Innovative informatics interventions to improve health and health care.

Abstract

In this editorial, I highlight 5 papers that address innovative informatics interventions—3 research studies and 2 reviews. The papers reflect a variety of information technologies and processes including mobile health (mHealth),1 behavioral nudges in the electronic health record (EHR),2 adaptive intervention framework,3 predictive models,4 and artificial intelligence (eg, machine learning, data mining, natural language processing).5 The interventions were designed to address important clinical and public health problems such as adherence to antiretroviral therapy for persons living with HIV (PLWH),1 opioid use disorder,3 and pain assessment and management,5 as well as aspects of healthcare quality including no-show rates for appointments4 and erroneous decisions, waste, and misuse of resources due to EHR choice architecture for clinician orders.3 Schnall et al1 completed a randomized controlled trial (RCT) to assess the efficacy of an mHealth self-management interventions for PLWH on antiretroviral adherence and viral suppression. The novel WiseApp intervention comprised testimonials of lived experiences, push-notification reminders, medication trackers, health surveys, chat rooms, and a daily “To-Do” list. In a sample of PLWH with suboptimal adherence, daily antiretroviral adherence was significantly higher in the WiseApp group as compared to attention control group from day 1 to day 59 but not for days 60–120. There were no significant differences in viral suppression. The authors suggest that there is a need for booster or a combination intervention approaches after the initial effects of the mHealth intervention wanes.