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Readers Write 11/13/08

November 12, 2008 Readers Write 5 Comments

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Report from AMIA 2008
By Grant Ritter


As a (now part-time) academic, I love coming to AMIA to see what kind of blue-sky thinking is going on in all those NLM-funded labs. As I’ve attended more conferences, however, I find that I enjoy the panels more than the paper sessions.

Dr. David Eddy of Archimedes gave a great keynote about the development of his system. I then went to the public policy session where Dr. David Blumenthal, an Obama advisor, gave his opinion of what will go on in the new administration. Unfortunately, because of his position, he couldn’t give much detail, but there is hope that the $50 billion promised for HIT will somehow survive.

I had another meeting on Monday, so I was sorry I missed “Movie Magic in the Clinic — Computer-Generated Characters for Automated Health Counseling” from Northeastern, along with other sessions on virtual worlds-virtual patients. There was a lot going on during the session about promoting informatics as a recognized profession, with board certification, etc.

Also, several panels on the AHIC successor, whose business model I still don’t understand (in whose interest is it to pay dues?)

The AMIA exhibit hall is little league compared to HIMSS, certainly tailored to the mainly academic audience — NLM, ISO press, Elsevier, training programs … In other words, no booth babes or free cappuccinos.

There were several Web 2.0-themed sessions, from decision support to PatientsLikeMe to one of the top student papers, “A Scientific Collaboration Tool Built on the Facebook Platform”.

Dan Masys’s year in review was probably, as always, the best-attended session (his slides are available on the Vanderbilt Web site). Afterward was a great session on informatics and entrepreneurship.

My favorite speaker of the conference was Craig Feied, founder of Azyxxi (now Amalga) and 13 other companies. The panel also had Michael Kaufman, formerly of Eclipsys. Great for academics to hear from real business people, especially when Mr. Kaufman started talking about EBIDTA. The panel also included some businesses that failed, so great lessons on both sides.A good panel on medical homes Wednesday morning as well.

Above all, the best part about AMIA is being able to go up to people like David Bates and hear what they have to say about your (or their own) ideas. I’m not sure how much interest there would be for someone actually running a clinical information system, but hopefully it provided some glimpses of the future of HIT.

Report from World of Health IT
By Maurice Ganier

I spoke at the World of Health IT last week. It was a real treat being at an HIT conference with only 2,000 attendees (“only” when compared with HIMSS 28,000) and where the focus was truly on the education sessions, most of which were very good. It was also enlightening to see how far behind we are here in the US compared to other countries with socialized medicine. Even just referring to what we call patients, as “citizens” brings home the point that they have a vested interest in caring for their populations.

Aside from the fact that Panasonic debuted their new mobile clinical assistant device to go head-to-head with the Motion C5 – and directly across the aisle from Motion’s booth, no less – the absolutely coolest thing in the hall was a booth run by the Danish government showing off their IT Experimentarium. It is a “dummy” hospital, complete with nursing unit and patient rooms equipped with all types of equipment, in which all health IT applications are designed, put through their paces to ensure that they address workflow adequately and optimally, and then used for training.

Better than the popular “conference room pilots” that we are accustomed to using, the “patients” (either real people being instructed by a doc behind the curtains through an earpiece, or a dummy with a built-in speaker through which the doc speaks) are able to convey real-life scenarios to the clinicians providing care either through a script or by incorporating “curve balls” to truly test the limits. There is a good video available all about it at www.regionh.dk/itx (scroll down to access the English-language version).

Clinical Software Review – Microsoft CUI
By The PACS Designer


The Microsoft Common User Interface has been released for review and user input based on Microsoft’s Silverlight platform. We did a review of the "Microsoft CUI Introduction" previously, so now we are going to follow the path for finding a patient.

To proceed with this lesson, you need to have Microsoft’s Silverlight platform installed on your system. Get the download here.

After logging off and relaunching your system, you can go to the Microsoft CUI by clicking this link.

We are going to launch the "Patient Journey Demonstration". Once you are on the Patient Journey Demonstration page, you are going to be navigating to the Primary Care section first, so click the "Launch Button" under "Primary Care".  Follow the steps below to learn the best method for navigating:

We want to find a patient in the Microsoft CUI named Brian Johnson so we can see the details on his condition for his next appointment.

  1. The first step is to look for Brian Johnson’s name in Dr. Oliver Cox’s schedule on the "GP landing page".
  2. Dr. Cox has an 8:50 appointment with Brian and wants to review his medical history. To view it, double click Brian’s name on the appointment schedule for Dr. Cox and you’ll see the many aspects of his medical record.
  3. Under "Most Recent Activities," click the clear box in the upper right hand corner to expand the record. Since Brian’s hypertension is now accompanied by chest pain, you want to next click the box for Dr. Christina Lee in the lower right hand corner. You will see that Dr. Paul Dunton, a cardiologist, is covering for Dr. Lee since there is a Green Bullet before his name. Click the Green Bullet for contact options and click desired method to launch Outlet Express 6 if you wanted to communicate with him. Click box in upper right hand corner to return to previous screen.
  4. Next, click the clear box in "Patient Charts" to expand Bryan’s charts for hypertension. Click the different chart descriptions to see their data points. When finished, move the mouse pointer to 2. Patient Record under Scenes at top of screen to return to previous screen.
  5. For the balance of this exercise, navigate to the other aspects of this record to view their details.


This completes this view session for Silverlight and the Microsoft CUI.  TPD will be doing Secondary Care next.

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Currently there are "5 comments" on this Article:

  1. The Feds talk about healthcare reform. Their definition is lower costs, higher qulality and patients safety, and universal health financed from the savings.

    Why are vendors not offering solutions to this?

    This is where the money is. I am confused

  2. “It was also enlightening to see how far behind we are here in the US compared to other countries with socialized medicine.”

    That statement needs qualifying, I’d say. Are we behind in cool technologies, or actual face-to-face healthcare end-results – and is that the actual patient’s… I mean, comrade’s… or rather, citizen’s point of view or just the technologists? I’m not picking a fight here, because I don’t know enough about it to do that – but I looked and found thousands of articles about the evident reality of socialized medicine and how agonizing and horrific much of socialized medicine really is. Apparently, while some in the US are rushing blindly into socialized medicine (and everything else), many others beyond whatever borders we still have seem to be running in our direction.

    I don’t know… I’m just sayin’.

  3. Grant, thanks for the AMIA write-up – you make me want to go to the next AMIA conference!… do you have any sound bites you can pass along from the content of the conference?… maybe something that made you say, “wow, I hadn’t heard that before”…or “I’ve heard of the concept, but this comment really puts meat on the bones”… looking forward to more fine reporting … thanks again…

  4. In response to SimpleOldGuy, my comments were not intended to place any values on socialized medicine other than that the incentives to manage the health of a population, and the resulting funding streams, are enabled through socialized medicine versus our very broken health care system in the US. The “cool” parts are both – state-of-the-art technologies as well as demonstrable results.

  5. We have an “IT Experimentarium” here at Kaiser called The Sidney Garfield Health Care Innovation Center, here is a description of the service it provides:

    The Sidney R. Garfield Health Care Innovation Center is a simulated care delivery environment for testing new ideas and designs. At the Garfield Center the people of KP, our members, and the communities we serve come together with a common vision to improve the care we deliver by developing and evaluating new technologies, products, clinical care processes, and facility designs.

    The Garfield Center provides a physical testing ground for new technologies, hospital design and materials, workflow, and biomedical equipment in advance of their adoption and utilization. Space includes:

    Clinical and nursing unit with patient rooms fully mocked up including medical surgery room, operating room, emergency department treatment Room, and labor & delivery room
    IT & Biomedical technology laboratory
    Rapid prototyping spaces
    Outpatient setting with provider offices, exam room, and reception areas
    Home care environment
    Learning and conference center
    Test Before Build

    Kaiser Permanente physicians and staff have the unique opportunity to work side-by-side with designers, architects, and technologists to test and evaluate everything from biomedical equipment, new technology, facility designs, and materials before implementation. For example:

    The Innovation and Advanced Technology Group will utilize testing environments to evaluate advance technologies
    National Facilities Services will take a look at workflow, paths of travel, patient monitoring and visibility, patient, family and staff amenities, and support and functional systems, as well as finishes, equipment and design standards
    Biomedical Engineering and KP-IT will utilize a “plug and play” testing area to support testing and training on the use of new devices.

    Just thought you should know

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