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Report from CHOP’s 5th Annual Healthcare Informatics Symposium

May 2, 2012
by David Raths
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Innovations range from IBM’s Watson to EHR-linked interactive voice response systems

More than 300 clinicians and researchers gathered April 27 for the 5th Annual Healthcare Informatics Symposium presented by the Center for Biomedical Informatics at the Children’s Hospital of Philadelphia (CHOP). Presentation topics ranged from IBM’s Watson supercomputer to clinical decision support to patient and family engagement innovations.

In one keynote address, Martin Kohn, M.D., chief medical scientist in care delivery systems for IBM Research, described how Watson, the supercomputer that became famous for winning at the game show Jeopardy is now being put to use in the healthcare field. The computer system’s strength is in natural language processing, he said. It can understand information provided by a clinician about an encounter with a patient and read unstructured data in an electronic health record. In addition, it can read 100 million pages of health literature a second.

Kohn said Watson could become invaluable as a diagnosis aide to physicians. Clinicians feed it clues about a beguiling set of symptoms and Watson scans the literature looking for matches before offering potential suggestions. With thousands of new studies published every year, it’s well beyond the ability of any one person to consume or assimilate, Kohn said. Watson is a tool that can read through all that literature and get the information relevant to the decision to be made. IBM has formed a partnership with Memorial Sloan-Kettering Cancer Center in New York to develop tools to help improve decision making for diagnosis and therapy in cancer, he said.

On the clinical decision support (CDS) front, Chris Lehmann, M.D., director of clinical information technology for Johns Hopkins Children's Medical and Surgical Center, said that solutions out of the box from EHR vendors still don’t work well enough. In his organization, he said, physicians overrode the drug-drug interaction tool supplied by the vendor 97 percent of the time. “So we built our own and reduced alerts by 90 percent,” he said, “but it takes a lot of time to do well.”

Lehman believes that associations will eventually become the stewards of clinical decision support knowledge bases.

The American Association of Pediatrics has held talks with EHR vendors on this topic, and Lehman said the message from vendors is clear: They can’t keep up with the constant change in CDS content, and they would like a trusted source to do this. The key is to develop web services that can be shared, he said. It will eliminate regional discrepancies and redundant development efforts.

We don’t often include the telephone when thinking about health IT innovations, but researchers at the Boston University School of Medicine described their work combining EHRs with interactive voice response (IVR) systems. William Adams, M.D., director of the BU Clinical and Translational Science Institute Clinical Research Informatics Group, said that integrated with an EHR, the IVR system can have an impact on child health supervision, medication safety and parental activation.

BU researchers created the Personal Health Partner with a synthetic voice as an automated telephone system designed to gather information about children before a primary care visit, share that information with the pediatrician, and follow up after the visit to review things that may have been done during the visit. “The data gathered in the call prepopulates the EHR, which is a time saver for the provider,” Adams said.

In the study, 80 percent of clinicians thought it improved efficiency, and integrated well into clinical workflow.

Adams added that the system helps parents provide information that can change what happens during an office visit. He said a next step is to make the system multichannel, so that parents can choose whether they’d rather interact on the Web or by phone.

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