Wednesday, August 22, 2007

Medinfo Day 3

Wednesday morning at the conference opened with two more plenary presentations in the Plaza Ballroom.

Marc Probst (CIO Intermountain Healthcare, USA) described the Mormon history and moved on to talk about the need for integrated approaches across several hospitals and myriad clinical specialties. He highlighted the growth in knowledge and variations in clinical practice providing drivers for the increase in automation, connectivity, decision support and data mining required by the organisation. He provided lots of figures and examples to say why the healthcare system he works for is providing the best care at the cheapest cost and described their aims for a new information systems. They could not buy one which meets their needs so, with GE they are building one over the next 10 years.

The second speaker was Yunkap Kwankam from the World Health Organisation in Switzerland. He described the potential ehealth has to make to sustainable healthcare systems, which meets fundamental rights of high standard and equity of access. He moved from the individuals needs to looking at current and future developments in a public health context.

Several of my discussions outside of formal sessions today have been about SNOMED and other terminology and classification systems. One of the participants described herself as a Snomedian - I wonder if this is the discovery of a new species?

The exhibition hall seemed busier than it had yesterday and there seemed to a stream of UK delegates visiting the IBA stand for news of their increased bid for iSoft (see next item on blog).

After coffee I attended a session with several papers on elearning and distance education. The first was from Grenoble university on how they are using DVD and web based systems to replace lectures in their medical education programme. The second speaker from Porto did not appear so we moved on to Niels Boye from Denmark who described the epistemological knowledge model which underpins their approach to mlearning for junior registrars. He also talked about the problems with the pda based hardware and software they were using. The final speaker in the session was Reena Patel form Auckland University who described the Evaluation and Assessment of the Online Postgraduate Critical Care Nursing Course. She described some of the issues for many of the nurses with little or no previous IT experience and the pre and post test methods they used to demonstrate the students satisfaction with the course and their abilities to apply their new knowledge to practice.

During lunchtime I managed to take a look at some of the hundreds of posters including one produced by Jonathan Bloom and colleagues to improve communication for junior doctors within the United Bristol Healthcare Trust.

I then attended a panel session under the "Orgnisational Issues" theme entitled Relations between industry and academia: How can do better? This included speakers from around the world and from both industry and university sectors. Floyd Eisenberg from Siemens AG briefly described the global structure of the company and it's operating entities before giving examples of their collaborations. He suggested the "Agile" development model with short project delivery times has benefits over the "Waterfall" model, but that some universities may have problems with this. He advocated further work through standards organisations and similar bodies such as IMIA.

H.M. Goh provided an Asian perspective of the different drivers and characteristics of academics and commercial companies. He described various collaborative models and some of the barriers, such as IP rights, which may cause problems.

The European perspective was given by Charles Parisot from GE Healthcare who talked about the development of local relationships with 3 different models:
1)Customer relationships - research to improve the product being used
2)Science/Physicstechnology development ahead of the product cycle, and
3)Collaboratives - such as standards groups which bring academics closer to the "real world" integrating wth healthcare enterprises.
The final speaker who provided a US educational perspective was Ted Shortliffe from Arizona University. He described how different sources of funding (eg government research grants), affect technology transferand licensing arrangements. He listed some of the challenges to collaboration and illustrated them with annecdotes from silicon valley with Stanford and Berkley (private universities) having an entrepreneurial culture, but public universities having to meet the agendas of government about economic growth and employment bring different pressures. He concluded with examples of positive drivers with an example from the New York State Foundation for Science, Technology and Innovation (NYSTAR) and the Centre for Advanced Technology at Columbia University.

There was a very good question and answer session exploring how to manage the collaboration process, lots of worries about IP and consideration of the role of industry in specifying curricula.

The final session of the day I attended was entitled Searching for Answers. Gunter Eysenbach from the University of Toronto described the development and testing of the FA4CT algorithm to help consumer evaluate the quality of medical claims within web sites. He was followed by Michel Joubert who described the development and use of the WRAPIN tool (an EU framework V funded project) to help people extract text from their electronic health record in a variety of langauges and automatically check it against reliable literature sources. The final speaker was Amy Lou a doctoral student from Sydney who described studies identifying biases in how clinicians search for information from the literature and use them in their decision making.

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