iHealth 2016 Panels

iHealth 2016 Panels address the following topics

Thursday, May 5

S02: Panel – Quality Improvement

Towards Better Health Outcomes – Informatics Role in Health Care Delivery 

Ravikumar Komandur Elayavilli, Mayo, Clinic
Sunghwan Sohn, Mayo Clinic
Vinod Kaggal, Mayo Clinic
Hongfang Liu, Mayo Clinic

Rapid adoption of electronic health records (EHRs) has enabled significant positive changes in quality of clinical practice and better health outcomes. Informatics infrastructure that performs advanced analytics empowers clinical practice and plays critical role in bringing efficient clinical practices and eliminates potential errors that might creep in. In this panel, we propose to brainstorm and discuss initiatives at Mayo Clinic with positive impact on health care outcomes for a large volume of patient population. We will specifically discuss how the robust infrastructure of both hardware and software has paved way for delivering individualized care solutions at the point of care.

S04: Panel – Patient Engagement

Informatics Strategies and Systems Engineering Tools for Making Acute Care More Patient-Centered

Patricia Dykes, Brigham and Women's Hospital, Harvard Medical School
Sarah Collins, Brigham and Women's Hospital, Harvard Medical School, Partners Healthcare
Kumiko Schnock, Brigham and Women’s Hospital, Harvard Medical School
James Benneyan, Northeastern University

A series of Institute of Medicine reports highlight the fact that too often healthcare results in patient harm and that one strategy for improvement is integration of systems engineering principles into healthcare processes. 1,2 The Brigham and Women’s Hospital (BWH) Patient Safety Learning Laboratory (PSLL) is a collaboration between the Center for Patient Safety, Research, and Practice at BWH and the Healthcare Systems Engineering Institute at Northeastern University. The BWH PSLL focuses on developing tools to engage patients, family, and professional care team members in reliable identification, assessment, and reduction of patient safety threats in real-time, before they manifest in actual harm. This panel will highlight the work of the BWH PSLL in general and then provide an overview of three projects that integrate health information technology, stakeholder engagement mechanisms, and process design/engineering methods to facilitate patient activation in eliminating harm in hospital settings. 

S06: Panel – Generating Evidence from Care Improvement

HeartLink Auscultation System Development and Proof of Concept in Yunnan Province, China

Lee Pyles, West Virginia University
Quan Ni, Children's HeartLink
Pouya Hemmati, Mayo Clinic
Andreas Tsakistos, Children's HeartLink
Bistra Zheleva, Children's HeartLink

One in 120 children is born with congenital heart disease (CHD); needs are unmet for 90% in developing countries. This project applies health information technology to provide a solution to meet this need. Finding children with CHD requires expertise to differentiate functional from pathologic murmurs. Children’s HeartLink (Minneapolis, MN) is a nongovernmental organization (NGO) that sponsors "HeartLink", a mobile health solution for CHD screening. Children's HeartLink's vision is to assure that children around the world have access to quality care for the treatment of heart disease by fostering development of self-sustaining centers of excellence.

The "HeartLink" application manages visual phonocardiographic tracings and heart sound recordings for remote review by a cardiac auscultation expert. The overall goal of the "HeartLink" Project is to connect underserved children, primary care providers and cardiologists in developing countries with expert volunteers to build a sustainable telemedicine mentorship model.

The panel will discuss the following areas:

Set-up and programming of the application on mobile platforms.
Rationale for project support at the NGO.
User survey and preparatory discussion at implementation site.
Report of field experience and telemedical analysis as follows: In 2015, 8000 children were screened with standard auscultation. Heart sounds were recorded for 149 subjects. “HeartLink” digital auscultation remote review via a cloud server found pathologic murmurs in 11 of 14 subjects with echo-diagnosed CHD. Accuracy was 136/149 (91%) with 10 false positives. Positive predictive value was 52% and negative predictive value was 98%. The phonocardiogram tracing facilitates visual analysis of S2 splitting and the duration and timing of cardiac murmurs, which is useful for teaching.
  5. Children’s HeartLink goals and overall strategy in China, future plans, and rationale for employing telemedicine in developing countries.

The panelists will present the “HeartLink” project from viewpoints of health informatician/pediatric cardiologist, biomedical engineer, physician trainee surveyor, non-governmental organization administrator and NGO program implementation specialist.

S10: Panel – Generating Evidence from Care Improvement

Comparative Effectiveness Research on Electronic Health Records: An Overview of the Clinical Informatics Research Collaborative

Dean Sittig, University of Texas Health Science Center at Houston
Carl Vartian, Hospital Corporation of America
Peter Embi, Ohio State University
Adam Wright, Harvard Medical School

Implementing, configuring, and optimizing electronic health records (EHR) in large healthcare delivery systems involves making 1000s of configuration decisions, 100s of workflow changes, and development of 100s of clinical content artifacts (i.e., order sets, alert logic, default values). Many of these decisions, changes, and artifacts have the potential to lead to significant adverse effects on patient safety, clinician efficiency, and organizational performance. To further complicate matters, there is very little empirical evidence upon which to base these decisions or changes in workflow. The goal of the Clinical Informatics Research Collaborative (CIRCLE) is to begin developing the evidence through comparative effectiveness research projects to help healthcare organizations make these decisions. CIRCLE consists of a network of applied clinical informaticians who are committed to improving our understanding of these issues. CIRCLE members are involved in various aspects of the design, development, implementation, use and evaluation of all aspects of health information technology with a particular emphasis on EHRs. To date, we have identified and carried out five different types of research including: interviews and observations; surveys; system demonstrations; and distributed queries; experimental interventions. During this panel, we will briefly describe several recent and current projects that have used these different research methods.

Friday, May 6

S13: Panel – CMIO, CNIO, CIO

The CCIO Task Force: An Interactive Panel on Knowledge, Education, and Skillset Requirements for the 21st Century

Joseph Kannry, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai
Roy Simpson, Cerner Corporation
Thankam Thyvalikakath, Indiana University School of Dentistry
Thomas Payne, University of Washington
John Poikonen, Avhana Health, Massachusetts College of Pharmacy and Health Sciences 

In 2013, the AMIA Board of Directors created the CCIO (Chief Clinical Informatics Officers) Task Force. The charge of the Task Force was to produce a report on the Informatics education and skillset of CCIO's The term "Chief Clinical Informatics Officer" (CCIO) is used to describe the person in charge of "Clinical Informatics encompasses the more commonly used Chief Medical Informatics Officer (CMIO) and Chief Nursing Informatics Officer (CNIO) as well as the rarely used Chief Pharmacy Informatics Officer (CPIO) and Chief Dental Informatics Officer (CDIO). While CCIOs may originate from clinical disciplines including dentists, pharmacists, nurses, and physicians, historically and currently non-clinicians have very successfully executed this role."

The task force explored the history, current state, and future directions of the CCIO role including training programs, certification processes, and skill sets. In an AMIA Board approved white paper the task force recommended that "1.) To achieve a predictable and desirable skillset, the CCIO must complete clearly defined and specified Clinical Informatics education and training. 2.) Future education and training must reflect the changing body of knowledge and must be guided by changing day-to-day informatics challenges." This panel will review and discuss these findings in further detail.

S17: Panel – Care Coordination

Approaches to Combating the Patient Portal Sprawl

Santosh Mohan, Stanford Health Care
Timothy Burdick, Oregon Health & Sciences University
Michelle McGuire, Kansas Health Information Network
Travis Bond, CareSync

The rising interest in and demand for patient-facing tools, especially patient portals, has attracted to the market a number of different vendor approaches and consumer-focused PHR offerings designed to meet various situation-specific provider and patient needs. However, interoperability challenges and the lack of a centrally envisioned strategy for making these tools available to patients are resulting in a landscape where health information is increasingly available online, but spread broadly across the portals of various care settings and organizations that own the data. As a result, patients are increasingly being challenged to interact with multiple portals offerings, often making it harder for them to be effective participants in their own care. Providers too are increasingly facing the need to integrate portals to improve service quality, enhance workflow, and provide a more unifying experience to patients in order to compete for consumer choices. This panel aims to discuss emerging approaches that provider organizations can pursue to seek integration of patient portals across various care settings and weigh the pros and cons of the these approaches. The panelists will provide actionable insights by highlighting key considerations to address and pitfalls to avoid when designing and implementing an integrated patient portal strategy.