Description
You click an order set and ten seconds later the labs, imaging and meds are in. A drug interaction alert fires, and you override it without reading. A sepsis score in the corner of the chart flags your post-op patient. Who built those defaults, who set that alert threshold, and was that score ever validated on surgical patients? Join Drs. Kevin Kniery, Mason Pearce, and Genevieve Melton-Meaux, a practicing colorectal surgeon and the American College of Surgeons' first Chief Health Informatics Officer, as they kick off the Clinical Informatics for Surgeons series. They explain what clinical informatics actually is (hint: not the help desk), how it is already running your operative day, and the few habits that let any surgeon shape the tools everyone else is stuck with.
Hosts: Genevieve Melton-Meaux, MD, PhD, Colon and Rectal Surgeon; Senior Associate Dean for Health Informatics and Data Science, University of Minnesota; Chief Health Informatics Officer, American College of Surgeons; Chair, AMIA Board of Directors Kevin Kniery, MD, FACS, Vascular Surgeon, Brooke Army Medical Center Mason Pearce, MD, General Surgery Resident and Clinical Informatics Fellow, University of South Florida; Behind the Knife Education Fellow Learning objectives: Define clinical informatics, distinguish it from information technology, and describe how physicians train and certify in the subspecialty (ACGME-accredited fellowship, ABPM/ABPath board exam). Identify four everyday systems that shape surgical care (order set defaults, medication alerts, embedded risk scores, OR scheduling logic) and recognize them as clinical design decisions. Explain alert fatigue as a patient safety problem and why independent external validation of predictive models matters, using the Epic Sepsis Model as an example. Describe the three core areas of the surgeon informatician: clinical decision-making and care process improvement; health information systems, data and analytics; and leadership and change management. Apply practical habits for informatics literacy: question a risk score's data and validation, report faulty alerts, and join the committees that maintain order sets and decision support. References: Felisberto M, Lima GDS, Celuppi IC, et al. Override rate of drug-drug interaction alerts in clinical decision support systems: a brief systematic review and meta-analysis. Health Informatics J. 2024;30(2):14604582241263242. https://pubmed.ncbi.nlm.nih.gov/38899788/ Ashton M. Getting rid of stupid stuff. N Engl J Med. 2018;379(19):1789-1791. https://pubmed.ncbi.nlm.nih.gov/30403948/ Rajamani G, Diethelm M, Gunderson MA, et al. Crowdsourcing electronic health record improvements at scale across an integrated health care delivery system. Appl Clin Inform. 2023;14(2):356-364. https://pubmed.ncbi.nlm.nih.gov/37164355/ Wong A, Otles E, Donnelly JP, et al. External validation of a widely implemented proprietary sepsis prediction model in hospitalized patients. JAMA Intern Med. 2021;181(8):1065-1070. https://pubmed.ncbi.nlm.nih.gov/34152373/ Osheroff J, Teich J, Levick D, Saldana L, Velasco F, Sittig D, Rogers K, Jenders R. Improving Outcomes with Clinical Decision Support: An Implementer's Guide. 2nd ed. HIMSS Publishing; 2012. ISBN 9780984457731. Book; not indexed in PubMed. Source of the CDS Five Rights framework. https://www.routledge.com/Improving-Outcomes-with-Clinical-Decision-Support-An-Implementers-Guide-S… Gardner RM, Overhage JM, Steen EB, et al. Core content for the subspecialty of clinical informatics. J Am Med Inform Assoc. 2009;16(2):153-157. https://pubmed.ncbi.nlm.nih.gov/19074296/ Zhao J, Forsythe R, Langerman A, Melton GB, Schneider DF, Jackson GP. The value of the surgeon informatician. J Surg Res. 2020;252:264-271. https://pubmed.ncbi.nlm.nih.gov/32402396/ Anderson TN, Jenkins PD, Doberne JW, Mohan V, Thanawala RM. Defining the clinical informatics knowledge gap in general surgery: evaluation of resident experience and perspectives. J Surg Educ. 2025;82(11):103682. https://pubmed.ncbi.nlm.nih.gov/40911943/ Lyu HG, Doherty GM, Landman AB. Surgical informatics: defining the role of informatics in the current surgical training paradigm. J Surg Educ. 2020;77(1):9-12. https://pubmed.ncbi.nlm.nih.gov/31477548/ AMIA. AMIA's role in the clinical informatics subspecialty and history (ABMS approval 2011; first exam October 2013). AMIA's Role in CIS and History Turner PL. Exploring artificial intelligence at the ACS. Bulletin of the American College of Surgeons. October 2024. Exploring Artificial Intelligence at the ACS | ACS Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: https://behindtheknife.org/premium
Hosts: Genevieve Melton-Meaux, MD, PhD, Colon and Rectal Surgeon; Senior Associate Dean for Health Informatics and Data Science, University of Minnesota; Chief Health Informatics Officer, American College of Surgeons; Chair, AMIA Board of Directors Kevin Kniery, MD, FACS, Vascular Surgeon, Brooke Army Medical Center Mason Pearce, MD, General Surgery Resident and Clinical Informatics Fellow, University of South Florida; Behind the Knife Education Fellow Learning objectives: Define clinical informatics, distinguish it from information technology, and describe how physicians train and certify in the subspecialty (ACGME-accredited fellowship, ABPM/ABPath board exam). Identify four everyday systems that shape surgical care (order set defaults, medication alerts, embedded risk scores, OR scheduling logic) and recognize them as clinical design decisions. Explain alert fatigue as a patient safety problem and why independent external validation of predictive models matters, using the Epic Sepsis Model as an example. Describe the three core areas of the surgeon informatician: clinical decision-making and care process improvement; health information systems, data and analytics; and leadership and change management. Apply practical habits for informatics literacy: question a risk score's data and validation, report faulty alerts, and join the committees that maintain order sets and decision support. References: Felisberto M, Lima GDS, Celuppi IC, et al. Override rate of drug-drug interaction alerts in clinical decision support systems: a brief systematic review and meta-analysis. Health Informatics J. 2024;30(2):14604582241263242. https://pubmed.ncbi.nlm.nih.gov/38899788/ Ashton M. Getting rid of stupid stuff. N Engl J Med. 2018;379(19):1789-1791. https://pubmed.ncbi.nlm.nih.gov/30403948/ Rajamani G, Diethelm M, Gunderson MA, et al. Crowdsourcing electronic health record improvements at scale across an integrated health care delivery system. Appl Clin Inform. 2023;14(2):356-364. https://pubmed.ncbi.nlm.nih.gov/37164355/ Wong A, Otles E, Donnelly JP, et al. External validation of a widely implemented proprietary sepsis prediction model in hospitalized patients. JAMA Intern Med. 2021;181(8):1065-1070. https://pubmed.ncbi.nlm.nih.gov/34152373/ Osheroff J, Teich J, Levick D, Saldana L, Velasco F, Sittig D, Rogers K, Jenders R. Improving Outcomes with Clinical Decision Support: An Implementer's Guide. 2nd ed. HIMSS Publishing; 2012. ISBN 9780984457731. Book; not indexed in PubMed. Source of the CDS Five Rights framework. https://www.routledge.com/Improving-Outcomes-with-Clinical-Decision-Support-An-Implementers-Guide-S… Gardner RM, Overhage JM, Steen EB, et al. Core content for the subspecialty of clinical informatics. J Am Med Inform Assoc. 2009;16(2):153-157. https://pubmed.ncbi.nlm.nih.gov/19074296/ Zhao J, Forsythe R, Langerman A, Melton GB, Schneider DF, Jackson GP. The value of the surgeon informatician. J Surg Res. 2020;252:264-271. https://pubmed.ncbi.nlm.nih.gov/32402396/ Anderson TN, Jenkins PD, Doberne JW, Mohan V, Thanawala RM. Defining the clinical informatics knowledge gap in general surgery: evaluation of resident experience and perspectives. J Surg Educ. 2025;82(11):103682. https://pubmed.ncbi.nlm.nih.gov/40911943/ Lyu HG, Doherty GM, Landman AB. Surgical informatics: defining the role of informatics in the current surgical training paradigm. J Surg Educ. 2020;77(1):9-12. https://pubmed.ncbi.nlm.nih.gov/31477548/ AMIA. AMIA's role in the clinical informatics subspecialty and history (ABMS approval 2011; first exam October 2013). AMIA's Role in CIS and History Turner PL. Exploring artificial intelligence at the ACS. Bulletin of the American College of Surgeons. October 2024. Exploring Artificial Intelligence at the ACS | ACS Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: https://behindtheknife.org/premium