A5075934122- Electronic Health Records Systems
- Healthcare Systems and Technology
- Biomedical Text Mining and Ontologies
- Ethics in Clinical Research
- Health Sciences Research and Education
- Medical Coding and Health Information
- Patient Safety and Medication Errors
- Genomics and Rare Diseases
- Primary Care and Health Outcomes
- Healthcare Technology and Patient Monitoring
- Pharmaceutical Practices and Patient Outcomes
- Quality and Safety in Healthcare
- Mobile Health and mHealth Applications
- Patient Satisfaction in Healthcare
- Clinical practice guidelines implementation
- Health Systems, Economic Evaluations, Quality of Life
- Emergency and Acute Care Studies
- Healthcare Policy and Management
- Hepatitis C virus research
- Pharmacogenetics and Drug Metabolism
- Health Literacy and Information Accessibility
- Nursing Diagnosis and Documentation
- Patient-Provider Communication in Healthcare
- Liver Disease Diagnosis and Treatment
- Health Policy Implementation Science
Icahn School of Medicine at Mount Sinai
2015-2024
Mount Sinai Medical Center
2003-2022
Mount Sinai Health System
2001-2020
Vanderbilt University
2016
Mount Sinai Hospital
1997-2013
Mount Sinai Hospital
2011
NewYork–Presbyterian Hospital
2007
Columbia University
2006-2007
New York Consortium in Evolutionary Primatology
2007
University of Victoria
2006-2007
Alcohol and drug use are leading causes of morbidity mortality that frequently go unidentified in medical settings. As part a multi-phase study to implement electronic health record-integrated substance screening primary care clinics, we interviewed key clinical stakeholders identify current practices, barriers screening, recommendations for its implementation.Focus groups individual interviews were conducted with 67 stakeholders, including patients, providers (faculty resident physicians),...
The exponential rise in genomics research over the past decade has yielded a growing number of sequence variants associated with medication response that may have clinical utility. Despite existing barriers, attention is turning to strategies integrate these data into care. CLIPMERGE PGx Program establishing best-practices infrastructure for implementation genome-informed prescribing using biobank-derived cohort, preemptive genetic testing, and real-time decision support deployed through...
There is consensus that incorporating clinical decision support into electronic health records will improve quality of care, contain costs, and reduce overtreatment, but this potential has yet to be demonstrated in trials.To assess the influence a customized evidence-based tool on management respiratory tract infections effectiveness integrating evidence at point care.In randomized trial, we implemented 2 well-validated integrated prediction rules, namely, Walsh rule for streptococcal...
Recent advances in the science and technology of artificial intelligence (AI) growing numbers deployed AI systems healthcare other services have called attention to need for ethical principles governance. We define provide a rationale that should guide commission, creation, implementation, maintenance, retirement as foundation governance throughout lifecycle. Some are derived from familiar requirements practice research medicine healthcare: beneficence, nonmaleficence, autonomy, justice come...
Abstract Background Integrating artificial intelligence (AI) in healthcare settings has the potential to benefit clinical decision-making. Addressing challenges such as ensuring trustworthiness, mitigating bias, and maintaining safety is paramount. The lack of established methodologies for pre- post-deployment evaluation AI tools regarding crucial attributes transparency, performance monitoring, adverse event reporting makes this situation challenging. Objectives This paper aims make...
Objectives: In the wake of Institute Medicine report, To Err Is Human: Building a Safer Health System (LT Kohn, JM Corrigan, MS Donaldson, eds; Washington, DC: National Academy Press, 1999), numerous advisory panels are advocating widespread implementation physician order entry as means to reduce errors and improve patient safety. Successful an system requires that attention be given user interface. The authors assessed satisfaction with interface two different systems—a commercially...
Abstract The development and implementation of clinical decision support (CDS) that trains itself adapts its algorithms based on new data—here referred to as Adaptive CDS—present unique challenges considerations. Although CDS represents an expected progression from earlier work, the activities needed appropriately manage establishment evolution require new, coordinated initiatives oversight do not currently exist. In this AMIA position paper, authors describe current emerging safe use lay...
<h3>Importance</h3> Guidelines recommend that adult patients receive screening for alcohol and drug use during primary care visits, but the adoption of in routine practice remains low. Clinics frequently struggle to choose a approach is best suited their resources, workflows, patient populations. <h3>Objective</h3> To evaluate how implement electronic health record (EHR)–integrated substance by comparing commonly used methods examining association with implementation outcomes. <h3>Design,...
Background: Health information exchange (HIE) is a potentially powerful technology that can improve the quality of care delivered in emergency departments, but little known about physicians' current perceptions HIE.
This study assessed physician attitudes toward adopting genome-guided prescribing through clinical decision support (CDS), prior to enlisting in the Clinical Implementation of Personalized Medicine Electronic Health Records and Genomics pilot pharmacogenomics project (CLIPMERGE PGx). We developed a survey instrument that includes Evidence Based Practice Attitude Scale, adapted measure genome-informed interventions (EBPAS-GII). The also items physicians’ characteristics (awareness,...
Clinical prediction rules (CPRs) represent well-validated but underutilized evidence-based medicine tools at the point-of-care. To date, an inability to integrate these into electronic health record (EHR) has been a major limitation and we are not aware of study demonstrating use CPR's in ambulatory EHR setting. The integrated clinical rule (iCPR) trial integrates two assesses both usability effect on practice primary care A multi-disciplinary design team was assembled develop prototype iCPR...
Genomic medicine has the potential to improve care by tailoring treatments individual. There is consensus in literature that pharmacogenomics (PGx) may be an ideal starting point for real-world implementation, due presence of well-characterized drug-gene interactions. Clinical Decision Support (CDS) avenue which implement PGx at bedside. Previous established theoretical models CDS implementation and discussed a number anticipated challenges. However, work detailing actual experiences been...
Background: The Centers for Disease Control and Prevention (CDC) recommends one-time hepatitis C virus (HCV) antibody testing “Birth Cohort” adults born during 1945–1965. Objective: To examine the impact of an electronic health record (EHR)-embedded best practice alert (BPA) HCV among Birth Cohort adults. Design: Cluster-randomized trial was conducted from April 29, 2013 to March 2014. Subjects Setting: Ten community hospital-based primary care practices. Participants were attending...
In this article, we describe a framework that have developed for improving the effectiveness of critical decision-making in selecting information systems. our framework, consider system selection terms strength evidence obtained from testing candidate systems order to reduce risk and increase likelihood implementation an effective safe system. Two case studies, one major North American hospital European hospital, are presented illustrate how methods such as usability can be applied improve...
Summary Objectives: Issues related to lack of system usability and potential safety hazards continue be reported in the health information technology (HIT) literature. Usability engineering methods are increasingly used ensure improved they also beginning applied more widely for ensuring HIT applications. These being design implementation many systems. In this paper we describe evidence- based approaches applying methods. Methods: A multi-phased approach healthcare is described. inspection...
Summary Background: Dissemination and adoption of clinical decision support (CDS) tools is a major initiative the Affordable Care Act’s Meaningful Use program. Adoption CDS multipronged with personal, organizational, settings factoring into successful utilization rates. Specifically, diffusion innovation theory implies that ‘early adopters’ are more inclined to use younger physicians tend be ranked in this category. Objective: This study examined differences across providers’ training level....
Abstract Background In 2011, the American Board of Medical Specialties established clinical informatics (CI) as a subspecialty in medicine, jointly administered by Pathology and Preventive Medicine. Subsequently, many institutions created CI fellowship training programs to meet growing need for informaticists. Although share similar features, there is considerable variation program funding administrative structures. Objectives The aim our study was characterize including governance...
The effective evaluation of health information technology (HIT) is currently a major challenge. It essential that applications we develop are usable, meet user needs and shown to be safe. Furthermore, provide appropriate feedback designers systems new methods for both formative summative needed as become more complex distributed. To ensure system usability variety have emerged from the area engineering been adapted healthcare. authors applied engineering, working with hospitals other...