Kristin Myers

The exponential rise in genomics research over the past decade has yielded a growing number of sequence variants associated with medication response that may have clinical utility. Despite existing barriers, attention is turning to strategies that integrate these data into clinical care. The CLIPMERGE PGx Program is establishing a best-practices infrastructure for the implementation of genome-informed prescribing using a biobank-derived clinical cohort, preemptive genetic testing, and real-time… Show more

The exponential rise in genomics research over the past decade has yielded a growing number of sequence variants associated with medication response that may have clinical utility. Despite existing barriers, attention is turning to strategies that integrate these data into clinical care. The CLIPMERGE PGx Program is establishing a best-practices infrastructure for the implementation of genome-informed prescribing using a biobank-derived clinical cohort, preemptive genetic testing, and real-time clinical decision support deployed through the electronic health record. Show less

The relationship between usability and training remains to be explored in health informatics. We examine the training given during the implementation of an institutional electronic medical record system, as well as the usability of the system from the perspective of new users who have been recently trained. We examine in which ways video-based usability testing with new users, who received classroom training one month earlier, can be used to a) indicate needed changes in the training program… Show more

The relationship between usability and training remains to be explored in health informatics. We examine the training given during the implementation of an institutional electronic medical record system, as well as the usability of the system from the perspective of new users who have been recently trained. We examine in which ways video-based usability testing with new users, who received classroom training one month earlier, can be used to a) indicate needed changes in the training program, and b) provide feedback to improve system customization and deployment. Usability testing methods were found to be an important adjunct to system deployment: they can improve the system implementation as well as suggest strategies for user education. Show less

The process of selecting electronic health record systems is one of the most critical decisions in the journey towards automating and improving healthcare using information technology. However, there are a wide variety of problems associated with system selection and procurement processes in healthcare. Indeed the literature contains numerous examples of systems that were purchased and customized that failed to meet user needs, were implemented well behind schedule, which cost much more than… Show more

The process of selecting electronic health record systems is one of the most critical decisions in the journey towards automating and improving healthcare using information technology. However, there are a wide variety of problems associated with system selection and procurement processes in healthcare. Indeed the literature contains numerous examples of systems that were purchased and customized that failed to meet user needs, were implemented well behind schedule, which cost much more than expected and which in some cases failed completely. In this paper we describe a framework which we have developed and have begun to apply in considering key processes in the selection of electronic health records - i.e. the testing of potential candidate systems to determine if they meet user and institutional needs. The objective of our work is to improve our understanding of and the effectiveness of this critical decision making aspect of health informatics. In our work we consider system selection in terms of strength of evidence obtained from testing candidate systems. Show less

ABSTRACT The experience of Mount Sinai Hospital is representative of the challenges and problems facing large academic medical centers in selecting an ambulatory EMR. The facility successfully revived a stalled process in a challenging financial climate, using a framework of science and rigorous investigation. The process incorporated several innovations: 1) There was a thorough review of medical informatics literature to develop a mission statement, determine practical objectives and guide the… Show more

ABSTRACT The experience of Mount Sinai Hospital is representative of the challenges and problems facing large academic medical centers in selecting an ambulatory EMR. The facility successfully revived a stalled process in a challenging financial climate, using a framework of science and rigorous investigation. The process incorporated several innovations: 1) There was a thorough review of medical informatics literature to develop a mission statement, determine practical objectives and guide the demonstration process; 2) The process involved rigorous investigation of vendor statements, industry statements and other institution's views of vendors; 3) The initiative focused on user-centric selection, and the survey instrument was scientifically and specifically designed to assess user feedback; 4) There was scientific analysis of validated findings and survey results at all steering meetings; 5) The process included an assessment of vendors' ability to support research by identifying funded and published research; 6) Selection involved meticulous total cost of ownership analysis to assess and compare real costs of implementing a vendor solution; and finally, 7) There were iterative meetings with stakeholders, executives and users to understand needs, address concerns and communicate the vision. Show less