Beyond Medical Informatics

Many use Google as a default search engine for free information, including freely available journal articles.

However, let’s not forget one of the most–if not the most–useful resource for free medical journals: PubMed Central.

PubMed Central (PMC) is the U.S. National Institutes of Health (NIH) free digital archive of biomedical and life sciences journal literature.

I can be guilty of using Google too much, even when other resources, especially PubMed Central, are more appropriate. This post is my way of reminding myself of this invaluable online resource.

Here are quick links for Health Informatics journals:

• PMC Journal List [Search result]
• The Open Medical Informatics Journal
• BMC Medical Informatics and Decision Making
• Journal of Pathology Informatics
• Cancer Informatics
• Journal of Pathology Informatics

For Telemedicine journals:

• PMC Journal List [Search result]
• International Journal of Telemedicine and Applications
• Telemedicine Journal and e-Health

I found a great online resource: IT Execs Release Guidebook on E-Health Records Implementation – CIO.com.

The College of Healthcare Information Management Executives released a guidebook for CIOs and other IT managers with tips and first-hand experiences in implementing electronic health records in order to meet government “meaningful use” standards.

…

The publication, The CIO’s Guide to Implementing EHRs in the HITECH Era, includes best practices and steps health-care organizations should take to successfully implement EMRs, from the initial planning through the final documentation of results.

The guidebook is free for the public and can be downloaded here.

From: PubMed Advanced Search Page Modified. NLM Technical Bulletin. 2010 May–Jun.

The PubMed Search Builder section of the Advanced Search page will soon be modified to provide users with a more cohesive method to build searches.

This should help make searching easier. I should start upgrading my PubMed searching skills.

—

Found a new e-Journal: Applied Clinical Informatics

ACI (Applied Clinical Informatics)

As the Official eJournal of IMIA and AMDIS, the online journal ACI will publish approximately 100 peer reviewed articles per year. It aims to establish a platform that allows sharing knowledge between clinical medicine and health IT specialists worldwide as well as bridging gaps between visionary design and successful and pragmatic deployment.

…

The core editorial subject matters of ACI are: Clinical information systems (including electronic medical records and systems, personal health records, physician/provider order entry, electronic prescribing, clinical decision support, nursing information systems, patient scheduling and tracking tools, lab information systems, radiology information systems, PACS, GP information systems), administrative and management systems, eHealth systems, information technology development,  deployment, and evaluation, socio-technical aspects of information technology and health IT training.

The target group of ACI is an international and potentially very influential readership, e.g.: Chief Information Officers, Chief Executive Officers, Chief Financial Officers, Medical Informatics Researchers, Nurse Informaticians, Consultants, Public Health Officials, Vendors, IT Safety Healthcare providers, Informatics trainees as well as organizations such as IMIA , AMDIS, AMIA, HIMSS or the equivalent.

I hope I get to read some of the articles. Access is not free so I will have to borrow from some friends.

—

This bit of news caught my eye: California hospital says it’s first to self-implement VistA

I found a great resource for NLM Updates:

NLM In Focus

This electronic newsletter gives readers a behind-the-scenes look at the National Library of Medicine and how its vast resources are being used to improve public health and safety, and advance science and medicine.

The US NLM is important to me because I spent over 2 years there for my Postdoc Fellowship in Medical Informatics. I am still looking forward to future collaborations with them once I get the right projects.

A personal emphasis on the article, Going Mobile: Information When and Where You Need It. It tackles research topics in Mobile technology and access–projects I worked with back in NLM with my mentor, Dr. Paul Fontelo (who was also mentioned in the article).

I got this through the Philippine Medical Informatics Society (PMIS) mailing list—a new online Wikibook entitled ‘Handbook of Biomedical Informatics’.

http://en.wikipedia.org/wiki/Book:Biomedicalnformatics

The sender was Instituto Edumed. Here’s an excerpt of the email.:

In another striking innovation in the world of electronic publications  and Web 2.0, the online encyclopedia Wikipedia, in its English version,  has published today a new online Wikibook entitled "Handbook of  Biomedical Informatics", version 1.0, after more than 5 months of  organization work. The book is based on articles published on the  subject by Wikipedia.

The book has 276 pages in its PDF version, and gathers, organizes and  classifies all the knowledge amassed by the Wikipedia articles on topics  in health informatics, telehealth, standards and classifications in  health informatics, and related topics, organized into 21 sections and  more than 250 entries. Thus, it is considered one of the most  comprehensive and complete books in the area.

Head on to the site and see for yourself!

I will give a review or update once I’ve time to run through the contents.

Just a quick observation: In the Wikipedia link, is it really Biomedicalnformatics? In all caps, this is how the namespace would look: BIOMEDICALNFORMATICS. There’s no I in Informatics.

I found very useful links c/o Neil Versel’s Healthcare IT Blog

An EHR primer
This is a short video on the concepts of EHR.

National Alliance for Health Information Technology
This one is new to me, but it’s already shutting down. Too bad. I also found out it published a good list of HIT definitions about a year ago. I like the idea of this National Alliance. Should we start one here in the Philippines? Is there one?

—

Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!

Here’s a list of news, links and articles about Medical Informatics, Healthcare and IT that I found interesting this past 3 weeks.

Medpedia
A new online resource for health professionals and patients. It is an online Wiki for medical knowledge. It adopts Web 2.0 concepts of open platforms, collaborative efforts and fostering communities to build an online repository of user-contributed, peer-reviewed health information.

Healthcare’s Most Wired Magazine
Website of a magazine that does annual benchmarking studies on US hospitals “to promote the effective use of information technology in achieving clinical and operational excellence”. Good resource for hospital managers and IT departments for possible projects.

Plain Language For Health Care Professionals To Improve Communication With Patients
Understanding what language to use based on the audience is important in effective communications. This article highlights the communication gap between doctors and patients and recommends a readibility toolkit to help bridge it. Consider this concept when understanding the differences in implementation, content and usability features of EMRs and PHRs.

Paperless health care? A hospital’s long journey
A short overview of one hospital’s effort to computerize its clinical processes. The article even describes pitfalls and provides tips to those who want to start on their own EMR efforts. Here’s my favorite line: “Building an EMR doesn’t just mean buying software and flipping a switch. It physically changes how doctors and nurses work…”

And some quick links to interesting articles:

• Saving the healthcare industry: EMRs are the ‘beginning, not the end’
• Text messaging promises cheap, effective delivery of health information–in Africa

—

Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!

This article got me thinking about an oft-forgotten but important function of medical informatics: support for life-long learning and continuing medical education (CME).

Most of the Health IT headlines highlight ‘darling’ projects of medical informatics: electronic medical records (EMR), hospital information systems (HIS), clinical decision support systems (CDSS) and even personal health records (PHR). These systems improve on the clinical processes.

Support for learning and medical education improves the user. Better and more competent healthcare teams improve clinical outcomes. Once in a while, every physician needs an ‘upgrade’.

Practical Tips

Here are practical tips for hospitals and organizations:

1) Provide ubiquitous Internet access

Medical departments and doctors’ lounges should have Net access, be it Wi-fi or cabled desktops. ‘Kahit dial-up, pwede na. Basta meron.’ If possible, nursing units and points-of-care should also have PCs with Net access.

2) Maintain a modern and Web-enabled medical library

Make sure PCs in medical libraries have ready links to PubMed, Medscape, WebMD, eMedicine and other online medical resources. Google is also a physician’s friend. If budget is an issue, consider buying single user access to MDConsult and UpToDate and just centralize search and article requests.

3) Build knowledge databases and networks

Store and share medical updates, case reports and journal articles within your group, department or hospital. Even paper printouts can be scanned, stored and shared among hospital staff. This can be done through shared file folders, group wikis or hospital intranets.

4) Create an interactive patient portal on your site

Patient questions and concerns can keep doctors and hospitals on their toes. Open up your site for patient interaction. This will not only contribute towards building knowledgebases but also towards building better relationships with your patients.

CME doesn’t have to be formal

The best method for life-long learning will always be self-driven. That’s why continuing medical education (CME) doesn’t have to be formal. Providing access, venues and stimulus for self-directed learning can help upgrade the skills and knowledge of the healthcare team.

Small practical steps to ‘upgrade’ your staff can make a big difference in the quality of care. So start doing them now.

—

How do you keep yourself or your staff updated? What sites do you visit? What creative ways do you employ to drive and improve self-directed learning?

When I have time to get my mind out of my hospital work, I sometimes wonder about national Healthcare IT initiatives. Where are we as a country in terms of Healthcare IT adoption and implementation?

First off, I don’t have the answer. Second, it is not a rhetorical question.

Health IT is now a ‘hit topic’ in US headlines, mainly because of the Health IT component of the US Stimulus Package. In my HIT List for June 20, I posted an article about Sweden launching a national electronic health record. According to Wikipedia, there are other nationwide projects in the UK and Canada.

Well, what about the Philippines?

The National Telehealth Center (NThC) is at the forefront of national telemedicine projects. And it is doing a very good job. But what about Hospital Information Systems (HIS) and Electronic Medical Records (EMR) adoption?

HIS and EMR adoption may be still be very low among Philippine hospitals, both public and private. Administrative, financial and inventory systems might exist but clinically-relevant applications might be sparse. I hear there are several pockets of successful clinical databank implementations, but data integration and interoperability are still monumental challenges.

Beyond a formal study of national EMR adoption, we can start doing benchmark exercises in our own organizations to see how we compare against US standards. It gives management valuable insight into what still needs to be done.

Benchmarking

Here are 2 good online resources to start benchmarking:

1) CDW Healthcare IT Checkup

The site is basically an online questionnaire. It guides the user to answer several questions about the organizational implementation of client technologies, IT infrastructure and clinical applications. Once completed, a conclusion and graph is shown to compare your hospital against CDW’s data on US hospital IT standards.

2) EMR Adoption Model from HIMSS Analytics

From the site: “HIMSS Analytics, the authoritative source on EMR Adoption trends, devised the EMR Adoption Model to track EMR progress at hospitals and health systems. The EMRAM scores hospitals in the HIMSS Analytics Database on their progress in completing the 8 stages to creating a paperless patient record environment.”

The EMR Adoption Model (PDF) and the EMR Adoption Model Descriptions can also be seen accessed, downloaded and studied for uses beyond benchmarking. It gives a rough draft of what is possible, what applications build on each other and what activities need to be done at a certain stage.

The 1st site is relatively new, but the 2nd one provides US benchmark data from as early as 2006.

National Discussion

I think we should start a national discussion on HIS and EMR adoption and implementation. The HIT advocacy by different groups and people are still ongoing, but it may be time to step it up a notch.

Benchmark data allows us to compare against other countries and establish a baseline. But we are not in a race with other countries. We are in a race with ourselves. So, the point of the exercise is not about catching up. It is about imagining possibilities, proposing local and national initiatives, and coming up with ways to improve delivery of care with the help of information technology.

Knowing where we are is NOT as important as knowing where we want to go.

—

Do you have your own online resources (or maybe offline articles and studies) to benchmark your HIT activities?

Do you know of national initiatives to promote HIS and EMR adoption? How do we jumpstart one? How do we improve efforts in HIT advocacy?

Here’s a list of news, links and articles about Medical Informatics, Healthcare and IT that I found interesting this past 2 weeks (June 7 – 20, 2009). Starting today, all HIT List posts will be every 2 weeks. Enjoy!

IMIA News
IMIA has a new news site! This blog “is the new online news and information service from the International Medical Informatics Association (IMIA – www.imia.org).” I suggest subscribing to its RSS feed. That’s what I did.

Sweden launches national electronic health record
“Sweden rolled out the first stage of the Swedish National Patient Summary initiative last month, according to the project’s partnering IT vendors, InterSystems and Tieto. The nationwide EHR is billed as one of the first of its kind in the world.” Inspiring. I hope it works out. It can eventually serve as a template or model for other countries to use.

Healthcare IT News
I found another good resource for Healthcare IT professionals. This site is published in partnership with HIMSS.

Information Technology: Not a Cure for the High Cost of Health Care
A critical take and look at the flurry of HIT and EMR adoption activities in the US. It makes several good points about whether Healthcare IT can really impact the cost and quality of healthcare.

Making human body a videogame controller
The possibilities are endless! This has a lot of impact on healthcare and medicine. I’m just not sure how ‘gamer couch potatoes’ will feel about moving around the living room to play their favorite games.

—

Is there an interesting Healthcare IT-related link you’d like to share? Please post them below. Thanks!