Many health care providers are overloaded with information. And more is coming. At The University of Texas School of Health Information Sciences at Houston (SHIS), research trainees are learning how to address the many issues raised by the explosion in e-information.

SHIS recently received a 5-year, $1.3 million grant from the Agency for Healthcare Research and Quality (AHRQ) to teach six young investigators how to conduct research in health information technology (Health IT). Four of the positions have been filled.

"There is a huge move to use health information technology to improve health care," said Todd R. Johnson, Ph.D., the grant's principal investigator and co-director, and associate dean for academic affairs at the UT School of Health Information Sciences. "The problem is that the current technology is not designed to efficiently support the information needs of clinicians. As a result, there have been many cases where the introduction of health information technology resulted in a decrease in efficiency and an increase in medical errors."

An Institute of Medicine (IOM) report estimates that as many as 44,000 to 98,000 people die in hospitals each year as a result of medical errors and that medical errors cost the nation about $38 billion a year.

"Most medical errors are caused in part by information overload," said Eric Thomas, M.D., co-director of the training grant, director of the University of Texas-Memorial Hermann Center for Healthcare Quality and Safety and the Griff T. Ross Professor in Humanities and Technology at The University of Texas Medical School at Houston. "People are trying to process an enormous amount of information."

The trainees are working on projects designed to increase patient safety.

One of the trainees, Mona Sawhney, M.D., is focusing on how best to design information communication systems so that physicians don't miss patients' abnormal test result notifications. "Some doctors receive more than 60 to 70 alerts per day of various types of notifications and prioritizing them can be a challenge. Here is where system design can help," she said.

Another, Roxana Maffei, M.S.N., R.N., wants to improve emergency room decision making. "Presently, the information needed to make these decisions is buried in medical charts or must be obtained by talking to several other clinicians," Johnson said. "She's working on an information dashboard that could be used to improve clinician decision making about how to allocate their time among patients and other activities, such as charting and viewing labs."

Joshua C. Goodwin is using radio identification technology to track the movements of both emergency room personnel and supplies. "The data will be analyzed to understand decision making, behavior, resource allocation and medical error occurrence in the emergency department," he said.

Nnaemeka Okafor, M.D., said, "My project is to use information from simulation studies to develop an IT solution that will improve the effectiveness and timeliness of clinical decisions in the emergency room. The goal is to reduce the risk of diagnostic errors associated with the top chief complaints," he said.

The trainees are working with researchers at other Texas Medical Center institutions through the Gulf Coast Consortia, which is administering the grant. The consortia is comprised of the Baylor College of Medicine, Rice University, University of Houston, The University of Texas Health Science Center at Houston, The University of Texas Medical Branch at Galveston and The University of Texas M. D. Anderson Cancer Center.

The trainees also will receive instruction from faculty members of the Center for Clinical and Translational Sciences (CCTS), a collaborative initiative involving the UT Health Science Center at Houston, the UT M. D. Anderson Cancer Center and the Memorial Hermann Healthcare System. The center was created in 2006 with a National Institutes of Health grant to fast track the application of scientific knowledge to patient care.

The grant is called the Agency for Healthcare Research and Quality Training Program in Patient Safety and Quality. It runs through 2013.

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Source: Robert Cahill
University of Texas Health Science Center at Houston