Warren G. Magnuson Health Sciences Center
University of Washington
February 1995
This work was supported in part by grant number G081M05620-01 from the National Library of Medicine. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Library of Medicine.
The overall goal of the University of Washington Health Sciences Center (UWHSC) implementation process is to create a comprehensive, integrated information access and management network that will complement and enhance the clinical, research, administrative and educational effectiveness of the UWHSC and its affiliated institutions and programs. This network provides researchers, educators, clinicians, librarians, students, administrators and staff with convenient and timely access to the information they need to function optimally, regardless of the physical location of the user, the resource or the system, or the format of the information package. Central to this vision is the recognition that an individual, in a given day, performs a variety of roles in the Health Sciences Center. These roles range from clinical decision making to research to administrative tasks to teaching and learning. In one task the individual may be an expert, while in another, a novice. The integrated systems we are designing and implementing must support this diversity of roles, responsibilities and skill levels.
In general we have made a good deal of progress toward meeting our goals in a number of areas. In fact, the rapid development and expansion of the World Wide Web (WWW) in general and Web browsers (e.g., Mosaic, Netscape) have provided us with tools to make extremely rapid progress in areas of integration and delivery much earlier in our implementation process than anticipated in our Strategic Plan. On the other hand, ramping up, that is recruiting and training staff to fill vacant positions has proceeded more slowly than expected.
Our progress toward this broad goal during the first year of our grant is outlined below, grouped according to the strategic aims in our implementation proposal.
Establish organizational relationships that support and facilitate integrated access to health information, specifically embracing systems initiatives of the Schools, Departments, the Medical Centers, the Health Sciences Libraries and Information Center (HSLIC), the Health Sciences Center for Educational Resources (HSCER), Medical Centers Information Systems, the University Libraries, University Office of Computing and Communications, and other affiliated entities.
Significant effort has gone into assuring that faculty, staff and students see a unified set of services, information resources and classes regardless of where they are -- clinic, hospital, office, home, lecture hall, laboratory. On the education side, HSLIC and HSCER staff are working together to ensure that our course offerings and facilities offer a seamless set of resources and services. Collaboration with Computing & Communications staff continues to be fruitful, both in terms of uniform graphical interface development (Willow) as well as in information navigation tools (UW Information Navigator) and in database offerings. Work with Medical Centers Information Systems and departmental clinical systems staff includes assistance in developing technical expertise with World Wide Web, as well as preparation and publishing through the Health Sciences Center World Wide Web Server (HealthLinks). More details on these developments are discussed below.
We are paying a good deal of attention to ensuring that IAIMS staff efforts in support of pilot developments are, as soon as practical, taken over by staff in an appropriate service area (e.g., HSLIC, HSCER, departments, etc.). We believe this is vital -- that IAIMS staff and funding be used as catalyst or seed money and not for ongoing service support. This will help ensure that IAIMS developments will "live on" at the conclusion of our implementation funding.
Harborview Medical Center (located a few miles from the Health Sciences Campus), early in 1994, was connected to the campus backbone via a T-1 link. Network connections were installed throughout Harborview over the spring and summer with completion in Fall 1994. Harborview staff now have access to all information resources through the same uniform interface as if they were on campus.
In addition, although the Health Sciences Center has been networked throughout office areas and clinical areas for the past few years, only recently were network connections brought to a variety of teaching classrooms and large auditoriums. With the recent completion of these network connections, it is much easier for faculty to teach using network tools and facilities. IAIMS staff assisted in making the case for the importance of these connections.
We have also been working hard on identifying strategies for SLIP and PPP connections to support remote users who wish to have the benefits of high-speed network connectivity to information resources through the World Wide Web and graphical viewers.
The UCARE (University Clinical, Administration, Research, and Education) project area, under the leadership of Debra Ketchell (who also serves as the Acting Deputy Director of the Health Sciences Libraries), has made rapid advances in organizing and delivering access to a variety of databases and resources. UCARE encompasses the backbone infrastructure of the IAIMS program, linking local, national and international health information resources through uniform navigation and empowerment tools. The goal is to provide these resources through intuitive interfaces, regardless of the user's change of focus throughout the day and regardless of the user's location. This year significant new features enriched the user desktop. New initiatives focused on testing and integrating new technologies to local and Internet resources and the establishment of server hardware and systems staff to broaden the depth of tools to integrate resources on the desktop.
The IDEAL (Integrated Databases for Enhanced Academic Learning) project area, under the leadership of Dr. Jim Barrett (who also serves as Director, Health Sciences Center for Educational Resources has made rapid progress in the development of an integrated approach to creating and delivering educational programs. These advancements are due in no small part to the work of Cliff Solomon who was the first full-time IAIMS professional staff member hired. Cliff brings unique strengths to the position including a significant amount of educational systems program development expertise to the IAIMS program area. In addition, as he has been a member of the HSCER staff for a number of years, he knows quite a few faculty as well as the HSCER staff and resources. Further, he previously held the position of Coordinator, Learning Resources Center, Norris Medical Library, University of Southern California and hence brings to bear direct knowledge of library and learning resource centers. Cliff's efforts were enhanced by the World Wide Web and related development and viewing tools.
HealthTracks was made available as a selection from the University of Washington Information Navigator (UWIN) in the Spring of 1994. Individuals throughout campus as well as throughout the region and nationally now have access to a variety of locally-developed resources. The successor to HealthTracks, HealthLinks, a World Wide Web server, became available on campus in the Fall of 1994. For a time HealthTracks and HealthLinks resources will exist in parallel (with HealthTracks accessible from HealthLinks); however, we are moving rapidly to integrate all resources under HealthLinks. This will not, however, disenfranchise users who are unable to run graphical viewers such as Mosaic, since HealthLinks will be viewable through LYNX and other character-based viewers.
Figure 2.
We have moved quickly to become the "publisher" of useful information resources from throughout the Health Sciences Center. These resources range from the mundane (but highly useful) schedule for the inter-hospital bus shuttle, to nutritional guidelines (previously published only in print but now published exclusively electronically with an annual savings of approximately $3500). A resource of particular interest currently under development in partnership with the Harborview Medical Center Refugee Clinic is a set of guidelines for health practitioners who need to have culturally relevant information regarding particular ethnic groups. We are working with Health Sciences News and Community Relations to provide patient and consumer health-related information, including publishing a series of health fact sheets titled HealthBeat.
In partnership with Dr. Roberta Pagon, Professor, Pediatrics we will be making available to health professionals nationally a database called HELIX. Supported by development funds from the National Library of Medicine, HELIX is a database of DNA Diagnostic Laboratories which provides very useful information regarding laboratories conducting the latest genetic tests. At the present time the database is only available through a phone call to the HELIX office. The number of phone calls to the HELIX office is mushrooming -- to 30 or more per day. As new genetic tests are coming out almost daily, we believe this will be a very popular database with health professionals, particularly family physicians who may see a particular genetic syndrome only once in many years. This highly volatile data regarding types and tests and locations of laboratories doing those tests is very relevant to an Internet-accessible database.
Work is underway with many other individuals and groups throughout the Health Sciences Center to electronically "publish" a variety of types of information and databases. Additional examples are listed below under clinical developments. For departments with useful information to share, we will provide the expertise to scan, process and code the documents in the Hypertext Mark-up Language (HTML) document format with the department or program responsible, of course, for the validity, integrity, and currency of the information. In the case of departments (such as Radiology) with a good deal of expertise in the creation of WWW documents and image presentation, we work collaboratively so as to share our expertise.
Hematology Image Resource - We now have a prototype hematology image resource available through HealthLinks. This resource, which has been available in CD-ROM format for a number of years, has been developed by Dr. Jim MacArthur (Dept. of Hematology) and John Bolles (HSCER) with support from the American Society of Hematology. We now offer faculty the opportunity, via the Internet, to select slides to show, for instance, various stages of hemophilia, to link those images together with text (coded in HTML), and deliver the entire instructional package to students via a uniform interface on the Internet. [Figure 3, page 6]
Figure 3
Sample IMAGE Database Development - Integrated Databases for Enhancing Academic Learning (IDEAL) is creating a database of images so that faculty and students may access useful visual and textual information and tailor its use to their needs. So far images from Biological Structure, Nursing, and Hematology have been incorporated into this database. In addition, this summer the IDEAL project welcomed a student from Wales who worked on the development of our image database and provided information on the United Kingdom's SuperJANET project, which uses high-speed computer equipment to transmit medical information.
Significant progress is being made, in collaboration with Dr. Cornelius Rosse and Dr. Jim Brinkley, on the development of a WWW version of the Digital Anatomist [Figure 4, page 8]. One of the stumbling blocks to this project, multiple simultaneous links to URL (uniform resource locators), was, we believe, recently solved with a new version of Mosaic. The accessibility of this resource likewise offers faculty the option of creating course instructional modules, selecting and linking anatomical images and presenting a uniform view of these images and texts all from the convenience of their own office computer.An important aspect of the IDEAL project is to establish what the instructional technology needs of the faculty are. To determine these needs, a faculty needs assessment tool is being written. After it has been revised by the IDEAL advisory committee, it will be distributed to faculty, and the results will be tabulated. The data collected from this survey will be very valuable in our future planning.
Several IDEAL promotional projects have begun. Printed materials are being developed that explain the project to prospective clients. Personal meetings with Health Sciences faculty have generated several intriguing topics of research, including the types of support that the IDEAL project can provide to the Family Medicine clinical clerkships, the development of a drug information tool, and assistance in the development of a computer program that teaches interviewing skills. The IDEAL project is sponsoring a series of mini-conferences to showcase innovative uses of educational technology to the University. In November the first of these conferences presented work in the Departments of Radiology and Biological Structure and in the Schools of Dentistry and Nursing.
Authoring System Analysis - There are many computer programs that faculty may use to develop computer-based instruction. However, most are either difficult to use or do not offer the necessary features. To fill this void, the IDEAL project is working to develop a practical, easy to use, authoring tool. The first step, which is currently being worked on, is to evaluate available computer programs. This evaluation will be completed by December 15, 1995.
CINAHL is a database of high interest not only in the School of Nursing faculty, staff and students but also to practitioners throughout the Medical Centers. The UW branch campuses in Bothell and Tacoma are now offering nursing programs, and the remote access to CINAHL has been particularly well-received there as well as by students, faculty and practitioners in the Health Sciences Center.
Figure 4
A working prototype of the X-Meta which uses the NLM's Knowledge Sources server over the Internet has been completed. [Figure 5] It was developed with Unified Medical Language System (UMLS) contract funding as well as institutional support. Usability and efficacy testing of the browser was completed in early 1995. Other institutions have expressed interest in having the code, and arrangements are now being made to share it.
A UMLS evaluation project, led by IAIMS Informatics Fellow Denise Radow, provided very useful data in the design of this browser. Ms. Radow's colleagues on this project included Ellen Howard, MLS, Harborview Medical Center; Maryanne Blake, MSLS and Linda Milgrom, MSLS, National Network of Libraries of Medicine, Pacific Northwest Region; and Cynthia Jones, Maren Ostergard and Erika Shaffer, graduate students, School of Library and Information Science, University of Washington.
Figure 5
The title of the project was "Developing a Metathesaurus Browser: a Pre-Implementation Study. We were very pleased that a poster reporting the findings for this project won first place in the poster competition at the November 1994 meeting of the Symposium on Computer Applications in Medical Care.
To offer guidance to the IDEAL project, an eight person advisory committee was established. One of the first tasks undertaken by Cliff Solomon, Educational Systems Designer was a personal consultation with each member of this committee. Highlights from these meetings include the following:
Dr. Doug Schaad, Department of Medical Education
From Dr. Schaad's perspective, the IDEAL project will be pivotal to the
informatics needs of the health sciences faculty. He stressed the need
to develop usable and up-to-date information.
Dr. Pam Mitchell, School of Nursing
The School of Nursing has developed several computer based training
modules. Dr. Mitchell's first task for IDEAL was enlisting our help in
placing one of these programs on the Internet.
Dr. John Evans, School of Dentistry
Dr. Evans is most interested in the development of an easy-to-use
computer-assisted instructional authoring program so that dental texts
can be presented using a computer.
Dr. Cynthia Riche, School of Social Work
Dr. Riche sees a real need to equip the School of Social Work with the
necessary computers and to hire staff who can assist with the computer
operation. Once this has happened, the use of computer programs can
proceed.
Dr. Tom Koepsell, School of Public Health
Dr. Koespell was very supportive of the IDEAL project. With his help a
presentation has been made to the Epidemiology faculty about their
interaction with the IDEAL program.
Karan Dawson, School of Pharmacy
Ms. Dawson is very interested in developing interactive programs that
teach pharmacists interpersonal skills. The School of Pharmacy has
recently moved into a new facility, one that will offer state of the
art computer equipment on which these programs can be presented. She
has requested that the IDEAL project consult on the development of the
computer lab.
Linda Kent, University of Washington Medical Center
Ms. Kent provided several interesting ideas, including the development
of programs that will help professionals with their decision making
skills and the possibility of developing educational technologies that
will help cut staff training costs while keeping learning high.
Dr. Jim Brinkley, Department of Biological Structure, School of
Medicine
Dr. Brinkley has been working for several years on computer programs
that teach anatomy to Health Sciences students. IDEAL is working on the
modification of these programs so that they can be delivered over the
Internet.
Due to the multiplicity of initiatives in the UCARE project, the IAIMS Core group decided to utilize several sub-project focus groups and a broad scale needs assessment survey rather than a single advisory committee. The survey will provide a method to gain input from a wide variety of faculty, staff and students regarding strategic directions and priorities for information resources. The focus groups will work with the project team to provide the crucial interactive feedback on information tools development. One focus group will also work on selection and support criteria for both local and purchased resources.
Willow, the UW graphic user interface, has had a number of feature enrichments in 1994. These include a "callable" external program on Web, that is, individuals running XMOSAIC can invoke Willow sessions within Mosaic. This means that databases requiring a search interface can, in fact, be listed as resources in a logical Mosaic framework. When a database such as MEDLINE is selected, Willow is automatically launched, without the user having to make a conscious selection. This is an important break-through in providing truly integrated access to information resources and databases.
A second important development is a Z39.50 compliant capability so that any Z39.50-compliant database on the Internet can be accessed through the Willow interface. The University Libraries is offering access to a number of such databases, including some from OCLC in this fashion. This frees us from having to continue to purchase and load locally all databases we wish to make available to our campus community, while at the same time offering a uniform interface to the database, regardless of the underlying structure or location. Other features added to Willow include: record options and custom filters, and MacX on desktop.
A Windows version of Willow is currently in beta testing. It has been in use by a handful of people (including Sherrilynne Fuller, IAIMS Principal Investigator) for a few months and has proven very popular. For a Windows user the look, feel and operation is very natural. It is very feature-rich, including easy email or download of selected references. Most importantly, the computer resource utilization is much less than the X version of the software (that is, it is no longer necessary to run x-emulation software on the PC). We expect that WinWillow will be a run-away hit as soon as the code is released for general use.
Released in April 1994, Willow 2.1 was downloaded from the FTP archive by more than 1300 sites in 38 countries during the first six months. It is now listed as another option for Z39.50 searching on the Clearinghouse for Networked Information Discovery and Retrieval HomePage. The URL is http://www.cac.washington.edu/willow/home.html
Drs. Rita Altamore, Jim LoGerfo and Sherri Fuller have worked with other IAIMS staff on a variety of clinical informatics initiatives. They submitted grant application to NLM/AHCPR for funding through Electronic Medical Record initiative (a collaborative effort among University of Washington Medical Center (UWMC), Group Health Cooperative, Seattle-King County Department of Public Health, and Washington State Department of Health). Although this proposal was not funded, it set the stage for further collaboration.
Mini-Medical Record - Medical Centers Information Systems released a mini-medical record database on X-terminals in clinical areas in the Fall of 1994. Our original plans had envisioned the development of a Willow prototype interface to the mini-medical record. However, Mosaic may provide a more feature-rich approach. We will be assessing our options for this work in the coming months.
A project on security and confidentiality was established within the IAIMS environment. A graduate student was recruited to assist in preparing a "white paper" outlining key issues and functional requirements, to span clinical, educational, and administrative domains. We intend to use these in developing/purchasing systems to meet those requirements and hopes for eventual publication.
Dr. Altamore coordinated development of a rule-based reminder system within MCIS, including coordination of MCIS rule-based reminder system and structured query capacity projects with IAIMS plans for Q1 toolbox.
Dr. Altamore participated in development of RFP for clinical information system for UWMC (components to include order entry, documentation, support for care maps, and clinical decision support).
IAIMS staff organized a demonstration of Veterans Administration order entry system for clinicians and others involved in RFP process.
We continued to work on a clinical data dictionary and moved toward the use of UMLS as a component part. Made progress on making UMLS content available in Ingres tables. We were awaiting availability of UMLS server, which has just been acquired.
Clinical Nutrition Guidelines, Ethnic Medicine Guide and UW adopted clinical guidelines are examples of electronic reference documents being created within the Medical Centers. IAIMS staff serve as consultants and advisors for electronic creation and distribution within the medical centers.
Drug reference guides. Investigative work has been undertaken to identify and evaluate licensable products (e.g., PDR, GenRX, Micromedex, Clinical Pharmacology) to be provided locally. GenRX has just become available over the Internet and is available from HealthLinks. The Drug Therapy Topics newsletter, produced by the medical center's pharmacy department, is being provided electronically through HealthTracks/Links. Prototyping of electronic distribution of the Medical Center's Hospital Formulary is being done in partnership with the Medical Center's Pharmacy Department. With the resolution of licensing issues for the 1995-96 edition, work will now proceed on indexing and presentation of this valuable in-house resource. Electronic distribution of Hansten's Drug Interactions, a comprehensive drug interaction database, is also under discussion with the authors.
Clinical textbooks. Investigative work is underway to identify and evaluate licensable products (including Scientific American Medicine (the new editor is Dr. David Dale, Professor, UW School of Medicine), locally authored Saunders wire-bounds, etc.) for local formatting and distribution.
Diagnostic support tools. Investigative work to test and license ILIAD, QMR and DXPLAIN was completed. ILIAD and QMR are currently available in the Health Sciences Libraries and Information Center's Teaching /Learning Center. IAIMS supported a test of the DXPLAIN gopher access, and has signed an agreement with Massachusetts General to provide access to the trial DXPLAIN Internet service. DXPLAIN is now accessible from HealthTracks and HealthLinks.
Needs assessment and priorities for clinical resources. Planning is underway to survey clinical faculty and residents in conjunction with a general survey on library and information services in preparation for a JCAHO accreditation visit.
Washington health reform and policy documents. Electronic health reform newsletter at Health Services was distributed via list distribution. The Washington State Health Security Act and Systems Plan was formatted and placed on HealthTracks/Links.
Institutional information. Contacts have been made to begin electronic distribution of newsletters and other textual information produced within the Health Sciences Center.
Consumer/patient health information. New JCAHO recommendations and the thrust of population-based health care have provided a revitalization of focus on patient information. The library has expanded the number of CD-ROM based products beyond Health Reference Center (e.g., Mayo Health Book) this year. The UW produced HealthBeat series of consumer articles and links to other quality resources via the Internet have been added to HealthTracks/Links.
This has been a very high profile area of concentration from all of the IAIMS staff, but in particular from those in the IDEAL project area which has lead responsibility. A number of hands-on classes were developed and piloted in the fall in collaboration with the Medical School Department of Medical Education. These included: Getting Connected to the Campus Computing Network (developed and taught by Sherrilynne Fuller, Lisa Oberg (Health Sciences Libraries and Information Services Librarian) and Nancy Press (NN/LM,PNR); Network Navigation Tools, Interfaces and Information Resources (developed and taught by Sherrilynne Fuller and Cliff Solomon) and Advanced Network Tools in Support of Curriculum Innovation (developed and taught by Cliff Solomon and Denise Radow). Faculty interest in these classes greatly exceeded computer classroom capacity. We plan to offer these classes on a continuing basis.
We continue to place heavy emphasis on teaching by HSLIC librarians. Examples include an autumn quarter Internet class under Lisa Oberg's direction; training on CINAHL for the School of Nursing under Janet Schnall's direction; a patient care health information course taught by Sherry Dodson; Ellen Howard's involvement with Ethnic Medicine as a key contact and original coordinator; a regular schedule of one-on-one Pine email classes spearheaded by Terry Jankowski; and new student "get an account" orientation for all nursing and medical students.
Cliff Solomon and Debra Ketchell have offered an extremely well attended series of noon hour presentations to introduce network navigation and tools to interested individuals throughout the Health Sciences Center. In addition, we sponsored an IAIMS educational workshop which highlighted the innovative teaching programs of three faculty from Health Sciences Schools. This workshop was very well attended. We expect to offer additional workshops winter and spring quarters.
A faculty advisory committee has been created to provide guidance in the development of the IDEAL program area. The committee is currently working on a faculty questionnaire to assess current faculty needs so that we may target our faculty development efforts more effectively.
Create educational programs and training opportunities in the effective use of information technology for health sciences students.
Our strategy has been to emphasize development of faculty expertise in the application of network tools, information resources and technology to teaching and learning. This strategy is definitely paying off with more and more faculty developing teaching tools and scheduling teaching time in the computer laboratories in the HSLIC Teaching Learning Center. The downside is that the number of students wanting and needing to use computers in the TLC exceeds the available equipment during peak times. We are working with the Health Sciences Schools to assess options for requiring (or at least strongly urging) students to have computers when they begin their education. This would reduce the requirement for us to provide "base-line" word-processing equipment and permit us to focus our scarce resources on high-end equipment in support of the instructional programs.
Develop an academic program to promote research, development and training in health informatics.
An Informatics Seminar series was offered for the first time in Spring Quarter 1994 and again Autumn Quarter. It was sponsored by the Department of Medical Education, School of Medicine and the Department of Health Services, School of Public Health and Community Medicine. A proposal to the Library School to be added as a co-sponsor is likely to be accepted in the near future. This series featured a number of speakers from on and off campus and was well attended. We will offer it on a continuing basis during Spring and Autumn Quarters.
Discussions have been underway with the Medical School Administration regarding the development of a formal informatics research and training program. Considerable progress has been made, and the leadership of the School is very supportive of such a program. Many details regarding placement in the School and relationship to other Schools remain to be worked out. From an IAIMS perspective it is very desirable that all Health Sciences Schools, as well as the Graduate School of Library and Information Science, to the extent they wish, feel a part of the program. Dr. Ira Kalet, Department of Radiation Oncology, School of Medicine, has been instrumental in the gathering of information in support of informatics training.
Drs. Jim LoGerfo, Sherrilynne Fuller, and Rita Altamore contributed to a Veteran's Administration (VA) proposal (Principal Investigator - Dr. Ken Hammond) for a Medical Informatics Training program, centered at the VA Seattle and Medicine Lake but with strong linkages to the University of Washington. We have just received word that this proposal has been funded.
Ensure adequate core resources to support Health Sciences Center-wide information systems integration.
Personnel
This has been a particular challenge during the first year of the grant. Recruiting staff has consumed a good deal of time of all of the members of the IAIMS Core Group. However, we are nearing completion of the recruitment for one key position: the Clinical Informatics faculty position. Steve Rauch was hired in January 1995 for the IAIMS Assistant position (working title is Network Information Management Consultant. He will focus on policy development, purchased information sources and menu organization, in consultation with faculty, librarians, and IAIMS staff.
A third important position, the Computer Systems Analyst, who will provide systems support to IAIMS staff as well as run the IAIMS server(s), is also likely to be filled shortly.
Technical Resource Development
1. Testing SLIP/PPP connections. As a result of the distributed nature of Health Sciences Center faculty staff and students (scattered throughout Seattle as well as a four state region) a very high priority for IAIMS staff is ensuring high-speed, high bandwidth connections to the campus networks. Debra Ketchell, UCARE lead, is a member of a campus test group for University-wide implementation of PPP server for faculty, staff and students. IAIMS and Regional Medical Library staff are testing SLIP/PPP provided through commercial Internet service providers. Fact sheets on options, costs and potential pitfalls of slower modem connections are being developed for dissemination.
2. High-end staff workstation for image and text manipulation. Gained proficiency with scanning and image manipulation (e.g., Photoshop) for network publishing (e.g., Web documents).
3. Use of existing library equipment (DEC 3100 and new DEC Alpha servers) with augmentation by additional hard disk storage has provided an acceptable short-term platform while reserving funds for purchase of a high-end server when the client-server platform market for CD-ROM and text/images data has stabilized. Testing of CD-ROM networking within Libraries has led to the adoption of Windows NT as the server platform. IAIMS and the Health Sciences Libraries will collaborate on a NT server in 1995. CD-ROM networking among 3 health sciences libraries was completed in 1993-94. We are currently involved in a beta test of ERL (Silverplatter over the Internet) and CDPlus' internet access in lieu of CD access for fast dissemination to desktops.
Identify, describe and, in partnership with other institutions, vendors and federal agencies, develop approaches to information policy issues including confidentiality, ownership, copyright and participatory use as they related to a variety of information formats.
We are cataloging these issues as they come up. In particular, the issue of confidentiality and security has been studied. A graduate student was hired to assist in the development of an issues paper on this topic to be used as the basis for discussion by the Medical Information Systems Steering Committee. We are working on approaches to ensuring protected linkages from HealthLinks to key clinical information resources. Jim Barrett, in his role as IDEAL project leader, and as a result of his position as Director of the Health Sciences Center for Educational Resources, is tracking national discussions and developments in these areas.
Support the development of local, statewide, regional and national high performance computing networks.
As mentioned earlier, discussions are underway regarding connecting the 36 county health departments to the internet. This connectivity is very desirable for the county health departments and the UW Health Sciences Center. IAIMS staff as well as faculty from the School of Public Health and Community Medicine and the Medical School are involved in this planning.
Work has continued through the National Network of Libraries of Medicine, Pacific Northwest Region (NN/LM,PNR) contract -- Bench to Bedside: Research and Testing of Internet Resources in Community Hospitals with IAIMS staff playing a continuing advisory role in this area. In addition, the NN/LM,PNR has received funding to run the national server and lead the development of WWW services with the other regions.
Evaluate and assess our accomplishments and shortcomings and share our findings with other institutions.
Usage: Use of MEDLINE on the campus system continues to rise (routine peak period use of 50 simultaneous users). These statistics demonstrate the very rapid growth of usage of these resources. Use of HealthTracks and HealthLinks continues to increase experientially.
Contributions to National IAIMS Development
We have had numerous requests for information from individuals representing institutions throughout the U.S. and Canada.
We will host the IAIMS Consortium meeting, July 20-21, 1995, and thus will be in a position to not only share our work to date but also receive critical input from attendees regarding future directions for our IAIMS Implementation.
The UW IAIMS Program is a participant in the American Medical Informatics Association's new Site Visit Program. We have identified two dates between February and April of 1995 when we will host visitors.
IAIMS staff continue to make numerous presentations and to publish articles regarding IAIMS locally, regionally and nationally.
Challenges for the future:
Key areas which will require our continued concentration over the next years include:
Obtaining funding for equipment to support the soaring student demand
Keeping up with demand for classes and consultations which is currently exceeding the availability of IAIMS staff resources.
Keeping up with change -- in particular, the rapid evolution of information management and access tools and technology.
Choosing wisely those areas to invest staff resources and funding which are likely to grow and bear fruit - with strong likelihood of continuing at the conclusion of funding.
http://healthlinks.washington.edu/hsl/iaims/docs/progress94.html