Friday, November 20, 2020

Assuming the Presidency of the International Academy of Health Sciences Informatics

One of the most enjoyable aspects of my work in biomedical and health informatics is the opportunity to interact with colleagues from around the world. As I wrote early on in the history of this blog, informatics is a field of global truths. Countries may have different healthcare systems and different resources for information technology, but informatics is driven across the planet by the goal of using information and data to improve all aspects of health and healthcare. Those of us in the academic portion of the field are also driven by research to push the boundaries of what can be done and by education to disseminate knowledge to current and future practitioners, researchers, and leaders in the field.

It is from this perspective that I am gratified to have been elected President of the International Academy of Health Sciences Informatics, or the Academy for short. I am assuming this role from my esteemed colleague and friend, Dr. Reinhold Haux, who has served as the Inaugural President of the organization. My main disappointment in starting my role is that I will need to do so virtually due to the COVID-19 pandemic. I would much prefer to have been in attendance with my friends and colleagues from around the world at the Plenary session of the Academy this weekend in Hamamtsu, Japan.
The Academy was established in 2017 by the International Medical Informatics Association (IMIA). As noted on its Web site, the Academy "serves as an honor society that recognizes expertise in biomedical and health informatics internationally. Academy Membership is one of the highest honors in the international field of biomedical and health informatics.  The Academy will serve as an international forum for peers in biomedical and health informatics. The Academy will play an important role in exchanging knowledge, providing education and training, and producing policy documents, e.g., recommendations and position statements.” With the recent election of the Class of 2020, there are now 179 fellows from around the world, diverse in their gender, ethnicity, and nationality.

I have had the pleasure of participating in almost all of the plenary sessions of the Academy so far. I am also guided by the vision for the Academy as published by Dr. Haux [1, 2] as well as the strategic focus document by the initial Board that was recently published [3]. I will draw on the latter document as a launching point activities of the fellows. My guiding principles will be to organize working groups accountable to the larger Academy and to be collaborative and non-duplicative with other informatics organizations and efforts. I look forward to this exciting two-year journey.
1. Haux, R., 2018. Visions for IAHSI, the International Academy of Health Sciences Informatics. Yearb Med Inform 27, 7–9.
2. Haux, R., Ball, M.J., Kimura, M., Martin-Sanchez, F., Otero, P., Huesing, E., Koch, S., Lehmann, C.U., 2020. The International Academy of Health Sciences Informatics (IAHSI): IMIAs Academy is Now Established and on Track. Yearb Med Inform 29, 11–14.
3. Martin-Sanchez, F., Ball, M.J., Kimura, M., Otero, P., Huesing, E., Lehmann, C.U., Haux, R., 2020. International Academy of Health Sciences Informatics (IAHSI): Strategy and Focus Areas, 1st Version. Yearb Med Inform 29, 15–25.

Friday, November 13, 2020

A Fall Conference Year Like No Other

A staple in my life each fall, dating back to 1986, is my annual attendance of what is now called the AMIA Annual Symposium. This year marks my 35th consecutive year of participation. I first attended this meeting when it was still called the Symposium on Computer Applications in Medicine Care (SCAMC).  I was a third-year internal medicine resident at the time, seeking to learn more about the field and how to pursue training in it. Since 1986, I have never missed this meeting each fall.

Of course, the 2020 version of the AMIA Annual Symposium will be like no other. We are in the midst of the COVID-19 pandemic, so like most scientific meetings in 2020, this year's meeting will be virtual. That won't keep me from attending all the meeting's usual events, including the opening session, the induction of fellows (of both ACMI and AMIA), the leadership gala dinner, the association business meeting, numerous scientific sessions, and the closing session. I will also conduct another staple AMIA activity of mine I have been doing since 2005, which is the in-person session that culminates the 10x10 course and will take place virtually this year. Finally, I will be making an appearance at the Oregon Health & Science University (OHSU) virtual booth in the Career Expo portion of the Exhibit Hall (see image below)

Although many activities will be recast in virtual format, there will be others not taking place that I will miss. My colleagues in AMIA are among my best friends in the world. Although my academic work interdigitates with a number of scientific fields, in the end, my primary field is informatics and the AMIA symposium is where the field all comes together. The social aspects of the meeting, from formal activities to hallway conversations, are what makes this meeting most special. I have often joked that walking across the hotel lobby at the meeting usually takes as much as an hour, stopping to say hello to so many friends and colleagues, one after another. And waving hello to so any others riding in opposite directions on the hotel escalators. AMIA also has among the greatest staff for professional organizations, with great longevity and institutional knowledge for putting on great meetings.

Another meeting I have attended almost every fall that typically occurs in proximity to AMIA is the Text Retrieval Conference (TREC). I attended the first TREC meeting in 1992 and have missed a few over the years, but otherwise have attended almost all of them. It has been gratifying to contribute to the leadership of the series of biomedically-oriented information retrieval challenge evaluations. At the 25th anniversary of TREC in 2016, I enjoyed giving an overview talk on all of the biomedical tracks up to that time (starting at just past 50 minutes into the Part 3 of the recorded Webcast). As with AMIA, the social aspects and hallway conversations are also what makes attending the meeting so enjoyable.

Some years I have had to made compromises with AMIA or TREC when they have been the same week but in different cities. Like AMIA, the TREC meeting will be virtual this year as well, and actually spread out over the entire week that also includes AMIA. But one upside to both conferences being virtual is that I can jump back and forth between the meetings.

These virtual conferences come on the heels of some of the early results of COVID-19 vaccines being released in the news media. I do hope that next year at this time, I will have immunity to SARS-CoV-2 as I attend in person both the AMIA and TREC meetings. We will see in retrospect that turns out to be wishful thinking.

Wednesday, November 11, 2020

15 Years of 10x10 ("Ten by Ten")

I like to believe that I have made many contributions to the field of biomedical and health informatics over the years, but I suspect the one that will most define my legacy in the field is the conceptualization and implementation of the first and still flagship course of the American Medical Informatics Association (AMIA) 10x10 program. This year marks the 15th year of the course, which has been completed by over 2700 people, dating back to 2005.

For me, the 10x10 course fulfills the three criteria of the Jim Collins' Good to Great hedgehog. I am passionate about the course as a way to disseminate knowledge of the informatics field. I also believe I am well-skilled in my ability to cover the important areas of the field, making them understandable, and giving the big picture and context of why they are important to biomedicine and health. And finally, the course has a revenue stream that enables me to devote a significant amount of my work time to teach it and keep it up to date.

I have always enjoyed teaching at the introductory level, introducing people to the field. The introductory course that comprises 10x10 came from an introductory course I first taught in the MPH program at Oregon Health & Science University (OHSU), Public Health 549, starting in the early 1990s. When we launched our informatics master’s degree program in 1996, that course became Medical Informatics 510 and it has served as the introductory course (now called Biomedical Informatics 510, or BMI 510) in our Biomedical Informatics Graduate Program to this day. The course has also been taken by students in other disciplines, including medicine, nursing, basic biomedical sciences, public health, and more.

I maintain a Web page that describes the course. It includes a link to the AMIA site where one can register for the next offering. I recently updated my chapter about the course in newly published second edition of Eta Berner's informatics education in healthcare book (Hersh W, Online Continuing Education in Informatics - the AMIA 10x10 Experience, in Berner ES (ed.), Informatics Education in Healthcare: Lessons Learned, 2nd Edition, New York: Springer, 2020, 251-262).

It would probably be a fascinating study to do a word analysis of my slides in the course. It would be interesting to see when various terms came into being used, such as “health information exchange” or “machine learning,” and which ones have faded away, such as “meaningful use.” It might also be interesting to see terms whose frequency have decreased and re-emerged over time, such as “artificial intelligence.” The image below shows a word cloud of the syllabus of the latest offering of the course.
The 10x10 course came about when then-President of AMIA Charles Safran called in 2005 for at least one physician and one nurse in each of the 6000 or so hospitals in the US to be trained in informatics. He asked directors of informatics education programs such as myself how many more students their programs could take. Many said they could increase 2-3 fold. However, as OHSU had already been teaching online since 1999, I told him that with enough lead time, we could expand and educate “all of them.” Rounding off some numbers, I came up with the name 10x10, indicating we could train 10,000 people by the year 2010. Ten thousand people did not show up, although I genuinely believe we could have handled that many with enough advance planning.

We also structured the 10x10 course so that those wanting to get academic credit for the OHSU BMI 510 course and pursue further study in the OHSU Biomedical Informatics Graduate Program. About 10-15% of those taking the course have chosen this option, pursuing the OHSU Graduate Certificate or Master of Science degree. Two of them ended up working all the way to a PhD. Others transferred the credits to educational programs at other institutions.

I offer the course three times a year with AMIA, with the four-month course starting each December, April, and July. The course includes an optional face-to-face session at the end of the course, where those completing the course meet those they have been studying with for the last several month and present their small course projects. I also provide special offerings with other groups, such as the American College of Emergency Physicians and Gateway Consulting in Singapore. The latter has been offered with my colleague KC Lun, PhD and includes 310 of the course's 2700 graduates. I have enjoyed my many trips to Singapore for the in-person session at the end of the course and have come to know the country, its stellar healthcare system, and its strong health IT environment well. I have also provided offerings in Thailand, Israel, Saudi Arabia, United Arab Emirates, and South Africa.

The 10x10 course is part of the fabric of my career. I have an offering of the course running almost all the time and do not foresee stopping this activit I enjoy so much any time soon. I am gratified that it has been an entry point into the informatics field for many of them.