Abstract:
BACKGROUND:UW Medicine was one of the first health systems to encounter and treat COVID-19 patients in the United States, starting in late February 2020. OBJECTIVE:Here we describe the rapid rollout of capabilities by UW Medicine Information Technology Services (ITS) to support our clinical response to the COVID-19 pandemic and provide recommendations for health systems to urgently consider, as they plan their own response to this and potentially other future pandemics. METHODS:Our recommendations include establishing a hospital incident command structure that includes tight integration with IT, creating automated dashboards for incident command, optimizing emergency communication to staff and patients, and preparing human resources, security, other policies, and equipment to support the transition of all nonessential staff to telework.We describe how UW Medicine quickly expanded telemedicine capabilities to include most primary care providers and increasing numbers of specialty providers. We look at how we managed expedited change control processes to quickly update electronic health records (EHR) with new COVID-19 laboratory and clinical workflows. We also examine the integration of new technology such as tele-intensive care (ICU) equipment and improved integration with teleconferencing software into our EHR. To support the rapid preparation for COVID-19 at other health systems, we include samples of the UW Medicine's COVID-19 order set, COVID-19 documentation template, dashboard metric categories, and a list of the top 10 things your health care IT organization can do now to prepare. CONCLUSION:The COVID-19 response requires new and expedited ways of approaching ITS support to clinical needs. UW Medicine ITS leadership hope that by quickly sharing our nimble response to clinical and operational requests, we can help other systems prepare to respond to this public health emergency.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Grange ES,Neil EJ,Stoffel M,Singh AP,Tseng E,Resco-Summers K,Fellner BJ,Lynch JB,Mathias PC,Mauritz-Miller K,Sutton PR,Leu MGdoi
10.1055/s-0040-1709715subject
Has Abstractpub_date
2020-03-01 00:00:00pages
265-275issue
2issn
1869-0327journal_volume
11pub_type
杂志文章abstract:BACKGROUND:Kidney disease is under-documented in physician notes. The use of template-guided notes may improve physician recognition of kidney disease early in training. OBJECTIVE:The objective of this study was to determine whether a computerized inpatient renal template note with clinical decision support improves r...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-07-RA-0048
更新日期:2013-11-13 00:00:00
abstract:OBJECTIVE:Venous thromboembolism (VTE) prophylaxis is an important consideration for hospitalized older adults, and the Padua Prediction Score (PPS) is a risk prediction tool used to prioritize patient selection. We developed an automated PPS (APPS) algorithm using electronic health record (EHR) data. This study examin...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1670678
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:We previously demonstrated that a general purpose text mining system, the Vaccine adverse event Text Mining (VaeTM) system, could be used to automatically classify reports of an-aphylaxis for post-marketing safety surveillance of vaccines. OBJECTIVE:To evaluate the ability of VaeTM to classify reports to th...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-11-RA-0049
更新日期:2013-02-27 00:00:00
abstract:OBJECTIVES:Unwarranted variance in healthcare has been associated with prolonged length of stay, diminished health and increased cost. Practice variance in the management of asthma can be significant and few investigators have evaluated strategies to reduce this variance. We hypothesized that selective redesign of orde...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2011-01-RA-0002
更新日期:2012-02-08 00:00:00
abstract:BACKGROUND:A structured report for imaging exams aims at increasing the precision in information retrieval and communication between physicians. However, it is more concise than free text and may limit specialists' descriptions of important findings not covered by pre-defined structures. A computational ontological str...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-03-RA-0037
更新日期:2016-08-24 00:00:00
abstract:BACKGROUND:Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were develop...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-08-RA-0129
更新日期:2016-11-09 00:00:00
abstract:BACKGROUND:In 2015, the German Federal Ministry of Education and Research initiated a large data integration and data sharing research initiative to improve the reuse of data from patient care and translational research. The Observational Medical Outcomes Partnership (OMOP) common data model and the Observational Healt...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0037-1617452
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:While evidence generally supports the use of medication management technology, systems are typically implemented and evaluated piecemeal rather than as part of a comprehensive model for medication management. Systems to support drug therapy optimization, increasingly a key role of pharmacists in our healthca...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0037-1620262
更新日期:2018-01-01 00:00:00
abstract::Patient-generated health data are coming into broader use across the health care spectrum and hold great promise as a means to improve care and health outcomes. At the same time, rapid evolution in the social media and mobile health (mHealth) market has promoted an environment in which creation and transmission of per...
journal_title:Applied clinical informatics
pub_type: 杂志文章,评审
doi:10.4338/ACI-2014-09-R-0082
更新日期:2015-01-14 00:00:00
abstract:BACKGROUND:Prescribers' inappropriate use of the free-text Notes field in new electronic prescriptions can create confusion and workflow disruptions at receiving pharmacies that often necessitates contact with prescribers for clarification. The inclusion of inappropriate patient direction (Sig) information in the Notes...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-03-CR-0022
更新日期:2014-08-06 00:00:00
abstract:BACKGROUND:Medical students may observe and subsequently perpetuate redundancy in clinical documentation, but the degree of redundancy in student notes and whether there is an association with scholastic performance are unknown. OBJECTIVES:This study sought to quantify redundancy, defined generally as the proportion o...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1692402
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:The use of text messaging in clinical care has become ubiquitous. Due to security and privacy concerns, many hospital systems are evaluating secure text messaging applications. This paper highlights our evaluation process, and offers an overview of secure messaging functionalities, as well as a framework for ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1678607
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outc...
journal_title:Applied clinical informatics
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0038-1676040
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Clinical trials are an important research method for improving medical knowledge and patient care. Multiple international and national guidelines stipulate the need for data quality and assurance. Many strategies and interventions are developed to reduce error in trials, including standard operating procedur...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0037-1621702
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Early detection and efficient management of sepsis are important for improving health care quality, effectiveness, and costs. Due to its high cost and prevalence, sepsis is a major focus area across institutions and many studies have emerged over the past years with different models or novel machine learning...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1710525
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:1. To conduct a review of the role of informatics in pediatric disaster preparedness using all medical databases. 2. To provide recommendations to improve pediatric disaster preparedness by the application of informatics. METHODS:A literature search was conducted using MEDLINE, CINHL and the Cochrane Library...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2009-12-R-0019
更新日期:2010-08-04 00:00:00
abstract:BACKGROUND:Several disease specific registers are operated by members of the 'TMF - Technology, Methods, and Infrastructure for Networked Medical Research', an umbrella organization of research networks in Germany. OBJECTIVE:To describe the coverage and the current state as well as financial and organizational issues ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2010-04-RA-0024
更新日期:2010-11-24 00:00:00
abstract:OBJECTIVE:With the increasing prevalence of type 2 diabetes (T2D) in youth, primary care providers must identify patients at high risk and implement evidence-based screening promptly. Clinical decision support systems (CDSSs) provide clinicians with personalized reminders according to best evidence. One example is the ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1710024
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To understand and build a collective vision of all existing institutions in the Portuguese National Health Service as well as to perceive how and how far the interaction between those multiple institutions is supported by Information Systems (IS). METHODS:Upon identification of the institutions involved in ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-08-RA-0135
更新日期:2016-12-21 00:00:00
abstract:OBJECTIVE:The Instrument for Evaluating Human-Factor Principles in Medication-Related Decision Support Alerts (I-MeDeSA) was developed recently in the US with a view towards improving considerations of human-factor principles when designing alerts for clinical decision support (CDS) systems. This study evaluated the ge...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-01-RA-0005
更新日期:2014-06-18 00:00:00
abstract:: ...
journal_title:Applied clinical informatics
pub_type: 社论
doi:10.1055/s-0038-1676332
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Preoperative assessments are a required and essential element of anesthetic care, yet little is known about the utilization of these documents by clinicians who are not part of the anesthesia care team. As part of perioperative workflow restructuring, we implemented a data visualization technique of electron...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-02-CR-0022
更新日期:2015-10-21 00:00:00
abstract:OBJECTIVES:More patients are receiving their test results via patient portals. Given test results are written using medical jargon, there has been concern that patients may misinterpret these results. Using sample colonoscopy and Pap smear results, our objective was to assess how frequently people can identify the corr...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1679960
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Medication dose adjustment is crucial for patients with renal dysfunction (RD). The assessment of renal function is generally mandatory; however, the renal function may change during the hospital stay and the manual assessment is sometimes challenging. OBJECTIVE:We developed the clinical decision support sy...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721056
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Although diagnostic error (DE) is a significant problem, it remains challenging for clinicians to identify it reliably and to recognize its contribution to the clinical trajectory of their patients. The purpose of this work was to evaluate the reliability of real-time electronic health record (EHR) reviews u...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1713750
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a revised guideline on statin therapy initiation. The guideline included a 10-year risk calculation based on regression modeling, which made hand calculation infeasible. Compliance to the guideline has been su...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1692186
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Care-management tools are typically utilized for chronic disease management. Sonoma County government agencies employed advanced health information technologies, artificial intelligence (AI), and interagency process improvements to help transform health and health care for socially disadvantaged groups and o...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1715894
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED). METHODS:We employed a mixed met...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-01-RA-0014
更新日期:2015-07-08 00:00:00
abstract:BACKGROUND:Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes. METHODS:A data dictionary, and subsequent data model, were developed describing EH...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1651496
更新日期:2018-04-01 00:00:00
abstract::Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustaine...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2017-05-RA-0088
更新日期:2017-10-01 00:00:00