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The promises and risks of Artificial Intelligence permeate current policy statements and have attracted much attention by AI governance research. However, most analyses focus exclusively on AI policy on the national and international level, overlooking existing federal governance structures. This is surprising because AI is connected to many policy areas, where the competences are already distributed between the national and subnational level, such as research or economic policy. Addressing this gap, this paper argues that more attention should be dedicated to subnational efforts to shape AI and asks which themes are discussed in subnational AI policy documents with a case study of Germany's 16 states. Our qualitative analysis of 34 AI policy documents issued on the subnational level demonstrates that subnational efforts focus on knowledge transfer between research and industry actors, the commercialization of AI, different economic identities of the German states, and the incorporation of ethical principles. Because federal states play an active role in AI policy, analysing AI as a policy issue on different levels of government is necessary and will contribute to a better understanding of the developments and implementations of AI strategies in different national contexts. [ABSTRACT FROM AUTHOR]

Purpose: Hospital information systems (HIS) play a critical role in modern healthcare by facilitating the management and delivery of patient care services. We aimed to evaluate the current landscape of HIS in the specialty of gynecology and obstetrics in Germany. Methods: An anonymous questionnaire was distributed via the German Society of Gynecology and Obstetrics newsletter in December 2022. The questionnaire covered the domains baseline demographic information, satisfaction with daily use, satisfaction with implementation, and degree of digitization. Results: Ninety-one participants completed the survey. Median age was 34 years; 67.4% (60 of 89) were female, and 32.6% (29 of 89) were male. Of the survey participants, 47.7% (42 of 88) were residents, 26.1% (23 of 91) senior physicians, and 9.1% (8 of 88) medical directors. The degree of digitization of clinical documentation is mainly mixed digital and paper-based (64.0%, 57 of 89) while 16.9% (15 of 89) operate mainly paper-based. The current HIS has been in use on average for 9 years. The median number of different software systems used in daily routine is 4. About 33.7% (30 of 89) would likely or very likely recommend their current HIS to a colleague. Conclusions: The current landscape of HIS in gynecology and obstetrics in Germany is characterized by a high heterogeneity of systems with low interoperability and long service life; thus, many healthcare professionals are not satisfied. There is both a need to enhance and an interest in modernizing the technological infrastructure to meet today's requirements for patient care. [ABSTRACT FROM AUTHOR]