1998 AMIA Annual Fall Symposium Family Practice/Primary Care Working Group Mini-Conference

Introduction

This page presents the program and selected proceedings of the 1998 American Medical Informatics Association Family Practice/Primary Care Working Group Mini-Conference. The mini-conference program was assembled and hosted by Dr. Robert Price. It took place from Nov 10 to 11 at Buena Vista Palace, Orlando, Florida.

Proceedings for the full AMIA 1998 conference are available from AMIA. Proceedings for this mini-conference are only available through this web site. A video summary of the presentations is being prepared by Dr. Price.

Hyperlinked presentation titles link to HTML presentations. Author name may link to author home pages. When applicable, links to PowerPoint presentations and zipped handouts follow the presentation titles. (See File Downloads.)

Mini-Conference Program/Proceedings

Day 1: Tuesday, November 10

8:30 – The "First Annual H. C. Mullins Primary Care Medical Informatics Keynote Address"
Speaker Introduction: John Zapp, M.D
Speaker: Kathleen McCormick, Ph.D.

This "First Annual H. C. Mullins Primary Care Medical Informatics Keynote Address" will provide a vision for primary care medical informatics. The emphasis of this first address will be placed on the role of primary care medical informatics research. The speaker will outline the research agenda for primary care informatics, and the potential relationships between participating agencies, organizations, and corporations.

9:15 - Seminar: Successful Implementation of the Electronic Medical Record
Seminar Moderator: Sam McGuire, M.D.

"Building the Infrastructure: The First Step for the EMR"
Speaker: Nancy Clark, M.Ed. PowerPoint 97 Slides, Handouts.

"Planting the Seeds - Getting Started: The Pitfalls and Sharks"
Speaker: Meredith Goodwin, M.D. PowerPoint 97 Slides

"Organizing and Managing for the EMR: The Plan is Key"
Speaker: John Zapp, M.D. PowerPoint 97 Slides

"Implementation: The Tallest Mountain"
Speaker: Robert D. Price, Ph.D. PowerPoint 97 Slides

This seminar will present the fundamental issues of a successful implementation of an electronic medical record. The seminar faculty will present the various key topics—from building an infrastructure, through evaluation and selection, and finally to the implementation process. Seminar faculty will respond to each other as well as to participant questions and issues. Guidelines and pitfalls will be identified. Seminar handout materials will be provided which participants can use in their individual settings.

Day 1: Afternoon - Conference Moderator, Robert Hausam, MD Chair Elect, Working Group

1:00 – "Implementation of the EMR in the Enterprise Environment: Or ‘What Page of the Music Are You On"?
Speaker: Sam McGuire, MD

Implementation of the EMR in the enterprise is difficult at best. Coping with the political, organizational, technical and financial issues are usually overwhelming for anyone involved in such a project. Dr. McGuire will present a plan for the implementation of the EMR in twenty enterprise-wide clinics.

1:30 – "Web Robots and Portable Web Documents with AvantGo and PalmPilot/WinCE Devices".
Speaker: John Faughnan, MD, MS

The PalmPilot is a preeminent example of "ubiquitous computing". It is a special-purpose device, optimized for ubiquity rather than general computing, and designed around size, price, and power constraints. AvantGo is a novel compound application made up of a web robot and HTML processing engine and a custom document viewer. The viewer is available for WinCE and Palm devices, the robot can run either on a personal Win95/98/NT desktop or (version 2) on a IIS 4.0/NT server. This lightweight presentation shows how both of these devices can be combined with a traditional web-based personal document archive in novel and useful ways.

2:00 – "Research - What's the Plan, Where is the Money?"
Speaker: H. C. "Moon" Mullins, MD

A Working Group committee has been developing a "White Paper’ on primary care medical informatics research over the last year. Dr. Mullins will present the results of this work and facilitate a discussion regarding the paper.

3:30 - " Getting Our Act Together": An Initial Discussion
Moderator: Kathleen McCormick, Ph.D

Panel:
Michael Fitzmaurice, Ph.D, AHCPR
Len Fromer, MD, AAFP
Susan Rehm, AAFP
Ed Hammond, Ph.D, AMIA
Glyn Hayes, M.B.Ch.B. D.R.C.O.G. F.B.C.S., Great Britain, IMIA
Blackford Middleton, MD, MedicaLogic
Andrew G. Ury, MD, Physician Micro Systems
H.C. Mullins, MD, Working Group
John Zapp, MD, Working Group

A panel to initiate a discussion for devising a cohesive strategy between the technology organizations, primary care specialties, international groups, vendors and the Government to help better educate and motivate primary care providers to use technology.

Day 2: Wednesday, November 11

Day 2: Morning - Conference Moderator - David Quillen, MD & Charles Sneiderman, MD 

8:30 – "The EMR And the Internet - Where Are We?"
Speaker: Robert Elson, MD, MS. PowerPoint 97 Slides

High startup and maintenance costs in the face of uncertain benefits have slowed the diffusion of clinical information technology (IT) into ambulatory care settings. Emerging intranet technologies, including IP networks, Web browsers and servers, the Java programming language, and CORBA, can reduce the cost of deploying and maintaining clinical IT in distributed ambulatory settings. Deferred pricing strategies (i.e. subscription fees, as opposed to up-front licensing) and subsidization afforded by transaction fees paid by other trading partners (e.g., reference labs, pharmacy benefit managers, and payors) make this approach even more attractive. Moreover, Web-based approaches are more suitable than traditional client-server EMR solutions for the connectivity required for information flow in complex multi-payor practice settings. This talk will review the state of the art of ambulatory care information services based on Web technologies, as well as the status of the rapidly evolving marketplace for such services.

9:00 – Teaching Primary Care Medical Informatics for the Future
Panel Moderator: Meredith Goodwin, MD.
Panelists:

Nick Booth, MA MB BS MRCGP DCH. Specialist Registrar Informatics Teaching in the UK - the SCHIN Experience
PowerPoint 97 Slides

Sheila Teasdale, MMedS. Collection of Health Data from General Practice: Training, Training, Training
PowerPoint 97 Slides

Jacob M. Reider, MD

Meredith Goodwin, MD Medical Informatics at Brown, or Do Medical Students Really Use Computers?
PowerPoint 97 Slides

Don Nelson, MD A Residency Informatics Curriculum
PowerPoint 97 Slides

The panelists, along with the moderator, will present the current state of teaching medical informatics to students, residents, medical school faculty and community-based practitioners. Various curriculum models will be presented along with unique teaching techniques, teaching materials and resources for the support of an informatics curriculum.

9:45 – "Security and Confidentiality For the Primary Care Office: The Potential Role of Java Technologies in Providing the Infrastructure"
Speaker: Alan Zuckerman, MD. PowerPoint 97 Slides

This presentation will focus on the challenges of implementing the Clayton Report "For the Record" in the primary care setting. It will discuss the role of Java technologies in providing encryption for client server systems, Java smart cards and other embedded devices and their potential role as security devices, and the role of the Web in supporting security and confidentiality initiatives in primary care.

10:15 – "Innovations From Across the Pond - The International Report"
Panel Moderator: Sheila Teasdale, MMedSci. (UK)

Panelists:

Mike Bainbridge, B.Med.Sci. B.M. B.S. MRCGP CBCS (UK). Primary Care Computing - UK and Europe.
PowerPoint 97 Slides

Pieter Houwink, MD (Netherlands) Ruminations from a waterlogged country. Structuring IT in Holland
PowerPoint 97 Slides

Mike Bainbridge will present current work in primary care informatics from the UK and Europe, including a discussion of communication issues and methodologies. Pieter Houwink will present the view of the Netherlands, including the long-standing work of this group with the EMR and other informatics activities. Sheila Teasdale will then lead a discussion on how we can best learn from each other in order to take what is best from each country while avoiding making the same old mistakes.

10:45 – "I Had (And Still Have) a Dream "
Panel Moderator: Robert D. Price, Ph.D.

Panelists:
Andrew Ury, M.D. - Physician Micro Systems
Blackford Middleton, M.D. - MedicaLogic
W. Ed. Hammond, Ph.D. - The Medical Record

Three outstanding leaders in medical informatics will discuss their vision. These individuals have been true visionaries with the electronic medical record, and as a group represent many years of experience with the EMR. Each speaker will outline the vision from which their work and products have developed, how they see the future of EMR development, and the role of the successful company in helping to define utilization of the EMR.

Notes

• File Downloads: For obscure reasons having to do with server configurations and MIME types (sorry you asked?), it works best to have binaries "zipped". If you've never unzipped a file, you probably need some techie help at this point. Bring some fatty snack to your resident nerd.