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McGowan's service to the field of health sciences librarianship
has been comprehensive and inspiring. She is a prolific author and
an active researcher, always pushing the frontiers of health information
practice. She has proved herself as an educator in both health sciences
librarianship and medical educational environments. McGowan has
been a member of the Medical Library Association for over twenty-seven
years and in the medical library profession for thirty years. Her
most recent MLA service includes membership on the Board of Directors,
1999-2002, the Nominating Committee, 2002/03, and the Donald A.
B. Lindberg Research Fellowship Jury, 2003/04. McGowan has chaired
several MLA committees and four sections: International Cooperation,
Medical Informatics, Medical School Libraries, and Research. In
addition, she has received three MLA awards: the Frank Bradway Rogers
Information Advancement Award (1996), the Medical Informatics Section/MLA
Career Development Grant (1997), and the Lucretia W. McClure Excellence
in Education Award (2001). McGowan was named an MLA fellow at MLA
'05 and is a fellow of the American College of Medical Informatics.
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Integrating Reference Information into the Electronic Health Record:
Practice and Standards
Wednesday, May 24, 9:00 a.m.–noon
One of the emerging methods for supporting evidence-based
health care is creating links between clinical information systems
and context-appropriate information resources. Two approaches are
currently in practice: clinical portals, which are libraries that
aggregate and simplify access to content, and clinical “info
buttons,” which use information from the clinical system to
focus retrieval from an information resource.
Introduction
Debra Ketchell, AHIP, is the associate
dean, Knowledge Management, and director, Lane Medical Library,
Stanford University Medical Center, Stanford University, and previously
was the deputy director of the University of Washington Health Sciences
Libraries. She will introduce the session and provide a framework
for the discussion.
The Standards Perspective
Guilherme del Fiol is a medical knowledge
engineer at Intermountain Health Care in Salt Lake City and works
on integrating health information resources with the electronic
health record (EHR). As a physician with a master’s degree
in computer science, he is leading the development of a standard
for Health Level 7 (HL7) to promote the use of information resources
at the point of care. HL7 is the leading organization for information
technology standards in health care. The emerging standard should
facilitate the context-aware integration between EHRs and clinical
references, especially through the development of “info buttons.”
The Clinical Knowledge Provider Perspective
Jerome Osheroff, chief clinical informatics
officer at Thomson Micromedex, helps ensure that their clinical
decision support (CDS) offerings are optimally responsive to clinicians’
and patients’ information needs. He is the lead author of the
2005 Healthcare Information and Management Systems Society (HIMSS)
book of the year, Improving Outcomes with Clinical Decision Support:
An Implementer’s Guide, and chairs the HIMSS CDS Task Force.
He recently cochaired development of a joint American Medical Informatics
Association/HIMSS whitepaper with recommendations and an action
plan on CDS in electronic prescribing and is coleading a follow-up
effort to develop a roadmap for national action on CDS.
The Electronic Health Record Provider
Perspective
Robert Abarbanel is a senior director
in the product strategy group at GE Healthcare Integrated IT Solutions
and is responsible for a content strategy that includes facilitated
in-context access to evidence-based information in internal and
external warehouses, decision support, and standard vocabularies.
He is the principal investigator of the Sharable Active Guideline
Environment (SAGE) project, sponsored by the National Institute
of Standards and Technology, demonstrating the feasibility of standard
computable clinical guidelines. He is a member of the CDS group
at HL7, where he is working on the info button and on emerging standards
for the virtual medical record that is in use in the SAGE project
today.
Part 2: Clinical
Knowledge Integration: Current Best Practice
Intermountain Healthcare Library
Portal and HELP2
Guilherme del Fiol will describe
the goals, strategies, processes, and tools to support the use of
health information resources at Intermountain Healthcare, especially
in the context of patient care using their EHRs, called HELP2. Two
information retrieval tools that have been integrated with HELP2
to support information needs at the point-of-care will be presented:
“On-line Medical Library Portal” offers links to resources
that are available corporate-wide, and “Info button” provides
links to resources based on data about the patient and the EHR user.
Finally, data on the use of these tools in the last four years will
be presented, and the pros and cons of each approach will be discussed.
Kaiser Permanente
Clinical Library and HealthConnect
Sara Pimental, AHIP, content project
manager, Kaiser Permanente Clinical Library, Oakland, CA, will describe
the integration of Kaiser’s Clinical Library into patients’
EHRs, called HealthConnect. The Active Guidelines feature moves
static best practice guidelines into the clinician’s workflow
and makes adherence to clinical paths as simple as clicking through
a flowchart. Context Sensitive Search allows clinicians to easily
query the clinical library from HealthConnect for guidelines and
patient education materials related to a patient problem. Primary
diagnosis, age, and gender metadata are used as search parameters
to return the most relevant materials from the clinical library.
Veteran’s Administration
VistA System Integration
Mary Fran Prottsman, AHIP, information
services librarian, Department of Veterans Affairs (VA), Silver
Spring, MD, will review integration of text with graphics into VistA,
the VA’s computerized patient record system, and its impact
on patient safety and satisfaction. In the VistA system, clinical
reminders are tied to clinical practice guidelines and links are
made to knowledge-based information such as UpToDate and Micromedex.
The system provides a seamless display of information that enhances
clinical decision making and integrated health information for patients
and their families. The VA’s personal health record, My HealtheVet,
and the Bidirectional Health Information Exchange between military
and VA facilities will be highlighted.
Evidence Integration
into Vanderbilt’s StarPanel
Annette Williams, associate director,
Library Operations, Eskind Biomedical Library, Vanderbilt University
Medical Center, Nashville, TN, will describe the Eskind Biomedical
Library’s provision of expert information to complex, patient-specific
questions from clinicians through the Vanderbilt EHR system called
StarPanel. Librarians receive queries through the “information
basket” linked to the EHR and respond with filtered evidence
that addresses case-specific details directly from the patient record.
Clinicians can choose to attach this evidence permanently to the
patient record. Librarians also dynamically link nationally recognized
guidelines through International Classification of Disease (ICD-9-CM)
coding to patient problem lists to place evidence for managing common
conditions directly in the EHR.
Link
to other EHR programs at MLA '06 and resources.
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