Kameron Black

All Publications

• An Electronic Health Record Alert for Inpatient Coronavirus Disease 2019 Vaccinations Increases Vaccination Ordering and Uncovers Workflow Inefficiencies. Applied clinical informatics Black, K. C., Snyder, N. A., Zhou, M., Zhu, Z., Uptegraft, C., Chintalapani, A., Orwoll, B. 2024; 15 (1): 192-198

  Abstract

   Despite mortality benefits, only 19.9% of U.S. adults are fully vaccinated against the coronavirus disease 2019 (COVID-19). The inpatient setting is an opportune environment to update vaccinations, and inpatient electronic health record (EHR) alerts have been shown to increase vaccination rates. Our objective was to evaluate whether an EHR alert could increase COVID-19 vaccinations in eligible hospitalized adults by prompting providers to order the vaccine. This was a quasiexperimental pre-post-interventional design study at an academic and community hospital in the western United States between 1 January, 2021 and 31 October, 2021. Inclusion criteria were unvaccinated hospitalized adults. A soft-stop, interruptive EHR alert prompted providers to order COVID-19 vaccines for those with an expected discharge date within 48 hours and interest in vaccination. The outcome measured was the proportion of all eligible patients for whom vaccines were ordered and administered before and after alert implementation. Vaccine ordering rates increased from 4.0 to 13.0% at the academic hospital (odds ratio [OR]: 4.01, 95% confidence interval [CI]: 3.39-4.74, p < 0.001) and from 7.4 to 11.6% at the community hospital (OR: 1.62, 95% CI: 1.23-2.13, p < 0.001) after alert implementation. Administration increased postalert from 3.6 to 12.7% at the academic hospital (OR: 3.21, 95% CI: 2.70-3.82, p < 0.001) but was unchanged at the community hospital, 6.7 to 6.7% (OR: 0.99, 95% CI: 0.73-1.37, p = 0.994). Further analysis revealed infrequent vaccine availability at the community hospital. Vaccine ordering rates improved at both sites after alert implementation. Vaccine administration rates, however, only improved at the academic hospital, likely due in part to vaccine dispensation inefficiency at the community hospital. This study demonstrates the potential impact of complex workflow patterns on new EHR alert success and provides a rationale for subsequent qualitative workflow analysis with alert implementation.

  View details for DOI 10.1055/a-2250-6305

  View details for PubMedID 38253337

  View details for PubMedCentralID PMC10917607

• Network Analysis of Academic Medical Center Websites in the United States. Scientific data He, S., Chen, D., Black, K. C., Chong, P., Marzouk, S., Yoon, B. J., Davis, K., Lee, J. 2023; 10 (1): 245

  Abstract

  Healthcare resources are published annually in repositories such as the AHA Annual Survey DatabaseTM. However, these data repositories are created via manual surveying techniques which are cumbersome in collection and not updated as frequently as website information of the respective hospital systems represented. Also, this resource is not widely available to patients in an easy-to-use format. Network analysis techniques have the potential to create topological maps which serve to aid in pathfinding for patients in their search for healthcare services. This study explores the topological structure of forty United States academic health center websites. Network analysis is utilized to analyze and visualize 48,686 webpages. Several elements of network structure are examined including basic network properties, and centrality measures distributions. The Louvain community detection algorithm is used to examine the extent to which these techniques allow identification of healthcare resources within networks. The results indicate that websites with related healthcare services tend to form observable clusters useful in mapping key resources within a hospital system.

  View details for DOI 10.1038/s41597-023-02104-3

  View details for PubMedID 37117246

  View details for PubMedCentralID PMC10147938

• An Analysis of US Academic Medical Center Websites: Usability Study. Journal of medical Internet research Gale, J. J., Black, K. C., Calvano, J. D., Fundingsland, E. L., Lai, D., Silacci, S., He, S. 2021; 23 (12): e27750

  Abstract

  Health care organizations are tasked with providing web-based health resources and information. Usability refers to the ease of user experience on a website. In this study, we conducted a usability analysis of academic medical centers in the United States, which, to the best of our knowledge, has not been previously carried out.The primary aims of the study were to the following: (1) adapt a preexisting usability scoring methodology to academic medical centers; (2) apply and test this methodology on a sample set of academic medical center websites; and (3) make recommendations from these results on potential areas of improvements for our sample of academic medical center websites.All website usability testing took place from June 1, 2020, to December 15, 2020. We replicated a methodology developed in previous literature and applied it to academic medical centers. Our sample included 73 US academic medical centers. Usability was split into four broad categories: accessibility (the ability of those with low levels of computer literacy to access and navigate the hospital's website); marketing (the ability of websites to be found through search engines and the relevance of descriptions to the links provided); content quality (grammar, frequency of information updates, material relevancy, and readability); and technology (download speed, quality of the programming code, and website infrastructure). Using these tools, we scored each website in each category. The composite of key factors in each category contributed to an overall "general usability" score for each website. An overall score was then calculated by applying a weighted percentage across all factors and was used for the final "overall usability" ranking.The category with the highest average score was technology, with a 0.82 (SD 0.068, SE 0.008). The lowest-performing category was content quality, with an average of 0.22 (SD 0.069, SE 0.008). As these numbers reflect weighted percentages as an integer, the higher the score, the greater the overall usability in that category.Our data suggest that technology, on average, was the highest-scored variable among academic medical center websites. Because website functionality is essential to a user's experience, it is justified that academic medical centers invest in optimal website performance. The overall lowest-scored variable was content quality. A potential reason for this may be that academic medical center websites are usually larger in size, making it difficult to monitor the increased quantity of content. An easy way to improve this variable is to conduct more frequent website audits to assess readability, grammar, and relevance. Marketing is another area in which these organizations have potential for improvement. Our recommendation is that organizations utilize search engine optimization techniques to improve their online visibility and discoverability.

  View details for DOI 10.2196/27750

  View details for PubMedID 34932015

  View details for PubMedCentralID PMC8734930

• Host control over infection and proliferation of a cheater symbiont. Journal of evolutionary biology Sachs, J. L., Russell, J. E., Lii, Y. E., Black, K. C., Lopez, G., Patil, A. S. 2010; 23 (9): 1919-27

  Abstract

  Host control mechanisms are thought to be critical for selecting against cheater mutants in symbiont populations. Here, we provide the first experimental test of a legume host's ability to constrain the infection and proliferation of a native-occurring rhizobial cheater. Lotus strigosus hosts were experimentally inoculated with pairs of Bradyrhizobium strains that naturally vary in symbiotic benefit, including a cheater strain that proliferates in the roots of singly infected hosts, yet provides zero growth benefits. Within co-infected hosts, the cheater exhibited lower infection rates than competing beneficial strains and grew to smaller population sizes within those nodules. In vitro assays revealed that infection-rate differences among competing strains were not caused by variation in rhizobial growth rate or interstrain toxicity. These results can explain how a rapidly growing cheater symbiont--that exhibits a massive fitness advantage in single infections--can be prevented from sweeping through a beneficial population of symbionts.

  View details for DOI 10.1111/j.1420-9101.2010.02056.x

  View details for PubMedID 20646131