Seminars
Weekly seminars are held on Fridays, 1-2 PM,
at the DSG Conference Room.
Everyone is welcome to attend!
9/5/2008
Lucila Ohno-Machado MD PhD
Title: State of the DSG
Abstract:
She will do a review of 2007-2008, highlighting achievements, and discussing DSG goals for 2008-2009.
9/12/2008
Frederic Resnic MD MS
Director, BWH Cardiac Catheterization Lab
Title: Automated Surveillance of Safety Signals in Cardiovascular Outcomes Databases
Recent Seminars (2008)
Previous Seminars (2007)
Previous Seminars (2006)
09/28/06
Lucila Ohno-Machado MD PhD
Title: SMART: Scalable Medical Alert Response Technology
Abstract:
Brigham & Women's Hospital proposes to combine existing and new technologies to develop SMART: Scalable Medical Alert and Response Technology, a system for patient tracking and monitoring that begins at the emergency site and continues through transport, triage, stabilization, and transfer between external sites and health care facilities as well as within a health care facility. The system is based on a scalable location-aware monitoring architecture, with remote transmission from medical sensors and display of information on personal digital assistants, detection logic for recognizing events requiring action, and logistic support for optimal response. Patients and providers, as well as critical medical equipment will be located by SMART on demand, and remote alerting from the medical sensors can trigger responses from the nearest available providers. The emergency department at the Brigham and Womens Hospital in Boston will serve as the testbed for initial deployment, refinement, and evaluation of SMART. This project will involve a collaboration of researchers at the Brigham and Womens Hospital, Harvard Medical School, and the Massachusetts Institute of Technology.
10/5/2006 Ronilda Covar Lacson MD PhD
Title: Automatic Analysis of Medical Dialogue in the Home Hemodialysis
Domain: Structure Induction and Summarization
Abstract:
Spoken medical dialogue is a valuable source of information for patients and caregivers. This work presents a first step towards automatic analysis and summarization of spoken medical dialogue. A dialogue is abstracted into a sequence of semantic categories using linguistic and contextual features integrated in a supervised machine-learning framework. This model has a classification accuracy of 73%, compared to 33% achieved by a majority baseline (p<0.01). A summarizer is then described and implemented utilizing this automatically induced structure. The evaluation results indicate that automatically generated summaries exhibit high resemblance to summaries written by humans. This work demonstrates the feasibility of automatically structuring and summarizing spoken medical dialogue.
10/12/2006 Jose Trevejo MD PhD
Title: Medical Applications of the Breath Analyzer
10/19/2006 Jerry Chen MD
Title: The use of machine learning techniques for classifying microcalcifications in digital mammograms
Abstract:
Dr. Chin-Yu Chen will be leading the discussion on the use of machine learning techniques for classifying microcalcifications in digital mammograms. He will begin by reviewing the attached journal article and then proceed with some thoughtful questions and ideas regarding his current research study.
10/26/2006 Michael Matheny MD
Title: Methodologies and Automated Applications for Post-Marketing Outcomes Surveillance of Medical Devices and Medications
11/2/2006 Margarita Sordo PhD
Title: On Sample Size and Classification Accuracy: A Performance Comparison
Abstract:
We investigate the dependency between sample size and classification accuracy of three classification techniques: Naïve Bayes, Support Vector Machines and Decision Trees over a set of ~8500 text excerpts extracted automatically from narrative reports from the Brigham & Women’s Hospital, Boston, USA. Each excerpt refers to the smoking status of a patient as: current, past, never a smoker or, denies smoking. Our empirical results confirm that size of the training set and the classification rate are indeed correlated. Even though these algorithms perform reasonably well with small datasets, as the number of cases increases, both SMV and Decision Trees show a substantial improvement in performance, suggesting a more consistent learning process. Unlike the majority of evaluations, ours were carried out specifically in a medical domain where the limited amount of data is a common occurrence. This study is part of the I2B2 project, Core 2.
11/9/2006 Samuli Niiranen PhD
Title: Types of Unintended Consequences Related to Computerized Provider Order Entry
Authors: Emily Campbell, Dean Sittig, Joan Ash, Kenneth Guappone, Richard Dykstra
Abstract:
Dr. Samuli Niiranen will begin by reviewing the attached journal article and then proceed to talk about how the paper relates to his current research.
11/30/2006 Pankaj Sarin MD
Title: Encouraging changes in anesthesiology practice through electronic feedback
Abstract:
This research focuses on providing electronic feedback to physicians regarding their practices and patient outcomes. After introducing the methods, there will be a discussion about the design and implementation of a study on electronic feedback to attending anesthesiologists and whether this feedback induced practice change in the group.
12/7/2006 Staal Vinterbo PhD
Title: Approximating the Minimal Cover Problem
Abstract:
The Minimal Cover problem is the problem of selecting m out of n finite sets such that the union of these m sets is minimal. This problem is interesting because an algorithm for Minimal Cover can be used to find a solution to the k-ambiguity by cell suppression problem. This latter problem is related to privacy in disseminated data.
The speaker will present a polynomial time algorithm for Minimal Cover that delivers a solution that is guaranteed not to be worse than m times the optimal. This algorithm allows us to find a solution to the k-ambiguity by cell suppression problem that is guaranteed not to be worse than (k-1) times the optimal. If time allows, he will show that there probably is no polynomial time algorithm that can guarantee solution quality within a constant factor of the optimal for both problems. These results are, as far as the speaker knows, the first of their kind for these problems.
12/14/2006 Robert Greenes MD PhD
Title: funding opportunities and possibilities at AHRQ and TATRC
12/21/2006 Esther Schilcrat PhD
Title: National and Local Databases to Support ePrescribing
Abstract:
DSG has been part of an ongoing effort to analyze the use of HL7 GELLO expression language in support of electronically mediated prior authorization within the context of ePrescribing. In particular, these efforts have also been directed towards the use of GELLO to create a nationally mandated ePrescribing prior authorization database (National).
The existence of a National will afford institutions the opportunity to create their own Local "version" DB. The Local can reflect rules from the National, as well as institution specific medical and business rules. Thus, an immediate issue is how to 'meld' local formularies and other rules with those presented in the National.
In addition, the Local may be further structured to support a variety of tasks beyond prior authorization. For one example, the Local could reflect local business rules. As another example, the Local could be designed to facilitate the execution of electronic guidelines. This would require information to be stored to facilitate quick identification of drugs in "categories of interest." We need to discover what these categories are by studying prescribing needs, such as are expressed in guidelines (ex., "is patient using inhaled steroid?" suggests the need to classify a drug as a steroid for quick
retrieval.)
These two issues have considerable overlap, as adapting rules from the National to the Local would seem to require similar use of categories.
For example, ideally, with the right categories, for any rule in the National, we can answer: does the local formulary already contain a 'close enough' drug? This information would then be used to decide on the contents of the Local.
There are many open questions, such as maintaining 'consistency' between the National and its Local variant. We also seek to create an 'updatable' ontology which will change as we learn more about the problem domain. This work is very preliminary and suggestions are most welcome!
1/11/2007 Chris Tsai MD MPH
Title: VIR-POX: An Agent-Based Analysis of Smallpox Preparedness and Response Policy
Authors: Benjamin M. Eidelson and Ian Lustick
Link: http://jasss.soc.surrey.ac.uk/7/3/6.html
Abstract:
He will be reviewing a journal article entitled "VIR-POX: An Agent-Based Analysis of Smallpox Preparedness and Response Policy". The link to the journal article is shown below. He will then discuss Agent-Based Modeling in general and its use in mass vaccinations.
1/18/2007 Qing Zeng PhD
Title: Text Characteristics of Clinical Reports and Their Implications for the Readability of Personal Health Records
Abstract:
Through personal health record applications (PHR), consumers are gaining access to their electronic health records (EHR). A new challenge is to make the content of these re-cords comprehensible to consumers. To address this challenge, we analyzed the lexical, syntactic and semantic characteristics of three sets of health texts: clinical reports from EHR, known difficult materials and easy-to-read materials. Our findings suggest that EHR texts are more different from easy texts and more similar to difficult texts in terms of syntactic and semantic characteristics; and EHR texts are more similar to easy texts and different from difficult texts in regard to lexical features. Since commonly used readability formulas focus more on lexical characteristics, this study points to the need to tackle syntactic and semantic issues in the effort to measure and improve PHR readability.
1/25/2007 Lola Ogunyemi PhD
Title: Probabilistic Reasoning for Trauma Decision Support
Abstract:
This talk will briefly examine different approaches adopted in the biomedical informatics domain for assessing the effects of penetrating trauma. The majority of the talk will be devoted to TraumaSCAN-Web, a web-based diagnostic decision support tool for penetrating trauma developed at DSG. Results of an assessment on Brigham & Women's Hospital Emergency Department residents, and an evaluation of a Bayesian network-only approach for penetrating trauma will be presented.
2/1/2007 Lucila Ohno-Machado MD PhD
Title: Uses and Misuses of the Coefficient of Variation: Implications for Studies of Ecosystem Stability
Abstract:
The ongoing controversy about the effects of biodiversity on ecosystem stability contributes to the challenge of establishing evidence-based conservation and restoration policies. The controversy may be partially explained by differences in the definition of stability and measurement indices. Some authors define stability as the lack of variability in biomass, often measured by the coefficient of variation (CV). Some studies conclude that increased biodiversity is associated with increased stability, and that stability necessarily increases from the species to the functional group to the community levels; others report either negative or no association. Even disregarding the effects of statistical averaging (the portfolio effect), the decline in CV may not necessarily indicate that systems are less variant, but be simply an artifact derived from misuse of the CV. Here we show that, in the context of observational studies in which variability for a single species is assessed in a multispecies environment, (1) the CV is a misleading index that can give rise to erroneous interpretations and
(2) comparisons using an alternative index are more appropriate for the assessment of ecosystem variability. The alternative index requires few but realistic assumptions about the relationship between the quantities for which variabilities are being compared.
2/8/2007 Mark Finlayson
Title: The Difficulties of (Medical) Text Annotation
Abstract:
The digitization of medical records presents exciting opportunities for improving medical care. For example, digitally-accessible medical records could conceivably enable a doctor to search his patient's records like he might search Google, allow a researcher to analyze large sets of records to study trends or the effectiveness of novel treatments, and make possible the training of exceptionally accurate, domain-specific diagnosis programs. But, despite the great efforts made toward these applications, they are foundering on what seems, on the face of it, a simple problem, but in truth is an extremely difficult technological shoal: the ability to translate free text into computer-understandable form. This is a general knowledge capture problem that has plagued many areas of artificial intelligence and computer science, and is not specific to medical text understanding. In
this talk I will review the general problem of natural language understanding with a view toward knowledge-capture systems, drawing my examples from medical record understanding, and present some recent progress that has been made in semi-automatic annotation tools that are the only feasible near-term solution to this problem.
Short Bio:
Mark A. Finlayson is a doctoral student under Patrick H. Winston at MIT's Computer Science and Artificial Intelligence Laboratory. His research is at the interface between Artificial Intelligence and Cognitive Science, focusing primarily on fielding models of psychological experiments regarding the effects of knowledge, culture, and expertise on cognition.
2/15/2007 Ronilda Covar Lacson MD PhD
Title: Predicting Mortality in Hemodialysis Patients Using Wavelets
Abstract:
The role of blood pressure in cardiovascular morbidity and mortality in hemodialysis patients has not been fully elucidated. High blood pressures as well as low blood pressures are poor prognostic indicators for mortality in this large population of patients. Hypertension is a known risk factor for mortality and cardiovascular disease in the general population. Recent studies, however, indicate an inverse association between blood pressure values and mortality in hemodialysis patients. Further, the range of blood pressure which would be considered hypertension is not clear for this subset of patients. Blood pressure is clearly a useful predictor to monitor because it is both easily measurable and it is modifiable. This talk will review various methods that have been used to predict mortality using blood pressure measurements. The speaker will then proceed to discuss a method that predicts mortality using multiple blood pressure values measured over time at varying intervals that takes the direction, magnitude and rate of change into consideration.
2/22/2007 Jerry Chin-Yu Chen MD
Title: Medical audit of mammography - what the data tell us.
Abstract:
The presentation will be based on a recently finished manuscript (attached file), which is not yet submitted for publication. The talk will begin with an introduction of mammography medical audit, and then proceed to discuss the results of medical audit when applied to the Taiwanese population. A comparison of these results will be done with those from North America. Finally, differences between the different subgroups of the study cohort will be discussed.
3/1/2007 Ilmo Parvinen, MD, Director, Sitra (The Finnish Innovation Fund, www.sitra.fi) Health Care Program
Title: Sustainable Health Care Systems : Impact of Value Based Improvements
Abstract:
The current state of the Finnish health care system is analyzed as a starting point for presenting Sitra?s view on how sustainable developments in health care can be attained. The key drivers and agents of change are
- Deployment of electronic services
- Structural changes in the health care delivery system
- Changes in the stature, actions and responsibilities of the citizen
The utility of these drivers and agents is also considered in an international context with a focus on the US. The key message is that although national situations vary, co-operation is vital and that discussion is not enough, concrete actions are needed.
3/8/2007 Lucila Ohno-Machado MD PhD
Title: Clustering medical informatics: a didactic presentation
Abstract:
In this talk, I will give a technical overview of unsupervised learning
techniques, primarily hierarchical clustering and multidimensional
scaling. I will then briefly discuss two examples that illustrate these
techniques and relate to the analysis of co-citations, specifically for
biomedical informatics literature. If time permits, I will take the
opportunity to discuss the primary venues for biomedical informatics
publication, emphasize the importance of participating in article and
grant reviews, and some practical hints (particularly for those who
want to pursue an academic career).
3/15/2007 Margarita Sordo PhD
Title: "Tutorial on Agent-Based Modeling and Simulation Part 2: How to Model
with Agents" by Charles M. Macal & Michael J. North
Abstract:
The paper is an introduction to Agent Based Modeling and Simulation
(ABMS). It is organized in two parts: 1) How to think about ABMS. The
background, motivating principles and main concepts are described.
Second part is on how to do ABMS. It presents practical applications,
toolkits and development approaches. Examples are presented throughout
the paper.
3/22/2007 Samuli Niiranen PhD
Title: Information Management in the Emergency Department
Abstract:
I will discuss two specific examples in this domain from my own work: computational understanding of chief complaint information and, briefly, visualization of emergency department patient flow.
4/5/2007 Ramin Khorasani, MD
Title: Information Management Systems Group, BWH
Abstract:
He will share the various research and initiatives of his group at the BWH Department of Radiology.
4/12/2007 Staal Vinterbo PhD
Title: Discernibility Properties of Bernoulli Process Data
Abstract:
Finding patterns that discern data-points in multidimensional data is NP-hard in general, forcing the use of approximations. The use of such patterns can be in classification or disclosure control. The talk will present properties of a discernibility matrix computed from binary data stemming from Bernoulli trials, and show that these can be used to gain insight into the efficacy of pattern recognition algorithms.
4/19/2007 Bonnie Kaplan PhD
Title: Same System - Different Views: Dilemmas and Research Avenues for IT
Abstract:
Many exciting uses of IT for healthcare were developed over the past 50 years. This experience informs us both of barriers and facilitators to IT adoption and use. My research focuses on how to design, deploy, and study IT in healthcare by investigating how people respond to IT applications. I will discuss research findings and suggest new research avenues involving management, organizational, ethical, social, and policy issues that may arise from new technologies in health care.
Bonnie Kaplan, Ph.D., is a Lecturer at the Yale Center for Medical Informatics; Adjunct
Clinical Professor, Department of Biomedical and Health Information Sciences, University of Illinois at Chicago; and President of Kaplan Associates. She chairs the International Medical Informatics Association's Working Group on Organizational and Social Issues, and founded the Yale Interdisciplinary Bioethics Center Working Group on Technology and Ethics as well as the Yale Whitney Humanities Center Working Group on Science, Technology, and Utopian Visions. She is author of more than 70 papers and book chapters on people's reactions to new technologies and computer systems in health care. Dr. Kaplan is a recipient of the American Medical Informatics Association President's Award and a Fellow of the American College of Medical Informatics.
She is an authority on people's reactions to new technologies in health care and on evaluating applications of computer information systems. She specializes in change management, benefits realization, and identifying and addressing clinician and patient concerns. Her clients include the US Department of Veterans Affairs (VA) and the US National Institute of Standards and Technology (NIST); the Universities of Pittsburgh, Chicago, Washington, and Cincinnati; Yale, Boston, Oregon Health Sciences, and Johns Hopkins Universities; and Massachusetts General Hospital.
Dr. Kaplan is the author of more than 70 refereed papers and book chapters, as well as numerous other articles and publications. She wrote invited chapters in the most important books on evaluating information systems in health care. Her most recent publications concern patients' reactions to using an automated telephone advisory system; a usability evaluation of a web based case for in medical education; issues in evaluating clinical decision support systems and medical informatics applications; a review of people, organizational, and social issues in medical informatics; and an volume of edited papers.
5/3/2007 Michael Matheny MD
Title: Impact on Patient Satisfaction with Physician Use of an Automated Test Results Management System
Abstract:
He will be discussing the strengths and weaknesses of using a pre-post randomized controlled design relative to a straight-forward randomized intervenion study. This statistical introduction will be followed by an application of this methodology for the evaluation of patient satisfaction with test results communication after the implementation of automated test results management system (Results Manager).
5/10/2007 Hyeoneui Kim PhD
Title: Beyond Surface Characteristics: A New Health Text-Specific Readability Measurement
Abstract:
Accurate readability assessment of health related materials is a critical first step in producing easily understandable consumer health information resources and personal health records. Existing general readability formulas may not always be appropriate for the medical/consumer health domain. We developed a new health-specific readability pilot measure, based on the differences in semantic and syntactic features as well as text unit length. The tool was tested with 4 types of materials: consumer health texts, electronic health records, health news articles, and scientific biomedical journals. The results were compared with those produced by three commonly used general readability formulas. While the general formulas underestimated the difficulty of health records by placing them at the same grade levels as consumer health texts, our method rated health records as the most difficult type of documents. Our ratings, however, were highly correlated with general formulas ratings of consumer health, news, and journal articles (r=0.81~0.85, p<.0001).
5/17/2007 Pankaj Sarin MD
Title: Improving healthcare for patients with cardiovascular disease in Tanzania:Technological limitations and solutions
Abstract:
Cardiovascular disease is 8% of disease burden in Tanzania and one of the top causes of morbidity and mortality amongst non-communicable diseases. Although focus has been on communicable diseases, it is projected that NCD will match CD in developing countries in disability adjusted life years (DALY) by 2030. I will provide an overview of the current healthcare system and needs, limitations of infrastructure affecting technology choices, and examine how technological solutions can be used within these constraints to provide improved healthcare to patients.
5/31/2007 Lucila Ohno-Machado MD, PhD
Title: Intermediate Phenotypes for Genetic Markers
6/7/2007 Chris Tsai MD MPH
Review
Title: Informatics Systems to Promote Improved Care for Chronic Illness: A Literature Review DAVID DORR, MD, MS, LAURA M. BONNER, PHD, AMY N. COHEN, PHD, REBECCA S. SHOAI, MPH, MSW, RUTH PERRIN, MA, EDMUND CHANEY, PHD, ALEXANDER S. YOUNG, MD, MSHS
Abstract:
Objective: To understand information systems components important in supporting team-based care of chronic illness through a literature search.
Design: Systematic search of literature from 1996-2005 for evaluations of information systems used in the care of chronic illness.
Measurements: The relationship of design, quality, information systems components, setting, and other factors with process, quality outcomes, and health care costs was evaluated.
Results: In all, 109 articles were reviewed involving 112 information system descriptions. Chronic diseases targeted included diabetes (42.9% of reviewed articles), heart disease (36.6%), and mental illness (23.2%), among others. System users were primarily physicians, nurses, and patients. Sixty-seven percent of reviewed experiments had positive outcomes; 94% of uncontrolled, observational studies claimed positive results. Components closely correlated with positive experimental results were connection to an electronic medical record, computerized prompts, population management (including reports and feedback), specialized decision support, electronic scheduling, and personal health records. Barriers identified included costs, data privacy and security concerns, and failure to consider workflow.
Conclusion: The majority of published studies revealed a positive impact of specific health information technology components on chronic illness care. Implications for future research and system designs are discussed. J Am Med Inform Assoc. 2007;14:156-163.
6/14/2007 Qing Zeng PhD
Title: Multifaceted Adaptive Testing Approach for Literacy in Older Adults
Abstract:
The overall objective of this study is to develop and validate a flexible health literacy instrument for older adults employing the state-of-art computational technology. A comprehensive health literacy framework as described in this proposal can be used to support research on health literacy, develop screening tools for clinicians and tailor health education materials for older adult patients and consumers at varying levels of literacy. This can contribute to empowering patients and health consumers as well as serving to narrow the digital divide.
6/21/2007 Esther Schilcrat PhD
Title: Toward a More Comprehensive Taxonomy of Consumer Health Information Needs
Abstract:
As consumers become savvier about health related resources, and more desirous of understanding their own, or family members’ health conditions, it is increasingly important to analyze and represent consumers’ health related information needs. On the basis of prior efforts, we developed a more comprehensive and detailed taxonomy of such needs. The taxonomy is also designed to capture consumer needs related to information resource characteristics. We present a description of our initial taxonomy and validation study. We also describe our on-going efforts to uncover and classify more consumer health needs.
7/12/2007 Aziz Boxwala, MD, PhD
Title: Obtaining medical history from the patient by computer-based
interviewing
Abstract:
Medical history obtained by a physician during a clinic visit has many
important deficiencies. Obtaining the history by having the patients enter
it in a computer has several advantages. While computer-based patient
interviewing programs have been experimented with for over 50 years,
clinical adoption is limited due to challenges including those related to
workflow and funding for deployment of such tools. A confluence of factors,
such as the availability of computers and high-speed network connections,
use of electronic medical records, and reimbursement predicated on the
comprehensiveness of documentation make this a more favorable time for use
of computer-based patient history taking. A recent pilot study at the
Brigham and Women's Hospital indicated that patients responded favorably to
computer-based interviews. Important lessons were learned on factors
affecting physician adoption.
8/9/2007 James Signorovitch PhD
Title: Practical Optimality Theory for Large-Scale Multiple Hypothesis Testing
Abstract:
Very large data sets are often generated with the goal of discovering a few
interesting patterns for further study. Genomewide association mapping,
health surveillance, text mining and gene expression microarray studies, to
name some current examples, all aim to discover the most promising signals
against vast backgrounds of random noise.
The potential for chance findings in such efforts is well-appreciated, and
statistical tools for limiting false discoveries are widely used.
However there has been little statistical theory to help us make as many
true discoveries as possible while limiting chance findings. Progress has
been made, with new ways of using information providing impressive gains in
power -- but these improvements have not been guided by a practical
optimality theory that tells us how to use all relevant information in the
data. Further improvements could be possible.
This talk will begin by briefly surveying the history of multiple hypothesis
testing as a scientific and a statistical endeavor. I'll then describe a
concise and practical optimality theory for multiple hypothesis testing that
tells us how to construct the best possible procedure, exploiting all
available information, for a wide range of problems. The proposed
procedures are evaluated through simulations and applications to gene
expression microarray data. Surprisingly, the new theory tells us that
commonly used testing procedures are far from optimal. Guided by the
optimality theory, we propose new testing procedures that can substantially
outperform existing methods by exploiting strong patterns in the data that
have generally been ignored.
8/23/2007 Joseph Kvedar MD
Title: The Connected Health Imperative: using patient-centric technologies to
improve quality, access and efficiency.
8/30/2007 David Kaelber MD PhD
Title: The Value of Information Technology-Enabled Diabetes Management.
Abstract:
Objective: To determine the financial and clinical costs and benefits of
implementing information technology enabled diabetes management systems.
Research Design and Methods: A computer model was created to project the
impact of information technology enabled disease management on care
processes, clinical outcomes and medical costs for type 2 diabetic patients
over the age of 25 in the United States. Several information technologies
were modeled: diabetes registries, computerized decision support, remote
monitoring, patient self-management systems and payer based systems.
Estimates of care processes improvements were derived from published
literature, trade publications, the general press, and experts. Simulations
projected outcomes for both payer and provider organizations, scaled to the
national level.
Results: All forms of information technology enabled disease management
improved the health of diabetic patients and reduced health care
expenditures. Over ten years, diabetic registries saved $14.5 billion,
computerized decision support saved $10.7 billion, payer-centered
technologies saved $7.10 billion, remote monitoring saved $326 million and
self-management saved $285 million. Integrated provider-patient systems
yielded $16.9 billion in savings. Provider-sponsored diabetes registries are
projected to be the least expensive approach for small and medium sized
practices. For large practices with electronic health record systems, it is
most economical to modify such systems with diabetes-specific clinical
decision support capabilities.
Conclusions: Information technology enabled diabetes management has the
potential to improve care processes, delay diabetic complications and save
healthcare dollars. Of existing systems, provider-centered technologies
such as diabetes registries show the most current potential for benefit.
Fully integrated provider-patient systems would have even greater potential
for benefit. Provider registries are generally the most economical
approach.
9/14/2007 Chris Hinske MD
Title: Developing a Software for the Human Simulation Center
Abstract:
The Human Simulation Center is one of the recent projects of the Department
of Emergency Medicine and Medical Management of the
Ludwig-Maximilians-Universität München (http://www.inm-online.de). It i s a
training center designed to train physicians and medical staff involved in
emergency care in the setting of "the complete emergency transportation
chain" (from accident to OR or ICU). It is also designed to investigate
common error types that occur under stressful conditions and in the process
of passing on information to others. One of the challenges was to develop a
software that offers an intuitive user-interface for tutors as well as
provides the flexibility to be used in changing settings and different
environments.
9/21/2007 Bill Long PhD
Title: Lessons Extracting Diseases from Discharge Summaries
Abstract:
We have developed a program using very limited natural language
processing and the UMLS to extract diseases and procedures from
discharge summaries and have applied this program to 96 cases annotated
by physicians. To evaluate the effectiveness of the program, we compared
the concepts it extracted to those extracted by the annotators. The
program extracts 93% of the desired concepts including some more
specific than those the annotators used. This talk will discuss the
reasons concepts were missed, including ambiguous phrases, phrases
missing words or were separated or needing deduction, among other
reasons. The false positives included insignificant findings, ambiguous
phrases, or concepts that did not apply to the patient now. The
analysis shows that extraction of medical concepts from discharge
summaries with limited natural language processing and no domain
inference is effective with still more potential.
9/28/2007 Leo Celi MD
Title: The Problem with Medicine: Re-Designing the ICU Workflow
Abstract:
Health care delivery is riddled with error-prone inefficiencies due to
variation in task design. The management of the same patient admitted with
pneumonia, for example, will vary from hospital to hospital, ward to ward,
and doctor to doctor, with respect to type and frequency of laboratory
testing, frequency of monitoring, antibiotics and other adjunctive
treatments. This variation in practice is worse in the ICU, which is
characterized by information overload. ICU workflow is a good reflection of
how a system has grown by accretion rather than evolution. The information
overload is driven by the false belief that outcomes are positively
influenced by the amount of information and minute-to-minute manipulation of
physiologic variables. The challenge for informatics in the ICU is not just
to translate tasks and processes; an outcomes-driven transformation is
necessary. The possible role of AI to this end is presented. Finally,
barriers to the development and implementation of workflow re-design and
other informatics applications in the ICU are discussed.
10/5/2007 Angela Haslbeck
Title: Remote Patient-Monitoring, Diagnostics and Therapy - An Attempt to
Predict Innovation and Industry Evolution Using the Delphi Method
Abstract:
Advances in wireless networking technologies and the miniaturization of
vital parameter sensors have, in the past half-decade and especially in the
U.S., induced entrepreneurial activity and investment from venture capital
firms into an emerging industry for mobile telemedicine solutions. The
impending cost collapse of health care systems and hopes for the
telemedicine industry to become an important economic factor have also led
policy makers in Europe to set up projects to develop and validate
innovative systems and services for remote and mobile health care. The
development of the Mobile Health Industry might accelerate in the next years
due to further technological advances in the field of biomedical computing
and trends towards integrated care and disease management. Angela' s
research aims to forecast the future technological and market development of
remote and wireless monitoring in the U.S. using the Delphi Method, a widely
approved qualitative forecasting approach utilizing expert opinion. Findings
from the study she then will use to test Christensen et al.'s hypothesis on
disruptive change in the healthcare industry.
10/12/2007 Steven Seltzer MD
Dr. Steven Seltzer is the Chairman of the Department of Radiology at the Brigham and Women’s Hospital.\\
Title: New Research Initiatives at the Department of Radiology
10/19/2007 Meghan Dierks MD
Title: Technology to Enhance Institutional M&M and QA Processes
Abstract:
Morbidity and mortality (M&M) conferences and peer review activities constitute important forums for the exploration and discussion of significant adverse clinical events. These activities are an ingrained component of hospital quality assurance and provide opportunities to systematically review system-based and individual factors that may have contributed to a patient injury, an unexpectedly poor clinical outcome or an adverse event with some degree of transparency. However, recent published reports suggest that there is wide variation in the methods by which cases are identified, criteria for case review and formal presentation, depth of
review, format for presentation, actions required in response to the event/case, and final disposition of cases. This variation is prominent at both the inter-institutional and intra-institutional level (i.e., between different departments or disciplines within an institution). To counter this trend, we have developed a data- and workflow- management system for the M&M/QA process. The system is a web-enabled and database-backed application that establishes a minimal structure, format and data set for investigation and analysis of an adverse event, provides a platform for collaborative cross-disciplinary review, commentary and follow-up on a case, enables comprehensive classification for subsequent analysis and trending, and
provides opportunities to audit case status.
While the system has improved workflow relating to case review, we are also evaluating the extent to which the system actually changes behavior around reporting morbidities/mortalities, enhances the institution's early recognition and understanding of important system-wide safety issues, and enables rapid dissemination of this knowledge throughout the institution. Specifically, we will determine the extent to which the system:
1. lowers the threshold for reporting/submitting cases for review
2. changes the demographics of who initially reports a case
3. increases collaborative, multidisciplinary review/critique of cases that cross disciplinary boundaries
4. improves tracking of the status of action plans/interventions emerging from a specific adverse event
5. standardizes the process and quality of case review across departments
6. enables identification of system-based or common cause failures/errors across different departmental boundaries (Provide capability for institution-wide aggregation/review of data)
10/26/2007 Jihoon Kim MS
Title: Difference-based clustering of short time-course microarray data with replicates
Abstract:
Background
There are some limitations associated with conventional clustering methods for short time-course gene expression data. The current algorithms require prior domain knowledge and do not incorporate information from replicates. Moreover, the results are not always easy to interpret biologically.
Results
We propose a novel algorithm for identifying a subset of genes sharing a significant temporal expression pattern when replicates are used. Our algorithm requires no prior knowledge, instead relying on an observed statistic which is based on the first and second order differences between adjacent time-points. Here, a pattern is predefined as the sequence of symbols indicating direction and the rate of change between time-points, and each gene is assigned to a cluster whose members share a similar pattern. We evaluated the performance of our algorithm to those of K-means, Self-Organizing Map and the Short Time-series Expression Miner methods.
Conclusions
Assessments using simulated and real data show that our method outperformed aforementioned algorithms. Our approach is an appropriate solution for clustering short time-course microarray data with replicates.
11/2/2007 Ivar Helgason MD
Title: The Theriak Medication Management (TMM)
Abstract:
TMM is a "closed loop" medication system, handling everything from prescription, pharmacy review and logistics to bedside verification. TMM is based on the unidose concept, and controls dispensing robots in the pharmacy and in some cases automated ward delivery systems. I will talk about our design philosophy and the challenges when implementing large clinical systems.
11/9/2007 Joaquin Blaya MS
Title: Implementing and evaluating laboratory information systems in resource-poor settings
Abstract:
Multi-drug resistant tuberculosis (MDR-TB) patients in resource-poor settings experience large delays in starting appropriate drug regimens and are often not monitored appropriately due to an overburdened health care system, communication delays, and missing or error-prone data. Information management and communication in medical care are especially critical in resource-poor settings where increased barriers to treatment include lack of coordination between national, regional and local health institutions, inefficient communication systems, and high turnover rates among personnel. Medical information systems can be used to alleviate these problems by increasing the timeliness and quality of laboratory information available. This thesis proposes to develop and implement such systems in the urban, resource-poor setting of Lima, Peru in both networked and non-networked institutions. Formal evaluation of these systems will then assess their effect on administrative and clinical metrics. The work presented will be divided into two parts. The first focuses on the electronic communication and reporting of tuberculosis laboratory information to health care personnel within a networked group of institutions. This should reduce the communication times of laboratory results, accelerate the start of treatment for high-risk patients, and decrease the frequency of errors. The second addresses the electronic collection of tuberculosis (TB) laboratory information from a distributed group of non-networked laboratories to reduce delays, errors and costs. These two parts will provide verified medical informatics tools for settings both with and without internet connectivity.
11/30/2007 Winston Kuo, DDS, MS, DMSc
Title: The Roles of miRNAs in Craniofacial Development
12/07/2007
Presenter: Melody In Chang PhD
Title: Regional Health Information Exchange- Experience in Taiwan
Abstract:
Health information technology has been identified as a key tool in addressing the major challenges that health care faces in efficiency, safety, and quality. With the growing healthcare expenditure, the government of Taiwan has shown its commitment to health information technology by initiating a five-year project, called National Health Information Project (NHIP), to establish a nationwide infrastructure for electronic medical record and health information exchange. A case of regional health information exchange in Taiwan, South Taiwan Medical Information Network (SMIN), will be presented. Some lessons learned in the SMIN project about data standards issues, policy and organizational support issues, information sharing issues, and privacy/security issues are discussed. These experiences, we expect, will be incorporated into the next generation of local health information infrastructure for building the nationwide network in the future.
12/14/07
Presenter: Hamish Fraser, MBChB, MRCP, MSc
Title: Clinical Information systems as tools to improve quality of care in developing countries: examples from HIV and TB treatment programs
Abstract:
The scale-up of HIV treatment in developing countries and the parallel creation of large scale treatment programs for multi-drug resistant tuberculosis (MDR-TB) require the creation of systems for chronic disease management in places where short-term care, or no care at all, is the tradition. Partners In Health (PIH), a health care non-profit based in Boston, provides care to some of the poorest communities in countries such as Haiti, Peru, Rwanda and Lesotho. PIH has pioneered the treatment of HIV and MDR-TB by focusing both on building capacity in local communities and bringing the best modern medications, investigations and training to these impoverished environments. One of the tools PIH has developed and deployed is a web-based electronic medical record system to track the treatment ofthese patients and their lab results and clinical progress. I will briefly describe the PIH-EMR and discuss how we use it to reduce medical errors, delays and oversights in treatment. I will also describe the evaluations we have performed on the system in use, and discuss the critical need for systems to reduce loss to follow-up in HIV treatment programs in Africa. Finally I will introduce the OpenMRS EMR architecture developed in collaboration with the Regenstrief Institute in Indiana and other groups in Africa.
12/21/07
Presenter: Blackford Middleton, MD, MPH, MSc
Director, Clinical Informatics Research and Development, Partners Healthcare
Title: Applied Clinical Informatics Research Highlights from Partners Clinical Informatics Research & Development (CIRD) and Center for Information Technology Leadership (CITL)
Abstract:
In this presentation, Dr. Middleton will provide an overview of the
Clinical Informatics R&D group, and the Center for Information
Technology Leadership, at Partners Healthcare. Selected research studies
will be highlighted, and issues surrounding conducting applied research
in an operational information systems environment will be discussed. An
overview of a new award for advanced clinical decision support research
will also be presented.
1/11/08
Presenter: Griffin Weber, M.D., Ph.D.
CTO, Harvard Medical School
Title: CTSA Data Sharing
Abstract:
The Clinical and Translational Science Award (CTSA) is an NIH-funded consortium of academic health centers located throughout the nation whose goal is to transform how clinical and translational research is conducted. Harvard submitted its proposal in November to become a CTSA institution. The 1,300 page proposal was the result of a two-year collaborative effort involving hundreds of individuals from Harvard and its affiliated hospitals and institutions. Novel tools for clinical research informatics are a core component of the proposal. One of these tools is the Shared Health Research Information Network (SHRINE), which will allow investigators to search the clinical data warehouses at each of the Harvard hospitals--a total population of 10 million patients. SHRINE will enable multi-institution queries to identify patient populations for clinical trials, and it will provide data analysis tools to help answer common questions investigators ask about their patient cohorts. SHRINE is an extension of software created for Informatics for Integrating Biology and the Bedside (i2b2), which is a National Center for Biomedical Computing based at Partners HealthCare System. This talk will present an overview of CTSA informatics at Harvard, show a demo of i2b2 software, and describe some of the challenges in creating SHRINE.
1/18/08
Presenter: Luke Sato, M.D.
CMO, Harvard Risk Management Foundation
Title: IT for Risk Management
1/25/08
Presenter: Kumiko Ohashi, RN, PhD
Title: Network and sensor technologies for medical fields - How can they ensure patient safety, and improve quality and efficiency of medical care?
Abstract:
In recent years, ubiquitous computing technologies have been applied in the field of medicine. Radio frequency identification (RFID) and small sensor networks provide information about medical practice and patient status that, in turn, improve the quality of medical care. We developed a new system named the "smart stretcher," which continuously monitors patients' vital signs and detects apnea during transfer within a hospital. We developed a bedside safety system for improving medical
efficiency and patient safety at the bedside. I will talk about these systems and some other future projects.
2/01/08
Presenter: Jonathan Jackson MEng
Title: Health technology in resource constrained settings
Abstract:
Dimagi is a Cambridge based startup from the MIT Media Lab and Harvard that focuses on providing technology solutions for healthcare in resource constrained settings. Dimagi's CEO, Jonathan Jackson, will discuss current projects as well as preliminary results from field trials in South Africa and Tanzania using decision support on mobile devices. His talk will also focus on the challenges and lessons learned from his first-hand field experience.
2/08/08
Presenter: Ronilda Lacson MD PhD
Title: Predicting Hemodialysis Mortality Using Serial Blood Pressure Measurements
Abstract:
Blood pressure is a significant predictor of mortality. This finding applies to hemodialysis patients who have the advantage of having serial blood pressure measurements recorded before and after each hemodialysis treatment. Several studies have focused on the effect of both high blood pressure and low blood pressure on mortality risk. In most studies, however, blood pressure is utilized as a fixed, often single average value, which summarizes all available blood pressure measurement for each individual. This method provides an acceptable representation of the overall blood pressure as well as limiting the number of variables in the prediction model(s). However, this method does not provide a good representation for the blood pressure variability and the trends over time, both of which are readily available from patients' data. I will discuss the results of utilizing time-series modeling techniques with support vector machine to predict hemodialysis mortality that incorporates serial systolic blood pressure measurements over time.
2/15/08
Presenter: Staal Vinterbo PhD
Title: Practical tools and tricks to keep your information safe
Abstract:
I will discuss some information on security issues and point out some steps one can take to avoid some of these. Particular focus will be on behavior on the net, communication security, authentication and how to manage passwords.
2/29/08
Presenter: Winston Hide PhD
Title: A computational approach towards the understanding of Tumor Initiating
Cell gene expression
Abstract:
Gene expression data is challenging in its heterogeneity and breadth.
By combining data my group has accessed from
Microarray, Massively Parallel Signature Sequencing (MPSS), Expressed
Sequence Tag (EST), rt-PCR and Capped
Analysis of Gene Expression(CAGE), it is possible to overcome
artifacts and biases inherent in each of the platforms, and exploit the strengths of each. Together with our collaborators my group has
developed an analysis platform for RNA from CD133hi cells that have
been extracted from melanomas of patients. The CAGE analysis platform
provides unique insight into internally
consistent transcription start site (TSS) expression level and
switching, together with direct context of publicly available FANTOM
3.0 CAGE TSS. We have discovered melanoma progenitor specific signals
that will be discussed.
3/14/08
Presenter: Qing Zeng-Treitler PhD
Title: Developing Informatics Tools to Empower Patients
Abstract:
In the presentation, I will briefly review our work in the area of
consumer health informatics including vocabulary, information retrieval
and health literacy, and then highlight a few new research directions we
are pursuing. I will also discuss a few areas that we are interested in
exploring.
3/21/08
Presenter: Chris Tsai MD MPH
Title: Characterizing Calibration in Cardiovascular Risk Prediction Models
Abstract:
Risk prediction models have been employed in cardiovascular disease
since the Framingham Study in 1950s. These global risk assessments are
the basis for guidelines-based preventive interventions, including drug
therapy. External validation has shown to be sometimes poor (while
discrimination is usually adequate, calibration is not). Thus, absolute
risk for an individual may not be reliably predicted. We are conducting
a systematic review specifically addressing the calibration of
cardiovascular models in external populations. I'll describe the
results we have so far.
3/28/08
Presenter: Francis X. Campion MD FACP
Director, Complex Chronic Care Program, Harvard Vanguard Medical Associates
Clinical Informatics Research, HMS Department of Ambulatory Care and Prevention
Title: Future of Public Health: Automating disease reporting and vaccine safety monitoring
4/04/08
Steven Labkoff MD, FACP
Senior Director, Pfizer Inc.
Title: Life after Fellowship: Getting into and Working in the Business World
Abstract:
After Medical Informatics fellowship is completed, a significant number
of fellows will pursue interests that lie in the business world. While
fellowships get one ready for a wide array of activities in life, I have
found that there is a significant opportunity to learn more about the
business world before you venture in. I will discuss pathways into
business, tools needed to learn about the business world, the role of
recruiters, what areas in industry are looking for Informatics Fellows
and more.
4/11/08
Carlos Nakamura PhD
Title:
The effects of specific support to hypothesis generation on the
diagnostic performance of medical students
Abstract:
Some researchers have argued that hypothesis generation is far more challenging to medical students than hypothesis evaluation because they are initially taught to reason from the diseases (hypotheses) to the symptoms (clues) rather than the other way around. In this presentation I report the results of a study on the effects of computer-based support to hypothesis generation on the diagnostic performance of 2nd and 4th year medical students.
4/18/08
Aziz Boxwala MD PhD
Title:
Reliable execution of important care processes
Abstract:
Errors in clinical care, especially those related to communications and handoffs in care, are a major cause of morbidity and mortality. For example, various studies have found that 10 to 30% of patients with positive mammograms do not have a timely follow-up. Current approaches, including informatics tools, to detect and prevent such failures are limited in their impact. I will describe a software system called ACE, that I am involved in the development of, for monitoring patient's clinical data. It can monitor the patient's status over long periods of time, detect important clinical events, notify a responsible provider, and then ensure that appropriate actions are taken.
4/25/08
Xiaole Shirley Liu PhD
Title:
ChIPing the Human Cistrome
Abstract:
Cistrome defines the set of cis-acting targets of a trans-acting factor on a genome scale. I will discuss our analysis of ChIP-chip on genome tiling microarrays and ChIP-seq on Solexa sequencing to discovery human cistromes. I will also discuss how to use the cistromes to understand transcriptional and epigenetic regulation of gene expression in cancer.
5/2/2008
Pedro Galante PhD
Title:
The complexity of the transcriptome: a large-scale analysis of intron retention and genes sense-antisense in the human and mouse genomes.
Abstract:
I will present a large-scale analysis of intron retention (a type of alternative splicing) and genes sense-antisense in the human and mouse genomes.
5/9/2008
Heimar Marin, RN, PhD and Eduardo Marques, MD, PhD
Federal University of Sao Paulo
Topic: Criteria for Certification of Hospital Information Systems software
Abstract:
Education on Health Informatics - IMIA Recommendations: In this presentation I will share the updated recommendations that IMIA is preparing related to the curriculum content to enable health care professionals to efficiently and responsibly use information and knowledge processing methodology and information and communication technology. I will also introduce some activities of the Brazilian Health Informatics Society related to the Process of Certification for Software in Healthcare. In the second part, a methodology for strategic planning of health information systems will be presented with the following goals:
- to translate the strategic objectives into a set of coherent performance indicators;
- to associate strategic objectives with long term targets and annual budgets;
- to clarify and obtain consensus regarding the strategy;
- to communicate strategy to all the organization;
- to align institutional and personal targets to strategy;
- to identify and align all the strategic initiatives;
- to stimulate timely and systematized strategic revisions and
- to obtain feedback to increase the knowledge about the strategy and to improve it
5/16/2008
Wallace Leung, PhD
Hong Kong Polytechnic University
Title: Clinical Decision Support Systems
Abstract:
We are developing a Clinical Decision Support System (CDSS) in RIIPT integrating various info (protein & gene biomarkers, patient data, lab test data, imaging etc.). By using rule-based, case-based or model-based engines (intelligent algorithms such as support vector machine, neural network, Bayesean network, AI etc.), we can analyze the extracted features and correlate the data for analysis and forecast. It can be used for diagnosis, prognosis and therapy. We are currently applying this for lung and Nasal pharangeal cancer but have interest to extend to any diseases, especially chronic diseases (cardiovascular, kidney, liver, etc.). Also we are partnering on this project with hospitals in Hong Kong and our biology and computing departments at the university.
5/23/2008
Michael Matheny MD MS MPH
Vanderbilt University
Title: Towards Automated Medication Outcomes Surveillance Among Hospitalized Patients in the Veteran's Administration
Abstract:
Post-marketing medication surveillance has received strong attention from the public and media in the last few years as a result of high profile medication and medical devices recalls by the FDA. As a result of a series of public hearings and IOM solicited recommendations, the FDA has begun to
focus on clinical registry and routine clinical data as complementary sources to its existing surveillance network. Effective use of each of these data sources for medical product surveillance faces a number of challenges at the intersection of medical informatics, observational cohort biostatistics, and pharmacoepidemiology.
This discussion will focus on aspects of the VA electronic health record and the current VA Health Services Research & Development research agenda that provide unique opportunities for medical informatics research, highlight particular opportunities and challenges for using natural language
processing on VA free text clinical records to produce computable concepts, facts, and values, and underscore the importance of risk modeling and risk stratification using both traditional and machine learning approaches as the keystone for addressing confounding in observational cohorts as well as predicting the propensity for use of medications or devices.
5/30/2008
Pankaj Sarin MD MS
Title: THE INTEGRATED CLINICAL EDUCATION (ICE) SYSTEM: A PILOT OF A SERVICE
SPECIFIC EDUCATION PORTAL EMBEDDED INTO CLINICAL WORKFLOW
Abstract:
Clerical tasks required to provide patient care take up significant physician time but
often do not directly have significant educational value. Educational questions may arise
during these tasks but are often lost to follow-up because
of time constraints. In anesthesia, the process of finding and assembling information
needed for a preoperative patient assessment is one such example. Resident physicians
navigate through a number of unlinked electronic based and paper based systems to locate
information, taking away from time that can be spent with patients or discussing cases
with attending physicians. We aim to develop an integrated web based portal application
that will significantly reduce the time the above clerical tasks take, integrate patient,
case, and physician level of training specific education (literature and
protocols/guidelines) into the workflow, and improve collaboration between attending and
resident level physicians. This proposed Integrated Clinical Education (ICE) system will
be created by enhancing previously created Partners IS and Dept of Anesthesiology
technologies. Integration of technologies used by non-medical information web sites,
such as mash-up sites that use Google services, Amazon.com "Recommendations for You", and
del.icio.us social bookmarking, will also occur. The proposed ICE system will be covered
during the presentation.
6/13/2008
Jeeyae Choi RN PhD
Title: Development and Evaluation of a Computerized Decision Support System for Genetic Counselors in Korea
Abstract:
Cancer rates for Korean women have been steadily increasing. The incidence of breast cancer among Korean women was 8.7% in 1985, and that rose to 11.4% in 1992 and to 12.5% in 1997. Other statistics showed that not only incidence but also the mortality rate of Korean women who are diagnosed with breast cancer have been continuously increasing since the 1980s.
Genetic counseling has been used for prevention and early diagnosis of breast cancer in the primary care settings. Korean clinicians have utilized genetic counseling as a part of their routine care since 1996. They use various breast cancer risk assessment models to assess the breast cancer risk during a counseling session. However, these models have been developed in western societies and are difficult to use within a limited time of genetic counseling.
The project proposes to validate four models, which are Gail, Claus, Couch and BRACAPRO, among Korean population and develop a suitable model for Koreans. Then, we would like to design and implement a computerized decision support system that can provide a breast risk assessment value to the clinician at the point-of-care.
6/20/2008
Robert A. Greenes, MD, PhD,
Ira A. Fulton Chair and Professor,
Department of Biomedical Informatics,
Arizona State University
Abstract:
DSG's founder will present an overview of BMI research and teaching activities at ASU.
David Ahern PhD
Title: The Role of HIT/eHealth in Patient Engagement and Quality Improvement
Abstract:
HIT/eHealth is the use of technology platforms, e.g., EMRs and emerging interactive
technologies to enable health improvement and health care services. Dr Ahern will discuss
the role of eHealth in various initiatives. He will talk about how eHealth can help
diverse consumers and patients to become:
1. more informed and knowledgeable about their health
2. activated in addressing their health concerns with their providers
3. skilled in self-management
