Easy-access medical records could help physicians quickly treat patients
An elderly woman suspected of having a stroke arrives confused at the emergency room. The physician uses the basic information she is able to provide to access the critical medical history that will help him treat her. In simplest terms, that's the promise of health information technology.
To move toward that future, biomedical and health informatics researchers at The University of Texas Health Science Center at Houston (UTHealth) have received a $15 million stimulus grant to establish the National Center for Cognitive Informatics and Decision Making in Healthcare (NCCD) at UTHealth. At the center, faculty will conduct breakthrough research to advance the adoption and meaningful use of health information technology.
"Much more than technology is required to make health information technology effective," said Jack Smith, M.D., Ph.D., dean of The University of Texas School of Health Information Sciences at Houston, part of UTHealth. "It must be easy to use and easy to learn. This grant will give us the opportunity to turn our ideas into practice and ultimately into improved patient care."
The UTHealth School of Health Information Sciences was awarded the money through the Strategic Health IT Advanced Research Projects (SHARP) Program, which seeks to support improvements in the quality, safety and efficiency of health care through advanced information technology.
The award was one of four presented by the Office of the National Coordinator for Health Information Technology (ONC) through the American Recovery and Reinvestment Act of 2009 to address key barriers to health information technology.
"Our school was an early visionary in understanding that technology must be adapted to the needs of users based on how they think, how they learn and how they make decisions, which is cognitive informatics," Smith said. "Since the inception of the school, we have been working to bring together the world's leading team in cognitive informatics."
One of the barriers to widespread electronic health record (EHR) use is that most EHR systems are not as user friendly as they should be, according to Vimla L. Patel, Ph.D., DSc, who is a NCCD co-director and a UTHealth School of Health Information Sciences professor.
Just as television viewers can become frustrated with a remote control that has too many buttons, the consumers of electronic health data can become frustrated with health information technology systems that do not take into account their information processing capabilities and decision processes, she said.
Health information technology systems need to be designed with an understanding of the minds of the people using them, Patel said. Human beings will choose what is easy to use, pleasant to work with and delivers what they want, she added.
"There is an opportunity to develop systems that are much more sensitive to users," said Edward Shortliffe, M.D., Ph.D., a professor at the UTHealth School of Health Information Sciences and the president and CEO of the American Medical Informatics Association in Washington, D.C. "Much of what is being done now is to get doctors to install electronic health record systems. Our research will ultimately help to ensure that these systems are used."
Brent King, M.D, chairman of the Department of Emergency Medicine at The University of Texas Medical School at Houston, a part of UTHealth, says he looks forward to the day when health information technology systems will be able to help clinicians with sophisticated decision making. "The doctor's brain shouldn't have to be the repository of all health information. There should be programs that signal the physician when it is important to act," he said.
Jiajie Zhang, Ph.D., the principal investigator for this $15 million grant and co-director of the NCCD, said that eventually accessing health information could be as easy as taking money out of an automatic teller machine. "You can go to any ATM and get cash even in a foreign country. The transactions are simple, safe and secure, and require no training. Likewise, healthcare information should be accessible by physicians and patients, anytime, anywhere, without much mental effort," he said.
Research at the center will focus on the use of information technology to support problem solving and decision making that optimizes patient outcomes, said Zhang, holder of the Dr. Doris L. Ross Professorship and associate dean of research at the UTHealth School of Health Information Sciences. This area of informatics is called patient-centered cognitive support.
The NCCD, which will carry out six research projects, is a collaborative initiative involving the University of Washington, Arizona State University, University of Maryland College Park, Baylor College of Medicine, Intermountain Healthcare, Department of Veterans Affairs and Baylor Health Care System. The center will be housed in the new UTHealth Behavioral and Biomedical Sciences Building.
"I am delighted to see our colleagues in the School of Health Information Sciences take the lead in this transformative project. I think the idea of engaging our university's experts to address the challenge of improving the ways physicians and other health professionals can take full advantage of the information embedded in electronic health records is a fabulous idea. My hat is off to Dean Smith and his faculty, including Drs. Jiajie Zhang, Vimla Patel and Edward Shortliffe," said Peter J.A. Davies, M.D., Ph.D., Provost and Executive Vice President for Research at UTHealth.
Shortliffe, a member of the Institute of Medicine, will serve as the Chair of the Project Advisory Board which is composed of researchers, patients, providers, HIT vendors, and other stakeholders from across the nation.
Also receiving four-year cooperative agreements were Harvard University, the Mayo Clinic, Rochester, Minn., and the University of Illinois Urbana-Champaign, Ill.
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