Exploring the Implementation Experience and Use of CONCERN Early Warning System in a Rural Community Hospital: A Mixed Method Convergent Approach

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2025 Annual Symposium On Demand

Presentation Time: 09:45 AM - 09:57 AM

Abstract Keywords: Clinical Decision Support, User-centered Design Methods, Patient Safety, Machine Learning
Primary Track: Applications
Programmatic Theme: Clinical Informatics

The Communicating Narrative Concerns Entered by RNs Early Warning System (CONCERN EWS) is a machine-learning predictive model that analyzes nursing documentation patterns to detect early signs of patient deterioration, with proven effectiveness in reducing the risk of in-hospital mortality and length of stay. This study extends the evaluation of CONCERN EWS beyond acute care settings to a rural community hospital, assessing user experience, system utilization, and accuracy in identifying patient deterioration. The study examined accuracy in a rural setting using a mixed-methods approach—qualitative interviews, quantitative data analysis, and clinical record reviews. Findings suggest that CONCERN EWS enhances early recognition of clinical deterioration and is usable in the context of busy acute care nursing workflows. These results support its adaptability to facilitate strengthening nursing surveillance, clinical decision-making, and patient safety in rural healthcare settings as well.

Speaker:
Youngjin Lee, phD
Ajou University

Authors:
Youngjin Lee, phD - Ajou University; Min Jeoung Kang, PhD - Brigham and Women's Hospital/ Harvard Medical School; Veysel Baris, Nurse - Dokuz Eylul University; Graham Lowenthal, BA - Brigham and Women's Hospital; Sarah Rossetti, RN, PhD - Columbia University Department of Biomedical Informatics; Kenrick Cato, PhD, RN, CPHIMS, FAAN, FACMI - University of Pennsylvania/ Children's Hospital of Philadelphia; Rachel Lee, PhD, RN - Columbia University; Janna Kramer, MS-HIA - Martha’s Vineyard Hospital; Richard Huffam, BSN - Martha’s Vineyard Hospital; PATRICIA C DYKES, PhD, MA, RN - Brigham and Women's Hospital/Harvard Medical School;

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Developing a User-Centered Mobile Application Prototype: Bridging Lower-Limb Fracture Care from Skilled Nursing Facility and Back to the Community

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2025 Annual Symposium On Demand

Presentation Time: 09:57 AM - 10:09 AM

Abstract Keywords: Mobile Health, User-centered Design Methods, Education and Training, Patient Engagement and Preferences
Primary Track: Applications
Programmatic Theme: Consumer Health Informatics

This study is part of the OsteoPorotic fracTure preventION System (OPTIONS) project which aims to develop an evidence-based mobile application for older adults transitioning from skilled nursing facilities (SNFs) back to the community after lower limb fractures. The app promotes exercise, nutrition, and bone health medications to prevent future fractures. Using a Design science framework, app requirements were identified by synthesizing scientific knowledge, clinical expertise, and end-user needs. An initial mockup was developed based on these specifications and iteratively refined through design sessions incorporating end-user feedback. The final OPTIONS app features four core functions: (1) task-based self-management support, (2) personalized exercises and education, (3) motivational messaging, and (4) progress tracking allowing users to monitor their progress through visualizations. By addressing usability challenges for older adults, the app provides a personalized, engaging experience for continuous health management.

Speaker:
Min Jeoung Kang, PhD
Brigham and Women's Hospital/ Harvard Medical School

Authors:
Min Jeoung Kang, PhD - Brigham and Women's Hospital/ Harvard Medical School; Veysel Baris, Nurse - Dokuz Eylul University; Alice Kim, MS, RD - Brigham and Women’s Hospital; Kumiko Schnock, RN, PH.D - Brigham and Women's Hospital/ Harvard Medical School; Pamela Garabedian, MS - Mass General Brigham Inc.; Nancy Latham, PhD PT - Brigham and Women's Hosptial; Denise Orwig, PhD - University of Maryland School of Medicine; Jay Magaziner, PhD - University of Maryland School of Medicine; Rodrigo Valderrábano, MD - Brigham and Women’s Hospital/ Harvard Medical School; Ling Tang, BS - University of Maryland School of Medicine; Elizabeth Dennis, PhD - University of Maryland School of Medicine; Jason Falvey, PhD - University of Maryland School of Medicine; PATRICIA C DYKES, PhD, MA, RN - Brigham and Women's Hospital/Harvard Medical School;

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Enhancing Health Research Results Dissemination for American Indian and Alaska Native Communities through Indigenous Community-Centered Design

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2025 Annual Symposium On Demand

Presentation Time: 10:09 AM - 10:21 AM

Abstract Keywords: User-centered Design Methods, Health Equity, Diversity, Equity, Inclusion, and Accessibility, Delivering Health Information and Knowledge to the Public
Primary Track: Foundations
Programmatic Theme: Consumer Health Informatics

American Indian and Alaska Native (AI/AN) communities not only face significant health disparities but are often underrepresented in health research dissemination. Existing communication tools may fail to effectively reach these communities in culturally relevant and accessible ways, limiting their ability to benefit from critical health research. We co-designed and evaluated a prototype for health research results dissemination for AI/AN communities. We created and evaluated the prototype drawing from previous co-design workshops with AI/AN people. 38 participants completed an evaluation providing feedback for further iteration and highlighting key features such as search functionality, ease of use, visual and interactive elements, and content accessibility. Participants emphasized the importance of community connection, educational resources, and personalized experiences. We feature an alternative design approach we call Indigenous Community-Centered Design to create more accessible and engaging health research communication tools for AI/AN communities, fostering stronger connections and more accurate research representation.

Speaker:
Lisa Dirks, MS, MLIS
University of Washington Information School

Authors:
Wanda Pratt, PhD, FACMI - University of Washington; Victoria BearBow, BS - University of Washington; Lisa Dirks, MS, MLIS - University of Washington Information School;

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A Framework for an Intelligent Social Engagement Support System: Identifying and Addressing Challenges at Multiple Levels to Reduce Health Disparities

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2025 Annual Symposium On Demand

Presentation Time: 10:21 AM - 10:33 AM

Abstract Keywords: Health Equity and Social Determinants of Health (SDoH), Population Health, Healthcare Economics/Cost of Care
Primary Track: Foundations
Programmatic Theme: Public Health Informatics

Increasingly managed care organizations (MCOs) – health plans that offer covered health services through networks of healthcare providers and hospitals – are recognizing the role of social drivers of health on both health outcomes and unnecessary healthcare utilization (e.g., emergency department visits) and are taking actions. They are employing social care navigators (SCNs) and screening for social needs such as food, housing, and transportation. However, individuals with social needs can experience barriers to completing the screening and to receiving social care when referred. Additionally, the volume of people with social needs means that SCNs have high caseloads. Without guidance on how to prioritize their efforts, the people who have the highest social needs may not be identified or receive SCN support. To address the many problems, we developed a framework for an intelligent social engagement support system. This framework builds on the Health Care System domain of the National Institutes on Minority Health and Health Disparities’ Health Disparities Research Framework as a foundation, leverages learning health system and community-engaged approaches, and incorporates machine learning at key points to create an adaptable, multi-level framework that is intended to have numerous positive outcomes, including reducing health disparities in socially-driven health outcomes. We discuss how we are using this framework and how we envision it could be adapted to different MCO contexts.

Speaker:
Tera Reynolds, PhD, MPH, MS
University of Maryland Baltimore County

Authors:
Tera Reynolds, PhD, MPH, MS - University of Maryland Baltimore County; Hala Algrain, MBBS, MPH, MBA, MPS - University of Maryland, Baltimore County; Lorena de Leon, DPA, MBA - Maryland Physicians Care; Bryce Parker, MPH - Maryland Physicians Care; Ian Stockwell, PhD - University of Maryland, Baltimore County;

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Comparing Patient-level Social Drivers of Health from Health Surveys and Electronic Health Records for Patients with Comorbid Hypertension and Uncontrolled Diabetes

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2025 Annual Symposium On Demand

Presentation Time: 10:33 AM - 10:45 AM

Abstract Keywords: Nursing Informatics, Chronic Care Management, Quantitative Methods
Primary Track: Applications
Programmatic Theme: Clinical Informatics

Social drivers of health significantly influence diabetes and hypertension outcomes. We assessed the concordance between social drivers of health data from a health-related social needs survey and data in electronic health records. A comparative analysis was conducted among 165 adults diagnosed with coexisting hypertension and uncontrolled diabetes at a singular academic health system. Each participant completed a standardized social needs survey, and corresponding electronic health record-based social drivers of health data were extracted. Concordance was assessed using Cohen’s Kappa and percent agreement. Overall, agreement between the social needs survey and electronic health records data was low, indicating only slight alignment across various social drivers of health domains. These findings suggest that relying solely on electronic health records data may underestimate the true prevalence of patient-reported social needs. To ensure high-quality care, healthcare systems must develop more effective and sustainable methods for capturing social drivers of health data in clinical practice.

Speaker:
Somin Sang, PhD Student/MSN, BSN
Duke University

Authors:
Somin Sang, PhD Student/MSN, BSN - Duke University; Ryan Shaw, PhD, RN, ACHIP - Duke University; Susan Silva, PhD - Duke University; Susan Spratt, MD - Duke; Anushka Palipana, PhD - Duke university; Lisvel Matos, PhD - Duke University; Matthew Crowley, MD - Duke; Molly Fitzpatrick, BSN - Duke university;

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Effectiveness of Home-based Cardiac Rehabilitation Interventions Delivered via mHealth Technologies: Systematic Review and Meta-analysis

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2025 Annual Symposium On Demand

Presentation Time: 10:45 AM - 10:57 AM

Abstract Keywords: Mobile Health, Chronic Care Management, Telemedicine
Primary Track: Applications
Programmatic Theme: Consumer Health Informatics

This podium abstract describes the methods and main findings of a systematic review and meta-analysis of randomized trials to determine the effectiveness of mHealth-supported home-based cardiac rehabilitation interventions compared with usual care or center-based cardiac rehabilitation in patients with heart disease. This systematic review and meta-analysis was recently published in The Lancet Digital Health.

Speaker:
Leah Li, PhD candidate
UIC

Authors:
Leah Li, PhD candidate - UIC; Mickaël Ringeval, PhD - HEC Montréal; Gerit Wagner, PhD - Otto-Friedrich-Universität Bamberg; Guy Paré, PhD - HEC Montréal; Cemal Ozemek, PhD - University of Illinois Chicago; Spyros Kitsiou, PhD - Department of Biomedical and Health Information Sciences, University of Illinois at Chicago;

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