A5067363466- Electronic Health Records Systems
- Patient Safety and Medication Errors
- Ethics in Clinical Research
- Biomedical Text Mining and Ontologies
- User Authentication and Security Systems
- Data Quality and Management
- Medical Malpractice and Liability Issues
- Healthcare Policy and Management
- Healthcare Systems and Technology
- Pharmaceutical Practices and Patient Outcomes
- Clinical practice guidelines implementation
- Advanced Malware Detection Techniques
- Quality and Safety in Healthcare
- Mobile Health and mHealth Applications
- Contemporary Sociological Theory and Practice
- Spam and Phishing Detection
- Biomedical and Engineering Education
- Radiology practices and education
- Information and Cyber Security
- Privacy, Security, and Data Protection
- Healthcare Technology and Patient Monitoring
- Telemedicine and Telehealth Implementation
- Primary Care and Health Outcomes
- Pharmaceutical industry and healthcare
- Business Process Modeling and Analysis
University of Pennsylvania
2016-2025
University at Buffalo, State University of New York
2019-2025
California University of Pennsylvania
2005-2024
University of Pennsylvania Health System
2020
Jacobs Institute
2019
Southern California University for Professional Studies
2017-2018
University of Southern California
2017-2018
Dartmouth College
2018
Philadelphia University
2005-2016
IEEE Computer Society
2015
Hospital computerized physician order entry (CPOE) systems are widely regarded as the technical solution to medication ordering errors, largest identified source of preventable hospital medical error. Published studies report that CPOE reduces errors up 81%. Few researchers, however, have focused on existence or types facilitated by CPOE.To identify and quantify role in facilitating prescription error risks.We performed a qualitative quantitative study house staff interaction with system at...
Many unintended and undesired consequences of Healthcare Information Technologies (HIT) flow from interactions between the HIT healthcare organization's sociotechnical system—its workflows, culture, social interactions, technologies. This paper develops illustrates a conceptual model these processes that we call Interactive Sociotechnical Analysis (ISTA). ISTA captures common types interaction with special emphasis on recursive processes, i.e., feedback loops alter newly introduced promote...
The authors develop a typology of clinicians' workarounds when using barcoded medication administration (BCMA) systems. Authors then identify the causes and possible consequences each workaround. BCMAs usually consist handheld devices for scanning machine-readable barcodes on patients medications. They also interface with electronic records. Ideally, help confirm five "rights" administration: right patient, drug, dose, route, time. While are reported to reduce errors--the least likely error...
In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board Directors convened a Task Force on Usability examine from literature make recommendations. This task force was composed representatives both academic settings vendors health (EHR) systems. After careful review vendor experiences with EHR design implementation, developed 10 recommendations in four areas: (1) human factors information...
Abstract In many hospitals and health systems, a ‘new’ electronic record means shift to one vendor: Epic, vendor that dominates in large medium hospital markets continues its success with smaller institutions ambulatory practices. Our paper examines the implications of this emerging monoculture: advantages disadvantages for physicians role innovation, professional autonomy, implementation difficulties, workflow, flexibility, cost, data standards, interoperability, interactions other...
Importance Medication computerised provider order entry (CPOE) has been shown to decrease errors and is being widely adopted. However, CPOE also potential for introducing or contributing errors. Objectives The objectives of this study are (a) analyse medication error reports where was reported as a ‘contributing cause’ (b) develop ‘use cases’ based on these test vulnerability current systems Methods A review United States Pharmacopeia MEDMARX reporting system made, taxonomy developed...
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The electronic health record (EHR) has become increasingly ubiquitous. At the same time, professionals have been turning to this resource for access data that is needed delivery of care and clinical research. There little doubt EHR made both these functions easier than earlier days when we relied on paper-based records. Coupled with modern database warehouse systems, high-speed networks, ability share others are large number challenges arguably limit optimal use OBJECTIVES: Our goal was...
Artificial intelligence models represented in machine learning algorithms are promising tools for risk assessment used to guide clinical and other health care decisions. Machine algorithms, however, may house biases that propagate stereotypes, inequities, discrimination contribute socioeconomic disparities. The include those related some sociodemographic characteristics such as race, ethnicity, gender, age, insurance, status from the use of erroneous electronic record data. Additionally,...
To model inconsistencies or distortions among three realities: patients' physical reality; clinicians' mental models of conditions, laboratories, etc; representation that reality in electronic health records (EHR). serve as a potential tool for quality improvement EHRs.Using observations, literature, information technology (IT) logs, vendor and US Food Drug Administration reports, we constructed scenarios/models how realities, models, EHRs can misalign to produce comprehension treatment. We...
Objective: To examine medication errors potentially related to computerized prescriber order entry (CPOE) and refine a previously published taxonomy classify them. Materials Methods: We reviewed all patient safety reports that occurred in the ordering phase from 6 sites participating United States Food Drug Administration–sponsored project examining CPOE safety. Two pharmacists independently each report confirm whether error ordering/prescribing was CPOE. For those CPOE, we assessed...
We address the challenges of transitioning from one electronic health record (EHR) to another-a near ubiquitous phenomenon in care. offer mitigating strategies reduce unintended consequences, maximize patient safety, and enhance care delivery.We searched PubMed other sources identify articles describing EHR-to-EHR transitions. combined these references with authors' extensive experience construct a conceptual schema recommendations facilitate transitions.Our query retrieved 1,351 citations:...
The COVID-19 pandemic response in the United States has exposed significant gaps information systems and processes that prevent timely clinical public health decision-making. Specifically, use of informatics to mitigate spread SARS-CoV-2, support care delivery, accelerate knowledge discovery bring forefront issues privacy, surveillance, limits state powers, interoperability between systems. Using a consensus-building process, we critically analyze informatics-related ethical light across 3...
Objectives: To assess the efficacy of a biomedical informatics boot camp with regards to improving skill sets its participants. Methods: The University at Buffalo hosts free, virtual annually. Lectures covering various subject matters are offered, e.g., general programming, machine learning, natural language processing, and clinical decision support. Once 2023 had concluded, an anonymous, voluntary survey was distributed. Results: 70% respondents indicated that they agreed their expectations...
Objectives: To identify the current state of medication‐taking practices community‐dwelling older adults on high‐risk medications. Design: Telephone survey filling prescriptions for warfarin, digoxin, or phenytoin from May 2, 2002, through June 30, 2003. Setting: The Pennsylvania Pharmacy Assistance Contract Elderly (PACE) Program, a state‐run program providing prescription drug coverage poor adults. Participants: PACE members. Measurements: Patients self‐reported sources information...
Workarounds to computer access in healthcare are sufficiently common that they often go unnoticed. Clinicians focus on patient care, not cybersecurity. We argue and demonstrate understanding workarounds workers' requires only analyses of rules, but also interviews observations with clinicians. In addition, we illustrate the value shadowing clinicians conducing groups understand their motivations tradeoffs for circumvention. Ethnographic investigation medical workplace emerges as a critical...
Physician burnout associated with EHRs is a major concern in health care. A comprehensive assessment of differences among physicians the areas EHR performance, efficiency, and satisfaction has not been conducted. The study sought to relationships physicians' perceived workload, satisfaction, usability using electronic record (EHR) comparisons by age, gender, professional role, years experience EHR.Mixed-methods assessments medical intensivists' use perceptions. Using simulated cases, we...
The current commercial health information technology (HIT) arena encompasses a number of competing firms that provide electronic applications to hospitals, clinical practices, and other healthcare-related entities. Such collect, store, analyze patient information. Some vendors incorporate contract language whereby purchasers HIT systems, such as hospitals clinics, must indemnify for malpractice or personal injury claims, even if those events are not caused fostered by the purchasers. require...
Conventional wisdom is that the textbook view describes reality, and only bad people (not good trying to get their jobs done) break rules. And yet it doesn't, circumvent.
Recommendations in the United States suggest limiting number of patient records displayed an electronic health record (EHR) to 1 at a time, although little evidence supports this recommendation.To assess risk wrong-patient orders EHR configuration clinicians vs allowing up 4 opened concurrently.This randomized clinical trial included 3356 large system New York and was conducted from October 2015 April 2017 emergency department, inpatient, outpatient settings.Clinicians were randomly assigned...
Background Nonvalvular atrial fibrillation (NVAF) affects almost 6 million Americans and is a major contributor to stroke but significantly undiagnosed undertreated despite explicit guidelines for oral anticoagulation. Objective The aim of this study investigate whether the use semisupervised natural language processing (NLP) electronic health record’s (EHR) free-text information combined with structured EHR data improves NVAF discovery treatment perhaps offers method prevent thousands...
This book, originally published in 1987, evaluates the human and managerial implications of new office information technology, based on actual experiences organisations using technology. A variety issues are examined including those centred role manger, producitivity, unemployment, physical mental health. Major emphasis is placed describing discussing implementation technology ways utilization which maximise benefits.