Health reform ruling punctuates AMDIS meeting

Veteran informaticist Dr. Scott Weingarten took to the podium right after breakfast to announce that the healthcare reform had been upheld.

The Supreme Court decision had hit the media maybe an hour earlier that morning, so it was not breaking news, even in California, where the Zynx Health co-founder and CEO and former director of health services research at Cedars-Sinai Medical Center in Los Angeles, was the day's first speaker at the 21st annual Physician-Computer Connection Symposium, hosted by the Association of Medical Directors of Information Systems in Ojai, Calif.

Weingarten's announcement was met with brief, polite applause from a majority, but clearly not all, of those 200 or so physician/information technology leaders in attendance. AMDIS Chairman Dr. William Bria dismissed the rather tepid response as a more of referendum on President Barack Obama than the reform proposal itself.

Two projects updated at the symposium are worthy of note.

One involves a team led by Dr. Joel Shoolin, vice president of clinical information for the Advocate Healthcare system based in Oak Brook, Ill., to produce an AMDIS-approved set of guiding principles for electronic documentation.

A controversial proposal, both at the symposium and in a previous dialogue on the AMDIS listserv, deals with whether the traditional structure of a portion of the medical record—the subjective/objective/assessment/plan, or SOAP note—should be revised. One idea is to have the assessment and plan elements of the note come into view in an EHR first (dubbed the APSO format)—once the initial note is created in the standard SOAP format.

Shoolin said the goal of the group is to have a white paper written with the group's findings and published within a month or two.

Also making a presentation of interest was Dean Sittig, professor in the School of Biomedical Informatics at the University of Texas, Health Sciences Center, and a co-principal investigator on a project to assess patient-safety events and malpractice liability stemming from the implementation of electronic health-record systems.

Sittig produced for review and discussion a list of the "Top 20 Ways to Improve Safety of an EHR-enabled Work System." He wasn't ready to publish the list, but asked that anyone interested in contributing to the effort join in at a wiki put up for that purpose.

Among the recommendations under review are the creation of a governance structure, including creating the position of health information technology safety officer, “to provide oversight and accountability for HIT safety.”

Slides of many of symposium presentations are available at the AMDIS website.

Follow Joseph Conn on Twitter: @MHJConn.