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James E Gray, MD

Contact Information

Professional Interests

Innovative uses of clinical informatics methods
Patient Safety
Family Centered Care
Economic analysis

Biography

James Gray M.D., M.S., Professor of Pediatrics at the Geisel School of Medicine at Dartmouth and Director of Clinical Informatics at the Children’s Hospital at Dartmouth-Hitchcock is an experienced neonatologist, informatician and health services researcher. His research has been focused on advancing patient safety and improving the quality of newborn care. To this end, he has developed innovative improvements to family-centered neonatal intensive care and the methods used to assess them in a rigorous program of research that has been recognized at multiple levels. This work has been supported by more than 4 million dollars in federal and foundation support and has resulted in invitations to serve as a faculty member and consultant to national quality and safety organizations

Dr. Gray has leveraged his combination of clinical care, informatics, epidemiology, and health services research skills to create novel approaches to significant clinical problems. In 1996, he helped to pioneer the use of WWW technologies in patient care with the creation of Baby CareLink. This multifaceted telemedicine application used emerging technologies including the WWW and videoconferencing to support to families of high-risk newborns. During this project he led a series of family and clinician focus groups to align the approach and functionality of Baby CareLink with stakeholder needs. In addition, Dr. Gray collaborated with the Picker Institute and families to develop a NICU Family Satisfaction survey that is still in use[33]. A randomized clinical trial using this and other metrics demonstrated the feasibility and value of Baby CareLink in NICU care.

With expanded use of the electronic health record (EHR), his work has capitalized on innovative uses of routinely collected data to promote improvements. He helped to improve newborn screening throughout Massachusetts by detecting high rates of failure to screen among NICU patients and well newborns discharged home early[35]. Working with state, regional and hospital leaders, successful programs were implemented to decrease incomplete screening. He has used EHR data to uncover and quantify the risks of NICU patient misidentification[36]. As a Vermont-Oxford Network faculty member, these results have been applied in work with national clinical and family leaders to reduce NICU misidentification.

Dr. Gray has led work to understand the complex clinical and operational systems that exist in healthcare using methodologies drawn from systems and complexity science. He has created new paradigms for examining dissemination strategies for device technologies and used network analysis to study the composition and function of NICU care teams. He has recently developed novel metrics of nursing continuity that correlate with both family satisfaction and the risk of spreading antibiotic resistant organisms.

Most recently Dr. Gray has served as Project Leader for two PCORI funded Eugene Washington Engagement Awards focused on bringing together multiple stakeholder groups (families, clinicians, technologists and institutional representative) to examine AI use in the NICU. He is currently working with colleagues at Dartmouth’s Thayer School of Engineering to develop algorithmic methods to optimize nurse patients assignments in inpatient care.