Artificial intelligence related safety issues associated with FDA medical device reports.

The Biden 2023 Artificial Intelligence (AI) Executive Order calls for the creation of a patient safety program. Patient safety reports are a natural starting point for identifying issues. We examined the feasibility of this approach by analyzing reports associated with AI/Machine Learning (ML)-enabled medical devices.

Inbox message prioritization and management approaches in primary care.

Objectives: Patient messaging to clinicians has dramatically increased since the pandemic, leading to informatics efforts to categorize incoming messages. We examined how message prioritization (as distinct from categorization) occurs in primary care, and how primary care clinicians managed their inbox workflows.

Materials And Methods: Semi-structured interviews and inbox work observations with 11 primary care clinicians at MedStar Health.

Does one size fit all? Developing an evaluation strategy to assess large language models for patient safety event report analysis.

Objective: Collecting and analyzing patient safety event (PSE) reports is a key component to the improvement of patient safety yet report analysis has been challenging. Large language models (LLMs) may support analysis; however, PSE reports tend to be a hybrid of clinical and general language.

Materials And Methods: We propose a data-driven evaluation strategy to assess LLM fit for report analysis.

Development and Evaluation of Patient Safety Interventions: Perspectives of Operational Safety Leaders and Patient Safety Organizations.

Objectives: The purpose of this study is to understand how patient safety professionals from healthcare facilities and patient safety organizations develop patient safety interventions and the resources used to support intervention development.

Methods: Semistructured interviews were conducted with patient safety professionals at nine healthcare facilities and nine patient safety organizations. Interview data were qualitatively analyzed, and findings were organized by the following: patient safety solutions and interventions, use of external databases, and evaluation of patient safety solutions.

A text mining approach to categorize patient safety event reports by medication error type.

Patient safety reporting systems give healthcare provider staff the ability to report medication related safety events and errors; however, many of these reports go unanalyzed and safety hazards go undetected. The objective of this study is to examine whether natural language processing can be used to better categorize medication related patient safety event reports. 3,861 medication related patient safety event reports that were previously annotated using a consolidated medication error taxonomy were used to develop three models using the following algorithms: (1) logistic regression, (2) elastic net, and (3) XGBoost.

Technology issues experienced by older populations responding to COVID-19 vaccine text outreach messages.

Text messages used by healthcare organizations to communicate with patients have known limitations for certain populations, especially older adults. This study analyzed text message interactions with over 17 000 patients aged 65 and older during the initial phase of the COVID-19 vaccination campaign. We coded the responses of 4247 patients who responded to this outreach to understand issues they experienced with the text message system.

The impact of COVID-19 on primary care accessibility and the role of telehealth for patients with chronic conditions.

Objectives: The objective of this study is to quantify how long patients took to complete their rescheduled primary care appointment pre-pandemic (2019) and during an initial pandemic period (2020). In doing so, the study evaluates telehealth's role in helping primary care patients - particularly in patients with chronic conditions - withstand COVID's significant disruption in care.

Methods: Cancelled and completed primary care appointments for adult patients were extracted from the beginning of the pandemic (March 1 to July 31, 2020) and a similar period pre-pandemic (March 1 to July 31, 2019).

A Clinical Decision Support System for Motivational Messaging and Tobacco Cessation Treatment for Parents: Pilot Evaluation of Use and Acceptance.

Background: Research is needed to identify how clinical decision support (CDS) systems can support communication about and engagement with tobacco use treatment in pediatric settings for parents who smoke. We developed a CDS system that identifies parents who smoke, delivers motivational messages to start treatment, connects parents to treatment, and supports pediatrician-parent discussion.

Objective: The objective of this study is to assess the performance of this system in clinical practice, including receipt of motivational messages and tobacco use treatment acceptance rates.

Using event logs to observe interactions with electronic health records: an updated scoping review shows increasing use of vendor-derived measures.

Objective: The aim of this article is to compare the aims, measures, methods, limitations, and scope of studies that employ vendor-derived and investigator-derived measures of electronic health record (EHR) use, and to assess measure consistency across studies.

Materials And Methods: We searched PubMed for articles published between July 2019 and December 2021 that employed measures of EHR use derived from EHR event logs. We coded the aims, measures, methods, limitations, and scope of each article and compared articles employing vendor-derived and investigator-derived measures.

The impact of expanded telehealth availability on primary care utilization.

The expanded availability of telehealth due to the COVID-19 pandemic presents a concern that telehealth may result in an unnecessary increase in utilization. We analyzed 4,114,651 primary care encounters (939,134 unique patients) from three healthcare systems between 2019 and 2021 and found little change in utilization as telehealth became widely available. Results suggest telehealth availability is not resulting in additional primary care visits and federal policies should support telehealth use.

Development and pilot evaluation of an electronic health record usability and safety self-assessment tool.

Objective: Poor electronic health record (EHR) usability contributes to clinician burnout and poses patent safety risks. Site-specific customization and configuration of EHRs require individual EHR system usability and safety testing which is resource intensive. We developed and pilot-tested a self-administered EHR usability and safety assessment tool, focused on computerized provider order entry (CPOE), which can be used by any facility to identify specific issues.

Evaluation of a Text Message-Based COVID-19 Vaccine Outreach Program Among Older Patients: Cross-sectional Study.

Background: COVID-19 vaccines are vital tools in the defense against infection and serious disease due to SARS-CoV-2. There are many challenges to implementing mass vaccination campaigns for large, diverse populations from crafting vaccine promotion messages to reaching individuals in a timely and effective manner. During this unprecedented period, with COVID-19 mass vaccination campaigns essential for protecting vulnerable patient populations and attaining herd immunity, health care systems were faced with the dual challenges of vaccine outreach and distribution.

Electronic Health Record-Embedded, Behavioral Science-Informed System for Smoking Cessation for the Parents of Pediatric Patients.

Background: Helping parents quit smoking is a public health priority. However, parents are rarely, if ever, offered tobacco use treatment through pediatric settings. Clinical decision support (CDS) systems developed for the workflows of pediatric primary care may support consistent screening, treatment, and referral.

Voice activated remote monitoring technology for heart failure patients: Study design, feasibility and observations from a pilot randomized control trial.

Background: Heart failure (HF) is a serious health condition, associated with high health care costs, and poor outcomes. Patient empowerment and self-care are a key component of successful HF management. The emergence of telehealth may enable providers to remotely monitor patients' statuses, support adherence to medical guidelines, improve patient wellbeing, and promote daily awareness of overall patients' health.

Usability and Accessibility of Publicly Available Patient Safety Databases.

Objectives: The aims of the study were to identify publicly available patient safety report databases and to determine whether these databases support safety analyst and data scientist use to identify patterns and trends.

Methods: An Internet search was conducted to identify publicly available patient safety databases that contained patient safety reports. Each database was analyzed to identify features that enable patient safety analyst and data scientist use of these databases.

A scoping review of interactive and personalized web-based clinical tools to support treatment decision making in breast cancer.

The increasing attention on personalized breast cancer care has resulted in an explosion of new interactive, tailored, web-based clinical decision tools for guiding treatment decisions in clinical practice. The goal of this study was to review, compare, and discuss the clinical implications of current tools, and highlight future directions for tools aiming to improve personalized breast cancer care. We searched PubMed, Embase, PsychInfo, Cochrane Database of Systematic Reviews, Web of Science, and Scopus to identify web-based decision tools addressing breast cancer treatment decisions.

Analysis of Electronic Health Record Use and Clinical Productivity and Their Association With Physician Turnover.

Importance: Physician turnover takes a heavy toll on patients, physicians, and health care organizations. Survey research has established associations of electronic health record (EHR) use with professional burnout and reduction in professional effort, but these findings are subject to response fatigue and bias.

Objective: To evaluate the association of physician productivity and EHR use patterns, as determined by vendor-derived EHR use data platforms, with physician turnover.

Clinician Perceptions on the Use of Free-Text Communication Orders.

Objective: The aim of this study was to investigate (1) why ordering clinicians use free-text orders to communicate medication information; (2) what risks physicians and nurses perceive when free-text orders are used for communicating medication information; and (3) how electronic health records (EHRs) could be improved to encourage the safe communication of medication information.

Methods: We performed semi-structured, scenario-based interviews with eight physicians and eight nurses. Interview responses were analyzed and grouped into common themes.