Journal of the American Medical Informatics Association Highlights

Cost-effectiveness of informatics and health IT: impact on finances and quality of care

Ohno-Machado, L. — 2012-04-09T07:38:02-07:00

This issue of the journal focuses on an important but often underpublished area of biomedical informatics: the cost-effectiveness of informatics interventions in healthcare. The adoption of electronic health records (EHR) across the USA has been accelerated in response to legislation, but there is still much uncertainty regarding costs as well as short and long-term effects, given the many different ways in which systems are implemented and the high diversity of institutions served. A systematic review by O'Reilly (see page 423) covers economic evaluations of medication management systems, and the author also describes the cost-effectiveness of a clinical decision support system (CDSS) for diabetes in another article (see page 341). Frisse (see page 328) reports on the financial impact of EHR in an emergency department, and Subramanian (see page 439) analyzes the financial impact of a CDSS for renal dose adjustments.

The...

Informatics research to enable clinically relevant, personalized genomic medicine

Ohno-Machado, L. — 2012-02-07T16:14:26-08:00

This is a particularly exciting issue of JAMIA. Not only do we display exceptional work spanning informatics research that integrates data from different biological levels (from molecules to tissues to individuals), but we also show how this research is greatly enhanced by clever integration of knowledge from publicly shared resources (from nucleotide sequences to gene and protein networks to data from the biomedical literature). The articles in this issue cover a broad range of approaches developed in different institutions spread over five countries and 12 US states, and are prime examples of the importance of a quantitative approach to health sciences that requires computational analysis of massive amounts of data that are now being generated at an accelerated pace.

Upon recognizing the importance of providing biomedical and behavioral researchers with algorithms, tools, and computational facilities that accelerate scientific discoveries, the NIH sponsored the creation of several National Centers for...

Computer-based safety surveillance and patient-centered health records

Ohno-Machado, L. — 2011-12-10T07:38:52-08:00

There is much debate on which types of computer-based systems have the most impact in healthcare delivery and patient outcomes. Safety surveillance systems, which have been around for several years, are probably at the top of the list. These provider-oriented clinical decision support systems allow healthcare providers to monitor the safety of medications and other interventions that are critical to prevent poor outcomes. However, another rapidly growing type of system related to personal health records (PHR) is likely to be a contender for the top position within the next few years. These ‘consumer’-oriented systems currently have a primary focus on providing information to patients, but soon will follow the evolution of provider-oriented systems to expand into consumer-oriented decision support systems. In this issue of JAMIA, we cover safety surveillance systems and patient-centric systems, which nicely complement articles covering the same topics that were published in our extraordinary online issue...

Innovative approaches to support patient decision making, improve safety, and enable large-scale clinical research

Ohno-Machado, L. — 2011-12-16T08:57:23-08:00

The Patient-Centered Outcomes Research Institute recently announced several funding opportunities for research focused on empowering patients to make informed decisions. The literature on patient-centered systems has been increasingly present in JAMIA, and we anticipate receiving several submissions on this topic in the upcoming year. Another topic of continued interest is patient safety: the recent IOM report on health IT and patient safety makes important recommendations regarding actions that federal agencies and the private sector should take to maximize the safety of electronic health record systems and other health IT software. It recognizes that, although one of the most impactful areas is medication safety, there are important gaps in the literature. JAMIA helps fill some of these gaps, featuring the outstanding work by the informatics community to address patient safety challenges. Finally, the ongoing discussion related to the new National Center for Advancing Translational Sciences (NCATS) at NIH illustrates the...

Use of electronic health record systems for decision support

Ohno-Machado, L. — 2011-10-18T14:19:34-07:00

This issue of JAMIA completes my first year as the Editor-in-Chief. The extended scope, improved workflow, and increase in editorial staff have allowed us to reduce the median review time to <30 days, even with a nearly 70% increase in original submissions. It is exciting to see an increasing number of authors with diverse backgrounds submitting from many different institutions in numerous countries, reinforcing our intent to reflect the best work of informatics without borders.

This issue focuses on electronic health records (EHRs, including medical and personal health records (PHRs)) and Clinical Decision Support Systems (CDSS). The debate on what really constitutes meaningful use of information technology (IT) in healthcare has never been so intense, with informatics professionals playing a central role in designing, implementing, and evaluating relevant information systems. EHRs and CDSS are critical components of meaningful use.

An editorial by Johnson (see page 730) elaborates on...

Realizing the full potential of electronic health records: the role of natural language processing

Ohno-Machado, L. — 2011-08-16T13:07:36-07:00

Meaningful use of electronic health records (EHRs) for patient care or for research requires data to be comparable. Many portions of EHRs continue to be unstructured, presenting significant challenges for biomedical informatics. This issue of the journal displays several solutions to this problem that are based on natural language processing (NLP) techniques. A high-level review by Nadkarni (see page 544) is intended to introduce the main components of NLP for the novice, and to briefly describe machine learning methods that are successfully being employed in the field. It includes a discussion on Watson, a contestant on ‘Jeopardy!,’ a popular question-and-answer TV show, and the ensuing speculations about its potential extensions to medical NLP. However, despite some notable examples of successful NLP applications in clinical care, progress in the field has been relatively slow.

Chapman and colleagues (see page 540) discuss the need to steer current...