Annual Reflections at the End of 2020

Since the inception of this blog in 2009, I have ended each year with a post reflecting back on the year. In the early years, a good deal of the focus of this blog was on the HITECH Act, especially its workforce development provisions. Later on, there were other topics such as the clinical informatics subspecialty and emergence of data science. And many more.

And now, the end of 2020, which has been a year like no other. The COVID-19 pandemic has upended our lives and society. It has not only created a public health emergency, but also uncovered other fault lines in our society, from systemic racism to political leadership more focused on personal aggrandizement than solving real problems in society.

Despite these challenges, other aspects of 2020 were successful. From a professional standpoint, my research and educational work barely missed a beat. I mostly publish as a senior author these days, and my name appeared in that position in a number of publications. I maintained my educational work as well, not only directing the OHSU Biomedical Informatics Graduate Program but also adding teaching that was needed to fill in for lost opportunities in the pandemic, especially for medical students.

I spent a fair amount of time in 2020 trying to reflect on gratitude, especially the value of the continuity of family and friends. There is no question that having a lifetime of friends and colleagues made the (hopefully temporary) transition to virtual life more tolerable. While life on the other side of COVID-19 will no doubt be different, I do look forward to returning to in-person interaction and being able to travel.

This all said, I am optimistic going into 2021. Vaccines are being rolled out, starting first with frontline workers and high-risk populations and then later to the rest of us. A new US political leadership promises a return to decision-making based on science and human dignity. And the need for the research and education in informatics will be needed more than ever.

Kudos for the Informatics Professor - Summer/Fall 2020 Update

You might not know it from the presence of the COVID-19 pandemic, but I was quite busy and productive since being relegated to virtual work since mid-March of 2020. In the last of my periodic kudos postings, I described all of what I accomplished in the first half of 2020, some of which took place during the early dark days of the pandemic. In the rest of 2020, I have published a number of scientific papers and book chapters as well as given a number of talks, some in distant places, albeit virtually.

Here is a list of papers published in the latter half of 2020:

• Chamberlin SR, Bedrick SD, Cohen AM, Wang Y, Wen A, Liu S, Liu H, Hersh WR, A query taxonomy describes performance of patient-level retrieval from electronic health record data, Health Search and Data Mining Workshop, Web Search and Data Mining (WSDM) Conference, 2020.
• Roberts K, Alam T, Bedrick S, Demner-Fushman D, Lo K, Soboroff I, Voorhees E, Wang LL, Hersh WR, TREC-COVID: rationale and structure of an information retrieval shared task for COVID-19, Journal of the American Medical Informatics Association, 27: 1431-1436.
• Cohen A, Chamberlin S, Deloughery T, Nguyen M, Bedrick S, Ko JJ, Amin J, Wei A, Hersh W, Detecting rare diseases in electronic health records using machine learning and knowledge engineering: case study of acute hepatic porphyria, PLoS ONE, 15: e0235574.
• Fultz Hollis K, Roberts K, Bedrick S, Hersh WR, Addressing the search challenges of precision medicine with information retrieval systems and physician readers, Studies in Health Technology and Informatics, 2020, 270: 813-817.
• Chamberlin SR, Bedrick SD, Cohen AM, Wang Y, Wen A, Liu S, Liu H, Hersh WR, Evaluation of patient-level retrieval from electronic health record data for a cohort discovery task, JAMIA Open, 3: 395-404.
• Liu S, Wang Y, Wen A, Wang L, Hong N, Shen F, Bedrick S, Hersh W, Liu H, Implementation of a cohort retrieval system for clinical data repositories using the Observational Medical Outcomes Partnership Common Data Model: proof-of-concept system validation, JMIR Medical Informatics, 8(10): e17376.
• Gray TR, McFarlane C, Finch M, Fuchs JM, Hersh W, Clouse J, Incentivizing change within social determinants of health using blockchain technology, Frontiers in Blockchain, 3: 10.3389/fbloc.2020.00040.

I also published a number of book chapters in the second part of this year (in addition to my own book, and stay tuned for some chapters in other books coming in the near future):

• Hersh W, Public Health in the Larger Context of Biomedical and Health Informatics, in Magnuson JA, Dixon B (eds.) Public Health Informatics and Information Systems, 3^rd Edition, New York: Springer, 2020, 31-41.
•  Hersh W, Online Continuing Education in Informatics - the AMIA 10x10 Experience, in Berner ES (ed.), Informatics Education in Healthcare: Lessons Learned, 2^nd Edition, New York: Springer, 2020, 251-262.
•  Hersh W, Open Educational Resources in Informatics, in Berner ES (ed.), Informatics Education in Healthcare: Lessons Learned, 2^nd Edition, New York: Springer, 2020, 277-285.

Here is a list of talks given since my last kudos posting:

• The Informatics Workforce and its Certification in the United States - XV Jornadas de Informática en Salud - Hospital Italiano Annual Conference, Buenos Aires, Argentina (virtual), November 3, 2020
• Impact of COVID-19 on Digital Health and Health Informatics - CBIS '20 - XVII Congresso Brasileiro de Informatica em Saude, Sao Paulo, Brazil (virtual), December 8, 2020
• The Informatics Response to COVID-19 - OHSU Department of Medicine Grand Rounds, Portland, OR, December 8, 2020

As noted earlier this year, I was elected President of the International Academy of Health Sciences Informatics (aka, The Academy). Since then, OHSU featured a posting about it and I had a chance to represent the Academy in a panel with the World Health Organization and its Director General Dr. Tedros Adhanom Ghebreyesus. The panel took place on December 16, 2020 and was entitled, Digital Health during COVID-19: Opportunities and Challenges. One of the topics I spoke on was the need for training and competence in informatics for both informatics as well as healthcare professionals.

 

As the pandemic relegated our educational program recruitment to virtual form, I had the opportunity to be featured with other faculty and students in promotional videos for our informatics educational programs:

• Our Master of Science (MS) program that offers thesis and non-thesis options for two majors: Health & Clinical Informatics and Bioinformatics & Computational Biomedicine. This program trains individuals to pursue a wide variety of professional careers in healthcare, industry, research, public health, and other settings.
• The OHSU Biomedical Informatics PhD program that prepares individuals for careers in research also in two areas: Health & Clinical Informatics and Bioinformatics & Computational Biomedicine. Most students in the program are supported through our NIH National Library of Medicine T15 Training Grant. (This training grant also offers funded postdoc positions for those seeking research careers who already have a doctoral degree in other field.)
• Our Clinical Informatics Subspecialty Fellowship that trains physicians aiming to become board-certified in the new subspecialty of clinical informatics. The ACGME-accredited fellowship requires certification in a primary specialty and offers the option of pursuing the MS degree.

I am pleased that 2020 turned out to be an academically productive year for me, but I am more than eager to return to normal living as vaccination and herd immunity are achieved for COVID-19 in 2021.

Next Year, Immune

There is a famous line at the end of the Jewish Passover Seder, Next year in Jerusalem. While some interpret the phrase literally, to most it means that next year the community will be together and stronger, no matter where in the world everyone is.

As the current COVID-19 pandemic rages out of control, there are some signs of hope. Two vaccines have been approved and are being rolled out across the country and the world. While I am envious of friends who are posting pictures of themselves getting their first injection on social media, I am content to wait my turn in line, as I am not a frontline clinician or other frontline worker, nor do I have co-existing medical conditions that would put me at higher risk for complications if I were to get infected with SARS-CoV-2. I will wait my turn, although I will show up in a heartbeat when my number is called, which I anticipate will be in the spring or summer of 2021.

In the meantime, while we are all waiting to get our vaccine shots, there are other things we can and should be doing, such as wearing masks and social distancing. I have lent my endorsement to another effort, signing my name on to a letter calling for the development of cheap, rapid, and frequently administered antigen tests. The idea of these tests is that if we all test frequently, we can learn if we are infectious and self-quarantine. These tests do not have same sensitivity and specificity as PCR tests, but they are much faster and cheaper, and tend to be positive when one is actively infectious. If we all used these simple paper-strip tests a couple times a week, and just as importantly, self-quarantined when positive, we could keep the virus at bay until we all have herd immunity from the vaccine.

Despite this being one of most challenging years in the history of many of our lives, I look to the future with an optimistic eye. The toll of COVID-19 has been devastating, not only to those who have perished but also the devastated economy and disruption of education, especially for children. But in the end, science will prevail and, over time, the worst of the pandemic will be behind us.

I feel fortunately in having always lived a relatively virtual work life, as noted in this blog last year, and I have had little trouble staying productive in the pandemic. But that does not mean that I miss going into the office, or attending conferences and other events. I am fortunate enough to have a lifetime of friends and colleagues, and keeping in touch with them by social media, videoconferencing, and the like has been easy. I am sure it is different for those without such a long time to build interpersonal bonds, such as those earlier in their careers.

Thus I do look forward to having immunity to SARS-CoV-2, or at least the COVID-19 disease that it causes. I look forward to seeing my family, friends, and colleagues again, and getting to once again visit the world. Travel will likely be different on the other side, not only due to the pandemic but also due to climate change, but I am confident I will again visit so many wonderful people and places around the world.