What I Am Looking Forward to at AMIA Symposium

In this heated political season, there is one debate I am really looking forward to: “Resolved: The lack of interaction and collaboration between health IT vendors and academic clinical informatics units is stifling innovation and will continue to have a detrimental effect on the evolution of commercial products.” The American College of Medical Informatics debate is just one of a dozen reasons I am excited about my trip to the AMIA 2014 Annual Symposium in Washington, D.C., Nov. 15-19.

The ACMI debate will feature John Glaser; CEO of the Health Services Business Unit of Siemens Healthcare; Ross Koppel; Adjunct Professor of Sociology at the University of Pennsylvania; Jonathan Silverstein, Vice President and Davis Family Chair of Informatics at NorthShore University HealthSystem; Curtis Langlotz, M.D., Professor of Radiology and Biomedical Informatics at Stanford University School of Medicine; and Alexa McCray, Co-Director of the Center for Biomedical Informatics at Harvard Medical School.

At a time when interoperability is on everyone’s mind, this debate should engender some lively discussions at the symposium. My experience of attending these AMIA meetings is that although the presentations are academic in nature, they are addressing the key issues facing providers of every stripe. Here is a sample of the sessions I am interested in attending and that I hope to report on for Healthcare Informatics’ readers in a few weeks:

• Multiple Perspectives on Clinical Decision Support:  A Qualitative Study of Fifteen Clinical and Vendor Organizations: To capture a picture of the entire clinical decision support (CDS) landscape including views of multiple stakeholders within and outside healthcare organizations, researchers at Oregon Health & Science University asked the following research question: How are the views of clinical stakeholders, CDS content vendors, and EHR vendors alike or different with respect to challenges in the development, management, and use of CDS?

• Validating Health Information Exchange (HIE) Data For Quality Measurement Across Four Hospitals.  There is also an opportunity to improve public health surveillance, quality measurement, and research through secondary use of HIE data, but data quality presents potential barriers. Researchers at Mount Sinai Medical Center sought to validate the secondary use of HIE data for two emergency department (ED) quality measures: identification of frequent ED users and early (72-hour) ED returns. They compared concordance of various demographic and encounter data from an HIE for four hospitals to data provided by the hospitals from their EHRs over a two-year period, and then compared measurement of our two quality measures using both HIE and EHR data.

• The Healthcare Services Platform Consortium – an Opportunity to Foster Truly Interoperable Health Care Applications. After more than a year of planning, the Health Services Platform Consortium (HSPC) has been incorporated as a nonprofit entity consisting of providers and vendors that are dedicated to fostering the development and use of interoperable applications in health care. The HSPC’s primary strategy is to establish a middle tier of standards-based services for data access, privacy and role-based authentication of users along with other capabilities to support business process management and decision support. The HSPC has adopted the HL7 FHIR model for data access. The success of the venture will depend on persuading commercial EHR vendors to support the standards-based services as part of their infrastructure.

• SMART on FHIR, with speakers David McCallie; Joshua Mandel; Stanley M. Huff; Kenneth D. Mandl; and Isaac S. Kohane. Kohane and Mandl first proposed the development of “substitutable apps” for healthcare systems in a widely discussed 2009 New England Journal of Medicine article.  SMART on FHIR represents a vendor-neutral, standards-based, real-world implementation of that vision in support of an “app store” for healthcare.  SMART on FHIR implements an open architecture to support interchangeable Web applications that can be “plugged in” to any compliant EHR or health data container.  They will demonstrate applications that visualize clinical data, provide decision support, and integrate clinical data with external sources including population health and HIE data.

• Safety-Enhanced Design as a Meaningful Use Objective: Evaluating and Advancing the Usability of Electronic Health Records. The ONC has required, for the first time, that institutions and vendors developing EHRs submit results of summative usability evaluations as part of their application for Meaningful Use Stage 2 certification. The intent was to let developers show evidence of usability of their product so consumers could make informed purchase decisions. Panelists will discuss test studies, results and lessons learned for three home-grown EHRs.

Watch this space for reporting from the symposium! Or perhaps I will see you there.