Background: One of the widely reported benefits of electronic health records (EHRs) is the ability to alert clinicians, especially regarding medication-related safety issues. However, soon after the installation of EHRs, the phenomenon of “alert fatigue” was realized. The Agency for Healthcare Research and Quality has shown clinicians override the vast majority of computerized physician order [...]

Background: EHR time motion studies have shown a significant time burden and concern that bedside manner, physical exam skills and physician wellness are at risk. However, nearly all studies to date have only focused on practicing physicians and residency training programs. Nearly all U.S. based medical schools allow medical student access, thus EHR exposure actually [...]

Background: Interventions to improve inpatient sleep rely on the ability to objectively quantify sleep; however existing methods of measurement (wrist actigraphy and patient survey) are resource intensive and impose a burden on patients. To overcome these barriers, we developed “sleep opportunity” (SLOP), a surrogate metric for sleep derived solely from the electronic health record (EHR). [...]

Background: Code status discussions and documentation are a key part of inpatient care for hospital medicine providers as they become more involved in caring for those with advanced illness. Hospitalists are challenged both with efficiently addressing a complicated subject due to time constraints and by a lack of established patient relationships. If it is not [...]

Background: The hospital discharge process is challenging and opportune for human error. Medication discrepancies continue to be a patient-safety problem, exacerbated with the multiple sources of discharge medication documentation. Medication discrepancies may lead to medication errors and may contribute to adverse drug events with potential subsequent healthcare utilization and cost. Discharge medications can be listed [...]

Background: Background: Patients transferred between hospitals undergo a high-risk transition of care, where communication is asynchronous, information is commonly lost, and mortality is disproportionately high. Prior studies have shown that standardizing communication through checklists can improve outcomes, and conversely lost documentation has been associated with higher mortality. The lack of interoperability of electronic health records [...]

Background: The electronic health record (EHR) is a major focus of a hospitalist’s daily work but is also often a frustration. Organizations offer providers the chance to recommend improvements to the system, but frequently there are significant delays in implementation or the request does not even cross the threshold for institutional action. Additionally, of those [...]

Background: The Department of Veterans Affairs (VA) originally released the Computerized Patient Record System (CPRS) in 1997. While revolutionary for its time, there has been limited substantial update in the last twenty years. Customization opportunities and ease of acquiring data are limited compared with newer, widely adopted electronic health record (EHR) systems. Purpose: To develop [...]

Background: When used optimally, technology should serve as a tool for clinicians, not an obstacle. Yet according to a recent study by the Mayo Clinic, Electronic Health Records (EHR) score in the bottom nineth percentile of technologies when evaluated for usability. This lack of usability can lead to increased documenting times, workflow bottlenecks, and physician [...]

Case Presentation: Learning Objectives: – To recognize ehrlichioisis as a possible cause of aseptic meningitis – To understand activities that increase the risk of tick-borne diseasesCase Presentation:A 69-year-old Black man presented to a Louisiana hospital with a two-day history of falls, intermittent disorientation, lower extremity weakness and pain, and urinary retention. He denied skin changes, [...]