Defining Core Competencies in Informatics

If you ask two well-regarded experts in informatics as to the definition of their discipline, you are highly likely to get two different answers. It is for this reason that it is remarkable that there are now several maturing efforts to define a set of core competences. These include those that are primarily around the implementation and use of clinical information/decision support systems. Others emphasize probabilistic reasoning, formalized decision science, statistically informed knowledge-mining and expertise in different communications modalities. Whatever the truly most central core competencies, it is very clear that we don't have enough experts in any of them.
Just as the lack of sufficiently well-trained bioinformaticians is delaying our harvest of the fruit of the human genome project, the lack of well-trained clinical informaticians is likely to be a rate-limiting step in the Recovery Act's plan to broadly implement electronic health record systems.


Medical Museum on the Web

(Originally uploaded by otisarchives1 )
An interesting example of how historical medical data can be shared more widely for scholars worldwide. If all medical libraries followed this lightweight formula for dissemination, we could avoid repeating many mistakes of the past and learn how better to deal with old challenges revisited (e.g. epidemics). Kudos to the Medical Museum.


Search + Internet = Better Public Health?

Our very own John Brownstein, has just published an article in the Canadian Medical Association Journal which demonstrates the consequences of removing information bottlenecks between the public and population-level analytics. Some have expressed skepticism regarding the value of mining web-activity for "objective" reporting but, in this instance at least, it seems that a distributed network of non-experts can be effective in detecting outbreaks earlier than through standard surveillance methods.


Disclosing to and educating patients about genetic risk

We've read a lot about direct to consumer disclosure of genetic risk. Here is an opportunity to learn from Prof Robert Green about what he has learned from the methodological study of the disclosure process of the genetic risk for a serious disease.

Translational Genomics Seminar Series
"Genetic Risk Assessment for Alzheimer's Disease: The REVEAL Study."
Robert C. Green, MD, MPH
Duncan Reid Conference Room Brigham and Women's Hospital on Thursday, March 19th at 5pm.


Pushing open access at Harvard Medical School

A very nice account here regarding the work of our very own Alexa McCray and Scott Lapinski in leading the medical school to implementation of an open access policy and compliance with the NIH's mandate for open access in for the publications funded by the NIH.

A cautionary note about electronic health records

Those of us who are pediatricians cannot help but take this personal story (Hat tip Ted Shortliffe) about the effect of electronic health records very seriously. It does point out that we are still a long way from the day when the computer is not a distracting magic box but rather serves as an active vigilant partner in the healthcare of our patients.


Open access week

The politics of openness are heating up. As per SPARC (Scholarly Publishing and Academic Resources Coalition):

"To accommodate widespread global interest in the movement toward Open Access to scholarly research results, October 19 – 23, 2009 will mark the first international Open Access Week. The now-annual event, expanded from one day to a full week, presents an opportunity to broaden awareness and understanding of Open Access to research, including access policies from all types of research funders, within the international higher education community and the general public.

Open Access Week builds on the momentum generated by the 120 campuses in 27 countries that celebrated Open Access Day in 2008. Event organizers SPARC (the Scholarly Publishing & Academic Resources Coalition), the Public Library of Science (PLoS), and Students for FreeCulture welcome key new contributors, who will help to enhance and expand the global reach of this popular event in 2009: eIFL.net (Electronic Information for Libraries), OASIS (the Open Access Scholarly Information Sourcebook); and the Open Access Directory (OAD).

For more information about Open Access Week and to register, visit http://www.openaccessweek.org."


Politics as Statistics

Our very own Ben Reis appears to have touched the same nerve that turns baseball fans into obsessed statisticians. Speechwars is now generating secondary analyses about the meaning of presidential utterances from a purely lexical perspective. Who is to say this is any less insightful that allegedly semantically rich punditry? Some have argued that Google's success points to the strengths of this "low-level" data driven perspective, Can we be equally effective in mining our clinical health records?


Extreme Social Networking

We already know that television viewing is associated with inactivity, obesity and a variety of other problems. Now, apparently Internet-borne social networking is being billed as a risk to cognitive development and a stable affect (or not). Yet, here is a stunning example of an extremely tight and productive social network. Most of us probably would not want to be this networked but some apparently do.

How do we know what works in medical informatics?

In the context of all the hubbub around the monies for health care information technology in the stimulus package, how are we going to know whether we will be have any lasting value from this investment?

This reminded me to peruse again the best resource on how to think about evaluation: Friedman and Wyatt's book on the topic "Evaluation Methods in Biomedical Informatics". Particularly useful is the chapter that describes approaches to evaluating systems when the conventional outcome metrics are either unavailable, premature, or inappropriate. Given that Chuck is in the Office of the National Coordinator for Health Information Technology, it's not unreasonable to suppose that some thought will be given to selecting those proposals for the stimulus that include worthy evaluations.