AMIA 2013 Student Design Challenge: Reinventing Clinical Documentation

November 16-20, Washington, DC

AMIA 2013 Annual Symposium

Washington Hilton hotel

AMIA 2013 Student Design Challenge: Reinventing Clinical Documentation

AMIA is pleased to announce a new event, Student Design Challenge. In this challenge we invite teams of graduate students from different scientific disciplines and of various backgrounds to propose creative solutions to a specified problem related to healthcare. We seek novel solutions that incorporate cutting edge computational and interactive technologies and take advantage of the considerable advances in such research areas as biomedical informatics, human-computer interaction, computer science, information visualization, pervasive and ubiquitous computing, among many others. A panel of distinguished members of the AMIA community will review the proposed solutions and select the best proposals based on a number of criteria, including their originality and transformative potential. Eight teams selected as finalists will be asked to attend AMIA Annual Symposium and present their solutions.

The focus of this design challenge is on designing novel methods for capturing and accessing clinical data that facilitate and enhance clinical work. We invite participants to re-invent electronic clinical documentation, broadly defined, and its role in medical practice. Specifically, we are looking for solutions that reduce documentation burden for clinicians, leverage strengths of human users and computing capabilities, support medical reasoning and decision-making, facilitate teamwork, capture clinical data in a way that enables secondary use of such data (for example for business and research purposes), and can be generalized to multiple settings and use cases.

Timeline

  • July 31 – proposal submission deadline
  • September 15 – notifications to authors
  • September 30 – camera-ready copy is submitted

Contact

Please read the entire Challenge description. If you have any questions about this process, please send an email to studentdesignchallenge@amia.org

AMIA 2013 Student Design Challenge on Facebook


Problem Introduction
Call For Submissions
SDC Committee

A clinical note, the most common form of clinical documentation, has a long and intriguing history. It was first introduced over 200 years ago; in its original form, a clinical note closely resembled lab notebook, and was designed to improve the rigor of medical practice. Over the years, researchers noted many different purposes of the patient record. For example, many suggested its role as a cognitive tool that augments clinical reasoning and decision-making and helps clinicians reflect on their thoughts about their patients (Patel et al. 2000). It was also viewed as a communication tool that helped different members of clinical teams to negotiate their varying perspectives and views on patient cases and their priorities in regards to medical care (Coiera 2000). Later, it was used supporting the business of medical practice. For example, a doctor’s note served as a record of the preformed services used for billing. It also served as a legal document that could be used in case the patient were not satisfied with the services and wanted to take legal action.

Electronic documentation—a process of composing clinical notes using an electronic note authoring tools provided by most of the modern electronic health record (EHR) systems—is redefining both the process of clinical documentation and the purpose of the clinical note. It is expected to enhance communication among clinicians, reduce error rates, improve documentation efficiency, and help prevent diagnostic errors (Schiff and Bates 2010).

Yet, the evidence of the positive impact of electronic documentation is mixed. Many studies of the time-saving potential of electronic documentation suggest that instead of saving clinicians’ time, it increased time spent documenting (Makoul, Curry, and Tang 2001). Many features common to electronic note writing, such as copy-and-paste, lead to deteriorating quality of clinical note, often containing uninformative repetitions, and outdated and erroneous information.

However, new advances in computing and information technologies open a broad range of opportunities to reinvent clinical documentation and breathe a new life into the process that is currently seen by many clinicians as a nuisance. For example, given growing body of research in ubiquitous and capture-and-access technologies (Hayes and Truong 2009), is it really necessary that clinicians keep a record of provided care, or is it possible to capture much of it automatically? Similarly, given the advances in Speech Recognition and Natural Language Processing, must clinicians use such relatively slow entry modes as typing, or can they rely on dictation and receive immediate feedback on the captured narrative? What interactive technologies and new human-computer interaction (HCI) techniques can help to maximize the potential of clinical notes to promote reasoning and decision-making? What lessons from social computing platforms promoting collective intelligence, such as Wikipedia, can be applied to clinical documentation to realize its potential as tool for supporting communication and collaboration? These are only a few of the questions that provide rich ground for exploration and for the development of new research agendas for present and future researchers.

The focus of this design challenge is on designing novel methods for capturing and accessing clinical data that facilitate and enhance clinical work. We invite graduate students from different scientific disciplines and of various backgrounds to re-invent electronic clinical documentation, broadly defined, and its role in medical practice. Specifically, we are looking for solutions that reduce documentation burden for clinicians, leverage strengths of human users and computing capabilities, support medical reasoning and decision-making, facilitate teamwork, capture clinical data in a way that enables secondary use of such data (for example for business and research purposes), and can be generalized to multiple settings and use cases. We seek novel solutions that incorporate cutting edge computational and interactive technologies and take advantage of the considerable advances in such research areas as biomedical informatics, human-computer interaction, computer science, information visualization, pervasive and ubiquitous computing, among many others. 

References

  1. Coiera, Enrico 2000 When Conversation Is Better Than Computation. Journal of the American Medical Informatics Association 7(3): 277 –286.
  2. Hayes, Gillian R., and Khai N. Truong 2009 Selective Archiving: A Model for Privacy Sensitive Capture and Access Technologies. In Protecting Privacy in Video Surveillance. Dr Andrew Senior, ed. Pp. 165–184. Springer London. http://link.springer.com/chapter/10.1007/978-1-84882-301-3_10, accessed April 15, 2013.
  3. Makoul, G, R H Curry, and P C Tang 2001 The Use of Electronic Medical Records: Communication Patterns in Outpatient Encounters. Journal of the American Medical Informatics Association: JAMIA 8(6): 610–615.
  4. Patel, Vimla L., Andre W. Kushniruk, Seungmi Yang, and Jean-Francois Yale 2000 Impact of a Computer-based Patient Record System on Data Collection, Knowledge Organization, and Reasoning 7(6): 569–585.
  5. Schiff, Gordon D, and David W Bates 2010 Can Electronic Clinical Documentation Help Prevent Diagnostic Errors? The New England Journal of Medicine 362(12): 1066–1069.

To participate in the challenge, we invite teams of students to submit their original design solutions for the next generation of clinical documentation. To qualify for participation, teams should include only students in degree-pursuing graduate programs (including post-doctoral fellows pursing MA or MS degrees). Given the nature of the creative process, we suggest that teams include no more than 4 or 5 individuals. No faculty advising is required for participation.

Each team will be asked to identify a specific challenge related to clinical documentation. We recommend that teams consider challenges that have significant impact on clinical processes. Some potential challenges related to data entry and presentation could include but are not limited to:

  • Reducing reliance on manual data entry;
  • Effectively capturing the interaction between the care provider and patient as part of the note;
  • Integrating the most useful data from the old notes into the new notes without the provider interaction;
  • Effectively capturing temporal evolution of the decisions and choices related to clinical care;
  • Allowing members of patient care teams collectively document their respective perceptions and care for the patient;

We envision a broad range of proposed designs including both interactive and computational solutions.

Competition Process

  1. Each team will submit an extended abstract (5 page maximum) discussing their description of the specific challenge related to electronic clinical documentation, the proposed solution, and their design process. Supplementary materials (including storyboards and mockups, or source code and sample output) can be submitted as PDF. The supplementary material would not count against the 5 page maximum. The submission process will be done through EasyChair (more details on the submission process are to follow). The submissions will be evaluated through a peer-review process by the SDC steering committee.
  2. The 8 best proposals will be asked to present their solutions during the AMIA poster session. At least one member from each of the 8 teams will be expected to attend the conference to present a poster illustrating their solution, discuss their solution, and the design process with conference attendees. AMIA will wave registration fee for one presenter from each of the eight teams, with the expectation that the presenter holds a student membership with either AMIA or ACM.
  3. 4 teams will also be notified prior to the conference that their proposal has been selected as a finalist for the AMIA SDC Award. They will be asked to give a presentation about their solution during the AMIA Student Design Challenge session. The 4 finalists will give an oral presentation and, where appropriate, demonstration of their design to the panel of SDC Judges and AMIA attendees. The judges will rank the solutions and presentations to identify the winner and subsequent 2nd and 3rd place teams. The winners will be announced during the last day of AMIA Annual Symposium and awarded cash prizes (the amount is to be determined).

Abstract Preparation

The participants will prepare an extended abstract (five pages maximum) written in the AMIA format that should include:

  • Definition of the selected challenge related to electronic clinical documentation grounded in deep understanding of related clinical processes
  • Description of the proposed solution
  • Discussion of alternative solutions considered
  • Discussion of the strengths and weakness of the chosen solution as compared to the alternatives
  • Proposed implementation and dissemination plan (what it would take for this solution to be adopted on a large scale)
  • Proposed evaluation plan (the participants will be expected to outline potential directions for evaluation, but not to perform it)

The Supplementary Materials should include:

  • For interactive solutions: a mockup or storyboard illustrating the proposed functionality and the interaction of the proposed solution, a link to a video demo of the system.
  • For computational solutions: source code of the solution as a text file or a link to the team’s github repository as well as sample output file (in a PDF document)

The completed abstract and any supplementary documents should be submitted using EasyChair by July 31, 2013.

Please create a new password and log-in to submit using Easy Chair for AMIA 2013

  • AMIA member log-in will not provide access to Easy Chair.
  • If you have used Easy Chair previously, you may use your prior log-in information or use Easy Chair password help.

Submission Link www.easychair.org/conferences/?conf=amia2013

Review Criteria

All proposed solutions will be reviewed by the SDC Steering Committee, consisting of distinguished members from the AMIA and HCI communities. The members of the Steering Committee will review the abstracts and assess their quality, focusing on both the actual proposed solution, and its description and justification in the proposal, based on the following criteria:

  • Understanding of the clinical process (does the solution address an important clinical problem in a realistic way and does it demonstrate a deep understanding of the clinical process)
  • Fit to the problem (how likely is the proposed solution to address the selected problem?)
  • Innovation (how novel and original is the solution?)
  • Transformative potential (how likely is it to transform the nature of clinical documentation?)
  • Completeness (is the solution is well thought-out and complete)
  • Clarity of the design process (how well the solution and the design process described in the abstract)
  • Clarity of the strengths and weaknesses discussion (do the teams have a realistic and thoughtful assessment of the strengths and weaknesses of their solutions?)
  • Appropriateness of the evaluation approach (is the evaluation plan appropriate for the solution?)

Awards

The SDC awards ceremony will take place during the last day of AMIA Annual Symposium. The winner, second and third place will receive plaques and cash prizes (amount to be determined).

Timeline

  • July 31 – proposal submission deadline
  • September 15 – notifications to authors
  • September 30 – camera-ready copy is submitted

Contact

If you have any questions about this process, please send an email to studentdesignchallenge@amia.org

Lena Mamykina, PhD, Assistant Professor
Department of Biomedical Informatics, Columbia University

Dr. Mamykina’s broad research interests include individual’s sensemaking and problem-solving in context of health management, collective sensemaking within online health support communities, clinical reasoning and decision-making, communication and coordination of work in clinical teams, and ways to support these practices with informatics interventions.

Dr. Mamykina received her B.S. in Computer Science from the Ukrainian State University of Maritime Technology, M.S. in Human Computer Interaction from the Georgia Institute of Technology, Ph.D. in Human-Centered Computing from the Georgia Institute of Technology, and M.A. in Biomedical Informatics from Columbia University. Her dissertation work at Georgia Tech focused on facilitating reflection and learning in context of diabetes management with mobile and ubiquitous computing. Prior to joining DBMI as a faculty member, she completed a National Library of Medicine Post-Doctoral Fellowship at the department.

Madhu Reddy, PhD, Associate Professor
College of Information Sciences and Technology (IST) Center for Integrated Healthcare Delivery Systems (CIHDS) Penn State University

Dr. Reddy’s research focuses on interested in understanding how people collaborate with each other during the course of their everyday work and how they can support this collaboration through the development of more effective information technologies. He is particularly interested in collaboration in the healthcare field. Consequently, much of his current research occurs at the intersections of CSCW and Medical Informatics with a focus on two major research topics: (1) collaborative information behavior and (2) collaboration and coordination issues in healthcare at the organizational and team levels.

Dr. Reddy received his Ph.D. from the Bren School of Information and Computer Science at the University of California, Irvine in what was then the Computing, Organizations, Policy, and Society (now known as Interactive and Collaborative Technologies) group.

Patricia Flatley Brennan, Ph.D, Moehlman Bascom Professor
Industrial and Systems Engineering, University of Wisconsin-Madison

Dr. Brennan's research focuses on designing and evaluating home care community computer systems for use by patients. Her work ranges from the development and evaluation of computer networks as a mechanism for delivering nursing care to homebound ill persons and their caregivers to assessing the impact of patient-centered computer technology on the health outcomes of persons following coronary artery bypass graft surgery. Her most current projects include exploring how individuals and families manage health information in their homes, studying the usability of secure email use in clinics, and is developing information tools and resources to support self-care and health self-management.

Paul Gorman, MD
Associate Professor,
Department of Biomedical Informatics, Oregon Health & Science University

Dr. Gorman's research is focused on the use of information by experts, mainly clinicians, in real-world problem-solving, mainly patient care. Most often, his work uses observational methods to study the activities of individuals and groups as they use information to perform real world tasks, e.g., information needs, seeking and use, naturalistic decision making, distributed cooperative problem solving, distributed cognition, and social informatics.

George Hripcsak, MD, MS, Chair, Department of Biomedical Informatics
Vivian Beaumont Allen Professor of Biomedical Informatics Director, Medical Informatics Services, NYP/Columbia

George Hripcsak, MD, MS, is Vivian Beaumont Allen Professor and Chair of Columbia University’s Department of Biomedical Informatics, Director of Medical Informatics Services forNewYork-Presbyterian Hospital, and Senior Informatics Advisor at the New York City Department of Health and Mental Hygiene. Dr. Hripcsak is a board-certified internist with degrees in chemistry, medicine, and biostatistics. He led the effort to create the Arden Syntax, a language for representing health knowledge that has become a national standard. Dr. Hripcsak’scurrent research focus is on the clinical information stored in electronic health records. Using data mining techniques such as machine learning and natural language processing, he is developing the methods necessary to support clinical research and patient safety initiatives.

Jonathan Nebeker, MD, MS
Associate Professor of Internal Medicine,
University of Utah, School of Medicine

Dr. Nebeker is currently interested in translating theoretical frameworks from social and cognitive psychology to medicine for designing and evaluating user interfaces for EHRs (with Charlene Weir and Frank Drews.) He led a project to translate the Contextual Control Model from a branch of Cognitive Systems Engineering. Guided by this translated model, his team developed a new paradigm for graphical user interfaces (GUIs) for EHRs. Instead of focusing on data, which is typical of current EHRs, the GUI focuses on thought- and workflow. The GUIs incorporate ideas from mindset, dual process, and communication theories. They featured information displays that are designed to reduce cognitive effort to understand what is going on with the patient. In a randomized controlled trial versus a widely used traditional interface, the new interfaces were significantly faster—despite minimal training in the unfamiliar interfaces.

Dr. Nebeker also has national leadership roles in VA. He is Director of VA Informatics and Computing Infrastructure (VINCI.) VINCI is a secure, powerful, virtualized computing environment with national clinical data back to 2000. In addition to directing the center, Dr. Nebeker leads GUI development for several applications. Dr. Nebeker is the Clinical Lead for the DoD-VA Integrated EHR Graphical User Interface. In this capacity he coordinates with national VA clinical leads and directs the vision for the new paradigm for the iEHR interfaces.

Wanda Pratt, Ph.D
Professor, Information School, Division of Biomedical & Health Informatics, University of Washington

Wanda Pratt is a Professor in both the Information School and the Division of Biomedical & Health Informatics in the Medical School at the University of Washington. She received her Ph.D. in Medical Informatics from Stanford University, her M.S. in Computer Science from the University of Texas, and her B.S. in Electrical and Computer Engineering from the University of Kansas. Her published papers span a wide range of topics whose central theme is to understand the problem of information overload in a variety of health contexts and to develop new types technology to address those problems. She received an NSF CAREER Award for her work on literature-based discovery systems.