Projects


Decision Making and Clinical Work of Test Result Follow-up in Health IT Settings

AHRQ R01HS022087 (PI – Hardeep Singh, MD, MPH 2013-2017) A significant number of patients with abnormal test results “fall through the cracks” of the health care system and experience delays in diagnosis and treatment. Although electronic health records enhance the communication of abnormal test results, they do not guarantee the prompt […]


Improving Quality by Maintaining Accurate Problem Lists in the EHR (IQ-MAPLE)

R01HL122225 (PI – Adam Wright, PhD  2014-2018) An accurate, complete clinical problem list the cornerstone of a problem-oriented medical record, and research shows that accurate problem lists improve healthcare quality; however, problem lists are often incomplete. In this study, we will develop and evaluate an intervention to identify gaps in […]


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 […]


Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts

OBJECTIVE: To identify key principles for establishing a national clinical decision support (CDS) knowledge sharing framework. MATERIALS AND METHODS: As part of an initiative by the US Office of the National Coordinator for Health IT (ONC) to establish a framework for national CDS knowledge sharing, key stakeholders were identified. Stakeholders’ […]


Use of order sets in inpatient computerized provider order entry systems: a comparative analysis of usage patterns at seven sites

BACKGROUND: Many computerized provider order entry (CPOE) systems include the ability to create electronic order sets: collections of clinically related orders grouped by purpose. Order sets promise to make CPOE systems more efficient, improve care quality and increase adherence to evidence-based guidelines. However, the development and implementation of order sets […]