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Data informatics in healthcare - Part 3

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Data informatics in healthcare - Part 3

Carly Noel, DO, MPH Clinical Informatics Fellow

Start

Disclosure

Dr. Noel is the President of the AMIA Clinical Informatics Fellows under the American Medical Informatics Association

How can we make sure that Sasha's health information gets back to her pediatrician?

Healthcare Data and Exchange standards

REFERENCES

Promotes consistent naming of individuals, events, diagnoses, treatments, and everything else in healthcare.
These standards allow for the fundamentals of informatics to be carried out! Such as information exchange, research, public health and technology advancements.
Allows for better use of data in patient care.

Healthcare Data and Exchange Standards

Imaging Standards

Patient Identifiers

  • Digital Imaging and Communications (DICOM) is intended for the transport of images
  • SSN? MRN? Lots of controversy in the United States!

Message Exchange Standards

Prescribing Standards

  • HL7 is widely used throughout healthcare
  • HL7 is a syntax, meaning that the sender and receiver must understand the meaning of the messages
  • HL7 also sets a standard for Clinical Documentation Architecture (CDA)
  • National Council for Prescription Drug Programs developed SCRIPT as the communication standard between prescriber and pharmacy

Healthcare Data and Exchange Standards

  • International Classification of Diseases (ICD)
    • Standard to help classify and code diseases, injuries, and health conditions
    • Take a look at the different ways and complexities that we can code for Sasha’s upper extremity fracture.
    • Let’s say she was visiting her grandparents in Florida when this happened. How can her pediatrician see information from this encounter?

Information Technology Systems

Info

Flip each card for the definition of the term

Health Information Systems (HIS)

Data Warehouses

Health Information Exchange (HIE)

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Sharing of this information across health systems (hospitals, physician practices, laboratories, pharmacies, nursing homes etc.)

The clinical systems used to retrieve patient data for review by their providers, for example, the electronic health record

Can be used for quality improvement, public health reporting, research, clinical trials etc (Epic Caboodle)

Title

Health Information Systems (HIS)

Title

Data Warehouses

Title

Health Information Exchange (HIE)

Write a brief description here

Write a brief description here

Write a brief description here

InteroperabilityDefined

  • HIE and Interoperability are different
    • HIE refers to the act of sharing information about a patient or population
    • Interoperability is a technical capability that allows information to be electronically exchanged
  • Both HIE and Interoperability are crucial for population health
Hover above the + sign for the definition!

Interoperability

HIE and Interoperability Networks

REFERENCES

Click on the icons below for more info

State Government- Facilitated HIE

Community-Based HIE

Vendor-Facilitated HIE

National Networks

Barriers for the HIE and interoperabiliy

REFERENCES

Financial Barriers
Technical Barriers
  • Takes time and money to adjust current EHR infrastructure
  • EHR vendors sometimes make it hard to exchange information
  • Institutions have significant customization
  • Different workflows
  • Different programming languages (getting better!)
  • HL7 is now a standard as Fast Healthcare Interoperability Resource (FHIR)

FHIR

FHIR

Fast Healthcare Interoperability Resources is a standard developed by Health Level Seven (HL7) International to facilitate the exchange of healthcare information between different healthcare systems

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.

API-based (application programming interfaces) communication to ensure efficient data exchange between systems

Sasha’s mom will be able to share the encounter on MyChart

FHIR is an open-sourced standard, meaning it is freely available for use by anyone -> reduces cost

FHIR provides rules for a common/standard data format so that systems can better understand data

SMART on FHIR is an application programming interface for medical apps

Title

Write a brief description here

Swipe through the cards to learn more about FHIR

Clinical Informatics Research

  • Clinical informaticians use health data to improve decisions, care, and delivery.
  • Growing healthcare data creates endless opportunities.
  • Epic COSMOS enables large-scale health research and innovation.
    • Especially useful for rare disease studies.

Key Research Areas

System Development Cycle

Info

Click to read more about leadership and change management

Planning

Analysis

Maintenance

Implementation

Testing

Design

Development

Artificial Intelligence (AI) & Machine Learning (ML)

REFERENCES

Natural Language Processing
Generative AI
Machine Learning
Why does it matter?
  • Healthcare is experiencing a data explosion between exponentially increasing electronic health record data, wearable devices, and integrated apps

Applications of AI in Healthcare

Diagnostics
Predictive Modeling
Personalized Treatment
Virtual Assistants

Examples of AI

1) The study used AI to analyze the structure and features of brain tissue

2) “The deep learning approach was applied to the prediction of cognitive impairment, a challenging problem for which no current human-performed histopathologic diagnostic tool exists”

Additional Topics to Explore

Where to Learn More

  • Visit: www.connect.AMIA.org
  • Podcasts
    • ACIF Go-Live
      • Produced by the AMIA clinical informatics fellows with expert interviews
    • For Your Informatics (FYI)
      • Explores the limitless world of medical informatics, showcases individuals at all career stages. Led by Women in AMIA.

Thank you!

Carly Noel Carly.Noel@CCHMC.org

State Government-Facilitated HIE

  • HITECH Act provided eligible U.S. hospitals and providers with incentives for adapting EHR systems and funding for the Office of the National Coordinator for Health Information Technology (ONC) to stimulate HIE
  • ONC invested over $500 million in state-based HIE programs
  • Example: Michigan created the Michigan Health Information Network (MiHIN)
Applications of AI in healthcare

Predictive Modeling

  • Machine learning can predict disease risk and progression using constantly updating models

Consider:

Does this make it easier to see Sasha’s encounter from across state lines?

Applications of AI in healthcare

Diagnostics

  • AI has been shown to be able to analyze imaging (such as chest x-rays) and provide timely results
  • Is it possible in the future AI will be able to read Sasha’s upper extremity x-ray correctly before a physician?
    • Yes! https://www.sciencedirect.com/science/article/pii/S2666639125000392
Applications of AI in healthcare

Personalized Treatment

  • Tailoring therapy based on current diagnosis and past medical history
Applications of AI in healthcare

Virtual Assistants

  • Chat bots providing triage or other health support

Natural language processing is a form of AI that enables computers to interpret and use human language

Generative AI is a machine learning technology that can create new content from the data it has been trained on

Correct!

HIE and Interoperability both share health information, improve access to patient care, and send secure data. HIE is the ACT of sending information while Interoperability is the technical ABILITY to send the information.

Leadership & Change Management in Clinical Informatics
  • Leadership is needed to ensure that new technologies and workflows are successfully adapted and used.
  • Typically as a physician, this is a Chief Medical Information Officer, Chief Technology Officer, Physician Builder, Physician Champion
  • Using the System Development Life Cycle is helpful with implementation

Machine learning is a key component of AI, which works by processing a vast amount of clinical data and uses algorithms to identify patterns and predict medical outcomes