Times are displayed in (UTC-07:00) Pacific Time (US & Canada) Change
11/12/2024 |
10:30 AM – 12:00 PM |
Imperial A
S72: FHIR App Showcase
Presentation Type: Late Breaking
HER in the EHR: A Clinical Decision Support Tool for Postpartum Depression Risk Assessment
Presentation Time: 10:30 AM - 12:00 PM
Postpartum depression (PPD) is a serious mental health condition with adverse maternal and infant health outcomes. Up to 20% of birthing parents experience PPD but half are undiagnosed. This project describes an AI-driven clinical decision support (CDS) system to support PPD prevention and diagnosis using Fast Healthcare Interoperability Resources (FHIR). Central to this CDS is a predictive model of PPD externally validated for generalizability and fairness. Our solution integrates with Epic EHR using FHIR for data extraction and ingestion, using resources including Patient, Episode of Care, Condition, MedicationRequest, Observation, Procedure, and Encounter. Importantly, the CDS is embedded seamlessly into the clinical workflow, offering risk assessment and information within clinician schedules. For patients flagged as high risk, clinicians are prompted to conduct PPD screening for subsequent actions including referrals to psychiatric care and preventive actions. Currently piloted in prenatal care clinics at NewYork-Presbyterian/Weill Cornell Medicine, the CDS is undergoing evaluation to assess user acceptability and effectiveness.
Speaker(s):
Yiye Zhang, PhD
Weill Cornell Medicine
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
Postpartum depression (PPD) is a serious mental health condition with adverse maternal and infant health outcomes. Up to 20% of birthing parents experience PPD but half are undiagnosed. This project describes an AI-driven clinical decision support (CDS) system to support PPD prevention and diagnosis using Fast Healthcare Interoperability Resources (FHIR). Central to this CDS is a predictive model of PPD externally validated for generalizability and fairness. Our solution integrates with Epic EHR using FHIR for data extraction and ingestion, using resources including Patient, Episode of Care, Condition, MedicationRequest, Observation, Procedure, and Encounter. Importantly, the CDS is embedded seamlessly into the clinical workflow, offering risk assessment and information within clinician schedules. For patients flagged as high risk, clinicians are prompted to conduct PPD screening for subsequent actions including referrals to psychiatric care and preventive actions. Currently piloted in prenatal care clinics at NewYork-Presbyterian/Weill Cornell Medicine, the CDS is undergoing evaluation to assess user acceptability and effectiveness.
Speaker(s):
Yiye Zhang, PhD
Weill Cornell Medicine
Author(s):
SERO – A mobile app for suicide prevention
Presentation Time: 10:30 AM - 12:00 PM
The SERO app is an innovative mobile application designed to support people experiencing thoughts of suicide and their families through evidence-based self-management strategies. The app, developed using a human-centered, participatory design approach, incorporates the PRISM™-S method, allowing individuals to rapidly assess their risk. This visual self-assessment tool helps people gauge their current mental state. People who use the app can create and share customized safety plans, which are crucial for preparing for potential crises. Based on the individual's safety plan, the app suggests tailored coping activities to help manage thoughts of suicide. SERO enhances access to immediate help during critical moments. All data collected by the app, including the visual risk assessments, are stored securely using health data standards in a privacy-compliant health data space. After 20 months of availability in app stores, more than 2100 people have registered to use the SERO app.
Speaker(s):
Kerstin Denecke, Dr.rer.nat.
Bern University of Applied Sciences
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
The SERO app is an innovative mobile application designed to support people experiencing thoughts of suicide and their families through evidence-based self-management strategies. The app, developed using a human-centered, participatory design approach, incorporates the PRISM™-S method, allowing individuals to rapidly assess their risk. This visual self-assessment tool helps people gauge their current mental state. People who use the app can create and share customized safety plans, which are crucial for preparing for potential crises. Based on the individual's safety plan, the app suggests tailored coping activities to help manage thoughts of suicide. SERO enhances access to immediate help during critical moments. All data collected by the app, including the visual risk assessments, are stored securely using health data standards in a privacy-compliant health data space. After 20 months of availability in app stores, more than 2100 people have registered to use the SERO app.
Speaker(s):
Kerstin Denecke, Dr.rer.nat.
Bern University of Applied Sciences
Author(s):
A Machine Learning-Driven Clinical SmartAlert Targeting Lab Overutilization
Presentation Time: 10:30 AM - 12:00 PM
An estimated 20-30% of inpatient standing daily lab orders are medically unnecessary, contributing to iatrogenic anemia, sleep disruption, and increased healthcare costs. The Society of Hospital Medicine identified routine repetitive complete blood count (CBC) and chemistry (BMP) as a common wasteful inpatient practice on the “Choosing Wisely” list. At our institution, repetitive inpatient CBC, BMP, magnesium, and phosphorus account for 20-30% of all labs, though 80% of results are stable by day 3 of admission. Clinicians’ cognitive burden and safety concerns are significant barriers to lab discontinuation. We leverage FHIR to implement a machine learning (ML)-driven real-time clinical alert within the electronic health record (EHR), or SmartAlert, to help clinicians identify patients in whom low yield testing can safely be discontinued.
Speaker(s):
April Liang, MD
Stanford University
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
An estimated 20-30% of inpatient standing daily lab orders are medically unnecessary, contributing to iatrogenic anemia, sleep disruption, and increased healthcare costs. The Society of Hospital Medicine identified routine repetitive complete blood count (CBC) and chemistry (BMP) as a common wasteful inpatient practice on the “Choosing Wisely” list. At our institution, repetitive inpatient CBC, BMP, magnesium, and phosphorus account for 20-30% of all labs, though 80% of results are stable by day 3 of admission. Clinicians’ cognitive burden and safety concerns are significant barriers to lab discontinuation. We leverage FHIR to implement a machine learning (ML)-driven real-time clinical alert within the electronic health record (EHR), or SmartAlert, to help clinicians identify patients in whom low yield testing can safely be discontinued.
Speaker(s):
April Liang, MD
Stanford University
Author(s):
Florence: A Bedside Charting Copilot for Nurses
Presentation Time: 10:30 AM - 12:00 PM
Nursing turnover is at 18.4%, and 44% of nurses cite burnout as the primary cause of turnover. The ANA indicates the top reasons for burnout include: "Patient load and clinical task volume", "Too many administrative tasks, such as charting, electronic health records and documentation", and "Challenging patients and families". Our solution listens to nurses as they speak with and about patients. It organizes the interaction into a completed flowsheet, which is then submitted to the EHR over FHIR. The solution also analyzes the recordings to reveal subtle indicators of patient load that are usually reported only subjectively, such as the number of questions asked by patients, the level of aggression, and the presence of family members. In this way it also reports on "challenging patients and families". As a result, our solution helps hospitals effectively combat 3 of the top 5 causes of nursing burnout.
In practice, our solution is used by nurses on a mobile device, which can include Vocera and Zebra devices. The nurse can inform the patient that they will be using a recording tool to help with documentation, and can click start recording. Once they are done, they can click stop, and the completed flowsheet appears on device for their review. Once done reviewing, the nurse clicks submit to insert the flowsheet into the EHR. In parallel, the recording is analyzed and insights into patient behavior and made available in a dedicated portal used by nursing managers, charge nurses, and leadership.
Speaker(s):
Rohan Arora, B.S.
Meru
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
Nursing turnover is at 18.4%, and 44% of nurses cite burnout as the primary cause of turnover. The ANA indicates the top reasons for burnout include: "Patient load and clinical task volume", "Too many administrative tasks, such as charting, electronic health records and documentation", and "Challenging patients and families". Our solution listens to nurses as they speak with and about patients. It organizes the interaction into a completed flowsheet, which is then submitted to the EHR over FHIR. The solution also analyzes the recordings to reveal subtle indicators of patient load that are usually reported only subjectively, such as the number of questions asked by patients, the level of aggression, and the presence of family members. In this way it also reports on "challenging patients and families". As a result, our solution helps hospitals effectively combat 3 of the top 5 causes of nursing burnout.
In practice, our solution is used by nurses on a mobile device, which can include Vocera and Zebra devices. The nurse can inform the patient that they will be using a recording tool to help with documentation, and can click start recording. Once they are done, they can click stop, and the completed flowsheet appears on device for their review. Once done reviewing, the nurse clicks submit to insert the flowsheet into the EHR. In parallel, the recording is analyzed and insights into patient behavior and made available in a dedicated portal used by nursing managers, charge nurses, and leadership.
Speaker(s):
Rohan Arora, B.S.
Meru
Author(s):
Carepal for SMART Liver – A Comprehensive Solution for Integrated Liver Cirrhosis Care
Presentation Time: 10:30 AM - 12:00 PM
Carepal for SMARTLiver offers an innovative solution for end-stage liver disease (ESLD) patients, enhancing patient engagement and provider communication. This integrated system combines Carepal, a patient-support smartphone app, with SMARTLiver, a physician-facing SMART-on-FHIR web app. The clinical care team, acting as air traffic controllers, uses SMARTLiver to guide patients through Carepal, empowering them to manage their own health effectively. Carepal provides patients with real-time health data access, PROMIS-29 reporting, medication reminders, and a liver disease-specific chatbot. SMARTLiver enhances clinical efficiency through specialized dashboards, automated task management, and integration of Clinical Practice Guidelines. Leveraging HL7 FHIR, both apps ensure seamless data exchange, enabling clinicians to monitor patient-reported outcomes and liver-related scores over time. This comprehensive approach addresses the global challenge of liver cirrhosis management, which contributes to over 2 million deaths annually. By improving medication adherence, facilitating personalized care plans, and providing educational resources, Carepal for SMARTLiver aims to reduce hospitalizations and enhance quality of life for ESLD patients while streamlining clinical workflows.
Speaker(s):
FNU Chandra Vikram, MS
Indiana University Indianapolis
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
Carepal for SMARTLiver offers an innovative solution for end-stage liver disease (ESLD) patients, enhancing patient engagement and provider communication. This integrated system combines Carepal, a patient-support smartphone app, with SMARTLiver, a physician-facing SMART-on-FHIR web app. The clinical care team, acting as air traffic controllers, uses SMARTLiver to guide patients through Carepal, empowering them to manage their own health effectively. Carepal provides patients with real-time health data access, PROMIS-29 reporting, medication reminders, and a liver disease-specific chatbot. SMARTLiver enhances clinical efficiency through specialized dashboards, automated task management, and integration of Clinical Practice Guidelines. Leveraging HL7 FHIR, both apps ensure seamless data exchange, enabling clinicians to monitor patient-reported outcomes and liver-related scores over time. This comprehensive approach addresses the global challenge of liver cirrhosis management, which contributes to over 2 million deaths annually. By improving medication adherence, facilitating personalized care plans, and providing educational resources, Carepal for SMARTLiver aims to reduce hospitalizations and enhance quality of life for ESLD patients while streamlining clinical workflows.
Speaker(s):
FNU Chandra Vikram, MS
Indiana University Indianapolis
Author(s):
Development of an App for Interhospital Transfer Between Acute Care Hospitals: User Needs and Conceptual Design
Presentation Time: 10:30 AM - 12:00 PM
Interhospital transfer (IHT) impacts over a million patients annually in the United States. Previous research has found that lack of health information exchange (HIE) interoperability during IHT weakens communication, thereby increasing patient risk for worse outcomes. Incomplete or missing information hinders both patient care planning and clinician work efficiency. The growth of standards for information technology presents an opportunity to remove these barriers through information synchronization. This IHT App, developed by Mass General Brigham (MGB), presents a single screen external to the electronic health record (EHR) to facilitate information review by a clinician across clinical domains and allows development of a personalized care plan. The application is designed to integrate information from both internal and external EHRs using Fast Healthcare Interoperability Resources (FHIR) and facilitate cognitive review through visualization and search capabilities. The application has undergone usability testing with both transfer center clinicians and admitting physicians and will be compared to other health IT interventions to improve IHT communication.
Speaker(s):
John D'Amore, Masters
More Informatics
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
Interhospital transfer (IHT) impacts over a million patients annually in the United States. Previous research has found that lack of health information exchange (HIE) interoperability during IHT weakens communication, thereby increasing patient risk for worse outcomes. Incomplete or missing information hinders both patient care planning and clinician work efficiency. The growth of standards for information technology presents an opportunity to remove these barriers through information synchronization. This IHT App, developed by Mass General Brigham (MGB), presents a single screen external to the electronic health record (EHR) to facilitate information review by a clinician across clinical domains and allows development of a personalized care plan. The application is designed to integrate information from both internal and external EHRs using Fast Healthcare Interoperability Resources (FHIR) and facilitate cognitive review through visualization and search capabilities. The application has undergone usability testing with both transfer center clinicians and admitting physicians and will be compared to other health IT interventions to improve IHT communication.
Speaker(s):
John D'Amore, Masters
More Informatics
Author(s):
FHIR-enabled eSourcing with CLEHR
Presentation Time: 10:30 AM - 12:00 PM
Traditional manual data entry for clinical research by study sites is inefficient, error-prone, and expensive. The cloud-based CLEHR eSourcing solution reduces this burden through the automated, reliable, compliant, and secure transfer of data directly from a hospital EHR into the study electronic data capture (EDC) system. Instead of copying and pasting data from the EHR into EDC forms, clinical research coordinators (CRCs) use CLEHR to map the records and the system does the rest of the work. Data is richer for improved analysis, and accuracy is guaranteed so time-consuming source data verification (SDV) is eliminated.
CLEHR uses standardized data elements (USCDI) that are already part of EHRs and FHIR to request data from the EHR. Unlike mapping tools on the market, CLEHR replaces manual entry as opposed to making manual entry more efficient. Importantly, by leveraging interoperability standards mandated by law, CLEHR can scale to many study sites, sponsors, and studies once connectivity is established.
CLEHR is successfully deployed in 4 health systems for an aggregate network of about 20 million patients, as part of Abiomed’s LOQI (Long-Term Outcome and Quality Indicator) Registry for the Impella heart pump. To date, Abiomed has reduced the manual data entry burden on sites from 100% to 30% with CLEHR. We are tracking to connect 5 additional health systems to CLEHR for an additional 35 million patients in the next 6-8 months.
Speaker(s):
Dan Housman, BS
Graticule
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
Traditional manual data entry for clinical research by study sites is inefficient, error-prone, and expensive. The cloud-based CLEHR eSourcing solution reduces this burden through the automated, reliable, compliant, and secure transfer of data directly from a hospital EHR into the study electronic data capture (EDC) system. Instead of copying and pasting data from the EHR into EDC forms, clinical research coordinators (CRCs) use CLEHR to map the records and the system does the rest of the work. Data is richer for improved analysis, and accuracy is guaranteed so time-consuming source data verification (SDV) is eliminated.
CLEHR uses standardized data elements (USCDI) that are already part of EHRs and FHIR to request data from the EHR. Unlike mapping tools on the market, CLEHR replaces manual entry as opposed to making manual entry more efficient. Importantly, by leveraging interoperability standards mandated by law, CLEHR can scale to many study sites, sponsors, and studies once connectivity is established.
CLEHR is successfully deployed in 4 health systems for an aggregate network of about 20 million patients, as part of Abiomed’s LOQI (Long-Term Outcome and Quality Indicator) Registry for the Impella heart pump. To date, Abiomed has reduced the manual data entry burden on sites from 100% to 30% with CLEHR. We are tracking to connect 5 additional health systems to CLEHR for an additional 35 million patients in the next 6-8 months.
Speaker(s):
Dan Housman, BS
Graticule
Author(s):
Child Health Improvement through Computer Automation (CHICA on FHIR)
Presentation Time: 10:30 AM - 12:00 PM
75 million US children receive preventive care annually, yet they receive less than half of recommended services. This problem has plagued pediatrics for years, resulting in significant health consequences for children. Just one example, autism, affecting 1 in 36, is often not diagnosed until after age 4 years, but therapy should start at age <2. Likewise, post-partum depression, effecting 1/3 of women, is addressed in less than 1/4, and, untreated, can cause emotional, cognitive, and interpersonal problems in the child. The root of the problem is too many competing guidelines. Currently, we use alerts or templates in EHRs for these, but the number of recommendations is simply too large to manage this way.
Pediatrics lacks a strategy to prioritize which services each patient should receive to optimize health outcomes. CHICA (Child Health Improvement through Computer Automation) is FHIR-enabled software proven to improve quality of care in the outpatient setting. CHICA’s guidance is based on authoritative primary care guidelines from the American Academy of Pediatrics, Centers for Disease Control, the US Preventive Services Task Force, and others. CHICA screens families in the waiting room and customizes and prioritizes 6 recommendations to the physician using decision theory, tailoring health risk assessments and advice to physicians and has been proven to work in dozens of trials.
CHICA is a validated solution to the problem of too many guidelines. CHICA handles an arbitrarily large number of reminders, but because they are pre-screened, prioritized, and limited, CHICA prevents interminably long templates and alert fatigue.
Speaker(s):
Stephen Downs, MD, MS
Wake Forest School of Medicine
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
75 million US children receive preventive care annually, yet they receive less than half of recommended services. This problem has plagued pediatrics for years, resulting in significant health consequences for children. Just one example, autism, affecting 1 in 36, is often not diagnosed until after age 4 years, but therapy should start at age <2. Likewise, post-partum depression, effecting 1/3 of women, is addressed in less than 1/4, and, untreated, can cause emotional, cognitive, and interpersonal problems in the child. The root of the problem is too many competing guidelines. Currently, we use alerts or templates in EHRs for these, but the number of recommendations is simply too large to manage this way.
Pediatrics lacks a strategy to prioritize which services each patient should receive to optimize health outcomes. CHICA (Child Health Improvement through Computer Automation) is FHIR-enabled software proven to improve quality of care in the outpatient setting. CHICA’s guidance is based on authoritative primary care guidelines from the American Academy of Pediatrics, Centers for Disease Control, the US Preventive Services Task Force, and others. CHICA screens families in the waiting room and customizes and prioritizes 6 recommendations to the physician using decision theory, tailoring health risk assessments and advice to physicians and has been proven to work in dozens of trials.
CHICA is a validated solution to the problem of too many guidelines. CHICA handles an arbitrarily large number of reminders, but because they are pre-screened, prioritized, and limited, CHICA prevents interminably long templates and alert fatigue.
Speaker(s):
Stephen Downs, MD, MS
Wake Forest School of Medicine
Author(s):
Wellmine
Presentation Time: 10:30 AM - 12:00 PM
Rare diseases affect 25-30 million individuals in the US, but collecting and managing patient data for research is a costly and inefficient process that hinders progress. To address this challenge, we developed Wellmine, a SMART-on-FHIR app that empowers patients to take control of their health data. By leveraging open-source tools, containerized architecture, and RTI Merge—a cloud data science and artificial intelligence (AI) platform—we created a secure, scalable, and user-friendly platform that enables seamless sharing of electronic medical records with clinical researchers and disease registries.
Our evaluation demonstrated the app's effectiveness in capturing a wide range of health information and providing a comprehensive view of patients' health histories. Caregivers found the app easy to use and valuable in gaining insights into their disease management. With its potential to reduce costs, accelerate research, and improve patient outcomes, Wellmine is poised to make a significant impact in the field of rare disease research, ultimately improving the lives of patients worldwide.
Speaker(s):
Joel Montavon, PharmD, MBA
RTI International
Author(s):
Presentation Time: 10:30 AM - 12:00 PM
Rare diseases affect 25-30 million individuals in the US, but collecting and managing patient data for research is a costly and inefficient process that hinders progress. To address this challenge, we developed Wellmine, a SMART-on-FHIR app that empowers patients to take control of their health data. By leveraging open-source tools, containerized architecture, and RTI Merge—a cloud data science and artificial intelligence (AI) platform—we created a secure, scalable, and user-friendly platform that enables seamless sharing of electronic medical records with clinical researchers and disease registries.
Our evaluation demonstrated the app's effectiveness in capturing a wide range of health information and providing a comprehensive view of patients' health histories. Caregivers found the app easy to use and valuable in gaining insights into their disease management. With its potential to reduce costs, accelerate research, and improve patient outcomes, Wellmine is poised to make a significant impact in the field of rare disease research, ultimately improving the lives of patients worldwide.
Speaker(s):
Joel Montavon, PharmD, MBA
RTI International
Author(s):
S72: FHIR App Showcase
Description
