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CLINICAL INFORMATICS & PATIENT-CENTERED TECHNOLOGIES
events of interest
Healthcare Information and
Management Systems Society (HIMSS)
2018 Annual Conference & Exposition
March 5-9, 2018, Las Vegas, NV
American Nursing
Informatics Association (ANIA)
2018 Annual Conference
May 10-12, Orlando, FL
Welcome
Farewell
Faculty Spotlight
Scholarly Projects
Recent Publications
We would like to welcome you to the new academic year of the Clinical Informatics and Patient-Centered Technologies program. As we welcome our new cohort of 24 students and new faculty, we also wish a heartfelt goodbye to outgoing program Director Dr. George Demiris. During his tenure the program has witnessed substantial growth as a top-tier clinical informatics program. Incoming Co-Directors, Dr. Hilaire Thompson and Dr. Andrea Hartzler, look forward to continued success of the program and that of its amazing students.
Dr. Hilaire Thompson is the Joanne Montgomery Endowed Professor in the Department of Biobehavioral Nursing and Health Informatics. She has an adjunct appointment in the School of Medicine in the Department of Biomedical Informatics and Medical Education. Her research focuses on improving lives of older adults through injury prevention as well as use of technology to support aging in place.
Dr. Andrea Hartzler is an Associate Professor in the Department of Biomedical Informatics and Medical Education in the School of Medicine, where her research focuses on the human-centered design of collaborative health technologies. She is eager to meet new and continuing CIPCT students. Before joining the faculty at the University of Washington, Andrea was a scientific Investigator at Kaiser Permanente Washington Health Research Institute and conducted research embedded within the healthcare delivery system.
Even in this time of change locally and nationally, clinical informatics continues to be a critical priority in the U.S. with growing opportunities for professional development of clinicians
and informatics professionals. Virtual care, data exchange, analytics, and the learning healthcare system are just a few of the clinical informatics trends that are more important than ever for improving healthcare. We look forward to engaging in these and many other exciting topics in this academic year.
In our Fall Newsletter we celebrate the accomplishments and contributions of Dr. Demiris to CIPCT and learn more about our new faculty member, Dr. David Crosslin. We are looking forward to a productive academic year!
WELCOME MESSAGE
A message from CIPCT Directors Dr. Andrea Hartzler & Dr. Hilaire Thompson
Dr. Hilaire
Thompson
Dr. Andrea
Hartzler
CONNECT WITH UW CIPCT!
“UW Clinical Informatics
and Patient-Centered
Technologies CIPCT”
“UW Clinical Informatics and
Patient-Centered Technologies”
“UW CIPCT”
@cipct_uw
FAREWELL
Celebrating Dr. George Demiris
It is with sadness, yet exceptional gratitude, that we bid goodbye to program director Dr. George Demiris, who has accepted a position as the University of Pennsylvania’s 22nd Penn Integrates Knowledge University Professor, starting January 1, 2018. Dr. Demiris will hold joint appointments in the School of Nursing and the Perelman School of Medicine. For a news release about Dr. Demiris’ new appointment, visit: https://news.upenn.edu/news/george-demiris-appointed-penn-integrates-knowledge-university-professor
Please join us in congratulating Dr. Demiris on this incredible honor!
George has been the program director of the CIPCT program since 2007. After taking over the directorship, George sought and was awarded HRSA funding to convert the CIPCT program to a fully distance accessible degree program, to expand the program nationally. During his tenure as program director, the program has graduated 130 individuals and enrollment grew from 10 students to its current 55. In this timeframe, he chaired 35 MS-CIPCT student projects, co-chaired an additional 12, and served as advisor to many more. He shared his teleheath expertise with more than 150 students in NSG540/MEBI581 and NURS526 over this time period.
Dr. Demiris is a prolific author, publishing more than 150 (!) articles and book chapters related to informatics since 2007. In addition, he has received a number of awards and accolades, including two Excellence in Teaching Awards (from SoM-Biomedical Informatics department in 2011 and from the SoN in 2017), being named a fellow of the American College of Medical Informatics in 2011, and he was awarded fellowship in the Washington State Academy of Sciences in 2014. It is an honor to celebrate these accomplishments and contributions to the Clinical Informatics and Patient-Centered Technologies program. Dr. Demiris will be greatly missed and we are committed to continuing and building upon his strong legacy with the CIPCT program.
Q: What can our students do to best
position themselves for a career in
informatics?
Learn how to communicate your ideas, besides
having a strong foundation in math and
computing.
Q: Would you tell us a little about your
research interests?
My research is focused on the area of
translational bioinformatics, with a combination
of computational tools development and
bioinformatics research, specifically integrating
genomics data into the electronic health record
for clinical decision support.
Q: What advice would you give to a
student enrolling in CIPCT this autumn?
It is never too early to start working on your
writing skills.
Q: What courses do you typically teach in
the CIPCT program?
This will be my first time teaching NMETH 520,
Scholarly Inquiry for Nursing Practice in Clinical
Informatics, which is similar to a course I’ve
taught in the Department of Biomedical
Informatics and Medical Education.
Q: How do you see information
technology impacting the health care
world in the near future?
Having access to up-to-date interpretation of
genetic variation, prior clinical associations, and
molecular annotation will allow for more
informed decisions in genetic diagnostics, and
ultimately better patient outcomes. With
advances in biotechnology, bioinformatics
software, and molecular annotation tools,
genetic health service is becoming more
informed.
FACULTY SPOTLIGHT
About our faculty...
Dr. Crosslin’s academic and professional research experience have
been focused on statistical genetics and bioinformatics with
applications to complex diseases. His doctorate research in
Computational Biology and Bioinformatics at Duke University
focused on the central theme of modeling metabolic pathways
through dimension reduction techniques of genomics data to
understand the etiology of complex traits such as cardiovascular
disease. Along with his BIME faculty appointment, Dr. Crosslin has
an affiliate faculty appointment at the Kaiser Permanente
Washington Health Research Institute, and an adjunct faculty
appointment in Genome Sciences. Dr. Crosslin’s research program focuses on translational
bioinformatics with a combination of bioinformatics, statistical association analyses, and
computational tools development for applied research. Specifically, his research focuses on
integrating genetic data into the electronic health record (EHR) for clinical decision support
(CDS). All efforts will advance the national electronic health information infrastructure in support
of personalized medicine. Dr. Crosslin has been and will continue to be affiliated with one such
NHGRI effort; the Electronic Medical Records & Genomics (eMERGE) Network is on the forefront of
precision medicine and discovery using mined phenotypes, and has transitioned from discovery to
interpretation and integration into the EHR for CDS.
SCHOLARLY PROJECTS
The Evaluation of an Education Intervention on Accurate Nursing
Documentation
Inaccurate documentation of the start and end time of the intravenous drug
Zometa can drastically increase a patient's bill. The purpose of this scholarly
project was to evaluate the accuracy of nursing documentation of infusion
administration times before and after the implementation of a process
improvement initiative focusing on timely, complete, and accurate nursing
documentation. A sample of de-identified Zometa infusion treatment summaries
was extracted from the Hospital of the University of Pennsylvania's outpatient chemotherapy electronic
health record database during baseline incidence
period and post-implementation period. The
purpose of the proposed study was to examine the
incidence of inaccurate nursing documentation and
evaluate the efficacy of process improvement
measures using an uncontrolled pre-post design.
June 2017. Project Committee: Brenda Zierler (chair),
David Masuda
Cross Sectional Review of Provider Continuity, Quality and Access to Care
Measures in Primary Care Clinics in the Military Health System
Background: Key elements of Patient Centered Medical Home (PCMH) care model
include ongoing continuity with a primary care provider (PCP), enhanced quality of
care, and more timely access to care (ATC). The study used a new self-service
business intelligence portal to determine how PCP continuity in the context of the
PCMH is related to other
measures of quality, ATC
standards in a large network of
integrated primary care clinics in the Military Health
System.
Methods: For this cross-sectional analysis, data from
October 2016 from 285 Army primary care teams were
collected. The data include measures of PCP continuity,
Healthcare Effectiveness Data and Information Set
(HEDIS) metrics, and third next available appointments.
Data were studied using a Spearman correlation
coefficient test.
Graduating CIPCT students each complete a scholarly project as part of their degree requirements. This
section highlights our students’ scholarly project submissions over the last few quarters.
(continued on next page)
SCHOLARLY PROJECTS
Results: After controlling for clinic enrollment using a weighted means transformation of PCP continuity
rates, correlation testing showed that: (1) there was a small degree of statistically significant, negative
correlation with all five HEDIS measures used in the sample including screening for breast, cervical, and
colon cancer; diabetes; and Chlamydia (2) care teams serving predominantly active duty populations had
a significant negative correlation with PCP continuity and (3) There was no significant correlation between
PCP continuity and either acute or routine ATC.
Conclusion: The results of the research suggest that there needs to be further research on the causal
relationship between continuity and quality outcomes, with specific attention to the counterintuitive
negative correlation observed in this analysis. Self-Service BI is a critical element of ongoing process
improvement and clinical research.
June 2017. Committee: William Lober (chair), Ardith Doorenbos
A History of Public Health Nursing in Washington State
Some patients have difficulty accessing birth control and family planning services
because of proximity to clinic locations, lack of transportation, financial
constraints, or a reluctance to pursue in-person care. Telehealth services, such as
those available through the Planned Parenthood (PP) Care Application (App), have
the potential for improving access to healthcare. Through the Care App, patients videoconference with a
doctor or nurse practitioner and can receive birth control via mail, when appropriate.
The purpose of this study was to quantitatively evaluate retrospective data of the utilization rates and
patterns for PP Care App patients, and those who seek subsequent in-clinic care. The sample included
1417 women who used the Care App for visits
related to family planning services (birth control).
The majority of PP Care App visits were by White
women, and women between 20 and 29 years of
age. It was more common for Care App users to
have a subsequent Care App (261) visit than an in-
clinic visit (219), and the most common visit type
for patients who had a subsequent in-clinic visit
was for birth control.
May 2017. Committee: George Demiris (chair), Brenda
Zierler
Systematic Review of the Impact of Healthcare Predictive Analytics on
Clinical Outcomes, Clinical Decision-Making and Healthcare Organization
Performance
Purpose: To systematically review the literature for evidence of healthcare
predictive analytics’ (HPA) impact on outcomes, decision-making and organization
performance.
(continued on next page)
(continued from previous page)
SCHOLARLY PROJECTS
Methods: An electronic literature search of PubMed, CINAHL, Web of Science and Business Source
Complete (BSC) databases was conducted for articles published from January 2010-January 2017. The
keywords for all database searches were (predictive analytics) OR (machine learning). The BSC search
also included AND (healthcare) to exclude non-healthcare industry results. All studies evaluating the
impact of HPA on performance, outcomes or decision-making were considered.
Results: Database searches returned 41382 unique articles and 257 of these required detailed abstract
review. Subsequently, 16 articles were retrieved for full article review. Five articles were deemed eligible.
The eligible articles focused on high-acuity service over-utilization and operations management
optimization. The studies focusing on operations
management demonstrated mixed results while
the studies focusing on high acuity services
demonstrated a reduction in over-utilization, but
were of variable quality and bias risk.
Conclusion: Applied HPA research is in its early
stages and there is insufficient high-quality
evidence to assert that HPA has significantly
impacted clinical outcomes, clinical decision-
making and organizational performance. Further
work may be needed to gain additional insight into
HPA’s impact across healthcare domains.
May 2017. Committee: Peter Tarczy-Hornoch (chair),
Fredric Wolf
Bloodworks NW Ergonomics Assessment Database
The goal of this scholarly project was to create an ergonomics database for
Bloodworks NW employees that serves as a sub-program to the organization’s
safety department. The database can be utilized to help reduce the organization’s
rates of injuries as well as drive down costs associated with preventable
musculoskeletal disorders. In partnership with the organization’s safety committee
and leadership team, a coordinated effort was be made to determine the essential
necessary components of the database that best suits the needs of the employees and users of the
program. The Bloodworks NW Ergonomics Assessment Database, created using Microsoft Access,
provides members of the safety committee a tool that can aid in onsite assessments of an employee’s
working environment. Additionally, the database has a variety of components such as queries, search
functions, tables, macros, forms and reports that work in unison to provide a feature rich user
experience which can be utilized by those individuals who operate the program to perform assessments.
Upon implementation of the program, Bloodworks NW safety committee members were able to utilize a
system specifically designed to help streamline and manage ergonomic assessments, reports, and
additional documentation for every employee who undergoes an assessment.
August 2017. Committee: George Demiris (chair), Meliha Yetisgen
(continued on next page)
(continued from previous page)
SCHOLARLY PROJECTS
Development of a Web Based Educational Module for Clinicians to Improve
Communication Around Pain Management In Hospice
During end-of-life care, family caregivers often find themselves in difficult
circumstances where they must provide emotional, financial and pain
management support to loved ones. During this period family caregivers are faced
with a multitude of variables that clinicians rarely address leaving these individuals
without dedicated resources to assist with their challenges and concerns. This
project aimed to close that gap by prototyping a web based educational resource
for providers focusing on the challenges caregivers face managing pain for loved ones. Using iterative
design, faults were identified throughout internal testing and adjustments made in order to prepare the
website for general testing by end-users such as
clinicians and social workers. The module provides
scenarios about pain management along with
assessment questions, potential actions items and
follow-up. Further analyses will determine the impact
of this module on communication surrounding pain
management in the hospice setting.
May 2017. Committee: George Demiris (chair), Hilaire
Thompson
(continued from previous page)
WELCOME AUTUMN 2017 CIPCT COHORT!
Back row: Kirsten Kincaid, Layla
Zagey, Yazan Kader, Matthew
Binder, Olivia Condotta, Nathan
Whetten, Akande Tokunbo,
Hardeep Bhamipuri, Reza
Sadeghian, Derek Rueber
Middle Row: Frine Santiago,
Kristina De la Cruz, Micaela
Davilar, Natalie Donahue,
Amanda Cox, Kathleen Estrada,
Lauren Pike, Barbara Presley,
Jayte Boehler
Front Row: Laura Roberts,
Madeline Lowry Woods, Jordana
Frenck, Nicholas Sich, Lauren
Mikell, Justin Stewart
Berry ABL, Lim C, Hartzler AL, Hirsch T, Ludman E, Wagner EH, Ralston JD. Creating Conditions for Patients' Values to Emerge in Clini-
cal Conversations: Perspectives of Health Care Team Members. DIS (Des Interact Syst Conf). 2017 Jun;2017:1165-1174.
Boston-Fleischhauer C, Rose R, Hartwig L. Cross-continuum Care Continuity: Achieving Seamless Care and Managing Comorbidi-
ties. J Nurs Adm. 2017 Jul/Aug;47(7-8):399-403.
Boston-Fleischhauer C. Consumer-Centric Care: Latest Buzzword or New Reality? J Nurs Adm. 2017 Nov;47(11):532-534.
Chi NC, Demiris G, Pike KC, Washington K, Oliver DP. Pain Management Concerns From the Hospice Family Caregivers' Per-
spective. Am J Hosp Palliat Care. 2017 Jan 1:1049909117729477.
Chi NC, Sparks O, Lin SY, Lazar A, Thompson HJ, Demiris G. Pilot testing a digital pet avatar for older adults. Geriatr Nurs. 2017 May 4.
pii: S0197-4572(17)30106-4.
Cho H, Iribarren S, Schnall R. Technology-Mediated Interventions and Quality of Life for Persons Living with HIV/AIDS. A Systematic
Review. Appl Clin Inform. 2017 Apr 12;8(2):348-368.
Chung J, Ozkaynak M, Demiris G. Examining Daily Activity Routines of Older Adults Using Workflow. J Biomed Inform. 2017 May 18. pii:
S1532-0464(17)30107-7.
De R, Verma SS, Holzinger E, Hall M, Burt A, Carrell DS, Crosslin DR, Jarvik GP, et al. Identifying gene-gene interactions that are highly
associated with four quantitative lipid traits across multiple cohorts. Hum Genet. 2017 Feb;136(2):165-178.
Evans HL, Lober WB. A Pilot Use of Patient-Generated Wound Data to Improve Postdischarge Surgical Site Infection Monitoring. JAMA
Surg. 2017 Apr 19.
Fletcher GS, Payne TH. Selection and Implementation of an Electronic Health Record. PM R. 2017 May;9(5S):S4-S12.
Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR, Leu MG, Powers ME, Rea C, Samuels J, Simasek M, Thaker VV,
Urbina EM. Subcommittee on Screening and Management of High Blood Pressure in Children: Clinical Practice Guideline for Screening
and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017 Sep;140(3). pii: e20171904.
Hall AK, Backonja U, Painter I, Cakmak M, Sung M, Lau T, Thompson HJ, Demiris G. Acceptance and perceived usefulness of robots to
assist with activities of daily living and healthcare tasks. Assist Technol. 2017 Nov 29:1-8.
Han CJ, Lee YJ, Demiris G. Interventions Using Social Media for Cancer Prevention and Management: A Systematic Review. Cancer
Nurs. 2017 Jul 27.
Hartzler AL, Osterhage K, Demiris G, Phelan EA, Thielke SM, Turner AM. Understanding views on everyday use of personal
health information: Insights from community dwelling older adults. Inform Health Soc Care. 2017 Apr 11:1-14.
Holzinger ER, Verma SS, Moore CB, Hall M, De R, Gilbert-Diamond D, Crosslin DR, et al. Discovery and replication of SNP-SNP interac-
tions for quantitative lipid traits in over 60,000 individuals. BioData Min. 2017 Jul 24;10:25.
Iribarren S, Siegel K, Hirshfield S, Olender S, Voss J, Krongold J, Luft H, Schnall R. Self-Management Strategies for Coping with
Adverse Symptoms in Persons Living with HIV with HIV Associated Non-AIDS Conditions. AIDS Behav. 2017 May 9.
Iribarren SJ, Ghazzawi A, Sheinfil AZ, Frasca T, Brown W 3rd, Lopez-Rios J, Rael CT, et al. Mixed-Method Evaluation of Social Media
-Based Tools and Traditional Strategies to Recruit High-Risk and Hard-to-Reach Populations into an HIV Prevention Intervention Study.
AIDS Behav. 2017 Nov 9.
Jones GT, Tromp G, Kuivaniemi H, Gretarsdottir S, Baas AF, Giusti B, Strauss E, Crosslin DR, et al. Meta-Analysis of Genome-Wide As-
sociation Studies for Abdominal Aortic Aneurysm Identifies Four New Disease-Specific Risk Loci. Circ Res. 2017 Jan 20;120(2):341-353.
Kalet AM, Doctor JN, Gennari JH, Phillips MH. Developing Bayesian networks from a dependency-layered ontology: A proof-of-
concept in radiation oncology. Med Phys. 2017 Aug;44(8):4350-4359.
Kelly CM, Van Eaton EG, Russo JE, Kelly VC, Jurkovich GJ, Darnell DA, Whiteside LK, Wang J, Parker LE, Payne TH, Mooney SD, Bush N,
Zatzick DF. Technology Use, Preferences, and Capacity in Injured Patients at Risk for Posttraumatic Stress Disorder. Psychiatry. 2017
Fall;80(3):279-285.
Khelifi M, Tarczy-Hornoch P, Devine EB, Pratt W. Design Recommendations for Pharmacogenomics Clinical Decision Support
Systems. AMIA Jt Summits Transl Sci Proc. 2017 Jul 26;2017:237-246. eCollection 2017.
Kneale L, Mikles S, Choi YK, Thompson H, Demiris G. Using scenarios and personas to enhance the effectiveness of heuristic usa-
bility evaluations for older adults and their care team. J Biomed Inform. 2017 Sep;73:43-50.
Lavin K, Davydow DS, Downey L, Engelberg RA, Dunlap B, Sibley J, Lober WB, Okimoto K, Khandelwal N, Loggers ET, Teno JM, Curtis
JR. Effect of Psychiatric Illness on Acute Care Utilization at End of Life From Serious Medical Illness. J Pain Symptom Manage. 2017 May 9.
pii: S0885-3924(17)30181-1.
RECENT PUBLICATIONS
Key: CIPCT Faculty in bold; CIPCT students in bold italics.
(Continued on next page)
Lee CJ, Devine B, Tarczy-Hornoch P. A Knowledge-based System for Intelligent Support in Pharmacogenomics Evidence Assessment:
Ontology-driven Evidence Representation and Retrieval. AMIA Jt Summits Transl Sci Proc. 2017 Jul 26;2017:175-184. eCollection 2017.
Lim CY, Berry ABL, Hirsch T, Hartzler AL, Wagner EH, Ludman EJ, Ralston JD. Understanding What Is Most Important to Individuals
with Multiple Chronic Conditions: A Qualitative Study of Patients' Perspectives. J Gen Intern Med. 2017 Dec;32(12):1278-1284.
Luo G, Stone BL, Johnson MD, Tarczy-Hornoch P, Wilcox AB, Mooney SD, Sheng X, Haug PJ, Nkoy FL. Automating Construction
of Machine Learning Models With Clinical Big Data: Proposal Rationale and Methods. JMIR Res Protoc. 2017 Aug 29;6(8):e175.
Mavroudis CD, Seung Kim D, Burnham N, Morss AH, Kim JH, Burt AA, Crosslin DR, et al. A vascular endothelial growth factor A genetic
variant is associated with improved ventricular function and transplant-free survival after surgery for non-syndromic CHD. Cardiol
Young. 2018 Jan;28(1):39-45.
Mosley JD, Shoemaker MB, Wells QS, Darbar D, Shaffer CM, Edwards TL, Crosslin DR, et al. Investigating the Genetic Architecture of
the PR Interval Using Clinical Phenotypes. Circ Cardiovasc Genet. 2017 Apr;10(2). pii: e001482.
Oliver DP, Washington K, Demiris G, Wallace A, Propst MR, Uraizee AM, Craig K, Clayton MF, Reblin M, Ellington L. Shared decision
making in home hospice nursing visits: A qualitative study. J Pain Symptom Manage. 2017 Nov 8. pii: S0885-3924(17)30625-5.
Rohrer Vitek CR, Abul-Husn NS, Connolly JJ, Hartzler AL, Kitchner T, Peterson JF, Rasmussen LV, Smith ME, Stallings S, Williams MS,
Wolf WA, Prows CA. Healthcare provider education to support integration of pharmacogenomics in practice: the eMERGE Network
experience. Pharmacogenomics. 2017 Jul;18(10):1013-1025.
Sakaguchi-Tang DK, Bosold AL, Choi YK, Turner AM. Patient Portal Use and Experience Among Older Adults: Systematic Review. JMIR
Med Inform. 2017 Oct 16;5(4):e38.
Schmidt AF, Swerdlow DI, Holmes MV, Patel RS, Fairhurst-Hunter Z, Lyall DM, Crosslin DR, et al. PCSK9 genetic variants and risk of
type 2 diabetes: a mendelian randomisation study. Lancet Diabetes Endocrinol. 2017 Feb;5(2):97-105.
Turner AM, Facelli JC, Jaspers M, Wetter T, Pfeifer D, Gatewood LC, Adam T, et al. Solving Interoperability in Translational
Health. Perspectives of Students from the International Partnership in Health Informatics Education (IPHIE) 2016 Master Class. Appl
Clin Inform. 2017 Jun 20;8(2):651-659.
Walker AJ, Lewis FM, Al-Mulla H, Alzawad Z, Chi NC. Being Fully Present: Gains Patients Attribute to a Telephone-Delivered Parenting
Program for Child-Rearing Mothers With Cancer. Cancer Nurs. 2017 Jun 7.
Washington KT, Demiris G, Oliver DP, Purnell G, Tatum P. Quality Hospice Care in Adult Family Homes: Barriers and Facilitators. J Am
Med Dir Assoc. 2017 Sep 30. pii: S1525-8610(17)30479-6.
Washington KT, Guo Y, Albright DL, Lewis A, Parker Oliver D, Demiris G. Team functioning in hospice interprofessional meetings: An
exploratory study of providers' perspectives. J Interprof Care. 2017 Apr 13:1-8.
RECENT PUBLICATIONS
Key: CIPCT Faculty in bold; CIPCT students in bold italics.
(Continued from previous page)
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May 1st
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