Charles Safran

Charles Safran
Harvard Medical School | HMS · Department of Medicine

BS, MS, MD

About

283
Publications
45,039
Reads
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6,870
Citations
Citations since 2017
20 Research Items
1732 Citations
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2017201820192020202120222023050100150200250300
2017201820192020202120222023050100150200250300
Additional affiliations
May 2007 - present
Beth Israel Deaconess Medical Center
Position
  • Chief
May 1990 - October 1990
University of Geneva
Position
  • Professor Invite
May 1983 - present
Harvard Medical School
Position
  • Professor

Publications

Publications (283)
Article
After 25 years of service to the American Medical Informatics Association (AMIA), Ms Karen Greenwood, the Executive Vice President and Chief Operating Officer, is leaving the organization. In this perspective, we reflect on her accomplishments and her effect on the organization and the field of informatics nationally and globally. We also express o...
Article
Objective While the judicious use of antibiotics takes past microbiological culture results into consideration, this data’s typical format in the electronic health record (EHR) may be unwieldy when incorporated into clinical decision-making. We hypothesize that a visual representation of sensitivities may aid in their comprehension. Materials and...
Chapter
In this chapter, we discuss the history of clinical informatics and the development of the Clinical Informatics subspecialty including the development of the board examination and certification. We discuss board eligibility criteria, results of initial application and examination efforts, maintenance of certification requirements, and the developme...
Article
Full-text available
Background: Health research apps often do not focus on usability as a design priority. This is problematic when the population of interest is disproportionately underrepresented as users of mobile apps, especially observed with aging older adults (> = 75). Challenges with the adoption of health information technology (HIT) among this group are exa...
Article
Full-text available
Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a key challenge in addressing quality of care in maternal health is the lack of accurate data and analytics. Implementing online communities of practice is a way to resolve this, but in low-and middle-income countries this is particularly challenging. We di...
Article
Full-text available
Globally, there is an expanding elderly population, and families are finding it increasingly challenging to coordinate care for their older family members. This paper reports on the usage patterns of InfoSAGE, an online private social network that has tools for communication and care coordination for elders and their families. This descriptive anal...
Article
Objective: The collection and use of a family health history are important for assessing the patient's risk of disease, but history taking is often impeded by practical barriers in the office. Provision for patient-computer dialogue, linked with the electronic health record, may enable patients to contribute their history while bypassing these bar...
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The design of a mobile medication manager within a broader family and elder-centric collaboration platform faces challenges of usability and wide applicability. To inform the development and use cases of eldercare apps, we present the preliminary results of a usability study of an iOS and Android app intended for both family members and aging adult...
Article
Full-text available
Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a key challenge in addressing quality of care in maternal health, is the lack of accurate data. We present a review of the difficulties of collecting and analyzing maternal health data. We propose a comprehensive informatics monitoring framework to track pr...
Article
Full-text available
With an increasingly elderly population, families are finding it increasingly challenging to coordinate care for their older family members. This paper reports on the findings of InfoSAGE, an online private social network that has tools for communication and care coordination for elders and their families. The InfoSAGE system has 257 registered use...
Article
We conducted a national study to assess the numbers and diversity of applicants for 2016 and 2017 clinical informatics fellowship positions. In each year, we collected data on the number of applications that programs received from candidates who were ultimately successful vs. unsuccessful. In 2017, we also conducted an anonymous applicant survey. S...
Article
Full-text available
Background Longevity creates increasing care needs for healthcare providers and family caregivers. Increasingly, the burden of care falls to one primary caregiver, increasing stress and reducing health outcomes. Additionally, little has been published on adults’, over the age of 75, preferences in the development of health information sharing with...
Article
To the Editor The Viewpoint by Drs Nochomovits and Sharma called for the creation of a new medical specialty: the medical virtualist.¹ Although we agree that physicians need to be trained to use technology wisely and well, we were surprised that the authors did not mention the new subspecialty of clinical informatics.² Clinical informatics provides...
Article
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Objective: Identify barriers impacting the time consuming and error fraught process of medication reconciliation. Design and implement an electronic medication management system where patient and trusted healthcare proxies can participate in establishing and maintaining an inclusive and up-to-date list of medications. Methods: A patient-facing e...
Article
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Objective Adherence to antiretroviral therapy (ART) is paramount to successful long-term suppression of human immunodeficiency virus (HIV). For poorly adherent patients with HIV, barriers to remaining adherent may be overcome by the implementation of targeted interventions delivered via mobile devices. This systematic review is focused specifically...
Article
Objective: Reuse of clinical data has broad use in clinical, research, governmental, and business settings. This summary provides an update on the benefits, barriers to use with large clinical databases, policy frameworks that have been formulated, and challenges. Methods: This report highlights some recent publications on the diverse uses of clini...
Article
Objective: Reuse of clinical data has broad use in clinical, research, governmental, and business settings. This summary provides an update on the benefits, barriers to use with large clinical databases, policy frameworks that have been formulated, and challenges. Methods: This report highlights some recent publications on the diverse uses of clini...
Article
Full-text available
Aging creates new information and communication needs for families who are helping to coordinate care for frail parents. To identify how information and communication needs evolve with the aging process, we created a living laboratory of families, supported by an online private social network with tools for care coordination. Site registrants are i...
Article
Incompletely reconciled medication lists contribute to prescribing errors and adverse drug events. Providers expend time and effort at every point of patient contact attempting to curate a best possible medication list, and yet often the list is incomplete or inaccurate. We propose a framework that builds upon the existing infrastructure of a healt...
Article
Accessing online health content of high quality and reliability presents challenges. Laypersons cannot easily differentiate trustworthy content from misinformed or manipulated content. This article describes complementary approaches for members of the general public and health professionals to find trustworthy content with as little bias as possibl...
Chapter
Available at https://www.elsevier.com/books/global-health-informatics/marin/978-0-12-804591-6 Global Health Informatics is a growing multidisciplinary field that combines research methods and applications of technology to improve healthcare systems and outcomes. Healthcare systems are facing many challenges including a growing population, the incr...
Article
Purpose: Elders in retirement communities face many challenges concerning information and communication. We know little about whether or how online technologies help meet their medical and social needs. The objective of this study was to gain insights into how these elders and their families manage health information and communication. Design and...
Article
The Health On the Net Foundation (HON) was born in 1996, during the beginning of the World Wide Web, from a collective decision by health specialists, led by the late Jean-Raoul Scherrer, who anticipated the need for online trustworthy health information. Because the Internet is a free space that everyone shares, a search for quality information is...
Article
Objective: Health care proxy (HCP) documentation is suboptimal. To improve rates of proxy selection and documentation, we sought to develop and evaluate a web-based interview to guide patients in their selection, and to capture their choices in their electronic health record (EHR). Methods: We developed and implemented a HCP interview within the...
Chapter
Full-text available
Delivering health care to a growing world population and to communities in underserved areas is a major global health challenge. Over the last few decades, many approaches have been developed under various frameworks such as telemedicine, telehealth, eHealth, and mhealth. This chapter reviews the evolution of these networks for coordination of pati...
Conference Paper
Full-text available
People-centered health care seeks an active role for the patient while empowering all other members of the health care team. By promoting greater patient responsibility and optimal usage, patient-centered health care leads to improved health outcomes , quality of life and optimal value for health care investment. This paper reviews some definitions...
Article
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Clinical informatics workforce development is a high priority for medicine. Professional board certification for physicians is an important tool to demonstrating excellence. The recent recognition of clinical informatics as a subspecialty board in the U.S. has generated interest and excitement among the U.S. informatics community. To determine the...
Article
Excitement around the adoption of electronic communication between physicians and patients is tempered by the possibility of increased clinical and legal risk. If patients do not read messages in a timely fashion, duplicative communication efforts may be required and patient safety may be jeopardized. We sought to assess the prevalence and risk pro...
Article
Elderly patients often share control of their personal health information and decision making with family and friends when needed. Patient portals can help with information sharing, but concerns about privacy and autonomy of elderly patients remain. Health systems that implement patient portals would benefit from guidance about how best to implemen...
Article
Full-text available
Patients want to be able to communicate with their physicians by e-mail. However, physicians are often concerned about the impact that such communications will have on their time, productivity, and reimbursement. Typically, physicians are not reimbursed for time spent communicating with patients electronically. But under federal meaningful-use crit...
Article
Objectives: To provide an overview of the benefits of clinical data collected as a by-product of the care process, the potential problems with large aggregations of these data, the policy frameworks that have been formulated, and the major challenges in the coming years. Methods: This report summarizes some of the major observations from AMIA an...
Chapter
Although the clinical informatics subspecialty is new, the term “clinical informatics” first appeared in the informatics literature in 1983 in an article in the Proceedings of the American Association for Medical Systems and Informatics (AAMSI) Congress by Michael A. Jenkin entitled “Clinical specialty systems as an introduction to Clinical Informa...
Article
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Large amounts of personal health data are being collected and made available through existing and emerging technological media and tools. While use of these data has significant potential to facilitate research, improve quality of care for individuals and populations, and reduce healthcare costs, many policy-related issues must be addressed before...
Article
Unlabelled: Healthcare can be enhanced by the effective use of information technology to improve the quality and safety of care and many healthcare providers are adopting advanced health information technology to improve their healthcare delivery process. Qatar is a relatively young Middle Eastern country with an ambitious and progressive national...
Chapter
In this paper the authors have extended the methodology for temporal analysis of online forums and applied the methodology to six online cancer forums (melanoma, prostate cancer, testicular cancer, ovarian cancer and breast cancer). The goal was to develop, apply and improve methods that quantify the responsiveness of the interactions in online for...
Article
Background: The widespread adoption of electronic health records (EHRs) is accelerating the collection of sensitive clinical data. The availability of these data raises privacy concerns, yet sharing the data is essential for public health, longitudinal patient care, and clinical research. Method: Following previous work in the United States [1,2...
Article
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The goal of this research is to determine if different gender-preferred social styles can be observed within the user interactions at an online cancer community. To achieve this goal, we identify and measure variables that pertain to each gender-specific social style.We perform social network and statistical analysis on the communication flow of 8,...
Article
Full-text available
The authors developed a computer-based general medical history to be taken by patients in their homes over the internet before their first visit with their primary care doctor, and asked six doctors and their participating patients to assess this history and its effect on their subsequent visit. Forty patients began the history; 32 completed the hi...
Article
Full-text available
Methicillin-resistant Staphylococcus aureus (MRSA) colonization in NICUs increases the risk of nosocomial infection. Network analysis provides tools to examine the interactions among patients and staff members that put patients at risk of colonization. Data from MRSA surveillance cultures were combined with patient room locations, nursing assignmen...
Article
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Online web-based interventions can be effective ancillary tools for managing diabetes. There is a high prevalence of diabetes in New Zealand Maori, and yet this group has generally been a low priority for web-based interventions due to perceptions of low Internet access and Internet literacy. To assess Internet access and literacy in New Zealanders...
Article
Full-text available
In this paper the authors have extended the methodology for temporal analysis of online forums and applied the methodology to six online cancer forums (melanoma, prostate cancer, testicular cancer, ovarian cancer and breast cancer). The goal was to develop, apply and improve methods that quantify the responsiveness of the interactions in online for...
Article
Public health agencies including federal, state, and local governments routinely send out public health advisories and alerts via e-mail and text messages to health care providers to increase awareness of public health events and situations. Agencies must ensure that practitioners have timely and accessible information at the critical point-of-care...
Article
Full-text available
We have developed a novel approach, the Digital Crumb Investigator, for using data collected as a byproduct of Electonic Health Record (EHR) use to help define care teams and care processes. We are developing tools and methods to utilize these routinely collected data to visualize and quantify care networks across acute care and ambulatory settings...
Article
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We have developed tools to explore social networks that share information in medical forums to better understand the unmet informational needs of patients and family members facing cancer treatments. We define metrics that demonstrate members discussing interleukin-2 receive a stronger response from the melanoma discussion group than a typical topi...
Article
Full-text available
To assess the patient-centeredness of personal health records (PHR) and offer recommendations for best practice guidelines. Semi-structured interviews were conducted in seven large early PHR adopter organizations in 2007. Organizations were purposively selected to represent a variety of US settings, including medium and large hospitals, ambulatory...
Conference Paper
In this paper, we present a model for temporal analysis of an online discussion group, also known as an online forum. We used a social network model and investigated an online melanoma forum in detail. Our overall goal is to develop methods that quantify the responsiveness of the interactions in online forums. In particular, we are interested in id...
Article
We have designed and deployed a novel approach to protecting Personal Healthcare Information in environments where a data center is remote and its physical security cannot be assured. Our "KeyServer" methodology uses a server-client-server architecture to dynamically serve keys from a distant server in a separate secure data center in the US. The a...
Conference Paper
The emergence and maturation of the electronic health records as well as the recent passage of the American Recovery and Reinvestment Act (ARRA) provides increasing opportunities to leverage decision support in electronic health record systems for public health. The Centers for Disease Control and Prevention (CDC), Johns Hopkins University Applied...
Article
The importance of training physicians and nurses in the art, skill and science of clinical informatics has never been greater. What level of training is necessary and sufficient to equip the 21st century healthcare workforce for the transformative opportunity enabled by widespread deployment of EHRs? Building on the success of its 10x10 program, AM...
Article
Don E. Detmer has served as President and Chief Executive Officer of the American Medical Informatics Association (AMIA) for the past five years, helping to set a course for the organization and demonstrating remarkable leadership as AMIA has evolved into a vibrant and influential professional association. On the occasion of Dr. Detmer's retirement...
Article
The Program Requirements for Fellowship Education identify the knowledge and skills that physicians must master through the course of a training program to be certified in the subspecialty of clinical informatics. They also specify accreditation requirements for clinical informatics training programs. The AMIA Board of Directors approved this docum...
Article
Personal health records (PHR) are a modern health technology with the ability to engage patients more fully in their healthcare. Despite widespread interest, there has been little discussion around PHR governance at an organizational level. We develop a governance model and compare it to the practices of some of the early PHR adopters, including ho...
Article
La pristinamycine est un antibiotique bactéricide dont le spectre couvre les principaux pathogènes respiratoires, y compris S. pneumoniae de sensibilité diminuée à la pénicilline. Elle n’avait pas encore été évaluée en traitement court dans les exacerbations aiguës de bronchite chronique (EABC) obstructive.
Article
Writing for publication can be a rewarding activity for researchers at all levels of experience. However, many students and researchers are less familiar with the various aspects of the publication process. The purpose of this workshop is to provide participants with the knowledge, skills, and practical advice that can lead to successful scientific...
Article
Full-text available
In the United States and Europe, electronic health records (EHRs) allow information technology and decision-support to facilitate the activities of clinicians and are considered an important component of health care improvement. However, actual adoption of EHRs by physicians has been slow and the use of decision support has been minimal. Part of th...
Article
Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activiti...
Article
Systematic analyses are included as integral parts of bioinformatic analysis. The use of phenetic and phylogenetic trees in many of the newer areas of biology create a need for bioinformaticists to understand more completely the nuances of systematic ...
Chapter
People play a critical role in achieving health for themselves, the people they care about, and the communities within which they live. Consumers of health services create and maintain healthy lifestyles, develop healthy communities, and, in collaboration with healthcare professionals, manage disease and its recovery. Similar to their professional...
Chapter
Application of information and communication technologies designed to enhance decision making and communication between providers, patients, and their families will play an important role in supporting the relationship between patient and provider and will assist patients to better understand their illness experience and how their own values affect...
Article
Full-text available
Editorial simultaneously published in several informatics journals, authored by all the journal editors-in-chief.
Article
As the Editors of leading international biomedical informatics journals, the authors report on a recent pattern of improper manuscript submissions to journals in our field. As a guide for future authors, we describe ethical and pragmatic issues related to submitting work for peer-reviewed journal publication. We propose a coordinated approach to th...
Article
As the Editors of leading international biomedical informatics journals, the authors report on a recent pattern of improper manuscript submissions to journals in our field. As a guide for future authors, we describe ethical and pragmatic issues related to submitting work for peer-reviewed journal publication. We propose a coordinated approach to th...
Article
Full-text available
To describe parental use of an Internet-based educational and emotional support system, in a regional NICU program. Baby CareLink was installed in NICUs in 4 Denver area hospitals in 2003. Parents were offered access from hospital terminals and from any other Internet access point. Data on use of the program was collected by the computer system. Di...
Article
Objective: To describe parental use of an Internet-based educational and emotional support system, in a regional NICU program. Methods: Baby CareLink was installed in NICUs in 4 Denver area hospitals in 2003. Parents were offered access from hospital terminals and from any other Internet access point. Data on use of the program was collected by...
Article
The AMIA 2003 Spring Congress entitled "Bridging the Digital Divide: Informatics and Vulnerable Populations" convened 178 experts including medical informaticians, health care professionals, government leaders, policy makers, researchers, health care industry leaders, consumer advocates, and others specializing in health care provision to underserv...
Article
Patients appear in the patient safety agenda in three important places: first and foremost as the individual most likely to experience the positive benefits of good care or negative consequences of unsafe care; second, as surveyors of quality of care indicators; and finally, through their presence as patient representatives on institutional safety...
Article
Background Pristinamycin is a bactericidal antibiotic whose spectrum covers the main respiratory pathogens including S. pneumoniae poorly sensitive to penicillin. It has not yet been evaluated in short course treatment of acute exacerbations of chronic obstructive bronchitis (AECB).Methods476 patients suffering from an AECB were randomised to eithe...
Article
Pristinamycin is a bactericidal antibiotic whose spectrum covers the main respiratory pathogens including S. pneumoniae poorly sensitive to penicillin. It has not yet been evaluated in short course treatment of acute exacerbations of chronic obstructive bronchitis (AECB). 476 patients suffering from an AECB were randomised to either a short course...
Article
Full-text available
We conducted a feasibility study of an innovative Internet-based system, designed to support collaboration between patients and providers around cancer related symptom management. Our objective was to demonstrate the system's potential to enhance communication and clinical decision making between patients and their providers. Considering the high p...