What’s Wrong With the EHR and How to Fix It

Moderator: Mark L Braunstein, MD

1. The Missing Link in the Evolution of Electronic Health Records

James J. Cimino, MD
Director, Informatics Institute, University of Alabama at Birmingham School of Medicine

Brief bio: Dr. James Cimino is a board certified internist and clinical informatician, currently a Professor of Medicine and inaugural Director of the Informatics Institute at the University of Alabama-Birmingham School of Medicine. He has been carrying out clinical informatics research, building clinical information systems, teaching medical informatics and medicine, and caring for patients for over 30 years, with principle research areas in desiderata for controlled terminologies, mobile and Web-based clinical information systems for clinicians and patients, context-aware form of clinical decision support called “infobuttons”, and clinical research data repositories. Past appointments include a Professor of Biomedical Informatics and Medicine at Columbia University and Chief of the Laboratory for Informatics Development at the NIH Clinical Center and the National Library of Medicine. He is co-editor (with Edward Shortliffe) of a leading textbook on Biomedical Informatics and is an Associate Editor of the Journal of Biomedical Informatics. His honors include Fellowships of the American College of Physicians, the New York Academy of Medicine and the American College of Medical Informatics (Past President), the Priscilla Mayden Award from the University of Utah, the Donald A.B. Lindberg Award for Innovation in Informatics and the President’s Award, both from the American Medical Informatics Association, the Medal of Honor from New York Medical College, the NIH Clinical Center Director’s Award (twice), and induction into the National Academy of Medicine (formerly the Institute of Medicine).

2. Too Many Ways to Make an Error!

Dean F. Sittig, PhD
Professor, School of Biomedical Informatics, University of Texas Health Science Center at Houston

Brief bio: Dean F. Sittig is a Professor in the School of Biomedical Informatics at the University of Texas Health Science Center in Houston, TX. He received his PhD in Medical Informatics from the University of Utah. His research interests center on design, development, implementation, and evaluation of all aspects of clinical information and communication systems. He is working to improve understanding of both the factors that lead to success, as well as, the unintended consequences associated with various forms of health information technology. Most recently he has focused his efforts on developing guidelines for the safe and effective implementation and use of electronic health records (EHRs) that are based on an 8-dimension socio-technical model that he developed with Hardeep Singh. This work lead to the development of the SAFER guides that were designed to help healthcare organizations conduct pro-active risk assessments of their EHRs. Most recently he authored a book entitled, “Clinical Informatics Literacy: 5000 Concepts That Every Informatician Should Know”.

3. Adapting the EHR to the future

W. Ed Hammond, PhD
Director, Duke Center for Health Informatics, Duke Clinical & Translational Science Institute, Duke University

Brief bio: W. Ed Hammond is an electronic health record and standards pioneer and a distinguished leader in the field of health informatics. He earned a BS and PhD in electrical engineering at Duke where he completed a post-doctoral program including preclinical courses in the School of Medicine. He joined the faculty of Community and Family Medicine and Pratt School of Engineering after graduation. He also has an appointment as Adjunct Professor in the Fuqua School of Business and Research Professor in the School of Medicine. In 1969 he began work computerization of the medical record called The Medical Record or TMR. The system included clinical, administrative, and financial characteristics. Key to vocabulary, data elements, decision support and functionalities was a metadata dictionary. TMR supported inpatient, outpatient, nursing homes, skilled nursing, and retirement communities. His team also developed GEMISCH (Generalized Medical Information System for Community Health), a high level interactive database management language used with the TMR. Forty four facilities nationwide implemented the system.

Dr. Hammond is a founding member and Fellow of Health Level Seven International (HL7) and has been HL7 Chair three times and now Chair Emeritus, a member of the Board of Directors, Treasurer, and has served as the Co-chair of several HL7 committees and councils. He has been active in numerous academic and leadership roles. He has served as Chair of ACM’s SIGBIO, AMIA, ACMI, Computer-based Patient Record Institute, He was inaugural chair of ISO TC 215 WG2 and the Joint Initiative Council.

His honors include the Morris F. Collen Award in 2003 from the American College of Medical Informatics; the Foundation of Accountability, Paul Elwood Lifetime Achievement Award; W. Ed Hammond Volunteer of the Year Award (HL7); the William W. Stead Thought Leadership Award (AMIA); and named fellow in ACMI, AIMBE, IMIA, and a founding member of the International Academy of Health Sciences Informatics (MIAHSI).

4. EHRs as a Platform for Innovation

Mark L Braunstein, MD
Professor of the Practice, School of Interactive Computing, Georgia Institute of Technology

Brief bio: A teacher, author and thought-leader in the field, Dr. Braunstein is a professor of health informatics for the School of Interactive Computing in the College of Computing at the Georgia Institute of Technology. He teaches introductory health informatics as a popular graduate seminar on campus and as a component of the OMSCS program. He also offers Health Informatics on FHIR a free, public Coursera MOOC.

He is the author of “Practitioners Guide to Health Informatics: a guide to health informatics for physicians and other non-technical readers” published by Springer in 2014 and “Contemporary Health Informatics,” a textbook published by the American Medical Informatics Association in 2015. He is Georgia Tech’s health informatics lead for the GaCTSA and teaches in its BD2K course as a part of the Masters of Clinical Research at Emory. He is involved in research that involves healthcare process mining at the Tennenbaum Institute. He is involved with the new HL7 Fast Healthcare Interoperability Resource (FHIR) standards effort and speaks about it and related topics in numerous venues each year. He is involved in community and industry outreach projects to improve the quality and efficiency of health care delivery.

Prior to joining Georgia Tech he founded several commercial health IT companies and won a 1996 Ernst and Young Entrepreneur of the Year Award for Emerging Companies, a 2006 Founder’s Award from the American-Israel Chamber of Commerce, and a 2013 Distinguished Alumni Award by the College of Medicine, Medical University of SC.