• AMIA 2011 Annual Symposium October 22-26, 2011

    Improving Health: Informatics and IT Changing the World


The following Workshop options are included in your Symposium registration.

Saturday, October 22 5:00 - 7:30 pm

Workshop 1: Just a Spoonful of Sugar: Improving Technology Change Success in Healthcare IT

B. Magda, V. Grady, George Washington University

In 2004, the White House mandated that medical facilities implement technology required to maintain electronic patient health information by 2014. The unique dynamics of the healthcare environment will challenge the timeline of the federal mandate. Magda (2009) notes that it is not only those implementing the new information systems that need to be technologically proficient, but it also will be crucial for employees maintaining health records to understand the comprehensive long-term objectives. In addition to the aforementioned technical challenges, many employees within these organizations will be confronted with organizational culture shifts in daily process and data flow within their respective organizations. With organizational change, failure rates approach 70% (Standish, 2009). It is critical, therefore, for the healthcare environment to embrace technology transformations, while maintaining a tight critical path to maximize potential for successful technology transition. This workshop will introduce the LOE Index (Grady, 2005), a quantitative diagnostic tool that identifies organizational symptoms typically experienced during a technology change, that unrecognized, can lead to an Organizational loss of effectiveness (LOE). Subsequently, utilizing the unique results of the LOE Index, the participants will be introduced to a qualitative process that creates a customized formula of leadership, communication, end-user involvement, and education.

Workshop 2: The Five-minute Hour: Online Clinical Interactions in the Era of Social Media

J. Reider, Twistle, Inc; M. Stuart, RWJ School of Medicine; H. Rippen, Westat; T. Agresta, University of Connecticut; H. Chueh, Massachusetts General Hospital; M. Weiner, University of Pennsylvania; S. Morgan, Partners HealthCare

Since the publication of the AMIA Guidelines for Clinical Use of Electronic Mail with Patients in 1998, e-mail has given way to Facebook, Twitter, and Skype, yet patients and clinicians remain separated by a chasm of legacy technology and clinician fears of an avalanche of uncompensated work. How can the clinical team provide true connected patient-centered care, while keeping their heads above water? The same tools that helped a generation of primary-care physicians to compress a therapeutic hour into fifteen minutes can now provide a virtual compression of time, space, and presence. The BATHE framework helps physicians achieve shared understanding, ownership, and direction in their relationships with patients. This model can guide online clinical interactions to become fluid, ongoing relationships - rather than a barrage of "extra work" for the harried clinician. The workshop will present a White Paper and a tool set. We will review the rationale for enhanced connectivity and collaboration among providers and patients, and introduce tangible processes that will enable participants to turn online interactions into a delightful component of the modern care-delivery environment.

Workshop 3: Security and Privacy

M. Gaynor, Saint Louis University

As we move from paper to Electronic Medical Records (EMRs), the technology of security and privacy has morphed from mostly physical to mostly electronic. Managers and practitioners must understand emerging security and privacy technologies to protect patient data and comply with federal regulations, such as HIPAA. Medical professionals, administrators of healthcarerelated organizations, lawyers, and policy- makers require updated skills to protect patient privacy. Health care managers who have a basic understanding of privacy and security of health care information are vital to the success of EMRs. Without understanding how to protect and ensure accurate medical information, the public will not have confidence to allow their medical information to benefit public health.

This workshop will consist of a simulation-based role-playing game allowing workshop participants to engage in the conceptual aspects of protecting EMRs. This hands-on approach provides workshop attendees with: an understanding of security; the ability to manage security and privacy infrastructure; an understanding of the basic concepts of privacy; an understanding of the unique aspects of privacy and security and its management in the health care industry; and an understanding of how to comply with HIPAA security and privacy regulations.

Workshop 4: i2b2/VA/Cincinnati Workshop on Natural Language Processing

O. Uzuner, University at Albany, SUNY; J. Pestian, University of Cincinnati; B. South, VA Salt Lake City Health Care

In 2011, i2b2 and the VA teamed with Cincinnati Children’s Hospital Medical Center, University of Cincinnati in organizing a two-track challenge on natural language processing. The i2b2/VA track of the challenge is focused on co-reference resolution on clinical records; the Cincinnati track is on data mining of emotions found in suicide notes. Both tracks are supported by annotated data that is provided by the organizers. This workshop will present the two tracks of the 2011 challenge, the results and evaluation of the systems developed for these challenges, and the state of the art in objective and subjective natural language processing.

Workshop 5: An Introduction to Agent Based Modeling (ABM) for the Health Sciences

J. Schindler, Northrop Grumman Corporation; J. Holmes, University of Pennsylvania

This workshop will provide attendees with an overview of the modeling process and the application of agentbased modeling (ABM) to the health sciences. We will: compare and contrast deterministic and ABM generative modeling approaches, examining how each can provide benefit to the modeler or researcher; provide an overview of the ABM model development process, looking at model concept development, model construction, model testing, and model dissemination; explore a sample of health science and public health models that have been developed using an ABM approach; give attendees who bring laptops (Windows or MacOSX) an opportunity to install and practice using a well-known ABM software tool, NetLogo; share a variety of online resources (tutorials, software tools, papers, journals, rofessional organizations) that can assist independent learners in developing their modeling skills.

Workshop 6: Electronic Health Record Facilitated Performance Measurement/Reporting

A. Jain, S. Hayden, Cleveland Clinic

Performance measurement and subsequent reporting of outcomes is critical in the current healthcare climate and a central focus of the EHR-incentive programs from CMS. The EHR and EHR-derived data are essential for efficient measurement and reporting of patient-specific process and outcomes measures. Governance issues, workflow consistency and technical challenges remain obstacles for institutions that have implemented an EHR for clinical purposes and that are now challenged with supporting local, regional and national quality initiatives. We illustrate the use of a multidisciplinary group at our institution to leverage our EHR-based clinical data repository for rapidly collecting, aggregating and validating patient-specific performance measures and outcomes.

We will use local, regional and national reporting obligations, such as our Aligning Forces for Quality community, and the “meaningful use” EHR-incentive program to demonstrate our process. Finally, we will focus on overcoming governance and clinical workflow challenges, extending investments already made in the health IT infrastructure and developing a team to manage the complexity of secondary use of EHR data to measure quality.

Workshop 7: Standards in Clinical Decision Support: Activities in Health Level Seven and Beyond

R. Jenders, National Institutes of Health; R. Jenders, Georgetown University; G. Del Fiol, University of Utah; K. Kawamoto, Duke University

Health Level Seven (HL7) is the principal international HIT standards development organization (SDO). Prominent among its suite of standards are formalisms related to clinical decision support (CDS), including the Arden Syntax, GELLO, Infobutton, and Decision Support Service (DSS) standards. Continuing improvement of these standards and ongoing development of future decision-support standards require wide participation in order to maximize their success. Accordingly, the purpose of the workshop is twofold. First, the instructors will convey the latest developments regarding existing CDS standards and related efforts to develop new standards. Second, the instructors will solicit feedback so that attendees who do not participate in HL7 can have input into the standards activities of that organization while placing them in the context of other SDOs and harmonization efforts. The instructors of this workshop, who are co-chairs of the CDS Work Group of HL7, will review progress in these areas. They will present details of ongoing development of the extant HL7 standards and planned future ones, including an Order Set and Virtual Medical Record (vMR) standard. Finally, they will solicit discussion regarding the future direction of standards development in these areas.

Workshop 8: Should AMIA Revise Its Code of Ethics?

R. Hsiung, dr-bob.org

The AMIA Board of Directors approved a Code of Ethics in 2007. As its authors stated when it was published, “the code ... is a dynamic document. It will evolve as the field itself evolves.” In 2011, the AMIA Board approved a Conflict of Interest Policy. It is now considering revisions or updates to the Code of Ethics. The Conflict of Interest Policy will be enforced. One issue to consider is whether the Code of Ethics should also be enforced. The authors of the Code also stated, “adoption of a code of ethical conduct naturally raises the questions of compliance. What are the consequences of violating the code? How is the code enforced? The authors have suggested to the AMIA Board that these are issues best decided by the AMIA membership itself. In future forums, AMIA will initiate a dialog with its membership to seek consensus on this important topic.” This workshop is such a forum. Hypothetical scenarios involving possibly unethical conduct, including conflicts of interest, are discussed. Half of the time is reserved for dialog. The session concludes with an informal vote to assess progress toward consensus and to provide feedback to the AMIA Ethics Committee and Board of Directors.