Unveiling readability challenges: An extensive analysis of consent document accessibility in clinical trials.

Background: Clinical research trials rely on informed consent forms (ICFs) to explain all aspects of the study to potential participants. Despite efforts to ensure the readability of ICFs, concerns about their complexity and participant understanding persist. There is a noted gap between Institutional Review Board (IRB) standards and the actual readability levels of ICFs, which often exceed the recommended 8th-grade reading level.

Implementing virtual desktops for clinical research at an academic health center: a case report.

Objectives: To address the challenges of sharing clinical research data through the implementation of cloud-based virtual desktops, enhancing collaboration among researchers while maintaining data security.

Materials And Methods: This case study details the deployment of virtual desktops at UMass Chan Medical School (UMass Chan). The process involved forming a Research Informatics Steering Executive workgroup, identifying key requirements, implementing Amazon WorkSpaces, and establishing configurable data management for research support.

Factors associated with non-adherence to dual-energy x-ray absorptiometry screening during the COVID-19 pandemic in an academic medical center.

Unlabelled: This study explored why some elderly females do not adhere to their bone density tests. It found that factors like age, race, marital status, insurance type, social vulnerability index, and vaccination status influence completion of these tests. Addressing these differences could improve the management of bone health in older adults.

COVID-19 Variant Surveillance and Social Determinants in Central Massachusetts: Development Study.

Background: Public health scientists have used spatial tools such as web-based Geographical Information System (GIS) applications to monitor and forecast the progression of the COVID-19 pandemic and track the impact of their interventions. The ability to track SARS-CoV-2 variants and incorporate the social determinants of health with street-level granularity can facilitate the identification of local outbreaks, highlight variant-specific geospatial epidemiology, and inform effective interventions. We developed a novel dashboard, the University of Massachusetts' Graphical user interface for Geographic Information (MAGGI) variant tracking system that combines GIS, health-associated sociodemographic data, and viral genomic data to visualize the spatiotemporal incidence of SARS-CoV-2 variants with street-level resolution while safeguarding protected health information.

The Implementation and Acceptability of a Combined Mobile Application with a COVID-19 at-Home Test Kit.

: Testing facilities for COVID-19 were stood up around the country during the pandemic, but could not handle the demand. This study aimed to combine a mobile application (App) with an at-home test kit to facilitate home-based testing. : After integrating an App with an at-home testing service, we measured the time between sample collection and notification of results.

Implementation of the pediatric weight management program: study protocol and baseline characteristics.

We are implementing , a primary care-based intervention to improve family-centered outcomes for children, ages 2-12 years, in organizations that care for low-income children. We will use the 'Reach-Effectiveness-Adoption-Implementation-Maintenance' framework to guide our mixed-methods evaluation to examine the effectiveness of stakeholder-informed strategies in supporting program adoption and child outcomes. We also describe characteristics of children, ages 2-12 years with a BMI ≥85th percentile and obesity-related care practices.

The Implementation and Acceptability of a Mobile Application for Screening for Atrial Fibrillation at Home.

Although patients are able to easily record electrocardiograms using consumer devices, these are typically not shared with their clinicians. This article discusses the development and acceptability of a mobile application (app) that integrates with the electronic health record to facilitate screening for atrial fibrillation (AF). After app development and implementation, we compared workflows with and without the mobile app.

Chronic disease outcomes from primary care population health program implementation.

Objectives: We implemented a health information technology-enabled population health management program for chronic disease management in academic hospital-affiliated primary care practices, then compared quality-of-care outcome measures among practices assigned a central population health coordinator (PHC) and those not assigned a PHC.

Study Design: Quasi-experimental.

Methods: Central PHCs were nonrandomly assigned to 8 of 18 practices.

Can Text Messages Improve Attendance to Primary Care Appointments in Underserved Populations?

We explored whether text message (TM) reminders could be used at a community health center (CHC) to improve primary care appointment attendance in adult patients. Over six months, we allocated 8,425 appointments to intervention and 2,679 to control. The proportion of no-shows in the intervention was 18.

Defining Team Effort Involved in Patient Care from the Primary Care Physician's Perspective.

Background: A better understanding of the attributes of patients who require more effort to manage may improve risk adjustment approaches and lead to more efficient resource allocation, improved patient care and health outcomes, and reduced burnout in primary care clinicians.

Objective: To identify and characterize high-effort patients from the physician's perspective.

Design: Cohort study.

Patient Navigation for Comprehensive Cancer Screening in High-Risk Patients Using a Population-Based Health Information Technology System: A Randomized Clinical Trial.

Importance: Patient navigation (PN) to improve cancer screening in low-income and racial/ethnic minority populations usually focuses on navigating for single cancers in community health center settings.

Objective: We evaluated PN for breast, cervical, and colorectal cancer screening using a population-based information technology (IT) system within a primary care network.

Design, Setting, And Participants: Randomized clinical trial conducted from April 2014 to December 2014 in 18 practices in an academic primary care network.

Development and Implementation of a Collaborative Team Care Model for Effective Insulin Use in an Academic Medical Center Primary Care Network.

Improving glycemic control across a primary care diabetes population is challenging. This article describes the development, implementation, and outcomes of the Diabetes Care Collaborative Model (DCCM), a collaborative team care process focused on promoting effective insulin use targeting patients with hyperglycemia in a patient-centered medical home model. After a pilot, the DCCM was implemented in 18 primary care practices affiliated with an academic medical center.

Health IT-assisted population-based preventive cancer screening: a cost analysis.

Objectives: Novel health information technology (IT)-based strategies harnessing patient registry data seek to improve care at a population level. We analyzed costs from a randomized trial of 2 health IT strategies to improve cancer screening compared with usual care from the perspective of a primary care network.

Study Design: Monte Carlo simulations were used to compare costs across management strategies.

A population management system for improving colorectal cancer screening in a primary care setting.

Rationale: Provision of colorectal cancer (CRC) screening in primary care is suboptimal; failure to observe screening guidelines poses unnecessary risks to patients and doctors.

Aims And Objectives: Implement a population management system for CRC screening; evaluate impact on compliance with evidence-based guidelines.

Design: A quasi-experimental, prospective quality improvement study design using pre-post-analyses with concurrent controls.

Building Equity Improvement into Quality Improvement: Reducing Socioeconomic Disparities in Colorectal Cancer Screening as Part of Population Health Management.

Background: Improving colorectal cancer (CRC) screening rates for patients from socioeconomically disadvantaged backgrounds is a recognized public health priority.

Objective: Our aim was to determine if implementation of a system-wide screening intervention could reduce disparities in the setting of improved overall screening rates.

Design: This was an interrupted time series (ITS) analysis before and after a population management intervention.

Clinical preventability of 30-day readmission after percutaneous coronary intervention.

Background: Early readmission after PCI is an important contributor to healthcare expenditures and a target for performance measurement. The extent to which 30-day readmissions after PCI are preventable is unknown yet essential to minimizing their occurrence.

Methods And Results: PCI patients readmitted to hospital at which PCI was performed within 30 days of discharge at the Massachusetts General Hospital and Brigham and Women's Hospital were identified, and their medical records were independently reviewed by 2 physicians.

Non-visit-based cancer screening using a novel population management system.

Background: Advances in information technology (IT) now permit population-based preventive screening, but the best methods remain uncertain. We evaluated whether involving primary care providers (PCPs) in a visit-independent population management IT application led to more effective cancer screening.

Methods: We conducted a cluster-randomized trial involving 18 primary care practice sites and 169 PCPs from June 15, 2011, to June 14, 2012.

Causes of short-term readmission after percutaneous coronary intervention.

Background: Rehospitalization within 30 days after an admission for percutaneous coronary intervention (PCI) is common, costly, and a future target for Medicare penalties. Causes of readmission after PCI are largely unknown.

Methods And Results: To illuminate the causes of PCI readmissions, patients with PCI readmitted within 30 days of discharge between 2007 and 2011 at 2 hospitals were identified, and their medical records were reviewed.

Development and implementation of a real-time 30-day readmission predictive model.

Hospitals are under great pressure to reduce readmissions of patients. Being able to reliably predict patients at increased risk for rehospitalization would allow for tailored interventions to be offered to them. This requires the creation of a functional predictive model specifically designed to support real-time clinical operations.

Applying operations research to optimize a novel population management system for cancer screening.

Objective: To optimize a new visit-independent, population-based cancer screening system (TopCare) by using operations research techniques to simulate changes in patient outreach staffing levels (delegates, navigators), modifications to user workflow within the information technology (IT) system, and changes in cancer screening recommendations.

Materials And Methods: TopCare was modeled as a multiserver, multiphase queueing system. Simulation experiments implemented the queueing network model following a next-event time-advance mechanism, in which systematic adjustments were made to staffing levels, IT workflow settings, and cancer screening frequency in order to assess their impact on overdue screenings per patient.

Assessing hospital readmission risk factors in heart failure patients enrolled in a telemonitoring program.

The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on psychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the impact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was collected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38% of study participants were readmitted to the hospital within 30 days.

Efficacy and cost-effectiveness of an automated screening algorithm in an inpatient clinical trial.

Introduction: Screening and recruitment for clinical trials can be costly and time-consuming. Inpatient trials present additional challenges because enrollment is time sensitive based on length of stay. We hypothesized that using an automated prescreening algorithm to identify eligible subjects would increase screening efficiency and enrollment and be cost-effective compared to manual review of a daily admission list.

Linking electronic health record-extracted psychosocial data in real-time to risk of readmission for heart failure.

Background: Knowledge of psychosocial characteristics that helps to identify patients at increased risk for readmission for heart failure (HF) may facilitate timely and targeted care.

Objective: We hypothesized that certain psychosocial characteristics extracted from the electronic health record (EHR) would be associated with an increased risk for hospital readmission within the next 30 days.

Methods: We identified 15 psychosocial predictors of readmission.

Queuing theory to guide the implementation of a heart failure inpatient registry program.

OBJECTIVE The authors previously implemented an electronic heart failure registry at a large academic hospital to identify heart failure patients and to connect these patients with appropriate discharge services. Despite significant improvements in patient identification and connection rates, time to connection remained high, with an average delay of 3.2 days from the time patients were admitted to the time connections were made.