Characterization of Electronic Health Record Use Outside Scheduled Clinic Hours Among Primary Care Pediatricians: Retrospective Descriptive Task Analysis of Electronic Health Record Access Log Data.

Background: Many of the benefits of electronic health records (EHRs) have not been achieved at expected levels because of a variety of unintended negative consequences such as documentation burden. Previous studies have characterized EHR use during and outside work hours, with many reporting that physicians spend considerable time on documentation-related tasks. These studies characterized EHR use during and outside work hours using clock time versus actual physician clinic schedules to define the outside work time.

Understanding the social determinants of health and genetic factors contributing to the differences observed in COVID-19 incidence and mortality between underrepresented and other communities.

COVID-19 has been a devastating disease, especially in underserved communities. Data has shown that Indigenous peoples, Latinx communities, and Black Americans have a 3.3, 2.

Relations Between BMI Trajectories and Habitual Physical Activity Measured by a Smartwatch in the Electronic Cohort of the Framingham Heart Study: Cohort Study.

Background: The prevalence of obesity is rising. Most previous studies that examined the relations between BMI and physical activity (PA) measured BMI at a single timepoint. The association between BMI trajectories and habitual PA remains unclear.

Associations Between the Digital Clock Drawing Test and Brain Volume: Large Community-Based Prospective Cohort (Framingham Heart Study).

Background: The digital Clock Drawing Test (dCDT) has been recently used as a more objective tool to assess cognition. However, the association between digitally obtained clock drawing features and structural neuroimaging measures has not been assessed in large population-based studies.

Objective: We aimed to investigate the association between dCDT features and brain volume.

A tribute to Karen Greenwood and her contributions to the American Medical Informatics Association.

After 25 years of service to the American Medical Informatics Association (AMIA), Ms Karen Greenwood, the Executive Vice President and Chief Operating Officer, is leaving the organization. In this perspective, we reflect on her accomplishments and her effect on the organization and the field of informatics nationally and globally. We also express our appreciation and gratitude for Ms Greenwood's role at AMIA.

Associations of Telehealth Care Delivery with Pediatric Health Care Provider Well-Being.

Background: The rapid, large-scale deployment of new health technologies can introduce challenges to clinicians who are already under stress. The novel coronavirus disease 19 (COVID-19) pandemic transformed health care in the United States to include a telehealth model of care delivery. Clarifying paths through which telehealth technology use is associated with change in provider well-being and interest in sustaining virtual care delivery can inform planning and optimization efforts.

Rapid Development of a Telehealth Patient Satisfaction Survey Using a Multi-Stakeholder Approach.

The COVID-19 pandemic has hastened the adoption of telehealth and the drastic shift to an unfamiliar process may impose significant impact to the quality-of-care delivery. Many providers are interested in understanding the quality of their telehealth services from the patients' experience. A telehealth patient satisfaction survey (TPSS) was developed by using an iterative stakeholder-centered design approach, incorporating elements from validated telemedicine and customer service survey instruments, and meeting the operational needs and constraints.

Validation of an ecological momentary assessment to measure processing speed and executive function in schizophrenia.

Cognitive impairments are a core feature of schizophrenia that have negative impacts on functional outcomes. However, it remains challenging to assess these impairments in clinical settings. Smartphone apps provide the opportunity to measure cognitive impairments in an accessible way; however, more research is needed to validate these cognitive assessments in schizophrenia.

"Digital Health Diplomacy" in Global Digital Health? A call for critique and discourse.

Actualizing the vision of Global Digital Health is a central issue on the Global Health Diplomacy agenda. The COVID-reinforced need for accelerated digital health progress will require political structures and processes to build a foundation for Global Digital Health. Simultaneously, Global Health Diplomacy uses digital technologies in its enactment.

Verification of the Abbott Alinity m Resp-4-Plex assay for detection of SARS-CoV-2, influenza A/B, and respiratory syncytial virus.

COVID-19 symptomology may overlap with other circulating respiratory viruses that may also cause severe disease and for which there are specific and potentially life-saving treatments. The Abbott Alinity m Resp-4-Plex assay is a multiplex PCR assay that simultaneously detects and differentiates infection with SARS-CoV-2, influenza A, influenza B, and respiratory syncytial virus (RSV). We characterized its accuracy, precision, and analytical sensitivity.

Patient generated health data: Benefits and challenges.

Patient Generated Health Data (PGHD) is defined as data generated by and from patients. The use of PGHD has rapidly increased with the widespread availability of smart phone mobile health applications (mHealth apps) and wearable devices. Currently, the vast majority of PGHD is generated via the use of mHealth apps and wearables like "Fitbit" or medical devices such as a continuous glucose monitoring device.

Notes at your fingertips: Open note considerations regarding pediatric and adolescent care.

The clinician's note serves an increasing number of audiences, the most recent addition being the patient and, in the case of pediatrics, the parent/guardian. The early work of the OpenNotes initiative followed by the recently enacted 21 Century Cures Act Information Blocking Rule has mandated easy and timely electronic access to notes involving their clinical care. While many benefits have already been described and most drawbacks unrealized, the care of pediatric and adolescent patients brings unique challenges to enable this functionality while preserving patient, parent, and family confidentiality.

Burnout in clinicians.

Burnout is a response to sustained job stressors manifesting as a classic triad of emotional exhaustion, depersonalization, and a sense of reduced accomplishment. With 42% of physicians demonstrating some symptoms of burnout, this has already reached epidemic proportions. The COVID-19 pandemic has only worsened this phenomenon.

Patient portals for the adolescent and young adult population: Benefits, risks and guidance for use.

Patient portals are the primary means by which electronic health information (EHI) is shared with patients and families. The use of patient portals increased during the COVID-19 pandemic and may continue to rise with the implementation and enforcement of the 21 Century Cures Act that encourages facilitation of access to EHI and prohibits information blocking. Research on the use of patient portals by adolescents and their families is limited.

How to Develop and Implement a Computerized Decision Support System Integrated for Antimicrobial Stewardship? Experiences From Two Swiss Hospital Systems.

Computerized decision support systems (CDSS) provide new opportunities for automating antimicrobial stewardship (AMS) interventions and integrating them in routine healthcare. CDSS are recommended as part of AMS programs by international guidelines but few have been implemented so far. In the context of the publicly funded COMPuterized Antibiotic Stewardship Study (COMPASS), we developed and implemented two CDSSs for antimicrobial prescriptions integrated into the in-house electronic health records of two public hospitals in Switzerland.

Future Directions in Artificial Intelligence.

No one knows what the paradigm shift of artificial intelligence will bring to medical imaging. In this article, we attempt to predict how artificial intelligence will impact radiology based on a critical review of current innovations. The best way to predict the future is to anticipate, prepare, and create it.

Alert burden in pediatric hospitals: a cross-sectional analysis of six academic pediatric health systems using novel metrics.

Background: Excessive electronic health record (EHR) alerts reduce the salience of actionable alerts. Little is known about the frequency of interruptive alerts across health systems and how the choice of metric affects which users appear to have the highest alert burden.

Objective: (1) Analyze alert burden by alert type, care setting, provider type, and individual provider across 6 pediatric health systems.

Prevalence and risk factors for venous thromboembolic events in critically ill patients with SARS-CoV-2 infection: a prospective observational study.

Background: The majority of prevalence studies on deep vein thrombosis (DVT) in severe COVID-19 patients are retrospective with DVT assessment based on clinical suspicion. Our aim was to prospectively and systematically estimate the occurrence of DVT in critically-ill mechanically-ventilated patients, and to identify potential risk factors for DVT occurrence and mortality.

Methods: All patients with COVID-19 admitted to our 45 beds in the Intensive Care Unit (ICU) between March 6, 2020, and April 18, 2020, requiring invasive ventilatory support were daily screened for DVT with lower extremities and jugular veins ultrasonography.

Assessment of Prevalence of Adolescent Patient Portal Account Access by Guardians.

Importance: Patient portals can be configured to allow confidential communication for adolescents' sensitive health care information. Guardian access of adolescent patient portal accounts could compromise adolescents' confidentiality.

Objective: To estimate the prevalence of guardian access to adolescent patient portals at 3 academic children's hospitals.

Early cost estimating model for new bioabsorbable orthopedic implant candidates: A theoretical study.

An early health technology assessment (HTA) study was performed to assess the need for developing a new bioabsorbable implant for the treatment of specific orthopedic injuries. The Anterior Cruciate Ligament Reconstruction (ACLR) procedure was selected based on the need and potential impact of bioabsorbable implants in the treatment of ACL injuries. The economic model considers the possible health events after an ACLR (failures and other complications such as stiffness and pain).

Challenges to Global Standardization of Outcome Measures.

Global standardization of outcome measures for disease states can help researchers and healthcare providers compare healthcare institutions' and populations' health outcomes. Despite the creation of standardized outcome sets, clinical institutions' adoption of these sets is not common. A literature review shows that among the challenges to standardizing outcome measures include the difficulties of achieving consensus in the working groups creating these outcome sets, the tradeoffs made when selecting outcome measurement tools, and the high costs of implementing a new or different set of outcome measures.