This month I have taken one article space to do a bit of editorializing on the challenges we face as a profession. I welcome feedback on what is, I hope, more than a little bit controversial. The more substantive material comes from Chris Brandt who presented his work on the Veterinary Computerized Anesthetic Record System at last summer's Talbot Symposium. He has made his slides as well as a demo of the application available on his web site. I hope this begins a process of balancing the research, standards, and clinical application content of this newsletter. To continue this, I need you all to continue to send your ideas and content.
These newsletters are available on our website on the Newsletters page. If you look closely, you'll see that the newsletter that went out the end of August is now called August-September. This gets the names based on the month starting instead of the month ending, which is more like other publications. This issue will thus be available by about mid-month as November.
Dr. Michael K. Martin
Last month I was in Chicago for the ID Expo meeting, surrounded by the latest in radio-frequency identification devices for tracking cattle from birth to slaughter with simple, automated readers in wands, chutes, and who knows where else. And yet, I still see a Veterinary Informatics profession suffering from a failure of imagination when it comes to discovering ways to improve the capture, processing, and use of information; and even in what we think information is.
I came to the meeting a couple of days early and had a chance to attend an outdoor concert by the Chicago Symphony Orchestra at Pritzker Pavilion in Millennium Park. If this had been a rock or hip-hop performance, I might have expected to come away impressed by the computer technology. But a classical orchestra under the direction of the likes of Daniel Barenboim seemed like the last place to find high-tech. If anyone would think their work too "nuanced" to be reduced to a wave-form it should be these folks, I thought. Their work is as pure, acoustic, and yes, classical as it comes. And was I ever wrong about that.
If you have ever listened to a classical orchestra in a really great concert hall, you know that the building is an important musical instrument. Your experience is a combination of the direct sound coming from the orchestra and the reflected harmonics. Outdoors the reflected sound usually doesn't exist, or if it does, it is only in a very small area inside the "shell" that surrounds the orchestra itself. Pritzker Pavilion gets around this through a very sophisticated system of microphones on the orchestra and suspended below the ceiling of the shell. The input from these microphones is digitally processed to add very carefully calculated time delays and then played through a system of speakers suspended on an overhead trellis. The results are astonishing. It sounds like you are hearing the orchestra with no amplification at all, but in a building with perfect acoustics.
Millenium Park, Pritzker Pavilion
So, did Mr. Barenboim's music lose its complexity or nuance by being reduced to numbers? Or, did information processing simply allow the audience to experience a sublimely analog performance as it was intended and as it was produced by the classical musicians on a traditional stage? And what can we learn from this? We expect a hip-hop band doing sampling and other tech effects to use computer technology as part of their performance. To do so takes some tech savvy but not particularly much imagination. To imagine the acoustics of a concert hall reproduced by information processing in an outdoor concert venue took imagination about just what constitutes information and information processing. We in Veterinary Informatics (and Medical Informatics) too often pat ourselves on the back for our limited progress in getting the obvious information processing done. But we far to often get stifled by arguments such as, "what we do is too nuanced to be digitally coded."
Next time you are faced with a challenging Informatics problem, even if it doesn't seem to be dealing with digital information, ask yourself, "Is this really a failure of technology or rather a failure of imagination?" And then get out there and imagine what could be done if we would just think of it.
Form Follows Function in Electronic Anesthetic Record
Back in the mid nineties the Apple Newton took the physician market by storm. No transportable computer form factor has matched it before or since. What explained this phenomenal success? The Newton was exactly the largest form factor that would still fit in a white coat pocket. It gave the doctors as much function and screen size that would still fit in with their work environment. Why was the Newton a commercial failure? Quite simply, business suits and shirts don't have pockets big enough to comfortably hold it. The Newton fit one niche very well and worked there. It failed in a seemingly very similar application because of minor differences in environment.
Those of us working with alternate form factors--alternates to the traditional monitor, keyboard, and mouse--would do well to learn the lesson from the Newton and the architect Louis Sullivan that "form follows function."
Dr. Chris Brandt presented his ongoing work with VCARS, the Veterinary Computerized Anesthetic Record System at the Talbot symposium. This is a case where the idioms reflected in the paper forms were so successful that they had to be replicated in the computer application. Traditional data entry in the environment of the OR was a distraction from rather than an aid to the anesthetist. By using a form factor that replicates the highly successful paper anesthetic record, Dr. Brandt is showing how alternate form factors can help preserve what is good about the paper form world while still making available the benefits of real-time data capture.
Dr. Brandt's Talbot presentation along with documentation and a demo of the program are available at http://vetpda.ucdavis.edu/VCARS
Harmonizing Standards
"The great thing about standards is that there are so many to choose from." This is a favorite quote used by those working on standards because it seems like an endless battle to keep standards from conflicting with each other. In human medical informatics ASTM E31 has been the leading standards body on policy-type standards while HL7 is the undisputed leader of messaging standards. But what happens when the messaging is to support policy? The two standards must work closely together if things are going to work. The best way to ensure that this happens is for the standards development organizations to work together directly. That is what is happening with the Continuity of Care Record standards for transfer of patient information when a patient is referred to a specialist or skilled nursing facility. Are there lessons here for veterinary referral practice informatics?
Harvard Conference: Personalized Medicine
We have been trying to limit these links to those related to Veterinary Informatics rather than general Biomedical Informatics. Those links are available from many other sources such as AMIA. This one on Personalized Medicine is relevant as a reminder about how rapidly genetic profiling is moving from the research lab into practice. The day when our management and care of animals, will be directed by genetic profiles is just around the corner. And with it will come a whole new realm of information that will need to be recorded processed and reported to the practitioner in meaningful ways.
Personalized Medicine: Promises and Prospects will be a one and a half day conference focused on the challenges that physicians, scientists, insurers and patients face in implementing the new paradigm of personalized medicine. The conference will focus on the perspectives of Government, Pharmaceutical, Academic, and Diagnostic leaders as well as those of healthcare providers and payors, with concentration on five PM case studies on topics such as lung cancer and cardiovascular disease. The conference will also highlight the information technology infrastructure needed to make PM a reality. The tone for the conference will be one that will explore what happens " on the ground" when personalized medicine is put into practice, and what that means for caregivers, patients and payors, as well as for the industries that develop products for personalized medicine.
http://www.hpcgg.org/News/conference.jsp
As an example, not a specific endorsement, take a look at Metamorphix which does cattle genomics among other things.
http://www.metamorphixinc.com/products1.html
Resume Site References Veterinary Informatics
At least one of those resume posting web sites finds Veterinary Informatics worth a page. Sadly, I could find no specific job postings, but at least they know we exist. And they link to our web site. The site is from the UK but lists many US positions. Again, this is not an endorsement, just an observation.
http://www.biohealthmatics.com/healthinformatics/vetinformatics/vetinformatics.aspx
Epidemiologist / Veterinarian: Texas Animal Health Commission
The Epidemiologist reports to the Deputy Director for Epidemiology, Laboratories, and Support Services, and is responsible for performing risk analyses to support Texas livestock industries or as related to Texas livestock health issues; advising on trends in disease control and eradication efforts; monitoring surveillance methods; conducting epidemiological investigations; determining disease classifications and diagnostic procedures; and, providing assistance to field personnel. The Epidemiologist is subject to travel extensively and to work overtime (overtime compensated on an hour-for-hour basis up to 160 hours maximum accrual of compensatory time).
http://www.tahc.state.tx.us/agency/employment/06-05-Epidemiologist.pdf
Dean: The University of Texas School of Health Information Sciences at Houston
The University of Texas Health Science Center at Houston announces the search for the Dean of the School of Health Information Sciences (SHIS). SHIS is one of six schools of the UT Health Science Center at Houston. The position offers exceptional opportunities for leadership in a comprehensive academic health science center located in the Texas Medical Center.
http://www.shis.uth.tmc.edu/NewsEvent/SHIS%20admin%20post.pdf
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