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Rutgers 30th Conference – Day 2 Summary April 17, 2012

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I think I am losing my ‘blogging touch’; I find it increasingly difficult to do the live blogging ‘on the fly’ of conference sessions that I have done in the past. maybe it is simply lack of practice, due to doing more tweeting from events. So, this post is a summary of Monday’s presentations and activity. My tweets can be found on @peterjmurray, or searching for hashtag #Rutgers30

The first full day of the conference began with a keynote from Michelle Troseth (@CPMRCmichelle on Twitter). Michelle is Chief Professional Practice Officer at Elsevier CPM Resource Center, and her talk was titled “Bridging the gap between interprofessional education and evidence-based practice: leveraging technology”. She began by noting the many problems of system integration in healthcare services, and that evidence-based care will be critical to the future, so there is a need to think about team-based care and interprofessional care-planning. She asked whether computer nowadays are getting in the way of interprofessional relationships, and discussed the need to design patient-centric systems.

She introduced the TIGER Initiative (http://www.thetigerinitiative.org/)  and TIGER recommendations around being interdisciplinary and evidence-based, as well as covering a number of reports that over the years have advocated the need for transformation of practice and modes of working, including:

  • Carnegie Foundation – Preparation of the Professions – studies call for radical transformation on how we teach and prepare nurses and clinicians for future of care.
  • IOM report on future of nursing – “nurses should be full partners with physicians and other health professions in redesigning care”

Michelle was also awarded the 15th Annual Award for the advancement of technology in healthcare that is traditionally presented at this event.

Other speakers during the day (I was only able attend one of each parallel session, most of which I was chairing/moderating):

Darlene Scott (Saskatchewan, Canada): Connecting the dots: using Web 2.0 tools for interprofessional education –  explored the development of a core IPE (interprofessional education) curriculum to embed in nursing and science and health programmes. It was designed to prepare collaborative, practice-ready care givers.

The conference continues today (Tuesday), beginning with a panel session and followed by individual presentations and keynotes. The conference website is at http://nursing.rutgers.edu/conferences/30th-annual-international-interprofessional-technology-conference


Rutgers 30th Conference – Day 1, Kulikowski Keynote April 16, 2012

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The Rutgers College of Nursing’s Thirtieth Annual International Interprofessional Technology Conference, in New Brunswick, New Jersey, USA  formally started on 15 April, 2012. Held at the Hyatt Regency New Brunswick, the fact that this year sees the 30th offering of this event makes it probably the longest-running annual event of its kind within nursing informatics within the USA. At least two of this year’s speakers, Casimir Kulikowski and Diane Skiba spoke at the second event, in 1984.

After pre-conference workshops, the opening keynote was given by Prof. Casimir Kulikowski, Board of Governors Professor of Computer Science at Rutgers University. Cas is also, among other post, a Vice president of the International Medical Informatics Association (IMIA – www.imia.org) and a co-editor of the IMIA Yearbook of Medical Informatics. He spoke on “How technology helps to improve healthcare globally”, although many of the points raised in his presentation pointed to areas in which technology does not always work at its best to improve health, but has other impacts.

Cas noted that, while we continue to see major advances in computer-information sciences, and advances around increasingly distributed, ubiquitous and mobile technologies, their impacts vary due to the contrasting challenges of developed and developing countries in applying information and computer technologies to health. The application of current technologies to the challenges of the burdens of chronic disease in the ageing in developed countries is still immature, and technologies are not readily available in many parts of the developing world where younger populations still face burdens of infectious disease. He noted the increasing economic challenges of radical shifts in the population support ratio, and also noted that wide disparities exist in terms of gender differences in the incidence of many diseases.

Among the questions he raised was whether it is better to invest spending (especially in terms of health spending) in breakthrough technologies that might have major impact, or to incremental improvements in systems. He noted that incremental changes often result in changes to systems and processes, and do not necessarily benefit people, or work in the best interests of patients.  They often occur in a system of legal constraints, and are responses to needs to reduce costs rather than improve care. He suggested the need to look at technologies that stimulate best care practices, and outlined examples of health-enabling technologies, smart homes/environments and social computing, to provide patient empowerment, self-care and preventive healthcare. He cited the work of colleagues such as Patti Brennan in Wisconsin, George Demiris and colleagues in Washington state, and Haux and Marschollek in Germany who are researching many of these areas, although noted that such work is still in early stages and many of the technologies remain immature.

Cas raised the idea that technology should not at the centre, but be part of a movement towards changing how people interact with technology in the home. There is, he suggests, a need for pervasive, personalised technologies to provide support (ambient assisted living), and that there are demonstrable cost savings if older persons can be supported in homes as opposed to being in hospital.  He introduced Demiris’ work on resistance to care if it is obtrusive, and noted that while smart home technology has the potential to support independence etc.,  using technology can also promote dependency.

Monday sees the first full day of presentations. The conference website is at http://nursing.rutgers.edu/conferences/30th-annual-international-interprofessional-technology-conference

Looking for the MIE2011 Blog? August 10, 2011

Posted by peterjmurray in conference, EFMI, Europe.
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UPDATED, 23 August 2011:

For the MIE2011 blog, please go to http://mie2011blog.wordpress.com – Thanks to Karl Oyri for setting up this blog for the MIE2011 conference and related activities.

Welcome to SINI2010 – day 1 July 21, 2010

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I have finally arrived here in a hot and humid Baltimore (hon) – from a hot and humid Washington DC – for the 20th anniversary SINI – http://nursing.umaryland.edu/sini/ At 2.30pm, the auditorium is filling up and we are nearly ready for the opening session.

I will be attempting to blog and tweet (hashtag #sini2010) from the event over the next few days.

Janet Allan, Dean of the School of Nursing, gave the opening welcome remarks. She noted that the School had started its first nursing informatics programme 22 years ago, and since has graduated over 500 nurses from informatics programmes. The theme of SINI2010 is ‘Nursing informatics: from first use to meaningful use’, and there are over 400 participants in the event.

Mary Etta Mills, conference co-chair followed and gave welcoming remarks to those attending in person and on webcast.

Dr Connie White Delaney (Professor and Dean, School of Nursing, University of Minnesota) is the opening keynote speaker, talking on “Nursing Informatics Empowering Meaningful Use: People, Processes, and Policy”. She began by noting that informatics is her ‘key addiction’ and noted the collegiality that exists in the nursing informatics community. She also noted that nurses have always been involved in person-centred care and the ‘meaningful use’ of data to support care.

Connie says that it is important that nurses’ voices be heard in the electronic health records, as well as the voices of people and families. She gave an overview of the funding opportunities that are expected, and are being granted, towards the development of initiatives in the area of health IT – eg, the funding of research to move beyond the barriers to IT adoption, and to support the development of national interoperability work. The focus, she notes, needs to be on the achievement of quality healthcare for all, through the use of health IT – but that we need to acknowledge the inter-professional and international aspects that have to be addressed.

Connie noted that the outcomes and discussions of many of the meetings of the HIT Policy Committee and HIT Standards Committee, and other related work, are available through the HealthIT website – via http://healthit.hhs.gov/portal/server.pt

Privacy and security, she says, are foundational to achieving meaningful use for health IT, and for developing electronic health information exchange; they are critical to building a foundation of trust to enable/support meaningful use by providers, hospitals, consumers and patients.

Connie notes that health information exchange is currently very patchy, and much work needs yet to be done.

After Connie finishes, we will move on to the traditional Exhibitor Evening and Dinner, held at the University.

OpenHealth, Belfast – morning keynotes January 21, 2010

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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.

OpenHealth conference; Belfast, January 2010 January 21, 2010

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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 – global health informatics November 16, 2009

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“Experiences and challenges of global health informatics” – a panel on global ehealth initiatives, presenting the experiences of practitioners from various parts of the world. The first presenter, Neil Advani, explored the distinction between global and international in terms of health. He says that ‘international health’ is based in tropical medicine, as a distinct speciality, and based in a foreign aid paradigm, while global health is based in global health threats that potentially affect all countries, and a paradigm of elf-sustainable development. International health sees innovation only in ‘developed nations’, while global health sees innovation required in, and occurring in the ‘global south’. International health is based in adapting high-tech solutions to resource constrained areas, while global health sees innovation and exchange occurring in both directions between developed and developing areas.

The first presenter is Muzna Mirza (on behalf of Scott McNab), on Saudi Arabian National Guard Electronic Disease Surveillance System. The system vision is around an integrated surveillance and information system designed for appropriate actions to prevent and control illness.

The second presentation is from Andrew Kanter, on “The Millennium Global Village Network”, a network of 10 countries in sub-Saharan Africa. MVP (Millennium Villages Project) is a partnership between UNDP, national governments, and Earth Institue at Columbia University; it is integrated project, not just focusing on health, but on other aspects of everyday life that influence health and disease.  The project covers about 500,000 people, at a cost of around $120 per person per year. The project is based around primary care clinic registers The project covers about 500,000 people, at a cost of around $120 per person per year. The project is based around primary care clinic registers, but wants to move to comparable and timely data, electronically stored. The project uses OpenMRS as a core to collect structured data from different facilities; information is aggregated, used locally, sent from district information systems to meet the needs of regional and national health ministry levels. The project wants to also find what works and what doesn’t work in different areas, and common themes.

The system needs to be population based, not just based in health clinics. A system built on Open Rosa uses a cellphone based data collection system to then send data to Open MRS and generate reports based in local communities. Challenges include human capacity, reliable electricity (often solar power based), clinician engagement, reliable connectivity (via 3G networks) and government policies. Conclusions include that open robust systems are an important part of these developments.

T Kass-Hout talked about disease surveillance through novel tools in InSTEDD, and the final speaker was Charles Safran, talking about diabetes management in Dubai, United Arab Emirates. About 30% of Emirati seem to develop diabetes later in life (versus a smaller percentage of around 7% in USA). Charles discussed population management of diabetes, and doing so from a distance. He discussed some of the cultural issues around people admitting to having diabetes, and aspects of care. Charles discussed some research into how IT available today can provide better healthcare in Dubai; the results found that people already made everyday use of IT (especially cellphones), but often are not trained in utilising them to their full potential. They found that ‘culture trumps everything’ – Charles suggests a need for ‘cultural informatics’ and a supporting research framework for comparative cultural explorations.

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

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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

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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