University Of Texas Medical Branch Research Articles

Exploring Side Effects of Sublingual Immunotherapy: A Systemic Review and Meta-Analysis.

Objective: Sublingual immunotherapy (SLIT) has emerged as a potentially safe and convenient option for allergen immunotherapy for patients with inhalant allergy. Larger studies on the overall side effects and severe reactions anaphylaxis are still lacking. Study Design: Systematic review and meta-analysis. Setting: Author's review was completed in the University of Texas Medical Branch. Methods: A systematic review and meta-analysis of prospective clinical trials focusing on SLIT safety published from January 1, 2001, to December 31, 2021, was conducted. Results: Twenty-six studies were included with analysis of 7827 patients, representing over 2.7 million SLIT doses. All studies focused on single-antigen immunotherapy. The mean duration of treatment was 11.54 months. Local side effects were present in 40.83% of patients [95% confidence interval (CI) 24.78-57.96]. Systemic side effects were encountered in 1.09% of SLIT patients (95% CI 0.57-1.78). Anaphylaxis was reported in 0.13% of patients (95% CI 0.06-0.22). Discontinuation rates due to side effects were low, at 4.32% of patients (95% CI 3.28-5.49). Conclusion: This meta-analysis shows that single-antigen SLIT is well-tolerated, with overall low rates of systemic side effects including anaphylaxis. Although there is a high rate of minor local side effect, the treatment attrition during the first year is low. With growing allergy burden worldwide, SLIT is a convenient and economically feasible option for immunotherapy. Further work is needed to evaluate long-term safety and efficacy of single as well as multi-antigen SLIT, including quality of life assessments.

Court rules against former medical resident

Case name: Daywalker v. University of Texas Medical Branch at Galveston, et al., No. 22‐40813 (5th Cir. 01/09/24).

Disparate outcomes in Hispanic patients with metabolic dysfunction-associated steatotic liver disease/steatohepatitis and type 2 diabetes: Large cohort study.

Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are a growing health burden across a significant portion of the global patient population. However, these conditions seem to have disparate rates and outcomes between different ethnic populations. The combination of MASLD/MASH and type 2 diabetes increases the risk of hepatocellular carcinoma (HCC), and Hispanic patients experience the greatest burden, particularly those in South Texas. To compare outcomes between Hispanic and non-Hispanic patients in the United States, while further focusing on the Hispanic population within Southeast Texas to determine whether the documented disparity in outcomes is a function of geographical circumstance or if there is a more widespread reason that all clinicians must account for in prognostic consideration. This cohort analysis was conducted with data obtained from TriNetX, LLC ("TriNetX"), a global federated health research network that provides access to deidentified medical records from healthcare organizations worldwide. Two cohort networks were used: University of Texas Medical Branch (UTMB) hospital and the United States national database collective to determine whether disparities were related to geographic regions, like Southeast Texas. This study findings revealed Hispanics/Latinos have a statistically significant higher occurrence of HCC, type 2 diabetes mellitus, and liver fibrosis/cirrhosis in both the United States and the UTMB Hispanic/Latino groups. All-cause mortality in Hispanics/Latinos was lower within the United States group and not statistically elevated in the UTMB cohort. This would appear to support that Hispanic patients in Southeast Texas are not uniquely affected compared to the national Hispanic population.

Ocular screening for chronic graft-versus-host disease in patients with allogeneic hematopoietic stem cell transplant

ObjectiveThis study investigates ocular manifestations of graft-versus-host disease in patients following allogeneic hematopoietic stem cell transplantation (HSCT) at the University of Texas Medical Branch (UTMB). Preferred practice pattern guidelines are proposed for ocular graft-versus-host disease (oGHVD) detection. MethodsThe Epic electronic medical record database at UTMB was screened using International Classification of Diseases, Tenth Revision (ICD-10), codes for bone marrow transplants, stem cell transplants, and complications of bone marrow transplants and stem cell transplants. We identified 50 patients with the ICD-10 codes that were seen at UTMB between 2000 and 2021. Patients who received an HSCT and follow-up care with UTMB were included in this study. Thirty-eight patients met the inclusion criteria, whereas 12 patients were excluded because they had no diagnosis of HSCT or did not follow-up with UTMB. ResultsOf the 38 patients in our cohort, 23.7% (n = 9) were noted to have oGVHD. As many as 89% of the patients with oGVHD presented with an ocular surface disease including keratoconjunctivitis sicca, meibomian gland dysfunction, and dry eye syndrome. Systemic GVHD also was found in 44% of the patients with oGVHD. Only 29% (n = 11) of the study population had referrals to ophthalmology. Most referrals (55%) were made within 1 year of getting the HSCT. None of the patients in our cohort received an ocular screening before HSCT. ConclusionsMany post-HSCT patients lack routine ophthalmic care. Regularly assessing post-HSCT patients for early signs and symptoms of oGVHD may limit adverse outcomes. Management of oGVHD should involve a multidisciplinary team approach.

Title: Influence of the NASA SPRINT exercise protocol on myonuclear and satellite cell content of the vastus lateralis and soleus during 70 days of bedrest

Objectives: The purpose of this study was to assess the effcacy of the NASA SPRINT exercise protocol in preserving myonuclear and satellite cell number of the quadriceps (vastus lateralis) and triceps surae (soleus) muscles following 70 days of bedrest (i.e., simulated microgravity). These two muscles were the focus of this study because they both atrophy significantly with microgravity exposure in the absence of countermeasures. Hypotheses: The SPRINT exercise protocol will preserve myonuclear number (MNN), myonuclear domain (MND), and satellite cell number (SCN) during 70 days of bedrest. Methods: Subjects were randomized into three groups: bedrest only (BR; n=8, 37±3 y), bedrest with endurance and resistance exercise (BRE; n=9, 34±2 y) and bedrest with endurance and resistance exercise and low dose testosterone injections (BRE+T; n=8, 33±3 y). Muscle biopsies were taken before and at the end of bedrest from the vastus lateralis and soleus, and were sectioned, immunofluorescently stained, and analyzed for MNN (myonuclei/fiber), MND (μm2/myonuclei), and SCN (satellite cells/fiber) in slow (myosin heavy chain (MHC) I) and fast (MHC IIa) muscle fibers. SCN was only determined in MHC I fibers for the soleus. Results: MNN, MND, and SCN in MHC I and IIa fibers of the vastus lateralis and soleus were unchanged (p<0.05) from pre- to post-bedrest within BR, BRE, and BRE+T. However, there was a main effect for time (p<0.05) for a decrease in MND for vastus lateralis MHC I fibers (-8%), as well as soleus MHC I (-18%) and IIa (-18%) fibers. Also, there was a trend for a main effect for time (P=0.059) for an increase (+37%) in SCN for vastus lateralis MHC IIa fibers, which was driven primarily by the exercise groups (BR: -4%, BRE: +36%, BRE+T: +67%). Conclusions: Myonuclear number appears to be unaltered during 70 days of simulated microgravity with or without countermeasures exercise. As a result, any changes in myonuclear domain correspond with alterations in muscle mass. Satellite cell number also appears to be relatively refractory to change, but may be influenced in fast muscle fibers under the combined dynamic cellular control mechanisms of exercise and atrophy encountered during relatively long-duration simulated microgravity. Funding Source: This research was supported by the National Aeronautics and Space Administration, NNJ06HF59G; the Institute for Translational Sciences at the University of Texas Medical Branch, supported in part by a Clinical and Translational Science Award (UR1TR000071) from the National Center for Advancing Translational Sciences, National Institutes of Health; the NASA Flight Analogs Project; and the Human Bioenergetic Program at Ball State University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Fiber type specific myonuclear and satellite cell content comparisons between the vastus lateralis and soleus muscles in humans

Objectives: The purpose of this study was to compare fiber type specific myonuclear and satellite cell number of the vastus lateralis and soleus muscles in humans. Hypotheses: Myonuclear number (MNN), myonuclear domain (MND), and satellite cell number (SCN) would be similar within each fiber type between the vastus lateralis and soleus. Methods: Muscle biopsies from the vastus lateralis and soleus of 24 individuals (34±7y, 24-55y) were sectioned, immunofluorescently stained, and analyzed for MNN, MND, and SCN in slow (myosin heavy chain (MHC) I) and fast (MHC IIa) muscle fibers. SCN was determined only in MHC I fibers for the soleus. MNN and MND were compared for 24 individuals, while SCN was compared for 19 individuals. Results: MNN was similar in MHC I (3.32±0.81 vs. 3.66±0.65 myonuclei/fiber, P=0.067) and IIa (3.63±0.82 vs. 3.83±0.68 myonuclei/fiber, P>0.05) fibers of the vastus lateralis and soleus. Similarly, MND was not different in MHC I (1649±305 vs. 1673±340 μm2/myonuclei, P>0.05) and IIa (1705±313 vs. 1819±394 μm2/myonuclei, P>0.05) fibers of the vastus lateralis and soleus. However, SCN was 62% higher (p<0.05) in MHC I fibers of the soleus (0.127±0.039 satellite cells/fiber) compared with MHC I fibers of the vastus lateralis (0.083±0.024 satellite cells/fiber). Conclusions: The literature is void of comparisons of myonuclei and satellite numbers across different human muscles. These initial results suggest myonuclear number and the area “governed” by each myonuclei (i.e., the myonuclear domain) appears to be similar within the two main fiber types found in the vastus lateralis and soleus muscles. Interestingly, within the same slow fiber type (i.e., MHC I fibers) across these two muscles, it appears the soleus is programmed to have a substantially higher satellite cell content. The basis for this intrinsic difference in slow myofiber satellite profile may be related to the differences in daily myocellular activity between the vastus lateralis and soleus. This research was supported by the National Aeronautics and Space Administration, NNJ06HF59G; the Institute for Translational Sciences at the University of Texas Medical Branch, supported in part by a Clinical and Translational Science Award (UR1TR000071) from the National Center for Advancing Translational Sciences, National Institutes of Health; the NASA Flight Analogs Project; and the Human Bioenergetic Program at Ball State University. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Racial Disparities in Selected Complications and Comorbidities among People with Type 2 Diabetes.

Type 2 diabetes (T2D) is a growing public health concern, disproportionately impacting racial and ethnic minorities. Assessing disparities is the first step towards achieving the translation goal to reduce disparities in diabetes outcomes, according to the Centers for Disease Control and Prevention (CDC)'s Division of Diabetes. We analyzed the data of patients (18+ years) diagnosed with T2D between 1 January 2012 and 31 March 2017, using the electronic health records of the University of Texas Medical Branch at Galveston. We compared the crude rate and age-standardized rate (using direct method) of selected micro- and macrovascular complication rates, associated obesity, and insulin dependence among racial and ethnic groups. Our sample included 20,680 patients who made 394,106 visits (9922 non-Hispanic White patients, 4698 non-Hispanic Black patients, and 6060 Hispanic patients). Our results suggest a higher risk of acquiring macrovascular (hypertension, ischemic disease, and stroke) and microvascular (renal, ophthalmic, and neurological) complications in Black patients compared to non-Hispanic White and Hispanic patients. The rates of stage I or II obesity were higher in Black patients compared with White and Hispanic patients. The rates of insulin use rather than oral hypoglycemics were also higher in Black patients than White and Hispanic patients. The disparities in terms of the higher susceptibility to complications among Black patients are possibly linked to the socioeconomic disadvantages of this population, leading to poorer management. Prevention strategies are warranted to reduce the incidence of T2D complications in racial minorities.

The first neurosurgical service in Texas: neurosurgery at the University of Texas Medical Branch (1937-2023).

The authors present a historical analysis of the first neurosurgical service in Texas. Initially established as a subdivision within the Department of Surgery in the early 1900s, this service eventually evolved into the Department of Neurosurgery at the University of Texas Medical Branch (UTMB). The pivotal contributions of individual chiefs of neurosurgery throughout the years are highlighted, emphasizing their roles in shaping the growth of the neurosurgery division. The challenges faced by the neurosurgical division are documented, with particular attention given to the impact of hurricanes on Galveston Island, Texas, which significantly disrupted hospital operations. Additionally, a detailed account of recent clinical and research expansions is presented, along with the future directions envisioned for the Department of Neurosurgery. This work offers a comprehensive historical narrative of the neurosurgical service at UTMB, chronicling its journey of growth and innovation, and underscoring its profound contributions to Galveston's healthcare services, extending its impact beyond the local community.

150 Envisioning a Multi-Site Translational Studio to Promote Scientific Integrity and Ethical Innovation

OBJECTIVES/GOALS: The goal of this study is to develop a multi-centered Translational Studio model that can help in the development of quality translational studies using resources from four different institutional partners (University of Texas Medical Branch, Texas Southern University, University of Houston Clear Lake and Houston Methodist). METHODS/STUDY POPULATION: We conducted two rounds of four Futures Workshops for a total participation of 28 stakeholders from four different partners. Future Workshops were used to critique, envision, and articulate novel “futures” that can be achieved at least partly through design practices (Muller, 2002). In the first round of workshops, we asked participants about their institutions’ strengths, weaknesses, resources and investigator needs regarding the Studio. In the second round we asked about different studio models, pros and cons of each model and guiding principles for a studio. Alongside a pragmatic content analysis, multi-stage deductive and inductive qualitative analyses were used to understand people’s views on the future of a multi-institutional Clinical Trials Studio. RESULTS/ANTICIPATED RESULTS: The first-round workshops’ analysis described peoples’ goals for what the studio should be. The future desired studio was described as guide, matchmaker, initiator and advocate. The second-round workshops’ analysis discussed the pros and cons of a variety of possible models including, centralized, decentralized, and topic-specific (and allowed other suggestions) while also describing principles for the guidance of a studio. Here the analysis showed people wanted certain characteristics for the studio (i.e. effective, efficient, locally-responsive, consistent, etc.). They also prescribed four principles that a studio should be guided by: non-hierarchical partnership, user-centeredness, respect/collegiality, and sharing. DISCUSSION/SIGNIFICANCE: The future workshops were useful in developing a shared multi-institutional Clinical Trials Studio model that is planned to be deployed in 2025. Participants valued a studio that was both directly supportive to participants and played a role in creating or advocating for institutional resources and policy for research.

Examining Factors Impacting Encounter Length and Missed Appointments at a Student-Run Free Clinic: A Retrospective Analysis

Background: St. Vincent's Clinic (SVC) is a free, student-run clinic affiliated with the University of Texas Medical Branch that has been an invaluable resource in providing free healthcare services to marginalized populations in Galveston, Texas. The clinic offers a wide variety of specialty services along with free resources such as transportation and medication assistance, telehealth options, and interpreter services. Despite these resources, the clinic has faced challenges with consistently high no-show rates and long encounter lengths, impacting overall efficiency and patient care. We aimed to explore factors that may contribute to these challenges and uncover opportunities to improve patient satisfaction and optimize clinic efficiency.
 Methods: A retrospective chart review was conducted on all patients seen at SVC across all specialty clinics between March 2021 and March 2023. Patient demographics, appointment status, encounter length, language spoken, department specialty, and appointment modality were recorded. A series of statistical analyses were conducted on collected variables, including chi-square analysis, unpaired t-tests, and single-factor analysis of variance (ANOVA) tests, to assess significant associations.
 Results: The average encounter length varies significantly across different spoken languages and specialty clinics, but no significance was observed between different appointment modalities. The no-show rates were significantly different depending on the appointment modality, specialty clinic, and patient language spoken. Notably, while the encounter length was significantly shorter for English-speaking patients, Spanish-speaking patients had a lower no-show rate and were more likely to keep scheduled appointments.
 Conclusions: Language barriers and specialty clinic types can impact the encounter lengths and no-show rates, highlighting the need for targeted interventions such as proper resource allocation. Limitations include potential data discrepancies from factors such as human error or variations in documenting appointments. Future research should explore patient perspectives and experiences to improve patient satisfaction and overall optimize clinic operations.

Quality of Surgical Care Within the Criminal Justice Health Care System

Individuals who are incarcerated represent a vulnerable group due to concerns about their ability to provide voluntary and informed consent, and there are considerable legal protections regarding their participation in medical research. Little is known about the quality of surgical care received by this population. To evaluate perioperative surgical care provided to patients who are incarcerated within the Texas Department of Criminal Justice (TDCJ) and compare their outcomes with that of the general nonincarcerated population. This cohort study analyzed data from patients who were incarcerated within the TDCJ and underwent general or vascular surgery at the University of Texas Medical Branch (UTMB) from 2012 to 2021. Case-specific outcomes for a subset of these patients and for patients in the general academic medical center population were obtained from the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) and compared. Additional quality metrics (mortality index, length of stay index, and excess hospital days) from the Vizient Clinical Data Base were analyzed for patients in the incarcerated and nonincarcerated groups who underwent surgery at UTMB in 2020 and 2021 to provide additional recent data. Patient-specific demographics, including age, sex, and comorbidities were not available for analysis within this data set. Perioperative outcomes (30-day morbidity, mortality, and readmission rates) were compared between the incarcerated and nonincarcerated groups using the Fisher exact test. The sample included data from 6675 patients who were incarcerated and underwent general or vascular surgery at UTMB from 2012 to 2021. The ACS-NSQIP included data (2012-2021) for 2304 patients who were incarcerated and 602 patients who were not and showed that outcomes were comparable between the TDCJ population and that of the general population treated at the academic medical center with regard to 30-day readmission (6.60% vs 5.65%) and mortality (0.91% vs 1.16%). However, 30-day morbidity was significantly higher in the TDCJ population (8.25% vs 5.48%, P = .01). The 2020 and 2021 data from the Vizient Clinical Data Base included 629 patients who were incarcerated and 2614 who were not and showed that the incarcerated and nonincarcerated populations did not differ with regard to 30-day readmission (12.52% vs 11.30%) or morbidity (1.91% vs 2.60%). Although the unadjusted mortality rate was significantly lower in the TDCJ population (1.27% vs 2.68%, P = .04), mortality indexes, which account for case mix index, were similar between the 2 populations (1.17 vs 1.12). Findings of this cohort study suggest that patients who are incarcerated have equivalent rates of mortality and readmission compared with a general academic medical center population. Future studies that focus on elucidating the potential factors associated with perioperative morbidity and exploring long-term surgical outcomes in the incarcerated population are warranted.

Invited Symposium 1: Traumatic Brain Injury: Highlighting the Contributions of Dr. Harvey S. Levin Ph.D., ABPP-CN, FACSM 1946 - 2022

Invited Symposium 1: Traumatic Brain Injury: Highlighting the Contributions of Dr. Harvey S. Levin Ph.D., ABPP-CN, FACSM 1946 - 2022

Diverse Clinical Manifestations and Challenges of Mucormycosis: Insights From Serial Cases

Abstract Mucormycosis is a severe and potentially life-threatening infection caused by a group of fungi classified as mucormycetes within the scientific order Mucorales. These infections are characterized by rapid and invasive fungal growth, presenting significant treatment challenges. Here we present 5 cases encountered from 2018 to 2022 at the University of Texas Medical Branch in Galveston, Texas, including a novel Apophysomyces species. These cases illustrate the diverse clinical manifestations of mucormycosis, including pulmonary, rhino-cerebral, gastrointestinal, and soft tissue involvement. Our investigation incorporates information provided by a multidisciplinary team of clinical collaborators, emphasizing the findings from radiology, histopathology, and microbiology. Given the escalating global incidence of mucormycosis, it is crucial for clinicians to become familiar with associated clinical findings, comorbidities, and risk factors to facilitate prompt recognition, appropriate diagnostic testing, and timely initiation of treatment.

Assigning lifetime occupation domains for older Mexicans: MHAS-O*NET linkage protocol.

We developed a MHAS (Mexican Health and Aging Study) and O*NET (Occupational Information Network) linkage to allow global researchers using MHAS data to assign lifetime occupation domains for older Mexicans. Three bilingual raters independently matched 440 records with 132 unique occupation codes from the 2012 MHAS. We used a modified Delphi technique to reach agreements. To assess reliability, we compared the distribution of observations between the MHAS file and the MHAS-O*NET linked file across five job categories (upper white collar, lower white collar, upper blue collar, low blue collar, and agriculture/fishing/forestry). The Institutional Review Board at the University of Texas Medical Branch reviewed and approved the research (IRB # 21-0268). Using the developed 1:1 MHAS-ONET linkage, consistency between MHAS and ONET was 97.4% across the five job categories. This MHAS-O*NET linkage will allow researchers to analyze the association between lifetime occupation and multiple dimensions of health, functionality, and retirement determinants for a low-middle income country with a large proportion of workers in the informal sector.

The Effect of Antiopioid State Laws on Prescribing Patterns in an Oculoplastic Practice

This study aimed to find out whether three Texas state policies restricting opioid prescriptions have influenced the prescribing patterns of the oculoplastic department at the University of Texas Medical Branch (UTMB). This is a retrospective chart review of 520 patients at UTMB between 2019 and 2021, reporting the amount of morphine milliequivalents (MMEs) prescribed to patients undergoing one of eight oculoplastic procedures before and after passage of each state policy. Of 520 patients, 218 received opioids. There were no changes in MMEs/month after the first policy (95% CI: −0.1531–0.1256, p = 0.85), second policy (95% CI: −0.000997–0.00093, p = 0.97), or third policy (95% CI: −0.001431–0.00164, p = 0.096). The passage and implementation of three Texas state antiopioid policies were not associated with significant changes in opioid prescribing patterns following oculoplastic and orbital surgeries at UTMB. Average MMEs/month were driven by orbital-floor fractures, which composed most procedures overall. Limitations included the small population and that only a single provider was reviewed. Future studies would be beneficial in further evaluating the role of state legislation on opioid prescribing patterns and usage among patients.

The impact of COVID-19 infection on heart transplant function

BackgroundHeart transplant recipients are a subset of immunocompromised patients at particularly high risk of morbidity and mortality from COVID-19. Acute effects of the viral infection have been well-described in the literature but the chronic effects persisting after recovery from infection have not. The aim of this study is to determine the impact of COVID-19 on heart transplant function both during and after recovery from acute infection.MethodsWe retrospectively analyzed the data of 32 heart transplant recipients at the University of Texas Medical Branch (UTMB). Echocardiograms of patients with documented COVID-19 infection were analyzed at three time points including pre-infection, peri-infection, and post-infection. Echocardiograms of patients without history of infection were analyzed as control. Left Ventricular Ejection Fraction (LVEF) and presence or absence of valvular insufficiency were collected from echocardiograms to assess systolic and valvular function.Results2 out of 10 COVID-19 positive heart transplant recipients had decreases in LVEF below 20% during the peri-infection period, and one of these patients passed away from complications of infection. Despite this, mean LVEF was not significantly different at peri-infection (p = .3, 95% CI − 11.5 to 27.6) or post-infection (p = .6, 95% CI − 3.6 to 5.8) time points when compared to pre-infection. A statistically significant increase in valvular dysfunction was found among COVID-19 positive patients without documented history of valvular dysfunction on pre-infection echocardiograms (p = .01, 95% CI 19.3% to 96.4%). COVID-19 negative heart transplant recipients did not experience statistically significant changes in LVEF 1, 2, or 3 years after baseline echocardiogram.ConclusionCOVID-19 may induce myocardial dysfunction resulting in decreased systolic function and valvular dysfunction among heart transplant recipients. Severity of systolic dysfunction may be a useful prognostic indicator among this patient population. More research must be conducted to fully elucidate the effects of COVID-19 infection on heart transplant recipients.

DrByron J. Bailey: The Life and Legacy of an Educator, Humanitarian, and Leader.

DrByron J. Bailey, a preeminent figure in the field of Otolaryngology, exemplified an unwavering commitment to patient care, resident education, research excellence, and humanitarian endeavors throughout his illustrious career. Born in 1934, DrBailey played a pivotal role in the growth and success of the Department of Otolaryngology at the University of Texas Medical Branch. A dedicated educator and researcher, he authored groundbreaking research and the seminal textbook, Bailey's Head and Neck Surgery-Otolaryngology. His leadership in major organizations and commitment to research integrity and quality are hallmarks of his career. DrBailey's philanthropic pursuits include improving Otolaryngology care and access in Vietnam and Cuba, and local community efforts in Galveston, Texas. His enduring legacy continues to inspire future generations of Otolaryngologists, serving as a testament to the power of perseverance and dedication to excellence in the pursuit of medical education.

Editorial introductions.

Editorial introductions.

Editorial introductions.

Editorial introductions.

Characterizing neurologist EHR use: a cross-sectional analysis (P7-7.003)

<h3>Objective:</h3> We evaluated electronic health record (EHR) use metrics across two academic systems using the same EHR vendor. <h3>Background:</h3> The use of standardized EHR metrics allows direct comparisons of individual and departmental EHR use and the ability to track changes over time. We evaluated the following ambulatory EHR metrics normalized to 8 hours of scheduled patient time: total EHR time, work outside of work (WOW), time on note documentation, time on orders, time on inbox and note length in characters. <h3>Design/Methods:</h3> Ambulatory audit log data per encounter from the University of Illinois at Chicago (UIC) and the University of Texas Medical Branch (UTMB) was evaluated for August 2022. <h3>Results:</h3> Among 36 neurologists in the analysis (22 at UIC [61%], and 12 at UTMB [39%], respectively), the average EHR-Time was 2.25 (±1.29) hours. WOW time was 2.01 (±1.53) hours. Time in Notes was 0.85 (±0.72) hours. Time on Orders was 0.33 (±0.30) hours. Times on Inbox 0.23 (±0.19) hours. Note length in characters was 5,963 (±3,062). No statistical differences were noted by metric across each EHR institutions (p&lt;0.05, t-test). <h3>Conclusions:</h3> Normalized EHR metrics can be used to evaluate EHR use by neurologists across institutions. Future initiatives to improve documentation practices (reducing note bloat and comply with E/M coding changes) can be tracked across institutions with suitable metrics. <b>Disclosure:</b> Dr. Rodriguez-Fernandez has nothing to disclose. Dr. Hier has nothing to disclose. Dr. Loeb has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Sturge Weber Foundation. Dr. Loeb has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for various Law firms. The institution of Dr. Loeb has received research support from Patrick Grange Memorial Foundation. Dr. Loeb has received intellectual property interests from a discovery or technology relating to health care.