A5024394615- Electronic Health Records Systems
- Telemedicine and Telehealth Implementation
- Health Systems, Economic Evaluations, Quality of Life
- Artificial Intelligence in Healthcare and Education
- Clinical practice guidelines implementation
- Cardiac, Anesthesia and Surgical Outcomes
- School Health and Nursing Education
- Healthcare Systems and Technology
- Patient-Provider Communication in Healthcare
- Asthma and respiratory diseases
- Hemodynamic Monitoring and Therapy
- Health and Medical Studies
- Patient Satisfaction in Healthcare
- Patient Safety and Medication Errors
- Meta-analysis and systematic reviews
- COVID-19 and healthcare impacts
- Mobile Health and mHealth Applications
- Pharmaceutical studies and practices
- Cell Adhesion Molecules Research
- Child and Adolescent Health
- Intellectual Property and Patents
- Neuroscience and Neuropharmacology Research
- Healthcare cost, quality, practices
- Topic Modeling
- Medication Adherence and Compliance
Stanford University
2015-2025
Stanford Health Care
2013-2024
Stanford Medicine
2018-2024
Digital Science (United States)
2024
Arizona State University
2023-2024
University of Colorado Denver
2021
Veterans Health Administration
2021
Denver Health Medical Center
2021
Regional Medical Center
2018
University of Wisconsin–Madison
2018
The COVID-19 pandemic changed clinician electronic health record (EHR) work in a multitude of ways. To evaluate how, we measure ambulatory EHR use the United States throughout pandemic.We meta-data from care clinicians 366 systems using Epic system December 2019 to 2020. We used descriptive statistics for including active-use time across clinical activities, after-hours, and messages received. Multivariable regression total after-hours adjusting daily volume organizational characteristics,...
Importance The emergence and promise of generative artificial intelligence (AI) represent a turning point for health care. Rigorous evaluation AI deployment in clinical practice is needed to inform strategic decision-making. Objective To evaluate the implementation large language model used draft responses patient messages electronic inbox. Design, Setting, Participants A 5-week, prospective, single-group quality improvement study was conducted from July 10 through August 13, 2023, at single...
Importance Timely tests are warranted to assess the association between generative artificial intelligence (GenAI) use and physicians’ work efforts. Objective To investigate GenAI-drafted replies for patient messages physician time spent on answering length of replies. Design, Setting, Participants Randomized waiting list quality improvement (QI) study from June August 2023 in an academic health system. Primary care physicians were randomized immediate activation group a delayed group. Data...
The ability of large language models (LLMs) to follow natural instructions with human-level fluency suggests many opportunities in healthcare reduce administrative burden and improve quality care. However, evaluating LLMs on realistic text generation tasks for remains challenging. Existing question answering datasets electronic health record (EHR) data fail capture the complexity information needs documentation burdens experienced by clinicians. To address these challenges, we introduce...
Electronic health record (EHR) log data have shown promise in measuring physician time spent on clinical activities, contributing to deeper understanding and further optimization of the environment. In this article, we propose 7 core measures EHR use that reflect multiple dimensions practice efficiency: total time, work outside work, documentation, prescriptions, inbox teamwork for orders, an aspirational measure amount undivided attention patients receive from their physicians during...
<h3>Importance</h3> Understanding how the electronic health record (EHR) system changes clinician work, productivity, and well-being is critical. Little known regarding global variation in patterns of use. <h3>Objective</h3> To provide insights into which EHR activities clinicians spend their time doing, tools they use, messages receive, amount using after hours. <h3>Design, Setting, Participants</h3> This cross-sectional study analyzed deidentified metadata ambulatory care systems US,...
Abstract Objective To reduce pathogen exposure, conserve personal protective equipment, and facilitate health care personnel work participation in the setting of COVID-19 pandemic, three affiliated institutions rapidly independently deployed inpatient telemedicine programs during March 2020. We describe key features early learnings these hospital setting. Methods Relevant clinical operational leadership from an academic medical center, pediatric teaching hospital, safety net county system...
l-Glutamate is a major excitatory neurotransmitter that binds ionotropic and metabotropic glutamate receptors. Cerebral endothelial cells from many species have been shown to express several forms of receptors; however, human cerebral not either the N-methyl-D-aspartate (NMDA) receptor message or protein. This study provides evidence protein for NMDA Human cell monolayer electrical resistance changes in response agonists, antagonists, second blockers were tested. RT-PCR Western blot analysis...
Background Order sets are widely used tools in the electronic health record (EHR) for improving healthcare quality. However, there is limited insight into how well they facilitate clinician workflow. We assessed four indicators based on order set usage patterns EHR that reflect potential misalignment between design and workflow needs. Methods data from all orders of medication, laboratory, imaging blood product items at an academic hospital itemset mining approach to extract frequently...
This study evaluates the pilot implementation of ambient AI scribe technology to assess physician perspectives on usability and impact burden burnout.
Cerebral endothelial cells in the rat, pig, and, most recently, human have been shown to express several types of receptors specific for glutamate. High levels glutamate disrupt cerebral barrier via activation N-methyl-d-aspartate (NMDA) receptors. We previously suggested that this glutamate-induced dysfunction was oxidant dependent. Here, we provide evidence respond by generating an intracellular stress NMDA receptor activation. loaded with oxidant-sensitive probe dihydrorhodamine were used...
Background: Provider organizations increasingly have the ability to exchange patient health information electronically. Organizational (HIE) policy decisions can impact extent which external is readily available providers, but this relationship has not been well studied. Objective: Our objective was examine between electronic of across and organizational HIE decisions. We focused on 2 key decisions: whether automatically search for from other require HIE-specific consent. Methods: conducted...
SummaryTo facilitate the development of machine-learning (ML) models in care delivery, which remain poorly understood and executed, Stanford Medicine targeted an effort to address this implementation gap at health system by addressing three key challenges: developing a framework for designing integration artificial intelligence (AI) into complex work systems; identifying building teams people, technologies, processes successfully develop implement AI-enabled executing manner that is...
Importance Understanding of the interplay between electronic health record (EHR), care team relations, and physician well-being is currently lacking. Approaches to cultivate interpersonal interactions may be necessary complement advancements in information technology with high-quality function. Objective To examine ways which EHR, functioning, intersect interact. Design, Setting, Participants Secondary qualitative analysis semistructured interview data from 2 studies used keyword-in-context...
This cross-sectional study of patient queries in US electronic health records examines laypersons’ satisfaction with answers generated artificial intelligence (AI) compared clinician responses, and whether results were concordant clinician-determined quality AI responses.
Importance Limited qualitative studies exist evaluating ambient artificial intelligence (AI) scribe tools. Such can provide deeper insights into AI implementations by capturing lived experiences. Objective To evaluate physician perspectives on scribes. Design, Setting, and Participants A study using semistructured interviews guided the Reach, Efficacy, Adoption, Implementation, Maintenance/Practical, Robust Sustainability Model (RE-AIM/PRISM) framework, with thematic analysis both inductive...
Patients' journeys across the care continuum can be improved with patient-centered technology integrated into process. Misaligned financial incentives, change management challenges, and privacy concerns are some of hurdles that have prevented health systems from deploying engages patients along continuum. Despite these sociotechnical organizations developed innovative approaches to engaging patients. We describe promising technology-enabled consumer engagement practices at two...
There is an emerging standard to provide patients rapid electronic access elements of their medical records. Although surveys generally support it, this practice controversial among oncologists, because few empiric data are available for scenarios potentially life-threatening conditions like cancer. We report the views oncologists about patient radiology and pathology results that could indicate disease progression.Four months before were surveyed, final radiology/pathology reports routinely...
The expanded availability of telehealth due to the COVID-19 pandemic presents a concern that may result in an unnecessary increase utilization. We analyzed 4,114,651 primary care encounters (939,134 unique patients) from three healthcare systems between 2019 and 2021 found little change utilization as became widely available. Results suggest is not resulting additional visits federal policies should support use.
L-glutamate, an excitatory neurotransmitter, binds to both ionotropic and metabotropic glutamate receptors. In certain parts of the brain BBB contains two normally impermeable barriers: 1) cerebral endothelial barrier 2) epithelial barrier. Human cells express NMDA receptors; however, date, human (neuroepithelial cells) have not been shown receptor message or protein. this study, hypothalamic sections were examined for receptors (NMDAR) expression via immunohistochemistry murine...
In the UK, since mid 1980s, supermarkets have accounted for an increasing volume of bread production. Occupational asthma among employees who produce from raw ingredients in has not been previously investigated. A cross-sectional survey was undertaken involving 239 (71%) 20 different supermarket bakeries. The work-related symptoms were investigated by using questionnaires and measuring radioallergosorbent test serum-specific immunoglobulin (Ig)E to flour fungal α-amylase. total 89 underwent...
Background: Regular health surveillance is commonly recommended for workers exposed to occupational antigens but little known about how effective it in identifying cases. Aims: To report one large company’s and compare its findings with those of a standard cross-sectional survey the same workforce. Methods: A supermarket company 324 in-store bakeries producing bread from raw ingredients conducted three-stage programme around 3000 bakery employees. The first stage involved administration...