An international conference addressing Information Technology and Communications in Health (ITCH)
Note: If attending two workshops, total cost is $350.00 for both.
ITCH 2013 WORKSHOPS
Registration opens at 8:30 a.m.
Morning Workshops (9:00 – Noon)
- Accelerating Consumer Health Solutions for Patients, Families and Caregivers
Jennifer Zelmer, Fraser Ratchford, and Chad Leaver, Canada Health Infoway, Canada
- Computerisation in General Practice: Lessons for Canada from the UK and Australia
Nicola Shaw, Health Informatics Institute, Canada
Mike Bainbridge, University of Victoria, Canada
- Social Media and Health Care Leadership: Separating the Wheat from the Chaff
Donald Juzwishin, Alberta Health Services, Canada
- Health Information Systems Safety and Usability Workshop
Elizabeth Borycki and Andre Kushniruk, University of Victoria, Canada
Christian Nohr, Aalborg University, Denmark
James Anderson, Purdue University, USA
- Evaluating Quality of Life for Health Information Technologies
Karen Courtney, University of Victoria, Canada
Scott R. Beach, University of Pittsburgh, USA
Afternoon Workshops (1:00 – 4:00)
- Ontology-Driven Configuration of Electronic Health Records Systems
John Chelsom, City University, UK
- Lessons from Complexity Science for the Future of eHealth
Dominic Covvey, National Institutes of Health Informatics, Canada
- Medication-related CDS Functions Usability Features: from Literature to the Design and Evaluation
Romaric Marcilly, Sylvia Pelayo, Régis Beuscart and Marie-Catherine Beuscart-Zephir, Univ Lille Nord de France, France
- Will Regulation Inhibit Health Information Technology's Enabling Potential?
Jos Aarts, Erasmus University, The Netherlands
Elizabeth Borycki and Andre Kushniruk, University of Victoria, Canada
Eric Eisenstein, Duke University Medical Center, USA
Farah Magrabi, University of New South Wales, Australia
Jennifer Zelmer, Senior Vice-President, Clinical Adoption and Innovation, Canada Health Infoway
Fraser Ratchford Group Program Director, Consumer Health and Innovation, Canada Health Infoway
Chad A. Leaver, Benefits Realization Leader, Canada Health Infoway
Workshop Description:
Interest in Consumer Health Solutions (CHSs) is rapidly expanding globally, due to the potential to improve patient access to health services, impact patient-provider interaction, transform the patient experience and contribute to improved patient outcomes. Canadians indicate that they are most interested in using particular types of CHS, such requesting prescription renewals, viewing laboratory test results, making appointments, or consulting with healthcare providers securely on-line. According to recent surveys, however, relatively few currently have access to such services.
In this workshop, facilitators will share the latest research in the area, as well as applied experiences from the field, in order to inform interactive dialogue amongst workshop participants. It will commence with an overview of the findings from recent qualitative and quantitative research about Canadians' expectations and current experience with CHS, as well as global experience with the use of CHS and their outcomes. A discussion grounded in the practical experiences of Canadian leaders in this area will follow, along with an interactive workshop exercise on accelerating the use of CHS.
Participants will also explore the application of Canada Health Infoway's Benefits Evaluation Framework to consumer health solutions in a way that supports the evaluation of the benefits of solutions across the continuum of implementation, adoption and benefits realization. This will include a discussion of an array of indicator domains and measurement approaches that can be used by stakeholders and the research community in the implementation, adoption and evaluation of consumer health solutions.
Learning Objectives:
- Provide an overview of experiences with CHS in Canada and abroad, drawing on implementation and outcomes experiences from innovators in the field.
- Engage participants in an interactive workshop exercise on accelerating the effective use of CHS in Canada.
- Explore the application of a health informatics benefits evaluation framework to CHS, in the context of different projects and evaluation approaches.
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Nicola T. Shaw, Health Informatics Institute & Algoma University, Sault Ste. Marie, On Canada
Mike Bainbridge, University of Victoria, Victoria, BC Canada
Shaw and Bainbridge have been working in the area of general practice computerisation for many years. Initially both from England, they have worked extensively in other countries with Shaw now working primarily in Canada and Bainbridge in Australia. Consequently, they have a wealth of experience and knowledge to draw upon in terms of what works in this area as well as what doesn't. Together, based on work that Shaw previously completed with Kidd, they have identified nine key issues that Canada must address or they feel we are doomed to repeat the same failures already seen in the UK and Australia.
These nine issues are:
- Education, Training & Support
- Common Data Model
- Clinical Coding
- Information Exchange/Interoperability
- Business Case
- Data Validation & Verification Procedures
- System Support
- Security & Confidentiality
- Research
This workshop will provide an overview of each of these issues. Shaw and Bainbridge will draw upon their experiences to provide examples of where there have been significant failures due to this specific area and they will highlight current activities taking place worldwide that are addressing the issue.
Shaw is the Scientific Director of the Health Informatics Institute in northern Ontario, Canada and the ESRI Canada Research Chair in Health Informatics. She also holds academic appointments with Algoma University, the Northern Ontario School of Medicine, the University of Ontario Institute of Technology, Lakehead University, Laurentian University, the University of Alberta and the University of Victoria.
Bainbridge is the Programme Clinical Lead (e-health Implementation) with the National E-Health Transition Authority (NEHTA) in Sydney, Australia. He holds an adjunct academic appointment with the University of Victoria, Canada and is the Clinical Architect and Director for ASE Consulting Pty. Ltd. (Australia).
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Social Media and Health Care Leadership: Separating the Wheat from the Chaff
Don Juzwishin, Director Health Technology Assessment and Innovation, Alberta Health Services, AB Canada
This is a highly interactive hands on experiential learning opportunity, for participants who want hands on exposure, to a wide range of social media with the purpose of identifying the strengths and weaknesses of each and how to assess the validity and value of their content. We will examine blogs, wikis, RSS, social networks, mashups, podcasts, microblogging, and folksonomies. Participants will be encouraged to identify other forms of emerging social media and we will explore approaches for assessing them.
The goal of the workshop is to provide participants with an understanding and tools to assess the value and trustworthiness of different forms of social media.
Learning Objectives:
- Participants will become familiar with the challenges and opportunities in social media for health care leadership
- Participants will become familiar with the scope, strengths and weaknesses of each of the social media techniques
- Participants will apply tools, checklists and frameworks to help them assess the trustworthiness and value of social media techniques
Resource: Each participant will be provided with a copy of "Social Media and Health Care Leadership: Implications, Issues and Opportunities"
Hands on experience: A limited number of computers will be available in the classroom with WIFI access however if you don't want to be disappointed please bring along your own notebook or tablet.
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Elizabeth M Borycki and Andre Kushniruk, University of Victoria, Victoria, BC Canada.
Christian Nohr, Aalborg University, Aalborg, Denmark.
James Anderson, Purdue University, Lafayette, Indiana, USA
The workshop goal is to familiarize participants with health information systems safety and human aspects of health informatics related to the design, evaluation and deployment of usable, useful and safe health information systems.
It has become increasingly recognized that ensuring the safety and usability of health information systems (such as the electronic health records, electronic medical records) is a key to successful and error free system implementation and use. Usability can be defined as a measure of how effective, efficient, safe, easy to learn and enjoyable to use a system is. Technology-induced errors refer to errors resulting from the design and implementation of technology that are typically only identified during use of information technology under complex work situations. Successful design, implementation and deployment of healthcare information systems is dependent on careful consideration of usability and reduction of usability problems that may lead to technology-induced error. This includes the study of the impact of systems on healthcare workers' cognition and workflow as well as consideration of interrelated social factors related to successful technology deployment. Indeed, the field of health informatics is littered with examples of systems and projects that have failed in large part due to lack of consideration of human-computer interaction and more specifically the relation between usability and safety.
In this workshop a practical framework for improving the safety and usability of healthcare systems will be presented. In particular the application of methods from the emerging fields of usability engineering and simulations will be described and demonstrated. This includes study of human computer-computer interaction in the design of a range of health informatics applications and consideration of low-cost rapid usability engineering methods. These methods, which can be deployed in any setting at a minimal cost, can provide powerful input into evaluating, and improving system usability, usefulness and safety. Approaches to the design and evaluation of systems that are safe and that reduce human error will be discussed, including recent use of portals for both health
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Karen Courtney, University of Victoria, Victoria, BC Canada
Scott R. Beach, University of Pittsburgh, Pittsburgh, PA USA
When assessing the effects of health information technologies, quality of life is often recognized as a valuable outcome. Despite the desirability of increasing or maintaining quality of life for end users, quality of life is often inconsistently evaluated. Evaluations may contain a generic quality of life measure, such as the Short Form Health Survey (SF-36) or condition-specific measures such as the Arthritis Impact Measurement Scale (AIMS) for arthritis. However, broad instruments may not be sensitive enough to capture the effects specific to a particular condition. Condition-specific measures may limit generalizations across studies. Missing from most quality of life evaluation plans are instruments that are specific to the information technology being evaluated. Without this information, it may be difficult to understand what interactions with the technology are affecting a user's quality of life. As a consequence, subsequent designs may inadvertently alter the very technology interactions that were effective in improving or maintaining a user's quality of life.
The Quality of Life Technology Engineering Research Center (QoLT ERC) has proposed that the planned evaluation of health information technologies should include a three pronged approach to measuring quality of life effects. This approach recommends using 1) a generic measure for comparability across populations, settings and technologies; 2) a condition-specific measure for sensitivity to disease or condition-specific effects; and 3) a technology-specific measure for sensitivity to effects of the technology being used.
In this workshop, we will discuss the application of this evaluation model to a diverse array of health information technologies under development by the QoLT ERC. We will encourage participants to explore how this evaluation model could be applied to health information technologies within their own practices or research programs.
After attending this workshop, participants will be able to:
- Describe standard, broad quality of life instruments typically used in research
- Identify condition-specific quality of life instruments
- Design technology-specific quality of life instruments
- Create a customized health information technology evaluation plan based on this evaluation model
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John Chelsom, Centre for Health Informatics, City University, London, UK
This workshop shows how an Electronic Health Record (EHR) system can be configured entirely using an ontology model that mirrors the ISO-13606 and HL7 CDA standards.
The topics to be covered are:
- Open source, open standards for clinical information systems
- Clinician-driven EHR development
- The ontology-driven EHRTools for ontology development
- Configuring the EHR data dictionary
- Form-based clinical data entry
- Summaries and visualisation of clinical data
- Clinical correspondence
Attendees will each receive a USB stick containing a fully functional, open source, EHR system (cityEHR) which can be run directly from the USB, without any local installation. All the techniques for ontology-driven modelling that are demonstrated in the workshop can be run using the cityEHR.
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Dominic Covvey, National Institutes of Health Informatics, Canada
Introducing ehealth into our health system is a world-class challenge. Right now we are investing heavily in ehealth. This increases the risk that we are pursuing a rate of change that our health system cannot safely attain, especially given a limited complement of competent informatics human resources, the possible underestimation of needed effort and investment, and our understanding of the complexity of the health system. This could set the stage for failure. One challenge for informatics solutions is that healthcare delivery systems are complex adaptive systems. To appreciate the implications of this, we will explore the nature of complexity and what it implies for developing, introducing and managing informatics interventions. In particular, we will question the current assumption that health care is a linear, non-interacting, predictable system and we will explore how complexity impacts our interventions. Then we will provide aides that will better equip us to deal with the challenges we face.
On completing this tutorial, participants will be able to:
- Understand the nature of complex adaptive systems and incorporate the lessons of Complexity Theory into their work.
- Conceptualize and implement new approaches to planning, development, implementation, management, and budgeting that are sensitive to the true nature of complex adaptive systems.
- Avoid the dead ends, traps, and failure modes that derive from our misconstruing health care as a linear, predictable system.
- Refocus their further study so as to more deeply appreciate and be able to apply Complexity Theory to their work.
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Romaric Marcilly, Sylvia Pelayo, Régis Beuscart and Marie-Catherine Beuscart-Zephir, Univ Lille Nord De France, France
Evidence that problems with Computerized Clinical Decision Support (CDS) system can pose a risk to patient safety is emerging although such systems are central to improving safety and quality of services. Safety considerations should also be at forefront of design, development, and evaluation of such systems. Currently, systematic patient safety evidence-based design is not common practice. Some initiatives tend to provide this kind of requirements for interface design, e.g. for the presentation of health data or for electronic patient record systems. But further work in this area is needed in terms of building an evidence-base of good (and bad) usability aspects that will assist in the design, development and evaluation of safe and usable software.
The aim of this workshop is to support the construction of a draft of a grid of medication-related CDS functions usability features and to make it meaningful and easy to apply in the frame of CDS system design and evaluation process (e.g. User-Centered Design process). With this aim in view, one requires taxonomy of those features balanced according to their potential impact in terms of usage and patient safety.
For this purpose, following Cochrane requirements, a systematic review of the literature on that topic has been performed on 5518 papers retrieved in Medline, Science Direct and Ergonomics Abstracts databases for screening. About 40 papers were kept for analysis. Its results will be presented at the beginning of the workshop and then will be discussed with the participants: is the literature exhaustive? What may be the biases and how to handle them? How to contextualize those results in the design/evaluation process? Etc.
To support the discussion, cognitive ergonomics methods to extract expert knowledge will be used. For instance, as experts in the field, participants will be invited to participate in a card sorting to generate - online during the session – a first taxonomy of the usability features that will compose the grid. The results of this taxonomy can thus be directly discussed, enriched, modified with all the participants to lead to a first draft at the end of the session.
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Jos Aarts, Erasmus University, The Netherlands
Elizabeth Borycki and Andre Kushniruk, University of Victoria, Canada
Eric Eisenstein, Duke University Medical Center, USA
Farah Magrabi, University of New South Wales, Australia
The Institute of Medicine's report 'Health IT and Patient Safety: Building Safer Systems for Better Care' has become an impetus for policy makers seeking to consider whether and how HIT should be regulated. This report cites poor usability, poor workflow integration and complex data interfaces as potential threats to patient safety and makes a number of recommendations for policy makers that include the mandatory reporting and oversight of patient safety issues. Although the report makes general recommendations, the precise details for how regulation would occur are lacking, allowing HIT industry representatives to claim that regulation will inhibit innovation and lead to higher costs for products.
One concern is that the IOM report goes beyond the boundaries of traditional pharmaceutical and device regulation by explicitly recognizing that HIT is a component within a complex sociotechnical system that includes both the HIT technology and its clinical users. This definition is important because current medical device regulation focuses on approved product use; whereas, the IOM definition may lead to a blurring of distinctions between HIT uses that are and are not officially approved by regulators. Clearly, we do not know whether and how policy makers in different jurisdictions and countries will decide to regulate HIT. However, we do know that the mode of regulation may have significant implication (both positive and negative) for the development and deployment of these technologies at a jurisdictional, country and global level.
This workshop will bring together experts in HIT safety regulation, usability, ethnographic, sociotechnical, and economic analysis. The objective is to apply these different perspectives to the problem of regulation in a manner that does not inhibit the enabling potential of HIT. In particular, we will highlight potential impacts of HIT regulation on the delivery of healthcare and personal health. In line with the ITCH 2013 themes, we will address the implications of regulation for HIT Availability both in traditional and alternative delivery mechanism, HIT Tailoring to conform to the unique needs of specific patients and groups, and HIT Closeness through eHealth and mHealth applications. Following short presentations by our subject matter experts, we will engage attendees in a discussion of HIT regulation through a series of case studies that demonstrate key components in an integrated HIT regulatory framework.
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