Machine learning-based clinical decision support tools for sepsis create opportunities to identify at-risk patients and initiate treatments earlier, critical to improving sepsis outcomes. Increasing use of such systems necessitates quantifying and understanding provider adoption. Using realtime provider interactions with a sepsis early detection tool (Targeted Real-time Early Warning System) deployed at five hospitals over a two-year period (469,419 screened encounters, 9,805 (2.1%) retrospectively-identified sepsis cases), we found high sensitivity (82% of sepsis cases identified), high adoption rates (89% of alerts evaluated by a physician or advanced practice provider and 38% of evaluated alerts confirmed) and an association between use of the tool and earlier treatment of sepsis patients (1.85 (95% CI:1.66-2.00) hour reduction in median time to first antibiotics order). Further, we found that provider-related factors were strongly associated with adoption. Beyond improving system performance, efforts to improve adoption should focus on provider knowledge, experience, and perceptions of the system.

We assessed temporal changes in the household secondary attack rate of SARS-CoV-2 and identified risk factors for transmission in vulnerable Latino households of Baltimore, Maryland. The household SAR was 45.8%, and it appeared to increase as the alpha variant spread, highlighting the magnified risk of spread in unvaccinated populations.

Background: Despite the disproportionate impact of COVID-19 on Latinos, there were disparities in vaccination, especially during the early phase of COVID-19 immunization rollout. Methods: Leveraging a community-academic partnership established to expand access to SARS-CoV2 testing, we implemented community vaccination clinics with multifaceted outreach strategies and flexible appointments for limited English proficiency Latinos. Results: Between February 26 and May 7 2021, 2250 individuals received the first dose of COVID-19 vaccination during 18 free community events. Among them, 92.4% (95% confidence interval [CI], 91.2%-93.4%) self-identified as Hispanic, 88.7% (95% CI, 87.2%-89.9%) were limited English proficiency Spanish speakers, 23.1% (95% CI, 20.9%-25.2%) reported prior COVID-19 infection, 19.4% (95% CI, 16.9%-22.25%) had a body mass index of more than 35, 35.0% (95% CI, 32.2%-37.8%) had cardiovascular disease, and 21.6% (95% CI, 19.2%-24.0%) had diabetes. The timely second-dose completion rate was high (98.7%; 95% CI, 97.6%-99.2%) and did not vary by outreach method. Conclusion: A free community-based vaccination initiative expanded access for Latinos with limited English proficiency at high risk for COVID-19 during the early phase of the immunization program in the US.