Correction: Performance of a Web-Based Reference Database With Natural Language Searching Capabilities: Usability Evaluation of DynaMed and Micromedex With Watson.

[This corrects the article DOI: 10.2196/43960.].

Performance of a Web-Based Reference Database With Natural Language Searching Capabilities: Usability Evaluation of DynaMed and Micromedex With Watson.

Background: Evidence-based point-of-care information (POCI) tools can facilitate patient safety and care by helping clinicians to answer disease state and drug information questions in less time and with less effort. However, these tools may also be visually challenging to navigate or lack the comprehensiveness needed to sufficiently address a medical issue.

Objective: This study aimed to collect clinicians' feedback and directly observe their use of the combined POCI tool DynaMed and Micromedex with Watson, now known as DynaMedex.

The Development and Piloting of the Ambulatory Electronic Health Record Evaluation Tool: Lessons Learned.

Background: Substantial research has been performed about the impact of computerized physician order entry on medication safety in the inpatient setting; however, relatively little has been done in ambulatory care, where most medications are prescribed.

Objective: To outline the development and piloting process of the Ambulatory Electronic Health Record (EHR) Evaluation Tool and to report the quantitative and qualitative results from the pilot.

Methods: The Ambulatory EHR Evaluation Tool closely mirrors the inpatient version of the tool, which is administered by The Leapfrog Group.

The tradeoffs between safety and alert fatigue: Data from a national evaluation of hospital medication-related clinical decision support.

Objective: The study sought to evaluate the overall performance of hospitals that used the Computerized Physician Order Entry Evaluation Tool in both 2017 and 2018, along with their performance against fatal orders and nuisance orders.

Materials And Methods: We evaluated 1599 hospitals that took the test in both 2017 and 2018 by using their overall percentage scores on the test, along with the percentage of fatal orders appropriately alerted on, and the percentage of nuisance orders incorrectly alerted on.

Results: Hospitals showed overall improvement; the mean score in 2017 was 58.

Design and testing of a mobile health application rating tool.

Mobile health applications ("apps") have rapidly proliferated, yet their ability to improve outcomes for patients remains unclear. A validated tool that addresses apps' potentially important dimensions has not been available to patients and clinicians. The objective of this study was to develop and preliminarily assess a usable, valid, and open-source rating tool to objectively measure the risks and benefits of health apps.

National Trends in the Safety Performance of Electronic Health Record Systems From 2009 to 2018.

Importance: Despite the broad adoption of electronic health record (EHR) systems across the continuum of care, safety problems persist.

Objective: To measure the safety performance of operational EHRs in hospitals across the country during a 10-year period.

Design, Setting, And Participants: This case series included all US adult hospitals nationwide that used the National Quality Forum Health IT Safety Measure EHR computerized physician order entry safety test administered by the Leapfrog Group between 2009 and 2018.

Assessing the safety of electronic health records: a national longitudinal study of medication-related decision support.

Background: Electronic health records (EHR) can improve safety via computerised physician order entry with clinical decision support, designed in part to alert providers and prevent potential adverse drug events at entry and before they reach the patient. However, early evidence suggested performance at preventing adverse drug events was mixed.

Methods: We used data from a national, longitudinal sample of 1527 hospitals in the USA from 2009 to 2016 who took a safety performance assessment test using simulated medication orders to test how well their EHR prevented medication errors with potential for patient harm.

The Impact of Alternative Payment in Chronically Ill and Older Patients in the Patient-centered Medical Home.

Background: Patient-centered medical home (PCMH) has gained prominence as a promising model to encourage improved primary care delivery. There is a paucity of studies that evaluate the impact of payment models in the PCMH.

Objectives: We sought to examine whether coupling coordinated, team-based care transformation plan with a novel reimbursement model affects outcomes related to expenditures and utilization.

Patient-Facing Mobile Apps to Treat High-Need, High-Cost Populations: A Scoping Review.

Background: Self-management is essential to caring for high-need, high-cost (HNHC) populations. Advances in mobile phone technology coupled with increased availability and adoption of health-focused mobile apps have made self-management more achievable, but the extent and quality of the literature supporting their use is not well defined.

Objective: The purpose of this review was to assess the breadth, quality, bias, and types of outcomes measured in the literature supporting the use of apps targeting HNHC populations.

Many Mobile Health Apps Target High-Need, High-Cost Populations, But Gaps Remain.

With rising smartphone ownership, mobile health applications (mHealth apps) have the potential to support high-need, high-cost populations in managing their health. While the number of available mHealth apps has grown substantially, no clear strategy has emerged on how providers should evaluate and recommend such apps to patients. Key stakeholders, including medical professional societies, insurers, and policy makers, have largely avoided formally recommending apps, which forces patients to obtain recommendations from other sources.

Evaluation: A Qualitative Pilot Study of Novel Information Technology Infrastructure to Communicate Genetic Variant Updates.

Background: Partners HealthCare Personalized Medicine developed GeneInsight Clinic (GIC), a tool designed to communicate updated variant information from laboratory geneticists to treating clinicians through automated alerts, categorized by level of variant interpretation change.

Objectives: The study aimed to evaluate feedback from the initial users of the GIC, including the advantages and challenges to receiving this variant information and using this technology at the point of care.

Methods: Healthcare professionals from two clinics that ordered genetic testing for cardiomyopathy and related disorders were invited to participate in one-hour semi-structured interviews and/ or a one-hour focus group.

Usability of Commercially Available Mobile Applications for Diverse Patients.

Background: Mobile applications or 'apps' intended to help people manage their health and chronic conditions are widespread and gaining in popularity. However, little is known about their acceptability and usability for low-income, racially/ethnically diverse populations who experience a disproportionate burden of chronic disease and its complications.

Objective: The objective of this study was to investigate the usability of existing mobile health applications ("apps") for diabetes, depression, and caregiving, in order to facilitate development and tailoring of patient-facing apps for diverse populations.

Developing a Framework for Evaluating the Patient Engagement, Quality, and Safety of Mobile Health Applications.

Rising ownership of smartphones and tablets across social and demographic groups has made mobile applications, or apps, a potentially promising tool for engaging patients in their health care, particularly those with high health care needs. Through a systematic search of iOS (Apple) and Android app stores and an analysis of apps targeting individuals with chronic illnesses, we assessed the degree to which apps are likely to be useful in patient engagement efforts. Usefulness was determined based on the following criteria: description of engagement, relevance to the targeted patient population, consumer ratings and reviews, and most recent app update.

Linking acknowledgement to action: closing the loop on non-urgent, clinically significant test results in the electronic health record.

Failure to follow-up nonurgent, clinically significant test results (CSTRs) is an ambulatory patient safety concern. Tools within electronic health records (EHRs) may facilitate test result acknowledgment, but their utility with regard to nonurgent CSTRs is unclear. We measured use of an acknowledgment tool by 146 primary care physicians (PCPs) at 13 network-affiliated practices that use the same EHR.

A novel clinician interface to improve clinician access to up-to-date genetic results.

Objectives: To understand the impact of GeneInsight Clinic (GIC), a web-based tool designed to manage genetic information and facilitate communication of test results and variant updates from the laboratory to the clinics, we measured the use of GIC and the time it took for new genetic knowledge to be available to clinicians.

Methods: Usage data were collected across four study sites for the GIC launch and post-GIC implementation time periods. The primary outcome measures were the time (average number of days) between variant change approval and notification of clinic staff, and the time between notification and viewing the patient record.

Usability of a novel clinician interface for genetic results.

The complexity and rapid growth of genetic data demand investment in information technology to support effective use of this information. Creating infrastructure to communicate genetic information to healthcare providers and enable them to manage that data can positively affect a patient's care in many ways. However, genetic data are complex and present many challenges.

Trends in primary care clinician perceptions of a new electronic health record.

Background: Clinician perceptions of a newly implemented electronic health record play an important role in its success or failure.

Objective: To measure changes in primary care clinician attitudes toward an electronic health record during the first year following implementation.

Design: Longitudinal survey.

Linking test ordering with order tracking: closing the loop in ambulatory care.

Test non-completion decreases quality of care and accounts for many diagnosis-related malpractice claims. Currently, clinicians using Partners' electronic Longitudinal Medical Record (LMR) can track results but lack a mechanism for tracking non-completed tests. This pilot intervention will study an "order tracking" functionality that flags newly-ordered tests and will lead to generation of written patient reminders if tests are not completed within pre-specified timeframes.

Trends in clinician perceptions of a new electronic health record.

Clinician perceptions of a newly implemented electronic health record (EHR) play an important role in its success or failure. Limited data exist describing how these attitudes change over time. We measured attitudes of primary care clinicians toward a new EHR during the first year following implementation.

Impact of ambulatory computerized physician order entry on clinicians' time.

While Ambulatory Computerized Physician Order Entry (ACPOE) may improve health care quality, the impact on clinician time may impose a barrier to implementation. We performed a time-motion analysis to evaluate this potential impact. The results indicate that there is no significant impact on clinicians' time with patients.

Do physicians take action on high risk family history information provided by patients outside of a clinic visit?

Clinically relevant family history information is frequently missing or not readily available in electronic health records. Improving the availability of family history information is important for optimum care of many patients. Family history information on five conditions was collected in a survey from 163 primary care patients.

Electronic health records in specialty care: a time-motion study.

Background: Electronic health records (EHRs) have great potential to improve safety, quality, and efficiency in medicine. However, adoption has been slow, and a key concern has been that clinicians will require more time to complete their work using EHRs. Most previous studies addressing this issue have been done in primary care.

An effort to improve electronic health record medication list accuracy between visits: patients' and physicians' response.

Objective: To evaluate the efficacy of a secure web-based patient portal called Patient Gateway (PG) in producing more accurate medication lists in the electronic health record (EHR), and whether sending primary care physicians (PCPs) a clinical message updating them on the information their patients provided caused physicians to update the EHR medication list.

Methods: We compared the medication list accuracy of 84 patients using PG with that of 79 who were not. Patient-reported medication discrepancies were noted in the EHR in a clinical note by research staff and a message was sent to the participants' PCPs notifying them of the updated information.

Impact of barcode medication administration technology on how nurses spend their time on clinical care.

In a time-motion study conducted in a hospital that recently implemented barcode medication administration (BCMA) technology, we found that the BCMA system did not increase the amount of time nurses spend on medication administration activities, and did not compromise the amount of time nurses spent on direct care of patients. Our results should allay concerns regarding the impact of BCMA on nursing workflow.