2008 Practical Informatics and API Courses
Practical Informatics is an intensive introduction to basic informatics concepts. The course is intended both for those with a limited background in informatics as well as those wishing to enhance their foundation and understanding of core informatics principles. Participants will learn fundamental concepts upon which they can build a better understanding of the role for informatics in pathology.
ASSOCIATION FOR PATHOLOGY INFORMATICS (API) COURSE:
Strategies for Improving and Making Your LIS Work for You - (Advanced)
Sunday, October 19, 2008 8:30am - 6:00pm
8:30 AM | Course Introduction – Dr. Parwani
8:35 AM | Outside the Box Interfaces – Agile Techniques for Getting Data In and Out of the LIS – Dr. Routbort
9:35 AM | Laboratories and the Public Good: Informatics at the Crossroads – Dr. Aller
10:35 AM | The Healthcare Data Warehouse Strategy – Dr. Dolan
11:35 AM | Making Your AP Lab System Work for You: Bar-coding and Workflow – Mr. Piccoli
12:35 PM | API Roundtable with LIS Vendors Luncheon
1:35 PM | Practical Image File Management - Beyond an Integrated Solution – Dr. Sinard
2:35 PM | Implementing Informatics-Driven Change in the laboratory – A Survival Guide! – Dr. Riben
3:35 PM | How an Electronic Employee Can Transform Your Pathology Workflow – Mr. Garniss
4:35 PM | Using the LIS to support LEAN and Six Sigma in Your Laboratory – Dr. Balis
5:35 PM | Q&A
APIII 2008 PRACTICAL INFORMATICS COURSE - (Beginners)
Monday, October 20, 2008 8:00am - Noon
Practical Informatics is an intensive introduction to basic informatics concepts. The course is intended both for those with a limited background in informatics as well as those wishing to enhance their foundation and understanding of core informatics principles. Participants will learn fundamental concepts upon which they can build a better understanding of the role for informatics in pathology.
8:00 - 8:15 Introduction to Pathology Informatics (Dr. Sinard)
What is informatics, difference between informatics and computer science, scope of informatics, subspecialty training, and the role of information management in the future of medicine.
8:15 - 9:00 Databases and Data Storage (Dr. Sinard)
Database terminology, database conceptualization, relational databases, database normalization, database abstraction, database management systems, data integrity, and SQL.
9:00 - 9:45 Data, Messaging Standards and Interfaces (Dr. Gilbertson)
Nature of interfaces, use of interfaces in pathology practice, importance of messaging standards to successful interfaces (and medical informatics in general), main messaging standards in medicine (HL7 and DICOM), how standards are developed and maintained, how pathologists (and residents) can be actively and productively involved in standards development.
9:45 - 10:00 Break
10:00 - 10:30 Digital Imaging Basics (Dr. Sinard)
Basic concepts of digital imaging (pixels, resolution, image size), image acquisition and workstation design, image storage and archiving, common uses of digital imaging.
10:30 - 11:15 Applications of Telepathology and Whole-Slide Imaging in Pathology (Dr. Parwani)
Introduction to telepathology and whole slide imaging, clinical applications, proven uses and future directions, multi-spectral imaging.
11:15 - 12:00 Introduction to Bioinformatics (Dr. Chandran)
Bioinformatics concepts including biological databases, analysis of data from high throughput genomic
technologies such as expression and single nucleotide polymorphism (SNP) arrays, and applications in cancer biomarker discovery.
Descriptions:
Outside the Box Interfaces – Agile Techniques for Getting Data In and Out of the LIS
Dr. Routbort
"Standard" HL7 electronic interfaces provide well-defined and carefully constrained portals of information transfer into laboratory information systems. However, they can be difficult to adapt to rapidly evolving needs, especially in the era of molecular pathology where both analysis and reporting have increasingly demanding requirements. In addition, not all systems can be readily electronically interfaced together, creating a need for techniques to bridge the gap between paper/forms generation and electronic data. We will examine through real-world examples and demonstration several "agile" techniques for facilitating data flow and in out of the LIS. These will include 1. Using a "print and parse" workflow solution in the flow cytometric laboratory to remove the need for paper-based distribution of documents and eliminate the manual transcription of data elements from specialized analysis software to the LIS, 2. Techniques using two-dimensional bar codes and the ubiquitous Adobe Reader application to create outreach forms which can be printed and then used to drive automatic importation of specimen and order data, and 3. Development of web services and report viewer controls to facilitate the accurate and timely reporting of pathology and laboratory data.
By the end of this presentation, attendees should be able to:
- Understand some of the benefits and limitations of traditional HL7 interfaces to the LIS
- Be familiar with using middleware approaches to automatically import heterogeneous data sources such as complex flow cytometric data
- Consider whether electronic forms software with bar-coded data representation might be an effective paper-to-electronic bridge in their own facilities
- Understand the potentially transformative power of web services on the reporting of pathology and laboratory data
Laboratories and the Public Good: Informatics at the Crossroads
Dr. Aller
Laboratories produce data that is of value far beyond individual episodes of patient care. Laboratory measurements can help assess the health of a population, discern patterns of disease, and detect individual cases that should be followed up to inhibit spread of disease. By communicating data from the LIS database – where it has been created for the sake of the individual patient – to regional databases that are focused on promoting the public good, we can provide many important benefits to our fellow citizens.
At the same time, transmission and usage of data must strictly respect the confidentiality of the patient. Although there is a HIPAA exemption for most aspects of public health reporting, there remains an obligation to safeguard information from public disclosure.
By the end of this presentation, attendees should be able to:
- Describe different data sources useful in the protection of the public
- Discuss the evolution in how we have used laboratory and clinical data to help detect disease outbreaks and identify opportunities for improvement in the public’s health
- List five reasons why fully automated data transmission is superior to manual reporting of disease cases
- Develop a specific action plan for adaptation of your particular laboratory information system, to become a valuable information resource for public health
The Healthcare Data Warehouse Strategy
Dr. Dolan
This presentation will give a description of a data warehouse as it applies to healthcare particularly in laboratory medicine. This presentation will define what a data warehouse is and then demonstrate the use of the system in their laboratory over the last twelve years. Particular emphasis will be given to the use of the warehouse in activity based costing, sales, billing, service systems management, dashboards, utilization of blood bank products, looking at utilization of resource, reference range determinations, and use of the system as a bioterrorism centinal system.
By the end of this presentation, attendees:
- Will understand the definition of a data warehouse
- Will see the utilization of the warehouse in healthcare overall
- Will see its practical applications laboratory medicine
- The overall impact on the delivery and cost of healthcare
Making Your AP Lab System Work for You: Bar-coding and Workflow
Mr. Piccoli
With increasing attention devoted to ensuring patient safety and improving efficiency of lab processes, the application of bar-coding technology and related process engineering has reached a new pitch in Anatomic Pathology practice. We will review and discuss an initiative stretching over the past three years to integrate 2-D bar-coding into all AP tissue samples and redesign lab processes and the supporting LIS workflow to gain efficiency and provide positive patient identification between samples.
Important topics in the development to be covered include:
- Advantages and disadvantages of developing an existing third-party solution
- Selection of optimal hardware solutions and changing targets over time
- Software components to trigger appropriate “checkpoints” in the anatomical pathology lab workflow
- Trials and mistrials of integrating other automated systems into the workflow
Practical Image File Management - Beyond an Integrated Solution
Dr. Sinard
Many LIS vendors have integrated digital imaging solutions into their products. While this integration provides many advantages, particularly with respect to setting up the system, it can end up restricting the availability of image capture options and image utilization procedures. This presentation will discuss an alternative approach which maximizes image capture options and facilitates access to the images. It will be presented as an example of how locally developed solutions can be integrated into commercial LIS software. In addition, we will also discuss how this same solution, with minor modification, has been used to manage images from scanned requisition forms.
By the end of this presentation, attendees:
- Will understand the advantages and disadvantages of integrated imaging solutions
- Will learn the importance of developing a robust image file management solution
- Will see examples of how locally developed software can be integrated into commercial systems
- Will explore options of semi-automated scanned document management at your local institutions
Implementing Informatics-Driven Change in the laboratory – A survival guide!
Dr. Riben
So you wake up and find yourself in charge of changing how things are done in the laboratory, and you realize no one else has volunteered. You know informatics will play a huge part… What now? This presentation will focus on strategies for leading informatics-driven change in the laboratory: The Good, The Bad and The Ugly.
By the end of this presentation, attendees should be able to:
- Drive bottom-up change with informatics solutions
- Develop change management infrastructure for informatics driven change
- Develop an RFP for technology assessment
- Use best practices for measuring and demonstrating change in the laboratory
How an Electronic Employee Can Transform Your Pathology Workflow
Mr. Garniss
An electronic employee is a software program that simulates a human LIS user for repetitive and/or well defined tasks on the LIS. An electronic employee can therefore be used to automate LIS activities without major custom software development and without modifying the LIS code base. At the Massachusetts General Hospital, electronic employees are used to economically and flexibly extend LIS capability and transform Pathology work flow.
By the end of the presentation, the attendee will:
- Understand how typical electronic employee software, Boston WorkStation (BWS), works
- Understand potential use case scenarios and examples of how MGH uses electronic employees to free up FTEs, save time, increase productivity, prevent serious medical and technical errors in anatomic and clinical pathology
- Understand the potential of electronic employees in LIS Alpha/Beta programming or in quickly trying new changes in workflow with out paying your vendor
- Be able to estimate ROI of an electronic employee and determine if an "electronic employee" is right in specific applications
Using the LIS to support LEAN and Six Sigma in Your Laboratory
Dr. Balis
This presentation will provide a structured and rational framework for one to construct cogent approaches to the implementation of Lean and Six Sigma solutions in Clinical Lab practice, using the LIS as a key enabling tool for the generation of critical data sets needed in support of evidence-based process change. The presentation will include both conceptual and technical, implementation-level detail in support of described approaches, and will be very practically-minded, towards the goal of the attendee taking these concepts back to the Gemba (Workplace) for immediate use.
By the end of this presentation, attendees will:
- Recognize the intrinsic value of Lean and Six Sigma approaches and how LIS integration of data and workflow is a key enabling component to facilitate their implementation
- Gain familiarity with effective methods of date extraction and data aggregation for both legacy and modern LIS systems
- Understand the use cases where data mirroring and transactional replication may be effective enabling tools
- Be familiar with the most likely targets in typical workflow to yield significant initial improvements in error reduction and productivity
- Have reviewed selected case studies
- Have reviewed effective project team constituencies and mission approaches
