Posts Tagged ‘Medical Informatics’
February 14, 2012
Algorithms have a growing place in medicine. There are at least two kinds of algorithms – practice guidelines and predictive.
Practice guideline or best practice algorithms may emerge out of practice-based research or consensus panels which recommend specific practices to improve care. One example relates to algorithms in intensive care. Cleveland Clinic has excellent examples on their medical education website which include everything from weaning to acid-based disorders. Some may criticize this as “cookbook medicine.” But with the complexity of care, especially intensive care, these kind of algorithms should be welcome. How these can be integrated into clinical decision support in electronic medical records is yet to be fully realized.
Predictive models, on the other hand, use patient-specific data to determine future risk of disease or risk. Predictive models are usually based upon large data sets and in recent years that means EMR data. A couple of examples:
- Predicting 6-Year Mortality Risk in Patients With Type 2 Diabetesby one of my colleagues
- Development and Validation of a Predictive Algorithm to Identify Adult Asthmatics from Medical Services and Pharmacy Claims Databases
- http://prostatecancerinfolink.net/tips-tools/kattan-nomograms/ by another colleague
February 2, 2012
Health Informatics: Practical Guide for Healthcare and Information Technology Professionals was just published last month by Bob Hoyt of University of Florida. This is the fifth edition and I had the privilege of writing a chapter for the book on eResearch. The chapter takes the view point of the clinical researcher, outlining informatics tools from work prepatory to research, initiation of studies, study recruitment, data management and data analysis. It concludes with future trend, such as, big data and social media.
The book overall includes a broad variety of chapters reflecting the maturity of health informatics from bioinformatics to clinical informatics. Written as a textbook, it will no doubt serve the growing needs of health informatics programs popping up in every state.Share this:
January 25, 2012
Last week I was invited to present to a medical school class on bioinformatics. My topic included EMR data standards, meaningful use and the use of EMR data in research. The session was very interactive and not totally captured in the slides. The challenge was presenting to medical students who are used to group activities, case studies and a research-based curriculum.Share this:
December 29, 2011
There are many top 10 predictions for 2012 out there. I could probably add my own for eHealth and mHealth.
These 10 Business Intelligence Trends for 2012 from Tableau Software apply to healthcare as much as any business.
December 26, 2011
It was a big year for traveling to conferences:
- February – HIMSS Annual Conference in Orlando – spoke at the Social Media center twice and presented on a panel on social media
- March – AMIA Clinical Research Informatics Summit in San Francisco. Two podium presentations (CKD Registry and REDCap business model) and two posters
- April – attended TEDx Maastricht in the Netherlands and a side trip to UMC Radboud in Nimegen.
- April – ACRT meeting (Association for Clinical Research Training) in Washington, DC – panel presentation on REDCap.
- May – Patient Experience Summit at Cleveland Clinic with Enoch Choi presenting
- June – consulting at a hospital in Michigan on data warehousing
- September – Medicine 2.0 Congress in Palo Alto, CA. Poster presentation
- October – American Association of Medical Colleges meeting on Big Data in Washington, DC
- October – Clinical and Translational Science Awards Informatics meeting at the National Institutes of Health. Bethesda, MD – poster presentation
- October – Panel at Case Medical School, Cleveland on Social Media in Clinical Trials
- November – Senior Workers Conference in Minneapolis, MN – presentation on Social Media and Electronic Medical Records
- December – Center for Health Services Research and Policy at MetroHealth Medical Center, Cleveland, on Disease Registries using EMR Data
December 10, 2011
On Dec. 2, I presented at the Center for Health Care Research and Policy at MetroHealth Medical Center on “Registry Using EMR Data: Chronic Kidney Disease Case Study.” This has been a successful registry which I am a coinvestigator on for the past 2 years. Some of the success factors include: a well-functioning interdisciplinary team, a systematic approach to the data, and a step-wise approach to publication and grant writing. It fits well into the IMO model of the Learning Healthcare System.
Slides are available here: http://www.chrp.org/seminars_past.aspShare this:
September 8, 2011
HealthIT.gov redesign was rolled out this week with seperate paths for providers and patients. It makes a great case for EHRs on the provider side including examples of successful implementations in small practices. On the Patient/Family side it explains the value of health IT in lay language and has great videos by some well known ePatients – ePatient Dave and Regina Holiday.
The other announcement is the new Query Health project from ONC which “aims to define and deliver the standards and services for distributed population health queries from certified EHRs and community records, originating in the routine course of patient care.” Excellent goal with some tough technical challenges ahead. Includes implementation, clinical, technical and business. Already many companies and institutions have joined. This has great potential in research for chronic disease and epidemics.
It is a great week for government efforts to enhance healthcare through information technology.Share this:
March 12, 2011
The first speaker I heard at the American Medical Informatics Joint Summit was Kenneth Buetow from the National Cancer Institute. In his typical provocative manner, he challenged the audience on the transition day from the Translational Bioinformatics to the Clinical Research Informatics Summits. He began with promoting the P4 Medicine as the new model for healthcare: personalized, predictive, preemptive, participatory. Although throughout the conference little was articulated on the participatory aspects with one exception. More on that later.
Buetow talked about defining cancer on the molecular level and the challenge of the exponential number of patients required to do genetic screening for a single disease. He referred to Pharma 3.0 from the Ernst and Young report on Progressions 2011 where patient engagement through social media as necessary in this new age of medicine. It is here that he stated, “All diseases will become orphans” meaning that as we understand more about genomics and are able to combine these findings with clinical data, we will understand each disease process on a truly personalized level and hopefully treat it as such.
As part of Pharma 3.0 and a new model for medicine, he did note some encouraging trends in volunteers for clinical trials, true patient activism in a full participatory sense. Specifically, he reported some recent statistics from Army of Women, a joint project of Avon and Susan Love to recruit an army of those willing to volunteer for research studies. Rapid recruitment occurred consistently for studies through this resource while traditional clinical trials continue to suffer from lack of full enrollment. He also referred to adaptive clinical trials as part of this new model. Finally, he discussed the Translatable Informatics Ecosystem as a way of describing how informatics will be key in this new paradigm using Services-Aware Interoperability Framework (SAIF) as one technology to reach that goal.
Many of the presentations at this year’s conference were focussed on data warehouses of clinical and genomic data and ontology development and application include many efforts in the semantic space.
Several speakers referred to Evidence Based Medicine, Personalized Medicine and the Learning Healthcare System implying if not explicitly stating that there is a convergence of the future of medicine and that medical informatics and clinical research informatics are at the center of this convergence. Bill Hersch, noting the explosion of data both in journals and through EHRs and others sources, citing Stead on the need for “Systems of Brains” to manage the amount of information now available
All agreed that Medical Informatics is at a crossroads and has the opportunity to take leadership in the future of medicine, managing the data explosion and making it managable in the personalized medicine era we are entering.Share this:
March 7, 2011
Heading to San Francisco for this AMIA meeting. Looking forward to the opportunity to present from the podium and poster session. Topics include:
- Development and Sustainability of an EHR-based Chronic Kidney Disease Registry
- REDCap – Characterizing the Rapid Adoption at a large Academic Health Center
- Design of a Registry Management Tool for EMR Data
- Research Recruitment in Anesthesia Using EMR Data
There will be many opportunities for networking. Hope to come home with lots of ideas.
Hash tag is #TBICRI11Share this:
November 8, 2010
The article I coauthored in the Clinical Journal of the American Society of Nephrology, Development and Validation of an Electronic Health Record–Based Chronic Kidney Disease Registry, received a nice press release from the American Society of Nephrology which was picked up by both medical and health IT news sources:
- Medscape: CKD Registry Could Help Physicians Improve Patient Care
- Healthcare IT News: EHR-based registry could transform chronic kidney disease care
- Healthcare Informatics: ??????Study: Kidney Disease Registry Could Help Patient Care
- Science Centric: Health registry could transform chronic kidney disease care
- Drugs-Expert: Chronic Kidney Disease Care Could be Transformed by Health Registry
I think that this registry is a model for others which utilize EMR data to study disease and potentially transform care.Share this: