Marvin is pragmatic and with a strong desire to evaluate practice or systems and their implementations and how they impact patient care. This has long led him to the use of data mining methods including natural language processing, machine learning and valued collaborations with local trainees and faculty as well as clinical informatics colleagues around the country. Lately, Marvin has developed an increasing focus on how we can improve and benchmark the quality of care across institutions and populations.
Research Background
Marvin Harper received his medical degree from the University of California at San Francisco before his clinical training in pediatrics and pediatric emergency medicine and pediatric infectious diseases (Boston Children’s Hospital). He joined the ED faculty in 1992. Marvin has long had an interest in clinical informatics and how to improve the end user experience and has worked with the Information Services Department since 1995 and has served as the Chief Medical Information Officer since 2008.
Education
Medical School
University of California, San Francisco
1986
San Francisco
CA
Internship
Pediatrics
Boston Children's Hospital
1987
Boston
MA
Residency
Pediatrics
Boston Children's Hospital
1989
Boston
MA
Fellowship
Boston Children's Hospital
1992
Boston
MA
Publications
The substance-exposed birthing person-infant/child dyad and health information exchange in the United States. J Am Med Inform Assoc. 2025 Jan 02. View Abstract
Bacteremia in Patients With Fever and Acute Lower Extremity Pain in a Non-Lyme Endemic Region. Pediatrics. 2024 Jan 01; 153(1). View Abstract
Bacteremia in Children With Fever and Acute Lower Extremity Pain. Pediatrics. 2023 05 01; 151(5). View Abstract
Boston Febrile Infant Algorithm 2.0: Improving Care of the Febrile Infant 1-2 Months of Age. Pediatr Qual Saf. 2022 Nov-Dec; 7(6):e616. View Abstract
Pediatric Emergency Department Sepsis Screening Tool Accuracy During the COVID-19 Pandemic. Pediatrics. 2022 07 01; 150(1). View Abstract
Tackling Ambulatory Safety Risks Through Patient Engagement: What 10,000 Patients and Families Say About Safety-Related Knowledge, Behaviors, and Attitudes After Reading Visit Notes. J Patient Saf. 2021 12 01; 17(8):e791-e799. View Abstract
Utility of Blood Cultures and Empiric Antibiotics in Febrile Pediatric Hemophilia Patients With Central Venous Access Devices. Pediatr Emerg Care. 2021 Dec 01; 37(12):e1531-e1534. View Abstract
Outcomes of Patients with Sepsis in a Pediatric Emergency Department after Automated Sepsis Screening. J Pediatr. 2021 08; 235:239-245.e4. View Abstract
Is lymphangitic streaking associated with different pathogens? Am J Emerg Med. 2021 08; 46:34-37. View Abstract
Comparison of Manual and Automated Sepsis Screening Tools in a Pediatric Emergency Department. Pediatrics. 2021 02; 147(2). View Abstract
Effect of a Sepsis Screening Algorithm on Care of Children with False-Positive Sepsis Alerts. J Pediatr. 2021 04; 231:193-199.e1. View Abstract
Presentation, Diagnostic Evaluation, Management, and Rates of Serious Bacterial Infection in Infants With Acute Dacryocystitis Presenting to the Emergency Department. Pediatr Infect Dis J. 2020 12; 39(12):1065-1068. View Abstract
Bacteriology of pediatric breast abscesses beyond the neonatal period. Am J Emerg Med. 2021 03; 41:193-196. View Abstract
Clinician Perceptions of Timing and Presentation of Drug-Drug Interaction Alerts. Appl Clin Inform. 2020 05; 11(3):487-496. View Abstract
Rapid Implementation of an Inpatient Telehealth Program during the COVID-19 Pandemic. Appl Clin Inform. 2020 May; 11(3):452-459. View Abstract
Identifying Patients at Lowest Risk for Streptococcal Pharyngitis: A National Validation Study. J Pediatr. 2020 05; 220:132-138.e2. View Abstract
Performance of an Automated Screening Algorithm for Early Detection of Pediatric Severe Sepsis. Pediatr Crit Care Med. 2019 12; 20(12):e516-e523. View Abstract
Variability in antimicrobial use in pediatric ventilator-associated events. Infect Control Hosp Epidemiol. 2019 01; 40(1):32-39. View Abstract
Predictors of Primary Intracranial Hypertension in Children Using a Newly Suggested Opening Pressure Cutoff of 280 mm H2O. Pediatr Neurol. 2019 02; 91:27-33. View Abstract
Predictors of a drainable suppurative adenitis among children presenting with cervical adenopathy. Am J Emerg Med. 2019 01; 37(1):109-113. View Abstract
An Investigation of Drug-Drug Interaction Alert Overrides at a Pediatric Hospital. Hosp Pediatr. 2018 05; 8(5):293-299. View Abstract
Should patients with complex febrile seizure be admitted for further management? Am J Emerg Med. 2018 08; 36(8):1386-1390. View Abstract
Association between Search Behaviors and Disease Prevalence Rates at 18 U.S. Children's Hospitals. Appl Clin Inform. 2017 10; 8(4):1144-1152. View Abstract
Doing More About Health Care Disparities: Moving Past Description to Action. Pediatrics. 2017 10; 140(4). View Abstract
Utility of Lumbar Puncture in Children Presenting With Status Epilepticus. Pediatr Emerg Care. 2017 Aug; 33(8):544-547. View Abstract
A Pediatric Approach to Ventilator-Associated Events Surveillance. Infect Control Hosp Epidemiol. 2017 03; 38(3):327-333. View Abstract
Use of cidofovir in pediatric patients with adenovirus infection. F1000Res. 2016; 5:758. View Abstract
Ventilator-Associated Events in Neonates and Children--A New Paradigm. Crit Care Med. 2016 Jan; 44(1):14-22. View Abstract
Drug-Drug Interactions Among Hospitalized Children Receiving Chronic Antiepileptic Drug Therapy. Hosp Pediatr. 2016 May; 6(5):282-9. View Abstract
An Introduction to Natural Language Processing: How You Can Get More From Those Electronic Notes You Are Generating. Pediatr Emerg Care. 2015 Jul; 31(7):536-41. View Abstract
Electronic medication reconciliation and medication errors. Int J Qual Health Care. 2015 Aug; 27(4):314-9. View Abstract
Factors associated with meaningful use incentives in children's hospitals. Pediatrics. 2015 Jun; 135(6):e1409-16. View Abstract
Preserving patient privacy and confidentiality in the era of personal health records. Pediatrics. 2015 May; 135(5):e1125-7. View Abstract
Group A streptococcal bacteremia without a source is associated with less severe disease in children. Pediatr Infect Dis J. 2015 Apr; 34(4):447-9. View Abstract
Impact of the meaningful use incentive program on electronic health record adoption by US children's hospitals. J Am Med Inform Assoc. 2015 Mar; 22(2):390-8. View Abstract
The Yield of Neuroimaging in Children Presenting to the Emergency Department With Acute Ataxia in the Post-Varicella Vaccine Era. J Child Neurol. 2015 Sep; 30(10):1333-9. View Abstract
Pediatric first time non-febrile seizure with focal manifestations: is emergent imaging indicated? Seizure. 2014 Oct; 23(9):740-5. View Abstract
Core drug-drug interaction alerts for inclusion in pediatric electronic health records with computerized prescriber order entry. J Patient Saf. 2014 Mar; 10(1):59-63. View Abstract
Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle. JAMA. 2013 Dec 04; 310(21):2262-70. View Abstract
A randomized controlled trial of a vancomycin loading dose in children. Pediatr Infect Dis J. 2013 Nov; 32(11):1217-23. View Abstract
Bacteremia risk and outpatient management of febrile patients with sickle cell disease. Pediatrics. 2013 Jun; 131(6):1035-41. View Abstract
Change in adoption of electronic health records by US children's hospitals. Pediatrics. 2013 May; 131(5):e1563-75. View Abstract
IT in the ED: past, present, and future. Pediatr Emerg Care. 2013 Mar; 29(3):402-5. View Abstract
Emergency department management of pediatric patients with cyanotic heart disease and fever. J Emerg Med. 2013 Mar; 44(3):599-604. View Abstract
IT in the ED: a new section of Pediatric Emergency Care. Pediatr Emerg Care. 2012 Dec; 28(12):1399-401. View Abstract
Yield of emergent neuroimaging among children presenting with a first complex febrile seizure. Pediatr Emerg Care. 2012 Apr; 28(4):316-21. View Abstract
Detecting unapproved abbreviations in the electronic medical record. Jt Comm J Qual Patient Saf. 2012 Apr; 38(4):178-83. View Abstract
Occurrence of metabolic acidosis in pediatric emergency department patients as a data source for disease surveillance systems. Pediatr Emerg Care. 2010 Oct; 26(10):733-8. View Abstract
Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics. 2010 Jul; 126(1):62-9. View Abstract
Risk of serious bacterial infection in isolated and unsuspected neutropenia. Acad Emerg Med. 2010 Feb; 17(2):163-7. View Abstract
Risk of Serious Bacterial Infection in Isolated
and Unsuspected Neutropenia. Acad Emerg Med 'In press'. 2010; 17:1-5. View Abstract
Acute Periorbital Infections: Who Needs Emergent Imaging?. Pediatrics. Accepted for publication. 2010. View Abstract
Effect of trainees on length of stay in the pediatric emergency department. Acad Emerg Med. 2009 Sep; 16(9):859-65. View Abstract
Assessing quality indicators for pediatric community-acquired pneumonia. Am J Med Qual. 2009 Sep-Oct; 24(5):419-27. View Abstract
Radiographic pneumonia in young, highly febrile children with leukocytosis before and after universal conjugate pneumococcal vaccination. Pediatr Emerg Care. 2009 Jan; 25(1):1-7. View Abstract
Utility of lumbar puncture for first simple febrile seizure among children 6 to 18 months of age. Pediatrics. 2009 Jan; 123(1):6-12. View Abstract
A decision rule for predicting bacterial meningitis in children with cerebrospinal fluid pleocytosis when gram stain is negative or unavailable. Acad Emerg Med. 2008 May; 15(5):437-44. View Abstract
Test characteristics and interpretation of cerebrospinal fluid gram stain in children. Pediatr Infect Dis J. 2008 Apr; 27(4):309-13. View Abstract
Pneumonia. Pediatric Infectious Diseases. The Requisites in Pediatrics. Editors Bergelson JM, Shah SS, Zaoutis TE. 2008; 117-124. View Abstract
Infection following bites. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2008; 525-30. View Abstract
The toddler with fever. Pediatric Infectious Diseases. The Requisites in Pediatrics. Editors Bergelson JM, Shah SS, Zaoutis TE. 2008; 245-250. View Abstract
Antimicrobials and Infectious Diseases. Manual of Pediatric Therapeutics. Editors Graef JW, Wolfsdorf JI, Greenes DS. 2008; 80-174. View Abstract
Pneumonia in the immunocompromised host. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2008; 265-9. View Abstract
Leukocyte counts in urine reflect the risk of concomitant sepsis in bacteriuric infants: a retrospective cohort study. BMC Pediatr. 2007 Jun 13; 7:24. View Abstract
Factors associated with antimicrobial resistance and mortality in pneumococcal bacteremia. J Emerg Med. 2007 May; 32(4):349-57. View Abstract
Clinical predictors of occult pneumonia in the febrile child. Acad Emerg Med. 2007 Mar; 14(3):243-9. View Abstract
Use of human immunodeficiency virus postexposure prophylaxis in adolescent sexual assault victims. Arch Pediatr Adolesc Med. 2006 Jul; 160(7):674-80. View Abstract
An automated electronic case log: using electronic information systems to assess training in emergency medicine. Acad Emerg Med. 2006 Jul; 13(7):733-9. View Abstract
Identifying hospitalized infants who have bronchiolitis and are at high risk for apnea. Ann Emerg Med. 2006 Oct; 48(4):441-7. View Abstract
Corrections for leukocytes and percent of neutrophils do not match observations in blood-contaminated cerebrospinal fluid and have no value over uncorrected cells for diagnosis. Pediatr Infect Dis J. 2006 Jan; 25(1):8-11. View Abstract
Sexually Transmitted Diseases. Textbook of Pediatric Emergency Medicine. Editors: Fleisher and Ludwig. 2006; 853-871. View Abstract
Pneumonia in hospitalized children. Pediatr Clin North Am. 2005 Aug; 52(4):1059-81, viii. View Abstract
Accuracy and test characteristics of ancillary tests of cerebrospinal fluid for predicting acute bacterial meningitis in children with low white blood cell counts in cerebrospinal fluid. Acad Emerg Med. 2005 Apr; 12(4):303-9. View Abstract
Fever. Signs and Symptoms In Pediatrics. Edited by Davis MA, Gruskin KD, Chiang VW, Manzi S, Davis MA. 2005; 183-198. View Abstract
A low peripheral blood white blood cell count in infants younger than 90 days increases the odds of acute bacterial meningitis relative to bacteremia. Acad Emerg Med. 2004 Dec; 11(12):1297-301. View Abstract
Explanation of mathematical model. Pediatr Infect Dis J. 2004 Sep; 23(9):893. View Abstract
Disseminated histoplasmosis in a nonendemic area. Pediatr Infect Dis J. 2004 Aug; 23(8):781-2. View Abstract
Intracerebral abscess in children: historical trends at Children's Hospital Boston. Pediatrics. 2004 Jun; 113(6):1765-70. View Abstract
Differentiating acute bacterial meningitis from acute viral meningitis among children with cerebrospinal fluid pleocytosis: a multivariable regression model. Pediatr Infect Dis J. 2004 Jun; 23(6):511-7. View Abstract
Update on the Management of the Febrile Infant. Clinical Pediatric Emergency Medicine. 2004; 5(1):5-12. View Abstract
Evaluation of a rapid urine antigen assay for the detection of invasive pneumococcal disease in children. Pediatrics. 2003 Dec; 112(6 Pt 1):1279-82. View Abstract
Utility of sepsis evaluation in infants 90 days of age or younger with fever and clinical bronchiolitis. Pediatr Infect Dis J. 2003 Dec; 22(12):1053-6. View Abstract
Identifying febrile young infants with bacteremia: is the peripheral white blood cell count an accurate screen? Ann Emerg Med. 2003 Aug; 42(2):216-25. View Abstract
Prolonged partial thromboplastin times in children with fever and petechiae without bacteremia or sepsis. Pediatr Emerg Care. 2003 Aug; 19(4):244-7. View Abstract
Antibiotic Therapy for Otitis Media In Children (ATOMIC)—Patient Risk Stratification and Evidence-Based Selection of Antimicrobial Therapy. Emergency Medicine Consensus Reports. 2003; 1-18. View Abstract
A clinical practice guideline for treatment of septic arthritis in children: efficacy in improving process of care and effect on outcome of septic arthritis of the hip. J Bone Joint Surg Am. 2003 Jun; 85(6):994-9. View Abstract
Utility of the peripheral blood white blood cell count for identifying sick young infants who need lumbar puncture. Ann Emerg Med. 2003 Feb; 41(2):206-14. View Abstract
The role of emergent neuroimaging in children with new-onset afebrile seizures. Pediatrics. 2003 Jan; 111(1):1-5. View Abstract
Pneumonia in the immunocompromised host. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2003; 237-241. View Abstract
Complications of acute pneumonia. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2003; 225-231. View Abstract
Persistent and recurrent pneumonia. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2003; 231-237. View Abstract
Rapid antigen assay for the diagnosis of pneumococcal bacteremia in children: a preliminary study. Ann Emerg Med. 2002 Oct; 40(4):399-404. View Abstract
Human Immunodeficiency Virus Infection. In Synopsis of Pediatric Emergency Medicine; Editors: Fleisher and Ludwig. 2002; 326-331. View Abstract
Management of febrile children in the age of the conjugate pneumococcal vaccine: a cost-effectiveness analysis. Pediatrics. 2001 Oct; 108(4):835-44. View Abstract
Time to positivity of blood cultures for children with Streptococcus pneumoniae bacteremia. Clin Infect Dis. 2001 Oct 15; 33(8):1324-8. View Abstract
Predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics. 2001 Aug; 108(2):311-6. View Abstract
Financial and clinical impact of false-positive blood culture results. Clin Infect Dis. 2001 Aug 01; 33(3):296-9. View Abstract
Lack of reduction in hospitalizations and emergency department visits for varicella in the first 2 years post-vaccine licensure. Pediatr Emerg Care. 2001 Apr; 17(2):101-3. View Abstract
Fever interval before diagnosis, prior antibiotic treatment, and clinical outcome for young children with bacterial meningitis. Clin Infect Dis. 2001 Feb 15; 32(4):566-72. View Abstract
Reliability of the urinalysis for predicting urinary tract infections in young febrile children. Arch Pediatr Adolesc Med. 2001 Jan; 155(1):60-5. View Abstract
Information System applications in the Emergency Department. Clinical Pediatric Emergency Medicine. 2001. View Abstract
Time to detection of positive cultures in 28- to 90-day-old febrile infants. Pediatrics. 2000 Dec; 106(6):E74. View Abstract
Predictors of bacteremia in febrile children 3 to 36 months of age. Pediatrics. 2000 Nov; 106(5):977-82. View Abstract
The pediatric forum: white blood cell count likelihood ratios for bacteremia in febrile young children Arch Pediatr Adolesc Med. 2000 Sep; 154(9):963-4. View Abstract
Reevaluation of outpatients with Streptococcus pneumoniae bacteremia. Pediatrics. 2000 Mar; 105(3 Pt 1):502-9. View Abstract
Human Immunodeficiency Virus Infection. Textbook of Pediatric Emergency Medicine; Editors: Fleisher and Ludwig. 2000; 795-809. View Abstract
Non-typhi Salmonella bacteremia in children. Pediatr Infect Dis J. 1999 Dec; 18(12):1073-7. View Abstract
Bacteremia-associated pneumococcal pneumonia and the benefit of initial parenteral antimicrobial therapy. Pediatr Infect Dis J. 1999 Dec; 18(12):1081-5. View Abstract
Nasopharyngeal colonization with pathogens causing otitis media: how does this information help us? Pediatr Infect Dis J. 1999 Dec; 18(12):1120-4. View Abstract
Bacteraemia in young children with high fever: still no easy answers. Med J Aust. 1999 May 17; 170(10):462-3. View Abstract
Low risk of bacteremia in febrile children with recognizable viral syndromes. Pediatr Infect Dis J. 1999 Mar; 18(3):258-61. View Abstract
Occult pneumonias: empiric chest radiographs in febrile children with leukocytosis. Ann Emerg Med. 1999 Feb; 33(2):166-73. View Abstract
Clinical implications of penicillin and ceftriaxone resistance among children with pneumococcal bacteremia. Pediatr Infect Dis J. 1999 Jan; 18(1):35-41. View Abstract
Occult bacteremia with group B streptococci in an outpatient setting. Pediatrics. 1998 Jul; 102(1 Pt 1):67-72. View Abstract
Risk of bacteremia for febrile young children in the post-Haemophilus influenzae type b era. Arch Pediatr Adolesc Med. 1998 Jul; 152(7):624-8. View Abstract
Parenteral vs oral antibiotics in the prevention of serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia: a meta-analysis. Acad Emerg Med. 1998 Jun; 5(6):599-606. View Abstract
Do oral antibiotics prevent meningitis and serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia? A meta-analysis. Pediatrics. 1997 Mar; 99(3):438-44. View Abstract
Antibiotics and Infectious Disorders. Manual of Pediatric Therapeutics. 1997; 76-164. View Abstract
Invasive pneumococcal infections in human immunodeficiency virus-infected children. J Infect Dis. 1996 Apr; 173(4):870-6. View Abstract
Effect of antibiotic therapy on the outcome of outpatients with unsuspected bacteremia. Pediatr Infect Dis J. 1995 Sep; 14(9):760-7. View Abstract
Group A beta-hemolytic streptococcal bacteremia: historical overview, changing incidence, and recent association with varicella. Pediatrics. 1995 Sep; 96(3 Pt 1):428-33. View Abstract
Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol. 1995 Aug; 165(2):399-403. View Abstract
Care of bereaved parents. A study of patient satisfaction. J Reprod Med. 1994 Feb; 39(2):80-6. View Abstract
Case report: streptococcal toxic shock syndrome presenting as septic thrombophlebitis in a child with varicella. Pediatr Infect Dis J. 1993 Dec; 12(12):1033-4. View Abstract
HIV-infected children in the pediatric emergency department. Pediatr Emerg Care. 1993 Oct; 9(5):265-9. View Abstract
Occult bacteremia in the 3-month-old to 3-year-old age group. Pediatr Ann. 1993 Aug; 22(8):484, 487-93. View Abstract