Linking Patient Encounters across Primary and Ancillary Electronic Health Record Systems: A Comparison of Two Approaches.

Background: To achieve scientific goals, researchers often require integration of data from a primary electronic health record (EHR) system and one or more ancillary EHR systems used during the same patient care encounter. Although studies have demonstrated approaches for linking patient identity records across different EHR systems, little is known about linking patient encounter records across primary and ancillary EHR systems.

Objectives: We compared a patients-first approach versus an encounters-first approach for linking patient encounter records across multiple EHR systems.

Leveraging generative AI for clinical evidence synthesis needs to ensure trustworthiness.

Evidence-based medicine promises to improve the quality of healthcare by empowering medical decisions and practices with the best available evidence. The rapid growth of medical evidence, which can be obtained from various sources, poses a challenge in collecting, appraising, and synthesizing the evidential information. Recent advancements in generative AI, exemplified by large language models, hold promise in facilitating the arduous task.

Implementation of a commercial federated network of electronic health record data to enable sponsor-initiated clinical trials at an academic medical center.

Background: A commercial federated network called TriNetX has connected electronic health record (EHR) data from academic medical centers (AMCs) with biopharmaceutical sponsors in a privacy-preserving manner to promote sponsor-initiated clinical trials. Little is known about how AMCs have implemented TriNetX to support clinical trials.

Findings: At our AMC over a six-year period, TriNetX integrated into existing institutional workflows enabled 402 requests for sponsor-initiated clinical trials, 14 % (n = 56) of which local investigators expressed interest in conducting.

An architecture for research computing in health to support clinical and translational investigators with electronic patient data.

Objective: Obtaining electronic patient data, especially from electronic health record (EHR) systems, for clinical and translational research is difficult. Multiple research informatics systems exist but navigating the numerous applications can be challenging for scientists. This article describes Architecture for Research Computing in Health (ARCH), our institution's approach for matching investigators with tools and services for obtaining electronic patient data.

Comparing automated vs. manual data collection for COVID-specific medications from electronic health records.

Introduction: Data extraction from electronic health record (EHR) systems occurs through manual abstraction, automated extraction, or a combination of both. While each method has its strengths and weaknesses, both are necessary for retrospective observational research as well as sudden clinical events, like the COVID-19 pandemic. Assessing the strengths, weaknesses, and potentials of these methods is important to continue to understand optimal approaches to extracting clinical data.

Assessment of Natural Sunlight Protection Provided by 10 High-SPF Broad-Spectrum Sunscreens and Sun-Protective Fabrics.

In 1978, the FDA Advisory Panel proposed both indoor and natural sunlight SPF testing methods but reverted to indoor testing only in 1993. Today's sunscreen sun protection and broad-spectrum claims are based on mandated clinical tests using solar simulators and in vitro spectrophotometers. This research evaluated the protection of 10 high-SPF (30-110), broad-spectrum sunscreen products, as well as 6 sun-protective fabrics against natural sunlight in Arequipa, Peru.

Multi-laboratory study of hybrid diffuse reflectance spectroscopy to assess sunscreen SPF and UVA-PFs.

Background: Proof-of-principle studies have established the use of Hybrid Diffuse Reflectance Spectroscopy (HDRS) methods to assess both Ultraviolet-A Protection Factor (UVA-PF) and Sun Protection Factor (SPF) indices in individual laboratories.

Methods: Multiple laboratories evaluated 23 emulsions and two spray sunscreen products to evaluate repeatability and accuracy of assessment of SPF and UVA-PF values, using HDRS test systems from various manufacturers using different designs.

Results: All of the laboratories reported similar SPF and UVA-PF values within a narrow range of values to establish the reliability of the HDRS methodology across laboratories, independent of equipment manufacturer or operator.

ReCiter: An open source, identity-driven, authorship prediction algorithm optimized for academic institutions.

Academic institutions need to maintain publication lists for thousands of faculty and other scholars. Automated tools are essential to minimize the need for direct feedback from the scholars themselves who are practically unable to commit necessary effort to keep the data accurate. In relying exclusively on clustering techniques, author disambiguation applications fail to satisfy key use cases of academic institutions.

Origins and Evolution of Photocarcinogenesis Action Spectra, Including Germicidal UVC.

Germicidal ultraviolet radiation (GUV) provides a means of dramatically reducing airborne spread of microorganisms in residential and workspace environments. Regarding design and use of GUV, both efficacy and safety data have accumulated over several decades, with a substantial increase of attention during the current COVID-19 pandemic. Considerations for skin and eye safety previously resulted in guidance on exposures in institutional and workplace settings.

A Method to Improve Availability and Quality of Patient Race Data in an Electronic Health Record System.

Background: Although federal regulations mandate documentation of structured race data according to Office of Management and Budget (OMB) categories in electronic health record (EHR) systems, many institutions have reported gaps in EHR race data that hinder secondary use for population-level research focused on underserved populations. When evaluating race data available for research purposes, we found our institution's enterprise EHR contained structured race data for only 51% (1.6 million) of patients.

Ten principles for data sharing and commercialization.

Digital medical records have enabled us to employ clinical data in many new and innovative ways. However, these advances have brought with them a complex set of demands for healthcare institutions regarding data sharing with topics such as data ownership, the loss of privacy, and the protection of the intellectual property. The lack of clear guidance from government entities often creates conflicting messages about data policy, leaving institutions to develop guidelines themselves.

Role of Technology in Self-Assessment and Feedback Among Hospitalist Physicians: Semistructured Interviews and Thematic Analysis.

Background: Lifelong learning is embedded in the culture of medicine, but there are limited tools currently available for many clinicians, including hospitalists, to help improve their own practice. Although there are requirements for continuing medical education, resources for learning new clinical guidelines, and developing fields aimed at facilitating peer-to-peer feedback, there is a gap in the availability of tools that enable clinicians to learn based on their own patients and clinical decisions.

Objective: The aim of this study was to explore the technologies or modifications to existing systems that could be used to benefit hospitalist physicians in pursuing self-assessment and improvement by understanding physicians' current practices and their reactions to proposed possibilities.

Global data of unprotected skin minimal erythema dose relationship to Individual Typology Angle.

Background: Determination of the Minimal Erythema Dose (MED ) of unprotected skin is perhaps the most critical aspect of the Sun Protection Factor (SPF) value and disproportionately influences the SPF. Individual Typology Angle (ITA°), a skin reflectance measure of the skin's pigmentation, has been used by many clinical laboratories to estimate the MED values for SPF testing.

Methods: Individual Typology Angle and unprotected MED data on 9931 individuals were received from 12 laboratories located on 5 continents to determine MED values in prospective sunscreen testing studies.

Replacing Paper Informed Consent with Electronic Informed Consent for Research in Academic Medical Centers: A Scoping Review.

Although experts have identified benefits to replacing paper with electronic consent (eConsent) for research, a comprehensive understanding of strategies to overcome barriers to adoption is unknown. To address this gap, we performed a scoping review of the literature describing eConsent in academic medical centers. Of 69 studies that met inclusion criteria, 81% (n=56) addressed ethical, legal, and social issues; 67% (n=46) described user interface/user experience considerations; 39% (n=27) compared electronic versus paper approaches; 33% (n=23) discussed approaches to enterprise scalability; and 25% (n=17) described changes to consent elections.

Evaluation of sunscreen efficacy over time and re-application using hybrid diffuse reflectance spectroscopy.

Background: In 2007, the FDA added requirements for sunscreens to be labeled "re-apply at least every 2 hours" based on very limited data. This study used hybrid diffuse reflectance spectroscopy (HDRS) to evaluate the persistence of protection by 80 minutes water-resistant sunscreen formulation with and without re-application, and with and without sweat-inducing activity over 6 hours.

Methods: Sunscreens were applied to subject's foreheads and backs, and they remained at rest or exercised to induce sweating in a heated environment.

A Method for Integrating Healthcare Provider Organization and Research Sponsor Systems and Workflows to Support Large-Scale Studies.

Healthcare provider organizations (HPOs) increasingly participate in large-scale research efforts sponsored by external organizations that require use of consent management systems that may not integrate seamlessly with local workflows. The resulting inefficiency can hinder the ability of HPOs to participate in studies. To overcome this challenge, we developed a method using REDCap, a widely adopted electronic data capture system, and novel middleware that can potentially generalize to other settings.

Implementation of Informatics to Support the NIH Research Program in a Healthcare Provider Organization.

The NIH All of Us Research Program, a national effort to collect biospecimens and health data for over one million participants from across the United States, requires participating healthcare provider organizations (HPOs) to use informatics tools maintained by the NIH to manage participant consent, biospecimen processing, physical measurements, and other workflows. HPOs also maintain distinct workflows for handling overlapping tasks within their individual aegis, which do not necessarily achieve seamless interoperability with NIH-maintained cloud-based systems. At our HPO, we implemented informatics to address gaps in enrollment workflows and hardware, clinical workflow integration, patient engagement, laboratory support, and study team reporting.

Evaluation of a REDCap-based Workflow for Supporting Federal Guidance for Electronic Informed Consent.

Adoption of electronic informed consent (eConsent) for research remains low despite evidence of improved patient comprehension, usability, and workflow processes compared to paper. At our institution, we implemented an eConsent workflow using REDCap, a widely used electronic data capture system. The goal of this study was to evaluate the extent to which the REDCap eConsent solution adhered to federal guidance for eConsent.

Evaluating sunscreen ultraviolet protection using a polychromatic diffuse reflectance device.

Background: Sun protection factor (SPF) and UVA protection factor (UVA-PF) are determined using in vivo tests, with high exposures of subjects to ultraviolet (UV) radiation. Hybrid diffuse reflectance spectroscopy (HDRS) enables estimation of both indices using only trace amounts UVB. However, the equipment requires two expensive monochromators that must synchronously scan the spectrum.

Design and Implementation of a Secure Computing Environment for Analysis of Sensitive Data at an Academic Medical Center.

Academic medical centers need to make sensitive data from electronic health records, payer claims, genomic pipelines, and other sources available for analytical and educational purposes while ensuring privacy and security. Although many studies have described warehouses for collecting biomedical data, few studies have described secure computing environments for analysis of sensitive data. This case report describes the Weill Cornell Medicine Data Core with respect to user access, data controls, hardware, software, audit, and financial considerations.

A scalable method for supporting multiple patient cohort discovery projects using i2b2.

Although i2b2, a popular platform for patient cohort discovery using electronic health record (EHR) data, can support multiple projects specific to individual disease areas or research interests, the standard approach for doing so duplicates data across projects, requiring additional disk space and processing time, which limits scalability. To address this deficiency, we developed a novel approach that stored data in a single i2b2 fact table and used structured query language (SQL) views to access data for specific projects. Compared to the standard approach, the view-based approach reduced required disk space by 59% and extract-transfer-load (ETL) time by 46%, without substantially impacting query performance.

Secondary Use of Patients' Electronic Records (SUPER): An Approach for Meeting Specific Data Needs of Clinical and Translational Researchers.

Academic medical centers commonly approach secondary use of electronic health record (EHR) data by implementing centralized clinical data warehouses (CDWs). However, CDWs require extensive resources to model data dimensions and harmonize clinical terminology, which can hinder effective support of the specific and varied data needs of investigators. We hypothesized that an approach that aggregates raw data from source systems, ignores initial modeling typical of CDWs, and transforms raw data for specific research purposes would meet investigator needs.

Yum-Me: A Personalized Nutrient-Based Meal Recommender System.

Nutrient-based meal recommendations have the potential to help individuals prevent or manage conditions such as diabetes and obesity. However, learning people's food preferences and making recommendations that simultaneously appeal to their palate and satisfy nutritional expectations are challenging. Existing approaches either only learn high-level preferences or require a prolonged learning period.

Effects of an e-Prescribing interface redesign on rates of generic drug prescribing: exploiting default options.

Objective: Increasing the use of generic medications could help control medical costs. However, educational interventions have limited impact on prescriber behavior, and e-prescribing alerts are associated with high override rates and alert fatigue. Our objective was to evaluate the effect of a less intrusive intervention, a redesign of an e-prescribing interface that provides default options intended to "nudge" prescribers towards prescribing generic drugs.