ChatGPT Use Among Pediatric Health Care Providers: Cross-Sectional Survey Study.

Background: The public launch of OpenAI's ChatGPT platform generated immediate interest in the use of large language models (LLMs). Health care institutions are now grappling with establishing policies and guidelines for the use of these technologies, yet little is known about how health care providers view LLMs in medical settings. Moreover, there are no studies assessing how pediatric providers are adopting these readily accessible tools.

Performance of ChatGPT and Google Translate for Pediatric Discharge Instruction Translation.

Background And Objectives: Patients who speak languages other than English face barriers to equitable healthcare delivery. Machine translation systems, including emerging large language models, have the potential to expand access to translation services, but their merits and limitations in clinical practice remain poorly defined. We aimed to assess the performance of Google Translate and ChatGPT for multilingual translation of pediatric discharge instructions.

Job search strategies and early careers of clinical informatics fellowship alumni (2016-2022).

Objective: To report on clinical informatics (CI) fellows' job search and early careers.

Materials And Methods: In the summer of 2022, we performed a voluntary and anonymous survey of 242 known clinical informatics fellowship alumni from 2016 to 2022. The survey included questions about their initial job search process; first job, salary, and informatics time after training; and early career progression over the first 1-6 years after fellowship.

An Algorithm to Assess Guideline Concordance of Antibiotic Choice in Community-Acquired Pneumonia.

Background And Objective: This study aimed to develop and evaluate an algorithm to reduce the chart review burden of improvement efforts by automatically labeling antibiotic selection as either guideline-concordant or -discordant based on electronic health record data for patients with community-acquired pneumonia (CAP).

Methods: We developed a 3-part algorithm using structured and unstructured data to assess adherence to an institutional CAP clinical practice guideline. The algorithm was applied to retrospective data for patients seen with CAP from 2017 to 2019 at a tertiary children's hospital.

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.

Creation and Evaluation of a Clinical Informatics Match: Initial Findings.

Background: Clinical Informatics (CI) fellowship programs utilize the Electronic Residency Application Service (ERAS) to gather applications but until recently used an American Medical Informatics Association (AMIA) member-developed, simultaneous offer-acceptance process to match fellowship applicants to programs. In 2021, program directors collaborated with the AMIA to develop a new match to improve the process.

Objective: Describe the results of the first 2 years of the match and address opportunities for improvement.

A Year of Inpatient Telehealth: Lessons From the COVID-19 Pandemic.

Background: Relaxation of telehealth regulation enforcement during the coronavirus disease 2019 pandemic opened the door to massive expansion. Here we describe inpatient telehealth usage across a pediatric academic hospital during the first year of the pandemic.

Methods: We created hospital bed-specific inpatient telehealth accounts and monitored their use over a 1 year period using data from our video conferencing vendor.

Survey of clinical informatics fellows graduating 2016-2024: experiences before and during fellowship.

Objective: To describe experiences and activities of Clinical Informatics (CI) fellows since the first fellowships were accredited in 2014.

Materials And Methods: We performed a voluntary and anonymous survey of 394 alumni and current clinical informatics fellows from the graduating classes of 2016-2024 in the summer of 2022.

Results: We received 198 responses; 2% declined to participate.

A Model for Work Intensity in a Pediatric Training Program.

Background: The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to monitor scheduling, work intensity, and work compression.

Objective: We aimed to create a model for assessing intern work intensity by examining patient and clinical factors in our electronic health systems using multiple linear regression.

Methods: We identified measurable factors that may contribute to resident work intensity within our electronic health systems.

Inpatient Telehealth Experience of Patients With Limited English Proficiency: Cross-sectional Survey and Semistructured Interview Study.

Background: Patients with limited English proficiency (LEP) are at a higher risk of poor health outcomes and are less likely to use telehealth than English-speaking patients. To date, there is no formal evaluation of inpatient (IP) telehealth user experience of patients and their families by language preference during visits with their clinicians.

Objective: This study aims to compare the experiences of English- and Spanish-speaking patients and their families using IP telehealth, as well as to evaluate the experience of Spanish interpreters providing services through IP telehealth.

Use of clinical data to augment healthcare worker contact tracing during the COVID-19 pandemic.

Objective: This work examined the secondary use of clinical data from the electronic health record (EHR) for screening our healthcare worker (HCW) population for potential exposures to patients with coronavirus disease 2019 (COVID-19).

Materials And Methods: We conducted a cross-sectional study at a free-standing, quaternary care pediatric hospital comparing first-degree, patient-HCW pairs identified by the hospital's COVID-19 contact tracing team (CTT) to those identified using EHR clinical event data (EHR Report). The primary outcome was the number of patient-HCW pairs detected by each process.

Pediatric Intern Clinical Exposure During the COVID-19 Pandemic.

Background And Objectives: Pediatric health care encounters declined during the coronavirus disease 2019 (COVID-19) pandemic, and pediatric residency programs have adapted trainee schedules to meet the needs of this changing clinical environment. We sought to evaluate the impact of the pandemic on pediatric interns' clinical exposure.

Methods: In this retrospective cohort study, we quantified patient exposure among pediatric interns from a single large pediatric residency program at a freestanding children's hospital.

Preserving privacy for pediatric patients and families: use of confidential note types in pediatric ambulatory care.

Objective: This study evaluates and characterizes the use of a confidential clinic note type as part of the implementation of open notes at a free-standing children's hospital. We describe how this electronic health record feature which disables patient and family access to selected notes in the patient portal is used across our institution, which clinicians are using this feature, and the type of data our clinicians consider confidential.

Materials And Methods: Through retrospective chart review, we have evaluated the use of a confidential note type over a 1-year period.

Rapid Implementation of an Inpatient Telehealth Program during the COVID-19 Pandemic.

Background:  Relaxation of laws and regulations around privacy and billing during the COVID-19 pandemic provide expanded opportunities to use telehealth to provide patient care at a distance. Many health systems have transitioned to providing outpatient care via telehealth; however, there is an opportunity to utilize telehealth for inpatients to promote physical distancing.

Objective:  This article evaluates the use of a rapidly implemented, secure inpatient telehealth program.

Digitizing U.S. Air Force Medical Standards for the Creation and Validation of a Readiness Decision Support System.

Introduction: Deployment-limiting medical conditions are the primary reason why service members are not medically ready. Service-specific standards guide clinicians in what conditions are restrictive for duty, fitness, and/or deployment requirements. The Air Force (AF) codifies most standards in the Medical Standards Directory (MSD).

Early experiences with combined fellowship training in clinical informatics.

Given the ubiquitous nature of information systems in modern health care, interest in the pursuit of formal training in clinical informatics is increasing. This interest is not restricted to generalists-informatics training is increasingly being sought by future subspecialists. The traditional structure of Accreditation Council on Graduate Medical Education subspecialty training requires completion of both clinical and clinical informatics fellowship programs, and understandably lacks appeal due to the time commitment required.

Have you got the time? Challenges using vendor electronic health record metrics of provider efficiency.

The rise of clinician burnout has been correlated with the increased adoption of electronic health records (EHRs). Some vendors have used data entry logs to measure the amount of time spent using the EHR and have developed metrics of provider efficiency. Initial attempts to utilize these data have proven difficult as it is not always apparent whether variations reflect provider behavior or simply the metric definitions.

A Quality Improvement Initiative to Decrease Platelet Ordering Errors and a Proposed Model for Evaluating Clinical Decision Support Effectiveness.

Background And Objectives: Clinical decision support (CDS) and computerized provider order entry have been shown to improve health care quality and safety, but may also generate previously unanticipated errors. We identified multiple CDS tools for platelet transfusion orders. In this study, we sought to evaluate and improve the effectiveness of those CDS tools while creating and testing a framework for future evaluation of other CDS tools.

Characteristics of the National Applicant Pool for Clinical Informatics Fellowships (2016-2017).

We conducted a national study to assess the numbers and diversity of applicants for 2016 and 2017 clinical informatics fellowship positions. In each year, we collected data on the number of applications that programs received from candidates who were ultimately successful vs. unsuccessful.

Automated Reporting of Trainee Metrics Using Electronic Clinical Systems.

Background: The Accreditation Council for Graduate Medical Education has called for increased emphasis on reporting objective performance measures to trainees and programs. However, reporting of objective measures, including clinical volume, is largely omitted from training programs.

Objective: To use automated electronic medical systems at a tertiary pediatric care hospital to create a dashboard that reports objective trainee and program metrics, including clinical volume and diagnoses in a pediatrics residency.

Electronic medication reconciliation and medication errors.

Objective: To measure the impact of electronic medication reconciliation implementation on reports of admission medication reconciliation errors (MREs).

Design: Quality improvement project with time-series design.

Setting: A large, urban, tertiary care children's hospital.