AMIA 2009 – opening session November 16, 2009
Posted by peterjmurray in AMIA, conference, health informatics.Tags: AMIA, conference, health informatics, San Francisco
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There was no reliable wifi for the opening session, so this blog post was written during the session and uploaded afterwards. Ted Shortliffe, AMIA CEO and President gave the opening and welcoming remarks. Attendance is on target for this year, with 1,900 so far, with expectation of over 2,000 due to on-site registrations to come. Lucila Ohn–Machado, SPC programme chair followed Ted; she reported that there are 360 posters, some panels and late-breaking sessions, and a number of other innovations. The SPC includes representatives from training programmes and journal editors or representatives. There is also a journal-eligible programme, with 7 journals (including JAMIA, IJMI). Lucila gave an overview of a number of highlights to be presented during the next few days.
Following this, there was an overview of the student paper competition from David Krusch; of 80 submissions, 52 were selected as short-listed finalists, then narrowed down to 8, from which the final three winners were selected. Winners will receive cheques and certificates – third place winner, from Carnegie-Mellon is Christopher Harley; second place from Columbia University is Chintan Patel; first place winner of student paper competition is John D Duke, from Indiana University and Regenstrief Institute.
David Bates, Chair of AMIA Board, was the next speaker, giving an overview of other award winners presented at the AMIA Leadership Dinner on Saturday evening. Joyce Mitchell, president of ACMI, then presented the Morris Collen Award (AMIA’s highest award, for lifetime achievement), given to Betsy Humphries, Deputy Director of the US National Library of Medicine, together with new inductees into the College (founded in 1984 with over 300 Fellows). The award was presented by Morris (currently 96 years old and living in the San Francisco bay area).
The opening keynote presentation was given by Mark D. Smith, President and CEO of California HealthCare Foundation. Mark says he is not in informatics, and is not a technologist, but is passionate about the use of IT in healthcare. He began by talking about ‘hope’ – he says the “stars are aligned” for delivering on the promises around using technology to change healthcare. Why can you put a piece of plastic in a hole in the wall anywhere in the world and get money from your bank account – but go to the hospital you were born in and they don’t know the most basic things about you? – a paraphrase of a question Mark asked. He gave a couple of examples of kiosk-based information and symptom checking.
Mark then moved on to the “hype”; starting with Gartner Hype Cycle – suggests we are at peak of inflated expectations in use of technology/IT in healthcare. He says there has been hype, and we have been having the same debates, for nearly 40 years, with predications/hype of change for that long. Avoiding the ‘road to hell’ – he suggests need to pay attention to policy, pay attention to key technology issues, and address the forces of inertia. A lot of scientific studies costing many millions of dollars have produced ‘nothing but tenure’ – but have had no effect on healthcare delivery systems – this has got to change, he says. The only thing we do more or less same as 20 years ago is healthcare – basic structures have changes, despite a few new gadgets etc – but technology has changed many other areas of everyday life. He gave the example of opentable.com as a way of booking a reservation for dinner; are integral to restaurant reservation systems. By implication, he asks – why cannot we do the same in healthcare? “The restaurant owner did not have to come to a conference to get 10×10 certified to be able to use the system to get more customers into his restaurant”.
Critical technology areas – embrace affordability (we know what we can afford, what can we get for it?) – need a priority in bringing down the costs of healthcare while maintaining quality etc. Need to focus on the consumer – technology needs to be simple and elegant if people are going to use them. We also need to “avoid analogue limbo” – we have fast cheap machines linked by slow, dumb humans; there is no end-to-end digital movement and manipulation of data. So pressing task is to eliminate the trapping of data in analogue limbo.
His final admonition – aimed at students, and the younger generation – this is the chance to fundamentally transform the system – so “don’t screw it up”.
AMIA2009 – Nursing Informatics Special Event November 15, 2009
Posted by peterjmurray in AMIA, USA, conference, health informatics, nursing informatics.Tags: AMIA, health informatics, nursing, San Francisco
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Sunday morning, early, and AMIA2009 activities are already in full swing. Peter is attending the the Nursing Informatics Working Group (NIWG) Special Event. The first part of the event was an overview by Charlotte Weaver, talking about current activities and goals etc for the group. A number of international participants are the event, including Polun Chang from Taiwan and Kaija Saranto from Finland. About 60 people are attending the event at present.
The second part of the event is Diane Skiba, introducing work on the TIGER initiative, covering the development of the project so far and future plans. Next, Sue Newbold introduced the nursing informatics history project; she introduced the origins of the project, and the pioneering work of people such as Harriet Weley and Virginia Saba. Sue says the project aims to reaearch and document the history, including the stories of the pioneers through video interviews. The history project webpages are at https://www.amia.org/niwg-history-page The common themes from interviews etc have been extracted (http://coursedocs.umaryland.edu/Projects/amia/interviews.htm)
The third session was lead by Kaija Saranto and Patti Brennan, who introduced the work and outputs of the NI2009 post-conference. The book has been produced rapidly though a collaborative effort. The books is available as “Personal Health Info management: tools and strategies for citizens’ engagement” at http://www.uku.fi/vaitokset/2009/isbn978-951-27-1321-9.pdf (Book Info: Kaija Saranto, PF Brennan, Anne Casey, eds “Personal Health Info management: tools and strategies for citizens’ engagement” (University of Kuopio) ISBN 978-951-27-1321-9.
AMIA 2009, San Francisco November 15, 2009
Posted by peterjmurray in USA, conference, education, health informatics.Tags: AMIA, conference, education, health informatics
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Peter is at the AMIA 2009 conference in San Francisco (http://symposium2009.amia.org/). I will be trying to blog some of the action from here – but may end up with most of my reportage being on Twitter – look for #amia2009sf
As of Saturday, 5:30 pm – Registration is now open – after a minor hiccough – and there are lots of people queuing to get their badges etc. A nice sunset over San Francisco at the moment, as viewed from the 35th floor of the hotel. I have been here for two days – done some of the usual tourist bits – some photos are uploaded at http://www.facebook.com/peterjmurray and I’ll try to add more in due course.
Any other tweeters or bloggers, let me know and I’ll add you a link/mention here. I know Kevin Clauson is on Twitter (@kevinclauson), as is Chris Paton (@DrChrisPaton). AMIA is now on twitter at http://twitter.com/AMIAinformatix
Healthcamp Toronto September 16, 2009
Posted by peterjmurray in conference, health informatics, unconference.Tags: eHealth
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Peter is at his first healthcamp/barcamp, here in Toronto. A lot of interesting, enthusiastic people here to look at a wide variety of issues. The formal website for the event, which will have summaries, conversations, links, etc is at http://www.socialtext.net/hctoronto/index.cgi?healthcamptoronto
A lot of the major conversation will be via Twitter – search using #hcTO
I am here to learn what these events are all about, how they work, etc., and what benefits there can be out of them.
UPDATE: 17 Sept. Healthcamp Toronto was an interesting experience; @carlosrizo and all his colleagues at the Innovation Cell did a great job of organising and running it – and of trying to capture all the conversations, which is a difficult task. It wil be interesting to see the various analyses that come out of it. Having been involved in running quite a few similarly semi-structured workshops etc. in the past, I appreciate the challenges of trying to get away from talking heads and monologues and death by powerpoint, etc.
The idea of having a ‘wall’ where people could post what they wanted to discuss in sessions worked well; although requires you to think quickly and try to grasp what the session ‘leader’ is looking to explore. A lot of the session notes, together with video clips and photos are on the website; I recommend you to go and explore that. A few ideas/issues I picked up from the sessions I went to:
- how do we bring people without technical skills into using online tools? – how do we overcome some of digital divides?
- will social networking tools become part of people’s normal social landscape in the future, and so these become ‘non-issues’ in the future?
- there were many differing views of the value of content on some online discussion areas – some suggest low value (too much ‘noise’), some report studies that give high value/accurate information (more accurate information often in areas for more specific/specialised diseases).
- do we need filtering of information, or does the good material rise and stay, and the dross fall away (via crowdsourcing etc)?
- what do we mean by Web 3.0 and what will it mean for health? (search Twitter for comments here).
The discussion 'grid'
Welcome to healthcamp - the rules of healthcamp ....
A Healthcamp Wordle from live analysis of tweets
MIE2009, Sarajevo – arrivals August 29, 2009
Posted by peterjmurray in EFMI, Europe, conference, health informatics.Tags: conference, Europe, informatics, MIE2009, Sarajevo
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Well, here I am, safely ensconced in the Holiday Inn, Sarajevo in Bosnia and Herzegovina for the MIE2009 (www.mie2009.org) conference. It looks like being another hot and humid day here. After a long day of travel yesterday, including a 5 hours wait between planes at Munich airport, finally got here last night. The pick-up arrangements were excellent (many thanks to Promo Tours for their excellent work – http://www.promotours.ba/), and so it was a quick trip from Sarajevo airport to the hotel.
The EFMI (www.efmi.org) Council meets all day today (after the EFMI Board meeting yesterday) – those of us here already and not involved will be taking the opportunity for tourism today and tomorrow. I have never been to Sarajevo before, so I am looking forward to seeing some of it – will post photos later.
Various other people will be reporting from MIE2009 (mainly tweeting, I think) – so, watch out for @CiscoGIII, @luisluque, @omowizard – or search Twitter with #MIE09
OK, enough sitting in the hotel over a laptop – off to see the sights.
UPDATE, 17:15hrs – after a wander round the old town, lunch (cevapi with onions – http://en.wikipedia.org/wiki/%C4%86evap%C4%8Di%C4%87i), turkish coffee and lemonade, and conference registration, we had a beer and chat with Ed Hammond at the conference hotel.
Some photos area at http://picasaweb.google.com/peterjmurray/MIE2009Sarajevo where more will be added later. Now the hard choices – where to have dinner; there seem to be plenty of choices.
MIE2009 – Sarajevo August 18, 2009
Posted by peterjmurray in EFMI, Europe, conference, education, health informatics.Tags: conference, EFMI, Europe, health informatics, MIE2009, Sarajevo
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We be blogging, tweeting etc from MIE2009 in Sarajevo at the end of the month.
MIE2009 (www.mie2009.org), the XXII International Conference of the European Federation for Medical Informatics (EFMI) will be held in Sarajevo, Bosnia and Herzegovina, on 29 August to 2 September, 2009. Full information, and the preliminary programme, are on the MIE2009 website.
If anyone else will be there and wants to link up blogs, tweets, etc., please tweet @peterjmurray. I suggest we use #MIE09 to help in searching tweets (thanks, @CiscoGIII).
Session 6F ‘Virtual Reality’ SINI09 07.24.09 Friday July 24, 2009
Posted by erdley in SINI2009, conference, education, future, health informatics, speaker.Tags: Baltimore, e-learning, education, nursing, SINI 2009
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John Miller, MN, RN and Cathy Walker, titled “Nursing Education in 3D: Leveraging Virtual Worlds and Immersive Learning Simulations”. Using 2 screens and projectors to demo SecondLife (SL). Slides at MUVers.org and at Slideshare.com as well as SINI site for this conference as well. 
Well attended with some 25 or so people in attendance. To emphasize and show better on screen the session is run with room lights off. They have created an ‘OS’ so medical equipment interacts within SL, records to off-world website, and so forth. Presentation is very verbal and demo-like to show how used and what it is all about.
Some events are scripted or the instructor can adjust as needed during the scenario. Also able to see thought / decision-making processes of student, instructor, or both if this is something desired. Interesting environment for students to experience such as monitor, drugs (administration), reading physician orders, IV pumps, and so forth. There is also a bit of ’selling’ here by the presenters about their corporation and services for hospital institutions. Question about research but there is no research ’cause they have no time (she is part of 3 companies; he is involved with full-time teaching along with collaborating other companies). A person recommended is Stephanie Stewart (formerly of UofW, Oshkosh). Otherwise very interactive with rolling ‘Q&A’ between audience and presenters. Nicely done. See YouTube clip, too, for a demonstration >>>
Presentation SINI2009 07.24.09 Session 5A July 24, 2009
Posted by erdley in SINI2009, conference, health informatics, nursing informatics, speaker.Tags: Baltimore, health, informatics, nursing, SINI 2009
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Presentation is recipient of practice award from SINI (see @m2hansen for tweets of this session). About 50 attendees in the main lecture hall, which also means this is webcast. Title is “Leveraging technology for nursing handoffs” presenters are from Northwestern Memorial Hospital. Authors are Stephanie Kitt, MSN, RN, Marilyn Szekendi, PhD, RN, and Kathleen Linn BSN, RN. Northwestern Memorial is a magnet hospital with over 900 beds total. Organization is reported to be about 99% digital / emr throughout. Provides background information regarding the need for nursing handoffs and impact on patient care and safety (aka ‘communication’). Effective handoff elements include f2f verbal with verbal report + hardcopy summary; current/up-to-date info, predictable / stable presentation format, minimal interruptions of report & unambiguous transfer of responsibility (cited from Patterson ES et al 2004 study; difficult to read so more not included). Cites 2 studies of handoff failures (Arora V. et al (2005) and McCann, L. et al (2007). Primary cause of failure was communication. Overall key factors of failure outlined (failure of communication primary).
NMH uses SBAR format (paper-based). Second presenter reviews what SBAR is and the actual paper-based form used by the organization. Stands for Situation-Background-Assessment-Recommendation. Deployment was piloted in medicine, surgery, oncology to one unit in each of these areas for 6 months. Implemented in med/surg and oncology units; training consisted of job aide document; train the trainer & coaching support available at change of shift. Described the deployment of this during the workflow process, which also includes prioritization of ‘next-to-go’ areas. During these processes the organization also underwent a model of care change (this tool reported to facilitate / aid the care change). These presenters did follow-up research of this implementation. Overall the shift report decreased to a 5-15 minute timeframe versus longer reports (still individualized based on patient and nurse). Suggestions by nurses to improve the report process included more specificity but at the same time more freespace; more accurate information (get rid of old information); viewable online to eliminate use of dead trees, and, get all units onboard with SBAR. Lessons learned is e-report format is preferable but not a panacea; stakeholder lead is imperative and nurse involvement is key! Nice presentation. Completed early so long time for Q&A session (about 15 minutes).
Afternoon session 07.23.09 July 23, 2009
Posted by erdley in SINI2009, USA, conference, education, health informatics, speaker.Tags: Baltimore, Genomics, informatics, SINI 2009
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Concurrent session 2, Jim Turley, titled “The impact of genomics on nursing care”. In the nether region of the School of Nursing (7th floor). Good attendance despite weather (very rainy – pouring more like it) and immediately post-lunch (about 17 so far). This is listed in the program as being at the ‘expert’ level. It is a session to generate questions and create discussion more than inform. Future and research involve genomics in health, individuals and society. Health & lifestyle facts indicate controllable variables versus genomics. So, the question, what to focus on? We understand behavior but not how to do it ‘well’ regarding behavior. How much can we txt via genomics and what might be ‘leftover’ or influenced by environment? Fair use is the discriminating question de jour.
Genomics & new conceptualization of health & illness; genomics -> study of all the genes in human genome together. . . health & disease no longer defined in terms of function (nursing assist with functional ‘things’ of patients); predictive models of intervention before loss of function; need for targeted care; blur boundary of health & chronic illness. One impact is redefinition of nursing role. Carol Bickford offered comment of nursing as a profession that’s ‘a bit conservative’ (to paraphrase). Knowledge of ‘risk state’: a non0symptomatic state after an individual or family is aware of their genetic risk. Treatments (individual, family), communication (other healthcare providers, other family members, and others). Agreement of baseline issues logically leads to traumatic re-definition of roles (for example nurses and informatics specialists) and therefore responsibilities (for example, informaticists and mathematical models of information delivery). Describes history of genetics, therapeutics and nursing. Discussion of examples include simple and not-so-simple genetic disorders. CF is an example of not-so-simple genetic disorder.
Suggests finding a gene on a chromosome map (see NCBI website). Core data site for computational genomics. SNPs is single nucleotide polymorphisms (individual A, T, G, or C). Humans are 99% identical at the level of genetic sequence. Diversity of remaining 1% variation is mostly due to SNPs. Common examploe is apoE and Alzheimer’s incidence. Also is BRCA1 & BRCA2 & breast cancer incidence and or chance thereof. SNPs we can know women at risk for breast cancer & heart disease, risk for PCN allergy, and kids with ASA trigger for asthma. Question – at what point, or when, does this sort of testing become cost effective? How does all of this impact nursing practice? Bedside technology now includes micro-array testing at POC. Given now able to own genetic testing some of the companies currently doing this are listed as examples by Jim. Questions arise, then. Intention and or quality of science, for example. 23andme (https://www.23andme.com/) and decode genetics (http://www.decode.com/) are examples. 23andme also purchased genetic code of Iceland (entire country), which are linked to the emr of Iceland, too.
Some side effects of all of this testing include the Human Genome Project Information site covering a lot of different issues as well as various articles talking about state regulation of this sort of testing (see Wired magazine) to the UK and regulation of genetic testing. Sharing will become more common (between those who can) so eventually a fair amount will be in the public domain. Postulated questions by Jim include the following:
- How to display a genome?
- Include in an EHR?
- What does it MEAN?
- What do you do while KNOWLEDGE is evolving?
- Do companies have the right to ‘buy’ the genomic data of a country?
- Should genomic data be available without a healthcare referral?
- Does it, genomic data, covered by HIPAA?
- Should genomic data be PUBLIC? (does social good out weigh privacy?)
- Should patients be required to ’share’ genomic data with their clinicians? (family members, insurance companies, employers/potential or actual)
- Are we ready for a new paradigm of research (where consumers pay and companies reap)?
- Is it truly a generational problem? (next generation & privacy)
Understanding the human genome project dvd is a nice information resource on many of these issues. See site >>> Excellent presentation and good Q&A with audience at end of session.
UPDATE – a video from Eric Rivedal >>>
OP331 NI2009 Teaching methodology 2 (1030-1215) July 1, 2009
Posted by erdley in NI2009, conference, education, health informatics, speaker.Tags: education, health informatics, Helsinki, NI2009, nursing
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Sorry, folks, late arrival from panel presentation with Peter. Only arrived late for 2nd presentation (obviously missed first one). 3rd presentation is “Educating a Health Terminologist” by J. Warren. She demonstrates terminology tools educators can use; basic session to inform participants and update them so ‘they’ may have a basic understanding of the role of health terminologist, responsibilities and then help educate others about this role. Some very nice graphic slides to help understanding available in her presentation.
4th presenter – T. Indergaard (Finland) “Counseling of problem-based learning (PBL) groups through videoconferencing”. Discusses project and advice for those pursuing videoconferencing solutions.
Final presenter is J. Brixey “Creating experiential learning activities using Web 2.0 tools and technologies: a case study.” Stressing the social need of connecting with others (see Siemen’s principles of connectivism). Making such connections possible with Web 2.0 tools / platform; ‘at/ap/ac’ if-you-will (anytime/anyplace/anywhere) – aka ‘cloud computing’. Describes project at Kansas University of using 2.0 tools / technologies for facilitation of learning experiences (such as conference attending and so forth). Nice list of social software toolkit application inclusion criteria on her slide (easy to dl/install to easy navigation to user interaction encouragement; about 10 items in all). Use of MSN Live Messenger dictated by desire for concurrent communication between students and faculty. Wide range of 2.0 tools used including SL. Activities within SL range from ppt evaluations to interactive socializations. Nicely done! Off to lunch then perhaps one of the 3 final sessions (start at 1315 through 1415). Final ceremony is from 1415 – 1600. I will not be blogging the closing ceremony because one of the closing speakers requires the use of my Mac computer for her presentation. Later!
