Publications by authors named "Julia Kay"

Objective: Despite interest in optimizing the electronic health record (EHR) to facilitate chronic disease care for conditions like rheumatoid arthritis (RA), progress in this area has been slow. EHR sidecar applications offer one solution, but little guidance exists to facilitate their successful development, deployment, and maintenance in the healthcare setting. We aimed to provide a roadmap for how to develop and deploy an EHR sidecar application based on our experience building a new EHR-integrated, patient-facing visualization tool that displayed disease outcomes to RA patients during a clinical visit (the "RA PRO dashboard") in a large academic health center.

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The academic-practice partnership has become increasingly important in nursing education. An academic-practice partnership between a health systems infection prevention and control (IPC) department and its academic affiliate may provide an opportunity to help advance undergraduate nursing students' IPC knowledge and skills and provide IPC staff the opportunity to develop their clinical teaching skills as they teach and mentor students. We convened an exploratory workshop between our private university-based college of nursing and its affiliated health care system IPC department to brainstorm and identify areas for mutual collaboration and gauge interest in formalizing a partnership.

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Article Synopsis
  • A study was conducted to assess how clinicians engage with performance dashboards from Qualified Clinical Data Registries (QCDR), leading to the creation of a framework called BDC (Breadth-Depth-Context).
  • The BDC framework evaluates user engagement based on breadth (dashboard sessions), depth (actions taken), and context (practice characteristics), and was tested using user log data from a rheumatology registry.
  • Findings revealed four engagement profiles among 213 practices, with factors like patient volume and specific electronic health record vendors influencing higher engagement levels, suggesting the BDC framework's potential for broader application in studying dashboard engagement.
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Article Synopsis
  • * The results demonstrated that GPT-4 significantly outperformed other models, achieving high accuracy (94% for hydroxychloroquine and 95% for prednisone) with as few as 100 in-context examples.
  • * The findings suggest that LLMs, especially GPT-4, have a strong potential to automate the extraction of structured data from complex medication signatures with minimal manual intervention, benefiting clinical and research settings.
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Objective: The American College of Rheumatology's (ACR) 2020 guidelines for the management of gout recommend using a treat-to-target approach to lower serum urate (SU). Using the ACR's Rheumatology Informatics System for Effectiveness registry, we examined the use of a treat-to-target approach among gout patients receiving long-term urate-lowering therapy (ULT) and followed longitudinally by rheumatologists.

Methods: Included patients had one or more diagnoses for gout in 2018-2019 and continuous use of ULT for ≥12 months.

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Background: Routine collection of disease activity (DA) and patient-reported outcomes (PROs) in rheumatoid arthritis (RA) are nationally endorsed quality measures and critical components of a treat-to-target approach. However, little is known about the role electronic health record (EHR) systems play in facilitating performance on these measures.

Objective: Using the American College Rheumatology's (ACR's) RISE registry, we analyzed the relationship between EHR system and performance on DA and functional status (FS) quality measures.

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Article Synopsis
  • Behçet's disease (BD) is a chronic condition with varying prevalence based on geography and ethnicity, and this study aimed to understand its characteristics and treatment among U.S. patients compared to endemic regions.* -
  • The analysis included 1,323 patients from the RISE registry, revealing a mean age of 48.7 years, a higher ratio of women to men (3.8:1), and predominately White demographics, with glucocorticoids and colchicine being the most common medications used.* -
  • Results indicated that U.S. BD patients were older and had a higher representation of women compared to data from endemic areas like Egypt and Turkey, suggesting a need for further investigation into gender differences
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Objective: Sarcoidosis is often treated with glucocorticoids, although the use of biologics is growing. Prescribing patterns for biologics for patients with sarcoidosis in US rheumatology practices have never been examined. Given that there are no steroid-sparing US Food and Drug Administration-approved therapies for sarcoidosis, we sought to characterize the real-world treatment of sarcoidosis and to assess practice-level variation in prescribing patterns.

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  • The study aimed to assess the quality of care for patients with systemic lupus erythematosus (SLE) using the American College of Rheumatology's RISE registry, focusing on specific quality measures.
  • Data from over 27,000 patients revealed significant gaps in care, such as inadequate renal disease screening and untreated hypertension, along with notable variations between different practices.
  • The findings highlight the need for tailored quality measures in SLE management to address these care gaps and potentially improve patient outcomes across the US.
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Objective: Immunosuppressant drugs can increase the risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) and tuberculosis (TB) reactivation. Using the American College of Rheumatology's Rheumatology Informatics System for Effectiveness (RISE) registry, we examined pre-treatment screening among new users of biologic or targeted synthetic disease modifying drugs (DMARDs).

Methods: Data, derived from RISE, included patients ≥ 18 years old who were new users of biologic or targeted synthetic DMARDs.

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