An environmental scan of shared access to patient portals
AbstractWe sought to understand the comprehensiveness of consumer-oriented information describing the availability of shared access to adult patient portals from publicly reported information on institutional websites of 20 large and geographically diverse health systems. All 20 health systems reported that they offer patients the ability to share access to their patient portal account with a family member or friend; however, the comprehensiveness of information regarding registration procedures, features, and terminology varied widely. Half of the systems (n = 10) reported having shared access available on t...
Source: Journal of the American Medical Informatics Association - August 25, 2017 Category: Information Technology Source Type: research

Are participants concerned about privacy and security when using short message service to report product adherence in a rectal microbicide trial?
ConclusionShort ID-related passwords, ambiguous language, and reminders to implement privacy and security-enhancing behaviors are recommended for SMS systems. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 24, 2017 Category: Information Technology Source Type: research

Re: Unit conversions between LOINC codes Published June 19, 2017
We applaud the work of Hauser et  al.,1 who have realized the potential for converting result values associated with one Logical Observation Identifiers Names and Codes (LOINC) term to those associated with another through mathematical operations. They applied these transforms to pairs of terms in several categories, including those expressed as molar versus mass units, simple counts on different scales, linear versus log values, and 2 terms that are inverses of each other. The authors also listed several interesting, but more problematic, conversion pairs, some of which might be grist for future work. They carefully ...
Source: Journal of the American Medical Informatics Association - August 23, 2017 Category: Information Technology Source Type: research

Lessons learned from piloting mHealth informatics practice curriculum into a medical elective
AbstractIntroductionThis case study reports the development and delivery of an mHealth elective piloted for first-year undergraduate medical students at Monash University (Australia) and the lessons learned by designers.ResultsThe students were not as adept at using mHealth devices as the literature had predicted. Expert speakers using mHealth for practice perceptibly engaged students. Force-field analysis was a useful basis for devising end-user evaluative research tools for practice. Combining small- and large-group discussions with eLearning discussions promoted student engagement with new concepts and associated jargon...
Source: Journal of the American Medical Informatics Association - August 23, 2017 Category: Information Technology Source Type: research

Electronic health record adoption in US hospitals: the emergence of a digital “advanced use” divide
AbstractObjectiveWhile most hospitals have adopted electronic health records (EHRs), we know little about whether hospitals use EHRs in advanced ways that are critical to improving outcomes, and whether hospitals with fewer resources – small, rural, safety-net – are keeping up.Materials and MethodsUsing 2008 –2015 American Hospital Association Information Technology Supplement survey data, we measured “basic” and “comprehensive” EHR adoption among hospitals to provide the latest national numbers. We then used new supplement questions to assess advanced use of EHRs and EHR data forp...
Source: Journal of the American Medical Informatics Association - August 22, 2017 Category: Information Technology Source Type: research

Association between workarounds and medication administration errors in bar-code-assisted medication administration in hospitals
ConclusionIn hospitals using barcode-assisted medication administration, workarounds occurred in 66% of medication administrations and were associated with large numbers of medication administration errors. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 22, 2017 Category: Information Technology Source Type: research

Implementing prescription drug monitoring and other clinical decision support for opioid risk mitigation in a military health care setting: a qualitative feasibility study
ConclusionMilitary providers were skeptical regarding the feasibility of MHS-based PDMP implementation, but provided important recommendations for CDS to support safe and appropriate opioid prescribing in military health care. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 21, 2017 Category: Information Technology Source Type: research

Biases introduced by filtering electronic health records for patients with “complete data”
ConclusionAs investigators design studies, they need to balance their confidence in the completeness of the data with the effects of placing requirements on the data on the resulting patient cohort. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - August 1, 2017 Category: Information Technology Source Type: research

Efficiency and safety of speech recognition for documentation in the electronic health record
AbstractObjective: To compare the efficiency and safety of using speech recognition (SR) assisted clinical documentation within an electronic health record (EHR) system with use of keyboard and mouse (KBM).Methods: Thirty-five emergency department clinicians undertook randomly allocated clinical documentation tasks using KBM or SR on a commercial EHR system. Tasks were simple or complex, and with or without interruption. Outcome measures included task completion times and observed errors. Errors were classed by their potential for patient harm. Error causes were classified as due to IT system/system integration, user inter...
Source: Journal of the American Medical Informatics Association - July 27, 2017 Category: Information Technology Source Type: research

NLPReViz: an interactive tool for natural language processing on clinical text
We report changes in performance relative to the quantity of feedback. Using initial training sets as small as 10 documents, expert review led to finalF1scores for the “appendiceal-orifice” variable between 0.78 and 0.91 (with improvements ranging from 13.26% to 29.90%).F1for “biopsy” ranged between 0.88 and 0.94 (−1.52% to 11.74% improvements). The average System Usability Scale score was 70.56. Subjective feedback also suggests possible design improvements. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - July 22, 2017 Category: Information Technology Source Type: research

A genome-by-environment interaction classifier for precision medicine: personal transcriptome response to rhinovirus identifies children prone to asthma exacerbations
Conclusion: The proposed framework provides an innovative approach to precision medicine. We show that quantifying personal pathway –level transcriptomic response to a disease-relevant environmental challenge predicts disease progression. This genome-by-environment interaction assay offers a noninvasive opportunity to translate omics data to clinical practice by improving the ability to predict disease exacerbation and increas ing the potential to produce more effective treatment decisions. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - July 22, 2017 Category: Information Technology Source Type: research

A technology-based patient and family engagement consult service for the pediatric hospital setting
Conclusion: This service is the first of its kind, offering a potentially generalizable and scalable approach to assessing health-related needs, meeting them with technologies, and promoting patient and family engagement in the inpatient setting. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - July 22, 2017 Category: Information Technology Source Type: research

Implementation of a scalable, web-based, automated clinical decision support risk-prediction tool for chronic kidney disease using C-CDA and application programming interfaces
Conclusions: We validated the use of interoperable documents and open-source components to develop a low-cost tool for automated clinical decision support. Since Consolidated Clinical Document Architecture –based data extraction extends to any certified EHR, this demonstrates a successful modular approach to clinical decision support. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - July 20, 2017 Category: Information Technology Source Type: research

Formalizing drug indications on the road to therapeutic intent
AbstractTherapeutic intent, the reason behind the choice of a therapy and the context in which a given approach should be used, is an important aspect of medical practice. There are unmet needs with respect to current electronic mapping of drug indications. For example, the active ingredient sildenafil has 2 distinct indications, which differ solely on dosage strength. In progressing toward a practice of precision medicine, there is a need to capture and structure therapeutic intent for computational reuse, thus enabling more sophisticated decision-support tools and a possible mechanism for computer-aided drug repurposing....
Source: Journal of the American Medical Informatics Association - July 17, 2017 Category: Information Technology Source Type: research

Automatable algorithms to identify nonmedical opioid use using electronic data: a systematic review
Conclusion: Automated algorithms may facilitate identification of patients and/or providers most likely to need more intensive screening and/or intervention for nonmedical opioid use. Additional implementation research in real-world settings would clarify their utility. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - July 12, 2017 Category: Information Technology Source Type: research

Mining 100 million notes to find homelessness and adverse childhood experiences: 2 case studies of rare and severe social determinants of health in electronic health records
Conclusion: We provide an efficient solution for mining homelessness and ACE information from EHRs, which can facilitate large clinical and genetic studies of these social determinants of health. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - July 8, 2017 Category: Information Technology Source Type: research

Tissue specificity of in  vitro drug sensitivity
Conclusion: Our meta-analysis of pan-cancer drug screening datasets indicates that most tested drugs exhibit tissue-specific sensitivities in a large panel of cancer cell lines. However, the observed preclinical results do not translate to the clinical setting. Our results suggest that additional research into showing parallels between preclinical and clinical data is required to increase the translational potential of in  vitro drug screening. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - July 7, 2017 Category: Information Technology Source Type: research

Development and validation of an electronic medical record (EMR)-based computed phenotype of HIV-1 infection
Conclusions: EMR-based phenotypes of HIV infection are capable of detecting cases of HIV-infected adults with good sensitivity and specificity. These algorithms have the potential to be adapted to other EMR systems, allowing for the creation of cohorts of patients across EMR systems. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - June 22, 2017 Category: Information Technology Source Type: research

Development of an electronic medical record –based child physical abuse alert system
AbstractObjective: Physical abuse is a leading cause of pediatric morbidity and mortality. Physicians do not consistently screen for abuse, even in high-risk situations. Alerts in the electronic medical record may help improve screening rates, resulting in early identification and improved outcomes.Methods: Triggers to identify children  
Source: Journal of the American Medical Informatics Association - June 21, 2017 Category: Information Technology Source Type: research

Participatory design of probability-based decision support tools for in-hospital nurses
Conclusions: Participatory design served as a valuable method in taking the first step toward developing PB-CDS tools for nurses. This information about preferred design elements of tools that support, rather than interrupt, nurses ’ cognitive workflows can benefit future studies in this field as well as nurses’ practice. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - June 19, 2017 Category: Information Technology Source Type: research

Unit conversions between LOINC codes
AbstractLogical Observation Identifiers Names and Codes (LOINC) is the most widely used controlled vocabulary to identify laboratory tests. A given laboratory test can often be reported in more than 1 unit of measure (eg, grams or moles), and LOINC defines unique codes for each unit. Consequently, an identical laboratory test performed by 2 different clinical laboratories may have different LOINC codes. The absence of unit conversions between compatible LOINC codes impedes data aggregation and analysis of laboratory results. To develop such conversions, a computational process was developed to review the LOINC standard for...
Source: Journal of the American Medical Informatics Association - June 19, 2017 Category: Information Technology Source Type: research

An informatics research agenda to support patient and family empowerment and engagement in care and recovery during and after hospitalization
AbstractAs part of an interdisciplinary acute care patient portal task force with members from 10 academic medical centers and professional organizations, we held a national workshop with 71 attendees representing over 30 health systems, professional organizations, and technology companies. Our consensus approach identified 7  key sociotechnical and evaluation research focus areas related to the consumption and capture of information from patients, care partners (eg, family, friends), and clinicians through portals in the acute and post-acute care settings. The 7 research areas were: (1) standards, (2) privacy and s...
Source: Journal of the American Medical Informatics Association - June 17, 2017 Category: Information Technology Source Type: research

The use of Twitter to facilitate sharing of clinical expertise in urology
AbstractThe use of social media in the urologic community is common and increasing. Although the potential benefits of platforms like Twitter have been described in the literature, the use of social media in the clinical context of Urology has not been explored.In this case report, we describe how we used Twitter to share ideas about the clinical management of a complex urologic patient. By posting a clinical scenario, a timely discussion was generated with global participation and expert suggestions. This knowledge was applied to the surgical management of a patient with positive clinical outcomes.The ability of Twitter t...
Source: Journal of the American Medical Informatics Association - June 7, 2017 Category: Information Technology Source Type: research

Implications of electronic health record downtime: an analysis of patient safety event reports
Conclusion: EHR downtime events pose patient safety hazards, and we highlight critical areas for downtime procedure improvement. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 30, 2017 Category: Information Technology Source Type: research

Sharing and helping: predictors of adolescents ’ willingness to share diabetes personal health information with peers
This study examines factors underlying adolescents ’ willingness to share personal T1D information with peers.Materials and Methods:Participants were 134 adolescents (12 –17 years of age; 56% female) who completed an online survey regarding experiences helping others with T1D, perceived social resources, beliefs about the value of sharing information and helping others, and willingness to share T1D information. Hemoglobin A1c values were obtained from medical reco rds.Results:Adolescents were more willing to share how they accomplished T1D tasks than how often they completed them, and least willing to share glu...
Source: Journal of the American Medical Informatics Association - May 29, 2017 Category: Information Technology Source Type: research

Identifying reports of randomized controlled trials (RCTs) via a hybrid machine learning and crowdsourcing approach
Conclusions: Hybrid crowd-ML strategies warrant further exploration for biomedical curation/annotation tasks. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 25, 2017 Category: Information Technology Source Type: research

Evidence appraisal: a scoping review, conceptual framework, and research agenda
Conclusions:Evidence appraisal faces several challenges, but implementing an informatics research agenda would likely help realize the potential of evidence appraisal for improving the rigor and value of clinical evidence. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 24, 2017 Category: Information Technology Source Type: research

Electronic clinical quality measure reporting challenges: findings from the Medicare EHR Incentive Program ’s Controlling High Blood Pressure Measure
Conclusion: With careful selection of measures relevant to the clinician ’s specialty, complete data entry, and support for continuous quality improvement, health care professionals can excel technically and clinically. As care delivery transitions from fee-for-service to quality- and value-based models, high performers may realize financial gains and better patient ou tcomes. These analyses suggest patterns that may inform steps to improve performance. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 19, 2017 Category: Information Technology Source Type: research

Asynchronous automated electronic laboratory result notifications: a systematic review
Conclusion:Several asynchronous automated electronic notification systems for laboratory results have been evaluated, most from>10 years ago. Further research on the effect of notifications on clinicians as well as the use of modern electronic health records and new methods of notification is warranted to determine their effects on workflow and clinical outcomes. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 18, 2017 Category: Information Technology Source Type: research

Mining e-cigarette adverse events in social media using Bi-LSTM recurrent neural network with word embedding representation
Conclusion: Although the conditional random field baseline model had slightly better precision than our approach, our Bi-LSTM model achieved much higher recall, resulting in the best F-measure. Our method can be generalized to extract medical concepts from social media for other medical applications. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 13, 2017 Category: Information Technology Source Type: research

Effect of health information exchange on recognition of medication discrepancies is interrupted when data charges are introduced: results of a cluster-randomized controlled trial
Conclusion: HIE may improve outcomes of medication reconciliation. Charging for access to medication information interrupts this effect. Efforts are needed to understand and increase prescribers ’ rectification of medication discrepancies. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 13, 2017 Category: Information Technology Source Type: research

Graph-based semi-supervised learning with genomic data integration using condition-responsive genes applied to phenotype classification
Conclusions: Simulation results demonstrate that integrating various data types enhances classification performance and leads to a better understanding of interrelations between diverse omics data types. The proposed approach outperforms many of the state-of-the-art data integration algorithms. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 13, 2017 Category: Information Technology Source Type: research

LabRS: A Rosetta stone for retrospective standardization of clinical laboratory test results
Objective: Clinical laboratories in the United States do not have an explicit result standard to report the 7 billion laboratory tests results they produce each year. The absence of standardized test results creates inefficiencies and ambiguities for secondary data users. We developed and tested a tool to standardize the results of laboratory tests in a large, multicenter clinical data warehouse.Methods: Laboratory records, each of which consisted of a laboratory result and a test identifier, from 27 diverse facilities were captured from 2000 through 2015. Each record underwent a standardization process to convert the orig...
Source: Journal of the American Medical Informatics Association - May 12, 2017 Category: Information Technology Source Type: research

Constructing the informatics and information technology foundations of a medical device evaluation system: a report from the FDA unique device identifier demonstration
Conclusion: The demonstration provided proof of concept that UDIs can be incorporated into provider and enterprise electronic information systems and used as the index key to combine device and clinical data in a database useful for device evaluation. Keys to success and challenges to achieving this goal were identified. Fundamental informatics principles were central to accomplishing the system of systems model. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - May 3, 2017 Category: Information Technology Source Type: research

Information technology to support patient engagement: where do we stand and where can we go?
Conclusion: While hospitals have reached modest levels of adoption of PE technologies, consistent monitoring of this capacity can identify opportunities to use technology to facilitate engagement. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - April 28, 2017 Category: Information Technology Source Type: research

The impact of home care nurses ’ numeracy and graph literacy on comprehension of visual display information: implications for dashboard design
Conclusion: Clinical dashboards are increasingly used to provide information to clinicians in visualized format, under the assumption that visual display reduces cognitive workload. Results of this study suggest that nurses ’ comprehension of visualized information is influenced by their numeracy, graph literacy, and the display format of the data. Individual differences in numeracy and graph literacy skills need to be taken into account when designing dashboard technology. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - April 27, 2017 Category: Information Technology Source Type: research

Patient and provider perspectives on the potential value and use of a bilingual online patient portal in a Spanish-speaking safety-net population
Conclusion: Bilingual patient portal implementation has considerable potential to promote health care engagement within Spanish-speaking safety-net populations; however, lack of provider engagement in the process could undermine the effort. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - April 27, 2017 Category: Information Technology Source Type: research

Automated identification of implausible values in growth data from pediatric electronic health records
Conclusion: This automated, flexible, and validated method for preparing large datasets will facilitate the use of pediatric EHR growth datasets for research. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - April 26, 2017 Category: Information Technology Source Type: research

Challenges in adapting existing clinical natural language processing systems to multiple, diverse health care settings
Conclusions: A key challenge in widespread application of NLP is adapting existing systems to new clinical settings. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - April 17, 2017 Category: Information Technology Source Type: research

A national survey assessing the number of records allowed open in electronic health records at hospitals and ambulatory sites
To reduce the risk of wrong-patient errors, safety experts recommend limiting the number of patient records providers can open at once in electronic health records (EHRs). However, it is unknown whether health care organizations follow this recommendation or what rationales drive their decisions. To address this gap, we conducted an electronic survey via 2 national listservs. Among 167 inpatient and outpatient study facilities using EHR systems designed to open multiple records at once, 44.3% were configured to allow ≥3 records open at once (unrestricted), 38.3% allowed only 1 record open (restricted), and 17.4% allowed...
Source: Journal of the American Medical Informatics Association - April 17, 2017 Category: Information Technology Source Type: research

A longitudinal analysis of data quality in a large pediatric data research network
Conclusion: While data quality is recognized as a critical aspect in establishing and utilizing a CDRN, the findings from data quality assessments are largely unpublished. This paper presents a real-world account of studying and interpreting data quality findings in a pediatric CDRN, and the lessons learned could be used by other CDRNs. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - April 8, 2017 Category: Information Technology Source Type: research

EliIE: An open-source information extraction system for clinical trial eligibility criteria
Conclusions: This study presents EliIE, an OMOP CDM–based information extraction system for automatic structuring and formalization of free-text EC. According to our evaluation, machine learning-based EliIE outperforms existing systems and shows promise to improve. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - April 1, 2017 Category: Information Technology Source Type: research

Using electronic medical record notes to measure ICU telemedicine utilization
Given the complexity of high-acuity health care, designing an effective clinical note template can be beneficial to both document patient care and clarify how telemedicine is used. We characterized documented interactions via a standardized note template between bedside intensive care unit (ICU) providers and teleintensivists in 2 Veterans Health Administration ICU telemedicine support centers. All ICUs linked to support centers and providing care from October 2012 through September 2014 were considered. Interactions were assessed based on initiation site, bedside initiator, contact type, and patient care change. Of 14&thi...
Source: Journal of the American Medical Informatics Association - April 1, 2017 Category: Information Technology Source Type: research

Do health information technology self-management interventions improve glycemic control in medically underserved adults with diabetes? A systematic review and meta-analysis
Conclusion: These results are similar to in-person DSME in medically underserved patients, showing that well-designed HIT DSME has the potential to increase access and improve outcomes for this vulnerable group. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - March 31, 2017 Category: Information Technology Source Type: research

Calibration drift in regression and machine learning models for acute kidney injury
Conclusions: Efficient and effective updating protocols will be essential for maintaining accuracy of, user confidence in, and safety of personalized risk predictions to support decision-making. Model updating protocols should be tailored to account for variations in calibration drift across methods and respond to periods of rapid performance drift rather than be limited to regularly scheduled annual or biannual intervals. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - March 31, 2017 Category: Information Technology Source Type: research

Information needs of physicians, care coordinators, and families to support care coordination of children and youth with special health care needs (CYSHCN)
Conclusion: Caring for CYSHCN generates a large amount of information needs that require significant effort from physicians, care coordinators, parents, and various other individuals. CYSHCN are often chronically ill and face developmental challenges that translate into intense demands on time, effort, and resources. Care coordination for CYCHSN involves multiple information systems, specialized resources, and complex decision-making. Solutions currently offered by health information technology fall short in providing support to meet the information needs to perform the complex care coordination tasks. Our findings present...
Source: Journal of the American Medical Informatics Association - March 24, 2017 Category: Information Technology Source Type: research

An analysis of patient-provider secure messaging at two Veterans Health Administration medical centers: message content and resolution through secure messaging
Conclusions: The majority of messages were transactional and initiated by patients or caregivers. Not all content categories were fully addressed over SM. Further education and training for both patients and clinical teams could improve the quality and efficiency of SM communication. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - March 24, 2017 Category: Information Technology Source Type: research

Patient portals and broadband internet inequality
Background: Patient portals have shown potential for increasing health care quality and efficiency. Internet access and other factors influencing patient portal use could worsen health disparities.Methods: Observational study of adults with 1 or more visits to the outpatient clinics of an urban public health care system from 2012 to 2015. We used mixed effects logistic regression to evaluate the association between broadband internet access and (1) patient portal initiation (whether a patient logged in at least 1 time) and (2) messaging, controlling for demographic and neighborhood characteristics.Results: There were 243&t...
Source: Journal of the American Medical Informatics Association - March 24, 2017 Category: Information Technology Source Type: research

Does electronic stewardship work?
AbstractFaced with national requirements to promote antimicrobial stewardship and reduce drug-resistant infections, community hospitals are challenged to make the best use of existing resources. Eighteen months after building antibiotic decision support into our electronic order platform, high-risk antibiotic use decreased by 83% (P 
Source: Journal of the American Medical Informatics Association - March 21, 2017 Category: Information Technology Source Type: research

Development of an automated assessment tool for MedWatch reports in the FDA adverse event reporting system
Conclusion: Our models produced prioritized report orderings that enable FDA safety evaluators to focus on reports that are more likely to contain valuable medication-related adverse event information. Applying our models to all FDA adverse event reports has the potential to streamline the manual review process and greatly reduce reviewer workload. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - March 21, 2017 Category: Information Technology Source Type: research