{"id":"https://openalex.org/W4416397247","doi":"https://doi.org/10.1007/s44163-025-00662-6","title":"Accuracy without compromise: a programming-inspired solution for EHR workflow redesign in the generative AI Era","display_name":"Accuracy without compromise: a programming-inspired solution for EHR workflow redesign in the generative AI Era","publication_year":2025,"publication_date":"2025-11-19","ids":{"openalex":"https://openalex.org/W4416397247","doi":"https://doi.org/10.1007/s44163-025-00662-6"},"language":"en","primary_location":{"id":"doi:10.1007/s44163-025-00662-6","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s44163-025-00662-6","pdf_url":"https://link.springer.com/content/pdf/10.1007/s44163-025-00662-6.pdf","source":{"id":"https://openalex.org/S4210220416","display_name":"Discover Artificial Intelligence","issn_l":"2731-0809","issn":["2731-0809"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Discover Artificial Intelligence","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://link.springer.com/content/pdf/10.1007/s44163-025-00662-6.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5081630617","display_name":"Edward R. Melnick","orcid":"https://orcid.org/0000-0002-6509-9537"},"institutions":[{"id":"https://openalex.org/I32971472","display_name":"Yale University","ror":"https://ror.org/03v76x132","country_code":"US","type":"education","lineage":["https://openalex.org/I32971472"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Edward R. Melnick","raw_affiliation_strings":["Department of Bioinformatics and Data Science, Yale University School of Medicine, New Haven, CT, USA","Department of Biostatistics (Health Informatics), Yale School of Public Health, New Haven, CT, USA","Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Ave, Suite 260, New Haven, CT, 06519, USA"],"affiliations":[{"raw_affiliation_string":"Department of Bioinformatics and Data Science, Yale University School of Medicine, New Haven, CT, USA","institution_ids":["https://openalex.org/I32971472"]},{"raw_affiliation_string":"Department of Biostatistics (Health Informatics), Yale School of Public Health, New Haven, CT, USA","institution_ids":[]},{"raw_affiliation_string":"Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Ave, Suite 260, New Haven, CT, 06519, USA","institution_ids":["https://openalex.org/I32971472"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5033407888","display_name":"Florian Moser","orcid":null},"institutions":[{"id":"https://openalex.org/I202697423","display_name":"University of Zurich","ror":"https://ror.org/02crff812","country_code":"CH","type":"education","lineage":["https://openalex.org/I202697423"]},{"id":"https://openalex.org/I202963720","display_name":"University of St.Gallen","ror":"https://ror.org/0561a3s31","country_code":"CH","type":"education","lineage":["https://openalex.org/I202963720"]},{"id":"https://openalex.org/I32971472","display_name":"Yale University","ror":"https://ror.org/03v76x132","country_code":"US","type":"education","lineage":["https://openalex.org/I32971472"]}],"countries":["CH","US"],"is_corresponding":false,"raw_author_name":"Felix P. Moser","raw_affiliation_strings":["Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Ave, Suite 260, New Haven, CT, 06519, USA","Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland","School of Medicine, University of St. Gallen, St. Gallen, Switzerland"],"affiliations":[{"raw_affiliation_string":"Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Ave, Suite 260, New Haven, CT, 06519, USA","institution_ids":["https://openalex.org/I32971472"]},{"raw_affiliation_string":"Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland","institution_ids":["https://openalex.org/I202697423"]},{"raw_affiliation_string":"School of Medicine, University of St. Gallen, St. Gallen, Switzerland","institution_ids":["https://openalex.org/I202963720"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5007346239","display_name":"Andrew J. Loza","orcid":"https://orcid.org/0000-0002-1754-5133"},"institutions":[{"id":"https://openalex.org/I32971472","display_name":"Yale University","ror":"https://ror.org/03v76x132","country_code":"US","type":"education","lineage":["https://openalex.org/I32971472"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Andrew J. Loza","raw_affiliation_strings":["Department of Bioinformatics and Data Science, Yale University School of Medicine, New Haven, CT, USA","Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Ave, Suite 260, New Haven, CT, 06519, USA","Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA"],"affiliations":[{"raw_affiliation_string":"Department of Bioinformatics and Data Science, Yale University School of Medicine, New Haven, CT, USA","institution_ids":["https://openalex.org/I32971472"]},{"raw_affiliation_string":"Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Ave, Suite 260, New Haven, CT, 06519, USA","institution_ids":["https://openalex.org/I32971472"]},{"raw_affiliation_string":"Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA","institution_ids":["https://openalex.org/I32971472"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5081630617"],"corresponding_institution_ids":["https://openalex.org/I32971472"],"apc_list":{"value":990,"currency":"EUR","value_usd":1067},"apc_paid":{"value":990,"currency":"EUR","value_usd":1067},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.29872106,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"5","issue":"1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.5447999835014343,"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"}},"topics":[{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.5447999835014343,"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"}},{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.27459999918937683,"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/T13248","display_name":"Healthcare Technology and Patient Monitoring","score":0.037700001150369644,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"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/workflow","display_name":"Workflow","score":0.7267000079154968},{"id":"https://openalex.org/keywords/documentation","display_name":"Documentation","score":0.6502000093460083},{"id":"https://openalex.org/keywords/toolbox","display_name":"Toolbox","score":0.46799999475479126},{"id":"https://openalex.org/keywords/robustness","display_name":"Robustness (evolution)","score":0.3856000006198883},{"id":"https://openalex.org/keywords/redundancy","display_name":"Redundancy (engineering)","score":0.37959998846054077},{"id":"https://openalex.org/keywords/generative-grammar","display_name":"Generative grammar","score":0.36970001459121704},{"id":"https://openalex.org/keywords/software","display_name":"Software","score":0.35109999775886536}],"concepts":[{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.7853000164031982},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.7267000079154968},{"id":"https://openalex.org/C56666940","wikidata":"https://www.wikidata.org/wiki/Q788790","display_name":"Documentation","level":2,"score":0.6502000093460083},{"id":"https://openalex.org/C115903868","wikidata":"https://www.wikidata.org/wiki/Q80993","display_name":"Software engineering","level":1,"score":0.5126000046730042},{"id":"https://openalex.org/C2777655017","wikidata":"https://www.wikidata.org/wiki/Q1501161","display_name":"Toolbox","level":2,"score":0.46799999475479126},{"id":"https://openalex.org/C63479239","wikidata":"https://www.wikidata.org/wiki/Q7353546","display_name":"Robustness (evolution)","level":3,"score":0.3856000006198883},{"id":"https://openalex.org/C152124472","wikidata":"https://www.wikidata.org/wiki/Q1204361","display_name":"Redundancy (engineering)","level":2,"score":0.37959998846054077},{"id":"https://openalex.org/C39890363","wikidata":"https://www.wikidata.org/wiki/Q36108","display_name":"Generative grammar","level":2,"score":0.36970001459121704},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.36469998955726624},{"id":"https://openalex.org/C2777904410","wikidata":"https://www.wikidata.org/wiki/Q7397","display_name":"Software","level":2,"score":0.35109999775886536},{"id":"https://openalex.org/C100521375","wikidata":"https://www.wikidata.org/wiki/Q2015382","display_name":"Competence (human resources)","level":2,"score":0.2937999963760376},{"id":"https://openalex.org/C2777062904","wikidata":"https://www.wikidata.org/wiki/Q545406","display_name":"Toolchain","level":3,"score":0.29190000891685486},{"id":"https://openalex.org/C192209626","wikidata":"https://www.wikidata.org/wiki/Q190909","display_name":"Focus (optics)","level":2,"score":0.2856999933719635},{"id":"https://openalex.org/C107457646","wikidata":"https://www.wikidata.org/wiki/Q207434","display_name":"Human\u2013computer interaction","level":1,"score":0.2838999927043915},{"id":"https://openalex.org/C2780385302","wikidata":"https://www.wikidata.org/wiki/Q367158","display_name":"Protocol (science)","level":3,"score":0.2797999978065491},{"id":"https://openalex.org/C180198813","wikidata":"https://www.wikidata.org/wiki/Q121182","display_name":"Information system","level":2,"score":0.27900001406669617},{"id":"https://openalex.org/C33762810","wikidata":"https://www.wikidata.org/wiki/Q461671","display_name":"Data integrity","level":2,"score":0.2703000009059906},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.26969999074935913},{"id":"https://openalex.org/C169590947","wikidata":"https://www.wikidata.org/wiki/Q47506","display_name":"Compiler","level":2,"score":0.259799987077713},{"id":"https://openalex.org/C2778755073","wikidata":"https://www.wikidata.org/wiki/Q10858537","display_name":"Scale (ratio)","level":2,"score":0.25110000371932983}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1007/s44163-025-00662-6","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s44163-025-00662-6","pdf_url":"https://link.springer.com/content/pdf/10.1007/s44163-025-00662-6.pdf","source":{"id":"https://openalex.org/S4210220416","display_name":"Discover Artificial Intelligence","issn_l":"2731-0809","issn":["2731-0809"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Discover Artificial Intelligence","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:8b4e8cf8a2dc4319b05cdb35f41ec895","is_oa":true,"landing_page_url":"https://doaj.org/article/8b4e8cf8a2dc4319b05cdb35f41ec895","pdf_url":null,"source":{"id":"https://openalex.org/S112646816","display_name":"SHILAP Revista de lepidopterolog\u00eda","issn_l":"0300-5267","issn":["0300-5267","2340-4078"],"is_oa":true,"is_in_doaj":true,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Discover Artificial Intelligence, Vol 5, Iss 1, Pp 1-6 (2025)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1007/s44163-025-00662-6","is_oa":true,"landing_page_url":"https://doi.org/10.1007/s44163-025-00662-6","pdf_url":"https://link.springer.com/content/pdf/10.1007/s44163-025-00662-6.pdf","source":{"id":"https://openalex.org/S4210220416","display_name":"Discover Artificial Intelligence","issn_l":"2731-0809","issn":["2731-0809"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310319965","host_organization_name":"Springer Nature","host_organization_lineage":["https://openalex.org/P4310319965"],"host_organization_lineage_names":["Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Discover Artificial Intelligence","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4416397247.pdf"},"referenced_works_count":11,"referenced_works":["https://openalex.org/W2276530525","https://openalex.org/W2829536104","https://openalex.org/W2985309991","https://openalex.org/W2999645127","https://openalex.org/W3005890082","https://openalex.org/W3111676352","https://openalex.org/W3112632867","https://openalex.org/W4220962859","https://openalex.org/W4303021190","https://openalex.org/W4407758839","https://openalex.org/W4413784171"],"related_works":[],"abstract_inverted_index":{"Ambient":[0],"AI":[1,122],"listening":[2],"technology":[3],"has":[4],"emerged":[5],"as":[6,182],"a":[7,67,90,115,152],"major":[8],"advance":[9],"in":[10,42,49,105,230],"clinical":[11,128,233],"documentation,":[12],"reducing":[13],"EHR":[14,95],"burden":[15],"and":[16,32,44,60,75,81,123,142,190,201,203,220,224,232],"allowing":[17],"clinicians":[18],"to":[19,94,118,195],"focus":[20],"more":[21],"fully":[22],"on":[23,184],"their":[24],"patients.":[25],"By":[26,156],"pairing":[27],"passive":[28],"listening,":[29],"speech-to-text":[30],"transcription,":[31],"large":[33],"language":[34],"models,":[35],"ambient":[36],"systems":[37,168],"can":[38],"generate":[39],"notes":[40],"nearly":[41],"real-time":[43],"capture":[45],"details":[46],"often":[47],"lost":[48],"traditional":[50],"documentation.":[51],"While":[52],"these":[53,86],"tools":[54,125],"substantially":[55],"reduce":[56,199],"after-hours":[57],"\u201cpajama":[58],"time\u201d":[59],"support":[61],"clinician":[62],"well-being,":[63],"they":[64],"are":[65],"not":[66],"complete":[68],"fix.":[69],"Documentation":[70],"errors,":[71],"propagation":[72],"of":[73],"inaccuracies,":[74],"persistent":[76],"challenges":[77],"with":[78,178],"information":[79,140,197],"review":[80],"retrieval":[82],"remain.":[83],"To":[84],"address":[85],"gaps,":[87],"we":[88],"propose":[89],"comprehensive,":[91],"programming-inspired":[92],"approach":[93,215],"workflow":[96],"redesign":[97],"modeled":[98],"after":[99],"the":[100],"Language":[101],"Server":[102],"Protocol":[103],"used":[104],"modern":[106],"software":[107],"development.":[108],"The":[109],"proposed":[110],"standards-based":[111],"platform":[112],"would":[113,132],"provide":[114],"shared":[116],"infrastructure":[117],"integrate":[119],"multiple":[120],"generative":[121],"decision-support":[124],"directly":[126],"into":[127,151],"workflows.":[129],"Core":[130],"features":[131],"include":[133],"context-aware":[134],"autocompletion,":[135],"inline":[136],"error":[137],"detection,":[138],"hover":[139],"boxes,":[141],"structured":[143],"chart":[144],"review,":[145],"transforming":[146],"documentation":[147],"from":[148,160],"static":[149],"recordkeeping":[150],"dynamic,":[153],"interactive":[154],"process.":[155],"separating":[157],"user":[158],"interfaces":[159],"back-end":[161],"services,":[162],"innovations":[163],"could":[164],"scale":[165],"rapidly":[166],"across":[167],"without":[169],"each":[170],"tool":[171],"reinventing":[172],"common":[173],"functionality.":[174],"This":[175],"architecture":[176],"aligns":[177],"broader":[179],"efforts":[180],"such":[181],"SMART":[183],"FHIR":[185],"by":[186],"emphasizing":[187],"modularity,":[188],"interoperability,":[189],"open":[191],"standards.":[192],"It":[193],"promises":[194],"streamline":[196],"management,":[198],"redundancy":[200],"error,":[202],"consolidate":[204],"critical":[205],"data":[206],"for":[207],"timely":[208],"decision-making.":[209],"Future":[210],"work":[211],"will":[212],"extend":[213],"this":[214],"beyond":[216],"early":[217],"use":[218],"cases":[219],"evaluate":[221],"its":[222],"technical":[223],"methodological":[225],"robustness":[226],"through":[227],"empirical":[228],"studies":[229],"simulated":[231],"settings.":[234]},"counts_by_year":[],"updated_date":"2026-03-17T17:19:04.345684","created_date":"2025-11-19T00:00:00"}