Applied Clinical Informatics最新文献

{"title":"A Comprehensive Approach to Clinical Decision Support in the Return of Genome Informed Risk Assessments to Primary Care Pediatricians.","authors":"Dean Karavite, Shannon Terek, John J Connolly, Margaret Harr, Naveen Muthu, Hakon Hakonarson, Robert W Grundmeier","doi":"10.1055/a-2445-9185","DOIUrl":"10.1055/a-2445-9185","url":null,"abstract":"<p><strong>Background: </strong> Primary care pediatricians play an important role in genetic testing, including referrals, test ordering, responding to results, assessing risk, treatment, and managing care. As genetic testing rapidly evolves to include new tests identifying patients at risk for certain conditions, alert-based clinical decision support is insufficient in assisting pediatric primary care providers in working with patients, parents, genetics, and other specialties. Supporting pediatricians in the return of these results requires addressing gaps in genetics training and integrating genetics into practice with education, information resources, and specialized tools.</p><p><strong>Objectives: </strong> This study aimed to capture requirements for developing systems and processes to support primary care pediatricians in the return of genome-informed risk assessments.</p><p><strong>Methods: </strong> We performed a requirements analysis to inform the design of clinical decision support tools and processes for pediatric providers of patients who received a genome informed risk assessment, a novel test that combines polygenic risk scores with patient and family histories to deliver a risk assessment for common medical conditions. We developed an interview guide consisting of scenario presentations, questionnaires, and semi-structured questions to elicit provider responses on a broad set of requirements to manage results with patients and caregivers.</p><p><strong>Results: </strong> Twenty providers from 10 primary care pediatric practices within a single health system participated in the study. The findings demonstrated that providers feel responsible to be involved in the process of returning results but require a support system that integrates education, provider and patient information resources, effective communication with genetics, and electronic health record decision support tools that can accommodate a range of clinical scenarios and provider workflow preferences.</p><p><strong>Conclusion: </strong> Supporting providers with the return of genetic testing results such as the genome informed risk assessment requires a comprehensive approach to decision support consisting of education, communication, and a comprehensive and integrated set of electronic health record tools.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":"16 1","pages":"193-204"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Dimensions of Clinical Data Sharing by U.S. Health Care Organizations for Purposes beyond Direct Patient Care: Interviews with Health Care Leaders.","authors":"Brian R Jackson, Bonnie Kaplan, Richard Schreiber, Paul R DeMuro, Victoria Nichols-Johnson, Larry Ozeran, Anthony Solomonides, Ross Koppel","doi":"10.1055/a-2432-0329","DOIUrl":"10.1055/a-2432-0329","url":null,"abstract":"<p><strong>Objectives: </strong> This study aimed to (1) empirically investigate current practices and analyze ethical dimensions of clinical data sharing by health care organizations for uses other than treatment, payment, and operations; and (2) make recommendations to inform research and policy for health care organizations to protect patients' privacy and autonomy when sharing data with unrelated third parties.</p><p><strong>Methods: </strong> Semistructured interviews and surveys involving 24 informatics leaders from 22 U.S. health care organizations, accompanied by thematic and ethical analyses.</p><p><strong>Results: </strong> We found considerable heterogeneity across organizations in policies and practices. Respondents understood \"data sharing\" and \"research\" in very different ways. Their interpretations of these terms ranged from making data available for academic and public health uses, and to health information exchanges; to selling data for corporate research; and to contracting with aggregators for future resale or use. The nine interview themes were that health care organizations: (1) share clinical data with many types of organizations, (2) have a variety of motivations for sharing data, (3) do not make data-sharing policies readily available, (4) have widely varying data-sharing approval processes, (5) most commonly rely on Health Insurance and Portability and Accountability Act (HIPAA) de-identification to protect privacy, (6) were concerned about clinical data use by electronic health record vendors, (7) lacked data-sharing transparency to the general public, (8) allowed individual patients little control over sharing of their data, and (9) had not yet changed data-sharing practices within the year following the U.S. Supreme Court 2022 decision denying rights to abortion.</p><p><strong>Conclusion: </strong> Our analysis identified gaps between ethical principles and health care organizations' data-sharing policies and practices. To better align clinical data-sharing practices with patient expectations and biomedical ethical principles, we recommend updating HIPAA, including re-identification and upstream sharing restrictions in data-sharing contracts, better coordination across data-sharing approval processes, fuller transparency and opt-out options for patients, and accountability for data-sharing and consequent harms.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"90-100"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Longitudinal Graduate Medical Education Curriculum in Clinical Informatics: Function, Structure, and Evaluation.","authors":"Bradley Rowland, Jacqueline You, Sarah Stern, Richa Bundy, Adam Moses, Lauren Witek, Corey Obermiller, Gary Rosenthal, Ajay Dharod","doi":"10.1055/a-2432-0054","DOIUrl":"10.1055/a-2432-0054","url":null,"abstract":"<p><strong>Background: </strong> There is a need to integrate informatics education into medical training programs given the rise in demand for health informaticians and the call on the Accreditation Council for Graduate Medical Education and the body of undergraduate medical education for implementation of informatics curricula.</p><p><strong>Objectives: </strong> This report outlines a 2-year longitudinal informatics curriculum now currently in its seventh year of implementation. This report is intended to inform U.S. Graduate Medical Education (GME) program leaders of the necessary requirements for implementation of a similar program at their institution.</p><p><strong>Methods: </strong> The curriculum aligns with the core content for the subspecialty of clinical informatics (CI) and is led by a multidisciplinary team with both informatics and clinical expertise. This educational pathway has a low direct cost and is a practical example of the academic learning health system (aLHS) in action. The pathway is housed within an internal medicine department at a large tertiary academic medical center.</p><p><strong>Results: </strong> The curriculum has yielded 13 graduates from both internal medicine (11, 85%) and pediatrics (2, 15%) whose projects have spanned acute and ambulatory care and multiple specialties. Projects have included clinical decision support tools, of which some will be leveraged as substrate in applications seeking extramural funding. Graduates have gone on to CI board certification and fellowship, as well as several other specialties, creating a distributed network of clinicians with specialized experience in applied CI.</p><p><strong>Conclusion: </strong> An informatics curriculum at the GME level may increase matriculation to CI fellowship and more broadly increase development of the CI workforce through building a cadre of physicians with health information technology expertise across specialties without formal CI board certification. We offer an example of a longitudinal pathway, which is rooted in aLHS principles. The pathway requires a dedicated multidisciplinary team and departmental and information technology leadership support.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"84-89"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Patient Record Duplication.","authors":"Onur Sahin, Audrey Zhao, Reuben Joseph Applegate, Todd R Johnson, Elmer V Bernstam","doi":"10.1055/a-2423-8499","DOIUrl":"10.1055/a-2423-8499","url":null,"abstract":"<p><strong>Objectives: </strong> Duplicate patient records can increase costs and medical errors. We assessed the association between demographic factors, comorbidities, health care usage, and duplicate electronic health records.</p><p><strong>Methods: </strong> We analyzed the association between duplicate patient records and multiple demographic variables (race, Hispanic ethnicity, sex, and age) as well as the Charlson Comorbidity Index (CCI), number of diagnoses, and number of health care encounters. The study population included 3,018,413 patients seen at a large urban academic medical center with at least one recorded diagnosis. Duplication of patient medical records was determined by using a previously validated enterprise Master Person Index.</p><p><strong>Results: </strong> Unknown or missing demographic data, Black race when compared with White race (odds ratio [OR]: 1.35, <i>p</i> < 0.001), Hispanic compared with non-Hispanic ethnicity (OR: 1.48, <i>p</i> < 0.001), older age (OR: 1.01, <i>p</i> < 0.001), and \"Other\" sex compared with female sex (OR: 4.71, <i>p</i> < 0.001) were associated with higher odds of having a duplicate record. Comorbidities (CCI, OR: 1.10, <i>p</i> < 0.001) and more encounters with the health care system (OR: 1.01, <i>p</i> < 0.001) were also associated with higher odds of having a duplicate record. In contrast, male sex compared with female sex was associated with lower odds of having a duplicate record (OR: 0.88, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong> The odds of duplications in medical records were higher in Black, Hispanic, older, nonmale patients with more health care encounters, more comorbidities, and unknown demographic data. Understanding the epidemiology of duplicate records can help guide prevention and mitigation efforts for high-risk populations. Duplicate records can contribute to disparities in health care outcomes for minority populations.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"24-30"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11710899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of the Nursing Information Security Questionnaire.","authors":"Xiaoyun Zhou, Xiujuan Jing, Tingting Gao, Hong Liu, Xuebing Jing","doi":"10.1055/a-2424-2103","DOIUrl":"10.1055/a-2424-2103","url":null,"abstract":"<p><strong>Background: </strong> Ensuring the security of nursing information holds substantial importance to nursing outcomes and healthcare system management. The awareness of information security among nurses in China is generally inadequate, and there is a lack of standardized evaluation tools for nurse information security in nursing practice. The nursing sector necessitates the establishment of a robust culture surrounding information security.</p><p><strong>Objective: </strong> The aim of this study was to construct a self-reporting instrument for evaluating nursing information security.</p><p><strong>Methods: </strong> The research team utilized literature analysis and group discussions to draft the item pool. After two rounds of Delphi consultation by 15 experts and pilot testing, the initial questionnaire was formed. Item analysis was carried out on the questionnaire, and the validity and reliability of the instrument were statistically tested by computing the Keiser-Meier-Olkin and Bartlett's tests, an exploratory factor analysis (EFA), a confirmatory factor analysis (CFA), convergent and discriminative validity, descriptive statistics, Cronbach's <i>α</i>, and test-retest reliability.</p><p><strong>Results: </strong> A total of 501 nurses participated in the study, supplemented by the inclusion of five experts who were invited to contribute to the assessment of content validity. Four factors were formed using EFA (<i>n</i> = 250), and the cumulative variance contribution rate was found to be 60.10%. The CFA (<i>n</i> = 251) showed that the model fit was good. The overall Cronbach's <i>α</i> coefficient of the questionnaire was 0.948, and the test-retest reliability was 0.837.</p><p><strong>Conclusion: </strong> Finally, the nursing information security questionnaire (NIS-Q) with 38 items and three dimensions of knowledge, attitude, and practice were formed. A promising assessment instrument for gauging the degree of nursing information security was introduced. Further, a foundational platform was established for implementing specific enhancement strategies aimed at advancing nursing information security.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"44-55"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Communication Challenges Experienced by Clinicians and Patients during Teleconsultation: A Scoping Review.","authors":"Takashi Sota, Tim Jackson, Eleanor Yang, Annie Y S Lau","doi":"10.1055/a-2425-8626","DOIUrl":"10.1055/a-2425-8626","url":null,"abstract":"<p><strong>Background: </strong> As teleconsultations continue to rise in popularity due to their convenience and accessibility, it is crucial to identify and address the challenges they present in order to improve the patient experience, enhance outcomes, and ensure the quality of care. To identify communication challenges that clinicians and patients experience during teleconsultation, a scoping review was conducted.</p><p><strong>Objective: </strong> This study aimed to identify communication challenges that clinicians and patients experience during teleconsultation.</p><p><strong>Methods: </strong> Studies were obtained from four databases (Ovid [MEDLINE], Ovid [Embase], CINAHL, and Scopus). Gray literatures were not included. Studies focused on communication challenges between clinicians and their patients during teleconsultation in the context of coronavirus disease 2019 (COVID-19) and published from January 2000 to December 2022, were collected. The screening process was conducted by two independent reviewers. Data extraction was performed using a standardized form to capture study characteristics and communication challenges. Extracted data were analyzed to identify the communication challenges during teleconsultation, adherent to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR).</p><p><strong>Results: </strong> A total of 893 studies were collected from four databases and 26 studies were selected based on inclusion/exclusion criteria. Of these 26 eligible studies, 12 (46%) were from the United States, 3 studies (12%) were from Australia, and 2 (8%) were from the United Kingdom and Canada. These studies included 12 (46%) qualitative studies, 6 (23%) quantitative studies, 6 (23%) review articles, and 2 (8%) case reports. Eight factors contributing to communication challenges between clinicians and patients during teleconsultations were identified: technical issues, difficulties in developing rapport, lack of non-verbal communication, lack of physical examination, language barrier, spatial issues, clinician preparation, and difficulties in assessing patients' health literacy.</p><p><strong>Conclusion: </strong> Eight factors were identified as contributing to communication challenges during teleconsultation in the context of COVID-19. These findings highlight the need to address communication challenges to ensure effective teleconsultations. With the rise of teleconsultation in routine health care delivery, further research is warranted to confirm these findings and to explore ways to overcome communication challenges during teleconsultation.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"56-66"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking a Team Approach: Keep Up with the EHR with a Training and Optimization Program.","authors":"Rachel K McEntee, Juvena R Hitt, Amber Sieja","doi":"10.1055/a-2437-0185","DOIUrl":"10.1055/a-2437-0185","url":null,"abstract":"<p><strong>Objectives: </strong> This study aimed to describe the current landscape of electronic health record (EHR) training and optimization programs (ETOPs) and their impact on health care workers' (HCWs) experience with the EHR.</p><p><strong>Methods: </strong> A 72-question electronic survey was developed and distributed to health care organization (HCO) leaders in clinical informatics (Chief Medical Information Officer [CMIO]/Chief Nursing Information Officer [CNIO]/Medical Informatics Executive, Associate CMIO/Medical Director of, Clinical/Nurse/Physician Informaticist) through various channels such as national informatics conferences, social media, and email distribution lists of vendors and informatics associations. The survey collected data on the characteristics, resourcing, approach, and outcomes of ETOPs. Descriptive statistics were applied to analyze the data.</p><p><strong>Results: </strong> There were 193 responses from 147 distinct HCOs. Of these, 69% offer ongoing EHR training, and 52% offer some version of an ETOP. Offered ETOPs vary in their timing, modality, audience, team composition, duration, and EHR build strategy. The most commonly measured outcomes were EHR satisfaction, efficiency, and provider burnout, and most ETOPs reported improvement in these areas.</p><p><strong>Conclusion: </strong> The findings suggest that ETOPs are inconsistently implemented across HCOs, and while there are some commonalities, there is a wide variety of designs and methods of evaluation for the programs. Though the problems to solve (EHR efficiency, proficiency, and satisfaction) are the same, the organizational structure and culture of HCOs vary widely, which may partially explain the variability seen in reported ETOPs. When considering the measured outcomes, ETOPs may have direct and indirect effects on HCW burnout by improving EHR efficiency and satisfaction, as well as driving organizational culture toward teamwork and flexible problem-solving. For this reason, ETOPs may also serve as a model for addressing other challenges in health care delivery. ETOPs are a promising intervention to enhance HCW experience with the EHR and reduce burnout. More research is needed to identify the optimal features, methods, and outcomes of ETOPs, and to disseminate them across HCOs.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"128-136"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Referrals to the Supplemental Nutrition Assistance Program through Clinical Integration of a Standards-Based Decision Support System.","authors":"Eliel Oliveira, Matti Hautala, JaWanna Henry, Vidya Lakshminarayanan, Vishal Abrol, Linda Granado, Shashank Shah, Anjum Khurshid","doi":"10.1055/a-2441-5941","DOIUrl":"10.1055/a-2441-5941","url":null,"abstract":"<p><strong>Background: </strong> The Supplemental Nutrition Assistance Program (SNAP) is one of the most successful national programs to reduce poverty and improve health outcomes, but millions of Americans who qualify still do not have access to SNAP, and limited data are available to determine how referrals to the program can be completed successfully.</p><p><strong>Objectives: </strong> We aimed to design and develop a standards-based digital care coordination platform to support closed-loop social services referrals between patients and social and health care providers and demonstrate the feasibility to screen, diagnose, plan, and complete interventions with selected patients in real settings.</p><p><strong>Methods: </strong> We partnered with community members to design the platform through Community Engagement Studios and with a Federally Qualified Health Center, Local Mental Health Authority, and Food Bank to determine the features and workflow requirements of the platform design. We customized currently available systems to use Fast Healthcare Interoperability Resources (FHIR) Application Programming Interfaces (APIs) that could exchange information in real time across providers and participants.</p><p><strong>Results: </strong> The platform was successfully demonstrated through a pilot where patients were recruited in clinical settings and referred to a Food Bank that provided SNAP application assistance to study participants. We translated the requirements of the platform to national standards and required workflows of providers and patients. Study participants were notified electronically of the specific steps to follow to complete their SNAP applications while receiving support from specialists from the Food Bank.</p><p><strong>Conclusion: </strong> The pilot demonstrated the feasibility of collecting granular social service referral information that can be used to better address gaps in social care. The pilot also highlighted the importance of further coordination on the usage and harmonization of needs assessment nationally and that current digital systems are still not ready to fully utilize national Social Determinants of Health data standards.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"167-176"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Health Record User Dashboard for Optimization of Surgical Resident Procedural Reporting.","authors":"Parker T Evans, Scott D Nelson, Adam Wright, Chetan V Aher","doi":"10.1055/a-2444-0342","DOIUrl":"10.1055/a-2444-0342","url":null,"abstract":"<p><strong>Background: </strong> While necessary and educationally beneficial, administrative tasks such as case and patient tracking may carry additional burden for surgical trainees. Automated systems targeting these tasks are scarce, leading to manual and inefficient workflows.</p><p><strong>Methods: </strong> We created an electronic health record (EHR)-based, user-specific dashboard for surgical residents to compile resident-specific data: bedside procedures performed, operative cases performed or participated in, and notes written by the resident as a surrogate for patients cared for. Usability testing was performed with resident volunteers, and residents were also surveyed postimplementation to assess for efficacy and satisfaction. Access log data from the EHR was used to assess dashboard usage over time. Descriptive statistics were calculated.</p><p><strong>Results: </strong> The dashboard was implemented on a population of approximately 175 surgical residents in 5 different departments (General Surgery, Obstetrics and Gynecology, Neurosurgery, Orthopaedics, and Otolaryngology) at a single academic medical center. Six resident volunteers participating in usability testing completed an average of 96% of preset tasks independently. Average responses to five questions extracted from the System Usability Scale (SUS) questions ranged from 4.0 to 4.67 out of 5. Postimplementation surveys indicated high resident satisfaction (4.39 out of 5) and moderate rates of use, with 46.4% of residents using the dashboard at least monthly. Daily use of the dashboard has increased over time, especially after making the dashboard a default for surgical residents.</p><p><strong>Conclusion: </strong> An EHR-based dashboard compiling resident-specific data can improve the efficiency of administrative tasks and supplement longitudinal education.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"185-192"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Stakeholder Perceptions about Using Artificial Intelligence for the Diagnosis of Rare and Atypical Infections.","authors":"Aysun Tekin, Svetlana Herasevich, Sarah A Minteer, Ognjen Gajic, Amelia K Barwise","doi":"10.1055/a-2451-9046","DOIUrl":"10.1055/a-2451-9046","url":null,"abstract":"<p><strong>Objectives: </strong> This study aimed to evaluate critical care provider perspectives about diagnostic practices for rare and atypical infections and the potential for using artificial intelligence (AI) as a decision support system (DSS).</p><p><strong>Methods: </strong> We conducted an anonymous web-based survey among critical care providers at Mayo Clinic Rochester between November 25, 2023, and January 15, 2024, to evaluate their experience with rare and atypical infection diagnostic processes and AI-based DSSs. We also assessed the perceived usefulness of AI-based DSSs, their potential impact on improving diagnostic practices for rare and atypical infections, and the perceived risks and benefits of their use.</p><p><strong>Results: </strong> A total of 47/143 providers completed the survey. Thirty-eight out of 47 agreed that there was a delay in diagnosing rare and atypical infections. Among those who agreed, limited assessment of specific patient factors and failure to consider them were the most frequently cited important contributing factors (33/38). Thirty-eight out of 47 reported familiarity with the AI-based DSS applications available to critical care providers. Less than half (18/38) thought AI-based DSSs often provided valuable insights into patient care, but almost three-quarters (34/47) thought AI-based DDSs often provided valuable insight when specifically asked about their ability to improve the diagnosis of rare and atypical infections. All respondents rated reliability as important in enhancing the perceived utility of AI-based DSSs (47/47) and almost all rated interpretability and integration into the workflow as important (45/47). The primary concern about implementing an AI-based DSS in this context was alert fatigue (44/47).</p><p><strong>Conclusion: </strong> Most critical care providers perceive that there are delays in diagnosing rare infections, indicating inadequate assessment and consideration of the diagnosis as the major contributors. Reliability, interpretability, workflow integration, and alert fatigue emerged as key factors impacting the usability of AI-based DSS. These findings will inform the development and implementation of an AI-based diagnostic algorithm to aid in identifying rare and atypical infections.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"223-233"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}