Background: There has been ample speculation about potential future applications of natural language processing and related technologies for clinical documentation, and yet the mechanics of clinical documentation have changed very little since the passage of the HITECH Act in 2009. Purpose: While awaiting the integration of more advanced technologies into electronic health records (EHRs), we [...]

Background: According to CDC estimates, Hospital-Acquired Infections (HAI) account for an estimated 1.7 million infections and 99,000 deaths each year. Studies have shown that using alcohol-based or chlorhexidine-based hand hygiene (HH) is associated with decreased rates of HAIs (1, 2). Nudge theory, a concept in behavioral science, uses positive reinforcement and indirect suggestions to achieve [...]

Background: Inpatient serum folate testing was recognized as a low-value practice by the Choosing Wisely campaign in 2015. Despite this recognition, clinicians at our hospital system continue to use this test in a standard workup for conditions such as anemia, dementia and altered mental status. Shifting practice patterns away from serum folate testing remains a [...]

Background: There has been ample speculation about potential future applications of natural language processing and related technologies for clinical documentation, and yet the mechanics of clinical documentation have changed very little since the passage of the HITECH Act in 2009. Purpose: While awaiting the integration of more advanced technologies into electronic health records (EHRs), we [...]

Background: Compared with health care systems globally, the U.S. health care system expends more resources yet achieves worse patient outcomes. Growing recognition that such low-value care is a system-level problem has spurred efforts to optimize system-level processes. Low-value hospital admissions are a major contributor to overall low-value care, but limited descriptions of specific processes for [...]

Background: Unplanned readmissions in the U.S. healthcare system cost over $15 billion annually, a burden that increasingly impacts health systems as more patients transition to fully capitated models [1-2]. Despite evidence supporting the protective effect of post-hospitalization visits with primary care providers (PCPs), patient completion rates of these visits remain low [3-5]. Barriers include provider [...]