Applied Clinical Informatics最新文献

{"title":"Special Issue on CDS Failures: Development and Evaluation of ORCA, a Resilient Solution for Order Set Access During EHR Downtimes.","authors":"Stephon N Proctor, Bimal Desai","doi":"10.1055/a-2620-6221","DOIUrl":"https://doi.org/10.1055/a-2620-6221","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision support systems (CDSS) are central to modern healthcare, but their effectiveness is compromised during system downtimes, which affect 96% of healthcare organizations. During these failures, clinicians lose access to critical decision-making tools like order sets, increasing the risk of medical errors. Traditional downtime solutions, such as paper-based protocols, are often impractical and difficult to maintain.</p><p><strong>Objectives: </strong>This study introduces and evaluates ORCA (Offsite Repository for Clinical Assets), a resilient web-based solution designed to maintain access to EHR order sets during system failures. We assessed its usability and effectiveness as a downtime decision support tool across various clinical settings.</p><p><strong>Methods: </strong>ORCA was developed based on analysis of previous downtime incidents, replicating essential order set functionality while ensuring offsite accessibility. We conducted usability testing with 16 clinicians from diverse specialties, using structured tasks and think-aloud protocols. User feedback was collected through the Usability Metric for User Experience (UMUX) questionnaire and thematic analysis of interview transcripts.</p><p><strong>Results: </strong>ORCA demonstrated strong usability (mean UMUX score: 86.2). Thematic analysis revealed key implementation challenges: system limitations (24.56% of responses), workflow integration (23.39%), and interface navigation (22.22%). Users valued ORCA's familiar interface and offsite accessibility but identified critical gaps in dynamic decision support capabilities.</p><p><strong>Conclusions: </strong>ORCA represents a viable approach to maintaining basic clinical decision support during downtimes. However, significant challenges remain in replicating dynamic CDS features and ensuring effective integration with existing downtime procedures. These findings inform future development of resilient CDS systems and highlight the importance of planned fallback pathways in clinical systems.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Computerized Alerts on Prescribing and Patient Outcomes: A Systematic Review.","authors":"Brian Bell, Adam Khimji, Basharat Hussain, Anthony Avery","doi":"10.1055/a-2620-3244","DOIUrl":"https://doi.org/10.1055/a-2620-3244","url":null,"abstract":"<p><p>Background In recent years, there has been an expansion in the literature on the effects of computerized alerts on prescribing and patient outcomes. The aim of our study was to examine the impact of these systems on clinician prescribing and patient outcomes. Methods We searched three databases (Medline, Embase and PsychINFO) for studies that had been conducted since 2009 and included studies that examined the effects of alerts at the point of prescribing. We extracted data from 69 studies. Results Most studies reported a beneficial effect on prescribing of computerized alerts (n = 58, 84.1%), including all studies (n=4) that used passive alerts. Seven of the 10 studies that reported on patient outcomes showed a beneficial effect. Both randomized controlled trials (RCTs) and non-RCTS showed beneficial effects on prescribing across a range of different types of alert. In 43 studies it was possible to ascertain the effects of different types of alert; the interventions that were most frequently associated with improvements in prescribing were drug-laboratory alerts (9/11; 81.8%); dose range checking (6/7; 85.7%); formulary alerts (8/9; 88.9%) and drug-allergy alerts (4/4; 100%). However, most of the studies did not satisfy the quality criteria. Conclusion Most of the studies found a beneficial effect of computerized alerts on prescribing. We have also shown that these benefits are apparent for a range of different types of alert. These findings support continued development, implementation and evaluation of computerized alerts for prescribing.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Typing proficiency among physicians in internal medicine: a pilot study of speed and performance.","authors":"Francois Bastardot, Vanessa Kraege, Julien Castioni, Alain Petter, David W Bates, Antoine Garnier","doi":"10.1055/a-2620-3147","DOIUrl":"https://doi.org/10.1055/a-2620-3147","url":null,"abstract":"<p><strong>Background: </strong>Electronic health records (EHR) are widely implemented and consume nearly half of physicians' work time. Despite the importance of efficient data entry, physicians' typing skills - potential contributors to documentation burden - remain poorly studied.</p><p><strong>Objective: </strong>To evaluate the typing skills of physicians and their associations with demographic characteristics and professional roles.</p><p><strong>Methods: </strong>This cross-sectional pilot study included a convenience sample of physicians (residents, chief residents, and attending physicians) from the internal medicine division of an academic hospital. Participants completed a one-minute typing test under supervised conditions. The primary outcome was raw typing speed, measured in words per minute (WPM). Secondary outcome was a performance score calculated by subtracting 50 points for each error from the total number of characters typed per minute.</p><p><strong>Results: </strong>Participation rate was 100% (82/82 physicians). Mean age 33.7 ± 7.3 years; 7.2 ± 7.1 years since graduation; 45.1% female. Mean typing speed was 53.4 WPM (range: 31-91 WPM), with 57.3% (47/82) of participants exceeding 50 WPM, a threshold commonly considered as professional. Bivariable analysis showed significant negative association with age (Spearman's ρ = -0.281, p = 0.011), which was not sustained in the multivariable analysis. No significant association was observed with sex, country of diploma, or role. Upon multivariable analysis, performance score showed significant negative association with age (β = -17.724, p = 0.009) but positive association with years since graduation (β = 16.850, p = 0.021), suggesting a generation- and experience-related interaction.</p><p><strong>Conclusions: </strong>Nearly half of physicians exhibited professional-level typing skills, yet overall performance varied widely and was influenced by both generational factors and clinical experience. Given that documentation burden affects clinicians across all skill levels, both individual and systemic strategies-such as improved EHR design and alternative input methods-should be explored.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Electronic Health Records to Classify Cancer Site and Metastasis.","authors":"Kurt Kroenke, Kathryn J Ruddy, Deirdre R Pachman, Veronica Grzegorczyk, Jeph Herrin, Parvez A Rahman, Kyle A Tobin, Joan M Griffin, Linda L Chlan, Jessica D Austin, Jennifer L Ridgeway, Sandra A Mitchell, Keith A Marsolo, Andrea L Cheville","doi":"10.1055/a-2544-3117","DOIUrl":"10.1055/a-2544-3117","url":null,"abstract":"<p><p>The Enhanced EHR-facilitated Cancer Symptom Control (E2C2) Trial is a pragmatic trial testing a collaborative care approach for managing common cancer symptoms. There were challenges in identifying cancer site and metastatic status.This study compares three different approaches to determine cancer site and six strategies for identifying the presence of metastasis using EHR and cancer registry data.The E2C2 cohort included 50,559 patients seen in the medical oncology clinics of a large health system. SPPADE symptoms were assessed with 0 to 10 numeric rating scales (NRS). A multistep process was used to develop three approaches for representing cancer site: the single most prevalent International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) code, the two most prevalent codes, and any diagnostic code. Six approaches for identifying metastatic disease were compared: ICD-10 codes, natural language processing (NLP), cancer registry, medications typically prescribed for incurable disease, treatment plan, and evaluation for phase 1 trials.The approach counting the two most prevalent ICD-10 cancer site diagnoses per patient detected a median of 92% of the cases identified by counting all cancer site diagnoses, whereas the approach counting only the single most prevalent cancer site diagnosis identified a median of 65%. However, agreement among the three approaches was very good (kappa > 0.80) for most cancer sites. ICD and NLP methods could be applied to the entire cohort and had the highest agreement (kappa = 0.53) for identifying metastasis. Cancer registry data was available for less than half of the patients.Identification of cancer site and metastatic disease using EHR data was feasible in this large and diverse cohort of patients with common cancer symptoms. The methods were pragmatic and may be acceptable for covariates, but likely require refinement for key dependent and independent variables.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":"16 3","pages":"556-568"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327476","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":"Sharing a Hybrid Electronic Health Record + Fast Healthcare Interoperability Resources Clinical Decision Support across Health Systems: Automating Smoking Cessation for Pediatric Caregivers.","authors":"Sameh N Saleh, Eric Kim, Jeritt G Thayer, Emara Nabi-Burza, Dean J Karavite, Jonathan P Winickoff, Alexander G Fiks, Brian P Jenssen, Nicholas Riley, Robert W Grundmeier","doi":"10.1055/a-2535-5823","DOIUrl":"10.1055/a-2535-5823","url":null,"abstract":"<p><p>Experiences sharing complex workflow-integrated clinical decision support (CDS) across health systems are sparse and not well reported. This case study presents the sharing of a hybrid electronic health record (EHR)-native and SMART-compatible CDS tool for automating provision of smoking cessation treatment for caregivers during pediatric visits.We conducted a comprehensive needs assessment using sociotechnical frameworks to identify workflow gaps and technical requirements. A multidisciplinary team of clinical informaticians, software developers, and EHR analysts guided the technology transfer. Iterative testing and feedback informed modifications. The evaluation tracked questionnaire uptake, tobacco use identification rates, and treatment acceptance metrics.The needs assessment revealed critical artifacts such as data architecture, source code repositories, and regulatory requirements, which informed adaptations for the recipient health system. In the preimplementation phase, JXPORT was identified for transferring EHR-native components and the EHR's Active Guidelines Framework was needed to extend the Fast Healthcare Interoperability Resources standard with ordering, posting flowsheet values, and launching activities in the embedded web application. The implementation process resulted in key modifications including same-day nicotine replacement therapy delivery through internal pharmacy services and optimized questionnaire design to improve usability. At the source system, 5.8% (<i>n</i> = 3,391) of caregivers reported active tobacco use with 46.9% (<i>n</i> = 1,590) accepting cessation resources. At the recipient system, 24.3% (<i>n</i> = 167) of caregivers listed tobacco use and 28.1% (<i>n</i> = 47) accepted treatment.The cross-system sharing of eCEASE serves as a nascent model for disseminating complex CDS tools and highlighted opportunities for improvement. Future work should focus on creating validated dissemination frameworks and improving use of standards for EHR integration.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"516-525"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400598","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":"Clinical Decision Support to Reduce Hospital Length-of-Stay for Cancer Patients with Fever and Neutropenia.","authors":"Julia Kw Yarahuan, Swaminathan Kandaswamy, Edwin Ray, Rachael Leroux, Wayne H Liang, Evan Orenstein, Claire L Stokes","doi":"10.1055/a-2540-2349","DOIUrl":"10.1055/a-2540-2349","url":null,"abstract":"<p><p>Pediatric cancer patients with fever and neutropenia are at risk for bacterial sepsis, traditionally requiring extended hospital stays on antibiotics until neutrophil counts recover. According to a newly validated scoring system, a subset of these patients is at lower risk and eligible for early discharge and reduced intravenous (IV) antibiotic exposure.Reduce length-of-stay (LOS) for febrile neutropenic patients using clinical decision support (CDS) to identify low-risk patients.A CDS system was developed to (1) screen febrile neutropenic patients using a validated clinical decision rule, (2) surface when low-risk patients become eligible for discharge, and (3) facilitate close phone follow-up for patients discharged early. The system was implemented in March 2023 and iteratively refined based on usability testing.Postimplementation, LOS did not improve significantly, and uptake of the CDS tool remained low. Though the tool had the potential to reduce LOS, the limited staff engagement was a significant barrier to success. Safety outcomes, including ICU readmissions and mortality, remained unaffected.Despite carefully designed CDS applying an evidence-based scoring system and using human-centered design methodology, the failure to achieve the desired reduction in LOS was primarily due to insufficient uptake by clinical staff. This highlights the need for stronger strategies to ensure clinician engagement and integration into workflows for CDS tools to be effective.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"538-543"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450629","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":"User Actions within a Clinical Decision Support Alert for the Management of Hypertension in Chronic Kidney Disease.","authors":"Lipika Samal, Sarah W Chen, Stuart Lipsitz, Heather J Baer, John L Kilgallon, Michael Gannon, Ryan Dunk, Weng Ian Chay, Richard Fay, Michael Sainlaire, Chenxi Gao, Matthew Wien, Pamela M Garabedian, Edward Wu, Hojjat Salmasian, David W Bates, Patricia C Dykes, Adam Wright, Allison B McCoy","doi":"10.1055/a-2554-3969","DOIUrl":"10.1055/a-2554-3969","url":null,"abstract":"<p><p>This study aimed to examine user actions within a clinical decision support (CDS) alert addressing hypertension (HTN) in chronic kidney disease (CKD).A pragmatic randomized controlled trial of a CDS alert for primary care patients with CKD and uncontrolled blood pressure included prechecked default orders for medication initiation or titration, basic metabolic panel (BMP), and nephrology electronic consult (e-consult). We examined each type of action and calculated percentages of placed and signed orders for subgroups of firings.There were firings for medication initiation (813) and medication titration (430), and every firing also included orders for nephrology e-consult (1,243) and BMP (1,243). High rates of override (59.6%) and deferral (14.6%) were observed, and CDS-recommended orders were only signed about one-third of the time from within the alert. The percentage of orders that were signed after being placed within the alert was higher for medication initiation than for medication titration (33 vs. 12.0% for angiotensin-converting enzyme inhibitors [ACEi] and 38.8 vs. 14% for angiotensin II receptor blockers [ARBs]). Findings suggest that users are hesitant to commit to immediate action within the alert.Evaluating user interaction within alerts reveals nuances in physician preferences and workflow that should inform CDS alert design. This study is registered with the Clinicaltrials.gov Trial Registration (identifier: NCT03679247).</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"595-603"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651507","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":"The STREAMLINE Pilot Study on Time Reduction and Efficiency in AI-Mediated Logging for Improved Note-Taking Experience.","authors":"Roheet Kakaday, Elizabeth Zoe Herrera, Olivia Coskey, Andrew W Hertel, Paulina Kaiser","doi":"10.1055/a-2559-5791","DOIUrl":"10.1055/a-2559-5791","url":null,"abstract":"<p><p>This pilot study aimed to evaluate the impact of an ambient listening AI tool, DAX CoPilot (DAX), on clinical documentation efficiency among primary care providers in a community-based setting.We conducted a randomized controlled trial among volunteer clinicians (physicians, nurse practitioners, and physician assistants in family medicine, internal medicine, pediatrics, and urgent care), who were asked to use DAX with a standardized note template (<i>n</i> = 25) or to continue with traditional documentation methods (<i>n</i> = 20) over a 3-month intervention period. We evaluated documentation efficiency with both standard and custom Epic metrics to evaluate the impact on all visit types as well as specifically problem-focused visits.Because of heterogeneity in DAX usage, we created post hoc categories of low (<45% of all visits, <i>n</i> = 12), moderate (45-69.9% of all visits, <i>n</i> = 6), and high-frequency (≥ 70% of all visits, <i>n</i> = 7) DAX users. We observed the largest differences among high-frequency DAX users. For problem-focused visits with clinicians in this group, a median of 50% of note characters were written by DAX, and we observed a 1.4-minute decrease in time spent on notes per visit (<i>p</i>-value: 0.38) and a 35% decrease in the median number of characters per note (<i>p</i>-value: 0.38) from baseline to the end of the study period. The control group metrics were largely unchanged throughout the study.Our findings suggest that DAX can improve documentation efficiency, particularly among clinicians who use it frequently. Healthcare systems might benefit by using AL-AI tools like DAX but should consider implementation scope and note template features. Future investigations are needed to further explore these trends and their additional implications for outcomes such as burnout.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"614-621"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651504","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":"Surveying the Efficacy of an Open Access Biomedical Informatics Boot Camp.","authors":"Skyler D Resendez, Gillian Franklin, Crystal Tomlin, Rachel Stephens, Heather Maness, Srikar Chamala, Ross Koppel, Peter L Elkin","doi":"10.1055/a-2547-5208","DOIUrl":"10.1055/a-2547-5208","url":null,"abstract":"<p><p>This study aimed to assess the efficacy of a biomedical informatics boot camp with regard to improving the skill sets of its participants.The University at Buffalo hosts a free, virtual biomedical informatics boot camp annually. Lectures covering various subject matters are offered, for example, general programming, machine learning, natural language processing, and clinical decision support. Once the 2023 boot camp had concluded, an anonymous voluntary survey was distributed.Seventy percent of the survey respondents indicated that they agreed that their expectations were met. Eighty-two percent of the respondents indicated that our JupyterHub and the associated educational coding materials are useful tools for learning. Free response answers showed a desire for additional hands-on courses over theoretical lectures.The results were overwhelmingly positive. Most respondents felt they had expanded upon their knowledge of informatics. The study also pointed out challenges, including keeping difficulty levels appropriate for an audience with diverse educational backgrounds.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"583-588"},"PeriodicalIF":2.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12196558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531018","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":"Digital Compassion Fatigue as an Emerging Phenomenon for Registered Nurses Experiencing Technostress.","authors":"Matthew Byrne","doi":"10.1055/a-2564-8809","DOIUrl":"10.1055/a-2564-8809","url":null,"abstract":"<p><p>Registered nurses increasingly work in remote care and digital interaction roles, offering flexibility and expansion of their scope of practice. These roles may expose nurses to digital compassion fatigue, a phenomenon proposed to be characterized by the negative psychological and emotional impact of caring for patients remotely through the use of technology.The first objective of this work is to propose the phenomenon of \"digital compassion fatigue\" as a potentially further evolved and differentiated form of \"compassion fatigue.\" The second objective is to produce a comparative analysis of attributes, antecedents, and consequences through literature reviews.An evolutionary concept analysis approach was selected as a guide for exploring, discussing, and defining the new concept of digital compassion fatigue. Concept analysis was selected given the need for a framework that accounts for the dynamic nature of technology and practice. The process of conducting a concept analysis includes consideration of diverse and multidisciplinary perspectives. As a result, those in caring, educational, and/or support service roles (e.g., social work, counseling, and teaching) for which distance suffering and technostress could feasibly be present were also included in the literature searches and reviews. Health care-specific studies often included nurses in the sample but may not have differentiated their specific insights or data points in the results.The concept analysis explored the attributes, antecedents, and consequences of digital compassion fatigue, differentiating it from its evolutionary parent, compassion fatigue. Key antecedents included technostress, distant suffering, and the unique challenges of delivering care remotely. A major confounding variable was the COVID-19 pandemic, which may have heightened or introduced new technology-related stressors or highlighted the existence of digital compassion fatigue.Further defining and understanding digital compassion fatigue is crucial for developing effective strategies to support nurses who may experience it or who are at risk.</p>","PeriodicalId":48956,"journal":{"name":"Applied Clinical Informatics","volume":" ","pages":"708-717"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701876","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}