Journal of the American Medical Informatics Association Viewpoint paper

Foundational biomedical informatics research in the clinical and translational science era: a call to action

Payne, P. R. O., Embi, P. J., Niland, J. — 2010-10-20T08:49:30-07:00

Advances in clinical and translational science, along with related national-scale policy and funding mechanisms, have provided significant opportunities for the advancement of applied clinical research informatics (CRI) and translational bioinformatics (TBI). Such efforts are primarily oriented to application and infrastructure development and are critical to the conduct of clinical and translational research. However, they often come at the expense of the foundational CRI and TBI research needed to grow these important biomedical informatics subdisciplines and ensure future innovations. In light of this challenge, it is critical that a number of steps be taken, including the conduct of targeted advocacy campaigns, the development of community-accepted research agendas, and the continued creation of forums for collaboration and knowledge exchange. Such efforts are needed to ensure that the biomedical informatics community is able to advance CRI and TBI science in the context of the modern clinical and translational science era.

Health information technology: fallacies and sober realities

Karsh, B.-T., Weinger, M. B., Abbott, P. A., Wears, R. L. — 2010-10-20T08:49:30-07:00

Current research suggests that the rate of adoption of health information technology (HIT) is low, and that HIT may not have the touted beneficial effects on quality of care or costs. The twin issues of the failure of HIT adoption and of HIT efficacy stem primarily from a series of fallacies about HIT. We discuss 12 HIT fallacies and their implications for design and implementation. These fallacies must be understood and addressed for HIT to yield better results. Foundational cognitive and human factors engineering research and development are essential to better inform HIT development, deployment, and use.

All's well that ends well for JAMIA editors

Miller, R. A. — 2010-10-20T08:49:30-07:00

Dr Randolph A Miller begins a self-imposed JAMIA retirement on January 1, 2011 after serving as Editor-in-Chief for eight and a half years. He lauds the selection of Lucia Ohno-Machado as an energetic, innovative, and highly qualified successor.

Drug safety surveillance using de-identified EMR and claims data: issues and challenges

Nadkarni, P. M. — 2010-10-20T08:49:30-07:00

The author discusses the challenges of pharmacovigilance using electronic medical record and claims data. Use of ICD-9 encoded data has low sensitivity for detection of adverse drug events (ADEs), because it requires that an ADE escalate to major-complaint level before it can be identified, and because clinical symptomatology is relatively under-represented in ICD-9. A more appropriate vocabulary for ADE identification, SNOMED CT, awaits wider deployment. The narrative-text record of progress notes can potentially be used for more sensitive ADE detection. More effective surveillance will require the ability to grade ADEs by severity. Finally, access to online drug information that includes both a reliable hierarchy of drug families as well as structured information on existing ADEs can improve the focus and predictive ability of surveillance efforts.