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Improving Accuracy of Vital Signs Capture Using Bedside Computerized Reminders for Nurses — Preliminary Results
Philip J. Kroth
The efficient and reliable capture of vital signs and other bedside data in the non-ICU setting has been a challenging problem for the medical informatics community. The problem is compounded by the complexities associated with storage of this data into an electronic medical record system (EMRS). There are a lack of off-the-shelf solutions that satisfy the basic system requirements of bedside data capture, user authentication, data validation prior to storage, error handling, and convenience. With the current state of technology available, we feel the solution to this problem requires the presence of a PC with custom interface software at the bedside. This allows for the successful interface between available vital signs capture devices, existing EMRSs, and the user. This presentation summarizes the alternatives we found and our proposed solution to this important problem.'
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Provider Stress and Electronic Health Records
Philip J. Kroth
While application of Health Information and Communication Technologies (HICT) has demonstrated significant potential to improve health care and reduced costs, the impact of HICT on health care professionals job satisfaction, productivity, and general wellness is largely unknown. Recent studies suggest that the impact of HICT on clinician stress and burnout may be considerable. Dr. Kroth will present on what is known about clinician stress and burnout that is attributable to the HICT design and outline his currently funded, multi-institutional study to look into this area with scientific rigor.'
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The Process of Evaluating a Cloud-Based ILS
Karen R. McElfresh, Jacob L. Nash, Robyn Gleasner, Victoria B. Rodrigues, and Laura J. Hall
OBJECTIVE: To describe the process our library used to evaluate OCLCs WorldShare Management Services (WMS), a new cloud-based Integrated Library System (ILS), as a potential replacement for our current system. METHODS: After forming an ILS Review Committee consisting of the staff from the library's technical services, circulation, and IT departments, we viewed multiple webinars and demonstrations given by OCLC staff. We also searched the literature for articles and case studies about WMS, and viewed several online presentations given by libraries that have already implemented WMS. We also conducted telephone interviews with librarians from two different libraries that are currently using WMS. RESULTS: WMS offers many advantages over our current system. WMS combines traditional catalog functions with an Electronic Resource Manager (ERM), which will eliminate the need to maintain records in two places. WorldCat Local, the discovery layer of WMS, is much more intuitive to use, which will be a tremendous benefit to our users. Our research into the experiences of other libraries was predominantly positive, and all libraries reported that they were happy with WMS. CONCLUSIONS: OCLC's WorldShare Management Services is truly an integrated system that will allow our library to provide a more modern and seamless search experience to users. In addition, WMS will help us to streamline the processes and workflows for our technical services staff. For these reasons, our library made the decision to purchase WMS, and we anticipate going live in January 2015.'
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The Valmora Industrial Sanatorium: A New Mexico Public Health Story
Jacob L. Nash, Laura J. Hall, Zsofia Szoke, and Gale Hannigan
The Valmora Industrial Sanatorium, located in Watrous, Mora County, New Mexico, was one of many Tuberculosis Sanatoria that sprang up in New Mexico around the turn of the century and represented one of the first Public Health efforts to take root in New Mexico. Valmora offered highly patient focused methods of treatment and integrated health education with leading a healthy lifestyle. Founded in 1909 by Dr. William T. Brown, Valmora was reorganized into a non-profit corporation supported by large businesses back east such as Marshall Fields, Sears & Roebuck, and the Chicago Daily News. This created the opportunity for working people to get effective care for TB that in the past was exclusively available to the wealthy. Valmora evolved over the 20th century from a self-sufficient industrial TB Sanatorium to a community clinic for heart and chest patients, in addition to a base of operations for the medical director., Dr. Carl H. Gellenthien, as he practiced old-fashioned' medicine across the better part of northern New Mexico, from delivering babies to stitching up knife wounds.'
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A Survey of Medical Schools' Disability Curricula
Ingrid C. Hendrix and Richard M. Kimball
It is a well established problem that people with disabilities (PWD), as with many other groups disadvantaged by social inequities, often receive suboptimal care from health care providers. The root cause of this inequity in care can be traced to a lack of training in dealing with PWD for health care providers. Barriers result from issues of communication, knowledge of resources available, access to clinics/hospitals, difficulty using diagnostic equipment (exam tables, scales, mammography, etc) and attitudes towards PWD. Despite numerous reports outlining this issue and calls to action to address deficiencies in the care of PWD, few medical schools currently address the care of patients with disabilities in their curriculum. This poster provides a survey of disability curricula in medical schools and a summary of their content/approach and effectiveness.
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Partners in Research Literacy: Librarians and Educators
Ingrid C. Hendrix and Sarah Knox Morley
PURPOSE Research literacy requires health sciences students to effectively locate, evaluate, use, and manage evidence-based information. Students in these programs are required to participate in assignments resulting in papers, posters, or publications. Library faculty created a medical school elective in 2006 using the scholarly communication cycle as a framework to teach information/research literacy. After successfully teaching the course for seven years, the librarian instructors adapted the course to provide a continuing education workshop for faculty. The intent of these offerings is to frame the research or information process as broadly as possible in order to delve into the world of information creation and dissemination. METHODS A School of Medicine course elective (Information Survival Skills') was developed and taught by two academic health sciences librarians. The elective, consisting of five session totaling 7.5 contact hours, involves interactive instructional methods to teach specific research literacy skills to 2nd and 3rd year medical students. Course content includes question formulation, database searching, evaluation of resources, and managing information using personal file management software. Evaluation methods comprised a pre/post self-assessment questionnaire to gauge students' knowledge and attitudes about information resources and skill set. In addition, anonymous post-course evaluations were collected by the Office of Undergraduate Medical Education. As a result of faculty feedback from presentations at medical education conferences, the elective was redesigned in 2012 as a faculty development workshop. This continuing education offering was abbreviated (3.5 hours) but contains similar content. RESULTS Since 2006, eighty-four 2nd and 3rd year medical students have completed the elective. In 2012, eighteen health sciences faculty attended 2 workshops. Both the elective and the workshop have consistently received high marks. Based upon qualitative evaluation data, learners in both groups reported high satisfaction with the hands-on format, introduction to and practice with unfamiliar resources, and information management. Final evaluations illustrate students realize the value of the elective in relation to their coursework, clinical and research experiences. Faculty workshop feedback echoed the benefit to themselves as clinicians/researchers and in their role as educators. CONCLUSIONS There is a broad misconception that students are facile in information retrieval and capable of critically evaluating that information. Faculty development opportunities allow educators to become more proficient in their ability to guide students to evidence-based information. Working in partnership with librarians, medical educators can avail themselves of knowledgeable practitioners and teaching partners to incorporate research literacy skills in courses throughout the curricula.'
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The Role of Librarians and Informationists in Disaster Response
Laura Banks, Brian Bunnett, and Richard Carr
The National Library of Medicine (NLM) Disaster Information Management Research Center (DIMRC) website provides a wealth of resources for disaster planning, deployment and reporting. Librarians can play a valuable role in training responders in use of tools such as WISER, CHEMM and REMM.
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Effects of Service Dogs Partnered with People with Mobility Challenges
Terry K. Crowe, Suzanne Perea-Burns, Jessica Salazar Sedillo, Ingrid C. Hendrix, Melissa Winkle, and Jean Deitz
Poster reporting the findings of a study investigating the functional performance and social interaction of individuals paired with service dogs.
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Demonstrating an anthropological application of the Economides orthodontic collection: deciduous and permanent tooth size in European and Hispanic Americans
Heather J.H. Edgar, Michael Haueter, Shamsi Daneshvari, Edward Harris, and Philip J. Kroth
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Ancestry Estimation in a Web-based, Searchable Database of Orthodontic Case Files for Patient Care, Education, and Research
Philip J. Kroth, Heather J.H. Edgar, Edward F. Harris, Summers Kalishman, and Shamsi Daneshvari
In 2005, the Maxwell Museum of Anthropology accepted a donation of orthodontic patient records from an orthodontist who has been practicing in the Albuquerque area since the early 1970s. This collection represents a diversity of patients not often encountered in orthodontic training in the United States. A virtual, de-identified, web-based version of a subset of the collection is now being developed. Users can search for cases with particular characteristics of interest (e.g., patient ancestry, extraction patterns, diagnoses, and cephalometric parameters), then review sequential intra-oral and Xray images to observe treatment outcomes. An innovative feature of the database is that it records multiple ancestry estimations, made at multiple points in time by multiple raters, along with a list of ancestry indicators on which the estimations are made (e.g., skin color, hair form and color, facial shape, name, and locality). This poster describes how the database can be used to overcome the limited diversity in the patient populations available to most orthodontics trainees. When this project concludes, the database will contain approximately 400,000 digitized images from 5650 individual cases.'
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A Web-based, Searchable Database of Orthodontic Case Files for Patient Care, Education, and Research
Philip J. Kroth, Heather J.H. Edgar, Edward F. Harris, and Summers Kalishman
In 2005, the Maxwell Museum of Anthropology accepted a donation of 5650 unique orthodontic patient records (treatment records, dental X-rays, dental casts, intra-oral and full facial photographs) from an orthodontists practice in Albuquerque, New Mexico from 1972 through 1999. This collection includes large samples of Hispanic and Native American populations, two groups not often encountered in orthodontic training in the United States or elsewhere. While investigators can use the collection on site at the Museum for approved research, a Web-based, de-identified version of the collection is being developed with input from orthodontics students and faculty from multiple institutions, so the collection can be freely accessed the world over. The database's unique design allows users to search for cases with particular characteristics of interest (e.g., patient ancestry, extraction patterns, diagnoses, and cephalometric parameters) and then review the sequenced intra-oral and X-ray images to observe variations of outcomes from treatments applied to patients with racial and other factors not often encountered in training or practice before.'
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Integrating Evidence-Based Practice (EBP) knowledge and skills into an undergraduate medical school curriculum
JD Eldredge, T Palley, E Cosgrove, and C Arndell
Medical students at UNM have learned Evidence-Based Practice (EBP) since the 1990s when they experienced an Evidence-Based Medicine Block during their transition to their clinical years. When the block was discontinued in 2002, the same training became integrated throughout the first three years of medical school. This integrated approach produced moderate success mostly because of strong support from curricular leaders and the persistence of a small cadre of faculty members.
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Information Survival Skills: Librarians in Medical Education. Poster presentation at: WGEA 2009 Annual Conf.; 2009 April 18; Santa Fe, NM.
Sarah K. Morley and Ingrid Hendrix
Context: The crisis in scholarly communication and the increased emphasis on evidence-based practice highlight the need for information literate health care professionals. Health sciences librarians play a critical role in raising student awareness of issues related to the evaluation, use, and communication of medical information by healthcare providers. To address this challenge, library faculty members created a medical school elective in 2006 covering these important issues. To date, this course has been taught three semesters. Objectives: Overall course objectives were to: Understand the changing nature of scholarly communication and online publishing; Identify resources and strategies for searching current best evidence; Apply methods for presenting and managing information. Key Message: By using a soup to nuts' approach, 2nd and 3rd year medical students were given the opportunity to become familiar with and understand all facets of the information cycle. The syllabus included sessions on the publication process, the rising cost of medical information leading to alternative publishing models, literature searching, resource management, and presentation. The authors were interested in introducing concepts and strengthening skills that students will use in their future careers as researchers and evidence based practitioners. Conclusion: This course elective provided practical application of evidence-based concepts and skills for students working on research projects or for students in the clerkship phase. Feedback from student participants reiterates the value of providing this type of information and has given us greater insight into optimal placement of topics in the broader school of medicine curriculum.'
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Institutional Repository Access Patterns of Nontraditionally Published Academic Content: What Types of Content are Accessed the Most?
Philip J. Kroth and Holly E. Phillips
TITLE: Institutional Repository Access Patterns of Nontraditionally Published Academic Content: What Types of Content are Accessed the Most? OBJECTIVE: To determine the value of posting nontraditionally published academic content, such as materials supplementary to peer-reviewed publications, poster images, graduate course research papers, and presentation slides to an institutional repository (IR). SETTING: A major, state-run universitys IR that has been operational since 2005 and that is actively supported by the institution's library. METHODS: Using the 'Statistics' functionality of the open-source IR software, DSpace, the monthly access rates were collected and analyzed for the following academic content types: 1) materials supplementary to journal articles published in traditional peer-reviewed journals, 2) slide images from presentations given at national or regional meetings, 3) research papers from a graduate student course in biomedical informatics in a Master of Science in Clinical Research program, and 4) poster images with or without the associated abstracts that were accepted for presentation at national or regional professional meetings. The analysis focused on both the access rates over time as well as comparing overall access rates between content types. RESULTS: The most frequently posted content type was poster images (24 items), followed by slide images (16), papers from the CTSC course (6) and supplementary materials (3). The most accessed content type during the first year after IR posting was supplementary materials to peer reviewed articles, papers from the CTSC informatics course, slide images then poster images. The average first year access rates were similar (from 17.3 to 25.7). After the first year, access rates decreased but did not completely stop. CONCLUSIONS: The average first year access rates were similar across content types, illustrating the utility of using IRs for the posting of nontraditional academic material. This is academic output that would not likely be otherwise captured and made freely available were it not for publication in an IR. Authors should be encouraged to post nontraditional content to IRs because it will likely be accessed for years to come.'
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The Future Roles of Librarians and the Interdisciplinary Imperative
Philip J. Kroth
Title: The future roles of librarians and the interdisciplinary imperative Abstract: Historically librarians have catalogued and organized a fairly small group of item types that were well standardized and relatively unchanging (e.g., books, journals, maps etc.) With the coming of the information age, not only is the amount of information that needs organizing increasing exponentially, but perhaps more significantly, the number of the kinds of items that need organizing are also increasing astronomically as well (e.g., genes, proteins, medications, electronic medical records, populations, etc.) Before the information age, the types of items were also tangible and easily understood. Now, they are more abstract, more complex, and more esoteric — often only well understood within the discipline or expertise that created them in the first place. Because of the exponentially increasing number of item types that need organizing, it will become imperative for librarians to collaborate with the disciplines creating the new item types they are helping to organize. Librarians will continue organize for sure, but not in the manner of just books and journals. Rather, the kinds of items they help organize will more numerous, more abstract, and oftenless tangible than perhaps anyone has imagined, \u2010\u2010 and perhaps much more exciting to work with.
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Using caTIES as a case-finding tool in tissue repositories: system challenges and lessons learned
Micaiah Evans, B.W. Trevor Rohm, Frederick Schultz, and Philip J. Kroth
The Cancer Text Information Extraction System (caTIES) comprises a set of tools that can dramatically streamline the tissue sample identification process using full text surgical pathology reports (SRPs) and natural language processing functionality. CaTIES also has the capability to de-identify SRPs. These functionalities can be of great value to tissue repositories by reducing human reviewer costs, making tissue with uncoded textbased SPRs much more available for research. Because caTIES is composed of multiple components, and has exact specifications for particular versions and configurations of these components, the installation and setup of caTIES presents a number of unique challenges. In addition, finding software support is often problematic as much of the documentation needed is incomplete, out of date, or located in obscure places. We summarized our experiences with setting up and configuring an instance of caTIES at the University of New Mexicos Tissue Repository and Experimental Pathology Laboratory by categorizing these challenges into four categories: 1) the pre-installation process; 2) the caTIES installation process; 3) program use and the user's manual; and 4) help and support. We describe the methods that we employed and the resources that we utilized in our successful installation. To evaluate the efficacy of caTIES for extracting accurate and relevant information from text-based SPRs, we are performing'
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Demystifying the NIH Public Access Policy: How to Optimize Access to Your Published Research
Philip J. Kroth, Holly E. Phillips, and Randall F. Stewart
This panel discussion and workshop will help AMIA members learn the skills necessary to participate in open access publishing, which include understanding the NIH Policy, choosing an optimal publication venue, and managing copyright. See full abstract in file attached to this record.
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Does Submitting Nontraditional Scholarly Content to an Institutional Repository Provide Academic Value to Submitters? A study at the University of New Mexico
Holly E. Phillips and Philip J. Kroth
Question:Does using the University of New Mexicos (UNM) institutional repository DSpaceUNM to publish nontraditional academic content, such as data sets, posters, and presentations, have tangible scholarly benefits for investigators. Participants: The study population is all registered users who have submitted scholarly work to the DSpaceUNM institutional repository. Setting: The study will take place at the UNM, a large academic institution located in Albuquerque, New Mexico. Method: An email will be sent to all DSpaceUNM users to learn if authors of archived information have gained any real professional value by posting their work to DSpaceUNM. Responses will be categorized by type of value and format of the posted work. Main Results: Anecdotally, the authors have experienced a number of unanticipated benefits from the posting of several pieces of nontraditional academic content into DSpaceUNM. We believe this study will uncover numerous other cases of unexpected benefits experienced by users who choose to deposit nontraditional ('grey') content. Conclusion: Using an institutional repository to disseminate nontraditional scholarly output is likely to increase investigators' exposure. The scholarly value of depositing nontraditional content in an institutional repository is likely to be demonstrated in unique and unexpected ways.'
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Poster: South Central Medical Library Conference
Claire Conrad and Deb LaPointe
Dr. Deb LaPointe and Claire Conrad performed a research project designed to answer the question: Wikis in Higher Education: Collaborative by Nature or Design? The research results were submitted as a poster at the South Central Medical Library Conference in Albuquerque in October 2007. Seven law students and six graduate students were interviewed. The students had been required to post content to wikis as a course requirement. The law students had posted content to the law clinic wiki while enrolled as students in the law school clinic. The six graduate students posted content to a wiki as part of Dr. LaPointes class on the Theory and Practice of Distance Learning in the College of Education. The students were interviewed and the results of the interviews were summarized in the poster. The research concluded that although wikis are easy to use and relatively inexpensive, designing wikis to actually be collaborative workspaces and guiding students to feel confident editing others' contributions requires investment of thought and planning. The poster received a second place award at the SCMLA Conference.'
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Re-imagining the Role of the Health Sciences Librarian in the New Information Economy: an Informaticists Perspective'
Philip J. Kroth
The future of medicine and medical librarianship is going to be significantly information and knowledge driven. How we defined physicians, patients, and librarians is going to be critical to the future success in these rapidly evolving fields. Philip J. Kroth, MD, MS, joined HSLIC in 2004 as the Assistant Director of Health Sciences Informatics Program Development and as an Assistant Professor in the School of Medicine. He holds a joint appointment in the Division of General Internal Medicine and is a practicing, board certified Internist. He is also the Biomedical Informatics Director for UNMs new Clinical and Translational Sciences Center. Dr. Kroth earned a Masters in clinical research and completed a 3-year, National Library of Medicine sponsored research fellowship in biomedical informatics, both at the Regenstrief Institute at Indiana University. He earned his BS is in Computer Engineering from the Rochester Institute of Technology and worked for 4 years in that capacity for Eastman Kodak Company in Rochester, NY before attending medical school at the Medical College of Ohio in Toledo. Dr. Kroth has performed research on the effectiveness of computerized decision support and his current interest is in quantifying the actual cost savings and quality improvements made possible in clinical care venues that have access to inter-institutional clinical data. Recent research also has focused on issues related to open access publishing: 'The National Institutes of Health (NIH) Policy on enhancing public access: tracking institutional contribution rates.' JMLA, 94(3): 279 — 283, July 2006. At HSLIC, Dr. Kroth is responsible for the development of the UNM Biomedical Informatics Training Program which is one of only a few in the country that are organizationally housed inside a health sciences library. This has provided Dr. Kroth with a very unique perspective on medicine and research from inside the 'librarians' world' as well as a view of the state of the health sciences librarian profession from the 'outside' perspective of physician and biomedical informatician.'
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Re-imagining Your Professional Boundaries and Future Patrons: Are You Ready for Your Second Life?
Holly E. Phillips, Deborah K. LaPointe, Geoffrey Alexander, and Nathaniel Schneider
Question/Purpose: To describe and demonstrate the virtual online world Second Life (SL) in the context of education, library, and health seeking behavior. Setting/Participants: An educator, a librarian, and a health seeking SL resident participate in a learner -oriented vignette on the SL Health Info Island. Brief Description: The authors will briefly describe the online virtual world SL, the relevant information seeking uses of the world, how the authors became interested in applying the online setting to health education and information dissemination, a few of the technological and social shortcomings of the site, and show a pre-recorded health education vignette in SL. Outcome: Over 7 million people worldwide have experienced SL. In many ways, the SL residents are using the virtual world in a manner similar to the geographically bounded world: meeting and communicating life experiences with new people, participating in an astonishing variety of educational sessions, and seeking informed and meaningful interaction with health professionals. Conclusion: As the world matures and SL locations become standardized with rules and interaction protocols, there will be a definite need for accurate and timely informational exchanges. There is already an information revolution occurring in SL, are you ready?
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