EPtalk by Dr. Jayne 10/3/24

The American Medical Informatics Association has given a shout-out recognizing the 10-year anniversary of Clinical Informatics Fellowships and Clinical Informatics Board Certification. I still remember sitting through the all-day informatics exam the first time it was offered, finding it much more terrifying than my clinical board exam. No one knew what to expect, so a lot of us decided to give it the “full send” and sign up since if we didn’t pass we could blame it on the fact that it was new. There are now 60 accredited Fellowships and 2,700 clinical informatics diplomates certified by the American Board of Preventive Medicine or the American Board of Pathology.

DirectTrust recently held its annual conference themed “The Future of Trust in Health.” Hot topics included patient matching, cybersecurity, identity matching, and of course interoperability. The agenda included a who’s who of healthcare technology, including Susannah Fox speaking about the patient-led data revolution, Micky Tripathi discussing digital infrastructure, and Greg Garcia presenting on cybersecurity. DirectTrust is a non-profit alliance that is working to build trust in healthcare-related data exchange and focuses on developing standards and accreditation. It has strategic partnerships with organizations like The Sequoia Project to help promote TEFCA-facilitated FHIR and convenes workgroups around topics like cybersecurity and innovation priorities.

The reader mailbag has been rich this week:

From Greek Gastronome: “Re: Hotmail HIPAA. A family member had a video visit with her physician, who needed a copy of some lab work that another physician had ordered. Apparently it wasn’t available through the group’s interoperability solutions, so the physician instructed the patient to email it to a Hotmail account. I didn’t realize that Hotmail was HIPAA compliant.” There are some days when I simply run out of words to describe the madness that is the US healthcare system, or non-system, as it is on most days.

From Return to Office: “Re: RTO. Since my company started pushing its return-to-office efforts earlier in the year, I have noticed an uptick in meetings that don’t start on time. It seems like it’s become the norm to ‘just give people a few minutes to hop on.’ My last call had 37 people burning time while we waited for a few more people. It was particularly annoying because it was also being recorded, so latecomers could have easily accessed what they missed.” I’ve worked from home since before working from home was a thing, so I’ll have to hypothesize on this one. Since returning to a corporate office likely means having to deal with traffic and parking or having to cross a cube farm to use the restroom between calls rather than going 10 feet down the hall at home, those might be contributing factors. I also suspect people might be getting waylaid in the corporate kitchen and finding it difficult to extract themselves, especially when they’re under the microscope to demonstrate that they’re collaborating with others. I would be interested to see what those of you who have had to return to office think about the phenomenon.

From Jean Claude: “Re: AI. I just read something that made me wonder if patients have anything to worry about with AI and the documentation of clinical (outpatient and inpatient) visits? Just curious on your thoughts.” For me, the major risk is when providers use AI tools to create documentation but don’t proofread their notes before signing. Any errors can be propagated downstream (such as when a consultant reviews an inaccurate history but doesn’t verify it with the patient) and can be compounded when people make decisions on those errors. However, playing devil’s advocate, I have to wonder if it’s any riskier than when we had handwritten illegible notes, or dictated notes that weren’t reviewed after being transcribed. My concern is less with AI-assisted documentation and more with using AI to try to summarize existing documentation or to generate a diagnosis or a treatment plan. Those areas seem much riskier to me.

From Patient Safety Fan: “Re: surgery gone wrong. “Did you see this article about the surgeon who confused the liver and the spleen during a surgery, removing the wrong organ? We need some AI tools to prevent that kind of mistake.” It’s been a long time since I ran the camera in a laparoscopic surgery, which was a prime medical student and intern job where I trained. The patient died after having his liver removed, with the surgeon having been found to have had a similar surgical misadventure in 2023. How cool would it be to have an AI-assisted superimposed surgical map as part of the camera feed for a procedure, similar to some of what can be delivered through military heads-up displays? Now that’s an AI startup I could get behind.

From Race Fan: “Re: branding. I know you aren’t thrilled about hospitals paying for exposure for sports teams and such, but check out this partnership between WVU Medicine and auto racing.” I agree that this partnership is pretty cool, with pediatric patients at the health system helping create designs for a race car. The design, created by three patients, appeared during a September 19 race at Bristol Motor Speedway. Other events at the race were designed to raise funds for WVU Medicine Children’s and to raise awareness of the hospital’s role in caring for the community. The driver’s racing suit will go under the auctioneer’s gavel at the hospital’s gala in February.

Conference season is upon us, and The Hustle had a great post on “Corporate swag will never die.” The piece has some outstanding examples of swag gone wrong, but I appreciate the entertainment value of some of the options. For those of you trying to figure out what you’re going to feature in your booth for upcoming conferences, may I suggest the beer burro, as shared by an intrepid reader who spotted it roaming the aisles at the recent American Academy of Family Physicians FMX conference in Phoenix. As a connoisseur of booth décor and giveaways, I can pretty much guarantee it would drive traffic.

We’ve all seen popcorn and stress balls, but what’s the best swag or best booth giveaway you’ve seen at a conference? Leave a comment or email me.

Email Dr. Jayne.