Health system-wide access to generative artificial intelligence: the New York University Langone Health experience.

Objectives: The study aimed to assess the usage and impact of a private and secure instance of a generative artificial intelligence (GenAI) application in a large academic health center. The goal was to understand how employees interact with this technology and the influence on their perception of skill and work performance.

Materials And Methods: New York University Langone Health (NYULH) established a secure, private, and managed Azure OpenAI service (GenAI Studio) and granted widespread access to employees.

The First Generative AI Prompt-A-Thon in Healthcare: A Novel Approach to Workforce Engagement with a Private Instance of ChatGPT.

Background: Healthcare crowdsourcing events (e.g. hackathons) facilitate interdisciplinary collaboration and encourage innovation.

Evaluation of GPT-4 ability to identify and generate patient instructions for actionable incidental radiology findings.

Objectives: To evaluate the proficiency of a HIPAA-compliant version of GPT-4 in identifying actionable, incidental findings from unstructured radiology reports of Emergency Department patients. To assess appropriateness of artificial intelligence (AI)-generated, patient-facing summaries of these findings.

Materials And Methods: Radiology reports extracted from the electronic health record of a large academic medical center were manually reviewed to identify non-emergent, incidental findings with high likelihood of requiring follow-up, further sub-stratified as "definitely actionable" (DA) or "possibly actionable-clinical correlation" (PA-CC).

Treating COVID-19 With Hydroxychloroquine (TEACH): A Multicenter, Double-Blind Randomized Controlled Trial in Hospitalized Patients.

Background: Effective therapies to combat coronavirus 2019 (COVID-19) are urgently needed. Hydroxychloroquine (HCQ) has in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the clinical benefit of HCQ in treating COVID-19 is unclear. Randomized controlled trials are needed to determine the safety and efficacy of HCQ for the treatment of hospitalized patients with COVID-19.

The Financial and Clinical Impact of an Electronic Health Record Integrated Pathway in Elective Colon Surgery.

Background: Enhanced Recovery after Surgery (ERAS) pathways have been shown to reduce length of stay, but there have been limited evaluations of novel electronic health record (EHR)-based pathways. Compliance with ERAS in real-world settings has been problematic.

Objective: This article evaluates a novel ERAS electronic pathway (E-Pathway) activity integrated with the EHR for patients undergoing elective colorectal surgery.

Design and implementation of a clinical decision support tool for primary palliative Care for Emergency Medicine (PRIM-ER).

Background: The emergency department is a critical juncture in the trajectory of care of patients with serious, life-limiting illness. Implementation of a clinical decision support (CDS) tool automates identification of older adults who may benefit from palliative care instead of relying upon providers to identify such patients, thus improving quality of care by assisting providers with adhering to guidelines. The Primary Palliative Care for Emergency Medicine (PRIM-ER) study aims to optimize the use of the electronic health record by creating a CDS tool to identify high risk patients most likely to benefit from primary palliative care and provide point-of-care clinical recommendations.

Interrupting providers with clinical decision support to improve care for heart failure.

Background: Evidence-based therapy for heart failure remains underutilized at hospital discharge, particularly for patients with heart failure who are hospitalized for another cause. We developed clinical decision support (CDS) to recommend an angiotensin converting enzyme (ACE) inhibitor during hospitalization to promote its continuation at discharge. The CDS was designed to be implemented in both interruptive and non-interruptive versions.

Interruptive Versus Noninterruptive Clinical Decision Support: Usability Study.

Background: Clinical decision support (CDS) has been shown to improve compliance with evidence-based care, but its impact is often diminished because of issues such as poor usability, insufficient integration into workflow, and alert fatigue. Noninterruptive CDS may be less subject to alert fatigue, but there has been little assessment of its usability.

Objective: This study aimed to study the usability of interruptive and noninterruptive versions of a CDS.

Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.

Objective: The purpose of this study was to determine whether an electronic health record-based sepsis alert system could improve quality of care and clinical outcomes for patients with sepsis.

Materials And Methods: We performed a patient-level interrupted time series study of emergency department patients with severe sepsis or septic shock between January 2013 and April 2015. The intervention, introduced in February 2014, was a system of interruptive sepsis alerts triggered by abnormal vital signs or laboratory results.

Impact of an Intervention to Improve Weekend Hospital Care at an Academic Medical Center: An Observational Study.

Background: Hospital care on weekends has been associated with delays in care, reduced quality, and poor clinical outcomes.

Objective: The purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends.

Monitoring the pulse of hospital activity: electronic health record utilization as a measure of care intensity.

Background: Hospital care on weekends has been associated with reduced quality and poor clinical outcomes, suggesting that decreases in overall intensity of care may have important clinical effects. We describe a new measure of hospital intensity of care based on utilization of the electronic health record (EHR).

Methods: We measured global intensity of care at our academic medical center by monitoring the use of the EHR in 2011.

The impact of the heparin-induced thrombocytopenia (HIT) computerized alert on provider behaviors and patient outcomes.

Objective: The aim of this study was to measure the effect of an electronic heparin-induced thrombocytopenia (HIT) alert on provider ordering behaviors and on patient outcomes.

Materials And Methods: A pop-up alert was created for providers when an individual's platelet values had decreased by 50% or to <100,000/mm(3) in the setting of recent heparin exposure. The authors retrospectively compared inpatients admitted between January 24, 2008 and August 24, 2008 to a control group admitted 1 year prior to the HIT alert.

Perceived barriers to trying self-management approaches for chronic pain in older persons.

Objectives: To examine older persons' willingness to participate in exercise and relaxation programs for managing chronic pain, to identify characteristics associated with willingness to participate, and to ascertain their barriers to participation.

Design: Cross-sectional survey.

Setting: A geriatric ambulatory care practice located in New York, New York, and the General Clinical Research Center of Weill Cornell Medical College.