Informatics in the Round

Reframing Minds: Combatting Medical Inequities with Data

In this episode, we look at the genetic basis for different psychiatric disorders, the interconnectedness of psychological and physical symptoms, and how they apply to our ongoing conversation regarding health equity. For this episode, we welcomed back some of our previous guests:
Lea Davis Ph.D. is an Associate Professor in the Division of Genetic Medicine in the Department of Medicine at Vanderbilt University Medical Center. Her work explores the genomic architecture of complex traits, defined as the type, frequency, and function of DNA variants en masse that contribute to the genetic predisposition of a given trait.
We also welcomed back the talented Jane Bach, a successful songwriter from Nashville, to help us dissect how exactly gene inheritance works and share her stories and music with us! Ellie Shuert, our new production assistant from the University of Pennsylvania, also joined in for the discussion. They both made our conversation so lively and fun, and they really helped us dig deep into the fundamentals of genetics and the importance of listening intentionally to patients' stories and symptoms.
We have new social media pages! Make sure to follow our new Facebook, Twitter, TikTok, Instagram, and Threads accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd and @htbland21. Thanks for listening!
Facebook: Informatics in the Round
Twitter: @infointhernd
TikTok: @informaticsintheround
Instagram: @infointheround
Threads: @infointheround
Website: https://www.kevinbjohnsonmd.net/podcast
 
 
 

The Future of AI in Medicine: Aladdin’s Lamp, or Pandora’s Box?

In this episode, we talk a bit about the recent advances in large language models, also known as GPT/ChatGPT.  We have two wonderful guests:
Christoph U. Lehmann, M.D., is a Professor of Pediatrics, Population and Data Sciences, and Bioinformatics at UT Southwestern, where he directs the Clinical Informatics Center. In addition, Chris was the first chair of the Examination Committee of the American Board of Preventive Medicine, Subcommittee for Clinical Informatics. Dr. Lehmann’s research focuses on improving clinical information technology and clinical decision support.
Yaa Kumah-Crystal Crystal MD, MPH, MS is an Assistant Professor of Biomedical Informatics and Pediatric Endocrinology at Vanderbilt University Medical Center. Yaa’s research focuses on studying communication and documentation in healthcare and developing strategies to improve workflow and patient care delivery. Yaa works in the Innovations Portfolio at Vanderbilt HealthIT on the development of Voice Assistant Technologies to improve the usability of the EHR through natural language communication.
Chris and Yaa bring very complementary perspectives to the topic of our future. Yaa's research focuses on how we can innovate to improve the use of technology in medicine. Chris is also internationally known as the Editor in Chief of Applied Clinical Informatics,
as well as one of the leaders in our clinical informatics board certification work.  He is intimately familiar with the potential uses of this technology beyond clinical care, but, as an actively practicing neonatologist, more than holds his own when it comes to how medicine can benefit from--or be harmed by--new technologies such as AI. 
We leave it to you to decide both which direction we're heading, and how we can put up the guardrails to keep us on the preferred track. And, I suspect this won't be our last discussion about AI in Medicine!

Informatics and Health Equity - A Critical Partnership

This episode is going to introduce the concepts of health equity and biomedical informatics. We'll revisit this theme multiple times in 2023 but ST and I wanted to kick off the year with this overview that will also serve to provide a framework for some of what we will be discussing as we revisit this theme. We are really lucky to have two guests, both of whom are great colleagues and friends, whose careers have focused on this topic from two very different disciplines.
Lea Davis Ph.D. is an Associate Professor in the Division of Genetic Medicine in the Department of Medicine at Vanderbilt University Medical Center. Her work explores the genomic architecture of complex traits, defined as the type, frequency, and function of DNA variants en masse that contribute to the genetic predisposition of a given trait.
Consuelo H. Wilkins, MD, MCSI, is a nationally recognized physician-scientist leader in health equity research focused on integrating social, cultural, and environmental factors into clinical and translational research. Dr. Wilkins is a Professor of Medicine in the Division of Geriatric Medicine within the Department of Medicine at Vanderbilt University Medical Center. She is Senior Vice President, Health Equity and Inclusive Excellence, VUMC; and Senior Associate Dean, Health Equity and Inclusive Excellence, Vanderbilt University School of Medicine.
 We also welcome back The Daily Fare Northern-born songwriters Alissa Abeler and Hannah Smith who’ve joined creative forces to form a musical duo with a unique sound and look for Nashville performers. The pair grew up on opposite sides of the music world with influences ranging from Judy Garland and Adele to Beethoven and Bach, with a healthy dose of Broadway, punk cabaret, and 80s ballads sprinkled in the mix.  They also share a story common with many newish groups breaking into the music biz that makes the topic of today one they relate to in ways you’ll readily appreciate.
St and I tried to keep this at high level, but we also weren’t afraid to push our friends to explain some difficult concepts. It was as important a discussion as it was enlightening and engaging, and I’m glad to be able to share it with the world. 

Fixing Medical Documentation - Less ”Whine” with your Cheese!

This episode, ST and I cover one of the hottest non-COVID topics in healthcare today.  We strike at the heart of clinician burnout and in particular issues related to unnecessary documentation.
Our guests today were discovered by Sam Butler from Epic, who invited them to present their incredible work at a national meeting where I was an attendee. I  thought this was work that needed to get noticed as quickly as possible. And so we decided to develop this podcast to discuss what they’ve been doing.
Dr. Heidi Twedt is Associate Chief Medical Information Officer, UW Health, and Clinical Professor of the division of General Internal Medicine at the University of Wisconsin in Madison.
Dr. Peter Kleinschmidt is the Medical Informatics Director of Quality and Safety and Assistant Professor in the division of General Internal Medicine at the University of Wisconsin.
The two of them have developed an entire program dedicated to reducing the length and complexity of physician documentation.  As they tell us during the episode, it's simple to implement technically, but, as one might imagine, very challenging to make "sticky" from a change management perspective. 
 
By the way, here's a link to a presentation by Heidi and Peter for those who want to hear more about this.
 

Health Information Exchanges: Myths and Realities

 
This promises to be an incredibly informative podcast for most of us.,  If there was anything learned from the pandemic, it was the importance of data and helping most of us track SARS CoV2 prevalence wherever we traveled when we traveled, as well as to manage vaccine compliance within specific regions or states.  Health information exchange was vital to many public health organizations. And our speakers today were front and center during the pandemic, as well as in some cases, decades before the pandemic, evangelizing this technology for the rest of us. We’ll hear from them and discuss both what health information exchange is and what health information hubs could be going forward. I learned a ton during this podcast. I hope you enjoy it.  ST Bland and I are proud to introduce you to three guests:
Brian Dixon is a Professor at Indiana University Richard M. Fairbanks School of Public Health and a world expert on the public health information ecosystem, including how things are accomplished and the information or tech used to accomplish them.
John Kansky is President and CEO at Indiana Health Information Exchange in Indianapolis, which is arguably the exemplar for health information exchanges around the world.
Morgan Honea is Executive VP of Contexture an IT services and consulting group in Denver and CEO of CSRI, the Consortium for State and Regional Interoperability, as well as CEO of CORHIO. The Colorado Regional Health Information Organization.

Overturning Roe: The Meteor that Hit Health Care

Hello and welcome to Informatics in the Round,  a podcast designed to help everyone become a part of the dialog about topics in biomedical informatics. 
I’m Kevin Johnson, a physician and informatics researcher at the University of Pennsylvania. @kbjohnsonmd on Twitter, www.kevinbjohnsonmd.net on the web! 
The overturning of Roe v. Wade has had a significant impact on our country. What many may not realize is the impact it might have across all of the health care system as we know it, including the informatics community.  However, this episode will enlighten us all about this, and, unfortunately, will probably make a few people lose sleep.
We are joined in this episode by Professor Bradley Malin, Accenture Professor of Biomedical Informatics, Biostatistics, and Computer Science, as well as Vice Chair for Research Affairs in the Department of Biomedical Informatics.  He is one of the world’s experts on data privacy, having invented or helped to debunk myths around the most common approaches used to protect electronic medical records from use or to facilitate safe data sharing.  He is an elected fellow of the National Academy of Medicine (NAM), the American College of Medical Informatics (ACMI), the International Academy of Health Sciences Informatics (IAHSI), and the American Institute for Medical and Biological Engineering (AIMBE).  In addition, he was honored as a recipient of the Presidential Early Career Award for Scientists and Engineers (PECASE) from the White House.
Brad is joined by Dr. Ellen Wright Clayton, JD, MD. Ellen is an internationally respected leader in the field of law and genomics who holds appointments in Pediatrics and in Health Policy at VUMC, and in the Law School as well as the Center for Biomedical Ethics and Society at Vanderbilt University. Ellen has helped to develop policy statements for numerous national and international organizations, including the Public Population Project in Genomics, Human Genome Organization, Council of International Organizations of Medical Sciences, the American Society of Human Genetics, and the American Academy of Pediatrics.
Ellen has worked on a number of projects for the Institute of Medicine (now the National Academy of Medicine) and is currently a member of its National Advisory Council, director of its Board on Population Health and Public Health Practice, and the Report Review Committee. For her service, she received the David P. Rall Medal from the IOM in 2013.  
In addition to these amazing guests, we’re excited to have ST Bland, a leader in Vanderbilt’s Center for Precision Medicine here, as well as Jane Bach, an extremely successful “performing” songwriter in Nashville. Jane is joined again by Jeanie McQuinn of http://www.greatbigrivermusic.com, a partner with Jane in songwriting. 
 

Finding Peace in Portals

 
This episode of IIR focuses on the functions we want in our EHR portals, including some research into some surprising new uses for portal information.
Our special guest is a brilliant young faculty member from Johns Hopkins. Kevon-Mark Jackman is a Dr.PH and MPH, and an assistant professor of pediatrics, in adolescent medicine. We met a few months ago, and I thought it would be fun to discuss some of what he’s doing with EHR patient portals with the group.
Sarah Bland, a leader in Vanderbilt’s Center for Precision Medicine is here, as is Jane Bach, an extremely successful “performing” songwriter in Nashville. Jane is joined by Jeanie McQuinn, a partner with Jane in songwriting. They go back many years—Jeanie was a huge fan of Jane’s,  as you’ll hear, and now work with her from time to time.  You’ll get to hear from all of them discussing Kevon’s work, as well as work that still needs to be done to improve the use of patient portals. 
During the episode, we made reference to the following work/people:
Special shout-out to Deborah Estrin, whose work on breadcrumbs informed our "wish list" for interoperability. Her TED talk on the topic is here: https://www.youtube.com/watch?v=lAEhSGYEHWU
Jeanie's production company is Great Big River Music. Check them out!
Jane has a new project that hasn't been formally announced, but you can follow her on https://janebachmusic.com/
 
 

Informatics, the EHR and LGBTQ+: Another issue out of the closet!

In this episode of Informatics in the Round  we have a small but MIGHTY team.
 
Sarah Bland, a leader in Vanderbilt’s Center for Precision Medicine is here, and offers her usual insight coupled with wit!
We’re happy to introduce you all to Dr. Jesse Ehrenfeld, who is the Senior Associate Dean and Director of the Advancing a Healthier Wisconsin Endowment, and Professor of Anesthesiology Medical College of Wisconsin.  But wait, there’s more. Jesse is chair of the American Medical Association Board of Trustees, a commander in the U.S. Navy and combat veteran,  the head of perioperative informatics at Vanderbilt before leaving for Wisconsin, and so much more.  
 
All the guests today have one or more non-heteronormative characteristics on our “problem list.”  We’re all in the SOGI remarkable group.  We are all in the LGBTQ+ tribe.  We’re all gay!
Our topic for this conversation focuses on the inclusion of LBGTQ+ data in the EHR.  In case you’re wondering how we can fill 50 minutes on that topic, suffice it to say that we had more than enough material. By the way, did I mention that Jesse was the former director of the Vanderbilt Program for LGBTQ Health, that he’s been a staunch supporter of LGBTQ+ rights, and has been at the center of much of the knowledge now published about the unique health requirements of patients who identify as LGBTQ+.   Oh, and then there’s his book, Lesbian, Gay, Bisexual, and Transgender Healthcare: A Clinical Guide to Preventive, Primary, and Specialist Care.