2024
Improving Cefazolin Administration for Surgical Prophylaxis in Reported Penicillin Allergy: A Retrospective Study of a Health System Intervention
Belmont A, Son M, Hyman J, You L, Su C, Kashyap N, Topal J, McManus D, Martinello R, Kwah J. Improving Cefazolin Administration for Surgical Prophylaxis in Reported Penicillin Allergy: A Retrospective Study of a Health System Intervention. Journal Of Allergy And Clinical Immunology Global 2024, 100377. DOI: 10.1016/j.jacig.2024.100377.Peer-Reviewed Original ResearchPenicillin allergy labelHospital-wide guidelinesSurgical site infectionAllergy labelsSurgical patientsSevere allergic reactionsSurgical prophylaxisSite infectionAssociated with increased rates of surgical site infectionRate of surgical site infectionMulti-drug resistant infectionsAllergic reactionsPrevent surgical site infectionsFirst-line antibioticsFirst-line prophylaxisAdministration of cefazolinAssociated with increased ratesRetrospective cohort studyGuideline-directed therapyAdult surgical patientsPre-intervention groupPost-intervention groupPenicillin allergyPerioperative outcomesCefazolin administrationFrom MedWreck to MedRec: A Call to Action to Improve Medication Reconciliation
Kashyap N, Jeffery S, Agresta T. From MedWreck to MedRec: A Call to Action to Improve Medication Reconciliation. Applied Clinical Informatics 2024, 15: 230-233. PMID: 37748724, PMCID: PMC10972679, DOI: 10.1055/a-2181-1847.Peer-Reviewed Original ResearchCreation and Validation of an Automated Registry for Outpatient Parenteral Antibiotics
Canterino J, Malinis M, Liu J, Kashyap N, Brandt C, Justice A. Creation and Validation of an Automated Registry for Outpatient Parenteral Antibiotics. Open Forum Infectious Diseases 2024, 11: ofae004. PMID: 38412514, PMCID: PMC10866572, DOI: 10.1093/ofid/ofae004.Peer-Reviewed Original ResearchElectronic medical recordsOutpatient parenteral antibiotic therapyOutpatient parenteral antibiotic therapy programsMedical recordsObjective dataHospital length of stayOPAT episodesLength of stayDischarge dispositionUnique patientsRegistryParenteral antibiotic therapyInsurance payorOutpatient parenteral antibioticsDeath rateHospital lengthHospital daysAntibiotic therapyParenteral antibioticsInfection syndromeHospitalProgramAntibiotic name
2023
Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection
Dullabh P, Heaney-Huls K, Chiao A, Callaham M, Desai P, Gauthreaux N, Kashyap N, Lobach D, Boxwala A. Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection. JAMIA Open 2023, 6: ooad098. PMID: 38028731, PMCID: PMC10646567, DOI: 10.1093/jamiaopen/ooad098.Peer-Reviewed Original ResearchElectronic health recordsHypertensive disordersRemote patient monitoring programPostpartum monitoringLocal clinical championsClinical championsPatient involvementIntegration standardsKey observationPilot interventionEHR developersClinician usersHealth recordsClinical workflowRemote monitoringDisordersPregnancyAppsSmartphone applicationInterventionData collectionPatientsDevelopersUsersUsability33 THE IMPLEMENTATION OF AN EMR-BASED AUTOMATED SYSTEM FOR IDENTIFICATION OF PATIENTS SUSPICIOUS FOR LYNCH SYNDROME HAS A DISPROPORTIONALLY POSITIVE IMPACT IN THE IDENTIFICATION OF DISADVANTAGED PATIENTS
Soleymanjahi S, Singh V, Liu J, Brown Q, Brierley K, Healy C, Xicola R, Kashyap N, Llor X. 33 THE IMPLEMENTATION OF AN EMR-BASED AUTOMATED SYSTEM FOR IDENTIFICATION OF PATIENTS SUSPICIOUS FOR LYNCH SYNDROME HAS A DISPROPORTIONALLY POSITIVE IMPACT IN THE IDENTIFICATION OF DISADVANTAGED PATIENTS. Gastroenterology 2023, 164: s-11. DOI: 10.1016/s0016-5085(23)00980-0.Peer-Reviewed Original ResearchExperiences with Cyclical User-Centered Design for Patient and Clinician Facing Medication Reconciliation mHealth Applications.
Polomoff C, Jeffery S, Agresta T, Bektashev S, Tran R, Frazier W, Demurjian S, O'Dell J, Sinha S, Kashyap N. Experiences with Cyclical User-Centered Design for Patient and Clinician Facing Medication Reconciliation mHealth Applications. AMIA Annual Symposium Proceedings 2023, 2022: 874-883. PMID: 37128468, PMCID: PMC10148378.Peer-Reviewed Original ResearchImplementing real-time prescription benefit tools: Early experiences from 5 academic medical centers
Luo J, Wong R, Mehta T, Schwartz J, Epstein J, Smith E, Kashyap N, Woreta F, Feterik K, Fliotsos M, Crotty B. Implementing real-time prescription benefit tools: Early experiences from 5 academic medical centers. Healthcare 2023, 11: 100689. PMID: 36989915, PMCID: PMC10880821, DOI: 10.1016/j.hjdsi.2023.100689.Peer-Reviewed Original ResearchColchicine and high-intensity rosuvastatin in the treatment of non-critically ill patients hospitalised with COVID-19: a randomised clinical trial
Shah T, McCarthy M, Nasir I, Archer H, Ragheb E, Kluger J, Kashyap N, Paredes C, Patel P, Lu J, Kandel P, Song C, Khan M, Huang H, Haq F, Ahmad R, Howes C, Cambi B, Lancaster G, Cleman M, Dela Cruz C, Parise H, Lansky A. Colchicine and high-intensity rosuvastatin in the treatment of non-critically ill patients hospitalised with COVID-19: a randomised clinical trial. BMJ Open 2023, 13: e067910. PMID: 36828654, PMCID: PMC9971831, DOI: 10.1136/bmjopen-2022-067910.Peer-Reviewed Original ResearchConceptsStandard of careHigh-intensity rosuvastatinElectronic medical recordsCOVID-19 diseaseMedical recordsPrimary endpointThromboembolic eventsYale New Haven Health SystemSevere COVID-19 diseaseCOVID-19Prespecified primary endpointVenous thromboembolic eventsRisk of progressionCombination of colchicineSafety monitoring boardCare armHispanics/LatinosTherapeutic anticoagulationIndex hospitalisationIll patientsMedian ageFuture trialsEffect of colchicineClinical trialsMonitoring boardImplementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection
Dullabh P, Heaney-Huls KK, Chiao AB, Callaham MG, Desai P, Gauthreaux NA, Kashyap N, Lobach DF, Boxwala A. Implementation and evaluation of an electronic health record-integrated app for postpartum monitoring of hypertensive disorders of pregnancy using patient-contributed data collection, JAMIA Open, Volume 6, Issue 4, December 2023, ooad098, https://doi.org/10.1093/jamiaopen/ooad098Peer-Reviewed Original Research In Press
2022
Where Do Real-Time Prescription Benefit Tools Fit in the Landscape of High US Prescription Medication Costs? A Narrative Review
Wong R, Mehta T, Very B, Luo J, Feterik K, Crotty B, Epstein J, Fliotsos M, Kashyap N, Smith E, Woreta F, Schwartz J. Where Do Real-Time Prescription Benefit Tools Fit in the Landscape of High US Prescription Medication Costs? A Narrative Review. Journal Of General Internal Medicine 2022, 38: 1038-1045. PMID: 36441366, PMCID: PMC10039141, DOI: 10.1007/s11606-022-07945-z.Peer-Reviewed Original ResearchConceptsMedication costsElectronic clinical decision support toolPocket medication costsPrescription medication costsPoor patient adherenceWorse clinical outcomesClinical decision support toolUS healthcare costsPocket cost informationElectronic health recordsPharmacologic treatmentClinical outcomesPatient adherencePrescription medicationsHealthcare costsPatientsNarrative reviewHealth systemMedicaid ServicesLimited evidenceHealth recordsHealthcare systemFinancial burdenAdherenceMultiple factorsIntegrating a Patient Engagement App into an Electronic Health Record-Enabled Workflow Using Interoperability Standards
Lobach D, Boxwala A, Kashyap N, Heaney-Huls K, Chiao A, Rafter T, Lomotan E, Harrison M, Dymek C, Swiger J, Dullabh P. Integrating a Patient Engagement App into an Electronic Health Record-Enabled Workflow Using Interoperability Standards. Applied Clinical Informatics 2022, 13: 1163-1171. PMID: 36516969, PMCID: PMC9750793, DOI: 10.1055/s-0042-1758736.Peer-Reviewed Original ResearchConceptsFast Healthcare Interoperability ResourcesApplication programming interfaceFHIR standardElectronic health recordsInteroperability standardsApplication development teamClinical workflowCOVID-19 trackerHealth recordsStandards-based approachIntegration of appsFHIR resourcesProgramming interfaceMobile health applicationsMobile applicationsWorkflow integrationDevelopment teamsClinician workflowPartial implementationWorkflowHealth applicationsAppsClinical systemsSuch integrationText messagesThe first 20 months of the COVID-19 pandemic: Mortality, intubation and ICU rates among 104,590 patients hospitalized at 21 United States health systems
Fiore M, Smith S, Adsit R, Bolt D, Conner K, Bernstein S, Eng O, Lazuk D, Gonzalez A, Jorenby D, D’Angelo H, Kirsch J, Williams B, Nolan M, Hayes-Birchler T, Kent S, Kim H, Piasecki T, Slutske W, Lubanski S, Yu M, Suk Y, Cai Y, Kashyap N, Mathew J, McMahan G, Rolland B, Tindle H, Warren G, An L, Boyd A, Brunzell D, Carrillo V, Chen L, Davis J, Dilip D, Ellerbeck E, Iturrate E, Jose T, Khanna N, King A, Klass E, Newman M, Shoenbill K, Tong E, Tsoh J, Wilson K, Theobald W, Baker T. The first 20 months of the COVID-19 pandemic: Mortality, intubation and ICU rates among 104,590 patients hospitalized at 21 United States health systems. PLOS ONE 2022, 17: e0274571. PMID: 36170336, PMCID: PMC9518859, DOI: 10.1371/journal.pone.0274571.Peer-Reviewed Original ResearchConceptsCOVID-19 patientsICU admission rateUnited States health systemState health systemAdmission ratesPositive COVID-19 PCR testCOVID-19 PCR testHospitalized COVID-19 patientsHealth systemHealth system contactElectronic health record dataICD-10 diagnosisAge 18 yearsCOVID-19 hospitalizationRisk-standardized mortalityHealth record dataHigh mortality rateCOVID-19 pandemicICU admissionHospitalized participantsEndotracheal intubationIntubation rateMean agePatient groupPatient outcomesSmoking Status, Nicotine Medication, Vaccination, and COVID-19 Hospital Outcomes: Findings from the COVID EHR Cohort at the University of Wisconsin (CEC-UW) Study
Piasecki T, Smith S, Baker T, Slutske W, Adsit R, Bolt D, Conner K, Bernstein S, Eng O, Lazuk D, Gonzalez A, Jorenby D, D’Angelo H, Kirsch J, Williams B, Nolan M, Hayes-Birchler T, Kent S, Kim H, Lubanski S, Yu M, Suk Y, Cai Y, Kashyap N, Mathew J, McMahan G, Rolland B, Tindle H, Warren G, An L, Boyd A, Brunzell D, Carrillo V, Chen L, Davis J, Deshmukh V, Dilip D, Ellerbeck E, Goldstein A, Iturrate E, Jose T, Khanna N, King A, Klass E, Mermelstein R, Tong E, Tsoh J, Wilson K, Theobald W, Fiore M. Smoking Status, Nicotine Medication, Vaccination, and COVID-19 Hospital Outcomes: Findings from the COVID EHR Cohort at the University of Wisconsin (CEC-UW) Study. Nicotine & Tobacco Research 2022, 25: 1184-1193. PMID: 36069915, PMCID: PMC9494410, DOI: 10.1093/ntr/ntac201.Peer-Reviewed Original ResearchConceptsNicotine replacement therapySARS-CoV-2 vaccinationCOVID-19 patientsCurrent smokersFormer smokersSmoking statusCOVID-19 outcomesICU admissionNRT prescriptionHospital outcomesVaccination statusReplacement therapySevere COVID-19 disease outcomesCOVID-19 clinical outcomesCOVID-19 disease outcomesBetter hospital outcomesOdds of deathBody mass indexElectronic health record dataLarge cohort studyCOVID-19 hospitalizationHealth record dataPotential beneficial effectsU.S. health systemEHR cohortAlerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure
Ahmad T, Desai NR, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Dhar R, Hsiao A, Kashyap N, Allen L, Velazquez EJ, Wilson FP. Alerting Clinicians to 1-Year Mortality Risk in Patients Hospitalized With Heart Failure. JAMA Cardiology 2022, 7: 905-912. PMID: 35947362, PMCID: PMC9366654, DOI: 10.1001/jamacardio.2022.2496.Peer-Reviewed Original ResearchConceptsUsual care groupElectronic health recordsHeart failureAlert groupMedian agePrimary outcomeFemale patientsTerminal pro-brain natriuretic peptide levelsYale New Haven Health SystemPro-brain natriuretic peptide levelsMedian NT-proBNP levelLeft ventricular ejection fractionLarge tertiary care centerHeart failure hospitalizationHeart failure medicationsNatriuretic peptide levelsNT-proBNP levelsHealth recordsHours of admissionTertiary care centerVentricular ejection fractionRate of hospitalizationIntensive care unitEthnicity groupsSmall community hospitalRelations of Current and Past Cancer with Severe Outcomes among 104,590 Hospitalized COVID-19 Patients: The COVID EHR Cohort at the University of Wisconsin
Nolan M, Piasecki T, Smith S, Baker T, Fiore M, Adsit R, Bolt D, Conner K, Bernstein S, Eng O, Lazuk D, Gonzalez A, Hayes-Birchler T, Jorenby D, D'Angelo H, Kirsch J, Williams B, Kent S, Kim H, Lubanski S, Yu M, Suk Y, Cai Y, Kashyap N, Mathew J, McMahan G, Rolland B, Tindle H, Warren G, Abu-el-rub N, An L, Boyd A, Brunzell D, Carrillo V, Chen L, Davis J, Deshmukh V, Dilip D, Goldstein A, Ha P, Iturrate E, Jose T, Khanna N, King A, Klass E, Lui M, Mermelstein R, Poon C, Tong E, Wilson K, Theobald W, Slutske W. Relations of Current and Past Cancer with Severe Outcomes among 104,590 Hospitalized COVID-19 Patients: The COVID EHR Cohort at the University of Wisconsin. Cancer Epidemiology Biomarkers & Prevention 2022, 32: 12-21. PMID: 35965473, PMCID: PMC9827105, DOI: 10.1158/1055-9965.epi-22-0500.Peer-Reviewed Original ResearchConceptsSevere COVID-19 outcomesCOVID-19 outcomesCurrent cancerCOVID-19 vaccinationPast cancerICU admissionSevere outcomesCancer typesCancer diagnosisHistory of cancerElectronic health record dataCOVID-19 patientsHealth record dataUnited States health systemCOVID-19State health systemEHR cohortHospital mortalityVaccination statusYounger patientsPatient characteristicsCancer characteristicsMost cancer typesOdds ratioHigh risk
2021
Accuracy of the Veterans Health Administration COVID-19 (VACO) Index for predicting short-term mortality among 1307 US academic medical centre inpatients and 427 224 US Medicare patients
King JT, Yoon JS, Bredl ZM, Habboushe JP, Walker GA, Rentsch CT, Tate JP, Kashyap NM, Hintz RC, Chopra AP, Justice AC. Accuracy of the Veterans Health Administration COVID-19 (VACO) Index for predicting short-term mortality among 1307 US academic medical centre inpatients and 427 224 US Medicare patients. Journal Of Epidemiology & Community Health 2021, 76: 254-260. PMID: 34583962, PMCID: PMC8483922, DOI: 10.1136/jech-2021-216697.Peer-Reviewed Original ResearchConceptsVACO IndexShort-term mortalityAcademic medical centerCause mortalityMedicare inpatientMedical CenterSingle US academic medical centerCOVID-19 indexTime of diagnosisUS academic medical centersUS Medicare patientsGreater clinical attentionCOVID-19SARS-CoV-2Nationwide cohortComorbidity diagnosesMedicare cohortInpatient populationUS veteransMedicare patientsHospital dataMedicare dataOutpatient dataClinical attentionInpatientsRacial disparities in the SOFA score among patients hospitalized with COVID-19
Tolchin B, Oladele C, Galusha D, Kashyap N, Showstark M, Bonito J, Salazar MC, Herbst JL, Martino S, Kim N, Nash KA, Tiako M, Roy S, Greeno R, Jubanyik K. Racial disparities in the SOFA score among patients hospitalized with COVID-19. PLOS ONE 2021, 16: e0257608. PMID: 34535009, PMCID: PMC8448580, DOI: 10.1371/journal.pone.0257608.Peer-Reviewed Original ResearchConceptsNon-Hispanic white patientsNon-Hispanic black patientsNon-Hispanic blacksSOFA scoreHours of admissionNon-Hispanic whitesWhite patientsHispanic patientsBlack patientsCOVID-19Yale New Haven Health SystemSequential Organ Failure Assessment scoreOrgan Failure Assessment scoreElevated SOFA scoreRetrospective cohort studyCrisis standardsMedical resourcesFull multivariate modelHospital mortalityCohort studyConsecutive patientsMedian agePrimary outcomeFirst admissionInclusion criteriaThe potential impact of triage protocols on racial disparities in clinical outcomes among COVID-positive patients in a large academic healthcare system
Roy S, Showstark M, Tolchin B, Kashyap N, Bonito J, Salazar MC, Herbst JL, Nash KA, Tiako M, Jubanyik K, Kim N, Galusha D, Wang KH, Oladele C. The potential impact of triage protocols on racial disparities in clinical outcomes among COVID-positive patients in a large academic healthcare system. PLOS ONE 2021, 16: e0256763. PMID: 34529684, PMCID: PMC8445412, DOI: 10.1371/journal.pone.0256763.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBlack or African AmericanConnecticutCOVID-19Delivery of Health CareFemaleHealthcare DisparitiesHispanic or LatinoHospital MortalityHospitals, UniversityHumansMaleMiddle AgedOrgan Dysfunction ScoresPandemicsRetrospective StudiesSARS-CoV-2TriageWhite PeopleYoung AdultConceptsCOVID-positive patientsHigher SOFA scoreSOFA scoreClinical outcomesBlack patientsHospital mortalityICU admissionTriage protocolYale New Haven Health SystemSequential Organ Failure Assessment scoreHealthcare systemLarge academic healthcare systemOrgan Failure Assessment scoreRacial disparitiesSimilar clinical outcomesWorse clinical outcomesAcademic healthcare systemChi-square testRace/ethnicityPredictors of interestRetrospective cohortWhite patientsInsurance statusCOVID patientsTriage toolDesign and rationale of the colchicine/statin for the prevention of COVID-19 complications (COLSTAT) trial
Shah T, McCarthy M, Nasir I, Archer H, Ragheb E, Kluger J, Kashyap N, Paredes C, Patel P, Lu J, Kandel P, Song C, Khan M, Ul Haq F, Ahmad R, Howes C, Cambi B, Lancaster G, Cleman M, Dela Cruz CS, Parise H, Lansky A. Design and rationale of the colchicine/statin for the prevention of COVID-19 complications (COLSTAT) trial. Contemporary Clinical Trials 2021, 110: 106547. PMID: 34461322, PMCID: PMC8397504, DOI: 10.1016/j.cct.2021.106547.Peer-Reviewed Original ResearchConceptsHospitalized COVID-19 patientsCOVID-19 patientsStandard of careElectronic health recordsComplications TrialSevere COVID-19 diseaseWorld Health Organization (WHO) ordinal scaleVenous thromboembolic eventsHealth recordsCombination of colchicineRates of morbidityCOVID-19 diseaseCost-effective treatmentPrimary endpointRespiratory failureThromboembolic eventsClinical improvementMyocardial injuryPragmatic trialClinical trialsPatientsEvent ascertainmentHealth NetworkRosuvastatinTrialsREVeAL-HF Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice
Ahmad T, Yamamoto Y, Biswas A, Ghazi L, Martin M, Simonov M, Hsiao A, Kashyap N, Velazquez EJ, Desai NR, Wilson FP. REVeAL-HF Design and Rationale of a Pragmatic Randomized Controlled Trial Embedded Within Routine Clinical Practice. JACC Heart Failure 2021, 9: 409-419. PMID: 33992566, DOI: 10.1016/j.jchf.2021.03.006.Peer-Reviewed Original ResearchConceptsHeart failurePatient outcomesClinical decision makingN-terminal pro-B-type natriuretic peptide levelsPro-B-type natriuretic peptide levelsPragmatic Randomized Controlled TrialIntravenous diuretic agentsNatriuretic peptide levelsRandomized Controlled TrialsRoutine clinical practiceEvidence-based interventionsElectronic health recordsControlled TrialsPatient populationAccurate prognosticationCommon causeDiuretic agentsPeptide levelsClinical practicePg/TrialsHealth recordsSignificant riskMortalityOutcomes