Collaborative design and implementation of a standards-based EHR-agnostic clinical decision support tool

Presentation Time: 02:45 PM - 03:00 PM

Abstract Keywords: Adaptive Clinical Decision Support, Cloud Computing and Storage, Health IT Standards (USCDI, FHIR®, SMART, etc.)
Primary Track: Industry and Commercial Partnership
Programmatic Theme: Clinical Decision Support and Analytics

We will describe the design, development, and implementation of a clinical decision-support solution to improve adherence to Centers for Disease Control and Prevention guidelines for gonorrhea treatment, HIV screening, and pre-exposure prophylaxis prescriptions. The requirements for the solution were to be standards-based (to be EHR-agnostic) and could be hosted in a cloud environment to be used by multiple clinical sites. We will describe the challenges faced and the lessons learned

Speaker:
Aziz Boxwala, MD, PhD
Elimu Informatics

Authors:
Andre Berro, MPH - CDC; Gema Dumitru, MD, MPH - Centers for Disease Control and Prevention; Ritche Hao, MD - Yale University; Sanjat Kanjilal, MD MPH; Saugat Karki, MD, MS - US Centers for Disease Control and Prevention; Charisse LaVell, MPH - Public Health Informatics Institute; Jeanne Ocampo, BS - Centers for Disease Control; Carlos Paredes, RN, BSN, AS - Yale New Haven Health; Alejandro Pérez; Sarah Shaw, MPH, PMP - Public Health Informatics Institute; Edna Shenvi, MD, MAS - Elimu Informatics Inc.; Amrita Tailor, MPH - Centers for Disease Control and Prevention; Jane Yang, MPH;

End user experiences at VA’s latest electronic health record transition site: a controlled, mixed-methods analysis

2025 Clinical Informatics Conference 25x5 Presentation

Presentation Time: 03:00 PM - 03:15 PM

Abstract Keywords: EHR Implementation and Optimization, Usability and Measuring User Experience, Clinician Burnout
Primary Track: Leadership and Governance
Programmatic Theme: Usability, Efficiency, and User Experience

Background: The Department of Veterans Affairs (VA) is undergoing a complex transition from a legacy electronic health record (EHR) system to a new commercial EHR, aiming to modernize technology, improve care quality, enhance clinician experience, and promote interoperability with the Department of Defense (DOD). Early transition sites reported user experience and patient safety challenges, prompting VA to delay further rollouts except at one joint VA/DOD facility, which went live in March 2024. We evaluated end-user experiences at this site and compared them to a contemporary control site still using the legacy EHR and a historical site that previously transitioned to the new EHR.

Methods: We used a concurrent mixed-methods approach, gathering quantitative survey data and qualitative interviews before, during, and after go-live. We analyzed survey and interview responses, and we present findings across methods.

Results: EHR users at the transition site reported challenges with usability, training, communication, and patient safety, although these experiences were less negative than at prior transition sites. Qualitative feedback highlighted positive aspects of the new EHR and specific areas of difficulty, particularly around lab ordering and scheduling. Peer support through VA’s National EHR Supplemental Staffing Unit (NESSU) was valued, providing context-sensitive training and support.

Conclusion: The VA’s approach to EHR transition is evolving. Intensive peer support and lessons from prior sites helped ease the transition, offering insights for future rollouts and strategies to enhance communication, training, and support for EHR users.

Speaker:
Seppo Rinne, MD, PhD
VA Bedford Healthcare System

Barriers to Real-world Implementation of a Multi-Modal Ophthalmology Clinical Decision Support Tool

Presentation Time: 03:15 PM - 03:30 PM

Abstract Keywords: Artificial Intelligence/Machine Learning, Bridging Analytics, Bedside Care, Clinical Documentation, and Education, Precision Health and Genomics, Quality Measures and eCQMs / Quality Improvement, Cross-organization Partnerships including Public-private Partnerships, Coordination Across the Continuum of Care, Clinical informatics organizational models
Working Group: Clinical Decision Support Working Group
Primary Track: AI and Care Outcomes
Programmatic Theme: Clinical Decision Support and Analytics

This study describes barriers encountered while working toward real-world implementation of a multi-modal artificial intelligence(AI) clinical decision support tool for glaucoma progression. Using longitudinal data and Amazon Web Services(AWS, Amazon Inc., Seattle, WA, USA) infrastructure, the tool integrates clinical data from the Electronic Health Record(EHR) and ophthalmic imaging and testing data from the Vendor Neutral Archive(VNA) and Picture Archiving and Communication System(PACS). Customized Python tools facilitated Digital Imaging and Communications in Medicine (DICOM) data handling.

Speaker:
Shahin Hallaj, MD
University of California, San Diego

Small Fixes, Big Impact: The Pebbles Program for Enhancing Provider Experience in the EHR

2025 Clinical Informatics Conference 25x5 Presentation

Presentation Time: 03:30 PM - 03:45 PM

Abstract Keywords: Building Value for Informatics via Education and Training, Clinician Burnout, Documentation Burden, EHR Implementation and Optimization, Workflow Efficiency
Primary Track: Documentation Burden, Clinician Well-Being and Care Outcomes
Programmatic Theme: Usability, Efficiency, and User Experience

The Pebbles Program was launched to empower providers to identify and report on annoyances and inefficiencies in the EHR that impact their workflow and well-being. Over 300 "pebbles" have been reported in year one, most of which were resolved through minor training or quick system modifications. This session will share our approach, lessons learned, and strategies for implementing a similar program to promote provider well-being through small but meaningful changes.

Speaker:
Dana Schinasi, MD, MSHI
Ann & Robert Lurie Children's Hospital of Chicago

Author:
Agata Nytko, BA - Ann & Robert H. Lurie Children's Hospital of Chicago;