One-stop MBL/NLM Spring 2009 BioMedical Informatics bloggage

Want to learn more about the MBL/NLM BioMedical Informatics course?

Without further ado:

Day One

• What is informatics?
• Bioinformatics
• Database design
• Disaster informatics

Day Two

• Controlled terminology
• Imaging informatics
• Telemedicine

Day Three

• Clinical information systems (CIS)
• NCBI, PubMed & more

Day Four

• Public health informatics
• Consumer health informatics
• Decision analytic tools for evidence-based practice
• Personal health records (PHR)

Day Five & Six

• Education informatics
• Care Provider Order Entry (CPOE)
• Evaluation
• Internet: What's coming
• Current issues

If anyone asks me how Woods Hole went, for the time being I spout forth one or more of the following

• Amazing. Just amazing.
• 125 people applied for 1 of the 30 spots there. Why did they pick me?
• Why isn't MLA collectively tapping Woods Hole alumni for the Vital Pathways project? Usually followed by an incoherent spiel about membership/organization ROI, future trends with electronic medical records, politics, etc.
• Check out this pen, it's also a 1G flash drive!

My advice: Apply next year if this grabs hold of you. I'll be working on an online class to teach others but I guarantee the experience won't come remotely close. The all-expenses paid fellowship is not just for Americans as we had a Norwegian there too (skol!) Our medical library profession needs all the help it can get for navigating and advocating in informatics. If you weren't accepted for the program this year, try again. Keep it real by speaking your truth, your passion, and your intent to go forth and help change things for the better. I did within 6 hours after class was over by connecting two people working at federal agencies who needed to be talking with each other about the projects they're working on!

You may never know what results come of your action, but if you do nothing there will be no result. ~Mahatma Ghandi

MBL/NLM MI Day 5/6: Insert witty title here

Please see yesterday's entry regarding my current cognitive ability, and note that not only was I not able to blog first thing this morning but it just took me 3 tries to spell cognitive correctly.

40 hours of continuing education in 5.5 days: Insane yet possible!



Dr. Christopher Cimino from the Office of Computer Based Education at Albert Einstein College of Medicine gave a presentation about education informatics. This isn't a frightening term, it's the use of technology in education, and mostly covered a lot of what I already knew from both my experience as an online graduate student and a current distance education teacher.

This reinforced much of what I suspect in that the role of evaluation is key for identifying educational needs first, then developing a goal, then the learning objectives, and only after all that delving into the method of teaching. Too often I think there is a push to go into 'teaching online' as a primary motivation and that usually doesn't result in successful educational experiences for either the teacher or the learner.



Kevin Johnson from the Department of Biomedical Informatics at Vanderbilt University made a return visit to do a presentation on Care Provider Order Entry (CPOE). He didn't win a repeat of Powerpoint layout prize, but did win for groaner comedy involving Presidents (see slides 12, 26, 77 and 82) while outlining the history and many current challenges involved with CPOE.



I feel bad that I didn't get a better picture of Dr. Joan Ash from the Department of Medical Informatics and Clinical Epidemiology at Oregon Health & Science University, especially since she was the only presenter from our awesome Pacific Northwest region!

She did a great job in her presentation both teaching about evaluation methods in general, applying them to informatics interventions, and keeping us alert with humor and a friendly competitive breakout group project.

Some would argue I wasn't paying close attention when I shared this quote from her presentation on Twitter, but others agreed it needed to be heard. I can always count on my colleagues to offer interesting perspectives too!



Dr. Lawrence Kingsland, Assistant Director for Applied Informatics at the National Library of Medicine, gave a presentation about future trends that are rapidly becoming the norm already on the Internet and the mind-blowing speed and functionality that is still to come on the horizon.

He also literally rocked the house when the bass was cranked a bit too high on the speakers as we watched this. I highly recommend it as part of the answer when someone asks 'What is Web 2.0?'






Last and nowhere near least was Dr. Donald Lindberg, Director of the National Library of Medicine. His presentation about current issues isn't online and includes some embedded features... and that was part of his point.

Online books, journals and related resources need to move beyond being mere reflections of their paper counterparts and fully use their capacity for being interactive publications. A great example of this is the recent Medical Library Association 2009 conference posters, some of which have videos and hyperlinks embedded in them. What if journal articles about electrocardiograph (ECG) studies actually included rhythm strips? How can we tell if someone learned more/better/faster through the use of "supplementary data" that does not yet have standardized metadata in PubMedCentral?

Fascinating and much to think about.

MBL/NLM MI Day 3: All I never asked for when pigs flew

I began the day over breakfast with Dr. Ed Hammond (current Chair of Health Level 7 (HL7), his wife, and Dr. Clem McDonald (Director of the Lister Hill National Center for Biomedical Communications -LHNCBC).

Ed teaches online in Second Life, something I haven't explored much yet since my workplace doesn't have an instruction space there, and I enjoyed his perspective of believing online modalities are becoming the way to go for education since he himself has been teaching for decades. Unfortunately Clem came to the table just as I was leaving so we weren't able to talk for very long, but I enjoyed meeting him and gave him my leftover syrup for his French toast.



Ed spared no punches with his presentation about clinical information systems and immediately following this slide he had another where he engaged us in a discussion about the following questions related to the recent projected stimulus funds of $36.5 billion to create a national network of electronic health records (EHRs)

• Can health information technology (HIT) improve health and health care?
• Can HIT save $77.8b each year through universal use of HIT?
• What enables this dream?
• What is meaningful use of EHR?

We weren't able to get through all the presentation but the class discussion was invaluable due to the multiple perspectives we all brought to the table & I look forward to much reflection later.



Clem's presentation isn't online yet and I will link to it when it is, but I had to smile during the detailed explanation of the components of HL7 as part of it. Over 10 years ago I worked for the information technology department of UW Medicine in fiscal administration, and one of the management involved in clinical computing systems had a button on his office nameplate that said 'Ask me about HL7'

I never did but I received an answer anyway all these years later!

I'm having trouble with downloading the audio from video on my cell phone so I won't spoil the surprise with too much detail. My future students will never forget what Logical Observation Identifiers Names and Codes (LOINC) is thanks to Clem's enthusiastic tossing of stuffed pink pigs at us.



Kathi Canese from the National Center for Biotechnology Information (NCBI) had the unenviable job of presenting after our shortened lunch and before we let out early for the day to catch the ferry to Martha's Vineyard and did a fantastic job with her presentation!

I'm purposely not linking to or discussing it here as this is deserving of a separate post during the Medlibs Round next week about PubMed since there is more news to share. Please submit your own blog entries in here!



I ended up doing none of what I had planned on at Martha's Vineyard and had a fantastic time!

MBL/NLM MI Day 2: Yarrr!

Thar be the wily Metathesaurus!

It's hard to tell unless you click the picture that Jim Cimino is wearing a shirt with a skull & crossbones from Captain Kidd. At least he chose that one instead of one about the beatings continuing until morale improves, although he is after us to complete our session evaluations since he has less than 100% compliance. We should probably watch out.

Controlled terminology is something I'll never get too excited about but I have to say this is the only 100+ slide powerpoint presentation that lasted all morning I've found to be very useful the entire time. I even sent a link to it on Twitter to help a colleague with a reference question about ICD-9 codes while it was happening, and know I'll be further investigating some of the terminologies I had never heard of before. Skip down to slide 120 to check out information about infobuttons in electronic medical records (EMRs).




Dr. Michael Ackerman, Assistant Director for High Performance Computing and Communications at the National Library of Medicine, is an engaging speaker who gave presentations on imaging informatics and telemedicine that were fantastic, inspirational, and challenged us to be innovative. It is rare that much of anything holds my rapt attention between 4-5 pm but he did, and I would have been perfectly happy to stay later and hear even more.

Our group project time after dinner was interesting as we managed to stump our fearless tech support with what we wanted to to in Drupal. I was particularly frustrated with myself since I teach online using another open source course management system (Moodle) and thought that I could either figure out for myself how to create things our group wanted to do or articulate well what we wanted. I failed miserably on both accounts.

The bar at Captain Kidd has pitchers of Murphy's stout that helped afterward though.

MBL/NLM MI Day 1: What's biomedical informatics anyway?

While I've simultaneously been excited about and scared of my time as a Marine Biological Laboratory/National Library of Medicine (MBL/NLM) fellow, I've never had a quick and easy way to say exactly what it is I'm studying here this week.

After our first full day of class, I still don't.

This is Dr. Jim Cimino at the beginning of our session mapping out our class answers to 'What is Biomedical informatics?'. Please note that all our presentation links won't last forever, if you see something you like grab it now.


That's about half the whiteboard and the other half has just as much scrawl to it. There is no elevator speech answer! Jim also did a great job in his afternoon database design presentation, and I'm remembering his class exercise activity on mapping out tables for a database with a Medline citation as a model to work from in my own teaching.

This is Dr. Joyce Mitchell's great bioinformatics presentation about genetics and the exciting opportunities that are in development now about research in the field and for us to think about how to integrate them into electronic medical records (EMRs).


Unfortunately I can't remember if the slide that was added in was part of Sid Phillips's presentation or Victor Cid's about the Disaster Information Management Research Center (DIMRC). It noted that 'swine flu' was the most-searched topic on Yahoo at one point, displacing 'American Idol', the Wikipedia swine flu page received 1.3 million hits, and Twitter had 125,000 swine flu tweets a day accounting for 1% of total traffic there.

This is both of them at the beginning of Victor's presentation which I highly recommend, very cutting edge information about the use of Web 2.0 technologies in disaster communication.


We also watched the University of Michigan's Health Sciences Library's YouTube video about Second Life and Public Health

Whew! Enough of all that, here is the beautiful setting of Woods Hole looking out across the Great Harbor.

EHRs & Woods Hole: What happens when I think on the bus

Four months ago I attended the Librarians and the EHR: Envisioning the Future continuing education event by our local Medical Library Association (MLA) chapter, PNC/MLA, with a fair amount of guilt. The only reason I was able to go was because I took the place of a colleague who was seriously ill and that is never a cause for joy. I should have shared my 5 pages of notes from the EHR CE long ago, they serve as a brief guide to the presentation audio files although I had to take a phone call in the middle of one of them so there's a gap of information somewhere.

It was there that I learned about the Woods Hole bioinformatics program, although with total bafflement at first: it was one of those things that everyone else already seemed to already know about and I didn't. On the bus home it occurred to me that maybe I should apply and create an online class teaching more about medical librarians' involvement with electronic medical records (EMRs) because I couldn't be the only one who didn't know about the Woods Hole program. If I am, it's ok to laugh at me now that I'm going there in May.

My goal is to share the value from the experience as much as possible because I don't want to be an information silo. I know I can't promise blogging from there beyond a picture a day due to the sheer volume of information we'll be going through. I have since heard from many medical librarians who have been to Woods Hole and heard of several others. I'm curious: What has what you have learned there done for you, your organization, etc.? Are we already collaborating on this as part of MLA advocacy and I've missed the boat entirely? Thank goodness Rachel shared the tip about no elevators there so I only pack what I can haul up the stairs myself!

Friday Foolery #21: The Phoenix of Full Disclosure

(I'm sorry for the lack of content since last Friday, I and my family have been ill and that's quite a drain on energy beyond life and work.)

This week's foolery is courtesy of myself in May, 2007

Note: No actual textbooks were incinerated in the production of this picture since I paid WAY too much money for them

Can you tell I didn't particularly enjoy that semester? Combining my payroll & human resources job, family (including a preschooler) and a full time load of distance education graduate classes in biomedical informatics (bottom text), information organization (top text), and electronic databases & services (no text) was not fun. It was, however, a necessity since being a full time student was a condition of the fellowship funding my education, for which I am eternally grateful. I wouldn't say that I hated any of the classes, but the amount of information from them was completely overwhelming to take in all at once.



At the end of May 2009, I will spent a long day en route from Seattle to Boston then take a two hour bus ride to Woods Hole, MA, because I learned on Tuesday that I was awarded a fellowship to study biomedical informatics there for a week.

Yes, one of the same subjects from May 2007 that almost drove me to the brink of insanity, and it gets even better. One or both of the authors of that informatics textbook will likely be there as instructors and one of them is the Director of the entire program. Is it possible to just die of embarrassment now and get it over with?

I'm sharing this in part to avoid an A-Rod situation and come clean from the start: I have zero natural talent here. I have enough existing knowledge to understand the basics of the field but am obsessed with learning even more from an impressive faculty without juggling other classes and the rest of my regular life duties at the same time. Hopefully I will not embarrass myself by asking too many stupid questions. My goal is to develop an online class to bridge the gap to health informatics for medical librarians because I truly believe we are all working towards the same goal (improved health information access) with many of the same tools but aren't speaking the same language.

With an increasing focus on the implementation of electronic medical records (EMRs), it's critical for medical librarians to not only be aware of but become actively involved with their planning and implementation at their facilities since we best understand the information-seeking behavior of our users. Information vendors would be very happy to entirely take over that role from us otherwise.