Clinical Informatics Sessions
Meaningful Reform Achieved through use of HIT: a View from Behind the Scenes at the HIT Policy Committee (HITPC)
Type: Semi-plenary
P. Tang, Stanford University
The HITECH Act provides an enabling framework for reforming the health system. Through meaningful use incentives and other Recovery Act programs, HHS’ policy on HIT is stimulating implementation and effective use of information to improve health and health care.
CONNECTing the Public and Private Sector Healthcare Communities
Type: Small Group
V. Sankaran, Department of Health and Human Services; D. Riley, Department of Health and Human Services; B. Behlendorf, Department of Health and Human Services
The CONNECT open source software and the CONNECT Community are paving the way for secure health-information exchange among organizations in line with Nationwide Health Information Network (NHIN) standards and governance. CONNECT allows healthcare providers, insurers, federal agencies, states and other health stakeholders to exchange health information with other organizations nationwide. Since its release, the CONNECT program has continued to develop the solution to meet the diverse needs of the 500+ organizations comprising the growing Community. This session will provide an update on CONNECT; an overview of how organizations are using the solution to create health-information exchanges; outline NHIN participation benefits for patients, care providers, payors, states and other stakeholders; detail benefits that a nationwide network of interoperable health IT will provide to citizens; and provide an overview of the CONNECT Community.
The Future Role of Health Information Technology in the Medical Home
Type: Small Group
D. Bates, Brigham and Women's Hospital
The medical home is one of the most exciting approaches for improving care, and most of the implementations of it have relied in large part on the electronic health record (EHR), but the EHRs of today only begin to scratch the surface of what is needed by advanced medical homes. Dr. Bates will describe the medical home movement, and the current requirements to meet NCQA criteria for a level 3 medical home. He will then go on to describe 7 key dimensions for HIT in the medical home, and what developments in those dimensions could make a major difference to medical homes in improving quality, safety and efficiency of care.
Monitoring EHRs to Ensure Safe and Effective Use: What is Required?
Type: Small Group
D. Sittig, University of Texas Health Sciences Center; A. Wright, Brigham & Women's Hospital; G. Kuperman, NewYork Presbyterian Hospital; D. Bates, Brigham & Women's Hospital; H. Singh, Houston VA
Many organizations are in the midst of implementing Electronic Health Records (EHRs). Research and experience gained over the past 20 years has shown that implementing EHRs is difficult, time-consuming, and expensive. In addition, recent reports indicate that many organizations continue to experience various types of unintended adverse consequences. In a recent Commentary in JAMA, we called for “periodic, unannounced, random, onsite inspections of EHR systems”. We went on to specify that those inspections must address all 8 dimensions of safe and effective EHR use that we previously outlined. Namely they must address: hardware and software, clinical content, user interfaces, user training and authorization procedures, clinical workflow and communication, organizational policies and procedures, compliance with state and federal rules and regulations, and periodic measurements of system activity. The goal of this workshop will be to discuss potential methods of inspecting EHRs along each of these 8 dimensions.
Beyond the Basics: Building an NLP Application and a Reference Standard with Open Source Tools
Type: Hands-on
B. South, S. Duvall, VA Salt Lake City Health Care; S. Shen, S. Meystre, University of Utah
Natural language processing (NLP) is key to unlocking the vast amount of information stored in narrative text within electronic medical records. This workshop will use a hands-on learning approach and introduce participants to application of NLP in the clinical domain. In the first part of this workshop participants will use a readily available open source annotation tool to demonstrate use of an annotation guideline, the development of an annotation schema, and a manual annotation task to develop a reference standard. This reference standard will be used in the second half of the workshop to demonstrate development and evaluation of a pipeline system for a particular clinical task using the Apache Unstructured Information Management Architecture (UIMA) Java Framework. De-identified healthcare documents will be provided along with open-source tools that allow participants to build reference standards and implement a working NLP system.
Terminologies and Meaningful Use: the Role of NLM
Type: Hands-on
S. Nelson, J. Kilbourne, J. Case, S. Srinivasan, J. Willis, National Library of Medicine (NLM)
The Notice of Proposed Rule Making for Meaningful Use of EHRs in the US names certain terminologies and value sets as standards. The National Library of Medicine is particularly interested in assisting users with obtaining and implementing these terminologies. NLM has played a key role in licensing SNOMED CT for use in the United States, and is the national release center responsible for distributing SNOMED CT in the U.S. NLM is the producer of RxNorm, and produces the Unified Medical Language System, of which RxNorm, SNOMED CT, and LOINC, all vocabularies named within these standards, are a part. The workshop will focus on methods of distributing the terminologies, subsets, and value sets, perceived and real obstacles to obtaining them, and user needs in implementing these terminologies. The primary purpose of the workshop is to encourage dialog with potential users of NLM services. The focus will be on how NLM can be of assistance and service as individuals and institutions address their terminology needs. Topics to be covered include the revision of the UMLS Knowledge Sources Server (KSS), submitting terminology requests, licensing issues, and methods of publishing, maintaining, and updating extensions and value sets. Participants should bring questions and suggestions.
National Clinical Decision Support Initiatives: Perspectives on the Current State and a Town Hall about a Way Forward
Type: Small Group
G. Kuperman, NewYork Presbyterian Hospital; J. Osheroff, Thomson Reuters; R. Greenes, Arizona State University; T. Payne, University of Washington; D. Sittig, University of Texas Health Sciences Center
Clinical decision support (CDS) is a critical enabler of care improvement and is a key component of the meaningful use criteria established by the Office of the National Coordinator. However, CDS still is an active area of research with many unresolved issues related to knowledge representation, knowledge maintenance, and how best to integrate CDS into workflow. Several initiatives at the national level, such as those sponsored by AHRQ and the National Quality Forum are focused on addressing these issues. This workshop will review CDS-related national initiatives and, through a “Town Hall” approach, solicit input from the audience about the extent to which those initiatives are addressing the most important outstanding questions related to CDS. The input received from the audience will provide input to AMIA’s positions CDS-related policy directions.
Introduction to Workflow Technology: Representation of Healthcare Processes in a Workflow Editor and their Execution in a Workflow Engine
Type: Small Group
V. Huser, Marshfield Clinic/University of Wisconsin-Madison
This workshop will provide an introduction to workflow technology, also known as Business Process Management (BPM). In the first part, the workshop will provide historical overview, evolution and introduction into Workflow Management Systems and introduce the benefits of formal representation of processes. The second part will provide overview of the current process representation standards and in detail describe the XPDL standard (XML process definition language) from Workflow Management Coalition. Finally, in the third part, the participants will be able to see (and follow) a hands-on demonstration of use of an open source workflow editor, engine, workflow mining tool and view and modify examples of healthcare process definitions. Relationship of decision support engines to workflow engines will also be discussed.
