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Patients who chose to use an electronic patient portal were not more highly activated than nonusers, although they were more educated and more likely to be Internet users.

Default options in health information technology exert a powerful effect on user behavior, an effect that can be leveraged to optimize decision making.

ClinicalTrials.gov, Identifier: NCT00603070.

Nutrient-based meal recommendations have the potential to help individuals prevent or manage conditions such as diabetes and obesity. However, learning people’s food preferences and making recommendations that simultaneously appeal to their palate and satisfy nutritional expectations are challenging. Existing approaches either only learn high-level preferences or require a prolonged learning period. We propose Yum-me, a personalized nutrient-based meal recommender system designed to meet individuals’ nutritional expectations, dietary restrictions, and fine-grained food preferences. Yum-me enables a simple and accurate food preference profiling procedure via a visual quiz-based user interface and projects the learned profile into the domain of nutritionally appropriate food options to find ones that will appeal to the user. We present the design and implementation of Yum-me and further describe and evaluate two innovative contributions. The first contriution is an open source state-of-the-art food image analysis model, named FoodDist. We demonstrate FoodDist’s superior performance through careful benchmarking and discuss its applicability across a wide array of dietary applications. The second contribution is a novel online learning framework that learns food preference from itemwise and pairwise image comparisons. We evaluate the framework in a field study of 227 anonymous users and demonstrate that it outperforms other baselines by a significant margin. We further conducted an end-to-end validation of the feasibility and effectiveness of Yum-me through a 60-person user study, in which Yum-me improves the recommendation acceptance rate by 42.63%.

Background Although federal regulations mandate documentation of structured race data according to Office of Management and Budget (OMB) categories in electronic health record (EHR) systems, many institutions have reported gaps in EHR race data that hinder secondary use for population-level research focused on underserved populations. When evaluating race data available for research purposes, we found our institution's enterprise EHR contained structured race data for only 51% (1.6 million) of patients. Objectives We seek to improve the availability and quality of structured race data available to researchers by integrating values from multiple local sources. Methods To address the deficiency in race data availability, we implemented a method to supplement OMB race values from four local sources—inpatient EHR, inpatient billing, natural language processing, and coded clinical observations. We evaluated this method by measuring race data availability and data quality with respect to completeness, concordance, and plausibility. Results The supplementation method improved race data availability in the enterprise EHR up to 10% for some minority groups and 4% overall. We identified structured OMB race values for more than 142,000 patients, nearly a third of whom were from racial minority groups. Our data quality evaluation indicated that the supplemented race values improved completeness in the enterprise EHR, originated from sources in agreement with the enterprise EHR, and were unbiased to the enterprise EHR. Conclusion Implementation of this method can successfully increase OMB race data availability, potentially enhancing accrual of patients from underserved populations to research studies.

Digital medical records have enabled us to employ clinical data in many new and innovative ways. However, these advances have brought with them a complex set of demands for healthcare institutions regarding data sharing with topics such as data ownership, the loss of privacy, and the protection of the intellectual property. The lack of clear guidance from government entities often creates conflicting messages about data policy, leaving institutions to develop guidelines themselves. Through discussions with multiple stakeholders at various institutions, we have generated a set of guidelines with 10 key principles to guide the responsible and appropriate use and sharing of clinical data for the purposes of care and discovery. Industry, universities, and healthcare institutions can build upon these guidelines toward creating a responsible, ethical, and practical response to data sharing.