The More AMIA Changes, the More It Stays the Same . . .

Right at this very moment, the American Medical Informatics Association (AMIA) 2022 Annual Symposium is underway in Washington, D.C., and we encourage you to visit NLM @ AMIA 2022 for updates on NLM’s products and programs. Now this may sound quite familiar to those of you who have attended AMIA annual symposiums in Washington, D.C., and other major cities over the past 30 years, but this year it is different. And yet, it is the same.

What’s the same? Well, for me and almost 3,000 other attendees, AMIA is our professional home. Through meetings and conversations, journal articles and webinars, and a host of new events and meetings, members build their knowledge about biomedical and health informatics, share that knowledge with colleagues, and advance the health of the public through informatics. We have built friendships, watched babies be born and grow into adults (including my son Conor), and grieved the loss of great leaders in the field. Colleagues have debated the wisdom of electronic health records that may have inadvertently contributed to clinician burnout and expanded the scope of our design and deployment efforts to encompass tools useful to consumers and language reflective of the diversity of society.

AMIA has welcomed young people into informatics and sponsored high school-student participation in national meetings. Special events now include rapid response to public health threats, special interest meetings for women in informatics, and expanded attention to diversity and inclusion. The fall symposium provides an opportunity for formal and informal mentoring, a quick hug with an old friend, and a reunion of those with whom we studied the basics of the field.

And yet, over 30 years, many things have changed! First and foremost, AMIA as an organization has grown, engaged new leadership, and developed new special interest groups. These each change the tenor of the meeting by adding new events to an already rich and attractive suite of offerings and bringing like-minded people together. The ideas shared and the research reported through the annual symposium have morphed throughout the years; now artificial intelligence takes center stage, tempered by thoughts of transparency and equity. A larger number of panels and industry sessions reflect the rapidly changing landscape of informatics. Electronic posters and smartphone apps take the place of what once were paper posters displayed in long corridors of bulletin boards and a three-inch-thick compilation—dare I say phone book size—of all the papers to be presented at the sessions.

And of course, the pandemic changed both everything and nothing. AMIA still hosted an annual symposium and participants still gathered, at least over video chat! Throughout the pandemic, AMIA offered virtual and hybrid conferences—this is the first annual symposium completely in person since 2019 and boy, was I ready for it!

So, rejoice with us—our annual touchstone of gathering for the science of biomedical informatics and the social support of friends and colleagues continued! Please plan to join us in 2023 and see for yourself what it is like!

Who Really Are Our Users, and How Can We Help Them?

Well, this is a question too big for even the largest biomedical library in the world to answer. Our users are everywhere, and in fact, the same user may approach us with very different needs or personas, such as the brilliant cell biologist who is also the mother of a sick toddler. Today, I am thinking of that huge army of applied clinical informatics specialists and how we might begin to help them.

Applied clinical informatics specialists form the technical workforce that make health information technologies work for patients and clinicians. These individuals often have a background in nursing, medicine, or another clinical specialization. Their advanced training and advanced certifications can attest to their understanding of how health care is delivered, the data and information resources needed to deliver that health care, the data underlying care, and the person-professional-technology engagement needed to better deliver care through effective use of information technology.

NLM is pretty clear about its role in supporting the enormous research and development efforts that design, deploy, and evaluate computer systems for health care and in making the basic and clinical biological and biomedical literature accessible to patients, clinicians, and researchers. To the best of my knowledge, NLM has not done enough to think about the applied clinical informatics community as a distinct stakeholder group, and it is now time to do so!

Applied clinical informatics professionals are skilled at designing, installing, and implementing electronic health records. Some of them specialize in evidence-based practice, bringing the research evidence into the point of care. Others focus on human computer interaction, striving to harness the power of computing to support practitioners and to avoid cumbersome or ill-designed clinical records systems. Still other applied clinical informatics professionals are crafting the decision-support tools that bring effective, ethical artificial intelligence into practice. Some serve key roles in their institutions’ value-based health care deliberations, bringing to light through data where health care interventions bring value to the patient and the system. And some applied clinical informatics specialists focus on translating science into care. These positions are critical to making sure that the advantages of information technology reach into the realm of clinical practice… and man oh man, are they busy!

This makes it hard for applied clinical informatics specialists to make use of NLM’s vast resources in the ways different from the typical researcher uses of these resources – as part of a larger process of building or evaluating research ideas, in a reflective manner, through exploration of several articles on the same theme, and with the time, the patience, and the purpose to discern lines of reasoning out of multiple articles. To best support the applied clinical informatics community, NLM needs to expand its ways of doing business, and find ways to make in-the-moment search for best practices or clinical guidance available. How can we do this?

Rethink the “typical library user” and be open to the atypical user. NLM also serves as the repository of record for biomedical knowledge. We have presumed that the synthesis and application of that knowledge is the responsibility of the reader. Perhaps now is time for us to find new ways to partner with outside organizations that can cast their special eye over our resources and to cull their knowledge for the applied clinical informatics specialist.

Work on translating our research findings into practical practices. NLM makes a substantial investment in developing new algorithms that find better ways to link clinical records together. We have a small but fledgling program, our tech transfer funding to stimulate new businesses relevant to the use of data in health care. Perhaps we should better advertise the availability of these funds and target the challenges experienced by applied clinical informatics practitioners.

Expand our abilities to cull basic science and clinical care innovations from the literature. Applied clinical informatics professionals have, as part of their job, the building of the information tools to bring science into practice. We need to learn from them so we can better expose our literature for their needs, keeping them abreast of new and emerging findings in the literature that will someday make their trajectory into practice.

Partner with specialty organizations to make sure that the important lifelong skill development of being an applied clinical informatics professional becomes a realistic process in their career trajectory.

A few months ago, I spent a morning speaking with applied clinical informatics professionals to affirm their interest in NLM supporting them in their work and to listen to their needs, dreams, and demands. In a future blog, I will tell you more about what I learned from them!

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