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AMIA 2009 – global health informatics November 16, 2009

Posted by peterjmurray in AMIA, conference, USA.
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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.

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AMIA 2009 – opening session November 16, 2009

Posted by peterjmurray in AMIA, conference, health informatics.
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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.