Publications

The SAFER guides: empowering organizations to improve the safety and effectiveness of electronic health records

With support from the Office of the National Coordinator for Health Information Technology (ONC), we used a rigorous, iterative process to develop a set of 9 self-assessment tools to optimize the safety and safe use of EHRs. These tools, referred to as the Safety Assurance Factors for EHR Resilience (SAFER) guides, could be used to self-assess safety and effectiveness of EHR implementations, identify specific areas of vulnerability, and create solutions and culture change to mitigate risks.

Development of a Clinician Reputation Metric to Identify Appropriate Problem-Medication Pairs in a Crowdsourced Knowledge Base

BACKGROUND: Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications […]

Clinical Decision Support Alert Appropriateness: A Review and Proposal for Improvement

BACKGROUND: Many healthcare providers are adopting clinical decision support (CDS) systems to improve patient safety and meet meaningful use requirements. Computerized alerts that prompt clinicians about drug-allergy, drug-drug, and drug-disease warnings or provide dosing guidance are most commonly implemented. Alert overrides, which occur when clinicians do not follow the guidance […]

Clinical Decision Support for Colon and Rectal Surgery: An Overview

Clinical decision support (CDS) has been shown to improve clinical processes, promote patient safety, and reduce costs in healthcare settings, and it is now a requirement for clinicians as part of the Meaningful Use Regulation. However, most evidence for CDS has been evaluated primarily in internal medicine care settings, and […]

State of the Art in Clinical Informatics: Evidence and Examples

OBJECTIVE: The field of clinical informatics has expanded substantially in the six decades since its inception. Early research focused on simple demonstrations that health information technology (HIT) such as electronic health records (EHRs), computerized provider order entry (CPOE), and clinical decision support (CDS) systems were feasible and potentially beneficial in […]

Early Results of the Meaningful Use Program for Electronic Health Records

In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act established Medicare and Medicaid incentive programs to encourage the adoption of electronic health records (EHRs) by hospitals and eligible professionals. Under Medicare, eligible professionals who show “meaningful use” of certified EHRs are eligible for payments up to […]

Health care transformation through collaboration on open-source informatics projects: integrating a medical applications platform, research data repository, and patient summarization

BACKGROUND: The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge bases to support problem-oriented […]