Joshua Ross
· Chief Medical Officer, American Family Children’s Hospital & UW Health KidsUniversity of Wisconsin-Madison · Emergency Medicine
Active 2012–2023
About
Dr. Joshua Ross is a Professor (CHS) of Emergency Medicine and Pediatrics at the University of Wisconsin–Madison. He serves as the Chief Medical Officer for the American Family Children's Hospital and UW Health Kids. Dr. Ross led the opening of the BerbeeWalsh Emergency Department expansion in November 2016, which included not only physical growth but also the implementation of innovative workflows to enhance patient flow and care. His academic interests include using interprofessional simulation and electronic health record (EHR) innovation to promote patient safety. He has led multiple grant-funded projects, including a $2.5 million AHRQ-funded study focused on developing simulations to optimize health information technology for pediatric trauma patient safety and communication, as well as a PCORI-funded project aimed at disseminating child abuse clinical decision support to improve detection, evaluation, and reporting. Prior to his current role, Dr. Ross completed his pediatric emergency medicine fellowship, chief residency, and residency at the Children’s Memorial Hospital affiliated with Northwestern University. He previously served as the Medical Director of Pediatric Emergency Medicine, leading two significant expansions of the Pediatric Emergency Department. Recognized for excellence in clinical care and teaching, he has received multiple departmental awards and was named a “Top Doctor” by Madison Magazine. A graduate of the UW Medical Foundation's Physician Leadership Development Program, Dr. Ross is dedicated to ensuring high-quality care at UW Health Kids and fostering a culture of excellence and professional satisfaction among healthcare teams.
Research topics
- Medicine
- Medical emergency
- Computer Science
- Psychology
- Nursing
- Political Science
- Artificial Intelligence
- Data Mining
- Family medicine
- Telecommunications
- Engineering
- Psychiatry
- Intensive care medicine
- Emergency medicine
- Pathology
- Internal medicine
Selected publications
JAMIA Open · 2023 · 10 citations
- Political Science
- Computer Science
- Psychology
Objectives: The use of electronic health record (EHR)-embedded child abuse clinical decision support (CA-CDS) may help decrease morbidity from child maltreatment. We previously reported on the development of CA-CDS in Epic and Allscripts. The objective of this study was to implement CA-CDS into Epic and Allscripts and determine its effects on identification, evaluation, and reporting of suspected child maltreatment. Materials and Methods: After a preimplementation period, CA-CDS was implemented at University of Wisconsin (Epic) and Northwell Health (Allscripts). Providers were surveyed before the go-live and 4 months later. Outcomes included the proportion of children who triggered the CA-CDS system, had a positive Child Abuse Screen (CAS) and/or were reported to Child Protective Services (CPS). Results: At University of Wisconsin (UW), 3.5% of children in the implementation period triggered the system. The CAS was positive in 1.8% of children. The proportion of children reported to CPS increased from 0.6% to 0.9%. There was rapid uptake of the abuse order set.At Northwell Health (NW), 1.9% of children in the implementation period triggered the system. The CAS was positive in 1% of children. The child abuse order set was rarely used. Preimplementation, providers at both sites were similar in desire to have CA-CDS system and perception of CDS in general. After implementation, UW providers had a positive perception of the CA-CDS system, while NW providers had a negative perception. Discussion: CA-CDS was able to be implemented in 2 different EHRs with differing effects on clinical care and provider feedback. At UW, the site with higher uptake of the CA-CDS system, the proportion of children who triggered the system and the rate of positive CAS was similar to previous studies and there was an increase in the proportion of cases of suspected abuse identified as measured by reports to CPS. Our data demonstrate how local environment, end-users' opinions, and limitations in the EHR platform can impact the success of implementation. Conclusions: When disseminating CA-CDS into different hospital systems and different EHRs, it is critical to recognize how limitations in the functionality of the EHR can impact the success of implementation. The importance of collecting, interpreting, and responding to provider feedback is of critical importance particularly with CDS related to child maltreatment.
Care transition of trauma patients: Processes with articulation work before and after handoff
Applied Ergonomics · 2021 · 15 citations
- Nursing
- Medicine
- Medical emergency
Western Journal of Emergency Medicine · 2020 · 8 citations
- Medicine
- Medical emergency
- Emergency medicine
INTRODUCTION: SARS-CoV-2, a novel coronavirus, manifests as a respiratory syndrome (COVID-19) and is the cause of an ongoing pandemic. The response to COVID-19 in the United States has been hampered by an overall lack of diagnostic testing capacity. To address uncertainty about ongoing levels of SARS-CoV-2 community transmission early in the pandemic, we aimed to develop a surveillance tool using readily available emergency department (ED) operations data extracted from the electronic health record (EHR). This involved optimizing the identification of acute respiratory infection (ARI)-related encounters and then comparing metrics for these encounters before and after the confirmation of SARS-CoV-2 community transmission. METHODS: We performed an observational study using operational EHR data from two Midwest EDs with a combined annual census of over 80,000. Data were collected three weeks before and after the first confirmed case of local SARS-CoV-2 community transmission. To optimize capture of ARI cases, we compared various metrics including chief complaint, discharge diagnoses, and ARI-related orders. Operational metrics for ARI cases, including volume, pathogen identification, and illness severity, were compared between the preand post-community transmission timeframes using chi-square tests of independence. RESULTS: Compared to our combined definition of ARI, chief complaint, discharge diagnoses, and isolation orders individually identified less than half of the cases. Respiratory pathogen testing was the top performing individual ARI definition but still only identified 72.2% of cases. From the pre to post periods, we observed significant increases in ED volumes due to ARI and ARI cases without identified pathogen. CONCLUSION: Certain methods for identifying ARI cases in the ED may be inadequate and multiple criteria should be used to optimize capture. In the absence of widely available SARS-CoV-2 testing, operational metrics for ARI-related encounters, especially the proportion of cases involving negative pathogen testing, are useful indicators for active surveillance of potential COVID-19 related ED visits.
International Journal of Medical Informatics · 2020 · 18 citations
- Computer Science
- Artificial Intelligence
- Medical emergency
BACKGROUND: Child maltreatment is a leading cause of pediatric morbidity and mortality. We previously reported on development and implementation of a child abuse clinical decision support system (CA-CDSS) in the Cerner electronic health record (EHR). Our objective was to develop a CA-CDSS in two different EHRs. METHODS: Using the CA-CDSS in Cerner as a template, CA-CDSSs were developed for use in four hospitals in the Northwell Health system who use Allscripts and two hospitals in the University of Wisconsin health system who use Epic. Each system had a combination of triggers, alerts and child abuse-specific order sets. Usability evaluation was done prior to launch of the CA-CDSS. RESULTS: Over an 18-month period, a CA-CDSS was embedded into Epic and Allscripts at two hospital systems. The CA-CDSSs vary significantly from each other in terms of the type of triggers which were able to be used, the type of alert, the ability of the alert to link directly to child abuse-specific order sets and the order sets themselves. CONCLUSIONS: Dissemination of CA-CDSS from one EHR into the EHR in other health care systems is possible but time-consuming and needs to be adapted to the strengths and limitations of the specific EHR. Site-specific usability evaluation, buy-in of multiple stakeholder groups and significant information technology support are needed. These barriers limit scalability and widespread dissemination of CA-CDSS.
Work system barriers and facilitators in inpatient care transitions of pediatric trauma patients
Applied Ergonomics · 2020 · 48 citations
- Nursing
- Medical emergency
- Medicine
Frequent coauthors
- 29 shared
Peter Hoonakker
University of Wisconsin Health
- 29 shared
Pascale Carayon
University of Wisconsin–Madison
- 27 shared
Michelle M. Kelly
University of Wisconsin–Madison
- 27 shared
Deborah A. Rusy
University of Wisconsin American Family Children's Hospital
- 19 shared
Bat‐Zion Hose
MedStar Health
- 18 shared
Ayşe P. Gürses
- 18 shared
Jonathan E. Kohler
University of California, Davis
- 17 shared
Tom Brazelton
University of Wisconsin–Madison
Awards & honors
- Physician Excellence Award in Clinical Leadership, UW Health…
- Section of Emergency Medicine Innovation and Education Award…
- Top Doctors, Madison Magazine (2016)
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