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Thursday 07.23.09 Full Day July 23, 2009

Posted by Scott Erdley in conference, education, nursing informatics, SINI2009, speaker, Uncategorized, USA.
Tags: , , ,

Recap of yesterday. Good start to conference. Well-received keynote by James Cimino. Intimate networking session during early evening. Today is first full day of conference. Day starting with planning committee meeting (of which I & Peter are members). A little early to be sure, too. And, post composition, good thing as the rain is really coming down by 0830! Pics from last evening will be posted under separate heading.

Opening distinguished lecturer is Marcelline Harris, PhD, RN, Senior Associate Consultant, Departments of Nursing & Health Sciences Research, Division of Biomedical Informatics, Mayo Clinic. Title of her presentation is ‘Pathways to Translational Informatics for Nursing’. Introduction supplied by Judy Ozbolt. Marcelline provided a bit of background about her place of employment – Mayo Clinic.

Initial talk begins with definition of translational informatics – what is it as a concept. Shift to applied aspect in ’07. Earlier demonstrated with grants for use of IT to help with or optimize utility and or use of information. National efforts, currently, now looks at it as linking with practice of informatics. Uses CTSA abbreviation – missed what this stands for. ’08 was first summit for translational bioinformatics – heavily genetic focus. Shared include translating research into practice / application. Informatics is the engine for translation (data, information, knowledge).

Asks is informatics a discipline and science providing support (sorry, missed her reasons) for postulating it is both. She then describes commonalities of different definitions of informatics. One is both science & discipline; focus on modeling of data, information, knowledge. Need to exchange data as a requisite concern or focus. Illustrates with Shortliffe’s graphic of scope of biomedical informatics, basic research to applied research. Also indicates informatics folks are vertical people & shows adaptation of C. Lehmann’s work on this (focus on modeling data, information & knowledge across layers).  Circular process of clinical practice and integration of information, data, knowledge at Mayo depicted as graphic of circle; scientific research similarly depicted. Stresses need to pull both together for translational with informatics as the middle / engine. Marcelline uses a lot of graphics to demonstrate or visualize for the audience. Sorry but not taking pics to post. Will be accessible later via link from Marcelline. Competencies outlined; informatic roles trying to promote / identify at Mayo include academic research (easy one); applied / professional roles (primary fxn is operational informatics), liason roles (nurses, MDs, in practice, delivery system & technology experts), and translational roles (primary fxn bridging from research science to applied). Nursing issues / priorities for cis’s include technology & usability, data retrieval / analysis and terminology uses.

Problems for nurses re: tech & usability issues. Reports of such include ’07 (Klas Report), ’08 (Advisory Board Reports) and ’09 (AAN study). Common theme is systems don’t support work of nurses (instead introduces complexity and such things do not coordinate, but fracture, care). She also depictes tne ’07 EMR Adoption Model (no translational concepts as well as no nursing visible). Shows 8 stages (0-7). Included as a follow-up is Gartner’s Hype Cycle (may be able to locate with a net search). Huges, AHRQ, 2008, report / book about nursing & technology an integrative review (free 3 volume book). Findings show chaos of implementation among others impacting nurse practice and perceptions. Data analysis / retrieval issues include unmet expectations, inspite of storage unable to find information and or generation of new knowledge. Touch briefly on the ‘meaningful use’ definition work. Policy priorities recently published on 07.17.09. Content issues include nursing terminology systems; maybe refocus on translational requirements and or meaningful use issues. Offers a slide showing, based on HIE work, offering the idea of content representation enabling translational informatics. Data/information/knowledge life cycle (Chute & Harris) is proffered as her understanding of what nurses may actually want as related to translational informatics. Offers examples of Mayo Clinic is doing in this overall area of translational informatics. Organizational culture of Mayo plays a big role in ‘what’ the clinic is. Mayo has an integrated medical dossier where ‘everything’ is related (diseases, medications, tests, life habits, and so forth). Current state is a big genetics initiative by Mayo; clinic keeps / stores a lot of stuff (included is clinical data as well as tissue ‘data’). Mayo has 100 years worth of all of this data. Very detailed graphic demonstrating the individualized medical record / care provided by / at Mayo. A highly ‘committee’ized’ organization with another graphic depicting this; chartless for about 5 years now (as a clinic). Practice convergence pathway depicted, too, demonstrating tech & practice integration. Modeling May Knowledge is underway. Various endorsed models depicted (concept, knowledge, etc.). All are available to all staff on their organizational website. Unified nursing assessment model depicted, too. Building own vocabulary and then mapping to other systems (ICNP, SNOMED, etc.). LexGrid as core model. Very detailed enterprise model of pain illustrated. Have an enterprise data trust in place. Closes with key lessons regarding vocabulary (use one that works); structured documents are not helpful (typicall organized from user perspective, not standardized), and so on. Does translational informatics work? Yes with standardized models of nursing knowledge guide retrievals / analytics somewhat independent of constraints in source information. Nurses are well prepared for translational informatics. If interested email speaker (harris.marcelline@mayo.clinic) for additional information.

Off to break and then session reports blogging!

UPDATE: Link to video clip courtesy of Eric Rivedal (recorded on iPhone): >>>



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