AMIA 2019 Clinical Informatics Conference Program Committee Members Share Itinerary Picks

Feliciano "Pele" Yu, Jr., MD, MSHI, MSPH, FAMIA

Chief Medical Information Officer, Arkansas Children's Hospital
Professor of Pediatrics and Biomedical Informatics
University of Arkansas for Medical Sciences

Areas of Interest
Clinician Burden/Documentation Burden, Clinical Decision Support, CPOE, Health Information Exchange, HIT/EHR Safety, Meaningful Use

As a CMIO of an academic pediatric medical center, I am very interested in learning about practical ways to improve our organization’s ability to improve EHR usability, clinical decision making and ultimately improving the safety and quality of care. There are so many great presentations this year. I think this is reflective of the level of maturity of the clinical informatics subspecialty and how it reacts to the glaring issues and opportunities of the day.

Individual presentation titles listed below.

I am particularly interested in the workshop on “Organizational Issues and Informatics: Translating Theory into Practice”– what I learned from doing this kind of work for over 13 years is that successful informatics implementations depend more on sociology than technology. Eager to learn from Kim Unertl!

  • Organizational Issues and Informatics: Translating Theory into Practice

There are also a couple of presentations that caught my eye. One of them is “A Data-Driven Strategy for Prioritization of Health Information Technology Safety Efforts” by Michael Oppenheim and the other is “Reducing Intrusive Alert Burden Using Quality Improvement Methodology” by Juan Chaparro. In my shop, we are very interested in minimizing the safety hazards that exist in our implementation and we are always looking for ways to reduce patient safety events that are attributed to our health IT systems. In addition, one of the common causes of clinician cognitive burden is alert fatigue, so I am interested in what Juan Chapparo has to say about formalizing the methods for improving our CDS deployments.

  • A Data-Driven Strategy for Prioritization of Health Information Technology Safety Efforts
  • Reducing Intrusive Alert Burden Using Quality Improvement Methodology

We are also very excited that we have a lot of panel-style talks that represent a host of perspectives on certain topics in clinical informatics. One of the panel presentations that I look forward to attending is the talk led by Howard Silverman – “A Tale of Two Practice Analyses: Clinical Informatics Subspecialty and Health Informatics.” I am eager to learn the results of the specialty practice analysis of the two distinct but related domains of practice. As our specialty moves forward, it would be great to develop a more formal valuation of the practice of Health Informatics, giving room for other members of the care delivery team to grow into this exciting field that we all love.

  • A Tale of Two Practice Analyses: Clinical Informatics Subspecialty and Health Informatics

At this conference, we also offer several “Ignite-style” presentations, where we group several presentations together and talk about cool CI topics. On Wednesday May 1, we have an Ignite style talk revolving around the EHR (S12: Ignite Style Talks 1), such as Pharmacogenomics, Use of SNOMED CT, and open EHR notes, among others! These types of presentations are served fast and they get right to the point quickly, getting me the most learning in a short amount of time!

  • Innovation and Improvement in EHR Utilization

Finally, we have a lot of poster submissions this year! It’s tough to pick a favorite without an actual face-to-face conversation with the presenter. But, as a pediatrician, I would like to learn more from Jonathan Elias about what he has to say about the “Perceptions of Health Information Exchange Use by Pediatric Providers.” There is certainly a lot of room for improvement in our nation’s current state of health information exchange. There are a lot of posters that focused on pediatric settings, there’s one by Martha Hellems about “An Inter-Professional Team Successfully Designs and Implements a Health IT Solution to Improve Communication and Workflow in a Multi-Specialty Pediatric Outpatient Clinic”, and then there’s another one by Melissa Van Cain on “Using Gamification and Asynchronous Mobile Learning to Improve HPV Vaccination Rates in Pediatric Primary Care Network.” There’re so many posters to choose from!

  • Perceptions of Health Information Exchange Use by Pediatric Providers
  • An Inter-Professional Team Successfully Designs and Implements a Health IT Solution to Improve Communication and Workflow in a Multi-Specialty Pediatric Outpatient Clinic
  • Using Gamification and Asynchronous Mobile Learning to Improve HPV Vaccination Rates in Pediatric Primary Care Network

Sarah (Collins) Rossetti, RN, PhD, FAMIA

Assistant Professor of Biomedical Informatics and Nursing
Columbia University Department of Biomedical Informatics

Areas of Interest
Big Data, Clinician Burden/Documentation Burden, Clinical Workflow, Electronic Health Records, Implementation, Nursing, Patient Centered Care

I am especially looking forward to the sessions focused on data science and knowledge generation that are expanding the types of data sources used in these applications, especially the use of nursing data.

Individual presentation titles:

  • Nursing Knowledge Big Data Science: A National Collaborative to Achieve an eHealthIt Ready Workforce
  • Exploring Clinical “Rules of Thumb” with Machine Learning Methods
  • Unsupervised-learning of Concern Topics Documented by Nurses About Hospitalized Patients Prior to a Rapid-response Event
  • The Promise of Big Data: One HIE’s Journey to Extract Greater Insights from Non-Standardized Data

I’m also interested in the data-driven studies focused on workflow and clinician efficiency which are essential to drive knowledge-based optimization of EHRs for us to effectively improve efficiency, satisfaction and decrease burden for all clinicians.

Individual presentation titles:

  • Challenges and Success of Conducting a Time Motion Study to Investigate Nursing Activities and Stress
  • Using Eye-Tracking to Support a Learning Electronic Medical Record System
  • Improving Provider Efficiency in the EHR
  • Getting Time Back in Your Day! Implementing a Multi-Faceted Approach to Optimizing the Electronic Health Record in the Ambulatory Setting
  • Reducing Intrusive Alert Burden Using Quality Improvement Methodology

John McGreevey, MD, FAMIA

Associate Professor of Clinical Medicine/Associate CMIO
University of Pennsylvania Health System

Areas of Interest
Clinical Decision Support, CPOE, Electronic Health Records, HIT/EHR Safety, Clinician Burden/Documentation Burden, Leadership, People and Organization Issues, Population Health

If your practice or health system is wondering how to make something work in health informatics (patient portals, Leapfrog performance, clinician wellness as it relates to EHRs, safety event detection etc.) chances are that someone at CIC has been thinking about the same thing and has started to tackle those challenges. This is the conference to truly learn from peers… recognizing that we each bring slightly different strengths and skillsets to our clinical informatics work. It’s about sharing knowledge and best practices within our clinical informatics community.

W04. Why? Curiosity: making a health app. Because that’s not at all my skillset and I’m curious how it is done.

  • W04: There's No App for That Yet? Let's Make One! Creating Health-Focused Android/iOS Apps with a Single Code Base

More than one offering of a workshop. So often there are multiple great presentations happening at once and I’m forced to choose just one. This year, for the first time I think in AMIA history, the CIC will inaugurate a reply of a popular workshop session, W02 about skills toward becoming an informatics leader. Early morning and late morning April 30. Also see W07. It’s been part of my feedback about AMIA meetings for several years – great to see the practice come to life!

Practical (how do I get started) sessions such a W05: Introduction to Human-centered Design and Usability Testing.

  • W02: Building Teams, Increasing Your Influence & Navigating Politics: Essential Skills to Thrive as an Informatics Leader (CMIO, CNIO, Director of Informatics, Aspirational Informatics Fellow)
  • W07: Clinicians Not Burned Out: But on FHIR®!
  • W05: Introduction to Human-Centered Design and Usability Testing

Opening Session with Stephen Klasko as keynote. An audacious leader who will challenge our thinking.

Presentations focused on improving clinician wellness – reducing alerts (Juan Chaparro, S05), simplifying information presentation (Nicholas Riley, S05), a sample of alert management strategies to reduce alerting burden from four health systems (John McGreevey et al., LB01), EHR optimization work geared toward returning time to clinicians (Carole Rosen, S06).

  • S05: Applications for Quality and Efficiency Improvement Processes
  • LB01: Your Attention Please! How Four Health Systems Approached the EHR Alert Burden on Clinicians
  • S06: Optimizing the EHR

S01 by Shyam Visweswaran: using eye tracking to support a learning electronic medical record system. That’s something our health system would like to do. This is the Missouri conference, so to speak, “show me how to do it” – I’m looking forward to the takeaways that our system could use to incorporate eye tracking into our toolkit!

  • S01: Great Expectations: EMRs that Learn and Promote Learning

Learning about real-time safety event detection (Kirkendall, S10).

  • S10: Improving Safety with CDS

Data governance presentation by Woeltje, S11, a growing and under-recognized challenge for health care, especially as health systems enlarge.

  • S11: Leveraging Workflow and Data to Promote Efficiency

Asking Adam Wright how to allow for and manage controlled innovation within an EHR while at the same time preserving EHR system consistency and stability, especially when the EHR impacts thousands of employees and patients across a large geographic area. Ignite S12.

  • S12: Innovation and Improvement in EHR Utilization

Learning about how we can develop interest in informatics among residents and to create a pathway for future careers in clinical informatics. CSI presentation by Ajay Dharod, S16.

  • S16: Novel Technologies for Advanced Information Capabilities and Analytics

Learning more detail about CIMI (S13), an area of interest for me but one where I don’t know nearly enough.

  • S13: Using CIMI Models to Facilitate Bidirectional Interoperability and Decrease Clinician Burden

Hearing about the concept of targeted provider alerting for laboratory results – intriguing and at the same time it seems to me it could present risks if not undertaken very carefully. Claude Pirtle. S18.

  • S18: Predictive Informatics: Just in Time Alerting

Learning from Yaa Kumah-Crystal about the Vanderbilt EHR voice assistant that retrieves information from the EHR and hoping it is scalable beyond centers of excellence such as Vanderbilt and across multiple EHR vendor platforms. S20.

  • S20: Novel Technologies for Advanced Information Capabilities and Analytics

Getting an update from Ohio State about their analysis of patient engagement with health portals. What lessons may be transferable to our health system that could inform our strategy with health portals? Gennaro Di Tosto, S22.

  • S22: Patient Generated Data and the EHR

Learning about progressive web applications – something I’ve heard about, like many topics, but need to learn more about, from Haipeng Zhang, S24.

  • S24: Clinician Challenges with Patient Engagement Tools

Hearing the sequel to the AMIA 2018 Vanderbilt presentation about their EHR implementation and their research study into same. Spencer Des Autels, S23.

  • S23: Translating Evidence into Practice in EHR Implementation and Optimization

Leapfrog CPOE survey experience and pointers from UPMC, S27. A topic of immediate interest and focus in our health system as well. In general, hearing all the presentations in S27 about EHR safety! Likewise more EHR safety – including how to detect events before they become problems – in S31!

  • S27: Enhancing Health IT
  • S31: Applications for Medication Safety and Event Identification

LB02 so as to learn more about CDS Connect and to ask the question, how do the various initiatives across the country to aggregate clinical decision support knowledge and then share it relate to one another? Are they partnering with each other? Or is each a one-off enterprise? Which of the initiatives has the greatest likelihood of succeeding? Which one is going to be the standard 3 years from now that our health system should pay attention to now?

  • LB02: To Share is Human! CDS Connect: A Growing National Repository of Shareable, Interoperable Clinical Decision Support

S38 as it is a session that integrates multiple concepts and will make sense of them, including CQL and FHIR. More of these please at CIC 2020! As Edward Tufte would say, show relationships. How do we harmonize quality measurement? Quality measurement today is something that is fragmented and inefficient.

  • S38: Igniting Harmonized Digital Quality Measurement through Terminology, CQL, and FHIR®

FAMIA induction ceremony – I’m grateful and honored to be part of the inaugural class of AMIA fellows.

Emily C. Webber, MD, FAAP, FAMIA

Chief Medical Information Officer, Riley Children’s Health
Indiana University School of Medicine

Areas of Interest
Clinical Decision Support, HIT/EHR Safety, Patient Safety, Clinical Workflow, Implementation/Optimization, Patient Engagement

I’m looking forward to the sessions on patient engagement and multidisciplinary collaboration. In the applied informatics world, it’s all about the workflow of how we provide care. This is also my own area of focus - what design choices and outcomes are proving effective.

Implementation was one thing, optimization is our new challenge! I think the sessions around the patient and team workflows will help anyone who is charged with coming up with safer and more effective communication.