. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 28, 2015 Category: Information Technology Authors: Kaziunas, E., Hanauer, D. A., Ackerman, M. S., Choi, S. W. Tags: Research and Applications Source Type: research

Evaluating the implementation of RxNorm in ambulatory electronic prescriptions
This study illustrates the need for technology vendors to improve their implementation of RxNorm; doing so will accelerate the adoption of RxNorm as the preferred alternative to using the NDC terminology in e-prescribing. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 28, 2015 Category: Information Technology Authors: Dhavle, A. A., Ward-Charlerie, S., Rupp, M. T., Kilbourne, J., Amin, V. P., Ruiz, J. Tags: Research and Applications Source Type: research

Evaluating the potential impact of a mobile telemedicine system on coordination of specialty care for patients with complicated oral lesions in Botswana
This study explores the potential impact of a mobile oral telemedicine system on the oral health specialty referral system in Botswana. Analysis of 26 eligible cases from June 2012 to July 2013 reveals high diagnosis concordance between dental officers and oral health specialists at 91.3% (21/23) but significant management plan discordance at 64.0% (16/25), over two-thirds of which involved the specialists disagreeing with the referring clinicians about the need for a visit to a specialist. These findings suggest mobile telemedicine can optimize the use of insights and skills of specialists remotely in regions where they a...
Source: Journal of the American Medical Informatics Association - October 28, 2015 Category: Information Technology Authors: Tesfalul, M., Littman-Quinn, R., Antwi, C., Ndlovu, S., Motsepe, D., Phuthego, M., Tau, B., Mohutsiwa-Dibe, N., Kovarik, C. Tags: Brief Communication Source Type: research

The Impact of Health Information Technology on Cancer Care across the Continuum: A Systematic Review and Meta-Analysis
Conclusion Based on current evidence, HIT interventions seem to be more successful when targeting physicians, care in the prevention phase of the cancer continuum, and/or decision making. An agenda for future research is discussed. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 24, 2015 Category: Information Technology Authors: Tarver, W. L., Menachemi, N. Tags: Review Source Type: research

An In silico method to identify computer-based protocols worthy of clinical study: An Insulin infusion protocol use case
Objective Develop an efficient non-clinical method for identifying promising computer-based protocols for clinical study. An in silico comparison can provide information that informs the decision to proceed to a clinical trial. The authors compared two existing computer-based insulin infusion protocols: eProtocol-insulin from Utah, USA, and Glucosafe from Denmark.Materials and Methods The authors used eProtocol-insulin to manage intensive care unit (ICU) hyperglycemia with intravenous (IV) insulin from 2004 to 2010. Recommendations accepted by the bedside clinicians directly link the subsequent blood glucose values to ePro...
Source: Journal of the American Medical Informatics Association - October 24, 2015 Category: Information Technology Authors: Wong, A. F., Pielmeier, U., Haug, P. J., Andreassen, S., Morris, A. H. Tags: Research and Applications Source Type: research

Provider variation in responses to warnings: do the same providers run stop signs repeatedly?
Conclusions The decision to override prescribing warnings shows variation between providers, and the magnitude of variation differs among the clinical domains of the warnings; more variation was observed in areas with more inappropriate overrides. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 24, 2015 Category: Information Technology Authors: Beeler, P. E., Orav, E. J., Seger, D. L., Dykes, P. C., Bates, D. W. Tags: Research and Applications Source Type: research

Cheminformatics-aided pharmacovigilance: application to Stevens-Johnson Syndrome
Conclusions We have demonstrated that QSAR models can accurately identify SJS active and inactive drugs. Requiring chemical structures only, QSAR models provide effective computational means to flag potentially harmful drugs for subsequent targeted surveillance and pharmacoepidemiologic investigations. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 24, 2015 Category: Information Technology Authors: Low, Y. S., Caster, O., Bergvall, T., Fourches, D., Zang, X., Noren, G. N., Rusyn, I., Edwards, R., Tropsha, A. Tags: Research and Applications Source Type: research

Alert dwell time: introduction of a measure to evaluate interruptive clinical decision support alerts
In this study, the authors determined whether alert dwell time—the time elapsed from when an interruptive alert is generated to when it is dismissed—could be calculated by using historical alert data from log files. Drug–drug interaction (DDI) alerts from 3 years of electronic health record data were queried. Alert dwell time was calculated for 25,965 alerts, including 777 unique DDIs. The median alert dwell time was 8 s (range, 1–4913 s). Resident physicians had longer median alert dwell times than other prescribers (P
Source: Journal of the American Medical Informatics Association - October 24, 2015 Category: Information Technology Authors: McDaniel, R. B., Burlison, J. D., Baker, D. K., Hasan, M., Robertson, J., Hartford, C., Howard, S. C., Sablauer, A., Hoffman, J. M. Tags: Brief Communication Source Type: research

Text message reminders do not improve hepatitis B vaccination rates in an Australian sexual health setting
Conclusion Clinician prompts to reduce missed opportunities and multiple recall interventions may be needed to increase HBV vaccination completion in this high risk population. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 24, 2015 Category: Information Technology Authors: McIver, R., Dyda, A., McNulty, A. M., Knight, V., Wand, H. C., Guy, R. J. Tags: Research and Applications Source Type: research

Food entries in a large allergy data repository
Conclusion New strategies are needed to represent and standardize food adverse sensitivity concepts, to improve documentation in EHRs. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 17, 2015 Category: Information Technology Authors: Plasek, J. M., Goss, F. R., Lai, K. H., Lau, J. J., Seger,, D. L., Blumenthal, K. G., Wickner, P. G., Slight, S. P., Chang, F. Y., Topaz, M., Bates, D. W., Zhou, L. Tags: Research and Applications Source Type: research

Quantifying usability: an evaluation of a diabetes mHealth system on effectiveness, efficiency, and satisfaction metrics with associated user characteristics
Conclusion Using the ISO 9241-11 usability standard, the SUS instrument for satisfaction and measuring user characteristics provided objective measures of patients’ experienced usability. These could serve as an exemplar for standardized, quantitative methods for usability studies on mHealth systems. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 15, 2015 Category: Information Technology Authors: Georgsson, M., Staggers, N. Tags: Research and Applications Source Type: research

Incorporating longitudinal pediatric patient-centered outcome measurement into the clinical workflow using a commercial electronic health record: a step toward increasing value for the patient
This study describes how Texas Children’s Hospital customized a commercial EHR system and assembled a cross-functional team to capture outcomes data using existing functionality. Prior to its installation and customization, no surgical subspecialties besides the congenital heart and transplant surgery groups conducted prospective, patient outcomes measurement, but by 2015, the outcomes of over 1300 unique patients with supracondylar fractures, cleft lip and/or palate, or voiding dysfunction had been tracked. Key factors for integrating outcomes measurement into the clinical workflow include ongoing communication betw...
Source: Journal of the American Medical Informatics Association - September 15, 2015 Category: Information Technology Authors: Carberry, K., Landman, Z., Xie, M., Feeley, T., Henderson, J., Fraser, C. Tags: Case Report Source Type: research

Real-time prediction of mortality, readmission, and length of stay using electronic health record data
Conclusions Bayesian Networks can model EHRs to provide real-time forecasts for patient outcomes, which provide richer information than traditional independent point predictions of length of stay, death, or readmission, and can thus better support decision making. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 15, 2015 Category: Information Technology Authors: Cai, X., Perez-Concha, O., Coiera, E., Martin-Sanchez, F., Day, R., Roffe, D., Gallego, B. Tags: Research and Applications Source Type: research

A design of experiments approach to validation sampling for logistic regression modeling with error-prone medical records
Conclusions The simulation comparisons demonstrate that this DSCVR approach can produce predictive models that are significantly better than those produced from random validation sampling, especially when the event rate is low. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 15, 2015 Category: Information Technology Authors: Ouyang, L., Apley, D. W., Mehrotra, S. Tags: Research and Applications Source Type: research

Assessment of patient engagement with a mobile application among service members in transition
This article examines engagement with a mobile application ("mCare") for wounded Service Members rehabilitating in their communities. Many had behavioral health problems, Traumatic Brain Injury (TBI), and/or post-traumatic stress disorder (PTS). The article also examines associations between Service Members’ background characteristics and their engagement with mCare.Materials and Methods: This analysis included participants who received mCare (n = 95) in a randomized controlled trial. mCare participants received status questionnaires daily for up to 36 weeks. Participant engagement encompasses exposure to m...
Source: Journal of the American Medical Informatics Association - September 11, 2015 Category: Information Technology Authors: Pavliscsak, H., Little, J. R., Poropatich, R. K., McVeigh, F. L., Tong, J., Tillman, J. S., Smith, C. H., Fonda, S. J. Tags: Research and Applications Source Type: research

Participatory design of ehealth solutions for women from vulnerable populations with perinatal depression
Conclusion Longitudinal participatory design groups are a promising, highly feasible approach to developing technology for underserved populations. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 5, 2015 Category: Information Technology Authors: Gordon, M., Henderson, R., Holmes, J. H., Wolters, M. K., Bennett, I. M., the SPIRIT (Stress in Pregnancy: Improving Results with Interactive Technology) Group Tags: Brief Communication Source Type: research

Desiderata for computable representations of electronic health records-driven phenotype algorithms
Conclusion A computable PheRM is needed for true phenotype portability and reliability across different EHR products and healthcare systems. These desiderata are a guide to inform the establishment and evolution of EHR phenotype algorithm authoring platforms and languages. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 5, 2015 Category: Information Technology Authors: Mo, H., Thompson, W. K., Rasmussen, L. V., Pacheco, J. A., Jiang, G., Kiefer, R., Zhu, Q., Xu, J., Montague, E., Carrell, D. S., Lingren, T., Mentch, F. D., Ni, Y., Wehbe, F. H., Peissig, P. L., Tromp, G., Larson, E. B., Chute, C. G., Pathak, J., Denny, J Tags: Research and Applications Source Type: research

Patient and physician predictors of patient receipt of therapies recommended by a computerized decision support system when initially prescribed broad-spectrum antibiotics: a cohort study
Conclusions We observed that ICU admission and renal impairment were negative predictors of patients’ receipt of CDSS-recommended antibiotic therapies. Patients admitted to ICU and those with renal impairment might have more complex clinical conditions that require a physician's assessment in addition to antibiotic CDSS. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 5, 2015 Category: Information Technology Authors: Chow, A. L., Lye, D. C., Arah, O. A. Tags: Research and Applications Source Type: research

Cardiac catheterization laboratory inpatient forecast tool: a prospective evaluation
Conclusion Data-driven predictive analytics may be used to accurately forecast daily demand for inpatient beds for cardiac catheterization patients. Connecting these analytics to EMR data sources has the potential to provide advanced operational decision support. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 5, 2015 Category: Information Technology Authors: Toerper, M. F., Flanagan, E., Siddiqui, S., Appelbaum, J., Kasper, E. K., Levin, S. Tags: Research and Applications Source Type: research

Using a configurable EMR and decision support tools to promote process integration for routine HIV screening in the emergency department
Given the clinical and public health benefits of routine Human Immunodeficiency Virus (HIV) testing in the emergency department (ED) and Centers for Disease Control and Prevention recommendations, Maricopa Medical Center, as part of Maricopa Integrated Health System, started Test, Educate, Support, and Treat Arizona (TESTAZ) and became the first and, to-date, only hospital in Arizona to implement routine, non-targeted, opt-out, rapid HIV screening in the ED. The authors describe the implementation of a universal, routine, opt-out HIV screening program in the adult ED of an urban safety-net hospital serving under-served pop...
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: McGuire, R., Moore, E. Tags: Case Report Source Type: research

The evolution of the market for commercial computerized physician order entry and computerized decision support systems for prescribing
Conclusions The CPOE/CDS market in England is still in an emergent phase. The rapid entrance of diverse products, triggered by federal policy initiatives, has resulted in premature adoption of systems that do not yet adequately meet the needs of hospitals. Vendors and adopters lacked understanding of how to design and implement generic solutions to meet diverse user needs. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Mozaffar, H., Williams, R., Cresswell, K., Morrison, Z., Bates, D. W., Sheikh, A. Tags: Research and Applications Source Type: research

A case study in open source innovation: developing the Tidepool Platform for interoperability in type 1 diabetes management
Conclusion The authors believe that the Tidepool Platform can solve two current problems in the T1D device landscape: 1) limited access to T1D device data and 2) poor interoperability of data from different devices. If proven effective, Tidepool’s open source, cloud model for health data interoperability is applicable to other healthcare use cases. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Neinstein, A., Wong, J., Look, H., Arbiter, B., Quirk, K., McCanne, S., Sun, Y., Blum, M., Adi, S. Tags: Research and Applications Source Type: research

Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?
Conclusions Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: O'Connor, S. D., Dalal, A. K., Sahni, V. A., Lacson, R., Khorasani, R. Tags: Research and Applications Source Type: research

The myth of standardized workflow in primary care
Conclusions Future healthcare redesigns should support a wide variety of task sequences to deliver high-quality primary care. The development of tools such as electronic health records must be based on the realities of primary care visits if they are to successfully support a PCP’s mental and physical work, resulting in effective, safe, and efficient primary care. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Holman, G. T., Beasley, J. W., Karsh, B.-T., Stone, J. A., Smith, P. D., Wetterneck, T. B. Tags: Research and Applications Source Type: research

What do we know about developing patient portals? a systematic literature review
Conclusion Our findings support a set of recommendations for advancement of the evidence base: future research should build on existing evidence, draw on principles from design sciences conveyed in the problem-solving cycle, and seek to produce evidence within various different organizational contexts. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Otte-Trojel, T., de Bont, A., Rundall, T. G., van de Klundert, J. Tags: Review Source Type: research

Opportunities and challenges in the use of personal health data for health research
Conclusion: Although challenges exist in leveraging PHD for research, there are many opportunities for stakeholder engagement, and experimentation with these data is already taking place. These early examples foreshadow a much larger set of activities with the potential to positively transform how health research is conducted. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Bietz, M. J., Bloss, C. S., Calvert, S., Godino, J. G., Gregory, J., Claffey, M. P., Sheehan, J., Patrick, K. Tags: Research and Applications Source Type: research

A new visual navigation system for exploring biomedical Open Educational Resource (OER) videos
Conclusion Using the proposed tool, users can efficiently and effectively find videos of interest, precisely locate video segments delivering personally valuable information, as well as intuitively and conveniently preview essential content of a single or a collection of videos. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Zhao, B., Xu, S., Lin, S., Luo, X., Duan, L. Tags: Research and Applications Source Type: research

Refilling medications through an online patient portal: consistent improvements in adherence across racial/ethnic groups
Conclusion In a well-controlled examination of diabetes patients’ behavior when using a new online feature for their healthcare management, patient portals were linked to better medication adherence across all racial/ethnic groups. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Lyles, C. R., Sarkar, U., Schillinger, D., Ralston, J. D., Allen, J. Y., Nguyen, R., Karter, A. J. Tags: Research and Applications Source Type: research

Medication-indication knowledge bases: a systematic review and critical appraisal
Conclusion This is the first study directly comparing public KBs of medication indications. We identified several gaps in the existing resources, which can motivate future research. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Salmasian, H., Tran, T. H., Chase, H. S., Friedman, C. Tags: Review Source Type: research

Combining billing codes, clinical notes, and medications from electronic health records provides superior phenotyping performance
Conclusion Multiple EHR components provide a more consistent and higher performance than a single one for the selected phenotypes. We suggest considering multiple EHR components for future phenotyping design in order to obtain an ideal result. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - September 2, 2015 Category: Information Technology Authors: Wei, W.-Q., Teixeira, P. L., Mo, H., Cronin, R. M., Warner, J. L., Denny, J. C. Tags: Research and Applications Source Type: research

Data integration of structured and unstructured sources for assigning clinical codes to patient stays
Conclusions We demonstrated that models using multiple electronic health record data sources systematically outperform models using data sources in isolation in the task of predicting ICD-9-CM codes over a broad range of medical specialties. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 27, 2015 Category: Information Technology Authors: Scheurwegs, E., Luyckx, K., Luyten, L., Daelemans, W., Van den Bulcke, T. Tags: Research and Applications Source Type: research

Report of the AMIA EHR 2020 task force on the status and future direction of EHRs
(Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 17, 2015 Category: Information Technology Authors: Payne, T. H., Corley, S., Cullen, T. A., Gandhi, T. K., Harrington, L., Kuperman, G. J., Mattison, J. E., McCallie, D. P., McDonald, C. J., Tang, P. C., Tierney, W. M., Weaver, C., Weir, C. R., Zaroukian, M. H. Tags: Amia Position Paper Source Type: research