{"id":"https://openalex.org/W7214064686","doi":"https://doi.org/10.1093/jamiaopen/ooag180","title":"Development to implementation to evaluation: step-by-step approach to embedding a clinical trial of a machine learning algorithm in the electronic health record","display_name":"Development to implementation to evaluation: step-by-step approach to embedding a clinical trial of a machine learning algorithm in the electronic health record","publication_year":2026,"publication_date":"2026-08-22","ids":{"openalex":"https://openalex.org/W7214064686","doi":"https://doi.org/10.1093/jamiaopen/ooag180","pmid":"https://pubmed.ncbi.nlm.nih.gov/42774289","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13593618"},"language":"en","primary_location":{"id":"doi:10.1093/jamiaopen/ooag180","doi":"https://doi.org/10.1093/jamiaopen/ooag180","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamiaopen/ooag180","pdf_url":null,"source":{"id":"https://openalex.org/S4210237468","display_name":"JAMIA Open","issn_l":"2574-2531","issn":["2574-2531"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310311647","host_organization_name":"University of Oxford","host_organization_lineage":["https://openalex.org/P4310311647"],"host_organization_lineage_names":["University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMIA Open","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1093/jamiaopen/ooag180","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5152496088","display_name":"Erin Morrison","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I132943300","display_name":"Emory Healthcare","ror":"https://ror.org/00yksxf10","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I132943300","https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Erin Morrison","raw_affiliation_strings":["Emory Healthcare , Atlanta, GA,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory Healthcare , Atlanta, GA,","institution_ids":["https://openalex.org/I132943300"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5152501068","display_name":"Jaes Overley","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I132943300","display_name":"Emory Healthcare","ror":"https://ror.org/00yksxf10","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I132943300","https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jaes Overley","raw_affiliation_strings":["Emory Healthcare , Atlanta, GA,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory Healthcare , Atlanta, GA,","institution_ids":["https://openalex.org/I132943300"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5152497724","display_name":"Kaitlin Wurm","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I132943300","display_name":"Emory Healthcare","ror":"https://ror.org/00yksxf10","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I132943300","https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Kaitlin Wurm","raw_affiliation_strings":["Emory Healthcare , Atlanta, GA,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory Healthcare , Atlanta, GA,","institution_ids":["https://openalex.org/I132943300"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5152500289","display_name":"Don Mock","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I132943300","display_name":"Emory Healthcare","ror":"https://ror.org/00yksxf10","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I132943300","https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Don Mock","raw_affiliation_strings":["Emory Healthcare , Atlanta, GA,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory Healthcare , Atlanta, GA,","institution_ids":["https://openalex.org/I132943300"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5075412880","display_name":"Sivasubramanium V. Bhavani","orcid":"https://orcid.org/0000-0002-9640-6720","observed_orcids":["https://orcid.org/0000-0002-9640-6720"]},"institutions":[{"id":"https://openalex.org/I132943300","display_name":"Emory Healthcare","ror":"https://ror.org/00yksxf10","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I132943300","https://openalex.org/I150468666"]},{"id":"https://openalex.org/I150468666","display_name":"Emory University","ror":"https://ror.org/03czfpz43","country_code":"US","type":"education","lineage":["https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Sivasubramanium V Bhavani","raw_affiliation_strings":["Department of Medicine, Emory University School of Medicine , Atlanta, GA 30307,","Emory Critical Care Center , Atlanta, GA,"],"raw_orcid":"https://orcid.org/0000-0002-9640-6720","affiliations":[{"raw_affiliation_string":"Department of Medicine, Emory University School of Medicine , Atlanta, GA 30307,","institution_ids":["https://openalex.org/I150468666"]},{"raw_affiliation_string":"Emory Critical Care Center , Atlanta, GA,","institution_ids":["https://openalex.org/I132943300"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5075412880"],"corresponding_institution_ids":["https://openalex.org/I132943300","https://openalex.org/I150468666"],"apc_list":{"value":3762,"currency":"USD","value_usd":3762},"apc_paid":{"value":3762,"currency":"USD","value_usd":3762},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.70942332,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"9","issue":"5","first_page":"ooag180","last_page":"ooag180"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.7720000147819519,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.7720000147819519,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.16380000114440918,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.03739999979734421,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/precise-trial","display_name":"PRECISE trial","score":0.8389999866485596},{"id":"https://openalex.org/keywords/machine-learning-algorithms","display_name":"machine learning algorithms","score":0.6430000066757202},{"id":"https://openalex.org/keywords/electronic-health-record-integration","display_name":"electronic health record integration","score":0.8209999799728394},{"id":"https://openalex.org/keywords/sepsis","display_name":"sepsis","score":0.9350000023841858},{"id":"https://openalex.org/keywords/crystalloids","display_name":"crystalloids","score":0.9470000267028809},{"id":"https://openalex.org/keywords/subphenotyping","display_name":"subphenotyping","score":0.8149999976158142},{"id":"https://openalex.org/keywords/learning-health-systems","display_name":"learning health systems","score":0.9150000214576721},{"id":"https://openalex.org/keywords/emergency-department","display_name":"emergency department","score":0.48100000619888306},{"id":"https://openalex.org/keywords/intensive-care-unit","display_name":"intensive care unit","score":0.9269999861717224}],"concepts":[{"id":"https://openalex.org/C3020144179","wikidata":"https://www.wikidata.org/wiki/Q10871684","display_name":"Electronic health record","level":3,"score":0.6553000211715698},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.6348999738693237},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.5982999801635742},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.5561000108718872},{"id":"https://openalex.org/C3019952477","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Health records","level":3,"score":0.5519999861717224},{"id":"https://openalex.org/C26517878","wikidata":"https://www.wikidata.org/wiki/Q228039","display_name":"Key (lock)","level":2,"score":0.5353999733924866},{"id":"https://openalex.org/C98045186","wikidata":"https://www.wikidata.org/wiki/Q205663","display_name":"Process (computing)","level":2,"score":0.4819999933242798},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.46129998564720154},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.4512999951839447},{"id":"https://openalex.org/C41608201","wikidata":"https://www.wikidata.org/wiki/Q980509","display_name":"Embedding","level":2,"score":0.40119999647140503},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3806999921798706},{"id":"https://openalex.org/C11413529","wikidata":"https://www.wikidata.org/wiki/Q8366","display_name":"Algorithm","level":1,"score":0.3765999972820282},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.37619999051094055},{"id":"https://openalex.org/C109359841","wikidata":"https://www.wikidata.org/wiki/Q728944","display_name":"Inclusion (mineral)","level":2,"score":0.3271999955177307},{"id":"https://openalex.org/C195910791","wikidata":"https://www.wikidata.org/wiki/Q1324077","display_name":"Medical record","level":2,"score":0.30630001425743103},{"id":"https://openalex.org/C3018060332","wikidata":"https://www.wikidata.org/wiki/Q10871684","display_name":"Electronic medical record","level":2,"score":0.3059000074863434},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.29510000348091125},{"id":"https://openalex.org/C182306322","wikidata":"https://www.wikidata.org/wiki/Q1779371","display_name":"Order (exchange)","level":2,"score":0.29269999265670776},{"id":"https://openalex.org/C148220186","wikidata":"https://www.wikidata.org/wiki/Q7111912","display_name":"Outcome (game theory)","level":2,"score":0.2831000089645386},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2827000021934509},{"id":"https://openalex.org/C2778384902","wikidata":"https://www.wikidata.org/wiki/Q183134","display_name":"Sepsis","level":2,"score":0.2818000018596649},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.27619999647140503},{"id":"https://openalex.org/C115901376","wikidata":"https://www.wikidata.org/wiki/Q184199","display_name":"Automation","level":2,"score":0.26930001378059387},{"id":"https://openalex.org/C63527458","wikidata":"https://www.wikidata.org/wiki/Q5133829","display_name":"Clinical decision support system","level":3,"score":0.2671999931335449},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.25690001249313354},{"id":"https://openalex.org/C2776542497","wikidata":"https://www.wikidata.org/wiki/Q5266672","display_name":"Development (topology)","level":2,"score":0.25459998846054077},{"id":"https://openalex.org/C124101348","wikidata":"https://www.wikidata.org/wiki/Q172491","display_name":"Data mining","level":1,"score":0.2540000081062317}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.1093/jamiaopen/ooag180","doi":"https://doi.org/10.1093/jamiaopen/ooag180","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamiaopen/ooag180","pdf_url":null,"source":{"id":"https://openalex.org/S4210237468","display_name":"JAMIA Open","issn_l":"2574-2531","issn":["2574-2531"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310311647","host_organization_name":"University of Oxford","host_organization_lineage":["https://openalex.org/P4310311647"],"host_organization_lineage_names":["University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMIA Open","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13593618","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13593618/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13593618/pdf/ooag180.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMIA Open","raw_type":"Text"},{"id":"pmid:42774289","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42774289","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMIA open","raw_type":"Case Reports"}],"best_oa_location":{"id":"doi:10.1093/jamiaopen/ooag180","doi":"https://doi.org/10.1093/jamiaopen/ooag180","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamiaopen/ooag180","pdf_url":null,"source":{"id":"https://openalex.org/S4210237468","display_name":"JAMIA Open","issn_l":"2574-2531","issn":["2574-2531"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-d","doyens","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3"],"host_organization":"https://openalex.org/P4310311647","host_organization_name":"University of Oxford","host_organization_lineage":["https://openalex.org/P4310311647"],"host_organization_lineage_names":["University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"JAMIA Open","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9476000070571899,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[{"id":"https://openalex.org/G9000369964","display_name":null,"funder_award_id":"K23 GM144867","funder_id":"https://openalex.org/F4320308849","funder_display_name":"Kaiser Permanente"},{"id":"https://openalex.org/G9000371481","display_name":null,"funder_award_id":"R01 HL175626","funder_id":"https://openalex.org/F4320308849","funder_display_name":"Kaiser Permanente"},{"id":"https://openalex.org/G9000902300","display_name":"Development and Validation of Correction Equations to Enhance Quality of Infrared Technology","funder_award_id":"R01HL175626","funder_id":"https://openalex.org/F4320337338","funder_display_name":"National Heart, Lung, and Blood Institute"},{"id":"https://openalex.org/G9000920117","display_name":"Identification of Precision Sepsis Subphenotypes Using Vital Sign Trajectories","funder_award_id":"K23GM144867","funder_id":"https://openalex.org/F4320337354","funder_display_name":"National Institute of General Medical Sciences"}],"funders":[{"id":"https://openalex.org/F4320308849","display_name":"Kaiser Permanente","ror":"https://ror.org/00t60zh31"},{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"},{"id":"https://openalex.org/F4320337338","display_name":"National Heart, Lung, and Blood Institute","ror":"https://ror.org/012pb6c26"},{"id":"https://openalex.org/F4320337354","display_name":"National Institute of General Medical Sciences","ror":"https://ror.org/04q48ey07"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":17,"referenced_works":["https://openalex.org/W2900326279","https://openalex.org/W2973871066","https://openalex.org/W4205439471","https://openalex.org/W4206521462","https://openalex.org/W4241014756","https://openalex.org/W4285586211","https://openalex.org/W4297174839","https://openalex.org/W4365138356","https://openalex.org/W4386983321","https://openalex.org/W4387638731","https://openalex.org/W4394571531","https://openalex.org/W4395067202","https://openalex.org/W4401246313","https://openalex.org/W4402599603","https://openalex.org/W4405917040","https://openalex.org/W4408578327","https://openalex.org/W4410339562"],"related_works":["https://openalex.org/W4410269334","https://openalex.org/W3037599769","https://openalex.org/W4221071301","https://openalex.org/W4399305161","https://openalex.org/W2771699609","https://openalex.org/W4322739540","https://openalex.org/W3082542523","https://openalex.org/W4406503228","https://openalex.org/W4389577264","https://openalex.org/W2900163257"],"abstract_inverted_index":{"Objective:":[0],"To":[1],"describe":[2],"the":[3,7,31,47,104,115,119,145],"implementation":[4],"process":[5],"for":[6,153],"Precision":[8],"Resuscitation":[9],"with":[10,89],"Crystalloids":[11],"in":[12,79,129],"Sepsis":[13],"(PRECISE)":[14],"trial,":[15],"a":[16,24,108,126,147,151],"pragmatic,":[17],"multihospital":[18],"randomized":[19],"controlled":[20],"trial":[21,71],"(RCT)":[22],"of":[23,110,121,137],"machine":[25],"learning":[26,155],"(ML)":[27],"algorithm":[28,102],"integrated":[29],"into":[30,46],"electronic":[32],"health":[33,156],"record":[34],"(EHR).":[35],"Materials":[36],"and":[37,63,86,96,113],"Methods:":[38],"Implementing":[39],"PRECISE":[40,70,98,132],"involved":[41],"building":[42],"4":[43],"key":[44],"components":[45],"EHR":[48],"using":[49],"standard":[50],"tools":[51],"within":[52,103,144],"Epic:":[53],"(1)":[54],"automated":[55],"inclusion":[56],"criteria,":[57],"(2)":[58],"real-time":[59],"subphenotyping.":[60],"(3)":[61],"randomization,":[62],"(4)":[64],"medication":[65],"alternative":[66],"alert.":[67],"Results:":[68],"The":[69],"was":[72],"deployed":[73],"across":[74],"6":[75,83],"Emory":[76],"Healthcare":[77],"hospitals":[78],"June":[80],"2024,":[81],"spanning":[82],"emergency":[84],"departments":[85],"17":[87],"ICUs":[88],"more":[90],"than":[91],"300":[92],"ICU":[93],"beds.":[94],"Discussion":[95],"Conclusion:":[97],"operationalizes":[99],"an":[100],"ML":[101,138],"Epic":[105],"to":[106,117,124],"identify":[107],"subgroup":[109],"sepsis":[111],"patients":[112],"prompts":[114],"clinician":[116],"order":[118],"type":[120],"fluids":[122],"thought":[123],"confer":[125],"mortality":[127],"benefit":[128],"this":[130],"subgroup.":[131],"demonstrates":[133],"that":[134,149],"precision":[135],"RCTs":[136],"algorithms":[139],"can":[140],"be":[141],"executed":[142],"entirely":[143],"EHR,":[146],"framework":[148],"represents":[150],"model":[152],"future":[154],"systems.":[157]},"counts_by_year":[],"updated_date":"2026-10-30T12:39:25.321706","created_date":"2026-09-23T00:00:00"}
