The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating.

Background And Objective: Recent external factors-the 21st Century Cures Act and the coronavirus disease 2019 (COVID-19) pandemic-have stimulated major changes in the patient portal landscape. The objective of this state-of-the-art review is to describe recent developments in the patient portal literature and to identify recommendations and future directions for the design, implementation, and evaluation of portals.

Methods: To focus this review on salient contemporary issues, we elected to center it on four topics: (1) 21st Century Cures Act's impact on patient portals (e.

Investigating the Interoperable Health App Ecosystem at the Start of the 21st Century Cures Act.

The objective of this study was to investigate the state of the interoperable mobile health application (app) ecosystem at the start of the 21st Century Cures Act to understand the opportunities currently available to patients for accessing and using their computable clinical data. Thus, we sought to identify third-party apps in the Apple App and Google Play Stores that seem to be capable of automatically downloading clinical data via a FHIR-based application programming interface through a targeted review of health apps. We found that few of the apps in this review have this capability (1.

"Mm-hm," "Uh-uh": are non-lexical conversational sounds deal breakers for the ambient clinical documentation technology?

Objectives: Ambient clinical documentation technology uses automatic speech recognition (ASR) and natural language processing (NLP) to turn patient-clinician conversations into clinical documentation. It is a promising approach to reducing clinician burden and improving documentation quality. However, the performance of current-generation ASR remains inadequately validated.

What Do Patients and Caregivers Want? A Systematic Review of User Suggestions to Improve Patient Portals.

Significant investments have been made in patient portals in order to provide patients with greater access to their medical records, as well as to other services such as secure electronic communication with their healthcare provider(s). Unfortunately, overall, patient adoption and use of patient portals has been lower than expected. According to the user-centered design philosophy, including end-user voices in all stages of the design process is critical to a technology's success.

Why do people oppose mask wearing? A comprehensive analysis of U.S. tweets during the COVID-19 pandemic.

Objective: Facial masks are an essential personal protective measure to fight the COVID-19 (coronavirus disease) pandemic. However, the mask adoption rate in the United States is still less than optimal. This study aims to understand the beliefs held by individuals who oppose the use of facial masks, and the evidence that they use to support these beliefs, to inform the development of targeted public health communication strategies.

Physician champions' perspectives and practices on electronic health records implementation: challenges and strategies.

Objective: Physician champions are "boots on the ground" physician leaders who facilitate the implementation of, and transition to, new health information technology (HIT) systems within an organization. They are commonly cited as key personnel in HIT implementations, yet little research has focused on their practices and perspectives.

Materials And Methods: We addressed this research gap through a qualitative study of physician champions that aimed to capture their challenges and strategies during a large-scale HIT implementation.

Migrating from One Comprehensive Commercial EHR to Another: Perceptions of Front-line Clinicians and Staff.

As healthcare organizations continue to grow and evolve, migrations from one commercial electronic health record (EHR) system to another are likely to become more common. However, little is known about front-line clinicians' and staff's perceptions of such changes. Our study addresses this gap through an organization-wide survey of employees immediately prior to the transition to a new commercial EHR.

Evaluating a handheld decision support device in pediatric intensive care settings.

Objective: To evaluate end-user acceptance and the effect of a commercial handheld decision support device in pediatric intensive care settings. The technology, pac2, was designed to assist nurses in calculating medication dose volumes and infusion rates at the bedside.

Materials And Methods: The devices, manufactured by InformMed Inc.

Understanding U.S. Adults' Zika Virus Risk Perceptions and Mitigation Behaviors to Improve Technology-Supported Risk Communication.

Understanding public risk perceptions, and how these affect behavior, is critical to public health's ability to leverage technology for risk communications. However, little is known about Zika virus risk perceptions. We addressed this gap by analyzing nationally representative (U.

Medication safety alert fatigue may be reduced via interaction design and clinical role tailoring: a systematic review.

Objective: Alert fatigue limits the effectiveness of medication safety alerts, a type of computerized clinical decision support (CDS). Researchers have suggested alternative interactive designs, as well as tailoring alerts to clinical roles. As examples, alerts may be tiered to convey risk, and certain alerts may be sent to pharmacists.

Understanding Patient Questions about their Medical Records in an Online Health Forum: Opportunity for Patient Portal Design.

There are many benefits of online patient access to their medical records through technologies such as patient portals. However, patients often have difficulties understanding the clinical data presented in portals. In response, increasingly, patients go online to make sense of this data.

Thinking Together: Modeling Clinical Decision-Support as a Sociotechnical System.

Computerized clinical decision-support systems are members of larger sociotechnical systems, composed of human and automated actors, who send, receive, and manipulate artifacts. Sociotechnical consideration is rare in the literature. This makes it difficult to comparatively evaluate the success of CDS implementations, and it may also indicate that sociotechnical context receives inadequate consideration in practice.

Understanding the Patterns of Health Information Dissemination on Social Media during the Zika Outbreak.

Social media are important platforms for risk communication during public health crises. Effective dissemination of accurate, relevant, and up-to-date health information is important for the public to raise awareness and develop risk management strategies. This study investigates Zika virus-related information circulated on Twitter, identifying the patterns of dissemination of popular tweets and tweets from public health authorities such as the CDC.

Using Social Media for Actionable Disease Surveillance and Outbreak Management: A Systematic Literature Review.

Objective: Research studies show that social media may be valuable tools in the disease surveillance toolkit used for improving public health professionals' ability to detect disease outbreaks faster than traditional methods and to enhance outbreak response. A social media work group, consisting of surveillance practitioners, academic researchers, and other subject matter experts convened by the International Society for Disease Surveillance, conducted a systematic primary literature review using the PRISMA framework to identify research, published through February 2013, answering either of the following questions: Can social media be integrated into disease surveillance practice and outbreak management to support and improve public health?Can social media be used to effectively target populations, specifically vulnerable populations, to test an intervention and interact with a community to improve health outcomes?Examples of social media included are Facebook, MySpace, microblogs (e.g.

Toward One Health: are public health stakeholders aware of the field of animal health?

Motivated by the perception that human and veterinary medicines can cooperate in more ways than just fighting zoonoses, the authors organized a roundtable during the 2013 annual meeting of the International Society for Disease Surveillance (ISDS). Collaborations between human and animal health sectors were reported to often rise in response to zoonotic outbreaks (during crisis time) and be mainly based on personal networks. Ways to maintain and strengthen these links were discussed.