Tutorial T1
The Practical Issues in Knowledge Engineering for the Electronic Medical Record—From Vocabulary Term to Encounter Form to Report
Content level: Basic.
The instructors will discuss the key concepts associated with practical knowledge engineering to capture the clinical encounter using the electronic medical record (EMR); demonstrate the steps in the process in designing, building, and using on-screen forms; and describe practical issues for a clinic or enterprise that decides to take advantage of emerging technologies to improve clinical efficiency and the quality of care.
After attending this tutorial, participants will be able to
- choose desired information to be extracted from an EMR system when in clinical use;
- describe vocabulary requirements and data entry methods appropriate for capturing and ultimately for retrieving selected information from an EMR system;
- judge the impact on clinical workflow support issues when designing forms for capturing the clinical encounter; and
- describe a process for designing, building, and testing forms for entering data to retrieve desired information from an EMR system.
Instructors: Blackford Middleton, M.D., M.P.H., M.Sc., FACP, Clinical Systems, MedicaLogic, Inc., Beaverton, and Fred E. ("Chip") Masarie, M.D., MedicaLogic, Inc., Portland, OR.
Who should attend: This tutorial is designed for physicians, nurses, clinic managers, and administrators involved in the selection, design, implementation, or use of EMR software and others interested in the practical issues faced when designing and using clinical documentation tools to support gathering, analyzing, and reporting on clinical information from an EMR system.
Concepts will be discussed in general terms and highlighted using existing commercial software. It is targeted at end-users who may be using any EMR software in practice or who are involved in knowledge engineering or an EMR.
Tutorial T2
Human Factors Engineering: The Usability Laboratory Methodology
Concept Level: Basic
Human factors analysis is rapidly becoming a standard mechanism for the evaluation of medical software, to facilitate rapid prototyping and software quality improvement. Nowhere is this more evident than with the creation of an electronic medical record (EMR) system. At the Mayo Clinic we have been making use of our usability laboratory for ongoing evaluation of our EMR components. In this tutorial, we propose to introduce participants to the underlying principles of human factors evaluations. We will
- extend this didactic to cover the methodology, design, and execution of usability laboratory experiments;
- posit that many studies are not appropriate for this type of evaluation and require other types of study designs to be effective learning environments;
- give examples of classes of experiments, which are well suited to a usability trial; and
- give examples of past usability trials executed at Mayo, examining their study designs, execution, and results;
These examples will form the basis for a simulated trial. Attendees will divide into two groups: one will design an experiment and the other will provide the participants. While the study is being designed, the participants will create a list of study goals for the designers of the usability experiment to meet. We will execute a simple study and then regroup and discuss the results, specifically addressing the goals developed by the participants. A handout on human factors analysis and usability trials will be distributed.
Participants in this tutorial will be able to
- demonstrate a basic understanding of the usability methodology;
- assess any previous usability experience; and
- describe the concepts related to laboratory design, usability study design, participant selection, study implementation, and study analysis.
Instructor: Peter L. Elkin, M.D., Heather Schwartz, and Brian Kaihoi, Mayo Foundation, Rochester, MN.
Who should attend: Physicians, nurses, clinic managers, administrators, information systems designers, implementation specialists, medical records specialists, or any other individual interested in the design, evaluation, or implementation of user interfaces (user centered design).
Tutorial 3
Computer-Based Support Systems for Patients in Crisis
Content Level: Basic
The instructor will discuss the theory and practice of developing patient-centered, computer-based information and support systems. Key concepts will include the theoretical basis for multiservice systems to effectively meet the needs of patients with various learning and coping styles and in different stages of dealing with their crisis; how to conduct patient needs assessment and its importance in designing system content; how to design services to meet the needs identified; and the impact such support systems can have on patient outcomes. After attending this tutorial, participants will be able to
- describe the theoretical basis for patient-centered information and support systems;
- describe the costs and benefits of developing and implementing such systems;
- begin design work on patient support systems in topics of interest; and
- advocate for more widespread use of patient-centered information and support systems.
Who should attend: This tutorial is designed for health educators and informatics developers interested in designing and implementing computer-based patient support systems; physicians, nurses, and other health care providers interested in how such support systems can benefit their patients; and health care administrators interested in how such support systems can impact quality of care and health care costs.
Concepts will be discussed in general terms and demonstrated using the Comprehensive Health Enhancement Support System (CHESS), which has been developed and evaluated by the instructor and his colleagues at the University of Wisconsin.
Tutorial 4
New Communication Technologies for Web-Based Health Information Systems
Content Level: 30% basic, 60% intermediate, 10% advanced.
The introduction of clinical workstations supporting multimedia threatens to make traditional computer networks (e.g., shared Ethernet or Token Ring) obsolete. They are insufficient to cope with the demands for increased bandwidth and short delay times as required for interactive communication services. New fast packet and cell-switching technologies promise to provide solutions. In a local area networking environment where fiber-optic communication lines are available, switched Ethernet (Fast- and Gigabit-Ethernets) and the Asynchronous Transfer Mode (ATM) form the basis for the next-generation, networking backbone of an institution.
Health care services in vertically integrated health care organizations require that the boundaries of the local area network be extended to include other hospitals, physician office practices, and homes of physicians and patients. The instructor will explore wide area networking technologies that offer new solutions, including the narrow-band Integrated Services Digital Network (ISDN), Asymmetric Digital Subscriber Line (ADSL), and ATM technologies. He will also address the best solutions for home-based users, comparing the benefits of using either ISDN or ADSL, and provide an overview of Web-based streaming protocols to support mutimedia broadcasts and digital video streaming services.
Participants in this tutorial will be able to
- demonstrate understanding of a broad technical overview of emerging communication technologies such as ATM, ISDN, and ADSL for local and wide area networking, and
- explain how these technologies are important for the next generation of distributed health information systems that link remote health care facilities and residential homes with tertiary health care centers.
Instructor: Helmuth F. Orthner, Ph.D., University of Utah School of Medicine, Salt Lake City, UT.
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