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Archive for the ‘Electronic Health Record’ Category

National Library of Medicine Informatics Lecture Series

Thursday, October 15th, 2015

Title: Use of Clinical Big Data to Inform Precision Medicine
Speaker: Joshua Denny, MD
Date: Wednesday, November 4, 2015
Time: 2:00 pm – 3:00 pm
Location: Lister Hill Center Auditorium

Abstract: Precision medicine offers the promise of improved diagnosis and more effective, patient-specific therapies.  Typically, clinical research studies have been pursued by enrolling a cohort of willing participants in a town or region, and obtaining information and tissue samples from them.  At Vanderbilt, Dr. Denny and his team have linked phenotypic information from de-identified electronic health records (EHRs) to a DNA repository of nearly 200,000 samples, creating a ‘virtual’ cohort.  This approach allows study of genomic basis of disease and drug response using real-world clinical data. Finding the right information in the EHR can be challenging, but the combination of billing data, laboratory data, medication exposures, and natural language processing has enabled efficient study of genomic and pharmacogenomic phenotypes.  The Vanderbilt research team has put many of these discovered pharmacogenomic characteristics into practice through clinical decision support.  The EHR also enables the inverse experiment – starting with a genotype and discovering all the phenotypes with which it is associated – a phenome-wide association study (PheWAS).  PheWAS requires a densely-phenotyped population such as found in the EHR. Dr. Denny’s research team has used PheWAS to replicate more than 300 genotype-phenotype associations, characterize pleiotropy, and discover new associations.  They have also used PheWAS to identify characteristics within disease subtypes.

Brief Bio: Joshua Denny, MD is an Associate Professor in the Departments of Biomedical Informatics and Medicine at Vanderbilt University Medical Center. A primary interest of his lab has been development of the PheWAS method applied to EHRs to rapidly uncover genetic pleiotropy and highlight potential drivers of genetic associations with endophenotypes.  He helps lead efforts for local and network pharmacogenetics implementation activities.  He is part of the NIH-supported Electronic Medical Records and Genomics (eMERGE) network, Pharmacogenomics Research Network (PGRN), and Implementing Genomics in Practice (IGNITE) networks. He is past recipient of the American Medical Informatics Association New Investigator Award, Homer Warner Award, and Vanderbilt Chancellor’s Award for Research. Dr. Denny remains active in clinical care and in teaching students. He is also a member of the National Library of Medicine Biomedical Library and Informatics Review Committee.

This talk will be broadcast live and archived at

Sign Language Interpreters will be provided.


Improving the Health Experience

Thursday, April 9th, 2015

The HxRefactored Conference brings together designers, health care providers, public health professionals, and others interested in the intersection of design and technology for a cross-disciplinary exploration of ways to improve the health experience. On April 1st and 2nd, I attended the conference in Boston, Massachusetts sponsored by MadPow and Health 2.0

The conference was jam-packed with inspiring presentations on topics including human centered design/usability, technology, health literacy/equity, mindfulness/stress reduction, behavior change, patient activism, electronic health records and organizational design.  Presenters shared ways to use design and technology to improve the health experience.  I hope you find these summaries of keynote presentations food for thought on creative ways to improve the health experience.

Keynotes ~ April 1, 2015

John Brownstein, Associate Professor at Harvard Medical School and the Computational Epidemiology Group at Children’s Hospital, explored the intersection of data and design for disease prevention in his keynote.  He asked, “How do we make everyone a stakeholder in public health?”  He shared real time detection of public health issues through social media platforms like HealthMap; StreetRx; and MEDWATCHER.  He also discussed new technology like iThermometer, a wearable thermometer that alerts parents of their child’s fever on their smartphone.   His presentation made me think about ways librarians can get involved with the development of social media platforms and new technologies to support public health.

Darshan Mehta, from MGH’s Benson-Henry Institute for Mind and Body Medicine, discussed how to build resiliency with an introduction to the relaxation response.  I’ve been practicing meditation since high school.  I enjoyed his guided relaxation.  It was a nice way to start the first day of the conference.  Mehta spoke about how meditation increases the cortical thickness and can change gene expression.  According to Mehta, mind/body practices reduce the frequency of medical symptoms, decrease the severity of psychiatric symptoms, and increase healthy lifestyles.  This presentation may inspire me to initiate a weekly mindfulness meditation group here at UMassMed School.

Keynotes ~ April 2, 2015

Steve Krug, author of Don’t Make Me Think and Rocket Surgery Made Easy, kicked off day two of the conference.  He only had twenty minutes but led a DIY (do-it-yourself) usability testing example with a volunteer from the audience.  His recommended DIY testing, preferably once a month on the same day – and stick to it!  Also, make it a spectator sport and have as many people as possible come watch.  Then, more people on your staff gain skill in usability testing.  For more information, check out his site, Advanced Common Sense

 Deborah Estrin, Professor of Computer Science  from Cornell NYC Tech, presented on small data.  She talked about using mHealth and small health to create data driven feedback loops of health.  She urged us to invest in interoperable and iterative approaches to benefit from reuse of tools and techniques.  She asked us: “How can we help create resources to help patients answer the question: are you feeling better?”  For examples of such resources, she mentioned Paragon Measure (turning mobile device use into actionable insights) and (using smartphones to improve mental health care).  She wrapped up by urging attendees to create an ecosystem around small data.

John Halamka, Chief Information Officer at the Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network, spoke about what’s new in HealthIT in 2015.  I’m sure many of you remember his excellent presentation at the NAHSL Annual Conference.  He discussed the federal interoperability roadmap, meaningful use stage 3, new mobile devices, private security challenges and the return to private sector innovation.  I was pleased to hear him mention National Library of Medicine’s free access to vocabulary standards for interoperability.  I was tweeting during the conference and my tweet with the link to NLM’s free APIs (application programming interfaces) was my most retweeted and favorited tweet of the conference.  Interested to learn more?  Check out how the NLM APIs can be used to support electronic health record certification and meaningful use.

Geoff Williams, of the University of Rochester Healthy Living Center Motivation Research Group, spoke about self-determination theory and how people change. He asked,”Does it come from the inside or outside?”  He told us about the psychological needs to support optimal health such as autonomy, competence, and feeling connected to others.

Jared Spool, author of Web Anatomy and Web Site Usability, declared design, “the rendering of intent.”  He asked: “What is the experience we want them to have?  Are we designing activities or experiences?”  He discussed a design process for the design experience and the importance of facilitated leadership.   According to Spool, “The best design teams worship inclusiveness.”

Julian Treasure, Master of Sound and author of Sound Business, was one of my favorite HxR presenters.  He told us the noise is the number one complaint in the hospital experience, the number one problem with productivity in the workplace, and that elevated noise leads to worse health.  He recommended improving acoustics, reducing noises, and designing soundscapes. He shared acronyms to help us learn to listen better and speak powerfully.  He wrapped up with a vocal toolbox activity.  If you are curious to learn more, listen to his TedTalk.

The HxR conference was full of creative and practical ways to improve the health experience. I left inspired to bring what I learned back to our network.  I learned about some amazing presenters that we might be able to host for regional conferences and webinars. I found it an insightful, useful conference and highly recommend it.  Stay tuned for my next blog post about what I learned at the breakout sessions.

Thanks MadPow and Health2.0 for a great conference!



Breaking an EHR system: a sandbox workshop

Monday, January 26th, 2015

The National Network of Libraries of Medicine, New England Region is offering this free workshop to its members.

Date: April 24, 2015

Place: Lamar Soutter Library, UMass Medical School

Time: 10AM-2PM

Instructor: PJ Grier, Outreach/Access Coordinator, National Network of Libraries of Medicine, Southeastern/Atlantic Region

Register at

Class Description:

The overall objective is to give librarians an opportunity to “touch and feel” the functionality of a certified electronic health record system (EHR-S) in a “safe harbor” demonstration environment. Because many health sciences librarians are currently excluded from accessing their institutional electronic health record system (EHR-S) on an operational, day-to-day basis, this class provides that opportunity, albeit in a “practice” environment.

EHRs are crucial building blocks in the formation of an encrypted national health information network. This is a key reason why health sciences librarians continue to be engaged in important EHR supporting roles within their respective institutions with regard to planning, deployment and even optimization efforts. Now is the time to start evaluating and identifying strategies of how health sciences librarians can best contribute to the value of an EHR from a daily operations, patient care perspective.

This course will access an EHR-S via actual use in a demo environment. Through guided instruction, lecture and videos, students will create practice authentication that will enable them to access and experiment with the functionality of a certified EHR-S. Practice system exercises include dashboard components such as charting, custom texts, adding/registering a new patient, alerts/warnings, medication reconciliation, patient scheduling, meaningful use and billing. From a clinical encounter perspective, there will be sufficient “sandbox” time to enter appropriate ICD-9 diagnosis codes and/or diagnosed health conditions, treatment plans and patient education information (via NLM’s MedlinePlus Connect query process), into the clinical narrative (SOAP Note) of a fictitious patient, as a “physician user”.

Webinar: An Exciting Program on Academic Electronic Health Records (EHRs)

Monday, October 27th, 2014

November 19, 2014

Instruction – An Exciting Program on Academic Electronic Health Records (EHRs)

Date and Time: Wednesday, November 19, 2014, Noon to 1:00pm (EDT)

Presenters: Kathleen Annala, Co-founder of Archetype Innovations, LLC and Carolyn Schubert, Health Sciences and Nursing Librarian, James Madison University

Contact: For additional information or questions about this webinar, please contact PJ Grier at

Summary: Many health sciences librarians are active in an advisory capacity to faculty curriculum committees as well partners with school faculty in developing specific course content. At the same time, curriculum developers in health sciences education including medicine, nursing, pharmacy, dentistry and medical coding now recognize that health care information technology (HIT) is an important component in the educational outcomes of future clinicians. Although there are other academic electronic health records (EHRs) in the marketplace, this exciting webinar will explore two EHRs in use today by health sciences schools, colleges and universities: Neehr Perfect and Sim Chart.

Two facts make academic EHRs different than ones deployed in actual patient care are:

  1. Academic EHRs usually integrate with a college or university’s learning management system (LMS) which is an important instruction and education tool for faculty and students,
  2. Academic EHRs are not HIPAA compliant and do not require certification as delegated by the Office of the National Coordinator in the Department of Health and Human Services.

Biographical Sketch: Kathleen Annala, MA, RN, President & Chief Operating Officer, Archetype Innovations, LLC, Duluth, MN.

Kathleen Annala is the owner of Archetype Innovations, an educational technology company that designs and supports EHR systems for educational use. Kathleen began her work designing EHRs for educational use over 15 years ago at the College of St. Scholastica where she was a professor of nursing and founding member of the nation’s first project to develop an EHR that could be used as an educational tool. She taught students with an educational EHR that she helped create and has been improving upon EHRs ever since. After teaming up with Archetype Innovations to design the “perfect” educational EHR, Neehr Perfect was released in 2009.

Summary: Kathleen will discuss the key features of an educational EHR and show how faculty and students simulate clinical practice and develop EHR competencies in an academic environment using Neehr Perfect. She will also discuss ways Neehr Perfect is customized with patient scenarios, documentation forms, references, resources and training tools to give students hands on experience with the type of patients, data and point-of-care opportunities available with EHR technology in healthcare.

Biographical Sketch: Carolyn  Schubert, MLS, Health Sciences and Nursing Librarian, James Madison University, Harrisonburg, VA.

Carolyn Schubert teaches a course titled “Introduction to Informatics for Health Care Professionals”.  Recent publications include the book chapter “What is Biomedical Informatics? An Overview and a Case Study” in the book Curriculum-Based Library Instruction. Her research interests include biomedical informatics, educational technologies and instruction, and scholarly communication.

Summary: Carolyn will discuss her training in Sim Chart, give a short demo of some of its functionality, speak about student perspectives with some insight on the faculty’s perspective and provide an overview of how it was incorporated into the University’s nursing curriculum. She received vendor-supplied training on Sim Chart alongside Nursing faculty. She has been given access to use and evaluate the system in relation to the library’s iPad program and point-of-care resources. She also uses other systems, such as Practice Fusion when teaching students about electronic health records.

Upon completion of the Beyond the SEA Webinar, each participant will receive 1 hour of continuing education credit awarded by the Medical Library Association. Certificates will be available electronically following completion of the online survey supplied at the end of the webinar.

What do you need to join this conference?

  • A computer (with Flash installed)
  • A telephone

How do I connect?

  • Go to this URL:
  • Enter as a Guest
  • Sign in with your first and last name
  • Follow the instructions in the meeting room to have Adobe Connect call your phone (this is the preferred way; however, if you have an extension or for some other reason cannot let Adobe connect call you phone, call 1-800-605-5167 and enter the participant code 816440 when prompted.)
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