Journal ArticleJoint Commission journal on quality and patient safety · November 2025
BackgroundThe US healthcare system is currently facing significant challenges in quality, affordability, and labor shortages. Artificial intelligence (AI) promises to transform healthcare delivery by making it safer, more effective, less wasteful, ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · July 2025
ImportanceThe US healthcare system faces significant challenges, including clinician burnout, operational inefficiencies, and concerns about patient safety. Artificial intelligence (AI), particularly generative AI, has the potential to address the ...
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Journal ArticleJ Am Med Inform Assoc · April 1, 2025
OBJECTIVES: Large language models (LLMs) are increasingly utilized in healthcare, transforming medical practice through advanced language processing capabilities. However, the evaluation of LLMs predominantly relies on human qualitative assessment, which i ...
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Journal ArticleJAMA Netw Open · March 3, 2025
IMPORTANCE: The rise of patient messages sent to clinicians via a patient portal has directly led to physician burnout and dissatisfaction, prompting uptake of artificial intelligence (AI) to alleviate this burden. It is important to understand patient pre ...
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Journal ArticleJ Am Med Inform Assoc · February 16, 2024
OBJECTIVE: The complexity and rapid pace of development of algorithmic technologies pose challenges for their regulation and oversight in healthcare settings. We sought to improve our institution's approach to evaluation and governance of algorithmic techn ...
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Journal ArticleBMJ Open · September 13, 2022
INTRODUCTION: Despite a higher risk of severe COVID-19 disease in individuals with HIV, the interactions between SARS-CoV-2 and HIV infections remain unclear. To delineate these interactions, multicentre Electronic Health Records (EHR) hold existing promis ...
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Journal ArticleJ Am Med Inform Assoc · August 16, 2022
Artificial intelligence/machine learning models are being rapidly developed and used in clinical practice. However, many models are deployed without a clear understanding of clinical or operational impact and frequently lack monitoring plans that can detec ...
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Journal ArticleJ Pers Med · August 26, 2020
Unplanned hospital readmissions represent a significant health care value problem with high costs and poor quality of care. A significant percentage of readmissions could be prevented if clinical inpatient teams were better able to predict which patients w ...
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Journal ArticleJMIR Med Inform · July 15, 2020
BACKGROUND: Successful integrations of machine learning into routine clinical care are exceedingly rare, and barriers to its adoption are poorly characterized in the literature. OBJECTIVE: This study aims to report a quality improvement effort to integrate ...
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Journal ArticleJAMIA Open · July 2020
Featured Publication
There is little known about how academic medical centers (AMCs) in the US develop, implement, and maintain predictive modeling and machine learning (PM and ML) models. We conducted semi-structured interviews with leaders from AMCs to assess their use of PM ...
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Journal ArticleJ Am Med Inform Assoc · June 1, 2020
The novel coronavirus disease-19 (COVID-19) pandemic has altered our economy, society, and healthcare system. While this crisis has presented the U.S. healthcare delivery system with unprecedented challenges, the pandemic has catalyzed rapid adoption of te ...
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Journal ArticleJ Am Med Inform Assoc · May 1, 2020
OBJECTIVE: While electronic health record (EHR) systems store copious amounts of patient data, aggregating those data across patients can be challenging. Visual analytic tools that integrate with EHR systems allow clinicians to gain better insight and unde ...
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Journal ArticleApplied clinical informatics · October 2019
BackgroundHealth systems often employ interruptive alerts through the electronic health record to improve patient care. However, concerns of "alert fatigue" have been raised, highlighting the importance of understanding the time burden and impact ...
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Journal ArticleJ Am Med Inform Assoc · August 1, 2018
OBJECTIVE: As available data increases, so does the opportunity to develop risk scores on more refined patient populations. In this paper we assessed the ability to derive a risk score for a patient no-showing to a clinic visit. METHODS: Using data from 2 ...
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Journal ArticleJournal of patient safety · June 2015
ObjectiveSafety advocates have identified barcode verification technology as an important tool to improve health-care practices.MethodsWe evaluated the evidence for the role of barcode technology in improving a wide range of medication sa ...
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Journal ArticleJMIR mHealth and uHealth · January 2015
BackgroundPhotographs are important tools to record, track, and communicate clinical findings. Mobile devices with high-resolution cameras are now ubiquitous, giving clinicians the opportunity to capture and share images from the bedside. However, ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · May 2014
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IntroductionElectronic prescribing systems have often been promoted as a tool for reducing medication errors and adverse drug events. Recent evidence has revealed that adoption of electronic prescribing systems can lead to unintended consequences ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · May 2014
Usability testing is increasingly being recognized as a way to increase the usability and safety of health information technology (HIT). Medical simulation centers can serve as testing environments for HIT usability studies. We integrated the quality assur ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · May 2014
Background and objectivePhysician awareness of the results of tests pending at discharge (TPADs) is poor. We developed an automated system that notifies responsible physicians of TPAD results via secure, network email. We sought to evaluate the im ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · June 2013
Emergency department (ED) electronic tracking boards provide a snapshot view of patient status and a quick link to other clinical applications, such as a web-based image viewer client to view current and previous radiology images from the picture archiving ...
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Journal ArticleBMJ quality & safety · November 2012
ObjectiveTo determine how often serious or life-threatening medication administration errors with the potential to cause harm (potential adverse drug events) result in actual harm (adverse drug events (ADEs)) in the hospital setting.Design
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Journal ArticleJournal of general internal medicine · November 2012
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PurposeTo erform a process analysis of missed and delayed diagnoses of breast and colorectal cancers to identify: (1) the cognitive and logistical factors that lead to these diagnostic errors, and (2) prevention strategies.MethodsUsing 56 ...
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ConferenceJournal of general internal medicine · October 2012
Featured Publication
BackgroundFailure to follow up microbiology results pending at the time of hospital discharge can delay diagnosis and treatment of important infections, harm patients, and increase the risk of litigation. Current systems to track pending tests are ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · September 2012
ObjectiveTo determine the effects of a personal health record (PHR)-linked medications module on medication accuracy and safety.DesignFrom September 2005 to March 2007, we conducted an on-treatment sub-study within a cluster-randomized tr ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · July 2012
BackgroundElectronic health record (EHR) adoption is a national priority in the USA, and well-designed EHRs have the potential to improve quality and safety. However, physicians are reluctant to implement EHRs due to financial constraints, usabili ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · July 2012
Physicians are often unaware of the results of tests pending at discharge (TPADs). The authors designed and implemented an automated system to notify the responsible inpatient physician of the finalized results of TPADs using secure, network email. The sys ...
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Journal ArticleJournal of general internal medicine · January 2012
BackgroundProvider and patient reminders can be effective in increasing rates of preventive screenings and vaccinations. However, the effect of patient-directed electronic reminders is understudied.ObjectiveTo determine whether providing ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · November 2011
Featured Publication
ObjectiveTo report the frequency, types, and causes of errors associated with outpatient computer-generated prescriptions, and to develop a framework to classify these errors to determine which strategies have greatest potential for preventing the ...
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Journal ArticleJournal of hospital medicine · May 2011
Featured Publication
BackgroundFailure to follow up microbiology results pending at discharge can delay appropriate treatment, increasing the risk of patient harm and litigation. Limited data describe the frequency of postdischarge microbiology results requiring a tre ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · March 2011
Actionable reminders (electronic reminders linked to computerized order entry) might improve care by facilitating direct ordering of recommended tests. The authors implemented four enhanced actionable reminders targeting performance of annual mammography, ...
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Journal ArticleJournal of hospital medicine · January 2011
BackgroundPatients are often discharged from the hospital before test results are finalized. Awareness of these results is poor and therefore an important patient safety concern. Few computerized systems have been deployed at care transitions to a ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · September 2010
Electronic health records (EHRs) and EHR-connected patient portals offer patient-provider collaboration tools for visit-based care. During a randomized controlled trial, primary care patients completed pre-visit electronic journals (eJournals) containing E ...
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Journal ArticlePediatrics · August 2010
ObjectivesThe objective of this study was to assess the effect of electronic health record (EHR) decision support on physician management and documentation of care for children with attention-deficit/hyperactivity disorder (ADHD).MethodsT ...
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Journal ArticleThe New England journal of medicine · May 2010
BackgroundSerious medication errors are common in hospitals and often occur during order transcription or administration of medication. To help prevent such errors, technology has been developed to verify medications by incorporating bar-code veri ...
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ConferenceMedical care · March 2010
BackgroundElectronic health records (EHRs) are widely viewed as useful tools for supporting the provision of high quality healthcare. However, evidence regarding their effectiveness for this purpose is mixed, and existing studies have generally co ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · November 2009
Patient experience was assessed by survey as part of a large, randomized controlled trial of a secure, practice-linked personal health record called Patient Gateway at Partners HealthCare in Boston, MA. The subjects were patients with Type 2 diabetes who p ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · September 2009
Technology has great potential to reduce medication errors in hospitals. This case report describes barriers to, and facilitators of, the implementation of a pharmacy bar code scanning system to reduce medication dispensing errors at a large academic medic ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · September 2009
The National Resource Center for Health Information Technology (NRC) was formed in the fall of 2004 as part of the Agency for Healthcare Research and Quality (AHRQ) health IT portfolio to support its grantees. One of the core functions of the NRC was to as ...
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Journal ArticleJournal of medical Internet research · August 2009
BackgroundThe ability to generate registries of patients with particular clinical attributes, such as diagnoses or medications taken, is central to measuring and improving the quality of health care. However, it is not known how many providers hav ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · July 2009
OBJECTIVE Electronic health records (EHRs) have potential to improve quality and safety, but many physicians do not use these systems to full capacity. The objective of this study was to determine whether this usage gap is narrowing over time. DESIGN Follo ...
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Journal ArticleJournal of general internal medicine · April 2009
BackgroundClinician perceptions of a newly implemented electronic health record play an important role in its success or failure.ObjectiveTo measure changes in primary care clinician attitudes toward an electronic health record during the ...
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Journal ArticlePediatrics · January 2009
BackgroundElectronic results management may improve the reliability and efficiency of test results management, but few studies have investigated this topic in pediatrics.MethodsWe conducted semi-structured, key informant interviews before ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · November 2008
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 th ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · November 2008
Provider-centric Electronic Health Records (EHRs) with clinical decision support have had a modest impact on improving quality care. However, they do not directly engage patients in promoting guideline adherence. Tethered Personal Health Records (PHRs) in ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · November 2008
Patient care registries allow physicians to identify patients based on a subset of conditions, including medicine prescribed, laboratory results and diagnosis. The presence of EHRs and a physician's ability to query across patient medical records is unknow ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · November 2008
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 ...
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Journal ArticleArchives of internal medicine · September 2008
BackgroundWeb-based personal health records (PHRs) have been advocated as a means to improve type 2 diabetes mellitus (DM) care. However, few Web-based systems are linked directly to the electronic medical record (EMR) used by physicians.Metho ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · May 2008
This Viewpoint paper has grown out of a presentation at the American College of Medical Informatics 2007 Winter Symposium, the resulting discussion, and several activities that have coalesced around an issue that most informaticians accept as true but is n ...
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Journal ArticleJournal of evaluation in clinical practice · February 2008
BackgroundLimited data exist to estimate the use of electronic health records (EHRs) in ambulatory care practices in the United States.MethodsWe surveyed a stratified random sample of 1829 office practices in Massachusetts in 2005. The on ...
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Journal ArticleThe Journal of nursing administration · January 2008
New medication administration systems are showing promise in improving patient safety at the point of care, but adoption of these systems requires significant changes in nursing workflow. To prepare for these changes, the authors report on a time-motion st ...
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Journal ArticleArchives of internal medicine · November 2007
BackgroundFew reliable and efficient systems support the communication of test results to outpatients, and this may lead to patient dissatisfaction with test result communication. The objective of this study was to assess the impact of physicians' ...
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Journal ArticleThe Journal of nursing administration · July 2007
Efforts to promote safe care prompted the development point-of-care technology, but successful adoption requires acceptance by nursing staff. To assess the satisfaction of nurses who use point-of-care technology that integrates nurse scanning of bar-coded ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · July 2007
BackgroundComputerized provider order entry (CPOE) systems can help hospitals improve health care quality, but they can also introduce new problems. The extent to which hospitals experience unintended consequences of CPOE, which include more than ...
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Journal ArticleArchives of internal medicine · April 2007
BackgroundBar coding can reduce hospital pharmacy dispensing errors, but it is unclear if the benefits of this technology justify its costs. The purpose of this study was to assess the costs and benefits and determine the return on investment at t ...
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Journal ArticleArchives of internal medicine · March 2007
BackgroundElectronic health records (EHRs) allow for a variety of functions, ranging from visit documentation to laboratory test ordering, but little is known about physicians' actual use of these functions.MethodsWe surveyed a random sam ...
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Journal ArticleStudies in health technology and informatics · January 2007
We describe a health maintenance module within a personal health record designed to improve the quality of routine preventive care for patients in a large integrated healthcare delivery network. This module allows patients and their providers to share an o ...
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ConferenceStudies in health technology and informatics · January 2007
Surveys of patients consistently demonstrate a very strong interest in having secure electronic access to their own laboratory test results. In recent years, a number of health care providers and lab service centers have offered this capability, which now ...
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ConferenceJournal of the American Medical Informatics Association : JAMIA · January 2007
ObjectiveDespite emerging evidence that electronic health records (EHRs) can improve the efficiency and quality of medical care, most physicians in office practice in the United States do not currently use an EHR. We sought to measure the correlat ...
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ConferenceJournal of the American Medical Informatics Association : JAMIA · November 2006
Confusion about patients' medication regimens during the hospital admission and discharge process accounts for many preventable and serious medication errors. Many organizations have begun to redesign their clinical processes to address this patient safety ...
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Journal ArticleDiabetes technology & therapeutics · October 2006
BackgroundDespite the availability of expert guidelines and widespread diabetes quality improvement efforts, care of patients with diabetes remains suboptimal. Two key barriers to care that may be amenable to informatics-based interventions includ ...
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Journal ArticleAnnals of internal medicine · September 2006
BackgroundMany dispensing errors made in hospital pharmacies can harm patients. Some hospitals are investing in bar code technology to reduce these errors, but data about its efficacy are limited.ObjectiveTo evaluate whether implementatio ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · January 2006
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 no ...
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Journal ArticleJournal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · January 2006Full textCite
Journal ArticleBMC medical informatics and decision making · January 2006
BackgroundComprehensive knowledge about the level of healthcare information technology (HIT) adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap.MethodsWe segmented HIT ...
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ConferenceJournal of general internal medicine · September 2005
BackgroundMedication errors are common among inpatients and many are preventable with computerized prescribing. Relatively little is known about outpatient prescribing errors or the impact of computerized prescribing in this setting.Objective< ...
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Journal ArticleHealth affairs (Project Hope) · September 2005
We describe the health information technology (HIT) required for a model of a national health information network (NHIN). Specifically, we define the functional HIT capabilities of an attainable NHIN and determine the gap between the current state of HIT a ...
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Journal ArticleAnnals of internal medicine · August 2005
BackgroundThe use of information technology may result in a safer and more efficient health care system. However, consensus does not exist about the structure or costs of a national health information network (NHIN).ObjectivesTo describe ...
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Journal ArticleAnnals of internal medicine · July 2005
BackgroundFailure to relay information about test results pending when patients are discharged from the hospital may pose an important patient-safety problem. Few data are available on the epidemiology of test results pending at discharge or on ph ...
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Journal ArticleJournal of biomedical informatics · February 2005
The adoption of electronic medical records (EMRs) and user satisfaction are closely associated with the system's usability. To improve the usability of a results management module of a widely deployed web-based EMR, we conducted two qualitative studies tha ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · January 2005
Within busy practice settings, it is difficult to provide adequate provider training on evolving electronic health record (EHR) functionality. As a result, providers may not reap the full benefits of EHR. This poster presents a systematic workflow study co ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · January 2005
We performed a direct observation prepost study to evaluate the impact of barcode technology on medication dispensing errors and potential adverse drug events in the pharmacy of a tertiary-academic medical center. We found that barcode technology significa ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · January 2005
Ambulatory computerized physician order entry (ACPOE) represents one strategy to improve physician ordering practices, compliance with guidelines, and patient safety. We surveyed primary care physicians (PCPs) regarding attitudes towards ACPOE and its vari ...
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Journal ArticleArchives of internal medicine · November 2004
BackgroundFailure to review and follow up on outpatient test results in a timely manner represents a patient safety and malpractice concern. Therefore, we sought to identify problems in current test result management systems and possible ways to i ...
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Journal ArticleHealth affairs (Project Hope) · July 2004
Few U.S. hospitals have implemented computerized physician order entry (CPOE) in spite of its effectiveness at preventing serious medication errors. We interviewed senior management at twenty-six hospitals to identify ways to overcome barriers to adopting ...
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Journal ArticleJournal of general internal medicine · April 2004
ObjectiveTo identify the communication factors that are significantly associated with appropriate short-term follow-up of abnormal mammograms.DesignProspective longitudinal study involving medical record review and patient survey.Sett ...
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Journal ArticleInternational journal of medical informatics · September 2003
ObjectivesFailures to follow-up abnormal test results are common in ambulatory care. Information systems could assist providers with abnormal test result tracking, yet little is known about primary care providers attitudes toward outpatient decisi ...
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Journal ArticleJournal of biomedical informatics · February 2003
Prior research has demonstrated that clinicians often fail to review and act upon outpatient test results in a timely and appropriate manner. To address this patient safety and quality of care issue, Partners Healthcare has developed a browser-based, provi ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · January 2003
We sought to identify the barriers to CPOE implementation and the strategies for overcoming them. By analyzing 57 transcripts of interviews with management officials at 25 US hospitals, we identified costs and physician resistance as the two most significa ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · January 2003
The Harvard Interfaculty Initiative developed a tool to assess the level of Information Technology adoption at healthcare organizations and asked an expert panel to rate the clinical functions where IT-based solutions can impact quality of care. The expert ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · January 2003
As the focus of medicine moves from acute episodic care in the hospital to chronic disease management in outpatients, the primary care physician will play an increasingly important role in the coordination of patient care activities. Traditional outpatient ...
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Journal ArticleAMIA ... Annual Symposium proceedings. AMIA Symposium · January 2003
Compliance with outpatient practice guidelines is low and clinical reminders have had variable success in improving adherence rates. We surveyed primary care physicians (PCPs) regarding practice guidelines and the perceived utility of electronic reminders ...
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Journal ArticleJournal of the American Medical Informatics Association : JAMIA · May 2002
The authors developed a novel feature in their clinical information systems, which allows clinicians to request notification about laboratory results. Clinicians who are expecting a particular laboratory result for a particular patient can request a report ...
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