Tulsa Physicians Promote Integration of Medical Informatics to Enhance Patient Care

David Kendrick, M.D., MPH, chair of the Department of Informatics, OU-TU School of Community Medicine, has a vision and a goal to use medical informatics to enhance population health and patient care. Success lies in shaping medical education to include greater emphasis on medical informatics as it relates to the patient experience.

Kendrick, along with colleagues, vice chair Blake Lesselroth, M.D., MBI, and Juell Homco, Ph.D., MPH, instructor and director of Research and Community Analytics, has worked to incorporate informatics content at the undergraduate and graduate medical education levels. Their collective vision is to teach how population analytics, systems-based improvement, computerized decision support and health information exchange are quickly becoming crucial clinical tools in the future healthcare landscape.

Lesselroth, who is also an associate professor of Internal Medicine at the OU-TU School of Community Medicine, recently returned from Lille, France, where he was a presenter at the highly regarded Context Sensitive Health Informatics Conference. His presentation, “Narratives and Stories: Novel Approaches to Improving Patient-Facing Information Resources and Patient Engagement,” focused on the role of consumer health informatics in achieving high-quality healthcare. He has delivered similar presentations at conferences in Victoria, Canada, and in Chicago. Lesselroth and Homco also presented a talk on the topic of informatics in undergraduate medical education at the American Informatics Association Educators’ Forum in St. Louis.

“Medical informatics, or MI – the science of information management - is the point where many sciences intersect – computer science and technology, health sciences, public health, social sciences, anthropology, sociology, engineering science and more,” he explained.

Studies have demonstrated that not all forms of patient care occur in a traditional clinical setting or are delivered directly by healthcare professionals. Outcomes have been shown to improve or decline in response to systems performance. Lesselroth said MI can help us understand how these operational factors influence outcomes.

“MI helps answer questions related to the efficiency of our electronic health records,” he said. “It can show where clinical processes enhance or detract from positive patient experience. We also glean insight from the tracking of health practices and patterns around the world.”

Leaders at the School of Community Medicine are interested in the impact of MI on population health and are convinced that appropriate integration of MI will advance the school’s mission of education, research and service.

“MI can improve the health and well-being of patients and providers,” Lesselroth said. “We think of data as being detached and impersonal. Integration gives it a place to live, breathe and influence outcomes.

“Computers are just one tool that guides interaction between MI and social systems, such as belief, culture, workflow and physical structures. The interaction is the actual science.”

The OU-TU School of Community Medicine currently offers MI as a course year round, in two-week and four-week rotations for third- and fourth-year medical students. Lesselroth and his team envision integration of this learning into the core curriculum of a four-year medical education.

Consumer health information systems are becoming increasingly prevalent and accessible. However, Lesselroth said these systems fail to capitalize on what we know about human understanding. Health and technology literacy issues continue to challenge effective communication.

“Confusion may lead to non-compliance, which often is a contributing factor in poor outcomes,” Lesselroth said. “The most effective way to reinforce learning and remembering is to tie information to stories and narratives. Consumer health information is most meaningful, and holds greater potential benefits, when integrated into narrative. This provides context for what otherwise might be disconnected bits of information.”

He said research will help developers understand and capitalize upon the potential benefits of integrating narratives into consumer health information.

“It’s a huge goal, but we believe the effective use of MI holds great promise. Our research to date suggests significant impact toward improving health in Oklahoma and beyond. It merits more than just a side-bar in developing competent, well-trained physicians.”