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Identifying the Issues and Mitigating the Impact
While unintended consequences (UCs) of electronic health records have been studied at depth, because health information exchange (HIE) is at its nascent phase, little has been done to consider the potential impact of UCs emerging from HIE. HIE is a critical component of meaningful use and yet many early forms of health information exchange have been less than fully successful, due not only to foreseeable challenges but also to unintended consequences. In an attempt to address the issues and potential solutions to mitigate them, the Office of the National Coordinator sponsored a Workgroup of HIE experts to develop a framework that can foster more effective HIE implementation while lessening risk and uncertainty.
This panel presents the findings of the Workgroup, a framework developed for future research, and the central role of key stakeholders from both the public and private sectors. This work is the first step in attempting to identify and categorize HIE UCs and their root causes, determine potential solutions applicable to the three stages of HIE implementation, and suggest an HIE research agenda that fosters new knowledge and the creation of utilities to ensure the vision of the National Health Information Network through Nationwide Health Information Exchanges.
Clinical decision support (CDS) is a tool for improving patient care. There are several efforts focused on implementing CDS more efficiently, with exciting progress being made in each. However, these efforts may appear to occur in parallel with no clear unified vision on how they should relate. Here, we present the leaders of three major CDS initiatives who will briefly discuss their individual project’s efforts and propose a unified vision for how these various initiatives can work together. Each project may be viewed as playing an essential role in delivering CDS, but each is insufficient by itself to address the challenge completely. We will identify the unique attributes of each project that contribute to a comprehensive framework for CDS technologies, and present a vision of the various components working synergistically in a comprehensive framework to support CDS implementation and effective use at scale. We suggest a unified framework for CDS will create a mechanism wherein multiple public and private sector organizations can innovate within the framework, and promote adoption and effective use of health information technology (HIT) with CDS. Because of its large involvement in the HIT market and product development, we include a perspective representing the US Federal Government.
In 1991, the Institute of Medicine produced its first internally generated policy report entitled, The Computer-based Patient Record: An Essential Technology for Health Care. Chaired by Don Detmer and staffed by Richard Dick and Elaine Steen, the report galvanized action in the informatics community both in the production of the study and following its release. The study created a vision for the future in electronic health record functional capabilities and it reviewed the status of users and uses, technology, and engaging the nation to implement EHRs on a widespread basis. Adele Waller, a Chicago-based attorney, crafted a chapter on Privacy and Security issues. Twenty-one years later, it seems timely for a panel of those involved in the original study to offer their reflections on how well the report has weathered in terms of vision and accomplishments to date. Learners should gain an understanding of the report and how EHRs and related policy making evolved through people directly engaged in the experience.
This panel will review the findings and recommendations of the 1991 Institute of Medicine report, The Computer-based Patient Record: An Essential Technology for Health Care from the context of the twenty-first year since its release. The moderator will set the stage for the panel by reviewing the report’s origins history. Panelists are individuals who held leadership roles in the study and each will reflect on the major dimensions engaged by the study and offer reflections on the current status of each domain. DonaldBerwick, Users and Uses Subcommittee chair (invited), or Paul Tang, assistant chair of the Implementation Subcommittee, will comment on current users and uses of electronic health records (EHRs); Dr. Morris Collen, Technology Subcommittee chair will offer comments that will be presented by Dr. Marion Ball, assistant chair of the Technology Subcommittee who will also offer her own reflections on technology, and Dr. Ted Shortliffe, CPR Implementation Subcommittee chair will reflection on implementation efforts. Ms. Adele Waller, a lawyer who crafted the chapter on Legal Issues will discuss this aspect since 1991.
To succeed, health reform and accountable care must be underpinned by nimble and flexible information systems that evolve rapidly and can be readily modified and extended. The Substitutable Medical Applications, Reusable Technologies (SMART) Platforms project (www.smartplatforms.org) seeks to develop an iPhone-like health information technology platform with substitutable apps constructed around core services. It is funded by a grant from Office of the National Coordinator of Health Information Technology’s Strategic Health IT Advanced Research Projects (SHARP) Program. SMART technologies enable existing electronic health records, personal health records, and health information exchanges to run substitutable apps. Substitutability is the capability inherent in a system of replacing one application with another of similar functionality. We bring together innovators from three academic health systems, a health information exchange, and an apps vendor to discuss experience thus far with the SMART ecosystem across four axes, and to lead a discussion with audience members: (1) The philosophy of substitutable applications; (2) Approaches to SMART-enabling existing platforms; (3) Building an ecosystem of smart apps; (4) A national-scale vision for SMART.
As biomedical research becomes increasingly complex, incentives and governance issues around data sharing become increasingly important. Though data sharing facilitates scientific advancement, researchers may also see data sharing as a threat to their careers or their original work. In addition, technologies that ease data transfer also heighten the concern of a multitude of stakeholders, especially “data owners”, who have an invested interest in data stewardship and the information that is generated from their data. Developing the right kinds of incentives and infrastructure to promote data sharing is important for the informatics community, and this panel will address issues involved in these processes from several viewpoints. Learning objectives for this panel include:
- Understand data governance issues in multi-stakeholder collaborations
- Identify strategies for developing effective incentives to reduce the obstacles to data sharing
- Understand the perspective on data sharing from national level programs such as the CTSAs and the NIH
Increasingly, modern US healthcare is being delivered with health information technology(IT). When properly designed, implemented, and used, health information technology can improve patient safety, care quality, and costs. With increased adoption of health IT, however, concerns arise with the associated occurrences of unintended consequences, or untoward outcomes such as medical errors and adverse events. Recent evidence suggests that some of these adverse events and unintended consequences may be due to highly variable design of health information technologies, or even poor design resulting in an unintuitive, or confusing, human computer interaction. The AMIA Usability Task Force developed consensus recommendations that address this issue, and suggest a way forward to improve the usability and effective use of health IT, and the quality and safety of patient care. These recommendations focus on best practices for usability and human factors considerations in the design and implementation of health information technology. The AMIA Usability Task Force recommendations (as ratified by the AMIA Board of Directors) will be presented along with both academic and industry perspectives. Ample time will be provided for panel discussion and audience questions and answers.
Human services address needs through public assistance programs, where “need” goes beyond health concerns, to include school, housing, food, abuse, foster care, employment, heat, electricity, and legal advice. The need to integrate data across many programs in order to serve clients better is as great, if not greater, than that in clinical care. There have been several exemplary models of such interoperability at all levels of government. At the federal level, MITA has provided Medicaid systems across the country a common architecture. At the State level, Virginia has pioneered the Commonwealth of Virginia-Health Information Exchange. At the County level, San Diego has pursued a comprehensive model to link all health and human services. And social venture organizations, such as Stewards of Change, have aimed to raise interoperability as an enabler for better systems functioning.
This panel comprises national leaders from each level—the architect of MITA, the Secretary of Health and Human Resources of the Commonwealth of Virginia, Director and Deputy Chief Administrative Officer, Health and Human Services Agency County of San Diego, and the co-founder and Managing Partner of Stewards of Change, and hopes to share their needs and experiences, to address the following questions: What can the medical/health communities learn from these efforts? What should the human-services community learn from medical and health efforts? An exemplar human services case will run through the presentation to show the impact of the initiatives.
Consumer use of mobile health (mHealth) tools and social media such as Facebook and Twitter are increasing. Such applications offer ever-greater opportunities to share and commercialize personal information, including health information. However, studies of user behavior suggest that many people don't understand how personal data, including personal health information, are stored, shared, and used by application developers and third-party vendors. Terms of service agreements, a common means by which consumers are informed of how their information will be used, typically provide much verbiage but little meaning for many users.
This panel will 1) identify privacy and security issues affecting users of health-related social media and mHealth applications; 2) review legal statutes and regulations relevant to the practice of mHealth development and social media use; and 3) discuss approaches (e.g., the Erasmus University icon) that help users understand how their information will be used so they can make informed choices about social media and mHealth use.
In its 2011 report the Institute of Medicine (IOM) recommended that the Food and Drug Administration immediately develop a framework for regulating health information technology (HIT), including standards for software manufacture, and a new federal entity to monitor, investigate and report patient harms. In other countries the safety of HIT is being addressed as part of large national programs including the English National Health Service (NHS) Connecting for Health (CfH) program and the American Reinvestment and Recovery Act (ARRA) program for meaningful use of electronic health records (EHRs). In Australia, a shared EHR will be deployed nationally in 2012. In this panel, national and international experts will provide a review of current national initiatives to address HIT safety in England, Denmark, the EU, the USA, Canada and Australia with specific focus on the CfH safety management program, the revised European Union medical device directive and North American initiatives.
The AMIA Student Working Group (ST-WG) proposes a panel of informatics professionals that will provide insights and perspectives on career development and career outlook for future informaticians in the post-HITECH era. With the growing and more competitive job market, a “Career Panel” will be valuable to new professionals needing guidance on career development and job opportunities. This year’s panel will feature panelists who are informatics professionals from different stages in their career, from a student to an informatics fellow, an early-career informatician, and an established informatics professional. This theme will provide differing but complementary views about career development and job outlook for post-HITECH graduates, which would prepare them toward their successful and exciting career paths in informatics.
Luke Rasmussen, Northwestern University; Brian Athey, University of Michigan Medical School and Michigan Institute for Clinical and Health Research (MICHR); Andrew Boyd, University of Illinois at Chicago; Bradley Malin, Vanderbilt University; Shawn Murphy, Partners Healthcare System
The use of an “honest broker” as an impartial mediator between the clinical and research domains is a commonplace practice when working to secure patient data. Honest brokers not only guard the link between clinical and research identifiers, but oftentimes act as a reviewer to ensure potentially identifiable information is not being released. As more sophisticated demonstrations of the re-identification of patients appear in the literature, the question of the honest broker’s role in the realm of data security comes into question
This panel will identify real-world implementations of honest broker systems, describe institutional and policy challenges during the planning and implementation, assess potential weaknesses within honest broker offerings, and provide insight on how the future of the honest broker must be coupled with institutional trust and policy.
The panel participants bring experience from four organizations with a mixture of systems and approaches to health care information technology. Each participant has expertise in health services research. Each organization has met the stage 1 certification requirements and is attesting to meaningful use. The participants will look back on their organization’s experience with meaningful use and describe the impact of the certification requirements and incentives on their organization. They will identify a significant win or set-back resulting from their organization’s response to meaningful use. They will describe what their organization did to achieve the win, or in hind sight what their organization might have done to avoid the set back. The moderator will collate the strategies for success into a collective list for refinement and expansion through discussion among the participants and the audience.
Insufficient access to information during patient transfers between acute and post-acute care settings contributes to high 30-day hospital readmission rates that in turn risk patient safety and add significant health care costs. Health information technology that leverages health information exchange holds promise in improving patient transfers by making available critical patient data to clinicians at the point of care. This multi-disciplinary panel will review the experience of a health information exchange (HIE) organization in its efforts to develop an electronic patient transfer form to improve the safety and cost-effectiveness of patient transfers. Their experiences demonstrate how stakeholders may succeed in developing and piloting an electronic transfer form that relies on HIE to aggregate, communicate, and display relevant patient transfer data across health care organizations. Their experiences also provide policy insights for promoting HIE applications to improve patient transfers between acute and post-acute care settings.
Multimorbid patients—patients with co-occurring multiple chronic conditions—account for a disproportionate share of health care utilization and spending. Clinical decision-making can be extremely complicated for these patients because their medical conditions often interact in intricate ways. For example, the presence of one condition may alter optimal management strategies for another condition (as occurs with hypertension care in a patient with diabetes) or the presence of two conditions may result in simultaneous indications and contraindications for a specific medication (as occurs when a patient has cardiovascular disease and comorbid asthma).
Clinical Decision Support systems and other informatics tools offer opportunities to help health care providers navigate these complex clinical cases.
This panel will discuss opportunities to address multimorbidity management challenges using novel health informatics tools. Panelists represent diverse perspectives, including primary care, geriatrics, biomedical informatics, health services research, and health systems management. Their presentations will include overviews of several tools that are being developed, implemented, and/or evaluated at Stanford University and within the Veterans Affairs system and Partners HealthCare System (PHS). These tools synthesize patient information and clinical guidelines related to multiple conditions, and enable health care providers to develop personalized, evidence-based treatment plans.
A variety of approaches to simulation have been applied in health informatics. These range from human-in-the-loop clinical simulations (involving study of health professionals interacting with health information systems) to “in-the-box” simulations involving computer and mathematical modeling. The authors describe their work integrating multiple forms of simulation, allowing results of clinical simulations to inform the design of mathematical models and computer-based simulations. Application of the approaches described have included identification and prevention of usability issues as well as technology-induced error resulting from introduction of healthcare IT. In addition, data from multiple qualitative and quantitative data sources have been used by the authors to base models of accidents and safety and injury. Implications of applying the approaches for evaluating and improving healthcare and system safety will be explored. The learning objectives of the panel are the following: (a) to introduce attendees to application of simulation approaches that can be used to improve safety (b) to provide examples of how work in human-in-the-loop simulations can be used to inform and drive computer-based simulations (c) to illustrate how both qualitative and quantitative data from empirical studies can be used to support reasoning and decision making about safety issues using computer simulations.
With the expanding use of electronic medical record (EMR) systems, there has emerged a concomitant risk of unintended consequences. These negative unintended consequences pose new risks to patient safety and are increasingly documented in the literature, as are frameworks for understanding them. The use of EMRs in the care of children potentially presents a new array of unintended consequences as a result of inadequate modifications to or inappropriate application of systems designed for adult care. This is because of specific differences in the clinical care of children relating to the age, developmental status, size, ability to communicate or other characteristics. This panel will present one of several organizing frameworks that have been proposed for characterizing unintended consequences and will also describe special requirements for EMRs used in the care of children. The panel members will discuss suitability of the existing framework for special problems in light of these unique requirements. Panel members will consider documented anecdotes of unintended consequences observed in pediatric settings, as well as hypothetical consequences and strategies for addressing them.
The potential utility of patient-reported data, commonly referred to as PROs, has been increasingly recognized for use in clinical management, research, and evaluating outcomes of care. Technological advances have made it easier to collect PRO in clinical care. This panel offers a thought-provoking discussion of the opportunities and challenges to the systematic collection of PROs in clinical practice, along with insights on how to overcome barriers.
The volume of healthcare data continues to grow at an enormous pace. Many organizations such as healthcare providers, governments and businesses are making use of this data to improve the health of their patients, citizens and customers. The ability to use this data for these varied activities is predicated upon anonymized patient level data being available for secondary uses – either for a fee or free. Between 2006-8 AMIA led an effort in the U.S. to set up a framework for data stewardship that defined how different US stakeholders would steward that data in a responsible and professional fashion. Europe, being a collection of countries, has policies and laws at the country level which are currently set up with conflicting rules, policies and regulations around responsible use of healthcare data for secondary uses. In May 2012, International Medical Informatics Association (IMIA) convened key stakeholders (government leaders, academics and commercial entities) to explore a pan-European framework to build consensus on the reuse of health data for public health, patient, and commercial benefit across the EU, to inform relevant policies, and to align with international initiatives. This panel will discuss the various points of view European framework for health data Stewardship and the outcomes from the Brussels meeting.
Effective communication amongst the interdisciplinary care team is critical for patient-centered care. Well-designed information and communication strategies have the potential to improve patient safety, maximize efficiency, and promote quality of care; however, challenges to using information technology to facilitate communication across disciplines persist. There has been an explosion in the uptake of IT-based communication tools in recent years, in part catalyzed by the surge in use of new generation mobile devices. Tools such as email, chat/SMS, video, and microblogs, and web-based “apps” are readily available and increasingly used by healthcare providers. However, providers use these tools without guidelines or consensus with regard to best practices and it is often unclear if these tools are optimally used to communicate effectively in the inpatient, care transitions, and ambulatory settings. Failure to communicate effectively in these settings can result in unsafe situations by facilitating both errors of omission and errors of commission.
Coeira’s model, the Communication Information Continuum, provides an overarching strategy for designing tools to facilitate communication and information transfer at specific stages of individual and shared understanding. This panel will address issues related to interdisciplinary communication and discuss the use of IT-based communication and information tools to promote safe, efficient, and effective care. Using Coiera’s Communication-Information Continuum to frame the problem, the four presentations will discuss a range of issues related to interdisciplinary communication and strategies to improve communication through innovative use of technology.
Electronic Health Record (EHR) systems capture and store unprecedented amounts of patient care information and ultimately should allow various stakeholders to access data by queries. This panel will discuss and critique an interdisciplinary initiative in which 1,593 End-of-Life episodes of care extracted from a larger database of care plan data (n=42,403) are being analyzed, mined, and findings converted to point of care decision support. The data were gathered on 9 medical-surgical units (4 unique hospitals) with an innovative web-based electronic care planning system that represented diagnoses, outcomes, and interventions with standardized terminologies. Since the plans of care were updated at every formal handoff, the standardized interoperable data provides information useful for identifying best care practices based on actual interventions and subsequent patient outcomes as well as best nurse staffing patterns that were associated with desired patient outcomes. The findings are being translated into meaningful visualizations of decision support information useful to front line clinicians and administrators. The project, Describing, Contrasting, and Visualizing EOL Care in the 21st Century, is funded by NIH R01 NR012949.
The United States federal government strategy for promoting nationwide adoption of electronic health record (EHR) systems is based on general regulations that apply to providers across all medical domains. However, specialty domains have unique features that affect workflow and data management, and that therefore affect the optimal design, implementation, and use of EHRs. Implementation by individual specialists, and large-scale deployment of interoperable systems within specialties, requires that these unique features be addressed for each domain. This Panel will include talks by clinical informatics specialists with backgrounds in specialty practice, primary care medicine, health care administration, and policy-making. The Panel will provide a forum, where speakers and audience members can discuss these challenges, along with potential solutions. In the long-term, awareness of these issues will facilitate higher-quality care using EHRs, improve system design, and promote the development of future federal EHR implementation guidelines that support the most meaningful use of technology. A goal of this Panel is to facilitate better communication among clinicians, IT specialists, and policy-makers about better approaches for using legislation to support large-scale EHR adoption to meet the needs of both primary care and specialty practices.
Consumer e-health initiatives aim to produce more effective self-care actions, better health care processes, enhanced communications, better health outcomes, and decreased costs. As with any intervention, it is important to foresee and prevent potential adverse effects.
In a project for the National Coordinator of HIT, the panelists were part of a Work Group charged to predict potential adverse unintended consequences of consumer e-health and to identify strategies to avert or mitigate them.
AMIAs Task Force on Usability has studied EMRs to determine how we can improve the usability of EMRs. This session tells the story of another industry’s experience improving usability: aircraft cockpit design. Air travel is safer than ever despite dramatic rise in passenger miles. At the same time, the number of cockpit crew has declined even as aircraft complexity has risen. The most important lesson from commercial aviation is the way a culture of quality and safety has guided remarkably successful innovations of interactive computing in flight decks. From the top of the organization to the bottom, people at aircraft manufacturers and their customer airlines are continually aware that lives depend on their work. It may be that the most important usability issue for the EHR industry is that a similar culture of quality and safety is still evolving for information systems that support clinical health care and safety-critical decisions.
This session will include a video describing contributions by aviation corporate leaders, human factors experts, pilots, engineers and others over decades that has resulted in the state today: safer flights for more people. Following the video a panel will discuss how this story might provide lessons for improving EMR usability.
It has been realized that adoption and meaningful use of electronic medical records (EMR) can help clinicians diagnose and treat patients and researchers conduct clinical trials of new diagnostic methods and treatments. However, to improve the quality of but yet reduce the total cost of care, financial incentives must also be in place, such as payment mechanisms that reward health care providers for more cost-effective care.
To achieve that, evidence of clinical effectiveness alone based on EMR data is not enough. Financial cost data, typically from administrative or insurance claims data, must be linked to clinical outcomes to enable health economics and outcome research, as well as outcome-based payment mechanisms (e.g. episode-based bundles). On the other hand, payment mechanisms relying solely on administrative or claims data may not be truly outcome-based or risk adjusted. The clinical information in EMR offers insight about the true course of treatment and outlines the patient-level unique risk factors and co-morbidities that must be considered when developing episode-based payment. Therefore, integration of EMR and claims data is necessary for health economics and outcome research, as well as outcome-based payment.
The panel aims to: 1) increase awareness of the need to integrate clinical and financial data for improving healthcare quality and reducing cost, 2) learn from different integration efforts for outcome research and outcome-based payment, and 3) promote more cross-industry collaboration between the AMIA community and healthcare payer industry.
Directions for Knowledge Building and Practice Improvement
The U.S. health care system is better poised than ever before for significant improvements in quality, access and cost management. Recent Federal initiatives have incented the adoption and meaningful use of health IT, concurrent with escalating innovations in delivery and payment models., The Agency for Healthcare Research and Quality (AHRQ) addresses the Nation’s need for sound evidence to inform and guide health IT policymaking, adoption, and integration into practice through a variety of mechanisms including grants, program announcements and notices of special emphasis.
The AHRQ Health IT Portfolio has produced preeminent evidence about what works and what does not, and will continue to provide field-leading opportunities to discover new evidence, advance the state of the science of health informatics and guide its application to practice. AHRQ’s Director, Health IT Portfolio Director, and lead health IT staff will discuss how current National priorities and evidence needs translate into research funding opportunities. Through a discussion, moderated by a former member of AHRQ’s National Advisory Council and leader in the field of informatics, AMIA researchers, health IT developers, and practitioners will help set the stage for the next round of investments.
Computerized provider documentation (CPD) is rapidly replacing handwritten and transcribed clinical documentation as electronic health record (EHR) implementation rates increase across the US. Recent research has revealed important lessons about the implications of CPD usage on healthcare quality and practice. This panel will explore such lessons and implications that should be considered by those involved in implementing and optimizing EHR and CPD systems. It should also relevant to those who mean to leverage clinical documentation for various healthcare and research purposes, particularly in light of evolving “Meaningful Use” requirements. Panelists include participants who have been at the forefront of studying CPD and its implications.
The panelists will provide an overview of a unique project underway at Indiana University, that will have an impact on the Indiana Network for Patient Care (INPC). The project has several aims: firstly, surface “deep” content from EMRs and other clinical systems as individual data elements and associated metadata, normalize the EHR data to facilitate sharing, and expose the normalized data for search. Secondly, create an ethics framework that encourages patient autonomy, privacy, and trust, while optimizing medical care of the individual and the public, and create a usable, browser based user interface that will allow patients to specify sharing and privacy preferences. And lastly, demonstrate the utility of our data element based approach by creating a sophisticated web based search and parallel filtering user interface for providers that incorporates patient preferences and is supported by the ethics framework.
The learning objectives for this panel are:
- Demonstrate the value and relevance of ethical analysis of at least one aspect of HIEs;
- Demonstrate the value and relevance of human factors approaches to the design of user interfaces with HIEs and EHRs; and
- Demonstrate the value and utility of the clinical chart search capability.
With the proliferation of medical information technology, users at all levels of the healthcare system have access to more data than ever before. This data can be of tremendous value but is often difficult to access and interpret. For example clinicians are often faced with the challenging task of analyzing large amounts of unstructured, multi-modal, and longitudinal data to effectively diagnose and monitor the progression of a patient’s disease. Similarly, patients are confronted with the difficult task of understanding the trends and correlations within data related to their own health. At the institutional level, healthcare organizations are faced with the desire to use data to improve overall operational efficiency and performance, while continuing to maintain the quality of patient care and safety.
Recent advances in visualization and visual analytics have the potential to help each of the user groups listed above do more with the often overwhelming amount of data available to them. However, to be successful, visualization designers and clinicians must work together closely to ensure that the right technologies are used to help address the meaningful problems. Unfortunately, despite the continuous use of scientific visualization and visual analytics in medical applications, the lack of communication between engineers and physicians has meant that only basic visualization and analytics techniques are currently employed in clinical practice. The goal of this panel is to present state-of-the-art visualization applications for healthcare and engage the leading physicians and clinical researchers at AMIA to discuss the areas in healthcare where additional visualization techniques are most needed.
The Strategic Health IT Advanced Research Projects (SHARP) grants were created by the Office of the National Coordinator for Health Information Technology (ONC) to address well-documented problems that impede the adoption of Health IT. The Pan-SHARP project is an initiative of the SHARP awardees to apply their technological innovations to real-world problems.
The focus of the Pan-SHARP project is medication reconciliation (“Med-Rec”). Med-Rec aims to prevent Adverse Drug Events (ADEs) and improper medication administration, a challenge faced by nearly all healthcare providers. Med-Rec requires the construction, review, and careful curation of a patient’s medication lists. Today, when this activity is performed, it consumes large amounts of clinician time. Nurses, physicians, and pharmacists require between 5 and 20 minutes to perform a single reconciliation. If medication reconciliation should be performed at each transition in care, there will be a dramatic, and probably unacceptable, decrease in healthcare productivity with current solutions. The Pan-SHARP effort uses state-of-the-art technology to address these challenges.
In this panel, researchers and innovators from each SHARP project will explain how their contributions will reshape Medication Reconciliation and healthcare.
Consumer Health Informatics applications such as Personal Health Records (PHR), and patient portals are developed to engage health consumers and promote healthy behaviors. However, these applications are rarely designed specifically to meet the unique needs of specific groups of health consumers. In this panel, we will focus on one particular group of health consumers, older adults, and to explore key issues unique for older adults to maintain their health and wellness in the e-health era. Older adults differ from younger users in important ways, including declining cognitive, physiological, and sensory abilities and social connectivity. Health IT (HIT) presents new opportunities to accommodate the unique needs of older adults while at the same time introducing new challenges that, without proper care, could easily leave older adults further behind in the e-health era. Bringing with them a broad range of disciplinary training and perspectives, the panelists will discuss lessons learned from their research and propose new approaches for developing consumer health informatics applications tailored to older adult health consumers. They will recommend design guidelines and directions for future research.
By the year of 2050, the number of individuals 65 and over will be 86.7 million, comprising 21% of the U.S. total.
Public health informatics (PHI) incorporates knowledge from technical, social science and health-related disciplines. Knowledge borrowed from these disciplines benefit problem solving by providing multiple perspectives into a problem solving situation. However, given the complexity of public health and informatics problems, these perspectives might fail to converge on a set of solutions for various reasons. These include: (1) a lack of shared mental models for problem solving; (2) inability to translate or apply evidence to practice and generate evidence from practice; and (3) potential conflicts during collaborative problem solving arising from discipline-specific training. This panel was assembled from members of a community of innovators in epidemiology and public health informatics (CoIEPHI). Members will discuss key challenges in PHI problem solving and how these may be addressed through a collaborative project using a problem solving approach to public health informatics practice, research and learning.
The lack of infrastructure for clinical data sharing and large-scale analytics, the obstacles to innovation in electronic health record (EHR) user interfaces, and the overwhelming amount of information in an EHR through which physicians must sift comprise some of the major challenges in informatics. This panel presents work from three large projects to find solutions, and it explores the benefits that accrue when all are integrated. Focal points of the panel include: integrating the i2b2 research data repository with the SMART medical app platform to improve clinical trial recruitment, and integration of patient-record summarization technology into SMART-enabled i2b2.
Learning objectives for this panel:
- Understand the challenges in clinical data sharing and analytics, and how i2b2 is enabling these goals.
- Understand the SMART medical app platform and the ways it is synergistic with i2b2.
- Explore the challenges related to physician cognitive overload and the physician-validated models being developed for automatic summarization.