Archive for the ‘Electronic Health Records’ Category
The next session of the National Library of Medicine Informatics Lecture Series will be held on November 4, at 11:00am-12:00pm PST, with the feature presentation Use of Clinical Big Data to Inform Precision Medicine. The speaker will be Joshua Denny, MD, Associate Professor in the Departments of Biomedical Informatics and Medicine at Vanderbilt University Medical Center. This talk will be broadcast live and archived.
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). 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.
Dr. Denny 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 a 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.
The National Library of Medicine has announced the release of the first video tutorial for the RxClass Web application. The five-minute Searching and Navigating Through Drug Classes Using RxClass Application tutorial describes the RxClass major interface elements and functionalities. RxClass allows users to explore drug classes and their members, links the drug classes to drug information in RxNorm, provides a browser interface for navigating the hierarchies of drug classes, and includes a search mechanism for locating specific drug classes or drugs. The tutorial is available from a link on the Learning Resources for NLM Clinical Terminology Artifacts and Tooling and the NLM Distance Education Resources pages.
NLM has also announced the release of the first video tutorial featuring the Value Set Authority Center (VSAC) REST API. The API allows remote retrieval of value set information through URL-based calls that contain functions and corresponding parameters. The API is based on the IHE Sharing Value Sets (SVS) Technical Framework. The new two-minute tutorial Authentication with the Value Set Authority Center (VSAC) SVS API demonstrates how to perform proper authentication when submitting requests to the VSAC REST API. The authentication process uses UMLS credentials (username and password) and consists of two steps. First request a Ticket Granting Ticket (TGT), then request the Service Ticket (ST). The TGT is valid for eight hours, while the ST is valid for five minutes and can be used to submit only one API request. Users must generate a new ST for each new API request. The tutorial is available from a link on the VSAC Support Center, Learning Resources for NLM Clinical Terminology Artifacts and Tooling, and the NLM Distance Education Resources pages.
NIH encourages the use of common data elements (CDEs) in clinical research, patient registries, and other human subject research in order to improve data quality and opportunities for comparison and combination of data from multiple studies and with electronic health records. The NIH Common Data Element Resource Portal provides access to information about NIH-supported CDEs, as well as tools and resources to assist investigators developing protocols for data collection. In addition, the session recording and presentation slides for the 90-minute webinar “NIH Common Data Element (CDE) Initiatives – Overview,” held on September 8, are available for viewing.
The National Library of Medicine (NLM) has released a new web page, Nursing Resources for Standards and Interoperability. The page is a resource for nurses, students, informaticians, and anyone interested in nursing terminologies for systems development. It describes the role of SNOMED CT and Laboratory Observation Identifiers Names and Codes (LOINC) in implementing Meaningful Use in the United States, specifically for the nursing care domain.
NLM has provided this resource in response to the position statement released by the American Nurses Association (ANA) that reaffirms support for use of recognized terminologies in coding nursing problems, interventions and observations (SNOMED CT), and in nursing assessments and outcomes (LOINC). In addition to SNOMED CT and LOINC, the Nursing Resources for Standards and Interoperability page provides information about other highly utilized nursing terminologies. The resource page provides a new two-minute video tutorial that describes how to use the Unified Medical Language System (UMLS) Metathesaurus Browser to find Concept Unique Identifiers (CUIs) and extract concept-level synonyms between SNOMED CT and other nursing terminologies. Additionally, links to other NLM Terminology resources and helpful resources are provided.
NLM welcomes feedback on the Nursing Resources for Standards and Interoperability page. Please send comments to NLM Customer Service.
NLM has announced the newly redesigned Health IT page. It showcases the useful products and tooling that NLM offers in the domain of clinical vocabulary standards and information exchange. It includes links for implementation resources, training opportunities, and research resources. The updated page has a Health IT News section with current news items. You also may subscribe to the new Health IT RSS feed to receive the news updates.
On May 7th, the Health Information Technology section of AHRQ (Agency for Healthcare Research and Quality) sponsored the presentation A National Web Conference on Assessing Patient Health Information Needs for Developing Consumer Health IT Tools. Featured speakers included:
- Wanda Pratt, Ph.D., Professor, Information School, University of Washington
- James Ralston, M.D., Associate Investigator/Physician, Internal Medicine, Group Health Research Institute
- Patricia Flatley Brennan, Ph.D., Moehlman Bascom Professor, College of Engineering, University of Wisconsin- Madison
The presenters described projects to improve communication of safety concerns among hospitalized patients, promote effective management of patients with diabetes, and improve asthma care in children. Presentation slides from the talks are now available on the Health Information Technology website.
Congratulations to Stephen Kiyoi, Library Director at San Francisco General Hospital, who is a Principal Investigator on a newly awarded three-year, $300,000 NLM Information Resource Grant to Reduce Health Disparities (G08) from the National Library of Medicine. The project, Patient Engagement with Personal Health Records, will support the research and development of better ways to engage safety net patients with personal health records.
Partnering on the grant are Courtney Lyles, PhD, and Urmimala Sarkar, MD, MPH, from the UCSF Center for Vulnerable Populations (CVP). The CVP is an internationally recognized leader in health communication and health policy to reduce health disparities, with special expertise in the social determinants of health. The team will also partner with Yemila Alvarez, Community Outreach Manager at the San Francisco Public Library (SFPL). SFPL will help disseminate and scale project interventions across its 27 branch locations.
On May 1, 2015, The National Library of Medicine (NLM) Value Set Authority Center (VSAC), in collaboration with the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS), published the annual update for the 2014 electronic clinical quality measures (eCQMs) value sets for eligible hospitals and eligible professionals. Providers will use these updated eCQM value sets to electronically report 2016 quality data for CMS quality reporting programs, including the Physician Quality Reporting System (PQRS), Inpatient Quality Reporting Program (IQR), and the EHR Incentive Programs. CMS updates these electronic reporting specifications annually to improve alignment with current clinical guidelines and terminologies and to remain relevant and actionable within the clinical care setting.
The VSAC offers a Downloadable Resource Table, accessible from the Download tab on the VSAC Web page, that provides prepackaged downloads for the most recently updated and released eCQM value sets, as well as for previously released versions. Access to the VSAC requires a free Unified Medical Language System® Metathesaurus License. NLM also provides the Data Element Catalog that identifies data element names (value set names) required for capture in electronic health record (EHR) technology certified under the 2014 Edition of the ONC Standards and Certification Criteria.
The NLM update of the VSAC eCQM value sets coincides with the CMS posting of the annual update for the 2014 eCQMs for eligible hospitals and eligible professionals, available in the CMS eCQM Library. CMS has re-specified all of the 2015 updated measures using Quality Data Model (QDM) 4.1.2 based-HQMF version R 2.1. 2014 Clinical Quality Measure Resources.
The following resources are available to help health care providers and vendors navigate the 2014 eCQMs.
The National Library of Medicine is saddened at the passing of Dr. Morris F. Collen, known around the world as “Mr. Medical Informatics,” on September 27, 2014. He was 100 years old. In addition to his wide-ranging contributions to medical informatics, Dr. Collen was a valued advisor to NLM. He was a member of the Lister Hill Board of Scientific Counselors from 1984 to 1987. He served on the Literature Selection Technical Review Committee, which advises NLM on the journals to be indexed in MEDLINE/PubMed, from 1997 to 2002, chairing the Committee from 2000 to 2002. He also contributed to NLM Long Range planning.
Morris Collen earned his bachelor’s degree in electrical engineering from the University of Minnesota and graduated from the University of Minnesota School of Medicine in 1938. His residency at the University of Southern California/Los Angeles County General Hospital took him to California, where he started what would become a legendary career at Kaiser (later Kaiser Permanente). He served as chief of medical services at Kaiser’s Oakland hospital from 1942 to 1952, and medical director the following year. From 1953 to 1961, Dr. Collen served as physician-in-chief at Kaiser Permanente (KP) in San Francisco.
During World War II, Dr. Collen was one of the first doctors to experiment with the use of a new wonder drug–penicillin–for the treatment of pneumonia in shipyard workers, at a time when most of the drug was shipped overseas for members of the armed forces. Dr. Collen’s interest in the use of computers as a way to improve medical care developed during a 1961 conference on biomedical electronics. Soon afterward, he founded Kaiser Permanente’s research division and created a prototype electronic health record fed by punch card into a huge IBM mainframe computer. The record included information from patient screenings and lab results. One of Dr. Collen’s major achievements at KP was the development of the multiphasic health checkup, which addressed the physician shortage of the 1950s, post-World War II. This series of procedures and tests, given to thousands of KP members, screened for conditions such as heart disease, diabetes, and cancer. Not only did these revolutionary tests save physicians’ time; they constituted a significant experiment in preventive care. Dr. Collen eventually automated the multiphasic health checkups, moving them onto a punch card system in 1964.
Electronic health records are in the headlines today, but their bloodlines run back to Dr. Collen. Kaiser Permanente’s early EHR system became internationally known because of his groundbreaking efforts. In fact, he predicted that the computer would have “the greatest technological impact on medical science since the invention of the microscope,” as noted in a 2008 Kaiser Permanente publication.
The National Library of Medicine has announced a new Value Set Authority Center (VSAC) tutorial, Updating Value Sets. The nine-minute tutorial is available as a link from the UMLS Video Learning Resources page, the NLM Distance Education Resources page, and is posted at the NLM YouTube site. Additional tutorials designed to assist users with VSAC and VSAC authoring tools are in development. NLM encourages comments about the tutorial and suggestions for further topics, which may be sent to NLM Customer Service.
The NLM Value Set Authority Center is developed by NLM in collaboration with Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) to provide searchable access to value sets that are used to define concepts used in clinical quality measures, and to support effective health information exchange and many other biomedical informatics applications and programs. Since October 2013, VSAC also offers the Authoring Tool that allows users to author value sets.