School of Medicine Selects Journal Article from Evidence-based Practice Center as Paper of the Month
One of the systematic reviews from the Pacific Northwest Evidence-based Practice Center, previously highlighted in Health Data, Information and Action, was selected as the OHSU School of Medicine Paper of the Month for March 2017. The journal article on low back pain was published in the February 14, 2017 issue of Annals of Internal Medicine. Congratulations, Dr. Roger Chou and team!
Informatics Fellows Win Award from Society for Imaging Informatics in Medicine (SIIM) for FHIR-Based Application
DMICE Clinical Informatics Fellow James Morrison, M.D., received a $10,000 prize in the first Innovation Challenge of the Society for Imaging Informatics in Medicine. Dr. Morrison, an interventional radiologist, and his team from OHSU presented their project, Voice Enabling the Imaging Enterprise, a voice interface going directly into the electronic health record (EHR) that allows quick, seamless data access through voice commands.
In addition to Dr. Morrison, the winning team included Steven Kassakian, M.D., former National Library of Medicine (NLM) post-doctoral fellow and now medical director of Clinical Informatics and assistant professor, DMICE; Eric Leung, Ph.D. student and NLM pre-doctoral fellow; and Jonathan Steinberger, M.D., assistant professor of interventional radiology.
The project uses Amazon Echo voice-activated hardware and connects with the EHR via the HL7 Fast Health Interoperability resources (FHIR) standard. The OHSU team envisions this technology as an optimal solution for getting information out of the EHR and other resources while allowing users to maintain focus on the task at hand, whether that is reading imaging studies in radiology, operating in the OR, or talking to a patient in clinic.
“The inaugural SIIM Innovation Challenge was an ideal venue to get feedback and exposure for our idea of bringing a more robust voice-activated interface in to the radiology reading room and outpatient clinic.,” said Dr. Morrison.
“Winning the Grand Prize and People’s Choice Award was validation of the underlying concept, and the $10,000 gave my co-founders and me the capital we needed to take our prototype to the next level. It’s fair to say that without SIIM’s support our idea may never have made it out of the dreamer phase.”
Dr. Morrison plans to use the funds to obtain additional hardware for development and testing.
The SIIM meeting was held in July 2016 in Portland, Ore., and the OHSU team will report on their progress at the 2017 meeting in June in Pittsburgh, Pa.
A video about the project can be viewed at https://youtu.be/W0pbgQ1k1vQ. Photo above provided by Society for Imaging Informatics in Medicine (SIIM).
The OHSU Biomedical Informatics Graduate Program has received university approval to rename the two tracks of its program to reflect changes in the field and evolving content in the curriculum.
Since 2006, the program has had two “tracks,” which we have called Clinical Informatics (CI) and Bioinformatics & Computational Biology (BCB). We have chosen to call these two pathways through our programs “tracks” because they represent two different foci within the larger field of biomedical informatics, which is the discipline that acquires, organizes, and uses data, information, and knowledge to advance health-related sciences. Historically, the differences between the tracks represented their informatics focus, in particular people, populations, and healthcare (clinical informatics) vs. cellular and molecular biology, genomics, and imaging (bioinformatics).
In recent years, however, these distinctions have blurred as “omics” science has worked its way into clinical medicine. At the same time, health, healthcare, and public health have become much more data-driven, due in no small part to the large-scale adoption of electronic health records. As such, the two tracks have begun to represent different but still distinct foci, mostly in their depth of quantitative methods (deep vs. applied) but also in coverage of other topics (e.g., system implementation, especially in complex health environments; usability; and clinical data quality and standards).
We believe that both tracks possess a set of common competencies at a high level that reflect the essential knowledge and skills of individuals who work in biomedical informatics. Our curriculum organizes these competencies into “domains,” which are groups of required and elective courses that comprise the core curriculum of each track. To reflect the evolution of the program, we have renamed the BCB track to Bioinformatics and Computational Biomedicine (still abbreviated BCB) and the CI track to Health and Clinical Informatics (now to be abbreviated HCI). The table lists below lists the common competencies and the names of the domains for each track. Each of the domains contains required courses, individual competency courses (where students are required to select a certain number of courses from a larger list, which we used to call “k of n” courses), and elective courses.
The program will continue the overall structure of the curriculum with the “knowledge base” that represents the core curriculum of the master’s degree and the base curriculum for advanced study in the PhD program. A thesis or capstone is added to the knowledge base to qualify for the MS or MBI (latter in the HCI Track only) degrees, respectively. Additional courses are required for the PhD, ultimately culminating in a dissertation.
We are in the process of updating the materials and Web site for our program to reflect the new names. We will also be evolving our course content as well as introducing new courses to reflect the foci of the new tracks. The program still fundamentally aims to train future researchers and leaders in the field of biomedical informatics.
Evidence-based Practice Center publishes two systematic reviews related to low back pain in Annals of Internal Medicine
The Pacific Northwest Evidence-based Practice Center (EPC), based in the Department of Medical Informatics and Clinical Epidemiology, had two systematic reviews related to low back pain published in the February 14, 2017 issue of Annals of Internal Medicine. The papers were published in conjunction with a clinical guideline on noninvasive treatments for subacute, and chronic low back pain, issued by the American College of Physicians (ACP).
Roger Chou, M.D., director of the EPC and professor of medical informatics and clinical epidemiology and medicine, was first author of the systematic review on systemic pharmacologic therapies for low pain. The review was conducted by EPC investigators and staff at OHSU along with EPC partners, the University of Washington CHASE Alliance and Spectrum Research, Inc. Among the co-authors were DMICE staff Tracy Dana, M.L.S., Jessica Griffin, M.S., and Sara Grusing, B.A.
The second systematic review focused on nonpharmacologic therapies for low back pain. Dr. Chou served as first author, with DMICE staff Ms. Tracy, Ms. Griffin and Ms. Grusing as co-authors, along with others at OHSU, the University of Washington, and Spectrum Research.
“Low back pain is a common problem and it continues to be a challenge for primary care and specialist providers,” said Dr. Chou. “The EPC evidence reviews to support the ACP guideline required a huge effort to gather and assess the abundance of evidence on nonpharmacological therapies as well as prescription and over-the-counter medications, and I’m grateful to our EPC investigators for their excellent teamwork.”
The ACP guideline on low back pain was prepared by the ACP Clinical Guidelines Committee. Linda Humphrey, M.D., M.P.H., professor of medicine and medical informatics and clinical epidemiology, and Devan Kansagara, M.D., M.C.R., associate professor of medicine and medical informatics and clinical epidemiology, served on the guidelines committee. Both physicians also work at the VA Portland Health Care System.
“The guidelines emphasize nonpharmacological treatments as first-line therapy for chronic LBP. In particular, they emphasize the limited role of opioids for LBP,” added Dr. Chou.
The EPC reviews are available from the Annals Web site:
Extension of Clinical Informatics Subspecialty Grandfathering Period Provides New Options for Physician Certification
In November, the American Board of Preventive Medicine (ABPM) announced that the “grandfathering period” for physicians to become board-certified in the new subspecialty of clinical informatics would be extended for five additional years, from 2017 to 2022 (see also). This means that physicians can become board-certified in the subspecialty through either the practice pathway or via “non-traditional” fellowships that include both the OHSU National Library of Medicine (NLM) fellowship as well as our master’s degree program, the latter of which is available online.
OHSU has developed an ACGME-accredited clinical informatics fellowship and we believe this is the gold standard for training in clinical informatics. However, we also recognize that a two-year on-site fellowship is not possible for all who desire to achieve certification in the subspecialty, especially those who are mid-career and not easily able to relocate for a full-time fellowship.
The requirements for board eligibility include board certification in a primary specialty and qualification via the practice pathway or a non-traditional fellowship. The practice pathway requires one to have “practiced” clinical informatics for 25% or more time over three of the last five years. Education time counts as half of the time of practice time, i.e., 50% or more time over three years, which is comparable to the duration of a one-and-a-half-year full-time master’s degree.
All practice pathway time is additive, so a combination of practice and/or educational activities can reach the threshold. In addition, a recent master’s degree from an established program (the actual list is not known but includes long-standing programs, including ours at OHSU) has been enough to achieve board eligibility. Those eligible for the exam can then apply to ABPM to take the exam, which is offered annually each October.
The OHSU Department of Medical Informatics & Clinical Epidemiology received word in December that our Biomedical Informatics Research Training Grant from the National Library of Medicine (NLM) of the National Institutes of Health (NIH) will be renewed for another five years from 2017-2022. This will enable us to provide financial support (stipends plus tuition) for doctoral (PhD) and postdoctoral trainees in our educational program for another five years.
Our program has been funded as an NLM training site continually since 1992. We are currently evaluating applicants to start in the 2017-2018 academic year. The application period for the 2017-2018 year has already closed, but it will open for the 2018-2019 academic year starting next summer.
The OHSU NLM Training Grant Program has produced a number of highly successful graduates, many of whom have gone to successful careers in academia, industry, and elsewhere. We hope to continue this success in the next five-year cycle of the training grant and beyond.
Heidi D. Nelson, M.D., M.P.H., M.A.C.P., has been awarded Mastership in the American College of Physicians (ACP), the national organization of internal medicine physicians. Dr. Nelson, Research Professor and Vice Chair in the Department of Medical Informatics and Clinical Epidemiology (DMICE), also serves as Director of Scholarly Projects for the Oregon Health & Science University School of Medicine, and Medical Director of Cancer Prevention and Screening at Providence Health and Services in Portland, Oregon.
Election to Mastership recognizes outstanding and extraordinary career accomplishments. Masters must have made a notable contribution to medicine. This includes, but is not limited to teaching, outstanding work in clinical medicine (research or practice), contributions to preventive medicine, improvements in the delivery of health care, and/or contributions to the medical literature. According to ACP bylaws, Masters are elected “on account of personal character, positions of honor, contributions toward furthering the purposes of the ACP, eminence in practice or in medical research, or other attainments in science or in the art of medicine.”
Dr. Nelson’s research, teaching, and clinical activities focus on clinical epidemiology, screening and prevention, women’s health, and health care policy and delivery. Within DMICE, Dr. Nelson serves as a lead investigator in the Pacific Northwest Evidence-based Practice Center and is the collaborating principal investigator for the HRSA-sponsored Women’s Preventive Services Initiative. Dr. Nelson has conducted numerous systematic reviews on screening and prevention topics used to inform decision making by the U.S. Preventive Services Task Force, AHRQ Effective Healthcare Program, National Institutes of Health, and multiple other partners since 1998. Her studies have been used to determine clinical practice guidelines, health policy, and formulary and coverage decisions affecting millions of Americans. She recently published a textbook on systematic review methodology (Systematic Reviews to Answer Health Care Questions. Wolters Kluwer: Philadelphia, 2014).
Dr. Nelson has also served as an investigator for several prominent national studies, including the Study of Osteoporotic Fractures, Breast Cancer Surveillance Consortium, Breast Pathology Study, and Melanoma Pathology Study. She has served on influential national panels including the Institute of Medicine Committee on Prevention Services for Women that determined services to be covered under the Affordable Care Act, PROSPR Scientific Consulting Committee for the National Cancer Institute, and the NIH Advisory Committee on Research on Woman’s Health. In the School of Medicine, Dr. Nelson develops and directs Scholarly Projects, a required component of the new MD curriculum in which medical students create in-depth investigative projects across the course of their medical school education with the goal of creating critical thinkers and lifelong learners.
ACP will honor new Masters at Convocation during Internal Medicine Meeting 2017, ACP’s annual scientific conference March 30-April 1 in San Diego.
Several department faculty will be attending the NIH Big Data to Knowledge (BD2K) Meeting and Open Science Symposium this week in Washington, DC. The department has two grants from the BD2K program to develop open educational resources and establish data science skills courses, all of which can be accessed by the project Web site.
The faculty will present three posters at the meeting:
- Data Science Educational Resources for Anyone, Anywhere
- Getting Your Hands Dirty With Data
- Get Real: A Synthetic Dataset Illustrating Clinical and Genetic Covariates
A team of students in the biomedical informatics program at OHSU took first place in the Student Design Challenge at the American Medical Informatics Association Annual Symposium, marking top honors for an OHSU team three years in a row. The winners were announced November 16, 2016, at the end of the symposium, held in Chicago, Ill.
Students Dana Womack, M.S., Steven Chamberlin, N.D., and Ian Stavros received the first place award with their presentation on SocialVue: Making Social Determinants of Health Visible in the EHR.
“The AMIA student design challenge was a positive learning experience for our team,” said Ms. Womack. “We look forward to future use of our design in the medical home to support care that is tailored to patients’ social determinants of health.”
In third place was another team from OHSU. Matthew Sundling, Ph.D., Vincent Caruso, M.S., Kristen Stevens, and Geoffrey Schau, M.S., presented Chronic Disease Monitoring with PrecisionPatientLedger and RAPID3.
“It gives me great pride to see the talent and insights among the diverse students in our program to win this challenge for the third year in a row,” said DMICE professor and chair William Hersh, M.D.
This year’s Student Design Challenge theme was The Human Side of Big Data – Facilitating Human-Data Interaction. Both teams gave podium presentations as well as displayed posters on their research at the AMIA meeting.
A third DMICE team, students Raja Cholan, Jennifer Pacheco, Gene Ren, and Laura Hickerson, were finalists in the Design Challenge with their project, Personalized Heart Disease Risk Manager: A Tool for Patients and Clinicians to Manage Cardiovascular Risk and presented a poster at the AMIA symposium.
A DMICE student team won the Design Challenge in both 2014 and 2015.