Friday
April 28, 2006

Information technology & electronic communications
in all aspects of the profession

Welcome to the AVINews Monthly. We'd love your feedback on our ongoing efforts to improve the newsletter and its format, so email us your comments: martinmkm@mminformatics.com


In This Issue:
Executive Board
President's Comments
Lab Network Messaging

 
In the News
Jobs
Membership Renewal Form


Executive Board

Your officers for 2005-2006 are:

President - Dr. Michael K. Martin
President-elect - Dr. Stanley Robertson
Secretary/Treasurer - Dr. Dennis Ballance
Past President - Dr. Stephen Pittenger


Feedback

Please let us know if you have any suggestions or comments about AVI.


President's Comments

The annual meeting is just about upon us. Those of us who are presenting at the Talbot Symposium have submitted our speakers' notes (right?), and we are all looking forward to four good days of informatics and a little sun and surf on the side.

With the annual meeting comes the election of officer(s). This year is the middle of Dr. Ballance's term as Secretary/Treasurer and Dr. Robertson is stepping into the Presidency. So we have only the office of President-Elect to fill. The executive board functions as the nominating committee and will present a slate of candidates prior to the meeting. Nominations from the floor will be allowed, but the process will be much more effective is members will submit their own names or those of colleagues to the executive committee now so we can include them in the official slate of candidates.

Serving as President Elect last year and President this year has been one of the most interesting challenges I've taken on. It has forced me to broaden my view of our profession to take in the full scope of activities that fall within veterinary informatics. I've known the thrill of getting really exceptional material submitted for the newsletter, and the anxiety of wondering if we were going to have a next edition. And I've fielded communications from people and companies throughout the world looking for advice on one aspect of veterinary informatics or another. The high point of the job has come when I have directed these inquiries to one or more of our members and been reminded of just how much world-class expertise is contained within the membership of AVI.

If you are ready to take on this challenge and reap the rewards that go with it, or if you know someone who is, you can submit their name(s) for nomination by e-mailing me. I will get the names to the rest of the executive committee.

This month's Jobs section is lifted directly from the AMIA Job Exchange. I thought it was worth including in our newsletter because it gives such a good representation of the kind of demand that is emerging for trained informaticists. Having spent a substantial part of my career in human public health and medical informatics, I can say with confidence that a veterinary informaticist with the right training would be a strong candidate for any of these positions. As one who has returned to veterinary regulatory practice, I can say that the lessons learned by spending time on the other side are very useful in "our" world.

Dr. Michael K. Martin


Using Data and Messaging Standards to Share Diagnostic Data in the National Animal Health Laboratory Network

USDA's Animal and Plant Health Inspection Service (APHIS) and the American Association of Veterinary Laboratory Diagnosticians (AAVLD) working initially with Booz Allen Hamilton and later with Communications Resource, Inc. (CRI) developed the first standards-based network of veterinary diagnostic laboratories, to support the National Animal Health Laboratory Network (NAHLN) program.

The Bioterrorism Act of 2002 called for the Nation to "develop an agricultural bioterrorism early warning surveillance system through enhancing the capacity of and coordination between State veterinary diagnostic laboratories, Federal and State agricultural research facilities, and public health agencies." The NAHLN is a program designed to improve the nation's capability and capacity for addressing animal health issues. An information technology system was needed to support the program's communication, collaboration and data sharing needs -- yet participating laboratories retained their own laboratory information management systems (LIMS), capturing diagnostic data in a non-standardized format, making it difficult to aggregate in a central repository.

Developing the NAHLN involved several distinct groups and a constant exchange of requirements, technical standards, and implementation details. High level requirements were developed by the NAHLN Steering Committee with representation from both USDA and AAVLD. These requirements were translated into technical requirements by the NAHLN Technical Committee and later the NAHLN Change Control Board. Guidance on implementation of standards was provided by individuals recruited to provide specific expertise on each standard. Contractor representatives received these requirements and incorporated them into development plans and ultimately the central database and message broker that forms the hub of the NAHLN Messaging System.

The process of designing the NAHLN Messaging System was a learning experience for all involved. The contractors needed to quickly learn the principles of HL7 messaging as well as the details of the original message design and the several iterations of improved designs. The participating laboratories had to develop an appreciation for the difference between producing results for local use and producing results that can be aggregated and interpreted at a national level. The two main HL7 experts went through a series of message profiles in an effort to maximize both efficiency and flexibility while meeting the changing data requirements from the Steering Committee. Early in the pilot phase, the NAHLN mechanism was quickly adopted to support the enhanced BSE testing program. Everyone involved quickly learned the political and personal sensitivities that must be respected by any data system. The contractors evaluated and suggested various tools that could be used for message construction and transmission. Several of the pilot laboratories also contributed knowledge and experience with various commercial and open source tools.

As much of a challenge as was the technical implementation of the system, a bigger issue was developing support systems for member laboratories. Initially, the documentation developed was at a technical level. The HL7 message profile was described in an implementation guide that included all the technical details but very little "how to" information. Vocabulary was initially provided to the contractor as a static list of fields and acceptable values. The same lists were provided to laboratories for use in their mapping efforts. This left all but the most technically oriented laboratories at a total loss as to how to move forward with a messaging project. And all of this was very static. Any changes to the system needed for support of new diseases or new disease control programs were very disruptive.

In the latest development cycle, much more attention has been paid to user support and responsiveness to change. The implementation guide has been supplemented with a more "user friendly" guide known as The Hitchhiker's Guide to NAHLN Messaging. Vocabulary lists have been moved to an actively maintained web tool supported by USDA funding to the Virginia-Maryland Regional College of Veterinary Medicine where most of veterinary medicine's SNOMED expertise resides.

The NAHLN is far from finished. Still in development are the ability to send and respond to request messages as well as the ability for laboratories to refer testing to NVSL or other NAHLN laboratories. While the design of the messages is intended to be able to support testing for any disease, not just those in the initial list, it is inevitable that minor changes will be needed to support new test types. An example of this that is just being examined is a new multiplexed testing technology.

State animal health laboratories represented by the AAVLD and federal laboratories represented by USDA's APHIS are cooperating to improve the nation's ability to detect the occurrence of animal disease by collaborating on surveillance activities and sharing diagnostic data. In the long term, veterinary diagnostic laboratories will be equipped to share data with other, standards-based systems outside the animal health community, without needing to map individual data values to meet requirements of these other systems. In addition, the laboratories participating in the NAHLN will be able to share data with one another, as desired, even outside the NAHLN system. Most important, the adoption of standards for messaging and data improves the comparability and data quality of information exchanged throughout multiple systems.

[This and many other topics will be presented in the informatics section at this year's AVMA meeting in Hawaii.]


In the News

Connecting for Health Releases Policy, Technical Guidelines

As the USDA moves toward the idea of implementing the animal tracking component of the NAIS as a federated database, we would be wise to pay attention to some of the work being done on similar federated data sharing in human medicine.

Connecting for Health, a public-private collaborative of more than 100 organizations, on Thursday released policy and technical guidelines developed by IT, health privacy law and policy experts. The report, "Common Framework: Resources for Implementing Private and Secure Health Information Exchange," is part of a comprehensive approach to securely share health information in diverse settings with various information systems.

Connecting for Health is led and managed by the Markle Foundation and funded by Markle and the Robert Wood Johnson Foundation. The organization's Common Framework - which in 2005 was tested in Boston, Indianapolis and Mendocino, Calif. - demonstrated that different health information networks using various technology still can communicate with one another and exchange data.
http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemid=119989



Second AMIA 10X10 Program Partner – University of Alabama at Birmingham

Bethesda, MD, April 10, 2006 – The American Medical Informatics Association (AMIA) is pleased to announce the formal partnership of the University of Alabama at Birmingham (UAB) in the AMIA 10x10 program. Eta S. Berner, Ed.D., FACMI, Professor in the Health Informatics Program in the Department of Health Services Administration in the School of Health Related Professions at the UAB, will serve as Director for the AMIA 10x10 at UAB offering.

The goal of the 10x10 program at UAB is to provide a broad survey of biomedical informatics, aiming to impart a detailed understanding of the use of information technology in health and biomedicine. This program is aimed to train clinicians and other health care professionals in informatics so they can be knowledgeable participants in IT implementations in their local settings.

"Students have commented that this course not only provides them with a wide-ranging perspective on the current 'hot topics' in health informatics, it also lays the foundation for their future studies in the field," said Dr. Berner.

Topics that will be covered by the AMIA 10x10 Program at UAB include:

  • Introduction to Health Informatics and Evolution of Healthcare Information Systems

  • System Lifecycle and Strategic Planning for Health Information Technology

  • Knowledge Management and Use of IT for Operational Efficiency

  • Planning for Acquisition and Implementation of Health Information Technology

  • Networking and Telecommunications, Information Integration, and Public Health Informatics

  • Electronic Health Records and Clinical Decision Support Systems

  • Databases, Data Warehouses, and Data Mining

  • Privacy and Security of Health Information

  • Evaluation of Health Information Technology

  • Telemedicine

  • Legal and Ethical Issues in Health Informatics

The course is offered in two parts: a 12-week Web-based component followed by an intensive in-person session held in conjunction with the AMIA 2006 Annual Symposium. The Web-based portion is provided through readings, lectures, interactive discussions, and self-assessment tests. The intensive session will bring together attendees to integrate the material, allow presentation of course projects, and meet leaders in the field as well as other students. The Web-based component of the course is an adaptation of the Introduction to Health Informatics and Health Care Delivery class currently taught at UAB.

The AMIA10x10 at UAB course offering will start on May 10, 2006, with the in-person session taking place during the AMIA 2006 Annual Symposium in Washington, DC, November 11 to 15, 2006. The registration deadline is May 1, 2006. Complete course description and registration is available on the AMIA Web site at: http://www.amia.org/10x10/partners/uab/

The American Medical Informatics Association (AMIA) is an organization of leaders shaping the future of health information technology in the United States and abroad. AMIA is dedicated to the development and application of medical informatics in support of patient care, teaching, research, and health care administration. Complete information about AMIA is available at: http://www.amia.org.



DICOM 2006 Released

The 2006 version of the DICOM Standard is, now, available on the DICOM Web Page at:

http://medical.nema.org/dicom/2006

and on DICOM's Public FTP site at:

ftp://medical.nema.org/MEDICAL/Dicom/2006/

Once again, we are deeply indebted to the Standard's VOLUNTEER editor, Dr. David Clunie.

Howard E. Clark, Ph.D.
DICOM Secretariat
National Electrical Manufacturers Assn.



Report: Personal Health Records and Personal Health Record Systems

Several AVI members have expressed interest in, or intention to develop products similar to the Personal Health Records that are starting to gain traction in human medicine. The list of AMIA members contributing to this effort is enough to make it worth reading.

The report was developed by the Workgroup on the National Health Information Infrastructure (NHII) of the National Committee on Vital and Health Statistics (NCVHS), the statutory public advisory body on health information policy to the Secretary of Health and Human Services. All of the members of the full National Committee, and particularly those who serve on the Subcommittee on Standards and Security and the Subcommittee on Privacy and Confidentiality, contributed to the final report. It is based on a letter report that was approved by the full Committee in September 2005 and sent to the Secretary. The letter report is available on the NCVHS Web site (http://ncvhs.hhs.gov/050909lt.htm). It has been slightly modified (but not substantively changed) to serve the wider audience interested in personal health records and systems.

The Committee is composed of 18 individuals distinguished in the fields of health statistics, electronic interchange of health care information, privacy and security of electronic information, population-based public health, purchasing or financing health care services, integrated computerized health information systems, health services research, consumer interests in health information, health data standards, epidemiology, and the provision of health services. Sixteen of the members are appointed by the Secretary of HHS for terms of four years each; with about four new members being appointed each year.

AMIA Members on the committee include:
AMIA Chairman, Paul C. Tang, MD
Simon P. Cohn, MD, MPH (NCVHS Chairman)
Jeffrey S. Blair, MBA
Stanley M. Huff, MD
Judith Warren, PhD, RN
J. Michael Fitzmaurice, PhD


Jobs and Training

Translational, Clinical Informatics Fellowship

Yale Center for Medical Informatics http://ycmi.med.yale.edu/
New Haven, CT

Translational/clinical fellowship positions are available starting July, 2006 or later in the year for a postdoctoral fellowship in the emerging field of Translational/Clinical Informatics at the Yale School of Medicine, sponsored by the National Library of Medicine. Candidates should have considerable computer programming experience. Clinician candidates should preferably have completed residency training. The program emphasizes the intersection of bioinformatics and disease, and includes topics from both bioinformatics and clinical informatics. Examples include 1) informatics research using genomic technologies to help better understand the mechanisms of disease, 2) organizing data from the electronic medical record to help define the clinical phenotype of many diseases, 3) building informatics tools that analyze clinical and bioscience data in an integrated fashion, and 4) the computer modeling of disease processes.

Complete Job posting available at: http://www.amia.org/inside/jobex/job.asp?jid=1241

Biomedical Informatics Academic Position

Fox Chase Cancer Center http://www.fccc.edu
Philadelphia, PA

Fox Chase Cancer Center seeks applicants for a position at either the postdoctoral or junior faculty level to work on the development and implementation of an inference-enabled ontology and knowledge base for translational research in oncology. The focus of the project is the development of an Integrated Clinical and Molecular Data Warehouse, funded by grants and contracts from the National Library of Medicine, the National Cancer Institute’s cancer Biomedical Informatics Grid (caBIG) program, and regional grants. The successful candidate will have a recent PhD in Computer Science, Computational Linguistics or Biomedical Informatics and will demonstrate considerable strength in one or more of the following areas: ontology development, text mining and information retrieval, knowledge representation, automated reasoning, or machine learning. Experience with problems in oncology, genetics or genomics and with the development of large software systems is also desired.

Complete Job posting available at: http://www.amia.org/inside/jobex/job.asp?jid=1247

Faculty Position in Informatics

The University of Texas School of Health Information Sciences
Houston, TX

Candidates should possess a doctoral degree in Health, Medical or Biomedical Informatics or a related cognate field (Nursing, Medicine, Dentistry, Public Health, Biomedicine, Computer and Information Science, Cognitive Science, Cognitive Engineering, Bioengineering, Bioinformatics, Biophysics, Anthropology, Organizational Behavior, Educational Technology etc.). Applicants with substantial expertise in the sub areas of bioinformatics, biomedical computing, structural biology, neuroinformatics, bioengineering, educational uses of technology or cognitive sciences in biomedicine or healthcare are encouraged to apply. A record of external funding published research and evidence of graduate level teaching abilities is preferred.

Complete Job posting available at: http://www.amia.org/inside/jobex/job.asp?jid=1248

Assistant/Associate/Full Professor

University of Missouri http://www.hmi.missouri.edu
Columbia, MO

Health Management and Informatics at the University of Missouri is currently recruiting a faculty member for our Health Informatics and Bioinformatics program. Candidates should have a Ph.D. in Informatics or a related discipline with demonstrated teaching and research records. Training in an informatics program on either the predoctoral or postdoctoral level is desired. We are seeking an assistant/associate/full professor of Data Mining in Biomedicine and Health Care. This faculty member is expected to work collaboratively within the environment of the Cerner EMR and the Center for Health Care Quality to analyze data being generated by the EMR and other initiatives such as the Patient Safety Net. This individual could also use databases associated with financial records with the institution to consider cost and process issues and could be expected to generate federal grant support to demonstrate improved clinical care related to the use of electronic systems.

Complete Job posting available at: http://www.amia.org/inside/jobex/job.asp?jid=1254

Chief Medical Information Officer

Cincinnati Children's Hospital Med Ctr http://cincinnatichildrens.org
Cincinnati, Ohio, USA

The Chief Medical Information Officer (CMIO) provides physician leadership to support the ongoing development and implementation of electronic health information systems related to the delivery of patient care at CCHMC. The CMIO will be responsible for supporting the clinical information needs that enable CCHMC to achieve the strategic goals described in its strategic plan. The CMIO leads the Clinical I.T. Advisory Committee to ensure the needs and requirements of the clinical community are met. The CMIO will promote the use of information technology in the clinical setting to improve safety, quality, patient and family satisfaction, efficiency in delivery of care, and integration with biomedical equipment. Additionally, the CMIO will ensure the use of informatics to support the needs of regulatory compliance. The CMIO will encourage support of the integration of clinical and research databases and seek solutions to meet this critical need. A major focus will be the support of efforts to track health care outcomes.

Complete Job posting available at: http://www.amia.org/inside/jobex/job.asp?jid=1255

Director, Information Sciences

The Cancer Institute of New Jersey http://www.cinj.org
New Brunswick, NJ

The Cancer Institute of New Jersey, part of UMDNJ-Robert Wood Johnson Medical School, seeks a Director of Information Sciences. The Director has responsibility to provide informatics support to cancer center members in their clinical and basic research efforts, including the development, procurement and maintenance of cancer center-specific applications. Faculty rank will be commensurate with experience. Requirements: PhD, MD, or MD/PhD. Must possess evidence of strong leadership and management skills, a strong informatics research background & demonstrated experience managing technology projects in a biomedical and clinical environment. Proven ability to express technical concepts effectively, both verbally and in writing. Experience in an NCI-designated cancer center preferred.

Complete Job posting available at: http://www.amia.org/inside/jobex/job.asp?jid=1257

Medical Informaticist

Posted by Korn/Ferry International http://www.kornferry.com
Southern New Jersey

Our client is currently seeking a Medical Informaticist to work in a new group that will play a crucial role in transitioning the organization into a fully digital environment. This digital transformation will include the building of two completely digital state-of-the-art regional facilities. Working in conjunction with their customer base (nurses, allied health professionals, physicians (both employed and contracted), support staff and other key care team members) the Informaticist will be charged with improving work flow, operationally, clinically, physically and digitally – optimizing processes and driving maximum value across the organization.

All Inquiries will be dealt with in the strictest confidence.

Complete Job posting available at: http://www.amia.org/inside/jobex/job.asp?jid=1263

Health Informatics Fellow

Boston University
Boston, MA

The Boston University component of the National Library of Medicine-funded Boston Biomedical and Health Informatics Training Program (BU, Harvard, MIT, Tufts) is recruiting a post-doctoral (M.D., D.D.S., Ph.D., etc) trainee for 2 years training, both didactic and supervised project. Possibility of M.Sc. at Harvard-MIT HST Program or other Masters Programs. Focus of BU component is using technology in chronic disease care and promoting health behavior change for patients and consumers. National Library of Medicine trainee stipend. Full tuition and travel benefits. Federal loan repayment available for eligible trainees. Contact the program’s administrator, Cherilyn Day at Cherilyn.day@bmc.org

Complete Job posting available at: http://www.amia.org/inside/jobex/job.asp?jid=1264


About AVI

Joining the AVI
You may renew or apply for membership in the AVI by completing an application and paying the annual dues. An application is also included in each issue of the AVI Newsletter. Membership is for a full year, expiring July 31 each year. You may select from several membership categories, work groups, and newsletter formats as described in the application. All member categories share the privileges of the newsletter and the communication services of the society. Full and corporate members have voting privileges. If you share AVI's interests, please join us.

Mission
The AVI, formerly the American Veterinary Computer Society, was formed to expand the use of the computer as a tool in veterinary medicine. This includes serving as an educational resource, promoting the use of information technology and electronic communications, and developing and promoting standards in veterinary information management.

Benefits
Membership benefits include the monthly AVI newsletter, participation in work groups, the AVI-L listserv discussion list, and an annual membership directory.

Levels
Membership incorporates a range of levels to encourage participation from all segments of the profession, veterinarians and non-veterinarians, as well as its supporting organizations. This includes veterinary practitioners and their staff, faculty and staff of veterinary?colleges, diagnostic laboratories, medical records personnel, medical librarians, students, software and hardware developers, and corporations supplying veterinary products and services. Over one third of the members are individuals working in the field of clinical veterinary medicine, one third are in academia, and the remainder are in industry, government, and other veterinary medicine. Membership is international, including Australia, Brazil, Canada, Israel, South Korea, and Saudi Arabia, as well as the United States.

Meeting
The annual membership meeting is held in conjunction with the AVMA Annual Convention and includes the one-day Richard B. Talbot Symposium on Veterinary Informatics and two days of general information on computer usage. The members of the Association are encouraged to write articles and/or make presentations regarding their experiences, as these are valuable to establish veterinary informatics as a legitimate discipline and to encourage individuals in the veterinary community to become more involved in the information age.

Application
Membership Application (HTML)
Membership Application (RTF)


Date:  _________________

Association for Veterinary Informatics Application and Renewal Form

O  New      O  Renewal of AVI membership # ______
Please circle change in address or other information.

Name:  _________          ___  ____________________          Dr.   
                 First                        M.I.  Last                                   
       Mr./Ms.

Organization:
___________________________

Address:  ________________________________________________

Phone:  (_____) _____________

________________________________________________________

Fax:      (_____) _____________

______________________   ____     __________            ________
City                                               State             Zip/PC                     Country

E-mail:_______________________

Membership Level

     Level

Description

Dues

Rights

O  Full

Individuals interested in the field of veterinary informatics

$35.00

Receipt of newsletter; participation in Work Groups; full voting rights; eligible for membership on standing committees.

O  Associate

Individuals who support the mission and goals of the Society

$20.00

Receipt of newsletter; participation in Work Groups; no voting rights; not eligible for membership on standing committees.  Limited to two years. 

O  Corporate

Corporations that support the goals of the Association

$100.00

Receipt of newsletter; participation in Work Groups; full voting rights (one per corporation); not eligible for membership on standing committees.

O  Student

Students enrolled in any academic program interested in the field of veterinary informatics

$10.00

Receipt of newsletter; participation in Work Groups; no voting rights; not eligible for membership on standing committees.

Newsletter format desired:  O  Hardcopy  O  Electronic (E-mail address required):_________________  O Both

Membership includes participation in one Work Group.  Please select one group from the list below.

O  Practice Management Systems

O  Data and Messaging Standards

O  Communications and Networking

O  Computer-Aided Instruction/Computer Assisted Learning

O  Computerized Patient Records

Primary work or occupation:  (Please note new categories.)

O  Small animal practice

O  Academic- Clinical, Education, R & D

O  Industry, Government

O  Mixed practice

O  Academic, Other, Diagnostic

O  Ophthalmology

O  Large animal practice

O  Other ____________________________

O  Student

Current interest or involvement in veterinary computing:

O  Basic computer usage in practice
O  Advanced computer usage in practice
O  Internet Usage                       
O  Tertiary Center Medical Records

O  Cutting edge computer technology
O  Education; undergraduate, continuing, or staff
O  Other ______________________________

What topics would you like to see in the newsletter or at the AVMA meeting?  Other comments?

Dues are payable by August 1.  Membership is from August 1 to July 31the following year.  Dues must be received by September 1 of each year in order to be listed in the directory.

Make check payable to:   Association for Veterinary Informatics

Mail dues and form to:      
Dr. Dennis Ballance, Secretary/Treasurer, AVI                       
VMTH Computer Services
1 Shields Ave
Davis, CA 95616  
E-mail:  dwballance@ucdavis.edu


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Copyright 2005, Association for Veterinary Informatics