Sunday, November 12, 2006

Off Topic: The AMIA Report

From the AMIA conference, in the liveblogging style, but really posted after the fact. I'll add links to resources and people later.

Note: It has been an extraordinarily busy week. Updates, more details on the sessions, and links to resources will come later.

-Panel Session: Emergency Response Information Technology.
-State of the Association Meeting, with box lunch.
-Presentation Sessions: Optimizing the Clinical Experience; Evaluating the Use of Clinical Systems

-Would anybody think it was exceptionally weird if I took my pear to the bathroom to wash it?
-Semi-Plenary Session: James J Morgan, MD of Partners HealthCare, "Framework for a High Performance Health System for the United States." We need changes to daily workflow, culture, and organization in order to improve healthcare. More later - there's a line for computers (but it's a T1 line...).
-Panel Session: Biosurveillance Systems and Situational Awareness in Public Health: How Far Should We Go to Protect the Public from Bioterrorism?"
-Lunch in Chinatown at Tony Cheng's. I'm really good with chopsticks and noodles.
-Afternoon - Smithsonian, Museum of Natural History.
-Evening - Quesadillas and beer special in the hotel bar.

-Breakfast at the hotel. Was wrong when I said "never again" - no time to go somewhere else. I accidentally ate apspartame. Cue stomach cramps, headache, and general out of it feeling.
-Another 3.5 hour tutorial, this time early in the morning. "Design and Conduct of Evaluation Studies in Biomedical Informatics," Charles Friedman of the National Heart, Lung and Blood Institute and Jeremy Wyatt of the University of Dundee. Again, very practical and useful. Good discussion and group work. Things to consider in study type and design.
-Lunch: Polo India Club. Indian buffet. Yum.
-Plenary Session: Robert Brook of RAND. Both inspiring and terrifying. Some notes from his talk, on improving healthcare:
  • Need e-prescribing systems that detect prescription drug underuse and informs providers
  • Pay providers for transparency rather than performance. Blacklist those who provide misleading data
  • Hospital CEOs should be able to press a button to let them know how many people he hospital killed in the previous 24 hours
  • Make sure patients get the procedures they need, and don't get the procedures they don't need
  • Make real-time quality data available to patients for informed decision-making
  • Incentivize patients to use safer hospitals
    Incentivize hospitals to use electronic medical record systems that provide real-time quality data
  • On coronary angiograms in New York State, re-read elsewhere: 48% exhibited at least one technical inadequacy; only 1/3 of those who got coronary artery bypass for left main disease actually had the disease; 1/3 of those with the disease were not diagnosed; 1/3 read correctly.
  • Using ~500 measures of quality at ~12 sites in the U.S., 50% of things patients needed when they went to the doctor actually happened. About 30% in geriatric patients.
  • This was a great session, and a challenge to everyone to agitate for better measures of and available information on healthcare provider and institution quality.
    -Dinner: Sandwiches at Cosi. Martinis and shrimp cocktail at Annie's with a former colleague who is now at NCBI. It turns out that he can get his hands on the content when JMLA issues are being uploaded to PubMed Central - now I know who to harrass about it. :)

    -Walked from the Hilton Washington to see: Washington Monument, Lincoln Memorial, Reflection Pool, WWII Memorial, White House, Vietnam Memorial. Nice to be there on Veterans' Day. Saw the outside of a World Health Organization building, National Academy of Sciences, Institute of Medicine, and Dept of State. White House is underwhelming.
    -Lunch at the hotel. Tuna salad sandwich, side salad and drink for 3 cost $40. Never again.

    -Tutorial: "The eXtensible Markup Language (XML)", Gretchen Purcell of Vanderbilt. 3.5 hours. Very practical and useful. I think I can do this now.
    -Dinner: Anna Maria's. Italian. Good. I think I ate a bit of a shimp tail.

    -Flew Delta from Nashville to Cincinnati. We were supposed to stay on the same plane, but had to switch at Cinci. The gates are not labelled well.
    -Got to the hotel. Sharing a room with two colleagues. Room has two tiny beds. Called for roll-away; checked at desk 1/2 hour later when it hadn't arrived. DC fire code doesn't allow 3 beds in a room. Hotel is sold out. I'm sleeping on the floor.


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