Projects and Publications

CI Fellow-Led Projects

 

One of the most frequently asked questions about Clinical Informatics Fellowship--not just at UCSF but at all institutions--is, "What do fellows actually do?"

Below is a partial list of our fellows’ recent projects--and, importantly, the role they have played in making these projects a success.

 

Clinical/Workflow Optimization 

  • e-Consent deployment. Evaluated role of trainees in e-consent for procedures and studied equity for limited English proficiency patients and efficiency gains in the operating room. 

  • Consult order: Developed and deployed a consult order workflow for the ED which automatically paged the consulting service; studied deployment for efficacy.  

  • Sepsis care quality improvement: Deployed a new sepsis model, alert, clinical summary, and orderset to improve sepsis care. 

  • ED workflow optimization: Improved documentation in the ED to support billing and optimized and patient-provider experience. 

  • Post-hospital discharge follow-up appointments: Developed a referral workflow to allow patients without a PCP to have a follow-up appointment at urgent care. 

 

Artificial Intelligence 

  • AI-generated patient portal messages: Served as prompt engineers, frontline providers, and aggregators of feedback to improve quality of AI-drafted patient messages across multiple specialties. 

  • AI scribe: Tested, deployed, and validated AI scribes in multiple clinical settings including the Emergency Department.   

  • LLMs for QI databases: Evaluated the use of LLMs for quality reporting for vascular surgery using narrative operative reports 

  • AI tools for hospital medicine: Deployed AI tool in hospital medicine to assist in clinical queries. 

 

Analytics & Dashboards 

  • Pediatric restraint orders in the Pediatric ICU: Studied the automatic notification mechanism for order expiry to ensure its efficacy.  

  • Electronic labor and deliver track board: Converted the physical labor board to an electronic labor board to summarize key indicators and aggregate data from the EHR 

  • Trainee competency dashboard: Used data visualization tools to develop a dashboard to monitor trainee development and performance. 

  • Hospital-acquired sepsis: Analyzed data around current hospital BPAs for sepsis to which providers were presented with BPAs and which actions were taken in response 

 

Leadership 

  • Committee membership: Provided department subject matter expertise to system-wide informatics committees. 

  • Data privacy: Collaborated with stakeholders to develop a guide for providers and for patients on data sharing in the EHR. 

 

CI Fellow Publications

Our fellows often publish papers about their projects, including many of the ones listed above, adding to the growing body of research in the world of clinical informatics. A selection of these publications are listed below.

 

Trang K, Pierce L, Wick EC. The Impact of Using Electronic Consents on Documentation of Language-Concordant Surgical Consent for Patients with Limited English Proficiency. Jt Comm J Qual Patient Saf. 2024 Mar 10:S1553-7250(24)00075-8. doi: 10.1016/j.jcjq.2024.03.005. Epub ahead of print. PMID: 38565472.

 

Decker H, Trang K, Ramirez J, Colley A, Pierce L, Coleman M, Bongiovanni T, Melton GB, Wick E. Large Language Model-Based Chatbot vs Surgeon-Generated Informed Consent Documentation for Common Procedures. JAMA Netw Open. 2023 Oct 2;6(10):e2336997. doi: 10.1001/jamanetworkopen.2023.36997. PMID: 37812419; PMCID: PMC10562939.

 

Judson TJ, Subash M, Harrison JD, Yeager J, Williams AM, Grouse CK, Byron M. Patient Perceptions of e-Visits: Qualitative Study of Older Adults to Inform Health System Implementation. JMIR Aging. 2023 May 26;6:e45641. doi: 10.2196/45641. PMID: 37234031; PMCID: PMC10257108.

 

Arvisais-Anhalt S, Ravi A, Weia B, Aarts J, Ahmad HB, Araj E, Bauml JA, Benham-Hutchins M, Boyd AD, Brecht-Doscher A, Butler-Henderson K, Butte AJ, Cardilo AB, Chilukuri N, Cho MK, Cohen JK, Craven CK, Crusco S, Dadabhoy F, Dash D, DeBolt C, Elkin PL, Fayanju OA, Fochtmann LJ, Graham JV, Hanna JJ, Hersh W, Hofford MR, Hron JD, Huang SS, Jackson BR, Kaplan B, Kelly W, Ko K, Koppel R, Kurapati N, Labbad G, Lee JJ, Lehmann CU, Leitner S, Liao ZC, Medford RJ, Melnick ER, Muniyappa AN, Murray SG, Neinstein AB, Nichols-Johnson V, Novak LL, Ogan WS, Ozeran L, Pageler NM, Pandita D, Perumbeti A, Petersen C, Pierce L, Puttagunta R, Ramaswamy P, Rogers KM, Rosenbloom ST, Ryan A, Saleh S, Sarabu C, Schreiber R, Shaw KA, Sim I, Sirintrapun SJ, Solomonides A, Spector JD, Starren JB, Stoffel M, Subbian V, Swanson K, Tomes A, Trang K, Unertl KM, Weon JL, Whooley MA, Wiley K, Williamson DFK, Winkelstein P, Wong J, Xie J, Yarahuan JKW, Yung N, Zera C, Ratanawongsa N, Sadasivaiah S. Paging the Clinical Informatics Community: Respond STAT to Dobbs v. Jackson's Women's Health Organization. Appl Clin Inform. 2023 Jan;14(1):164-171. doi: 10.1055/a-2000-7590. Epub 2022 Dec 19. PMID: 36535703; PMCID: PMC9977563.

 

Ravi A, Shochat G, Wang RC, Khanna R. Improvements to emergency department length of stay and user satisfaction after implementation of an integrated consult order. J Am Coll Emerg Physicians Open. 2023 Mar 21;4(2):e12922. doi: 10.1002/emp2.12922. PMID: 36960353; PMCID: PMC10028414.

Swanson K, Ravi A, Saleh S, Weia B, Pleasants E, Arvisais-Anhalt S. Effect of Recent Abortion Legislation on Twitter User Engagement, Sentiment, and Expressions of Trust in Clinicians and Privacy of Health Information: Content Analysis. J Med Internet Res. 2023 May 12;25:e46655. doi: 10.2196/46655. PMID: 37171873; PMCID: PMC10221497.

 

Karl Swanson, Shuhan He, Josh Calvano et al. Biomedical Text Readability and Cognitive Burden after Hypernym Substitution with Fine-Tuned Large Language Models, 05 January 2023, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-2410184/v1]

 

Arvisais-Anhalt S, Ratanawongsa N, Sadasivaiah S. Laboratory Results Release to Patients under the 21st Century Cures Act: The Eight Stakeholders Who Should Care. Appl Clin Inform. 2023 Jan;14(1):45-53. doi: 10.1055/a-1990-5157. Epub 2022 Nov 30. PMID: 36452981; PMCID: PMC9848892.

 

Kadambi A, Fulcher I, Venkatesh K, Schor JS, Clapp MA, Wen T. Predicting the risk of gestational diabetes using clinical data with machine learning: a predictive model study. Am J Obstet Gynecol MFM. 2023 Jul;5(7):100965. doi: 10.1016/j.ajogmf.2023.100965. Epub 2023 Apr 8. PMID: 37037325.

 

Pala AN, Chuang JC, Chien A, Krauth DM, Leitner SA, Okoye NM, Costello SC, Rodriguez RM, Sheira LA, Solomon G, Weiser SD. Depression, anxiety, and burnout among hospital workers during the COVID-19 pandemic: A cross-sectional study. PLoS One. 2022 Dec 9;17(12):e0276861. doi: 10.1371/journal.pone.0276861. PMID: 36490248; PMCID: PMC9733879.

 

Muniyappa AN, Raitt MH, Judson GL, Shen H, Tarasovsky G, Whooley MA, Dhruva SS. Factors associated with remote monitoring adherence for cardiovascular implantable electronic devices. Heart Rhythm. 2022 Sep;19(9):1499-1507. doi: 10.1016/j.hrthm.2022.04.025. Epub 2022 Apr 29. PMID: 35500792.

 

Nguyen MP, Morshed RA, Dalle Ore CL, Cummins DD, Saggi S, Chen WC, Choudhury A, Ravi A, Raleigh DR, Magill ST, McDermott MW, Theodosopoulos PV. Supervised machine learning algorithms demonstrate proliferation index correlates with long-term recurrence after complete resection of WHO grade I meningioma. J Neurosurg. 2022 Jun 3;138(1):86-94. doi: 10.3171/2022.4.JNS212516. PMID: 36303473.

Ramaswamy P, Shah A, Kothari R, Schloemerkemper N, Methangkool E, Aleck A, Shapiro A, Dayal R, Young C, Spinner J, Deibler C, Wang K, Robinowitz D, Gandhi S. An Accessible Clinical Decision Support System to Curtail Anesthetic Greenhouse Gases in a Large Health Network: Implementation Study. JMIR Perioper Med. 2022 Dec 8;5(1):e40831. doi: 10.2196/40831. PMID: 36480254; PMCID: PMC9782391.

 

Ramaswamy P, Xie J, Marsiglio AM, Burgart AM, Schmiesing CA, Cohen NH, Robinowitz DL, Wang E. Keeping an Open Mind About Open Notes: Sharing Anesthesia Records With Patients. Anesth Analg. 2022 Oct 1;135(4):697-703. doi: 10.1213/ANE.0000000000005800. Epub 2022 Sep 15. PMID: 36108183.

 

Ramaswamy P, Gong JJ, Saleh SN, McDonald SA, Blumberg S, Medford RJ, Liu X. Developing a COVID-19 WHO Clinical Progression Scale inpatient database from electronic health record data. J Am Med Inform Assoc. 2022 Jun 14;29(7):1279-1285. doi: 10.1093/jamia/ocac041. PMID: 35289912; PMCID: PMC9196693.

 

Chong P, Grob P, DiMattia G, Calvano J, Swanson K, He S, Gubler KD, LaPorta A. Website Usability Analysis of U.S. Military Residency Programs. Mil Med. 2022 Oct 6:usac290. doi: 10.1093/milmed/usac290. Epub ahead of print. PMID: 36200474.

 

Trang K, Pierce L, Wick EC, Hirose K. Using Electronic Health Record Meta-Data to Identify Variation in Trainee Progress Note Writing Patterns: Opportunity to Enhance Systems-Based Care. J Surg Educ. 2022 Nov-Dec;79(6):e257-e262. doi: 10.1016/j.jsurg.2022.08.011. Epub 2022 Sep 9. PMID: 36096881.

 

Glencer AC, Lin JA, Trang K, Greenberg A, Kirkwood KS, Adam MA, Sarin A. Assessing the role of robotic proctectomy in obese patients: a contemporary NSQIP analysis. J Robot Surg. 2022 Dec;16(6):1391-1399. doi: 10.1007/s11701-022-01380-2. Epub 2022 Feb 11. PMID: 35147841; PMCID: PMC9365884.

 

Arvisais-Anhalt S, Lehmann CU, Bishop JA, Balani J, Boutte L, Morales M, Park JY, Araj E. Searching Full-Text Anatomic Pathology Reports Using Business Intelligence Software. J Pathol Inform. 2022 Feb 7;13:100014. doi: 10.1016/j.jpi.2022.100014. PMID: 35251753; PMCID: PMC8892022.

 

Liu X, Anstey J, Li R, Sarabu C, Sono R, Butte AJ. Rethinking PICO in the Machine Learning Era: ML-PICO. Appl Clin Inform. 2021 Mar;12(2):407-416. doi: 10.1055/s-0041-1729752. Epub 2021 May 19. PMID: 34010977; PMCID: PMC8133838.

 

 

Arvisais-Anhalt S, Lau M, Lehmann CU, Holmgren AJ, Medford RJ, Ramirez CM, Chen CN. The 21st Century Cures Act and Multiuser Electronic Health Record Access: Potential Pitfalls of Information Release. J Med Internet Res. 2022 Feb 17;24(2):e34085. doi: 10.2196/34085. PMID: 35175207; PMCID: PMC8895284.

 

Arvisais-Anhalt S, Wickenhauser KA, Lusk K, Lehmann CU, McCormack JL, Feterik K. Direct Secure Messaging in Practice-Recommendations for Improvements. Appl Clin Inform. 2022 May;13(3):767-773. doi: 10.1055/s-0042-1753540. Epub 2022 Aug 4. PMID: 35926794; PMCID: PMC9352441.

 

Subash M, Sakumoto M, Bass J, Hong P, Muniyappa A, Pierce L, Purmal C, Ramaswamy P, Sono R, Uptegraft C, Feinstein D, Khanna R. The emerging role of clinical informatics fellows in service learning during the COVID-19 pandemic. J Am Med Inform Assoc. 2021 Mar 1;28(3):487-493. doi: 10.1093/jamia/ocaa241. PMID: 33164076; PMCID: PMC7717323.

 

Subash M, Liu LH, DeQuattro K, Choden S, Jacobsohn L, Katz P, Bajaj P, Barton JL, Bartels C, Bermas B, Danila MI, Downey C, Ferguson S, Reiter K, Wahl E, Weinstein E, Zell J, Schmajuk G, Yazdany J. The Development of the Rheumatology Informatics System for Effectiveness Learning Collaborative for Improving Patient-Reported Outcome Collection and Patient-Centered Communication in Adult Rheumatology. ACR Open Rheumatol. 2021 Oct;3(10):690-698. doi: 10.1002/acr2.11310. Epub 2021 Jul 20. PMID: 34288595; PMCID: PMC8516100.

 

Shenson JA, Jankovic I, Hong HJ, Weia B, White L, Chen JH, Eisenberg M. Engaging Housestaff as Informatics Collaborators: Educational and Operational Opportunities. Appl Clin Inform. 2021 Oct;12(5):1150-1156. doi: 10.1055/s-0041-1740258. Epub 2021 Dec 8. PMID: 34879406; PMCID: PMC8654580.

Torous J, Bauer A, Chan S, Boland R, Ramo D. Smart Steps for Psychiatric Education: Approaching Smartphone Apps for Learning and Care. Acad Psychiatry. 2018 Dec;42(6):791-795. doi: 10.1007/s40596-018-0901-y. Epub 2018 Apr 10. PMID: 29637514; PMCID: PMC6179955.

 

Kim JW, Torous J, Chan S, Gipson SYT. Developing a Digitally Informed Curriculum in Psychiatry Education and Clinical Practice. Acad Psychiatry. 2018 Dec;42(6):782-790. doi: 10.1007/s40596-018-0895-5. Epub 2018 Feb 22. PMID: 29473134.

 

Chan S, Godwin H, Gonzalez A, Yellowlees PM, Hilty DM. Review of Use and Integration of Mobile Apps Into Psychiatric Treatments. Curr Psychiatry Rep. 2017 Oct 30;19(12):96. doi: 10.1007/s11920-017-0848-9. PMID: 29082425.