A5011452909- Electronic Health Records Systems
- Machine Learning in Healthcare
- Healthcare Systems and Technology
- Artificial Intelligence in Healthcare and Education
- Head and Neck Cancer Studies
- Colorectal Cancer Screening and Detection
- Mobile Health and mHealth Applications
- Innovations in Medical Education
- Primary Care and Health Outcomes
- Palliative Care and End-of-Life Issues
- Ethics in Clinical Research
- Telemedicine and Telehealth Implementation
- Healthcare Technology and Patient Monitoring
- Occupational Health and Safety Research
- Hepatitis C virus research
- Chronic Disease Management Strategies
- Embedded Systems Design Techniques
- Sepsis Diagnosis and Treatment
- Healthcare cost, quality, practices
- Healthcare professionals’ stress and burnout
- Advanced Combustion Engine Technologies
- Video Surveillance and Tracking Methods
- Diversity and Career in Medicine
- Health Systems, Economic Evaluations, Quality of Life
- Head and Neck Surgical Oncology
Stanford University
2012-2024
Stanford Medicine
2019-2024
Translational Research Informatics Center (Japan)
2018
Stanford Health Care
2015-2016
General Motors (India)
1975-1976
Ideas and Opinions3 July 2018Physician Burnout in the Electronic Health Record Era: Are We Ignoring Real Cause?N. Lance Downing, MD, David W. Bates, MSc, Christopher A. Longhurst, MSN. MDStanford University School of Medicine, Stanford, California (N.L.D.)Search for more papers by this author, MScBrigham Women's Hospital, Harvard Medical School, Public Health, Boston, Massachusetts (D.W.B.)Search MSUniversity California, San Diego, (C.A.L.)Search authorAuthor, Article, Disclosure...
Access to palliative care is a key quality metric which most healthcare organizations strive improve. The primary challenges increasing access are combination of physicians over-estimating patient prognoses, and shortage staff in general. This, with treatment inertia can result mismatch between wishes, their actual towards the end life. In this work, we address problem, Institutional Review Board approval, using machine learning Electronic Health Record (EHR) data patients. We train Deep...
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,...
<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,...
Computer vision, a rapidly progressing domain of artificial intelligence, may ultimately permit further improvement in patient safety. Researchers have been testing an AI-based system for detecting deviations from such essential behavior as maintaining hand hygiene.
Improving the quality of end-of-life care for hospitalized patients is a priority healthcare organizations. Studies have shown that physicians tend to over-estimate prognoses, which in combination with treatment inertia results mismatch between wishes and actual at end life. We describe method address this problem using Deep Learning Electronic Health Record (EHR) data, currently being piloted, Institutional Review Board approval, an academic medical center. The EHR data admitted are...
Abstract Early and frequent patient mobilization substantially mitigates risk for post-intensive care syndrome long-term functional impairment. We developed tested computer vision algorithms to detect activities occurring in an adult ICU. Mobility were defined as moving the into out of bed, a chair. A data set privacy-safe-depth-video images was collected Intermountain LDS Hospital ICU, comprising 563 instances mobility 98,801 total frames video from seven wall-mounted depth sensors. In all,...
Background Sepsis remains the top cause of morbidity and mortality hospitalised patients despite concerted efforts. Clinical decision support for sepsis has shown mixed results reflecting heterogeneous populations, methodologies interventions. Objectives To determine whether addition a real-time electronic health record (EHR)-based clinical alert improves adherence to treatment guidelines outcomes in with suspected severe sepsis. Design Patient-level randomisation, single blinded. Setting...
psychotropic drugs at the onset of COVID-19 pandemic that persisted through September 2020.Although absolute increases in prescribing were small, they disproportionate to expected secular trends from April 2018 February 2020, and distinct observed changes for other during pandemic.This study examined patterns multiple classes as well which not change pandemic.The results thus expand on those a United Kingdom, reported increased antipsychotic medications among patients with dementia pandemic....
Despite growing interest in using large language models (LLMs) healthcare, current explorations do not assess the real-world utility and safety of LLMs clinical settings. Our objective was to determine whether two can serve information needs submitted by physicians as questions an informatics consultation service a safe concordant manner. Sixty six from consult were GPT-3.5 GPT-4 via simple prompts. 12 assessed LLM responses' possibility patient harm concordance with existing reports...
Background High blood pressure affects approximately 116 million adults in the United States. It is leading risk factor for death and disability across world. Unfortunately, over past decade, hypertension control rates have decreased Prediction models clinical studies shown that reducing clinician inertia alone sufficient to reach target of ≥80% control. Digital health tools containing evidence‐based algorithms are able reduce a good fit turning tide control, but careful consideration should...
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...
One in twenty-five patients admitted to a hospital will suffer from acquired infection. If we can intelligently track healthcare staff, patients, and visitors, better understand the sources of such infections. We envision smart capable increasing operational efficiency improving patient care with less spending. In this paper, propose non-intrusive vision-based system for tracking people's activity hospitals. evaluate our method problem measuring hand hygiene compliance. Empirically,...
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...
Clinicians spend significant time working in the electronic health record (EHR). The US is an outlier EHR time, suggesting that EHR-related work may be driven part by legal environment and threat of malpractice. To assess this, we evaluate association between state-level malpractice climate clinician spent EHR.We use metadata from 351 ambulatory care systems United States using Epic January-August 2019 combined with data on incidence payouts. We used descriptive statistics to measure...
Clinicians spend a large proportion of their days using the electronic health record (EHR). There are known negative associations between measures EHR use and clinician experience.1 Primary care clinicians significantly more total after-hours time in than medical specialty surgical colleagues.2 However, little is regarding variation across primary specialties, such as adult pediatric care. In this cross-sectional study, we compared general pediatrics, internal medicine, family medicine clinicians.
Few machine learning (ML) models are successfully deployed in clinical practice. One of the common pitfalls across field is inappropriate problem formulation: designing ML to fit data rather than address a real-world pain point.We introduce practical toolkit for user-centred design consisting four questions covering: (1) solvable points, (2) unique value (eg, automation and augmentation), (3) actionability pathway (4) model's reward function. This was implemented series six participatory...
Increasing use of EHRs has generated interest in the potential computerized clinical decision support to improve treatment sepsis. Electronic sepsis alerts have had mixed results due poor test characteristics, inability detect a timely fashion and outside software limiting widespread adoption. We describe development, evaluation validation an accurate severe alert with impact management.To develop, evaluate, validate embedded commercial EHR.The was developed by identifying most common...
As the senior population rapidly increases, it is challenging yet crucial to provide effective long-term care for seniors who live at home or in facilities. Smart homes, which have gained widespread interest healthcare community, been proposed improve well-being of living independently. In particular, non-intrusive, cost-effective sensors placed these homes enable gait characterization, can clinically relevant information including mobility level and early neurodegenerative disease risk....
Introduction Patients undergoing therapy for nasopharyngeal carcinoma (NPC) often experience dysfunction of the sinonasal mucosa as a side effect radiotherapy and chemotherapy. Sinonasal mucosal changes may vary throughout treatment posttreatment periods, but little objective data exist characterizing such changes. We evaluated serial radiologic paranasal sinus in patients with NPC treatment. Methods Medical radiographic records were reviewed all treated between 2004 2006 at Stanford...