9:45 a.m. – 10:45 a.m.
S03: Panel – Clinical Informatics Fellows Project Ignite Talks
C. Hollweg, University of Arizona COM
The purpose of this session is to showcase projects in progress and offer a means of sharing with other fellows and the rest of the informatics community the great ongoing work that may not be ready for formal submission. This could potentially facilitate cross-institutional collaboration.
11:00 a.m. – 12:00 p.m.
S07: Panel – LEANing Into the Quality Payment Program: Using Agile Strategies for Real Practice Improvement
J. Skapik, Cognitive Medical Systems, Inc./Inova Health Systems; K. Larsen, Centers for Medicare and Medicaid Services; S. McBride, Texas Tech University Health Sciences Center; J. James, Evolent Health; M. Hangsleben, Telligen
As CMS announces the end of the Meaningful Use era and ushers in the Quality Payment Program, lessons learned from MU and innovative health systems can be applied to inform an agile strategy towards these new programs and the constellation of other quality and reporting activities faced by health systems and providers. In this session, we walk attendees through an “Ignite-style” strategy and application exercise where we take “HealthESystem”, a theoretical group of outpatient clinics through the steps of selecting an approach to participating in the Quality Payment Program for 2019 and beyond. The session includes within its scope an environmental scan of measurement and reporting activities, understanding of quality and cost opportunities, alignment with larger business and strategic goals, creation of a team of process improvement and informatics “blackbelts”, process assessment and documentation, IT alignment to process, and then the application of data analytics and feedback for iteration. At each stage in the process, panelists provide references to existing resources for attendees as well as tips and tricks to maximize the return on investment of their efforts and avoid pitfalls.
2:30 p.m. – 3:30 p.m.
S11: Panel – Quality Measurement: Authoring and Implementing With Clinical Quality Language and FHIR
B. Hamlin, A. Smith, NCQA; B. Rhodes, HarmonIQ; C. Macumber, Apelon
CMS announced it will be using clinical quality language (CQL) for the electronic clinical quality measures starting in 2018. This panel will present how the new HL7 standards are used to author quality measures. With broad adoption of CQL, other measure sets such as those for HEDIS or QPP may now be successfully expressed in a digital format.
4:00 p.m. – 5:00 p.m.
S15: Panel – New Approaches for Improving CPOE Safety: Indications-based Prescribing and CancelRx
G. Schiff, Brigham and Women's Hospital/Harvard Medical School; N. Pamela, Brigham and Women's Hospital/Partners HealthCare System, Inc; C. Cheng, First Databank/UC San Francisco; S. Pitts, Johns Hopkins University School of Medicine
While electronic prescribing represents a major advance for medication safety, the next generation of prescribing tools and workflows will need to incorporate a series of enhancements to both overcome existing limitations as well as take advantage of powerful capabilities to achieve even greater potential for CPOE quality/quality. This panel will spotlight two needed advances---a) incorporating indications into prescribing/prescriptions and b) reliably ensuring medications discontinued in the EMR CPOE systems are communicated and acted upon at the pharmacy and patient level. We will use a series of conceptual models, studies and insights from our recent AHRQ-funded project on incorporating indications into prescribing. This will include new data from a randomized head-to-head trial comparing an indications-based prescribing prototype vs. the 2 leading commercial EMR vendors, demonstrating significant improvements in quality, safety, and satisfaction. We will also present data analyzing abilities of indications to differentiate look-alike sound alike drug names. Finally, we will present an overview of the issues and findings from current research on pilot implementation of CancelRx, a new Surescripts functionality to electronically communicate discontinuation of medications from the CPOE system to pharmacies to prevent erroneous dispensing.
8:00 a.m. – 9:00 a.m.
S19: Panel - Implementing and Spreading Patient-Centered, Evidence-Based Technologies: The Fall TIPS Story
P. Dykes, Brigham and Women’s Hospital; J. Adelman, NYP/Columbia University Medical Center; D. Goldsmith, AMIA Nursing Informatics Working Group/Previous Brigham and Women's Hospital
The Fall TIPS (Tailoring Interventions for Patient Safety) program is based on over a decade of research supporting its effectiveness with reducing falls and related injuries in hospitals. The Fall TIPS program is currently used in over 100 hospitals in the US, Canada, China and Taiwan. This panel will highlight the intersections of fall prevention research and quality improvement in a multi-center Fall Prevention collaborative spanning three major institutions: Brigham & Women’s Hospital, Montefiore Health System, and New York Presbyterian (NYP) Health System. Panelists will relate their experiences with translating research into practice and announce opportunities for future collaboration to reduce falls.
Patricia C. Dykes, PhD, RN, FAAN, FACMI, will present the evidence base behind the Fall TIPS Toolkit. Denise Goldsmith MPH, MS, RN, FAAN will discuss the challenges of integrating evidence-based content into enterprise vender-based EHR systems, and Jason Adelman, MD, MS, will share his experiences with adapting and spreading the Fall TIPS interventions across multiple sites using a variety of electronic and paper medical record systems.
9:15 a.m. – 10:15 a.m.
S23: Panel – Closing-the-loop: Transforming Medical Information into Action
C. Christenson, K. Katranji, G. Schneider, Geisinger Medical Center
When care is administered to a patient, we often collect a surplus of vital information without any means for follow-up. The findings, while important, may also be considered “incidental” because they don’t relate to the reason the study was performed. Geisinger Medical Center (GMC) has developed a process to help “Close-the-Loop” that takes important “incidental” medical findings and provides a means for appropriate follow-up. Lung nodules and Triple A: In our healthcare system thousands of Chest/Thorax and Abdominal CTs are ordered daily for various reasons. Radiologists routinely report on incidental findings such as pulmonary nodules or aortic aneurysms. The Close the Loop clinical program uses Natural Language Processing (NLP) techniques to evaluate radiology notes in order to isolate pulmonary nodules and determine the urgency of follow-up care and/or testing Genome: Geisinger collects genomic information from patients enrolled in the MyCode project. When one of 76 variants where medical action can be performed is identified, the system will connect the patient with a genetic counselor and the appropriate physician to monitor the disease.
10:45 a.m. – 11:45 a.m.
S27: Panel – Clinical Informatics Efforts to Combat the Opioid Crisis – Experiences from the Front Line
S. Labkoff, Purdue Pharma; P. Burns, Principled Strategies; B. Blumenfeld, Research Triangle International; J. Huizenga, Appriss Health; D. Michaels, Centers for Disease Control and Prevention
The opioid crisis continues to be one of the nation’s largest medical challenges of this century. Efforts to stem issues related to the crisis are happening at nearly every level of the country – from government programs to grass-roots community-based efforts. The work is focused at nearly every part of the nation ranging from early intervention with middle school children to recovery high schools, to drug courts, to helping pregnant women who have opioid use disorder. From a medical point of view, efforts are being taken at nearly every segment of the healthcare ecosystem. From prevention, diagnosis, treatment, and recovery. One common thread with many of these efforts is that information and informatics can be at the core of such solutions. One way of intervening is by helping clinicians and patients directly at the point of care. This is accomplished by providing new approaches to clinical decision support. Various aspects of CDS are needed, from simple reminders to guidelines, to patient-centric tools – all focused on ensuring that there is a laser focus on patient care while maintaining patient safety.
This panel will discuss the impacts being made by members of the informatics community on this major public health issue. The panel will discuss clinical decision support tool use in medical practice, enabling clinicians with predictive modeling tools, and converting clinical guidelines into CDS for clinical applications.
The attendee will hear real-world examples of what’s working, what’s not and where new efforts can be focused on using informatics in helping to deal with the opioid crisis. In addition, the attendee will leave with a better understanding of the impact that Informatics is having with patients and clinicians.
12:45 p.m. – 1:45 p.m.
S30: Panel – The Use, Usability, and Experience of Implementing a Systemwide Inpatient Portal (IPP)
J. Hefner, T. Huerta, A. McAlearney, D. Walker, The Ohio State University
The Ohio State University Wexner Medical Center implemented an inpatient portal facility-wide starting in 2013 and has evaluated three components of implementation: use, usability, and experience. Evaluating use involves analyzing audit log files to assess how, when, and which features of the inpatient portal were used. Usability was tested by having participants use the portal while talking through any issues they encountered and answering questions about the portal functionality, features, processes, user interface, and user-system interactions. Finally, qualitative interviews with patients, caregivers, and healthcare providers provided data about the user experience and implementation recommendations. Inpatient portals are a relatively new technology, and there is a need for research informing implementation of these tools on a large scale. While prior research about outpatient portals can inform inpatient portal design and implementation, there is little evidence in the literature and some experiential evidence from our research that inpatient portals offer new implementation challenges. Our intent in this panel is thus to explore how the inpatient portal tool is used, how use shapes experience, and how and why individuals have varied experiences.
2:00 p.m. – 3:00 p.m.
S33: Panel – The Clinical Informatics Fellowship: A Fellow’s Perspective
W. Lancaster, Vanderbilt University Medical Center; C. Parsons, Boston Children’s Hospital; C. Dameff, University of California San Diego; M. Van Cain, Boston Children’s Hospital
Physicians who have completed a primary specialty can gain experience in informatics by completing a clinical informatics fellowship. The fellowships are relatively new and the differences in the fellowships, the motivations of the fellows, and the career paths for the graduates are largely unknown. This panel brings together four fellows from different training programs in different stages of their training to discuss their experiences. Jake Lancaster initially trained as an internist and is a second-year fellow at Vanderbilt University Medical Center. Chase Parsons completed a combined residency in internal medicine and pediatrics and is a second-year fellow at Boston Children’s Hospital. Christian Dameff completed emergency medicine residency and is a first-year fellow at University of California San Diego. Lastly, Melissa Van Cain completed pediatric residency and is a first-year fellow at Boston Children’s Hospital. The panel will examine their own motivations for pursuing an informatics fellowship and dissect the similarities and differences between their programs.