Special Issue on Informatics Education: Vanderbilt Clinical Informatics Center Education Strategy: To Infinity and Beyond!

Background: The Vanderbilt Clinical Informatics Center (VCLIC) is based in the Department of Biomedical Informatics (DBMI) and operates across Vanderbilt University Medical Center (VUMC) and Vanderbilt University (VU) with a goal of enabling and supporting clinical informatics research and practice. VCLIC supports several types of applied clinical informatics teaching, including teaching of students in courses, professional education for staff and faculty throughout VUMC, and workshops and conferences that are open to the public.

Objectives: In this paper, we provide a detailed accounting of our center and institution's methods of educating and training faculty, staff, students, and trainees from across the academic institution and health system on clinical informatics topics, including formal training programs and informal applied learning sessions.

Using large language model to guide patients to create efficient and comprehensive clinical care message.

Objective: This study aims to investigate the feasibility of using Large Language Models (LLMs) to engage with patients at the time they are drafting a question to their healthcare providers, and generate pertinent follow-up questions that the patient can answer before sending their message, with the goal of ensuring that their healthcare provider receives all the information they need to safely and accurately answer the patient's question, eliminating back-and-forth messaging, and the associated delays and frustrations.

Methods: We collected a dataset of patient messages sent between January 1, 2022 to March 7, 2023 at Vanderbilt University Medical Center. Two internal medicine physicians identified 7 common scenarios.

Structure and Funding of Clinical Informatics Fellowships: A National Survey of Program Directors.

Background: In 2011, the American Board of Medical Specialties established clinical informatics (CI) as a subspecialty in medicine, jointly administered by the American Board of Pathology and the American Board of Preventive Medicine. Subsequently, many institutions created CI fellowship training programs to meet the growing need for informaticists. Although many programs share similar features, there is considerable variation in program funding and administrative structures.

A Systematic Approach to the Design and Implementation of Clinical Informatics Fellowship Programs.

Clinical Informatics (CI), a medical subspecialty since 2011, has grown from the initial four fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) in 2014 to more than 50 and counting in the present day. In parallel, the literature guiding Clinical Informatics Fellowship training and the curriculum evolved from the original core content published in 2009 to the more recent CI Subspecialty Delineation of Practice and the updated ACGME Milestones 2.0 for CI.

A Unified Approach to Clinical Informatics Education for Undergraduate and Graduate Medical Education.

Vanderbilt University Medical Center has adopted a unified approach to undergraduate and graduate clinical informatics education. Twenty-three learners have completed the course which is designed around four key activities: 1) didactic sessions 2) informatics history and physical where learners observe clinical areas, document workflows, identify a problem to solve and propose an informatics-informed solution 3) informatics clinic where learners are side-by-side with practicing clinical informaticians and 4) interactive learning activities where student groups work through case-based informatics problems with an informatics preceptor. These experiences are coupled with opportunities for asynchronous projects, reflections, and weekly assessments.

Development and Validation of Inpatient Hypoglycemia Models Centered Around the Insulin Ordering Process.

Background: The insulin ordering process is an opportunity to provide clinicians with hypoglycemia risk predictions, but few hypoglycemia models centered around the insulin ordering process exist.

Methods: We used data on adult patients, admitted in 2019 to non-ICU floors of a large teaching hospital, who had orders for subcutaneous insulin. Our outcome was hypoglycemia, defined as a blood glucose (BG) <70 mg/dL within 24 hours after ordering insulin.

Clinician collaboration to improve clinical decision support: the Clickbusters initiative.

Objective: We describe the Clickbusters initiative implemented at Vanderbilt University Medical Center (VUMC), which was designed to improve safety and quality and reduce burnout through the optimization of clinical decision support (CDS) alerts.

Materials And Methods: We developed a 10-step Clickbusting process and implemented a program that included a curriculum, CDS alert inventory, oversight process, and gamification. We carried out two 3-month rounds of the Clickbusters program at VUMC.

International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study.

Background: Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country.

A Randomized Controlled Trial on the Safety and Efficacy of Exenatide Therapy for the Inpatient Management of General Medicine and Surgery Patients With Type 2 Diabetes.

Objective: This multicenter, open-label, randomized trial examined the safety and efficacy of exenatide alone or in combination with basal insulin in non-critically ill patients with type 2 diabetes (T2D).

Research Design And Methods: A total of 150 patients with blood glucose (BG) between 140 and 400 mg/dL, treated at home with diet, oral agents, or insulin at a total daily dose <0.5 units/kg, were randomized to exenatide alone (5 μg twice daily), exenatide plus basal insulin, or a basal-bolus insulin regimen.

X Marks the Spot: Mapping Similarity Between Clinical Trial Cohorts and US Counties.

When patients and doctors collaborate to make healthcare decisions, they rely on clinical trial results to guide discussions. Trials are designed to recruit diverse participants. The question remains - how well do trial results apply to me or to people who live in our area? This study compared one complete clinical trial dataset (SPRINT) and one published study (ACCORD) to the Community Health Status Indicators dataset to assess the similarity of the trial populations to US county populations.