SMART on the Agenda at AMIA 2012

The AMIA 2012 Annual Symposium begins today in Chicago, where it is currently “Informatics Week” as declared by Mayor Rahm Emanuel.

SMART will be highlighted in Scientific Sessions S27 & S33 on Monday and S94 & S99 on Wednesday, as well as in Poster Session 2 on Tuesday.

S27 Supporting Population Queries and Clinical Trials in i2b2 with SMART
Monday, November 5
Time: 1:45–2:05 pm (Full session till 3:15 pm)
Presenter: Shawn Murphy

Papers/Podium Presentations – Data Sharing for Research
Session Chair: Philip Payne
Theme: Clinical Research Informatics
Abstract: Informatics for Integrating Biology and the Bedside (i2b2) is one of the sponsored initiatives of the NIH Roadmap National Centers for Biomedical Computing. One of the goals of i2b2 is to provide clinical investigators broadly with the software tools necessary to collect and manage clinical research data in the genomics age as a cohesive entity—a software suite to construct and manage the modern clinical research chart. An important part of performing population queries is the ability to be sure that the query “gets it right.” This often requires looking at individual patients in order to see if they fit the profile that the query intended. The i2b2 software is a platform that is used to perform population queries at more than 60 sites nationwide. We are adding the capability to look at individual patients by putting i2b2 together with the Substitutable Medical Applications and Reusable Technology (SMART) platform. The SMART platform adds the capability to build classic Electronic Health Record (EHR) Patient Centric views with a set of Apps created by developers outside of the context of a single EHR system. The Apps exist in an ecosystem similar to the Apps on an iPad or iPhone. They are built in a competitive environment because they are substitutable into any SMART container, of which i2b2 has become one. Patient Centric Views of both Identified and De-identified information on individual patients is enabled by this integration.

S33 Building the SMART Platforms Ecosystem: Toward an Apps-based Health Information Economy
Monday, November 5
Time: 3:30–5:00 pm
Panel: Kenneth Mandl (Chair), Brian Athey, Daniel Fritsch, Shawn Murphy, Will Ross

Theme: Interactive Systems
Abstract: To succeed, health reform and accountable care must be underpinned by nimble and flexible information systems that evolve rapidly and can be readily modified and extended. The Substitutable Medical Applications, Reusable Technologies (SMART) Platforms project seeks to develop an iPhone-like health information technology platform with substitutable apps constructed around core services. It is funded by a grant from Office of the National Coordinator of Health Information Technology’s Strategic Health IT Advanced Research Projects (SHARP) Program. SMART technologies enable existing electronic health records, personal health records, and health information exchanges to run substitutable apps. Substitutability is the capability inherent in a system of replacing one application with another of similar functionality. We bring together innovators from three academic health systems, a health information exchange, and an apps vendor to discuss experience thus far with the SMART ecosystem across four axes, and to lead a discussion with audience members: (1) The philosophy of substitutable applications; (2) Approaches to SMART-enabling existing platforms; (3) Building an ecosystem of smart apps; (4) A national-scale vision for SMART.

S94 The Medical App Store, Research Data Repositories, and Physician Cognitive Overload: Uniting Three Large, Multisite Grants for Health Care Transformation
Wednesday, November 7
Time: 10:30 am – 12:00 pm

Panel: Jeffrey Klann (Chair), Adam Wright, Allison McCoy, Shawn Murphy
Theme: Clinical Informatics
Abstract: Several major challenges in healthcare informatics include: lack of infrastructure for clinical data sharing and large-scale analytics; obstacles to innovation in electronic health record (EHR) user interfaces; and, overwhelming volumes of information in the EHR through which physicians must sift. This panel presents work from three large projects to find solutions to these challenges, and it explores the benefits that accrue when all are integrated. Focal points of the panel include two of these integrations: connecting the i2b2 research data repository with the SMART medical app platform to improve clinical trial recruitment, and integration of patient-record summarization technology into SMART-enabled i2b2. Learning objectives for this panel: • Understand the challenges in clinical data sharing and analytics, and how i2b2 is enabling these goals. • Understand the SMART medical app platform and the ways it is synergistic with i2b2. • Explore the challenges related to physician cognitive overload and the physician-validated models being developed for automatic summarization. • Become familiar with the accrued benefit from integrating these three projects.

S99 Apps to Display Patient Data, Making SMART Available in the i2b2 Platform
Wednesday, November 7
Time: 10:50–11:10 am (full session 10:30 am – 12:00 pm)
Presenter: Nich Wattanasin

Papers/Podium Presentations – Interoperability and Information Exchange
Session Chair: TBA
Theme: Data Interoperability and Information Exchange
Also see Nich on Tuesday at Board 56 in Poster Session 2, 5:00–6:30 pm
Abstract: The Substitutable Medical Apps, Reusable Technologies (SMART) project provides a framework of core services to facilitate the use of substitutable health-related web applications. The platform offers a common interface used to “SMART-ready” health IT systems allowing any SMART application to be able to interact with those systems. At Partners Healthcare, we have SMART-enabled the Informatics for Integrating Biology and the Bedside (i2b2) open source analytical platform, enabling the use of SMART applications directly within the i2b2 web client. In i2b2, viewing the patient in an EMR-like view enables a natural-feeling medical review process for each patient.

In addition, during the 11:30–11:50 am segment of S99, the SMART project will be discussed as a case study, based on an assessment by SMART External Evaluator Dr. Patricia Brennan of UW–Madison and Project HealthDesign.

Guiding the Design of Evaluations of Innovations in Health Informatics: a Framework and a Case Study of the SMART SHARP Evaluation
Presenter: Edmond Ramly
Abstract: Development of health information systems innovations is necessary to create a better future for health and health care, but evaluating them is challenging. This paper examines the problem of evaluating health IT projects in which innovation is agile, adaptive, and emergent, and in which innovation diffusion and production are interlinked. We introduce a typology of mindsets for evaluation design that are typically used in health informatics: optimality, contingency, and usefulness, and make the case for a modularity mindset. We propose a model that shifts the unit of analysis from an evaluation as a whole, to specific modules of an evaluation, such as purpose, target, and methods. We then use retrospective participant observation to illustrate the approach using a case study: the ONC SHARP Harvard project developing the SMART platform. We find that the proposed modular approach to evaluation design provides a balanced alternative to standard archetypical designs on the one hand, and fully custom-made designs, on the other hand.

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