Searching Patient Data:
A Role for Librarians in the
Improvement of Healthcare
Margaret Henderson, MLIS, AHIP
Tompkins-McCaw Library
How it all started:
Practicum Project
"To improve patient outcomes, proactively identify
chronic and high-risk patients in this new
environment, and effectively manage their financial
performance, healthcare organizations must be able
to provide analytics at the point of service and rely
on historical and longitudinal data to manage
patient populations.”
Health Research Institute (2012). Needles in a haystack: Seeking knowledge with clinical
informatics. http://www.pwc.com/us/en/health-industries/publications/needles-in-ahaystack.jhtml.
The Biomedical Informatics Core (BIC) of the Center for
Clinical and Translational Research (CCTR) supports
research with various data services.
i2b2
Informatics for Integrating Biology & the Bedside
•
•
•
•
•
Name of the software and an NIH-funded National Center
for Biomedical Computing based at Partners HealthCare
System in Boston, MA.
Software is open source and modular.
Developed for
translational research.
Doesn’t require IRB approval to
use at VCU
www.i2b2.org
Ontologies used in i2b2
Librarians know ontologies!
• International Classification of Diseases, Ninth Revision,
Clinical Modification - ICD9-CM
• Logical Observation Identifiers Names and Codes - LOINC
• National Drug Code - NDC
• Systematized Nomenclature of Medicine – Clinical Terms SNOMED-CT
Various places to find these on the Internet for further study.
Could be used to reinforce use of MeSH.
I2b2 Interface
Clinical Data Warehouse
CALL BOB!!!!
Health Facts
• Cerner product
• HIPAA-compliant database collected from
participating clinical facilities
• De-identified, real-world data
• Especially helpful for comparative effectiveness
research on drugs
How can we help?
Physicians must be dutiful.
The ability to retrieve (from electronic databases and other
resources), manage, and utilize biomedical information for
solving problems and making decisions that are relevant to
the care of individuals and populations.
Medical School Objectives Project. Report I. Learning Objectives for Medical Student
Education: Guidelines for Medical Schools. AAMC. January 1998.
Role of Researcher
1. Determine what data exist relative to a clinical question or
formal hypothesis, demonstrating the following:
a. The ability to use information technology to locate
existing data sources.
b. Knowledge of data sources …at one’s own institution…
c. The ability to locate existing data sets not maintained at
one’s own institution…
Medical School Objectives Project. Report II. Contemporary Issues in Medicine: Medical
Informatics and Population Health. AAMC. June 1998.
Be Aware of EHR Data Problems
• Clinicians don't always document everything.
• Billing codes aren't always the best description of
problem.
• Too many variations of disease names.
• Coding errors.
• Narrative versus structured data.
Published Uses of EHR Data
Open Data
Library and information professionals:
• need to become more involved with semantic
web or users will reinvent wheel (i.e. ontologies)
• have the interpersonal and subject specialization
for reference/consultation that IT doesn't have
Stuart, David.(2011) Facilitating Access to the Web of Data: a Guide for
Librarians. Facet Publishing.
Look for Health Data Everywhere
Questions?