Designing risk prediction models for ambulatory no-shows across different specialties and clinics
ConclusionOverall, this work highlights both the opportunity for and the importance of leveraging the available electronic health record data to develop more refined risk models. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - February 9, 2018 Category: Information Technology Source Type: research

Dose effect of patient –care team communication via secure portal messaging on glucose and blood pressure control
ConclusionsThe digital divide exists not onlybetween portal users and nonusers but alsoamong portal users. Research exploring the relationship between intensity of bidirectional secure messaging and health outcomes for a broader scope of chronic conditions is needed. Future implementation research must also elucidate best practices that enhance not only theuse of portals by patients and providers, buthow they use portals. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - February 9, 2018 Category: Information Technology Source Type: research

A dashboard-based system for supporting diabetes care
AbstractObjective To describe the development, as part of the European Union MOSAIC (Models and Simulation Techniques for Discovering Diabetes Influence Factors) project, of a dashboard-based system for the management of type 2 diabetes and assess its impact on clinical practice.Methods The MOSAIC dashboard system is based on predictive modeling, longitudinal data analytics, and the reuse and integration of data from hospitals and public health repositories. Data are merged into an i2b2 data warehouse, which feeds a set of advanced temporal analytic models, including temporal abstractions, care-flow mining, drug exposure p...
Source: Journal of the American Medical Informatics Association - February 2, 2018 Category: Information Technology Source Type: research

A snapshot of health information exchange across five nations: an investigation of frontline clinician experiences in emergency care
Conclusion As countries continue to pursue broad-based HIE, they appear to be facing similar challenges in realizing HIE value and therefore have an opportunity to learn from one another. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - February 2, 2018 Category: Information Technology Source Type: research

Tool for filtering PubMed search results by sample size
ConclusionsThe proposed tool was validated as useful for advanced PubMed searches of clinical trials when the user is interested in identifying trials of a given sample size. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - February 1, 2018 Category: Information Technology Source Type: research

Medication class enrichment analysis: a novel algorithm to analyze multiple pharmacologic exposures simultaneously using electronic health record data
ConclusionsIn clinical and simulation studies, MCEA demonstrated superior sensitivity and specificity for identifying pharmacologic classes associated with CDI compared to logistic regression. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - January 25, 2018 Category: Information Technology Source Type: research

Meaningful use ’s benefits and burdens for US family physicians
Conclusion MU was discontinued, but the merit-based incentive payment system within the Medicare Access and CHIP Reauthorization Act of 2015 adopted its criteria. For many physicians, MU created a significant practice burden without clear benefits to patient care. This study suggests that policymakers should not assess MU in aggregate, but as individual criteria for open discussion. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - January 23, 2018 Category: Information Technology Source Type: research

Erratum
Vigo M, Hassan L, Vance W, Jay C, Brass A, and Cruickshank S. Britain Breathing: using the experience sampling method to collect the seasonal allergy symptoms of a country.J Am Med Inform Assoc 2018; 25:88 –92; DOI:https://doi.org/10.1093/jamia/ocx148. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - January 19, 2018 Category: Information Technology Source Type: research

SemEHR: A general-purpose semantic search system to surface semantic data from clinical notes for tailored care, trial recruitment, and clinical research*
ConclusionResults from the multiple case studies demonstrate SemEHR ’s efficiency: weeks or months of work can be done within hours or minutes in some cases. SemEHR provides a more comprehensive view of patients, bringing in more and unexpected insight compared to study-oriented bespoke IE systems. SemEHR is open source, available athttps://github.com/CogStack/SemEHR. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - January 19, 2018 Category: Information Technology Source Type: research

Impact of problem-based charting on the utilization and accuracy of the electronic problem list
We report the effect of PBC on problem list utilization and accuracy at an academic intensive care unit (ICU).Materials and MethodsAn interrupted time series design was used to assess the effect of PBC on problem list utilization, which is defined as the number of new problems added to the problem list by clinicians per patient encounter, and of problem list accuracy, which was determined by calculating the recall and precision of the problem list in capturing 5 common ICU diagnoses.ResultsIn total, 3650 and 4344 patient records were identified before and after PBC implementation at Stanford Hospital. An increase of 2.18 p...
Source: Journal of the American Medical Informatics Association - January 18, 2018 Category: Information Technology Source Type: research

DataMed – an open source discovery index for finding biomedical datasets
ConclusionOur manual review shows that the ingestion pipeline could achieve an accuracy of 90% and core elements of DATS had varied frequency across repositories. On a manually curated benchmark dataset, the DataMed search engine achieved an inferred average precision of 0.2033 and a precision at 10 (P@10, the number of relevant results in the top 10 search results) of 0.6022, by implementing advanced natural language processing and terminology services. Currently, we have made the DataMed system publically available as an open source package for the biomedical community. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - January 13, 2018 Category: Information Technology Source Type: research

Designing and evaluating an automated system for real-time medication administration error detection in a neonatal intensive care unit
In this study, we developed a real-time MAE detection system and evaluated its performance prior to system integration into institutional workflows.Methods. Our prospective observational study included automated MAE detection of 10 high-risk medications and fluids for patients admitted to the neonatal intensive care unit at Cincinnati Children ’s Hospital Medical Center during a 4-month period. The automated system extracted real-time medication use information from the institutional electronic health records and identified MAEs using logic-based rules and natural language processing techniques. The MAE summary was d...
Source: Journal of the American Medical Informatics Association - January 10, 2018 Category: Information Technology Source Type: research

Expanding a radiology lexicon using contextual patterns in radiology reports
DiscussionThe unstructured text of clinical notes contains a wealth of information about human diseases and treatment patterns. However, searching and retrieving information from clinical notes often suffer due to variations in how similar concepts are described in the text. Biomedical lexicons address this challenge, but are expensive to produce and maintain. Distributional semantics algorithms can assist lexicon curation, saving researchers time and money. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - January 10, 2018 Category: Information Technology Source Type: research

Discovering foodborne illness in online restaurant reviews
ConclusionsOur system has been instrumental in the identification of 10 outbreaks and 8523 complaints of foodborne illness associated with New York City restaurants since July 2012. Our evaluation has identified strong classifiers for both tasks, whose deployment will allow DOHMH epidemiologists to more effectively monitor Yelp for foodborne illness investigations. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - January 10, 2018 Category: Information Technology Source Type: research

Interactive or static reports to guide clinical interpretation of cancer genomics
AbstractObjectiveMisinterpretation of complex genomic data presents a major challenge in the implementation of precision oncology. We sought to determine whether interactive genomic reports with embedded clinician education and optimized data visualization improved genomic data interpretation.Materials and MethodsWe conducted a randomized, vignette-based survey study to determine whether exposure to interactive reports for a somatic gene panel, as compared to static reports, improves physicians ’ genomic comprehension and report-related satisfaction (overall scores calculated across 3 vignettes, range 0–18 and ...
Source: Journal of the American Medical Informatics Association - January 5, 2018 Category: Information Technology Source Type: research

Patient portal use and hospital outcomes
ConclusionUse of the patient portal in the inpatient setting may not improve hospital outcomes. Future research should examine the association of portal use with more immediate inpatient health outcomes such as patient experience, patient engagement, medication reconciliation, and prevention of adverse events. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - December 28, 2017 Category: Information Technology Source Type: research

Patient preferences toward an interactive e-consent application for research using electronic health records
ConclusionThis study contributes new insights on how e-consent applications could be designed to ensure that patients ’ information needs are met when seeking consent for research use of health record information. Also, this study offers a potential electronic approach to meeting the new Common Rule requirement that consent documents contain a “concise and focused” presentation of key information followed by more details. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - December 19, 2017 Category: Information Technology Source Type: research

Biomedical informatics and data science: evolving fields with significant overlap
Big data and data science investigations hold great promise for making efficient use of data generated in the course of daily life: from social media transactions, news, and a variety of apps used by a large portion of the world ’s population, including data generated for health care and life sciences research. Data science brings new insights when large-scale datasets are brought together to characterize and address complex problems. The past decade has seen a plethora of federal and private investments in biomedical dat a science collection, organization, and analysis, including the National Institutes of Health&rs...
Source: Journal of the American Medical Informatics Association - December 18, 2017 Category: Information Technology Source Type: research

Corrigendum
In the paper, “Synthea: An approach, method, and software mechanism for generating synthetic patients and the synthetic electronic health care record,” we unfortunately made an error in the citations. The correct citation is as follows: (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - December 15, 2017 Category: Information Technology Source Type: research

A value set for documenting adverse reactions in electronic health records
ConclusionThis work contributes a value set, harmonized with existing data, to improve the consistency and accuracy of reaction documentation in electronic health records, providing the necessary building blocks for more intelligent clinical decision support for allergies and adverse reactions. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - December 14, 2017 Category: Information Technology Source Type: research

Patient perceptions of receiving test results via online portals: a mixed-methods study
ConclusionGiven the absence of national guidance, our findings could help strengthen policy and practice in this area and inform innovations that promote patient understanding of test results. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - December 12, 2017 Category: Information Technology Source Type: research

Response to Letter to the Editor regarding “Online physician ratings fail to predict actual performance on measures of quality, value, and peer review”
We thank Dr Bardach for her critical review of our paper evaluating the relationship between online ratings and objective measures of physician quality, value, and peer review. Her principal argument is that quality and value of care are opaque to consumers and therefore not reflected in online ratings of physicians. Indeed, this is the very crux of our paper ’s message. Dr Bardach details the ways in which our chosen metrics for quality and value of care – Choosing Wisely measures, cost of care, length of stay, and peer review – are outside of the scope of the patient experience and therefore unlikely to...
Source: Journal of the American Medical Informatics Association - December 11, 2017 Category: Information Technology Source Type: research

Letter to the Editor in response to “Online physician ratings fail to predict actual performance on measures of quality, value, and peer review”
DearJAMIA Editors, (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - December 11, 2017 Category: Information Technology Source Type: research

Data discovery with DATS: exemplar adoptions and lessons learned
AbstractThe DAta Tag Suite (DATS) is a model supporting dataset description, indexing, and discovery. It is available as an annotated serialization with schema.org, a vocabulary used by major search engines, thus making the datasets discoverable on the web. DATS underlies DataMed, the National Institutes of Health Big Data to Knowledge Data Discovery Index prototype, which aims to provide a “PubMed for datasets.” The experience gained while indexing a heterogeneous range of >60 repositories in DataMed helped in evaluating DATS ’s entities, attributes, and scope. In this work, 3 additional exempl...
Source: Journal of the American Medical Informatics Association - December 8, 2017 Category: Information Technology Source Type: research

PIE: A prior knowledge guided integrated likelihood estimation method for bias reduction in association studies using electronic health records data
ConclusionsThis study demonstrates that the proposed method can effectively reduce estimation bias caused by imperfect phenotyping in EHR-derived data by incorporating prior information through integrated likelihood. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - December 1, 2017 Category: Information Technology Source Type: research

Estimating the causal effects of chronic disease combinations on 30-day hospital readmissions based on observational Medicaid data
ConclusionMulti-hypothesis causal analysis, a new methodological tool, generates meaningful insights from health care claims data, guiding the design of care and intervention programs. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 30, 2017 Category: Information Technology Source Type: research

Clinical documentation variations and NLP system portability: a case study in asthma birth cohorts across institutions
DiscussionThe criteria for asthma ascertainment are largely dependent on asthma-related concepts. Therefore, we believe that semantic similarity is important to estimate NLP system portability. As the Mayo Clinic and SCH corpora were relatively homogeneous at a semantic level, the NLP system, developed at Mayo Clinic, was imported to SCH successfully with proper adjustments to deal with the intrinsic corpus heterogeneity. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 30, 2017 Category: Information Technology Source Type: research

User needs analysis and usability assessment of DataMed – a biomedical data discovery index
ConclusionWhile available data and researchers ’ information needs are complex and heterogeneous, a successful DDI must meet those needs and fit into the processes of biomedical researchers. Research directions include formalizing researchers’ information needs, standardizing overviews of data to facilitate relevance judgments, implementing user interfaces for concept-based searching, and developing evaluation methods for open-ended discovery systems such as DDIs. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 30, 2017 Category: Information Technology Source Type: research

3D-MICE: integration of cross-sectional and longitudinal imputation for multi-analyte longitudinal clinical data
Conclusions3D-MICE offers a novel and practical approach to imputing clinical laboratory time series data. 3D-MICE may provide an additional tool for use as a foundation in clinical predictive analytics and intelligent clinical decision support. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 30, 2017 Category: Information Technology Source Type: research

Are all certified EHRs created equal? Assessing the relationship between EHR vendor and hospital meaningful use performance
ConclusionVendor choice accounts for a meaningful proportion of variation in hospital meaningful use performance, and specific vendors are consistently associated with higher or lower performance across criteria. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 24, 2017 Category: Information Technology Source Type: research

CLAMP – a toolkit for efficiently building customized clinical natural language processing pipelines
AbstractExisting general clinical natural language processing (NLP) systems such as MetaMap and Clinical Text Analysis and Knowledge Extraction System have been successfully applied to information extraction from clinical text. However, end users often have to customize existing systems for their individual tasks, which can require substantial NLP skills. Here we present CLAMP (Clinical Language Annotation, Modeling, and Processing), a newly developed clinical NLP toolkit that provides not only state-of-the-art NLP components, but also a user-friendly graphic user interface that can help users quickly build customized NLP ...
Source: Journal of the American Medical Informatics Association - November 24, 2017 Category: Information Technology Source Type: research

Assessing the capacity of social determinants of health data to augment predictive models identifying patients in need of wraparound social services
DiscussionThe need for various social service referrals can be predicted with considerable accuracy using a wide range of readily available clinical and community data that measure socioeconomic and public health conditions. While the use of SDH did not result in significant performance improvements, our approach represents a novel and important application of risk predictive modeling. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 21, 2017 Category: Information Technology Source Type: research

Hierarchical attention networks for information extraction from cancer pathology reports
ConclusionsHAN-based DL models show promise in information abstraction tasks within unstructured clinical pathology reports. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 16, 2017 Category: Information Technology Source Type: research

Managing public health data: mobile applications and mass vaccination campaigns
AbstractIn response to data collection challenges during mass immunization events, Denver Public Health developed a mobile application to support efficient public health immunization and prophylaxis activities. The Handheld Automated Notification for Drugs and Immunizations (HANDI) system has been used since 2012 to capture influenza vaccination data during Denver Health ’s annual employee influenza campaign. HANDI has supported timely and efficient administration and reporting of influenza vaccinations through standardized data capture and database entry. HANDI’s mobility allows employee work locations and sch...
Source: Journal of the American Medical Informatics Association - November 13, 2017 Category: Information Technology Source Type: research

Assessing privacy risks in population health publications using a checklist-based approach
ConclusionThis study has demonstrated that a checklist can be a reliable tool to assist researchers with anonymizing analysis outputs in population health research. This further suggests that such an approach may have the potential to be developed into a broadly applicable standard providing consistent confidentiality protection across multiple analyses of the same data. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 10, 2017 Category: Information Technology Source Type: research

Decentralized and reproducible geocoding and characterization of community and environmental exposures for multisite studies
ConclusionThe open source DeGAUSS software overcomes multiple challenges in the use of address data in multisite studies and also serves as a more general reproducible research tool for geocoding and geomarker assessment. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 8, 2017 Category: Information Technology Source Type: research

Higher accuracy of complex medication reconciliation through improved design of electronic tools
AbstractObjectiveInvestigate the accuracy of 2 different medication reconciliation tools integrated into electronic health record systems (EHRs) using a cognitively demanding scenario and complex medication history.Materials and MethodsSeventeen physicians reconciled medication lists for a polypharmacy patient using 2 EHRs in a simulation study. The lists contained 3 types of discrepancy and were transmitted between the systems via a Continuity of Care Document. Participants updated each EHR and their interactions were recorded and analyzed for the number and type of errors.ResultsParticipants made 748 drug comparisons tha...
Source: Journal of the American Medical Informatics Association - November 7, 2017 Category: Information Technology Source Type: research

Corrigendum
to: The use of Twitter to facilitate sharing of clinical expertise in urology (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 4, 2017 Category: Information Technology Source Type: research

Erratum to: Evaluation of an electronic health record-supported obesity management protocol implemented in a community health center: a cautionary note
Steglitz J, Edberg D, Sommers M, Talen MR, Thornton LK, Spring B. Evaluation of an electronic health record-supported obesity management protocol implemented in a community health center: a cautionary note.J Am Med Inform Assoc 2015; 22:755 –763; DOI:https://doi.org/10.1093/jamia/ocu034 (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 3, 2017 Category: Information Technology Source Type: research

Enabling phenotypic big data with PheNorm
ConclusionThe accuracy of the PheNorm algorithms is on par with algorithms trained with annotated samples. PheNorm fully automates the generation of accurate phenotyping algorithms and demonstrates the capacity for EHR-driven annotations to scale to the next level – phenotypic big data. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - November 3, 2017 Category: Information Technology Source Type: research

Using machine learning for sequence-level automated MRI protocol selection in neuroradiology
We present a machine learning method for analyzing the unstructured text of clinical indications and patient demographics from magnetic resonance imaging (MRI) orders to automatically protocol MRI procedures at the sequence level. We compared 3 machine learning models – support vector machine, gradient boosting machine, and random forest – to a baseline model that predicted the most common protocol for all observations in our test set. The gradient boosting machine model significantly outperformed the baseline and demonstrated the best performance of the 3 mo dels in terms of accuracy (95%), precision (86%), re...
Source: Journal of the American Medical Informatics Association - October 27, 2017 Category: Information Technology Source Type: research

FACETS: using open data to measure community social determinants of health
ConclusionFACETS is an important first step in standardizing and compiling SDH-related data in an open architecture that can give context to a patient ’s condition and enable better decision-making when developing a plan of care. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 27, 2017 Category: Information Technology Source Type: research

Medication-related clinical decision support alert overrides in inpatients
ObjectiveTo define the types and numbers of inpatient clinical decision support alerts, measure the frequency with which they are overridden, and describe providers ’ reasons for overriding them and the appropriateness of those reasons.Materials and MethodsWe conducted a cross-sectional study of medication-related clinical decision support alerts over a 3-year period at a 793-bed tertiary-care teaching institution. We measured the rate of alert overrides, the rate of overrides by alert type, the reasons cited for overrides, and the appropriateness of those reasons.ResultsOverall, 73.3% of patient allergy, drug-drug i...
Source: Journal of the American Medical Informatics Association - October 27, 2017 Category: Information Technology Source Type: research

Characteristics of knowledge content in a curated online evidence library
ObjectiveTo describe types of recommendations represented in a curated online evidence library, report on the quality of evidence-based recommendations pertaining to diagnostic imaging exams, and assess underlying knowledge representation.Materials and MethodsThe evidence library is populated with clinical decision rules, professional society guidelines, and locally developed best practice guidelines. Individual recommendations were graded based on a standard methodology and compared using chi-square test. Strength of evidence ranged from grade 1 (systematic review) through grade 5 (recommendations based on expert opinion)...
Source: Journal of the American Medical Informatics Association - October 27, 2017 Category: Information Technology Source Type: research

Factors contributing to medication errors made when using computerized order entry in pediatrics: a systematic review
ConclusionsThis review highlights 5  key factors that contributed to the occurrence of CPOE-related medication errors in pediatrics. Dosing support is the most important. More advanced clinical decision support that can suggest doses based on the drug indication is needed. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 26, 2017 Category: Information Technology Source Type: research

Ethical issues in the use of SMS messaging in HIV care and treatment in low- and middle-income countries: case examples from Mozambique
AbstractThe introduction of mobile communication technologies in health care in low- and middle-income countries offers an opportunity for increased efficiencies in provision of care, improved utilization of scarce resources, reductions in workload, and increased reach of services to a larger target population. Short message service (SMS) technologies offer promise, with several large-scale SMS-based implementations already under way. Still largely lacking in the research literature are evaluations of specific ethical issues that arise when SMS programs are implemented and studied in resource-limited settings. In this pape...
Source: Journal of the American Medical Informatics Association - October 26, 2017 Category: Information Technology Source Type: research

Exploring completeness in clinical data research networks with DQ e -c
ConclusionEHR data quality assessment has been hampered by implementation of ad hoc processes. The architecture and implementation of DQe-c offer valuable insights for developing reproducible and scalable data science tools to assess, manage, and process data in clinical data repositories. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 23, 2017 Category: Information Technology Source Type: research

Clinical decision support alert malfunctions: analysis and empirically derived taxonomy
ConclusionCDS alert malfunctions are frequent. The empirically derived taxonomy formalizes the common recurring issues that cause these malfunctions, helping CDS developers anticipate and prevent CDS malfunctions before they occur or detect and resolve them expediently. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - October 16, 2017 Category: Information Technology Source Type: research

High-fidelity phenotyping: richness and freedom from bias
AbstractElectronic health record phenotyping is the use of raw electronic health record data to assert characterizations about patients. Researchers have been doing it since the beginning of biomedical informatics, under different names. Phenotyping will benefit from an increasing focus on fidelity, both in the sense of increasing richness, such as measured levels, degree or severity, timing, probability, or conceptual relationships, and in the sense of reducing bias. Research agendas should shift from merely improving binary assignment to studying and improving richer representations. The field is actively researching new...
Source: Journal of the American Medical Informatics Association - October 12, 2017 Category: Information Technology Source Type: research