In the initial plenary session, Health Informatics was defined as "the science and practice around information in health that leads to informed and assisted healthcare". For me, this was a great reminder that IT in general is typically the means, not the end. While some of the presentations were highly scientific, I enjoyed them nonetheless and found that I could relate to them because health is a field where I think there is a natural affinity - we've all been a patient after all.
The first sessions I went to were presented by NeHTA, where they provided update on their work in Clinical Terminologies, Secure Messaging and Health Identifiers. From these presentations it sounded that NeHTA would offer some middleware to the medical software industry, but the details weren't clear to me from the presentations. Heather Grain from eHealth Education in Victoria gave a demo of a research technology called SmartTermer to take clincian shorthand (it was claimed to be natural language - didn't seem natural to me!) and map to the SNOMED standard terminology. It was a very interesting demo. From this session I also learned that:
- the specifications for Secure Messaging will be submitted to Standards Australia by the end of the month
- the initial release of the UHI service will not allow for wildcard searches (portrayed as a privacy measure)
Chris Bain presented "Informatics at the Frontier of healthcare management". The key point I took out of this presentation is to remember that implementing a system is a socio-technical activity. As a technologist it is sometimes easy for me to forget the "socio" aspect. It was an effective point, simply made.
Peter Croll and Tony Sara presented a primer on Security and Privacy. I had seen this type of presentation before from Peter. It's a great primer and does help security professionals understand what makes for the unique security and privacy challenges in this sector. Some of the real use cases presented highlighted the harmonization challenges very well.
Michael Gill (Cisco) and George Margelis (Intel) presented "Making a direct link between mobility and improved clinical outcomes". This described a trial at Robina Hospital for new mobile workstations (Mobile Clinical Assistant). One nice thing I picked up was a clean way to categorize the various mobility models:
- Walk around
- Wheel around
- Walk and dock
One other aspect was raised around the use of classic notebook computers in a health context, from a hygeine perspective. I never thought of this but after cleaning out my keyboard before writing this blog entry I got the point. Yuck!
One of the first keynotes was from Prof. Ronald Tomkins of the Harvard Medical School. He spoke about his work in the treatment of burns. It was a very medical presentation and I felt lost most of the time. But I did learn what these three phrases mean:
Thank you, Wikipedia!
Senator Stephen Conroy also delivered a keynote. He spoke about the NBN as an enabler for e-Health. He quoted a study from iSOFT that said that the NBN could pay for itself twice over with the e-Health benefits alone. Senator Conroy also made references to the report from Access Economics commissioned by IBM.
Following on the back of Senator Conroy was Laurence Paratz from ACACIA. He reminded us that outcomes come from the applications not the infrastructure itself. This was a reminder of the definition of Health Informatics given to us at the start of the conference.
Dr Louise Ryan from CSIRO described the rising importance of visualization of data as the way to create information with context. In IBM's Smarter Planet terms, this is what allows us to reach "intelligent" from "intrumented and interconnected". Dr Ryan gave an example around some swine flu data. Part of this was how Google flu trends mapped closely to, and was ahead in predicting the same trend identified by the CDC for the spread of swine flu. Dr Ryan also quoted Hal Varian, Google Chief Economist on the subject of statistcs. Believe it or not, statisticians will hold the "sexy" jobs of the 2010s. Mind you, Hal also considered computer engineering the sexy jobs of the 1990s. I never knew the public thought of me that way :)
Janette Bennett from BT Healthcare talked about her experiences with "Reliable, Secure, Confidential and Safe Integrated Healthcare Record Sharing" in the UK, Hungary and elsewhere. The UK system integrated software from 185 vendors. Interestingly, there was a belief that approximately 80% of the system was constructed from custom code. Janette stated that maintaining unique identifiers is an ongoing activity, not a one-time process. An interesting observation on data quality is that it is necessary to embed the traits of accountability and responsibility for data quality at the individual level. In Hungary, it was also noted that the system did not have unique identiifiers for citizens.
Howard Pai from the British Columbia Cancer Agency talked about a trial using e-health for a set of prostate cancer patients in Canada. This allowed participants to view data and general clinical information via a web site.Some of the results of the survey given to the participants were as follows. 65% thought that the security and privacy of their information was preserved. Yet, there was a much higher percentage for general contentment with the trial and 100% of participants would recommend the trial to others.
Nicola Shaw from University of Alberta talked about privacy and eHRs in Canada. By her own ommission, she raised questions, not answers. Nicola quoted a study (I didn't note the reference) that said that a number of US doctors would rather retire than adopt electronic health records. That was an interesting way to state the challenge.
The conference was punctuated at the second of the second day with a gala dinner at Parliament House. It was a very well attended event and it was my first time back in the seat of government in Australia since I went there as a student in the 1980s.
Peter Fleming, CEO of NeHTA gave a key note on the last morning. Peter emphasised collaboration above all, particular when it came to the change management aspects of the e-Health transition that NeHTA is stewarding. This session generated the most interaction from the audience of all key notes, which made it clear how passionate people are on the subject of the work that NeHTA has been brought together to address. Peter spoke of the efforts to restructure NeHTA work products for improved consumability. For example, information about a particular work stream is available in a high level format (e.g. one pager) through to the more detailed specifications.
Chris Hockings and I were scheduled to present our poster sessions on the last afternoon. It would have been nice to have had the presenters a little more spaced out so that individual conversations could have been less subject to ambient noise. On the positive side, there was interest in our work and the work of the people scheduled at the same time which helped to create the buzz around the display screens.
In the final plenary session, James Kavanaugh from Microsoft spoke spoke about cloud computing and how it might be applied in the e-Health context. One clever aspect of the economics of cloud that he shared was around hardware maintenance for systems that compose a cloud. For example, containers full of servers are only serviced from a hardware perspective when more than 10% of the servers require it. A simple idea enabled by the mass virtualization that cloud can offer.
Overall the conference was a great event (inter-disciplinary from my perspective). It is surely a challenge when the material to draw upon is so broad but I think the organizers did a good job given that challenge. As with the first time at any conference, I came away with wide open eyes and lots of ideas on how to get even more out of the event next year.