Allison Beck McCoy

Allison Beck McCoy
Vanderbilt University | Vander Bilt · Department of Biomedical Informatics

PhD, Biomedical Informatics

About

75
Publications
17,021
Reads
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1,468
Citations
Introduction
My current research aims to develop and implement novel, generalizable approaches to evaluating and improving electronic health records and clinical decision support using existing data sources to promote safer and more affordable healthcare.
Additional affiliations
August 2018 - present
Vanderbilt University
Position
  • Professor (Assistant)
July 2013 - June 2018
Tulane University
Position
  • Professor (Assistant)
July 2013 - January 2017
Tulane University
Position
  • Professor (Assistant)
Education
May 2008 - December 2010
Vanderbilt University
Field of study
  • Biomedical Informatics
July 2006 - May 2008
Vanderbilt University
Field of study
  • Biomedical Informatics
August 2002 - May 2006
Baylor University
Field of study
  • Computer Science

Publications

Publications (75)
Article
Full-text available
Clinical decision support (CDS) is essential for delivery of high-quality, cost-effective, and safe healthcare. The authors sought to evaluate the CDS capabilities across electronic health record (EHR) systems. We evaluated the CDS implementation capabilities of 8 Office of the National Coordinator for Health Information Technology Authorized Certi...
Article
Full-text available
Alerting systems, a type of clinical decision support, are increasingly prevalent in healthcare, yet few studies have concurrently measured the appropriateness of alerts with provider responses to alerts. Recent reports of suboptimal alert system design and implementation highlight the need for better evaluation to inform future designs. The author...
Article
Full-text available
We describe a novel, crowdsourcing method for generating a knowledge base of problem-medication pairs that takes advantage of manually asserted links between medications and problems. Through iterative review, we developed metrics to estimate the appropriateness of manually entered problem-medication links for inclusion in a knowledge base that can...
Article
Full-text available
Background: Many healthcare providers are adopting clinical decision support (CDS) systems to improve patient safety and meet meaningful use requirements. Computerized alerts that prompt clinicians about drug-allergy, drug-drug, and drug-disease warnings or provide dosing guidance are most commonly implemented. Alert overrides, which occur when cl...
Article
Full-text available
Objective: To quantify the percentage of records with matching identifiers as an indicator for duplicate or potentially duplicate patient records in electronic health records in five different healthcare organisations, describe the patient safety issues that may arise, and present solutions for managing duplicate records or records with matching i...
Article
Objectives Complex interventions with multiple components and behavior change strategies are increasingly implemented as a form of clinical decision support (CDS) using native electronic health record functionality. Objectives of this study were, therefore, to (1) identify the proportion of randomized controlled trials with CDS interventions that w...
Article
Importance: Understanding the differences and potential synergies between traditional clinician assessment and automated machine learning might enable more accurate and useful suicide risk detection. Objective: To evaluate the respective and combined abilities of a real-time machine learning model and the Columbia Suicide Severity Rating Scale (...
Article
Background: Patients taking high doses of opioids, or taking opioids in combination with other central nervous system depressants, are at increased risk of opioid overdose. Coprescribing the opioid-reversal agent naloxone is an essential safety measure, recommended by the surgeon general, but the rate of naloxone coprescribing is low. Therefore, w...
Article
Full-text available
Objective To quantify initial tidal volume (VT) during neonatal volume-targeted ventilation (VTV) and to characterize the agreement of initial VT with the limited-evidence available. Study design We performed a multi-center retrospective observational cohort study in two Neonatal Intensive Care Units evaluating 313 infants who received VTV as the...
Article
Objective: We describe the Clickbusters initiative implemented at Vanderbilt University Medical Center (VUMC), which was designed to improve safety and quality and reduce burnout through the optimization of clinical decision support (CDS) alerts. Materials and methods: We developed a 10-step Clickbusting process and implemented a program that in...
Article
Developing a diverse informatics workforce broadens the research agenda and ensures the growth of innovative solutions that enable equity-centered care. The American Medical Informatics Association (AMIA) established the AMIA First Look Program in 2017 to address workforce disparities among women, including those from marginalized communities. The...
Article
Purpose: The purpose of this study was to evaluate the current state of problem list maintenance at an academic medical center. Summary: We included problem list data for patients who had at least 2 face-to-face encounters at Vanderbilt University Medical Center or its clinics between January 1, 2018, and December 31, 2019. We used the frequency...
Article
Full-text available
Objective Accurate and robust quality measurement is critical to the future of value-based care. Having incomplete information when calculating quality measures can cause inaccuracies in reported patient outcomes. This research examines how quality calculations vary when using data from an individual electronic health record (EHR) and longitudinal...
Article
Pneumonia is the most frequent cause of infectious disease-related deaths in children worldwide. Clinical decision support (CDS) applications can guide appropriate treatment, but the system must first recognize the appropriate diagnosis. To enable CDS for pediatric pneumonia, we developed an algorithm integrating natural language processing (NLP) a...
Article
Objective Clinical decision support (CDS) can contribute to quality and safety. Prior work has shown that errors in CDS systems are common and can lead to unintended consequences. Many CDS systems use Boolean logic, which can be difficult for CDS analysts to specify accurately. We set out to determine the prevalence of certain types of Boolean logi...
Article
Objective: To quantify and contextualize the risk for coronavirus disease 2019 (COVID-19)-related hospitalization and illness severity in type 1 diabetes. Research design and methods: We conducted a prospective cohort study to identify case subjects with COVID-19 across a regional health care network of 137 service locations. Using an electronic...
Article
Purpose: Kidney stone recurrence rates vary between patients. A patient's risk informs the frequency and intensity of preventative interventions. Clinicians routinely use clinical experience to estimate risk. We sought to compare clinician estimated recurrence risk with the recurrence of kidney stones (ROKS) nomogram. Materials and Methods: We sur...
Presentation
Effect of a Clinical Decision Support Alert Encouraging Prescribing of Naloxone for Patients at High Risk of Opioid Overdose
Article
In the past 2 decades, the United States has seen widespread adoption of electronic health records (EHRs) and a transition from mostly locally developed EHRs to commercial systems. However, most research on quality improvement and safety interventions in EHRs is still conducted at a single site, in a single EHR. Although single-site studies are imp...
Poster
Full-text available
Purpose: The problem list was introduced to the patient chart in the 1960s to improve the efficiency of patient review. Since then, the use of the problem list has expanded and regulatory agencies have required problem list maintenance in the health record; however, questions have been raised related to its accuracy and completeness. The literature...
Poster
Full-text available
What might the attendee be able to do after being in your session? Attendees will learn how to plan and implement decision support for intravenous (IV) to oral (PO) conversion of inpatient medications at their institutions. Topics include medication selection analysis, clinical decision support (CDS) implementation, and cost savings analysis. Descr...
Article
Objective Within the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC), a learning health network developed to improve outcomes for patients with hypoplastic left heart syndrome and variants, we assessed which centers contributed to reductions in mortality and growth failure. Study design Centers within the NPC-QIC were div...
Article
Full-text available
To overcome limitations of previously developed scientific productivity ranking services, we created the Biomedical Informatics Researchers ranking website (rank.informatics-review.com). The website is composed of four key components that work together to create the automatically updating ranking website: 1) list of biomedical informatics researche...
Poster
Full-text available
The problem list was introduced to the patient chart in the 1960s to improve the efficiency of patient review. Since then, the use of the problem list has expanded to clinical decision support (CDS), problem-oriented charting, reporting, research, and even billing. Subsequently, regulatory agencies have required problem list maintenance in the heal...
Article
There is a critical need need for multi-institutional, large-scale, international applied clinical informatics research, given the global, widespread use of commercially-available electronic health records with different designs, capabilities, configurations, and implementation strategies. The Clinical Informatics Research Collaborative (CIRCLE) ai...
Article
Objective: The study sought to determine availability and use of structured override reasons for drug-drug interaction (DDI) alerts in electronic health records. Materials and methods: We collected data on DDI alerts and override reasons from 10 clinical sites across the United States using a variety of electronic health records. We used a multi...
Article
Full-text available
Objective We identified the methods used and determined the roles of electronic health records (EHRs) in detecting and assessing adverse drug events (ADEs) in the ambulatory setting. Methods We performed a systematic literature review by searching PubMed and Google Scholar for studies on ADEs detected in the ambulatory setting involving any EHR use...
Article
Full-text available
Objective: Developing effective and reliable rule-based clinical decision support (CDS) alerts and reminders is challenging. Using a previously developed taxonomy for alert malfunctions, we identified best practices for developing, testing, implementing, and maintaining alerts and avoiding malfunctions. Materials and methods: We identified 72 in...
Article
Full-text available
Background Value-based payment for care requires the consistent, objective calculation of care quality. Previous initiatives to calculate ambulatory quality measures have relied on billing data or individual electronic health records (EHRs) to calculate and report performance. New methods for quality measure calculation promoted by federal regulati...
Article
Full-text available
Objective: We assessed changes in the percentage of providers with positive perceptions of electronic health record (EHR) benefit before and after transition from a local basic to a commercial comprehensive EHR. Methods: Changes in the percentage of providers with positive perceptions of EHR benefit were captured via a survey of academic health...
Article
Full-text available
Objective The United States Office of the National Coordinator for Health Information Technology sponsored the development of a “high-priority” list of drug-drug interactions (DDIs) to be used for clinical decision support. We assessed current adoption of this list and current alerting practice for these DDIs with regard to alert implementation (pr...
Conference Paper
Full-text available
Purpose of Study: Electronic health records (EHR) have the potential to improve health care delivery and enhance patient safety. We sought to identify factors associated with clinician perception of improved patient safety following the transition from a basic, locally-developed EHR to a comprehensive, commercially-available EHR. Methods Used: We...
Article
Full-text available
We developed the Biomedical Informatics Researchers ranking website (rank.informatics-review.com) to overcome many of the limitations of previous scientific productivity ranking strategies. The website is composed of four key components that work together to create an automatically updating ranking website: (1) list of biomedical informatics resear...
Article
Full-text available
Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging. We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs i...
Article
Full-text available
Background: Therapy for certain medical conditions occurs in a stepwise fashion, where one medication is recommended as initial therapy and other medications follow. Sequential pattern mining is a data mining technique used to identify patterns of ordered events. Objective: To determine whether sequential pattern mining is effective for identify...
Article
To measure performance by eligible health care providers on CMS's meaningful use measures. Medicare Electronic Health Record Incentive Program Eligible Professionals Public Use File (PUF), which contains data on meaningful use attestations by 237,267 eligible providers through May 31, 2013. Cross-sectional analysis of the 15 core and 10 menu measur...
Article
Background: Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on pr...
Article
Full-text available
Clinical databases may contain several records for a single patient. Multiple general entity-resolution algorithms have been developed to identify such duplicate records. To achieve optimal accuracy, algorithm parameters must be tuned to a particular dataset. The purpose of this study was to determine the required training set size for probabilisti...
Article
Full-text available
The field of clinical informatics has expanded substantially in the six decades since its inception. Early research focused on simple demonstrations that health information technology (HIT) such as electronic health records (EHRs), computerized provider order entry (CPOE), and clinical decision support (CDS) systems were feasible and potentially be...
Article
Full-text available
Automated summarization tools that create condition-specific displays may improve clinician efficiency. These tools require new kinds of knowledge that is difficult to obtain. We compared five problem-medication pair knowledge bases generated using four previously described knowledge base development approaches. The number of pairs in the resulting...
Article
Full-text available
The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge ba...
Article
Full-text available
Introduction Clinical databases require accurate entity resolution (ER). One approach is to use algorithms that assign questionable cases to manual review. Few studies have compared the performance of common algorithms for such a task. Furthermore, previous work has been limited by a lack of objective methods for setting algorithm parameters. We co...
Article
Full-text available
In a prior study, we developed methods for automatically identifying associations between medications and problems using association rule mining on a large clinical data warehouse and validated these methods at a single site which used a self-developed electronic health record. To demonstrate the generalizability of these methods by validating them...
Article
Full-text available
Background: Electronic health record (EHR) users must regularly review large amounts of data in order to make informed clinical decisions, and such review is time-consuming and often overwhelming. Technologies like automated summarization tools, EHR search engines and natural language processing have been shown to help clinicians manage this infor...
Article
Full-text available
Background and objectives: The impact of AKI on adverse drug events and therapeutic failures and the medication errors leading to these events have not been well described. Design, setting, participants, & measurements: A single-center observational study of 396 hospitalized patients with a minimum 0.5 mg/dl change in serum creatinine who were p...
Article
Full-text available
Clinical decision support (CDS) has been shown to improve clinical processes, promote patient safety, and reduce costs in healthcare settings, and it is now a requirement for clinicians as part of the Meaningful Use Regulation. However, most evidence for CDS has been evaluated primarily in internal medicine care settings, and colon and rectal surge...
Article
Full-text available
The HITECH Act created incentives to encourage adoption of electronic health records. As of May 2012, only 12.2% of 62,226 eligible professionals had attested to meaningful use, including 9.8% of specialists and 17.8% of primary care providers.
Article
Full-text available
Bar coded medication administration (BCMA), the automated electronic verification of medications by nurses at the patient bedside, provides an additional layer of safety to the process of medication administration in the hospital setting. We performed a retrospective, descriptive study of BCMA alerts for elevated potassium (>5.5 mg/dL) in place wit...
Conference Paper
Full-text available
Increased amounts of data contained in electronic health records (EHRs) has led to inefficiencies for clinicians trying to locate relevant patient information. Automated summarization tools that create condition-specific data displays rather than current displays by data type have the potential to greatly improve clinician efficiency. These tools r...
Article
Full-text available
Objective To try to lower patient re-identification risks for biomedical research databases containing laboratory test results while also minimizing changes in clinical data interpretation. Materials and methods In our threat model, an attacker obtains 5–7 laboratory results from one patient and uses them as a search key to discover the correspondi...
Article
Full-text available
Objectives: Clinical decision support (CDS), such as computerized alerts, improves prescribing in the setting of acute kidney injury (AKI), but considerable opportunity remains to improve patient safety. The authors sought to determine whether pharmacy surveillance of AKI patients could detect and prevent medication errors that are not corrected by...
Article
Full-text available
OBJECTIVE: Clinical summarization, the process by which relevant patient information is electronically summarized and presented at the point of care, is of increasing importance given the increasing volume of clinical data in electronic health record systems (EHRs). There is a paucity of research on electronic clinical summarization, including the...