Informatics in the Round

Inside the World of Precision Medicine: Delivering Care that Works the First Time

This episode we talk about one of the hottest areas of research in the field of informatics: Precision Medicine.  Precision medicine is the culmination of years of work collecting health care data about every individual and putting it into a computable form in an electronic health record.  The holy grail of informatics was the idea that we could reuse these data to make sure that information unique to you was used to make diagnoses, prescribe medicines, and even tell you about your disease risks.  
Josh Denny, MD, MS is a physician and fellow informaticist who has been a world leader in this movement for over 15 years. It’s a pleasure to have him on the podcast.  Josh has played a major role in the creation of  The AllofUs initiative at the National Institutes of Health. This is a big precision medicine initiative with the goal of collecting data for at least 1 million people in a secure and private way, but also in a way that supports researchers around the world who are doing precision medicine research. In fact, Josh is now CEO of the AllofUs Program, which, when you hear him talk about this topic, will come as no surprise to you. He’s low key, affable, funny, and really smart!
We also welcome Brian Carlson, MHSA, who is Vice President for Patient Experience at Vanderbilt University Medical Center, and an expert in patient-facing technologies. He knows his way around information technology and informatics as well, as you’ll soon discover. 
 
Last but NEVER least, it was a pleasure to have Rischelle Jenkins sit in. Rischelle is the Graduate Program Manager in Biomedical Informatics.  Rischelle offered a practical perspective about precision medicine and helped us to break down this complex topic into much more understandable chunks.
We didn’t have a songwriter for this episode,  unfortunately, but we have the next best thing:  a songwriter AFTER this episode. I asked a friend who you heard sing on our inaugural episode. Rhett McDaniel is a quintessential Nashville in the Round songwriter with some really powerful songs like the one you're about to hear.  When he told me about this song, I realized it fit the conversation we had in this episode about precision medicine very well.  The song is called "The Dash"  co-written and sung in part by Adam James Deiboldt.
I asked Rhett how he came up with this song, and this is what he told me:
It was on a sign in front of a church. The song is tricky because it takes on some pretty big existential ideas. The song is about a man who is packing up the last things from the house where he grew up and is reminded how his parents lived a good life, full of love. And that things like letters and photos are kinds of artifacts we leave behind. The character in the song has a moment of realization that he was able to learn more about them by seeing these things packed away for years that revealed new insights into their lives before he was born. He then realizes that life is full of little “births and deaths” and that waking in through front for and then out the back to leave is one as well. What’s important is all the stuff that happened between the times he did that. This is about his time growing up and then moving out. Also, his parents’ time in the house and, even this day he came in, learned new things about his parents and remembered his life inside there...and closed the door behind him, ending this chapter and starting a new one.
Please take a listen to this amazing song and let http://www.rhettmcdaniel.com/  know you love it!
Please check me out on twitter @KBJVanderbilt, and on facebook, @Informatics in the Round.  If you like this podcast, please subscribe on podbean or your favorite podcast platform!

Informatics and the COVID-19 Pandemic

This episode of Informatics in the Round includes a number of fantastic guests.
 
Josh Peterson (heard first after my introduction to the episode, but not formally introduced in the audio) is an internist, a brilliant informatician, and an expert in precision medicine here.  Josh received his M.D. through the Vanderbilt University School of Medicine in 1997. He completed an Internal Medicine residency at Duke University Medical Center, a fellowship in General Internal Medicine at the Brigham and Women’s Hospital, and a Masters of Public Health degree at the Harvard School of Public Health.  Josh is known internationally for his work in precision medicine He has been coordinating a set of national responses to the disease, through his as well as spending time on the front line of care.    
Melissa McPheeters is an expert in epidemiology, health policy, and informatics at Vanderbilt. She received her PhD in Epidemiology at the University of North Carolina at Chapel Hill in 2003. She was on faculty here for 10 years as director of the Vanderbilt Evidence-based Practice Center, before taking on the tough role as the Director of the Office of Informatics and Analytics at the Tennessee Department of Health, and Principal Investigator on three federally funded grants to address the opioid epidemic, each with a strong focus on analytics.
It’s a pleasure to have  Shannon Rich back, and on hand to keep it real. Shannon is a lot of things: Insightful, unafraid, and so quick-witted. But it was hard to be witty in a room this topic, which literally has changed the course of how we live and think.
Charles K Brown.  Singer, Songwriter, and friend of mine. Charlie Brown (yes, that’s his name) is the first person I knew whose birthday was April 1st.  I remember asking him if his parents named him Charlie Brown as an April Fools day joke. He didn’t answer.  But he does speak volumes with his songwriting here in town and around the country.  He’s on youtube, and I hope you take a listen to his work there.
Charlie and Shannon listened and asked a lot of questions, but it was clear that there was one central issue on both of their minds, so we went there.  We covered relatively little about the range of ways informatics is involved in collecting data, sharing it for prediction and research projects, and also making changes to electronic health records to support the rapid dissemination of knowledge to the nurses and physicians caring for these patients. But trust me, all that is happening around the world right now. Instead, we focused on a couple of other things, and as always, I want the conversation to be one that is led by our non-informatics guests, so that’s where we went.   I think it will resonate well with a lot of you, and give those of you who are fellow informaticians some practical and useful ideas for work we need to do better.
 
This was a really important episode to record. I hope you agree.
 

Automated Resilience: Biomedical Informatics as a Safety Net for Life

We decided to publish this episode before one that was recorded earlier, because the theme of this episode was simply too important to NOT publish now, given all that we are facing with tornados and COVID-19.  This was a remarkable episode, and one that I think should help many people understand what role biomedical informatics can play and is playing as we deal with various societal pressures, a stressed healthcare system, and a series of calamities.
Thanks to our guests:
Scott Scovill - Entrepreneur, singer, songwriter, and incredible human being.
Laurie Novak, Ph.D. - anthropologist specializing in biomedical informatics and organizational routines
Coda Davison, FACHE, PMP, MPA, BBA -  senior project manager at Vanderbilt, and my co-conspirator bringing this team together
Sarah Bland, MPH, MBA -  project manager in at Vanderbilt, and super smart, funny, insightful, and occasionally provocative!
Please, please take a listen to Scott's music and download some from the links on his web page (www.scottscovill.com). We end the episode with one of Scott's songs that speaks to the theme of the episode. Thanks, Scott, for everything you were willing to share, and for your efforts to support the music industry here in Nashville.
 

AI and Medicine: The Slippery Slope to an Uncertain Future

Thanks to my guests: 
Michael Matheny, MD, MS, MPH, co-author of a recent report on AI from the National Academy of Medicine; 
Tom Lasko, MD, PhD, specialist in deep learning in medicine,
Freneka Minter, PhD, Ms, MCHES, PMP, Senior Research Specialist, Vanderbilt University Medical Center
Elyse Adler, Assistant Director for Education and Literacy, Nashville Public Library
In this episode of IIR, we covered the field of AI and some of the ways it impacts life today that we hope will translate into impact on the field of health care with the involvement of experts like Michael and Tom from Vanderbilt University Medical Center.  
For those interested in some of the details from this podcast episode, check out Google Flu Trends,  Theranos,  and Deep Medicine by Eric Topol, which informed our discussion and gave us more than a little bit to think about!
 
Also, check out the other excellent podcast on Informatics, the Biomedical Informatics Roundtable Podcast. Jason and Marylyn are doing fantastic work!

Informatics innovations: Getting trust and traction is tricky!

Thanks to my guests!  Jane Bach (songwriter and educator) (https://www.janebach.com/) her husband Gary, Daniel Fabbri (informatics) and Shannon Rich (twitter star!) 
This episode, we get into the opportunities and challenges that arise when a computer scientist wants to change health care using machine learning, novel technologies, and "obvious" improvements, but is confronted by the realities of what patients want, what they believe, and what they understand.  Lots of food for thought here, coupled with some great bonding through song!
Thank you, Gary, for letting us get a little personal with his story, and allowing us to frame a complicated topic with a real-world example.  You guys were amazing!
 

Informatics - Say What?

Thanks to my guests!  Rhett McDaniel (songwriter), Adam Wright (informatics) and Shannon Rich (twitter star!) 
This episode covers an essential topic that I'm sure is on everyone's mind: What exactly is biomedical informatics?   We had a good time discussing it, and hopefully cleared it up a little for some of you.  Let us know what you think!

Naming the Baby- bonus episode

Bonus Episode!  Ever wonder what goes into picking a podcast title?  No?  Then you're not quite as obsessive as a typical person doing biomedical informatics!  Take a listen to some of the potential titles for this podcast, and meet a couple of people who do work in the field, with a few laughs along the way (at least I laughed!)  Thanks to Scott Nelson and Dax Westerman who were the naming finalists.  Great job, gentlemen!