Mixed-methods study to involve individuals with CF in guiding the development of engaging, effective, user-friendly adherence promotion apps that meet their preferences and self-management needs.From Hillard et al., 2014.

Abstract:

Background: Little is known about how physician time is allocated in ambulatory care.
Objective: To describe how physician time is spent in ambulatory practice.
Design: Quantitative direct observational time and motion study (during office hours) and self-reported diary (after hours).
Setting: U.S. ambulatory care in 4 specialties in 4 states (Illinois, New Hampshire, Virginia, and Washington).
Participants: 57 U.S. physicians in family medicine, internal medicine, cardiology, and orthopedics who were observed for
430 hours, 21 of whom also completed after-hours diaries.
Measurements: Proportions of time spent on 4 activities (direct clinical face time, electronic health record [EHR] and desk work, administrative tasks, and other tasks) and self-reported afterhours work.
Results: During the office day, physicians spent 27.0% of their total time on direct clinical face time with patients and 49.2% of their time on EHR and desk work. While in the examination room with patients, physicians spent 52.9% of the time on direct clinical face time and 37.0% on EHR and desk work. The 21 physicians who completed after-hours diaries reported 1 to 2 hours of after-hours work each night, devoted mostly to EHR tasks.
Limitations: Data were gathered in self-selected, highperforming practices and may not be generalizable to other settings.
The descriptive study design did not support formal statistical comparisons by physician and practice characteristics.
Conclusion: For every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another 1 to 2 hours of personal time each night doing additional computer and other clerical work.

Sinsky et al., 2016

Article reviewing the results of a 2016 AMA survey on the toll that prior authorization takes on patients, physicians and medical practices.

ABSTRACT
Synchronizing medication refills-renewing all medications at the same time from the same pharmacy-is an
increasingly popular strategy to improve adherence to medication regimens, but there has been little research
regarding its effectiveness. In light of increasing policy interest, we evaluated the impact of a pilot refill
synchronization program implemented by a large national insurer. A random sample of Medicare Advantage
patients receiving mail-order refills for common maintenance medications (antihypertensive, lipid-lowering, or
antidiabetic agents) were invited to join the program and followed for twelve months. On average, the absolute
increase in the proportion of patients deemed adherent during follow-up was 3-10 percentage points for the
intervention group, compared to 1-5 percentage points for the control group. Patients with poorer baseline
adherence showed larger increases in the absolute proportion deemed adherent in intervention (23-26 percentage
points) compared to a control group (13-15 percentage points). Synchronizing refills might be a promising
intervention to improve adherence to maintenance medications, especially among Medicare patients with low adherence to maintenance medications, especially among Medicare patients with low baseline adherence.

Doshi et al., 2016

Literature review of articles related to medication adherence, diabetes, and cardiovascular disease from Brown et al. (2016.) The authors examine critical predictors of adherence and multifactoral solutions to improve medication adherence.

As a result of a collaboration between the NAM and the Office of the National Coordinator for Health Information Technology, this NAM Special Publication summarizes and builds upon a meeting series in which a multistakeholder group of experts explored the potential of clinical decision support (CDS) to transform care delivery by ameliorating the burden that expanding clinical knowledge and care and choice complexity place on the finite time and attention of clinicians, patients, and members of the care team. This summary also includes highlights from discussions to address the barriers to realizing the full benefits of CDS-facilitated value improvement.  
 

 This document identifies the need for a continuously learning health system driven by the seamless and rapid generation, processing, and practical application of the best available evidence for clinical decision-making, and lays out a series of actionable collaborative next steps to optimize strategies for adoption and use of clinical decision support.

Opioid addiction has been declared a public health emergency in the United States. It is vital that organizations and providers provide high quality clinical documentation, to guarantee the data which drives research and education on this topic is based on the correct information. There are seven characteristics of high quality clinical documentation. If a provider learns how to document using these characteristics to guide their documentation habits, they will provide trustworthy documentation.

This tip sheet has been developed by the American Health Information Management Association to guide providers in learning the documentation elements that are needed when documenting opioid use, abuse, or dependency. In the tip sheet, each of the seven characteristics of high quality clinical documentation are listed in the first column. Under the example column are scenarios of when each of these characteristics is missing within the clinical documentation. The final column provides an example of poor documentation that is frequently seen in opioid documentation. Then there is an explanation of the missing clarity followed by what a high quality documentation statement would look like.

The National Academies of Sciences, Engineering, and Medicine convened a workshop to assist the Federal Bureau of Investigation Weapons of Mass Destruction Directorate in understanding the applications and potential security implications of emerging technologies at the interface of the life sciences and information sciences. At the workshop, participants from wide ranging backgrounds discussed the rapid pace of growth in the bioeconomy, with a particular focus on the bioinformatics economy, and the imperative to safeguard it in the interest of national security.

The National Academies of Sciences, Engineering, and Medicine conducted a workshop to assist the Federal Bureau of Investigation Weapons of Mass Destruction Directorate in understanding the applications and implications of emerging technologies at the interface of the life sciences, chemical sciences, and other areas of science and engineering. Workshop participants identified and discussed areas of convergence in the life sciences research enterprise, how these emerging areas may be incorporated into the global bioeconomy, and the security implications of their development.

Prepared statement of Edward H. You Supervisory Special Agent, Biological Countermeasures Unit, Countermeasures and Operations Section, Weapons of Mass Destruction Directorate, FBI.

Testimony for the U.S.-China Economic and Security Review Commission1
March 16, 2017

This statement describes the development of the bioeconomy within the United States and China, identifies the opportunities and security challenges facing the United States, and how the United States might better expand the scope of what is determined to be a biological threat and support biotechnology research and industry development for national security.