Coordinates: 33°47′30″N 84°19′11.7″W / 33.79167°N 84.319917°W / 33.79167; -84.319917Emory Healthcare is a health care system in the U.S. state of Georgia. It is part of Emory University and is the largest health care system in the state. It comprises 11 hospitals, the Emory Clinic and more than 250 provider locations. Established in 2011, the Emory Healthcare Network is the largest clinically integrated network in Georgia with more than 2,800 physicians concentrating in 70 different subspecialties.
Previous reports have suggested concurrence of cervical dystonia (CD) and chronic migraine (CM); however, the extent of the burden is unclear. This analysis estimated the prevalence of comorbid CD and CM (CD + CM) and described patient characteristics and health care costs among real-world patients with CD + CM. This retrospective cohort study used administrative claims data from the Merative MarketScan (January 1, 2017–December 31, 2021) and Optum® Market Clarity databases (January 1, 2017–September 30, 2021). Adults with CD and/or CM were identified using ICD-10-CM diagnosis codes. Outcomes were summarized descriptively and included prevalence of CD, CM, and CD + CM; relative risk of comorbid CD + CM; patient characteristics stratified by cohort and botulinum neurotoxin (BoNT) exposure status; and health care costs for CD + CM. In 2017–2021, numbers of patients identified as above annually ranged from 10.5 million to 16.3 million. The relative risk of CM among patients with CD, and of CD among patients with CM, was 31.8 and 39.5, respectively. Among patients with CD, the overall prevalence of CD + CM from 2017 to 2021 was 12.6
Objective:This study explored how administering an innovation contest was associated with work experiences among nurses, providers, and staff in primary care.Background:Innovation contests offer structured ways for employees to share ideas and engage in organizational problem-solving. Given high burnout and turnover in US primary care, such interventions may foster a more supportive work environment.Methods:All 778 employees across a health system's primary care network were invited to submit and vote on ideas to improve recruitment, retention, and workflow. Senior leaders implemented ideas selected through voting. A follow-up survey measured feeling heard, organizational identification, job satisfaction, and burnout.Results:Employees aware of the contest reported greater organizational identification. Those who observed winning ideas being implemented reported higher levels of feeling heard, identification, and job satisfaction. Simply submitting or voting was not associated with differences.Conclusions:Acting on employee-generated ideas may improve workplace engagement and satisfaction in primary care.
Importance:Artificial intelligence (AI)-enabled scribes have been proposed to reduce electronic health record (EHR) burden and improve clinician satisfaction. There is limited evidence about their associated results across multiple sites and relative benefits for different clinician groups. Objective:To assess the association of AI scribe adoption with changes in EHR time expenditure and visit volume and how associations vary by clinician characteristics. Design, Setting, and Participants:Multisite, longitudinal cohort study of AI scribe adoption conducted at 5 US academic health care institutions that introduced AI scribes to their clinicians between June 2023 and August 2025. Participants were ambulatory clinicians. Exposures:AI scribe adoption, defined as receiving access to an AI scribe. This was determined by opt-in decisions by eligible physicians at 4 of the 5 sites. Main Outcome and Measures:Total time spent on the EHR, time spent on documentation, and time spent on the EHR outside scheduled hours or on unscheduled days, all normalized to 8 scheduled patient hours; weekly visit volume. Results:The sample comprised 8581 clinicians, including 1809 AI scribe adopters. Participants were 57.1% female and were split between primary care (24.4%), medical (62.4%), and surgical (13.2%) specialties. Most (74.1%) were attending physicians, with 18.1% advanced practice clinicians and 7.8% resident physicians. In a difference-in-differences analysis, AI scribe adoption was associated with 13.4 (95% CI, 9.1-17.7) fewer minutes of EHR time, 16.0 (95% CI, 13.7-18.3) fewer minutes of documentation time, and 0.49 (95% CI, 0.17-0.81) additional weekly visits delivered. Electronic health record time outside work hours did not change significantly. Changes associated with AI scribe adoption were greatest for primary care specialists, advanced practice clinicians, female clinicians, and clinicians who used AI scribes in 50% or more of visits. Conclusions and Relevance:AI scribe adoption was associated with modest decreases in total EHR time and documentation time and with a modest increase in weekly visit volume.
Deep brain Stimulation (DBS) surgery effectively alleviates troublesome motor symptoms of Parkinson’s disease (PD) such as tremor, rigidity, bradykinesia, motor fluctuations and dyskinesia. It also improves some non-motor symptoms and quality of life. DBS should thus be considered when these symptoms interfere with quality of life despite optimal medical treatment. While DBS benefits are clear, access by eligible patients remains low. Patients and their caregivers should be educated regarding DBS surgery and referrals for surgical evaluation should occur alongside ongoing medication adjustments—particularly when those changes fail to adequately control motor symptoms—regardless of the stage of disease progression. This international panel of DBS experts developed consensus recommendations with the goals of promoting timely referrals and approvals, while reducing misconceptions and stigma associated with brain surgery. These recommendations provide a framework for referring providers, ensuring that appropriate candidates receive timely access to this beneficial treatment.
BACKGROUND:Religious and spiritual (R/S) concerns are common among patients with serious illness. Attending to the R/S concerns of patients is a core component of quality palliative care. OBJECTIVES:Our aim was to describe the prevalence and demographic, medical, and religious correlates of R/S concerns in patients receiving palliative care. DESIGN:Multisite, cross-sectional study. SETTING/SUBJECTS:Adult patients in the United States receiving inpatient or outpatient palliative care. METHODS:Chaplains completed the PC-6, an interview-based spiritual assessment, as part of routine palliative care practice. The PC-6 evaluates six domains of R/S concern: relationships, meaning, legacy, dying, religious/spiritual struggle, and treatment decision-related concerns. Demographic, clinical, and religious affiliation data were obtained from the medical record. RESULTS:A total of 172 palliative care patients were included. Fifty percent were assessed to have moderate or severe concerns in at least one of six spiritual domains, and 17% had concerns in two or more domains. The most prevalent concerns involved relationships (19.2%), dying (14.5%), meaning (14.0%), and legacy (11.0%). In multivariable analyses, patients with no religious affiliation were more than three times more likely to have moderate or severe spiritual concerns compared to those with a Protestant affiliation. Demographic characteristics and primary diagnosis were not associated with the presence of spiritual concerns. CONCLUSIONS:Moderate to severe spiritual concerns are prevalent among patients receiving palliative care, including among those without a religious affiliation. Integrating spiritual assessment into palliative care workflows may facilitate specialty spiritual care and comprehensive attention to patients' multidimensional suffering.
