Potential unintended consequences of health information exchange.

Accountable models of care delivery demand that health care provider organizations be able to exchange clinical data about the patient. The "Meaningful Use" program is helping to advance health information exchange by requiring physicians and hospitals to exchange clinical data about patients in order to qualify for incentive payments for electronic health records. Early studies demonstrate that the ability to exchange clinical data among provider organizations has the potential to improve clinical care.

Linking health information technology to patient safety and quality outcomes: a bibliometric analysis and review.

Objective: To assess the scholarly output of grants funded by the Agency for Healthcare Research and Quality (AHRQ) that published knowledge relevant to the impact of health information technologies on patient safety and quality of care outcomes.

Study Design: We performed a bibliometric analysis of the identified scholarly articles, their journals, and citations. In addition, we performed a qualitative review of the full-text articles and grant documents.

Use of social network analysis tools to validate a resources infrastructure for interinstitutional translational research: a case study.

Question: How can knowledge management and innovative technology, cornerstones of library practice, be leveraged to validate the progress of Clinical and Translational Science Awards?

Setting: The Indiana Clinical and Translational Sciences Institute (Indiana CTSI) promotes interdisciplinary research across academic institutions.

Methods: Using social networking tools and knowledge management skills enabled the department of knowledge informatics and translation to create a visualization of utilization of resources across different Indiana CTSI programs and coauthorship and citation patterns.

Results: Contacts with different resources per investigator increased; every targeted program was shown to be linked to another.

Electronic laboratory data quality and the value of a health information exchange to support public health reporting processes.

There is increasing interest in leveraging electronic health data across disparate sources for a variety of uses. A fallacy often held by data consumers is that clinical data quality is homogeneous across sources. We examined one attribute of data quality, completeness, in the context of electronic laboratory reporting of notifiable disease information.

The future of health IT innovation and informatics: a report from AMIA's 2010 policy meeting.

While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability.

Enhancing a taxonomy for health information technology: an exploratory study of user input towards folksonomy.

The U.S. Agency for Healthcare Research and Quality has created a public website to disseminate critical information regarding its health information technology initiative.

The selection of high-impact health informatics literature: a comparison of results between the content expert and the expert searcher.

Background: The Agency for Healthcare Research and Quality (AHRQ) National Resource Center for Health Information Technology (NRC) created the Health IT Bibliography that contains peer-reviewed articles in eleven different health informatics categories. To create the bibliography, informatics experts identified what they considered the seminal articles in each category.

Methods: Using the same eleven categories, an expert searcher (librarian) compiled a list of the "best" health informatics articles using information seeking and retrieval tools.

Evaluating healthcare information technology outside of academia: observations from the national resource center for healthcare information technology at the Agency for Healthcare Research and Quality.

The National Resource Center for Health Information Technology (NRC) was formed in the fall of 2004 as part of the Agency for Healthcare Research and Quality (AHRQ) health IT portfolio to support its grantees. One of the core functions of the NRC was to assist grantees in their evaluation efforts of Health IT. This manuscript highlights some common challenges experienced by health IT project teams at nonacademic institutions, including inappropriately scoped and resourced evaluation efforts, inappropriate choice of metrics, inadequate planning for data collection and analysis, and lack of consideration of qualitative methodologies.

A health information technology glossary for novices.

To deliver information to providers across the U.S., the Agency for Healthcare Research and Quality's National Resource Center for Health IT (NRC) created a public domain Web site containing a number of tools and resources.

Facilitating informatics knowledge dissemination: targeted implementation resources for health care providers.

The AHRQ National Resource Center for Health IT (NRC) maintains a public Web site with a large repository of diverse informatics knowledge resources. The NRC recently added a new tool -- the Health IT Bibliography -- to better disseminate key resources to health care organizations. The bibliography filters resources from the NRC's larger online knowledge library, providing quicker access for those who desire to learn more about implementing clinical IT applications.

Rural RHIOs: common issues in the development of two state-wide health information networks.

Unlabelled: Over one hundred Regional Health Information Organizations (RHIOs) are under development in the United States. Many of these will fail but many will become a vital part of the Nationwide Health Information Network (NHIN).

Methods: Documentation was reviewed and summarized and a core group of Vermont Information Technology Leaders (VITL, Inc.

Formative evaluation: a critical component in EHR implementation.

This Viewpoint paper has grown out of a presentation at the American College of Medical Informatics 2007 Winter Symposium, the resulting discussion, and several activities that have coalesced around an issue that most informaticians accept as true but is not commonly considered during the implementation of Electronic Health Records (EHR) outside of academia or research institutions. Successful EHR implementation is facilitated and sometimes determined by formative evaluation, usually focusing on process rather than outcomes. With greater federal funding for the implementation of electronic health record systems in health care organizations unfamiliar with research protocols, the need for formative evaluation assistance is growing.

Educating medical students as competent users of health information technologies: the MSOP data.

Unlabelled: As more health information technologies become part of the health care environment, the need for physicians with medical informatics competencies is growing. In 2006, a survey was created to determine the degree to which the Association of American Medical College's Medical School Objectives Project (MSOP) medical informatics competencies had been incorporated into medical school curricula in the United States.

Methods: a web-based tool was used to create the survey; medical education deans or their designees were requested to complete the survey.

Development of a taxonomy for health information technology.

Taxonomies provide schemas to help classify entities and define the relationships between them. Early computing enabled the development of ontologies and Medical Subject Headings (MeSH), the first modern classification of medical terminology as applied to medical literature. Later developments, such as MEDLINE, expanded MeSH to include a number of medical informatics terms.

Indianapolis I3: the third generation Integrated Advanced Information Management Systems.

In 2001, the Regenstrief Institute for Health Care and the Indiana University School of Medicine (IUSM) began an IAIMS planning effort to create a vision and a tactical plan for the first Integrated Advanced Information Management Systems (IAIMS) implementation to cross a large area and include unaffiliated institutions. A number of elements made this planning effort unique. Among these elements were the existence of a network infrastructure that supported the Indianapolis Network for Patient Care, the existence of a mature medical informatics program at the Regenstrief Institute, and the existence of a wide-area knowledge network fostered by the IUSM libraries.

Proposed curricular objectives to teach physicians competence in using the World Wide Web.

As the World Wide Web becomes more ubiquitous, physicians are increasingly using the information it provides as part of medical practice. The Web can be a valuable information resource for patient education and decision support or it can be a troubling source of misinformation for providers and patients alike. Attempts have been made to apply quality standards to Web sites, but these have been only moderately successful.

Implementing wireless evaluation in a hospital-based OSCE center.

To provide an effective and efficient means to gather assessment data during Objective Structured Clinical Examinations [OSCEs] and integrate the data into ANGEL, the Indiana University School of Medicine's [IUSM] curriculum management system, a wireless approach using PDAs was selected, configured and evaluated. Following a systems architecture and human-computer interface analysis of the project, a system with less functionality but greater reliability was designed and implemented.

A model for assessing information retrieval and application skills of medical students.

Purpose: To develop and evaluate a model for assessing information retrieval and application skills, and to compare the performances on the assessment exercises of students who were and were not instructed in these skills.

Method: The authors developed a set of four examination stations, each with multiple subtasks, and administered the exams to students at two medical schools. Students at one school had intensive instruction in literature searching and filtering skills for information quality (instructed group), and those at the other school had minimal instruction in these areas (uninstructed group).

The Medical Library Association: promoting new roles for health information professionals.

As the Medical Library Association (MLA) enters its second century, its role in providing leadership and focus for the education of health information professionals in a changing environment will be critical. MLA members face dramatic changes in the health care environment as well as significant opportunities and must position themselves to thrive in the new environment. This paper examines new roles for health information professionals, new approaches to education and training, and related issues of credentialing, certification/and licensure.