Wearable technologies promise to redefine assessment of health behaviors, yet their clinical implementation remains a challenge. To address this gap, two of the NIH’s Big Data to Knowledge Centers of Excellence organized a workshop on potential clinical applications of wearables. A workgroup comprised of 14 stakeholders from diverse backgrounds (hospital administration, clinical medicine, academia, insurance, and the commercial device industry) discussed two successful digital health interventions that involve wearables to identify common features responsible for their success. Seven features were identified including: a clearly defined problem, integration into a system of healthcare delivery, technology support, personalized experience, focus on end-user experience, alignment with reimbursement models, and inclusion of clinician champions. Health providers and systems keen to establish new models of care inclusive of wearables may consider these features during program design. A better understanding of these features is necessary to guide future clinical applications of wearable technology.

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Purpose: An oncology electronic health record (EHR) was implemented without prior usability testing. Before expanding the system to new clinics, this study was initiated to examine the role of usability testing in the evaluation of an EHR product and whether novice users could identify issues with usability that resonated with more experienced users of the system. In addition, our study evaluated whether usability issues with an already implemented system affect efficiency and satisfaction of users. Methods:A general usability guide was developed by a group of five informaticists. Using this guide, four novice users evaluated an EHR product and identified issues. A panel of five experts reviewed the identified issues to determine agreement with and applicability to the already implemented system. A survey of 42 experienced users of the previously implemented EHR was also performed to assess efficiency and general satisfaction. Results:The novice users identified 110 usability issues. Our expert panel agreed with 90% of the issues and recommendations for correction identified by the novice users. Our survey had a 54% response rate. The majority of the experienced users of the previously implemented system, which did not benefit from upfront usability testing, had a high degree of dissatisfaction with efficiency and general functionality but higher overall satisfaction than expected. Conclusion:In addition to reviewing features and content of an EHR system, usability testing could improve the chances that the EHR design is integrated with existing workflow and business processes in a clear and efficient way.

BackgroundThe widespread adoption of electronic health records provides new opportunities to better predict which patients are likely to suffer a stroke. Using electronic health records, we assessed the correlation of different laboratory tests to future occurrences of a stroke.MethodsWe examined the electronic health records of 2.4 million people over a two year time span. These records contained 26,964 diagnoses of stroke. Using Cox regression analysis, we measured whether any one of 1796 different laboratory tests were effectively correlated with a future diagnosis of stroke.ResultsWe identified 38 different laboratory tests that had significant short-term (two year) prognostic value for a future diagnosis of stroke. For each of the 38 laboratory tests we also compiled the Kaplan-Meier survival curve, and relative risk ratio that the test confers.ConclusionSeveral dozen laboratory tests are effective short-term correlates of stroke.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-016-0619-y) contains supplementary material, which is available to authorized users.