ArticleJournal of the American Medical Informatics Association : JAMIA2021
Healthcare Process Modeling to Phenotype Clinician Behaviors for Exploiting the Signal Gain of Clinical Expertise (HPM-ExpertSignals): Development and evaluation of a conceptual framework.
Article in Journal of the American Medical Informatics Association : JAMIA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors underpinning the performance of implemented artificial intelligence-based patient deterioration prediction systems: reasons for selection and implications for hospitals and researchers.Journal of the American Medical Informatics Association : JAMIA · 2025Pooled it
- Real-time surveillance system for patient deterioration: a pragmatic cluster-randomized controlled trial.Nature medicine · 2025Trial
- Influence of the CONCERN Early Warning System on Unanticipated ICU Transfers, In-Hospital Mortality, and Length of Stay: Results from a Multi-site Pragmatic Randomized Controlled Clinical Trial.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Trial
- Earlier ICU Transfer after CONCERN Early Warning System Score Escalation Reduced Sepsis-related Mortality: Results from a Multi-site Pragmatic Cluster Randomized Controlled Trial.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Trial
- Validating medical digital twins for clinical decision support: beyond predictive accuracy.JAMIA open · 2026Review
- Mapping ICU nursing intervention notes to clinical care classification using a large language model: an evaluation study.BMC nursing · 2026Article
- Enhancing prediction of inpatient deterioration by combining clinical and nurse concern features, with or without temporal clustering.JAMIA open · 2026Article
- Conceptual framework for prediction models of patient deterioration based on nursing documentation patterns: reproducibility and generalizability with a large number of hospitals across the United States.Journal of biomedical informatics · 2025Article
- Evaluating Equity in Usage and Effectiveness of the CONCERN Early Warning System.Applied clinical informatics · 2025Article
- Knowledge, attitudes, and practices toward postoperative rehabilitation among females with rotator cuff injury: a cross-sectional study.Journal of orthopaedic surgery and research · 2025Article
- Developing a clinical decision support framework for integrating predictive models into routine nursing practices in home health care for patients with heart failure.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2025Article
- Reimagining clinical AI: from clickstreams to clinical insights with EHR use metadata.npj health systems · 2025Review
- Designing and testing clinical simulations of an early warning system for implementation in acute care settings.JAMIA open · 2024Article
- Early Prediction of Cardiac Arrest in the Intensive Care Unit Using Explainable Machine Learning: Retrospective Study.Journal of medical Internet research · 2024Article
- Multisite Pragmatic Cluster-Randomized Controlled Trial of the CONCERN Early Warning System.medRxiv : the preprint server for health sciences · 2024Article
- Examining the Generalizability of Pretrained De-identification Transformer Models on Narrative Nursing Notes.Applied clinical informatics · 2024Article
- Toward Identifying New Risk Aversions and Subsequent Limitations and Biases When Making De-identified Structured Data Sets Openly Available in a Post-LLM world.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Generative AI Demonstrated Difficulty Reasoning on Nursing Flowsheet Data.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- EHR Documentation Frequency Changes Across the COVID-19 Pandemic.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Translating Nursing Data into Computational Metrics: An Evaluation Guideline for Inpatient Intravenous and Subcutaneous Insulin Management.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectiveThere are signals of clinicians' expert and knowledge-driven behaviors within clinical information systems (CIS) that can be exploited to support clinical prediction. Describe development of the Healthcare Process Modeling Framework to Phenotype Clinician Behaviors for Exploiting the Signal Gain of Clinical Expertise (HPM-ExpertSignals). MATERIALS AND
methodsWe employed an iterative framework development approach that combined data-driven modeling and simulation testing to define and refine a process for phenotyping clinician behaviors. Our framework was developed and evaluated based on the Communicating Narrative Concerns Entered by Registered Nurses (CONCERN) predictive model to detect and leverage signals of clinician expertise for prediction of patient trajectories.
resultsSeven themes-identified during development and simulation testing of the CONCERN model-informed framework development. The HPM-ExpertSignals conceptual framework includes a 3-step modeling technique: (1) identify patterns of clinical behaviors from user interaction with CIS; (2) interpret patterns as proxies of an individual's decisions, knowledge, and expertise; and (3) use patterns in predictive models for associations with outcomes. The CONCERN model differentiated at risk patients earlier than other early warning scores, lending confidence to the HPM-ExpertSignals framework. DISCUSSION: The HPM-ExpertSignals framework moves beyond transactional data analytics to model clinical knowledge, decision making, and CIS interactions, which can support predictive modeling with a focus on the rapid and frequent patient surveillance cycle.
conclusionsWe propose this framework as an approach to embed clinicians' knowledge-driven behaviors in predictions and inferences to facilitate capture of healthcare processes that are activated independently, and sometimes well before, physiological changes are apparent.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.