Informatics in the Round – Details, episodes & analysis

Live from the studio, it's Informatics in the Round! Okay, we aren't technically live, but we are bringing you an extra special episode from the Penn Engineering Online studio! Since all our guests are from the University of Pennsylvania, we thought we would sit down in-person to enjoy this lively discussion. Today we are talking all about chatbots and the future of generative AI in medicine. We discuss topics such as what chatbots are, whether they present the markers of true artificial intelligence, what innovations we are looking forward to, and the benefits and barriers to integrating them into our healthcare settings. 

First, we had Dr. Angela Bradbury, an Associate Professor of Medicine and a medical ethicist at the University of Pennsylvania. She is also founder of the Penn Telegenetics Program, a national program using telehealth and digital tools to increase access to genetic medicine. Her research program has been developing patient-centered digital tools, including chatbots, to address the use of genetics in medicine and a limited genetics workforce. As a medical ethicist, she is particularly interested in how we responsibly deploy digital tools and generative AI in medical practice to improve patient outcomes.

We also had Lyle Ungar, a Professor of Computer and Information Science at Penn. He researches the psychological dimension of natural language processing and artificial intelligence. His research group of psychologists and computer scientists study what language reveals about physical and mental well-being. They are building culturally aware chatbots for mental health support and teaching "soft skills" to high school students.

Finally, we had Chris Callison-Burch, a Professor of Computer and Information Science whose AI course at Penn has one of the highest enrollments at the university with about 750 students. His research focuses on applications of large language models to address long-standing challenges in artificial intelligence. He’s a leading expert on AI and has appeared in front of Congress as well as on many podcasts to discuss the future of generative AI and intellectual property. We are so grateful to have all these expert guests on this episode and in the room with us!

Oh, and we had a guest star hosting this episode—Ellie Shuert, our production assistant, stepped out from behind the scenes. She is freshly graduated from the University of Pennsylvania with a degree in English and Linguistics. Her curiosity about AI and natural language processing gave our guests lots to think about, and it was so fun to let her direct an episode.

Thank you so much to Penn Engineering Online for hosting us in your beautiful studio space! It was the perfect place to enjoy this conversation. If you are listening, we suggest maybe going over to our YouTube channel to watch us film in such a cool space!

This is truly one of our favorite episodes of the year, and we are so excited to share it with you!

Make sure to follow our Instagram, X, Threads, and TikTok accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd. You can find us wherever you typically get your podcasts. Thanks for listening!

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Welcome, everyone, to your introductory course in public health informatics! On today's episode, we discuss all things public health, including what it is, how it varies on a state and national level, and how health departments respond to public health crises. We demystify some of our misconceptions about how the public health system works, like how state departments are separate from the CDC, how we share disease statistics such as during the COVID-19 pandemic, and how our medical history may or may not travel with us from state to state. Of course, our question always is, why does informatics matter in this conversation? Our guests have many ideas about how we can utilize informatics to create more efficient means of sharing data and, by extension, improving our overall public health.

Dr. Bryant Thomas Karras is the Chief Medical Informatics Officer at the State of Washington Department of Health and a faculty member at the University of Washington's School of Public Health. He is a physician, biomedical engineer, and informatician who uses his multifaceted experience to promote interoperability and help various agencies utilize new technologies in their public health efforts. He's advised health departments on a local, state, and national level, including the Center of Disease Control and Prevention and the U.S. Department of Health and Human Services.

Dr. Jessie Tenenbaum is an Associate Professor at Duke University School of Medicine, and she recently concluded a five-year tenure as the Chief Data Officer for the North Carolina Department of Health and Human Services. Her work focuses on enhancing data-driven decision-making to improve public health outcomes and finding AI methods to improve whole person health. She's served on the editorial board for the Journal of Biomedical Informatics, on AMIA's Board of Directors, and on the Board of Scientific Counselors for the National Library of Medicine, all while advocating for women in STEM and precision medicine efforts. We were so thankful to have both of these experts on this episode!

Last but not least, we were joined by a new guest—Lauren Malloy joined us as a co-host for this episode. Lauren is the administrative coordinator for the Artificial Intelligence for Ambulatory Care Innovation Laboratory at the University of Pennsylvania, which investigates how technology can address healthcare challenges. Her insights into how public health issues manifest in our daily lives were invaluable, and we were honored to have her as a guest star!

We hope you enjoy this episode as much as we did filming it!

"Cheat Sheet" to the acronyms discussed in this episode:

-AMIA: American Medical Informatics Association

-APHL: Association for Public Health Laboratories

-CDC: Center for Disease Control and Prevention

-CDO/CIO/CMIO: Chief Data Officer, Chief Information Officer, Chief Medical Informatics Officer

-ECR: electronic case reporting

-EHR: electronic health record

-EIS: Epidemic Intelligence Service

-IIS: Immunization Information System

-IPS: International Patient Summary (Canada)

-HHS: Department of Health and Human Services

-NPI: National Patient Identifier, also National Provider Identifier

-PPRL: Privacy Protecting Record Linkage

-VCI: verifiable clinical information

Make sure to follow our Instagram, Twitter, Threads, and TikTok accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd. You can find us wherever you typically get your podcasts. Thanks for listening!

Instagram: @infointhernd

Twitter: @infointhernd

Threads: @infointhernd

TikTok: @infointhernd

Website: https://www.kevinbjohnsonmd.net/

This episode, ST and I cover one of the hottest non-COVID topics in healthcare today.  We strike at the heart of clinician burnout and in particular issues related to unnecessary documentation.

Our guests today were discovered by Sam Butler from Epic, who invited them to present their incredible work at a national meeting where I was an attendee. I  thought this was work that needed to get noticed as quickly as possible. And so we decided to develop this podcast to discuss what they’ve been doing.

Dr. Heidi Twedt is Associate Chief Medical Information Officer, UW Health, and Clinical Professor of the division of General Internal Medicine at the University of Wisconsin in Madison.

Dr. Peter Kleinschmidt is the Medical Informatics Director of Quality and Safety and Assistant Professor in the division of General Internal Medicine at the University of Wisconsin.

The two of them have developed an entire program dedicated to reducing the length and complexity of physician documentation.  As they tell us during the episode, it's simple to implement technically, but, as one might imagine, very challenging to make "sticky" from a change management perspective. 

By the way, here's a link to a presentation by Heidi and Peter for those who want to hear more about this.

This promises to be an incredibly informative podcast for most of us.,  If there was anything learned from the pandemic, it was the importance of data and helping most of us track SARS CoV2 prevalence wherever we traveled when we traveled, as well as to manage vaccine compliance within specific regions or states.  Health information exchange was vital to many public health organizations. And our speakers today were front and center during the pandemic, as well as in some cases, decades before the pandemic, evangelizing this technology for the rest of us. We’ll hear from them and discuss both what health information exchange is and what health information hubs could be going forward. I learned a ton during this podcast. I hope you enjoy it.  ST Bland and I are proud to introduce you to three guests:

Brian Dixon is a Professor at Indiana University Richard M. Fairbanks School of Public Health and a world expert on the public health information ecosystem, including how things are accomplished and the information or tech used to accomplish them.

John Kansky is President and CEO at Indiana Health Information Exchange in Indianapolis, which is arguably the exemplar for health information exchanges around the world.

Morgan Honea is Executive VP of Contexture an IT services and consulting group in Denver and CEO of CSRI, the Consortium for State and Regional Interoperability, as well as CEO of CORHIO. The Colorado Regional Health Information Organization.

Hello and welcome to Informatics in the Round,  a podcast designed to help everyone become a part of the dialog about topics in biomedical informatics. 

I’m Kevin Johnson, a physician and informatics researcher at the University of Pennsylvania. @kbjohnsonmd on Twitter, www.kevinbjohnsonmd.net on the web! 

The overturning of Roe v. Wade has had a significant impact on our country. What many may not realize is the impact it might have across all of the health care system as we know it, including the informatics community.  However, this episode will enlighten us all about this, and, unfortunately, will probably make a few people lose sleep.

We are joined in this episode by Professor Bradley Malin, Accenture Professor of Biomedical Informatics, Biostatistics, and Computer Science, as well as Vice Chair for Research Affairs in the Department of Biomedical Informatics.  He is one of the world’s experts on data privacy, having invented or helped to debunk myths around the most common approaches used to protect electronic medical records from use or to facilitate safe data sharing.  He is an elected fellow of the National Academy of Medicine (NAM), the American College of Medical Informatics (ACMI), the International Academy of Health Sciences Informatics (IAHSI), and the American Institute for Medical and Biological Engineering (AIMBE).  In addition, he was honored as a recipient of the Presidential Early Career Award for Scientists and Engineers (PECASE) from the White House.

Brad is joined by Dr. Ellen Wright Clayton, JD, MD. Ellen is an internationally respected leader in the field of law and genomics who holds appointments in Pediatrics and in Health Policy at VUMC, and in the Law School as well as the Center for Biomedical Ethics and Society at Vanderbilt University. Ellen has helped to develop policy statements for numerous national and international organizations, including the Public Population Project in Genomics, Human Genome Organization, Council of International Organizations of Medical Sciences, the American Society of Human Genetics, and the American Academy of Pediatrics.

Ellen has worked on a number of projects for the Institute of Medicine (now the National Academy of Medicine) and is currently a member of its National Advisory Council, director of its Board on Population Health and Public Health Practice, and the Report Review Committee. For her service, she received the David P. Rall Medal from the IOM in 2013.  

In addition to these amazing guests, we’re excited to have ST Bland, a leader in Vanderbilt’s Center for Precision Medicine here, as well as Jane Bach, an extremely successful “performing” songwriter in Nashville. Jane is joined again by Jeanie McQuinn of http://www.greatbigrivermusic.com, a partner with Jane in songwriting. 

This episode of IIR focuses on the functions we want in our EHR portals, including some research into some surprising new uses for portal information.

Our special guest is a brilliant young faculty member from Johns Hopkins. Kevon-Mark Jackman is a Dr.PH and MPH, and an assistant professor of pediatrics, in adolescent medicine. We met a few months ago, and I thought it would be fun to discuss some of what he’s doing with EHR patient portals with the group.

Sarah Bland, a leader in Vanderbilt’s Center for Precision Medicine is here, as is Jane Bach, an extremely successful “performing” songwriter in Nashville. Jane is joined by Jeanie McQuinn, a partner with Jane in songwriting. They go back many years—Jeanie was a huge fan of Jane’s,  as you’ll hear, and now work with her from time to time.  You’ll get to hear from all of them discussing Kevon’s work, as well as work that still needs to be done to improve the use of patient portals. 

During the episode, we made reference to the following work/people:

• Special shout-out to Deborah Estrin, whose work on breadcrumbs informed our "wish list" for interoperability. Her TED talk on the topic is here: https://www.youtube.com/watch?v=lAEhSGYEHWU
• Jeanie's production company is Great Big River Music. Check them out!
• Jane has a new project that hasn't been formally announced, but you can follow her on https://janebachmusic.com/

In this episode of Informatics in the Round  we have a small but MIGHTY team.

Sarah Bland, a leader in Vanderbilt’s Center for Precision Medicine is here, and offers her usual insight coupled with wit!

We’re happy to introduce you all to Dr. Jesse Ehrenfeld, who is the Senior Associate Dean and Director of the Advancing a Healthier Wisconsin Endowment, and Professor of Anesthesiology Medical College of Wisconsin.  But wait, there’s more. Jesse is chair of the American Medical Association Board of Trustees, a commander in the U.S. Navy and combat veteran,  the head of perioperative informatics at Vanderbilt before leaving for Wisconsin, and so much more.  

All the guests today have one or more non-heteronormative characteristics on our “problem list.”  We’re all in the SOGI remarkable group.  We are all in the LGBTQ+ tribe.  We’re all gay!

Our topic for this conversation focuses on the inclusion of LBGTQ+ data in the EHR.  In case you’re wondering how we can fill 50 minutes on that topic, suffice it to say that we had more than enough material. By the way, did I mention that Jesse was the former director of the Vanderbilt Program for LGBTQ Health, that he’s been a staunch supporter of LGBTQ+ rights, and has been at the center of much of the knowledge now published about the unique health requirements of patients who identify as LGBTQ+.   Oh, and then there’s his book, Lesbian, Gay, Bisexual, and Transgender Healthcare: A Clinical Guide to Preventive, Primary, and Specialist Care.  

Hello and welcome to Informatics in the Round,  a podcast designed to help everyone become a part of the dialog about topics in biomedical informatics. 

I’m Kevin Johnson, a physician and informatics researcher at the University of Pennsylvania. @kbjohnsonmd on Twitter, www.kevinbjohnsonmd.net on the web! 

In this episode of Informatics in the Round  I’m joined by a half dozen guests.  

• Sarah Bland, a leader in Vanderbilt’s Center for Precision Medicine is here, along with her son Bradley.
• Dr. Yaa Kumah Crystal, a clinical informatics expert and role model for African American women, is here with her son Jude.
• Jane Bach (songwriter and storyteller extraordinaire) is here
• Shannon Rich (my very smart and very courageous friend) is here.

Why all these guests? Because today’s topic is all about me and my new Children’s book called Who, Me? I’m a Biomedical Informatics Expert Now.  It’s part of a series that Professor David Weintraub, Professor Ann Neely, and I are producing. 

I want to warn you that the guests ask me some very personal questions that I answer honestly. It might not be for everyone’s tastes. But that’s what the fast forward button is for. 

Anyway, I hope you learn a bit about me, and about my journey from this episode.

We end with a wonderfully fitting song for this episode, written by Jane Bach and sung by Jo Dee Messina:  Dare to Dream. https://www.youtube.com/watch?v=pg2aF1z9myw. Thanks for letting me end with such great music!

Hello and welcome to Informatics in the Round,  a podcast designed to help everyone become a part of the dialog about topics in biomedical informatics. 

I’m Kevin Johnson, physician and informatics chair at Vanderbilt. @kbjohnsonmd on twitter, www.kevinbjohnsonmd.net on the web! 

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In this episode of Informatics in the Round, we get some follow-up information.  A few episodes back, Dr. Trent Rosenbloom led a discussion about impending changes and a lot of national concern about a statutory response to information blocking that has resulted in patients having immediate access to clinical encounter summaries but also lab results.  We were wrapped in anticipation of the fallout from implementing this change, and have eagerly awaited hearing from a patient and from Trent.  So….

Here we are! Digging into the aftermath. The nuclear option, or tempest in a teapot?

Trent is Professor of Biomedical Informatics, nursing, medicine and pediatrics. He directs the Vanderbilt patient portal, known as MyHealthatVanderbilt.   MyHealth for short.  He’s also an avid runner, with his own marathon.  Here's a link to his marathon:   https://www.harpethhillsmarathon.com/

Sarah Bland is a regular guest on this podcast. By day, she’s a senior project manager and all around funny person, but, as you’ve been learning and will hear more about today…she has layers.  She’s also at Vanderbilt.

We were able to get a friend of Trent's, a geek, and a musician all in one in the form of Karl Kersey.  Karl’s band, Doonthebray, represents yet another form of music in Music City. And then there's Karl—He’s low key, with a wonderful dry wit, and asks the hard questions. Trent didn’t disappoint. He knows this stuff, and had great information to share both in response to questions we asked during the episode, and questions other listeners will undoubtedly be asking. 

https://www.facebook.com/doonthebrae

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By the way, tell a friend about the podcast. I’d love to get our listenership over 5K, and I need your help. If you have suggestions or ideas, hit me up on Twitter @kbjohnsonmd, or if think tweeting is for twits, email me at kevin1061@comcast.net. I love hearing from you!

In this episode, we talk in a bit more honest detail about clinician burnout and the role electronic health records are playing in taking the joy out of health care for some professionals, and in the case of some patients, making it completely unclear what is changing with their own health.

For those of you who are regular listeners to this podcast, you’ll recall that our last episode focused on the issue of women in health. We’re joined by that team again.

• Allison McCoy is an assistant  professor of biomedical informatics at VUMC, 
• Sarah Bland is a senior project manager and all-round funny person, also at VUMC
• Suzie Brown Sacks was a special guest on both episodes.  She’s a terrific storyteller, as we’ve come to learn, and uses those stories to illustrate her life in podcasts, and in song.

We had two other special guests on this episode:

• Sarah Collins Rossetti  Assistant Professor of Biomedical Informatics and Nursing, Columbia University
• Mollie Hobensack,  Doctoral Student, National Institute of Nursing Research Predoctoral Trainee, Columbia University School of Nursing

You can find more music from Suzie Brown here:  https://www.suziebrownsongs.com/

You can find out more information about the 25 x 5 effort here: https://www.dbmi.columbia.edu/25x5/

You can find out more about Clickbusters here:  https://www.vumc.org/vclic/clickbusters