This investment, funded by the American Recovery and Reinvestment Act of 2009, will help grow the emerging health information technology (HIT) industry, which is expected to support tens of thousands of jobs ranging from nurses to technicians and trainers. UTHealth is one of 28 organisations awarded a total of more than $267 million to establish RECs.
An elderly woman suspected of having a stroke arrives confused at the emergency room. The physician uses the basic information she is able to provide to access the critical medical history that will help him treat her. In simplest terms, that's the promise of health information technology.
To move toward that future, biomedical and health informatics researchers at the University of Texas Health Science Center at Houston have received a $15 million stimulus grant to establish the National Center for Cognitive Informatics and Decision Making in Healthcare (NCCD) at UTHealth. At the centre, faculty will conduct breakthrough research to advance the adoption and meaningful use of health information technology.
"Much more than technology is required to make health information technology effective", stated Jack Smith, M.D., Ph.D., dean of the University of Texas School of Health Information Sciences at Houston, part of UTHealth. "It must be easy to use and easy to learn. This grant will give us the opportunity to turn our ideas into practice and ultimately into improved patient care. Our school has been a leader in interdisciplinary innovation in clinical and public health informatics, and now we will lead in the ambitious national goal of implementation of an electronic health record for every citizen."
"The RECs are a touchstone for achieving this goal and are the HIT equivalent of agricultural extension services. They will train and field the army of HIT implementation agents which will sweep through primary practice settings in Texas to bring the best HIT technology to bear", stated Jack Smith, the Gulf Coast REC's principal investigator. "They will do this based on the best evaluation and testing environments for HIT products that is available. Our testing and evaluation centre will draw heavily on our outstanding faculty in clinical and public health informatics."
In Texas, the Gulf Coast REC at UTHealth is joined by three other regional extension centres at Texas Tech Health Sciences Center, Texas A&M University and the Dallas-Fort Worth Hospital Council Education and Research Foundation. Collectively, the state RECs received $35,7 million, and there is a collaborative working group to co-ordinate their efforts.
"It is particularly gratifying to me to also see how our REC grant team was so instrumental in organizing all of Texas through multiple tightly integrated RECs that blanket the entire state", Jack Smith stated. "Our leadership in the Gulf Coast REC and all the proposed Texas RECs is just another example of how UTHealth is the best hope for a healthier future."
Kim Dunn, M.D., Ph.D., the executive director of the Gulf Coast REC, said the RECs will offer primary care physicians, nurse practitioners, and physician assistants on-site technical assistance. They will support physicians with everything from vendor selection and group purchasing to implementation, project management and best practices in privacy and security.
Kim Dunn, assistant professor of health informatics at UTHealth, said the RECs will benefit physicians in a number of ways. "One of the most important benefits is that the RECs will help restore integrity to the doctor-patient relationship by giving physicians access to the right data at the right time", she stated. "RECs will help physicians take patient data and translate that into information that's actionable. Having the resources to provide patients with the best possible care will foster trust in the physician."
The Gulf Coast REC will serve the southern half of the state. Joseph McCormick, M.D., the Gulf Coast REC southern associate director and regional dean of the University of Texas School of Public Health Brownsville Regional Campus, said the RECs will benefit individual patients as well as entire communities.
Others from UTHealth who will be part of the Gulf Coast REC's leadership team are Operations Manager Pam Salyer, R.N., Ph.D., assistant professor of health informatics; Quality Management Director Dean Sittig, Ph.D., associate professor of health informatics; Usability and User Feedback Director Jiajie Zhang, Ph.D., the Doris L. Ross Professor and associate dean of research at the UTHealth School of Health Information Sciences; and Workforce Training Director Jim Turley, R.N., Ph.D., associate professor of health informatics.
The UTHealth School of Health Information Sciences was awarded the money through the Strategic Health IT Advanced Research Projects (SHARP) Programme, which seeks to support improvements in the quality, safety and efficiency of health care through advanced information technology. The award was one of four presented by the Office of the National Co-ordinator for Health Information Technology (ONC) through the American Recovery and Reinvestment Act of 2009 to address key barriers to health information technology.
"Our school was an early visionary in understanding that technology must be adapted to the needs of users based on how they think, how they learn and how they make decisions, which is cognitive informatics", Jack Smith stated. "Since the inception of the school, we have been working to bring together the world's leading team in cognitive informatics."
One of the barriers to widespread electronic health record (EHR) use is that most EHR systems are not as user friendly as they should be, according to Vimla L. Patel, Ph.D., DSc, who is a NCCD co-director and a UTHealth School of Health Information Sciences professor. Just as television viewers can become frustrated with a remote control that has too many buttons, the consumers of electronic health data can become frustrated with health information technology systems that do not take into account their information processing capabilities and decision processes, she said.
Health information technology systems need to be designed with an understanding of the minds of the people using them, Vimla L. Patel said. Human beings will choose what is easy to use, pleasant to work with and delivers what they want, she added.
"There is an opportunity to develop systems that are much more sensitive to users", stated Edward Shortliffe, M.D., Ph.D., a professor at the UTHealth School of Health Information Sciences and the president and CEO of the American Medical Informatics Association in Washington, D.C. "Much of what is being done now is to get doctors to install electronic health record systems. Our research will ultimately help to ensure that these systems are used."
Brent King, M.D, chairman of the Department of Emergency Medicine at the University of Texas Medical School at Houston, a part of UTHealth, said he looks forward to the day when health information technology systems will be able to help clinicians with sophisticated decision making. "The doctor's brain shouldn't have to be the repository of all health information. There should be programmes that signal the physician when it is important to act", he stated.
Jiajie Zhang, Ph.D., the principal investigator for this $15 million grant and co-director of the NCCD, said that eventually accessing health information could be as easy as taking money out of an automatic teller machine. "You can go to any ATM and get cash even in a foreign country. The transactions are simple, safe and secure, and require no training. Likewise, health care information should be accessible by physicians and patients, anytime, anywhere, without much mental effort", he stated.
Research at the centre will focus on the use of information technology to support problem solving and decision making that optimizes patient outcomes, said Jiajie Zhang, holder of the Dr. Doris L. Ross Professorship and associate dean of research at the UTHealth School of Health Information Sciences. This area of informatics is called patient-centred cognitive support.
The NCCD, which will carry out six research projects, is a collaborative initiative involving the University of Washington, Arizona State University, University of Maryland College Park, Baylor College of Medicine, Intermountain Healthcare, Department of Veterans Affairs and Baylor Health Care System. The centre will be housed in the new UTHealth Behavioral and Biomedical Sciences Building.
"I am delighted to see our colleagues in the School of Health Information Sciences take the lead in this transformative project. I think the idea of engaging our university's experts to address the challenge of improving the ways physicians and other health professionals can take full advantage of the information embedded in electronic health records is a fabulous idea. My hat is off to Dean Smith and his faculty, including Drs. Jiajie Zhang, Vimla Patel and Edward Shortliffe", stated Peter J.A. Davies, M.D., Ph.D., Provost and Executive Vice President for Research at UTHealth.
Edward Shortliffe, a member of the Institute of Medicine, will serve as the Chair of the Project Advisory Board which is composed of researchers, patients, providers, HIT vendors, and other stakeholders from across the nation. Also receiving four-year co-operative agreements were Harvard University, the Mayo Clinic, Rochester, Minnesota, and the University of Illinois at Urbana-Champaign, Illinois.
Located within the Texas Medical Center, the UTHealth School of Health Information Sciences provides a unique collaborative research and learning environment in biomedical informatics. The school's mission is interdisciplinary graduate education and research, bringing together the engineering, computer, cognitive and biological sciences. The educational programmes lead to certificates in Health Informatics and Public Health Informatics, a Master's degree, or a Doctoral degree in Biomedical Informatics.