Publications by authors named "Gellert G"

Objective: This analysis describes the use patterns of web-based virtual triage (VT) by pregnant patients before and during the first two years of the COVID-19 pandemic, and how the pandemic influenced frequency of VT use, nature of symptoms reported, and the associated implications for maternal healthcare delivery.

Methods: An online survey of 36,910 patients who reported pregnancy was completed between January 1, 2019 and June 30, 2022. The data were segmented into six month periods to allow comparative analyses of usage frequency and changes in initial complaints over the study period, with particular emphasis on the early months of the COVID-19 pandemic.

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Objective: Gather insights into healthcare organization (HCO) preparedness for new 21st Century Cures Act information blocking disincentives and challenges in achieving greater accuracy /interoperability of patient identity/data.

Methods: Survey of 197 U.S.

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Article Synopsis
  • The study assessed how many patients reporting severe symptoms to an AI-based virtual triage (VT) didn't actually intend to seek emergency care despite needing it.
  • Over 38% of these patients showed no intention to consult a physician for conditions like heart attacks or strokes, even when their symptoms indicated urgent care was necessary.
  • The findings suggest that VT can help identify patients who underestimate their symptoms' severity, potentially speeding up necessary medical care to prevent worsening conditions.
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Objective: To complete a review of the literature on patient experience and satisfaction as relates to the potential for virtual triage (VT) or symptom checkers to enhance and enable improvements in these important health care delivery objectives.

Methods: Review and synthesis of the literature on patient experience and satisfaction as informed by emerging evidence, indicating potential for VT to favorably impact these clinical care objectives and outcomes.

Results/conclusions: VT enhances potential clinical effectiveness through early detection and referral, can reduce avoidable care delivery due to late clinical presentation, and can divert primary care needs to more clinically appropriate outpatient settings rather than high-acuity emergency departments.

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Article Synopsis
  • The review explores how improving clinician satisfaction through technology, specifically virtual triage (VT), can enhance clinical care and benefit healthcare organizations.
  • It analyzes evidence indicating VT's potential to reduce administrative burdens, improve resource management, and enhance communication, thereby addressing common sources of clinician dissatisfactions.
  • The findings suggest that implementing VT can lead to better clinician experiences and satisfaction, helping healthcare organizations provide more effective, efficient, and cost-efficient care.
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  • COVID-19 vaccine delivery posed significant challenges for organizations, emphasizing the need for security in patient data and verifying clinician identities.
  • Deployment of identity access management (IAM) and single sign-on (SSO) technologies proved essential for quickly establishing vaccine delivery centers during the crisis.
  • Innovative uses of IAM/SSO allowed for rapid authentication of hundreds of new personnel, showcasing how existing digital identity solutions can enhance response efforts in public health emergencies.
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  • The use of medical scribes has shown benefits in physician workflow and productivity, but some studies indicate they may have limited or negative effects.
  • The sheer volume of published biomedical literature—over 103 million articles and clinical trial reports in a physician's career—poses a significant challenge for doctors to stay updated and effectively integrate this knowledge into practice.
  • For specialized physicians, even a low relevance percentage of this literature means sifting through tens of thousands of potentially applicable studies, while generalists may face the daunting task of reviewing over a million pertinent articles.
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Objective: To describe the use patterns, impact and derived patient-user value of a mobile web-based virtual triage/symptom checker.

Methods: Online survey of 2,113 web-based patient-users of a virtual triage/symptom checker was completed over an 8-week period. Questions focused on triage and care objectives, pre- and post-triage care intent, frequency of use, value derived and satisfaction with virtual triage.

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Background: Surging volumes of patients with COVID-19 and the high infectiousness of SARS-CoV-2 challenged hospital infection control/safety, staffing, care delivery and operations as few crises have. Imperatives to ensure security of patient information, defend against cybersecurity threats and accurately identify/authenticate patients and staff were undiminished, which fostered creative use cases where hospitals leveraged identity access and management (IAM) technologies to improve infection control and minimise disruption of clinical and administrative workflows.

Methods: Working with a leading IAM solution provider, implementation personnel in the USA and UK identified all hospitals/health systems where an innovative use of IAM technology improved facility infection control and pandemic response management.

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The impact of two years of the COVID-19 pandemic on the relationship between employers and employees are explored, including changing employee sensibilities with respect to future employment, work-life balance, remote and flexible work, and the great resignation. Lasting work changes induced by the pandemic expand employee empowerment and demand for greater work flexibility. Flexibility no longer provides employers a unique selling point and hiring/retention competitiveness - it has become an expected standard.

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In the midst of the political leadership crisis caused by the COVID-19 pandemic in the United States, a framework of public health nonfeasance, misfeasance and malfeasance is described in order to define, categorize and understand the various forms of public health performance failure of the U.S. government during the COVID-19 outbreak response thus far.

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Objective: The aim of this study was to quantify the impact of electronic health record (EHR) workstation single sign-on (SSO) for nurses.

Background: SSO was implemented in 19 hospitals for expedited EHR access.

Methods: Login durations before and after SSO implementation were compared, and the financial value of nursing time liberated from keyboard was estimated.

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Article Synopsis
  • A health system introduced single sign-on (SSO) technology in 19 hospitals to streamline clinician access to electronic health records (EHR) by using identification badge readers instead of manual logins.
  • The study aimed to evaluate how SSO impacted clinical workflow and saved time, measuring login durations before and after SSO implementation while calculating the dollar value of time saved for various healthcare professionals.
  • Results showed significant time reductions: first-of-shift logins decreased by 5.3 seconds and reconnect logins by 20.4 seconds, totaling a weekly time savings of 943.4 hours across all facilities, translating to an annual savings of over $3.2 million in clinician time.
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Evaluate the impact of multi-component quality improvement for pediatric asthma care focusing on serial use of an evidence-based clinical pathway via paper order sets, pathway integration into computerized provider order entry (CPOE), use of a clinical respiratory score (CRS) and a discharge checklist. Outcomes were assessed over three intervention periods and 50 months on: time to beta-agonist and steroid first administration, frequency of readmissions and hospital length of stay. A general linear model estimated mean log(LOS) over time and between study periods.

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  • Patients undergoing interventional cardiology procedures are at high risk for hemodynamic instability, traditionally monitored through invasive methods that are time-consuming and carry risks of complications.
  • Over the past two years, over 400 valve procedures have utilized the noninvasive ClearSight system, which employs finger-cuff technology for continuous monitoring.
  • The ClearSight system shows comparable accuracy to invasive methods in measuring arterial pressure and cardiac output, while also providing additional metrics that can improve decision-making and lead to better postoperative outcomes.
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Species reintroductions - the translocation of individuals to areas in which a species has been extirpated with the aim of re-establishing a self-sustaining population - have become a widespread practice in conservation biology. Reintroduction projects have tended to focus on terrestrial vertebrates and, to a lesser extent, fishes. Much less effort has been devoted to the reintroduction of invertebrates into restored freshwater habitats.

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This case represents the first reported simultaneous TAVR and TMVR for native aortic and mitral stenosis performed via the transapical approach.

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  • The Joint Commission has reversed its approval of secure clinical texting for issuing patient care orders, now prohibiting it again.
  • Despite the usefulness of texting for daily patient care, concerns about transmission delays in high-acuity scenarios could jeopardize patient safety.
  • A review found that 84% of secure clinical texting vendors promote their services for critical care settings, highlighting the need for clearer policies to mitigate risks associated with texting in healthcare.
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  • Monthly reports tracking CPOE usage by physicians can encourage adoption by highlighting their contributions to patient safety and quality improvement, especially among those affected by performance-based financial incentives.
  • Misattributions of order sources can undermine physician confidence and motivation to use CPOE effectively, which could have implications for patient safety and legal matters.
  • In a study of one hospitalist group, 4.18% of orders were incorrectly attributed, primarily from nursing (42%) and pharmacy (38%), indicating the need for improved order management protocols to maintain accurate CPOE reporting.
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Background: CHRISTUS Health began implementation of computer workstation single sign-on (SSO) in 2015. SSO technology utilizes a badge reader placed at each workstation where clinicians swipe or "tap" their identification badges.

Objective: To assess the impact of SSO implementation in reducing clinician time logging in to various clinical software programs, and in financial savings from migrating to a thin client that enabled replacement of traditional hard drive computer workstations.

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