Medical Informatics

Conference focuses on transforming health care through informatics

The sudden growth of medical informatics is having an impact on all segments of America's health care system. A glimpse of what is to come was provided at the American Medical Informatics '99 Annual Symposium, which was held November 6-10 in Washington, DC.

This year's theme was "Transforming Health Care Through Informatics: Cornerstones for a New Information Management Paradigm." Topics ranged from methods for representing drug terminology, terminology issues in user access to Web-based medical information, and computerized interviews for childhood psychiatric diagnosis, to use of pen computers by patients to record their symptoms, and use of the Web to reduce postoperative pain at home.

Eight of the studies presented at the conference, which were published along with several hundred other papers in the 1999 Journal of the American Medical Informatics Association symposium supplement, were supported in whole or in part by the Agency for Healthcare Research and Quality. They are:

• Bourie, P.Q., Phipps, M.A., McKay, M., and others. "Risk alerts in an on-line nursing assessment," p. 1030 (AHRQ grant HS08749). Patient data combined with clinician-defined rules can generate an automated alert designed to inform nurses about potentially serious clinical situations. This paper describes a computer-based alert specifically designed to improve nursing care and outcomes.
• Chute, C.G., Elkin, P.L., Sherertz, D.D., and others. "Desiderata for a clinical terminology server," p. 42 (AHRQ grant HS08751). Consistently entered information, which is comparable across care providers and care settings, is increasingly being emphasized. This paper describes experience with a clinical terminology server that focuses on consistent entry of clinical observations, findings, and events.
• East, T.D., Heermann, L.K., Bradshaw, R.L., and others. "Efficacy of computerized decision support for mechanical ventilation: Results of a prospective multi-center randomized trial," p. 251 (AHRQ grant HS06594). These researchers examined the efficacy of a computerized decision support system to manage the care of 200 adult respiratory distress patients at different centers. The results indicated that this approach to ventilator management can be effectively transferred to many clinical settings and significantly improve patient health.
• Elkin, P.L., Bailey, K.R., Ogren, P.V., and others. "Randomized double-blind controlled trial of automated term dissection," p. 62 (AHRQ grant HS08751). This paper describes a mechanism for automated term dissection using the semantic types available from within the Unified Medical Language System. The system uses a specific search engine to retrieve a list of suggested terms, which are then analyzed to find the best ones to construct understandable compositional expression.
• Goldsmith, D.M., and Safran, C. "Using the Web to reduce postoperative pain following ambulatory surgery," p. 780 (AHRQ grant HS08749). This paper describes the use of a Web site to provide educational information to 195 at-home patients following outpatient surgery. Patients who had access to the pain management information on the ambulatory surgery Web site reported significantly less postoperative pain at home.
• Hsu, C., and Goldberg, H.S. "Knowledge-mediated retrieval of laboratory observations," p. 809 (AHRQ grant HS08749). These researchers developed an ontology for laboratory observations and made the ontology accessible in a distributed environment through a knowledge mediator offering several services.
• Lobach, D.F., Spell, R.U., Hales, J.W., and others. "A Web link management tool for optimizing utilization of distributed knowledge in health care applications," p. 839 (AHRQ grant HS09436). Thousands of Web sites now post health-related information. While search engines exist for finding sites, few tools are available for managing Web-based health care information. This paper describes development and use of a Web-link manager to identify relevant Web sites, evaluate the quality of the information they contain, and manage the accumulation of these resources over time.
• Reilly, C.A. "Examining the symptom experience of hospitalized patients using a pen-based computer," p. 364 (AHRQ grant HS08950). This investigator had 72 patients use a pen-based computer to write down their symptoms. Patients found it useful, and study findings support the inclusion of such self-reported symptom data in electronic health records and national health care databases.

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