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OpenHealth, Belfast – morning keynotes January 21, 2010

Posted by peterjmurray in conference, Europe, health informatics.
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The first keynote talk of the morning session is from Joseph dal Molin, on “Open and connected health: a North American perspective – it’s time for the new paradigm”. Joseph is President of e-cology corporation and Director of WorldVista (http://www.worldvista.org/); he is also adviser to the Jordanian government on EHR implementation using Vista. Joseph began by saying that an open and connected health model is a patient-centric ecosystem; there is a great deal of complexity that must be taken into account; holistic perspective is needed, and all domains affecting care must be taken into account. A simple industrial model does not work; much of current health system is based in silos of information etc.

Joseph says that the US VA ecosystem delivers high quality care, and is very cost-effective; number of veterans treated from 1996 to 2003 rose by 75% (with increasing complexity of care), but the budget only rose by 32% in total over that period. Barcode medication administration has virtually eliminated medication errors in their system, and there have been many other high standards in quality indicator achievement. In most other places, legacy software industry models (based in proprietary systems) have failed to deliver, he says – reinventing the wheel is a pandemic.

Joseph outlined a summary of the open source development model, and likened it to the cycle of evidence-based medicine leading to exploration and improvement of the software. Among open source applications used in health in North America are VistA, OSCAR as EHR solutions; Indivo and MyOSCAR as personally controlled health records; NHIN CONNECT Gateway in USA is an open source project, sponsored by US Health and Human Services Department; Open Health Tools (http://www.openhealthtools.org/). But, he says, open isn’t enough, and semantic interoperability is needed, and is essential for comparability of data. Costs are often a barrier here at present, but there are open source terminology projects seeking to address the issues.

Challenges for open connected health include governments not knowing how to accept free software, not invented here syndromes, procurement processes being based in expensive proprietary software and being hindrances to innovation.

The second keynote presentation of the morning is from Gerald Hurl, from the Health Services Executive (HSE) in the Republic of Ireland, and chair of Health Informatics Society of Ireland (HISI) talking on ‘Delivering connected health in a national context’. Gerald began with an overview of the changes in delivery of health and social care in Ireland, and intentions to move from episodic to holistic care, with the implications for where health service staff may work in the shift from institutional to community-based health and social care services. This has implications for ICT, if services are integrated around the patient, and requires a focus on connectivity and connected health. The new ICT strategy reflects this new model/paradigm of care. But a key challenge will be the lack of ICT staff with the domain knowledge and expertise to support the delivery of the necessary ICT.

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OpenHealth conference; Belfast, January 2010 January 21, 2010

Posted by peterjmurray in conference, Europe, health informatics.
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Peter is at the OpenHealth conference in Belfast, Northern Ireland today, and will be doing some blogging and tweeting (search for #openhealth on Twitter). Information on the event is at www.openisland.net It is being held at the Spires Centre and the Europa Hotel today, and tomorrow’s linked event will be at the University of Ulster Jordanstown Campus.

Today’s event is  a one day free conference on open and connected technologies / services solutions for healthcare and the issues surrounding them, and also includes the official launch of BCS Health Northern Ireland – a new forum for knowledge sharing in Health Informatics & Connected Health in Northern Ireland. The current interim committee for BCS Health NI also includes Jonathan as secretary, and Paul Comac as Treasurer.

Jonathan Wallace opened the event and will chair today’s conference. The first speaker is Prof. Roy Harper, chair of BCS Health Northern Ireland, who outlined the aims of the group, and the wish to be open and inclusive as far as membership of the group – www.bcs.org/health/ni

Jean Roberts followed Roy to give a formal welcome from BCS and introduction, including formal greetings from BCS President Elizabeth Sparrow.

AMIA 2009 – opening session November 16, 2009

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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, conference, health informatics, nursing informatics, USA.
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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 conference, education, health informatics, USA.
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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.
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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).
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The discussion 'grid'

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Welcome to healthcamp - the rules of healthcamp ....

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A Healthcamp Wordle from live analysis of tweets

MIE2009, Sarajevo – arrivals August 29, 2009

Posted by peterjmurray in conference, EFMI, Europe, health informatics.
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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 conference, education, EFMI, Europe, health informatics.
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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 Scott Erdley in conference, education, future, health informatics, SINI2009, speaker.
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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. IMG_0157 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 Scott Erdley in conference, health informatics, nursing informatics, SINI2009, speaker.
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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).