Perspectives on the role of industry in informatics research and authorship.

Objectives: Advances in informatics research come from academic, nonprofit, and for-profit industry organizations, and from academic-industry partnerships. While scientific studies of commercial products may offer critical lessons for the field, manuscripts authored by industry scientists are sometimes categorically rejected. We review historical context, community perceptions, and guidelines on informatics authorship.

Contemporary clinical decision support standards using Health Level Seven International Fast Healthcare Interoperability Resources.

Objective: To facilitate the development of standards-based clinical decision support (CDS) systems, we review the current set of CDS standards that are based on Health Level Seven International Fast Healthcare Interoperability Resources (FHIR). Widespread adoption of these standards may help reduce healthcare variability, improve healthcare quality, and improve patient safety.

Target Audience: This tutorial is designed for the broad informatics community, some of whom may be unfamiliar with the current, FHIR-based CDS standards.

Feasibility of Prioritizing Drug-Drug-Event Associations Found in Electronic Health Records.

Background And Objective: Several studies have demonstrated the ability to detect adverse events potentially related to multiple drug exposure via data mining. However, the number of putative associations produced by such computational approaches is typically large, making experimental validation difficult. We theorized that those potential associations for which there is evidence from multiple complementary sources are more likely to be true, and explored this idea using a published database of drug-drug-adverse event associations derived from electronic health records (EHRs).

Analyzing Information Seeking and Drug-Safety Alert Response by Health Care Professionals as New Methods for Surveillance.

Background: Patterns in general consumer online search logs have been used to monitor health conditions and to predict health-related activities, but the multiple contexts within which consumers perform online searches make significant associations difficult to interpret. Physician information-seeking behavior has typically been analyzed through survey-based approaches and literature reviews. Activity logs from health care professionals using online medical information resources are thus a valuable yet relatively untapped resource for large-scale medical surveillance.

Recommendations to improve the usability of drug-drug interaction clinical decision support alerts.

Objective: To establish preferred strategies for presenting drug-drug interaction (DDI) clinical decision support alerts.

Materials And Methods: A DDI Clinical Decision Support Conference Series included a workgroup consisting of 24 clinical, usability, and informatics experts representing academia, health information technology (IT) vendors, healthcare organizations, and the Office of the National Coordinator for Health IT. Workgroup members met via web-based meetings 12 times from January 2013 to February 2014, and two in-person meetings to reach consensus on recommendations to improve decision support for DDIs.

Inter-rater agreement among physicians on the clinical significance of drug-drug interactions.

Background: Alert fatigue could potentially be improved if physicians agreed on which alerts were clinically significant. We conducted a study to determine the extent to which physicians agree on which drug-drug interactions are clinically significant.

Methods: Two groups of eight generalist physicians reviewed 100 randomly selected drug-drug interactions from the Medi-Span® Drug Therapy Monitoring System™ database and indicated whether they thought each interaction was clinically significant based on the full-text clinical discussion contained within each interaction monograph and their clinical experience.

Health data use, stewardship, and governance: ongoing gaps and challenges: a report from AMIA's 2012 Health Policy Meeting.

Large amounts of personal health data are being collected and made available through existing and emerging technological media and tools. While use of these data has significant potential to facilitate research, improve quality of care for individuals and populations, and reduce healthcare costs, many policy-related issues must be addressed before their full value can be realized. These include the need for widely agreed-on data stewardship principles and effective approaches to reduce or eliminate data silos and protect patient privacy.

Clinical information system services and capabilities desired for scalable, standards-based, service-oriented decision support: consensus assessment of the Health Level 7 clinical decision support Work Group.

A standards-based, service-oriented architecture for clinical decision support (CDS) has the potential to significantly enhance CDS scalability and robustness. To enable such a CDS architecture, the Health Level 7 CDS Work Group reviewed the literature, hosted multi-stakeholder discussions, and consulted domain experts to identify and prioritize the services and capabilities required from clinical information systems (CISs) to enable service-oriented CDS. In addition, relevant available standards were identified.

Terminology challenges implementing the HL7 context-aware knowledge retrieval ('Infobutton') standard.

Point-of-care information needs are common and frequently unmet. One solution to this problem is the use of Infobuttons, which are context-sensitive links from electronic health records (EHR) to knowledge resources, sometimes involving an intermediate broker known as an Infobutton Manager. Health Level Seven (HL7) has developed the Context-Aware Knowledge Retrieval (Infobutton) standard to standardize the integration between EHR systems and knowledge resources.

Implementations of the HL7 Context-Aware Knowledge Retrieval ("Infobutton") Standard: challenges, strengths, limitations, and uptake.

Unlabelled: To support clinical decision-making, computerized information retrieval tools known as "infobuttons" deliver contextually-relevant knowledge resources into clinical information systems. The Health Level Seven International (HL7) Context-Aware Knowledge Retrieval (Infobutton) Standard specifies a standard mechanism to enable infobuttons on a large scale.

Objective: To examine the experience of organizations in the course of implementing the HL7 Infobutton Standard.

Multi-National, Multi-Institutional Analysis of Clinical Decision Support Data Needs to Inform Development of the HL7 Virtual Medical Record Standard.

An important barrier to the widespread dissemination of clinical decision support (CDS) is the heterogeneity of information models and terminologies used across healthcare institutions, health information systems, and CDS resources such as knowledge bases. To address this problem, the Health Level 7 (HL7) Virtual Medical Record project (an open, international standards development effort) is developing community consensus on the clinical information exchanged between CDS engines and clinical information systems. As a part of this effort, the HL7 CDS Work Group embarked on a multinational, collaborative effort to identify a representative set of clinical data elements required for CDS.

A large-scale knowledge management method based on the analysis of the use of online knowledge resources.

Unlabelled: Online health knowledge resources can be integrated into electronic health record systems using decision support tools known as "infobuttons." In this study we describe a knowledge management method based on the analysis of knowledge resource use via infobuttons in multiple institutions.

Methods: We conducted a two-phase analysis of laboratory test infobutton sessions at three healthcare institutions accessing two knowledge resources.

KnowledgeLink update: just-in-time context-sensitive information retrieval.

Medical knowledge expands at a pace that makes it impossible for the individual clinician to keep up, especially for medications. Medication-related queries are the most common type of query that typically go unanswered during the course of providing care.1 Unanswered questions may result in errors, as found in one study evaluating systems failures associated with adverse drug events.

SKOLAR MD: a model for self-directed, in-context Continuing Medical Education.

Unlabelled: SKOLAR has implemented a web-based CME program with which physicians can earn AMA Category 1 credit for self-directed learning.

Methods: Physicians researched their questions in SKOLAR and applied for CME. Physician auditors reviewed all requests across two phases of the project.

Structured data management--the design and implementation of a web-based video archive prototype.

In response to the lack of readily available multimedia rich medical knowledge sources to support medical education and patient care, we designed and implemented a web-based video publishing platform. In order to promote the development of high-quality, up-to-date educational content, we have devised a scalable structure that allows online submissions and continuous updating of video and accompanying textual descriptions. Our goal is to enable experts in varied medical domains to collaborate in the construction of a video library using an intuitive web-based interface.

Versatile user interface using UMLS Metathesaurus.

One of the obstacles for a successful search in the biomedical field is that different vocabularies are used by different databases but more than one database is usually needed to respond adequately to a healthcare professional's query. A typical searcher usually is unfamiliar with these vocabularies and the sophisticated measures to narrow or broaden a search. As a result, a failed search is often due to using "inappropriate" search terms.

What's related? Generalizing approaches to related articles in medicine.

Introduction: We did formative evaluations of several variations to the computation of related articles for non-bibliographic resources in the medical domain.

Methods: A binary model and several variations of the vector space model were used to measure similarity between documents. Two corpora were studied, using a human expert as the gold standard.

Analysis of information needs of users of the Stanford Health Information Network for Education.

Objective: To examine the information needs of users of the Stanford Health Information Network for Education (SHINE), an integrated information retrieval (IR) system.

Methods: A subset of queries from the SHINE log were categorized into one or more of 33 categories.

Results: Drugs and infectious disease accounted for 25% of categorizations, and otherwise the distribution of categorizations was quite broad.

Moving towards an electronic patient record: a survey to assess the needs of community family physicians.

Objective: To determine the needs of community family physicians regarding electronic patient records (EPRs).

Design: A comprehensive survey was sent to 101 community family physicians in Hamilton, Ontario, who had expressed an interest in EPRs.

Results: 46 physicians responded (46%).