Dr. Jayne Goes to AMIA–Saturday

Since I live in a city with multiple academic medical centers, I expected to run into a friend or two on the way to the conference. I was surprised, however, to see two other physicians on my parking shuttle. Although one was headed to AMIA, the other was headed to The Liver Meeting 2015, which is also being held in San Francisco.

Given my crazy frequent flyer status, I was one of the first on the plane and watched at least a dozen other physicians and health informatics professionals pass by. I was relieved that if the question was to be asked whether there was a doctor on the plane, I would have backup (although as an emergency department doc, I’d likely be a better choice than the pediatric hepatologist for most in-flight issues).

I had the chance to catch up on the flight with a friend of mine who works for my former health system. They’re on a journey to a massive rip-and-replace. There is no shortage of informatics work to be done as they retire dozens of major systems in the name of single-database efficiency.

There was another informaticist seated near me and it was interesting to eavesdrop on his chat with his seat mate. He was explaining what he does. There was a brief discussion about data sharing and the difficulties of doing it not only technically, but also about the nervousness of physicians in sharing some of the more sensitive health information that is out there.

We’ve gotten to a point where the incidents of hacks and breaches are too numerous to count. I get the sense that physicians are at the tipping point of being more worried about unauthorized access to medical data than they are about patients having the data. In some ways, that’s a good thing because my peers are getting over their resistance to patient ownership of their own health information. It’s been a long time coming.

The Hilton Union Square was also hosting a nursing convention, where I spotted several people wearing this tee shirt. I’m going to have to seriously think about ordering a few for some of the people I’m working with right now.

I was able to check in to my room a couple of hours early, which was much appreciated and allowed me to head to Union Square. I got a kick out of watching the ice skaters, most of whom didn’t have much experience, but were giving it a good try. Several were watching one man who was there teaching his son and who clearly had spent some time on the ice. I was tempted to rent skates and show off my winter sports skills, but decided to head to the cable car line instead. No less than 30 minutes after I left Union Square, there was a horrific crash of two double-decker tour buses. I wish a speedy recovery for all those injured.

After a couple of hours roaming the city, I returned to the hotel to register for the conference. I loved the Wall of Ribbons and picked up a couple of gems to wear during the week. The conference program guide had a lot of helpful information such as “remove your lanyard when you leave the hotel so you’re not immediately recognized as a tourist,” but it didn’t include a warning that apparently in San Francisco, you’re expected to bring your own bag for carry-out restaurants. Oherwise, there is a bag charge. I’m pretty good at the reduce/reuse/recycle game, but got caught off guard when picking up lunch earlier in the day. That kind of local color information might be helpful in future programs. I appreciated the adjustability of the AMIA lanyards, which allows those of us on the shorter side to hang our badges somewhere north of our navels.

Fast forward to Saturday, when the pre-symposia sessions began. I attended one on “Health Information Exchange Challenges and Methods.” There was a lot of good information covering the different models of HIE and the evolution from early systems to where we are today. There are still quite a few barriers to effective data exchange, including lack of a unique patient identifier or universal physician directory. I learned about a couple of new approaches to bridging between centralized and federated models, but based on the amount of multitasking going, on I’m not sure everyone in the room was as interested.

Maybe they were distracted by the “Data Mining for Medical Informatics – Predictive Analytics” session being held in the next room that must have been pretty exciting judging by the seven rounds of applause heard through the wall in the first 90 minutes of the presentation. For the people who were multitasking, though, may I recommend 3M’s lovely line of privacy screens to keep your neighbors from seeing everything you are doing if you choose to multitask? Surfing Facebook doesn’t make you look like a serious informaticist, although debugging code does. I felt for the gentleman who was doing the latter.

At the break, I ran into HIStalk songwriter extraordinaire Ross Martin, who happened to be seated next to a friend from my customer days at a shared EHR vendor. It’s the first AMIA meeting for both of us and neither of us had dinner plans, so I appreciated the serendipity of running into her.

During the afternoon, I attended a session on “Practical Modeling Issues: Representing Coded and Structured Patient Data in EHR Systems.” Presented by Intermountain Healthcare’s CMIO Stan Huff, it definitely earned its stripes for Maintenance of Certification credit. The session was highly detailed and I got a lot out of it, but I’m sure it was overwhelming for some. I hadn’t heard about the Clinical Information Modeling Initiative becoming one of the HL7 workgroups, but it sounds like it has a lot of potential.

One of the interesting points Stan brought up was the challenge of handling data from a subject who might not be the patient. For example, information on fetal characteristics documented when treating a pregnant woman, or information on tissue donor characteristics for the recipient’s chart. It’s not something I’ve had to do much of in the ambulatory space, but it grabbed my attention. I also enjoyed watching a physician at the next table doing origami with dollar bills. It just goes to show that informatics professionals are a talented bunch.

Do you multitask during conferences? Email me.

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