INFORMATICS ACROSS THE SPECTRUM

Overview

I was delighted and honored to serve as Chair of the Scientific Program Committee for the 2007 AMIA Spring Congress at the Walt Disney World Swan and Dolphin resort in Lake Buena Vista, Florida. The 2007 Spring Congress drew on the expertise of the informatics community from across the country, and the education program provided attendees with focused content in five important topic areas. The Clinical Decision Support, Nursing Informatics, Personal Health Records, Public Health Informatics, and Translational Research Informatics tracks spoke directly to how informatics and the use of health information technology (HIT) can catalyze advances in clinical care, public and population health, and translational research informatics. The Scientific Program Committee did fabulous work planning a cohesive program of thought-provoking talks, panels, and poster presentations that provided state-of-the-industry information and stimulated some new thinking.

The Congress kicked off with a stimulating keynote address from one of the leading thinkers at Google Health-Adam Bosworth, VP. All enjoyed his perspective on "Putting Health into the Patient's Hands: Consumerism and Health Care," and he stimulated much discussion about realistic patient expectations during the Q&A time. The closing session featured a lively panel on "Clinical Decision Support: Today and Tomorrow." Moderated by Dan Masys, the panel featured perspectives from four settings: clinical (Dean Sittig), research (Chris Chute), public health (Sherrilynne Fuller), and patient (Patti Brennan). The panel served to trigger some new and interesting ideas and left the audience members energized to return to their workplaces.

Clinical Decision Support Track

Definition: The goal of clinical decision support (CDS) is to ensure that optimal, usable, and effective clinical knowledge is widely available to healthcare providers, patients, and individuals where and when they need it to make highquality, cost-effective healthcare decisions. The study of CDS encompasses a variety of tools and interventions, such as computerized alerts and reminders, clinical guidelines, order sets, patient data reports and quality dashboards, documentation templates, diagnostic support, and clinical workflow tools. Achieving desirable levels of patient safety, care quality, patient centeredness, and cost-effectiveness requires that the health system optimize its performance through consistent, systematic, and comprehensive application of available health-related knowledge-that is, through appropriate use of CDS.

Objectives for track:

* To learn a framework for developing, deploying, and assessing clinical decision support

* To acquire techniques for implementing specific clinical decision support interventions

* To appreciate how clinical decision support may be deployed to enhance patient safety and disease management

* To review and gain an understanding of key lessons learned by clinical decision support implementers

Highlight: There was much discussion on how to ensure that clinical decision support is embedded into automated ordering and documentation systems and integrated into the clinician's workflow to recognize value and achieve the benefits of patient safety and quality care.

Nursing Informatics Track

Definition: Nursing informatics is a field in which information processes and tools are used to improve healthcare decision making, communication, and delivery, and to facilitate the unique contribution of nurses across the care continuum. The American Nurses Association (ANA) defines nursing informatics as "a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information, and knowledge to support patients, nurses and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology."¹ Nurse informaticists actively participate in all levels of healthcare to leverage healthcare technology and informatics processes to support the health of people worldwide.

Objectives for track:

* Identify the maximal role of nursing informatics for supporting nurses as patient advocates, care coordinators, and communicators

* Describe the uses of informatics to improve nursing clinical and operational outcomes

* Describe best practice and future directions for using informatics to integrate evidence into practice

Highlight: There were several excellent presentations on the integration of knowledge in clinical systems and supporting the delivery of evidence-based nursing practice, along with the nursing roles required to execute this transformation.

Personal Health Records Track

Definition: Personal health records (PHRs) have recently been proclaimed "the hottest thing in HIT right now." This track will focus on the PHR, with experts discussing the role of the first generation of PHR in the broader scheme of electronic health record systems, what it looks like now, and what future PHR might be if conceptualized as part of an individual's personal health system and how it will interact in a fully functioning interoperable health system.

Objectives for track:

* Describe two to three research efforts under way for innovations in PHRs

* Identify issues and challenges in implementing PHRs

* Describe consumer views of PHRs as revealed in surveys and personal testimony

Highlight: One of the panels in the track included four of the Robert Wood Johnson Foundation Project Health Design awardees, who reported on their first year of work in designing and testing bold ideas for how consumers can use information technology (IT) to better manage their health and navigate the healthcare system.

Public Health Informatics Track

Definition: Public health informatics and its corollary, population informatics, are concerned with communications and IT that focuses on groups, rather than individuals. This parallels the field of public health. Public health is potentially extremely broad and might even reflect an interest in IT with regard to ecology, architecture, climate, agriculture, and such. AMIA will focus on aspects of public health that are considered to be in the purview of the Centers for Disease Control, including security with respect to biosurveillance and bioterrorism. At this time, it does not concern itself with IT for the broadest reaches of public health.

Objectives for track:

* Identify areas of interaction among PHRs, health information exchanges, and public health

* Articulate challenges and opportunities in global health informatics

* Evaluate low-tech informatics solutions for public-health problems

* Compare informatics-supported methods of disease or event surveillance

Highlight: A "reactor panel" discussed their views/ thoughts on a plenary presentation by Kelly Cronin from the Office of the National Coordinator for Health Information Technology regarding the opportunities, challenges, and policy issues facing public health informatics initiatives.

Translational Research Informatics Track

Definition: This track addresses the various topics about informatics support to translational biomedical research, including both aspects of the translation, such as applying discoveries generated during research in the laboratory and in preclinical studies to the development of trials and studies in humans, and enhancing the adoption of best practices in the community. It spans the entire spectrum of research, from the molecular level to the human population, emphasizing the critical role of informatics in facilitating and optimizing dissemination of biomedical knowledge to biomedical scientists, clinicians, and patients.

Objectives for track:

* To present the latest progress on using informatics approaches to improve translational biomedical research

* To provide a platform to share information among the nationwide initiatives on translational research informatics, such as Clinical and Translational Science Awards, Cancer Biomedical Informatics Grid, The National Center for Biomedical Informatics, etc.

* To identify the current challenges of translational research informatics and to define the future directions

Highlight: There was much discussion on how to take biomedical informatics research from the "bench" to the "bedside," including aspects such as embedding biomedical knowledge in clinical systems and electronic health records, as well as incorporating biomedical data in enterprise data warehouses.

Reference:

1. American Nurses Association (2001). Scope and Standards of Nursing Informatics Practice. American Nurses Association: Silver Spring, MD.

Judy Murphy, RN, FACMI, FHIMSS

The 2007 AMIA Spring Congress

May 22-24, 2007

VISTACAST UNVEILS THE IPOD TRAINING SYSTEM SOLUTION FOR FULL-COURSE TRACKING AND REPORTING TRAINING CAPABILITY FOR LEARNERS USING IPODS

Vistacast LLC and Makau Corporation have announced the vLearning iPod Training System (ViTS), an enterprise software solution that enables course developers and training administrators to load educational courses in the Apple iPod. Courses can incorporate multimedia or video, provide quizzes, and report results to a learning management system for measurement and accreditation.

The training administrator has complete access to metrics information for each learner authorized in the iPod. The system is designed to have a software module that runs on the administration server interfacing to the learning management system (LMS) and another software module that runs in tandem with iTunes on the user's PC.

ViTS is the first end-to-end solution to offer content providers the flexibility of using several transports, such as satellite, Internet, and ATSC datacasting to reach a mobile workforce and maintain educational standards for distance learning.

ViTS is currently available directly from Vistacast and reseller partners. For more information, visit http://www.vistacast.com.