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NPUC 2007 logo: Stethoscope with binary streams

Monday, July 9, 2007


Astounding scientific advances in the 20th century have transformed medicine from folk art into a knowledge-driven, high tech industry. From using sensors and tests for diagnosis to new drugs, machines and surgeries for treatment, in addition to better organization and specialization for increased efficiencies, modern healthcare provides an unprecedented product -- longer and healthier lives. It is something that touches each of us daily.

And yet we sense that modern healthcare staggers under the weight of its own success. Today's healthcare professionals must handle vast amounts of data, knowledge, and treatment options, complicated by billing and insurance, in a web of complicated moving people and equipment. For the most part healthcare still relies on decades old paper and telephone-based communications and collaboration. Healthcare consumers are more engaged and have more options than ever before, but this also means they face puzzling choices and confusing bills. We believe it is time for advances in the healthcare interface to improve the experience for professionals and consumers alike.

In our fifteenth annual New Paradigms for Using Computers (NPUC), we invite you to explore with us the positive changes that computing technology can have on the user experience in healthcare. We will take a broad view and consider user interface issues in hospitals, clinics, the home and over the web. We will also discuss some of the challenges of adopting electronic technologies while preserving privacy and safety in a rapidly evolving networked information age. We hope to inspire the NPUC community to turn some of their deep talent in human computer interfaces to these important, valuable and challenging new paradigms for using computers.

NPUC 2007 Registration Closed. Hope to see you next year.

Agenda and Links to Speaker Abstracts and Biographies

  • 8:30am Registration, Continental Breakfast
  • 9:00am Welcome John Barton, NPUC Chair. (Aud. A/B)
  • 9:15am Paul C. Tang, MD, Palo Alto Medical Foundation
  • 10:15am Morning coffee break.
  • 10:30am Jakob E. Bardram, IT University of Copenhagen
  • 11:30am Introductions for Posters and Demos
  • 12:00 Noon Lunch J2-109, and Cafeteria Patio
  • 1:00 Coffee Dessert, Posters and Demo Session, Networking (Servery outside Aud.)
  • 2:00pm Peter Miller, Vanderbilt HealthTech Laboratory
  • 3:00pm Coffee Break
  • 3:15pm Barbara Bennett, Partner, Hogan & Hartson, LLP
  • 4:15pm Break
  • 4:30pm Elizabeth Mynatt, Georgia Institute of Technology
  • 5:30pm Reception on Mark Dean's Patio

Paul C. Tang, MD, Palo Alto Medical Foundation
HC-DUI: Creating a Health Care Digital User Interface

Abstract

Even more fragmented than American health care is the management of its information. Faced with a barrage of poorly organized health information, physicians and other clinicians must sift through uninspired displays to glean pearls of information necessary to make clinical decisions. The human-computer interface can either shroud or reveal the important elements of patient information and integrate it with domain knowledge bearing on the decisions at hand. Increasingly, patients and consumers will be the recipients and users of primary health information. New tools for information gathering from patients and for information rendering to patients must be developed in order to activate patients and their informal caregivers to become fully informed and fully empowered members of their health care team.

Biography
Paul Tang photo

Paul C. Tang, M.D., M.S., is an Internist and Vice President, Chief Medical Information Officer at the Palo Alto Medical Foundation (PAMF), Sutter Health. He is also Associate Clinical Professor at the University of California, San Francisco, School of Medicine. At PAMF, Dr. Tang is responsible for clinical information systems, including an enterprise-wide electronic health record (EHR) system and an integrated personal health record (PHR) system. PAMF has been using an EHR system since 1999 and deployed its PHR system in 2002. Over 80,000 patients (representing over 40% of PAMF’s primary care patients) are actively using the online PHR system (PAMFOnline).

Dr. Tang received his B.S. and M.S. in Electrical Engineering from Stanford University and his M.D. from the University of California, San Francisco. He completed his residency in Internal Medicine at Stanford University and is a Board-certified practicing Internist. Dr. Tang co-chaired the Strategy and Implementation subcommittee of the 1991 Institute of Medicine (IOM) committee which recommended that the United States adopt computer-based patient record systems nationwide, and later served as Chairman of the Board of the Computer-based Patient Record Institute, a public-private entity created following the release of the IOM’s report.

In 1994, Dr. Tang was appointed Medical Director of Information Systems at Northwestern Memorial Hospital and Associate Professor of Medicine at Northwestern University Medical School. At Northwestern, Dr. Tang implemented a computer-based patient record (CPR) system, for which he received the 1998 Nicholas E. Davies Award for Excellence in CPR System Implementation.

Dr. Tang is Chairman of the Board for the American Medical Informatics Association, the nation’s premier association of over 3,500 medical informatics professionals, and is a member of the National Committee on Vital and Health Statistics (NCVHS). Dr. Tang serves on the IOM’s Health Care Services Board and chaired a recent IOM patient safety committee whose reports were published in 2003-4: Patient Safety: A New Standard for Care, and Key Capabilities of an Electronic Health Record System. He is a member of Markle Foundation’s Connecting for Health Steering Committee and its Personal Health Technology Council. He chairs the Robert Wood Johnson Foundation’s National Advisory Council for ProjectHealth Design (dealing with PHRs).

Dr. Tang has served on numerous committees of the National Institutes of Health, National Research Council, National Academy of Sciences, Institute of Medicine, and Computer Science and Technology Board. He is a Fellow of the American College of Physicians, the American College of Medical Informatics, the College of Healthcare Information Management Executives, and the Healthcare Information and Management Systems Society

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Jakob E. Bardram, IT University of Copenhagen
From the Desktop to the Operating Room (and beyond...)

Abstract
Healthcare is currently facing a number of significant challenges mainly due to an increasing elderly population combined with a lack of resources. There is a general agreement that information and communication technology (ICT) holds promise for mitigating these challenges. The problem is, however, that contemporary technology to a large degree is built for information worker in an office environment - not for use in hospitals or in the patient's home. In the talk I will present how studies of hospital work, including the use of computer technology has motivated a range of pervasive computing projects and technologies. Particularly, I will present two cases. The first case presents the concepts and technologies of "Activity-Based Computing" (ABC), which seeks to provide a new foundation for the design and development of pervasive computing technologies. ABC has special focus on mobility, context-awareness, collaboration, integration between heterogenous systems and devices, as well as new user-interface concepts. The second case presents work on supporting social, spatial, and temporal awareness for nomadic clinicians in an operating ward.
Biography
Jakob Bardram photo

Jakob E. Bardram is a professor at the IT University of Copenhagen (ITU). Prior to this position, he was an associate professor at the Computer Science Department, University of Aarhus and the manager of the Danish Centre for Pervasive Healthcare. His research interests are Pervasive Computer Systems, Object Oriented Software Architecture, Computer Supported Cooperative Work (CSCW); and Human-Computer Interaction (HCI). The main application area of this research is within healthcare, especially Pervasive Healthcare.

In the summer of 2006 he co-founded the company C3A Medical which specialize in the development of pervasive computing technology for hospitals, and he has also help found CLC Bio which develops bioinformatics software.

Jakob E. Bardram has previously held positions as project manager and IT architect at IBM Denmark, where he architected and managed several e-business projects. And he has been an industrial research fellow at CSC Scandihealth, where he worked with software architectures for cooperative systems in hospitals.

Jakob E. Bardram received his PhD in computer science in 1998 from the University of Aarhus, Denmark. Since returning to academia in 2001, he has been involved in several research and development projects with industry. He has just finished editing a book on Pervasive Healthcare and has edited a special issue of Pervasive Healthcare in the IEEE Transactions on Information Technology in Biomedicine. During his scientific career, Jakob Bardram has published more than 40 original papers in international scientific books, journals, and conference proceedings.

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Peter Miller, Vanderbilt HealthTech Laboratory
Designing a Portable Clinical Gateway

Abstract

The locus for the delivery of healthcare services is found primarily in emergency rooms, primary and group practice offices, specialized care settings and hospital clinics. Other locations, such as assisted living facilities, nursing homes and hospices are becoming increasingly important as the elderly cohort of the population continues to grow in size. However, fundamental changes may be in store for the future. Today’s loosely coupled network of individuals, providers and payers will evolve into to a more tightly coupled network of individuals, families, their support community and their community of care. Clinical care will be delivered on a spectrum that stretches from self-care and monitoring to full-fledged clinical engagement in a tertiary medical care setting.

A new information and knowledge management approach is essential to support this emerging new healthcare architecture. Healthcare providers may no longer be able to depend on having the full facilities of a modern medical center at each encounter with an individual. Neither will they be guaranteed to have required medical history or other relevant clinical information available in a convenient form.

The Vanderbilt HealthTech Laboratory believes that a Portable Clinical Gateway (or PCG) can supply healthcare providers with the knowledge, information and data they require in real time at the point of care. The end result of such a capability will be improved quality of care and reduced errors. While the underlying computational and communication technologies are quickly converging to enable this kind of capability, institutional, policy and privacy concerns must be addressed or it will never have the opportunity of becoming a reality.

The sine quo non of a Portable Clinical Gateway is the ability to access situation-specific information, knowledge and data relevant to carrying out the responsibilities of a healthcare provider. The ability to issue orders and prescribe medications is also critical to its success. For the PCG to succeed, it must be location-aware and operate correctly in different settings. It must also seamlessly connect to wireless-based monitors, sensors, and sensor networks.

A key success factor for the PCG is the user interface. As Apple has shown with the recent introduction of its iPhone, the user interface of a smartphone must be highly intuitive and non-intrusive. The PCG, while operating, must in essence, disappear in a clinical encounter. A key interface technology will most likely be voice. It is the natural method of creating notes and observations (for later transcription or conversion to digital form). However, anticipatory and task-based individualized interfaces (using both supervised and unsupervised learning techniques) will be necessary to reduce the learning curve and utilization overhead to as low a threshold as possible. Technologies such as eye-tracking when used in conjunction with a miniaturized virtual screen can facilitate the rapid navigation of potentially large amounts of information. Cues and guides of various sorts will help point the user to the relevant information for a given situation. And contexts of all kinds will be preserved and not lost as a user smoothly moves from one function to another and back again. Designing a powerful non-intrusive user interface for the PCG will be a major challenge that must be met if it is to succeed.

Biography
Peter Miller photo

Peter Miller is the Director of the Vanderbilt HealthTech Laboratory, whose mission is to foster the revolutionary transformation of healthcare process through the discovery and demonstration of disruptive informatics-based technologies empowered by a unique public-private collaborative ecology.

In 2003, because of a personal commitment to improving our nation?s security, Mr. Miller chose to leave private industry to join the U.S. Department of Homeland Security. He was the Director of the Mission Support Office of the Homeland Security Advanced Research Projects Agency, a component of the Science and Technology Directorate. In recognition of his contributions, In 2005 Mr. Miller won the Secretary's Award for Excellence and the Under Secretary's award for Program Management.

Mr. Miller was the founder and CEO of 1010data, Inc., a provider of advanced data mining and analysis services over the Internet. He was a founder and President of ON Technology, Inc a pioneering developer of advanced networked collaborative applications. He founded an Internet travel company and was a partner with John Sculley in a private equity/venture capital business. Mr. Miller was a senior corporate Vice President at Viacom, Inc. in charge of interactive services, Head of Engineering for the Consumer Products Division of Apple Computer and Director of Advanced Technology at Lotus Development Corporation.

Mr. Miller graduated from the City University of New York with a B.S in mathematics where he received the Borden prize and from the Massachusetts Institute of Technology with an SMEE in computer science and electrical engineering. He has published papers in the areas of computer language development, security and access control, data base architecture, programming environments, artificial intelligence applications in medical diagnosis and knowledge representation.

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Barbara Bennett Partner, Hogan & Hartson, LLP
Health Care Legal Implications of User Interface Technology

Abstract

Innovation and progress in health care is hampered by an often Byzantine regulatory framework that is slow to adapt and quick to punish. Health care is one of the most heavily regulated industries in the U.S., and health care laws tend to be among the most counterintuitive. The convergence of information technology, a virtually unregulated industry, and health care creates new legal and ethical decision points that tend to confound those new to the area, often at inconvenient times in the business cycle.

Numerous areas in health care law not only can have a profound impact on the success of a product or application, but can prevent its ever reaching the market. The federal Food and Drug Administration regulates medical devices, radiation-emitting devices, and software used to diagnose or treat disease in humans or animal: how each is made, packaged, labeled, marketed and sold. Rules and regulations that determine whether and how medical products and services will paid for by Medicare and other third party payors--an essential requirement for a medical device or service--are not readily apparent and must be taken into account early in the development cycle. The myriad overlapping and complex federal and state privacy and security rules that apply to health information and any product, device or application that collects, stores, analyzes or transmits that data require close attention and planning on the front end by engineers, scientists and top management. The user interface aspect in each case can be the component most severely scrutinized for legal compliance, not only by enforcement authorities but also by investors and business partners.

All these considerations must be factored into business strategy and budget and identified as risk factors to the market. And the considerations are not static--the state of the law and technology both are dynamic and not at all in sync with one another. There are guiding principles, however, to identifying and managing legal risk in a way that facilitates business strategy. This discussion identifies selected high level legal issues relevant to emerging user interface technology, provides concrete examples of their application to specific technologies, and suggests techniques for managing the risk and even shaping the law.

Biography
Barbara Bennett photo

Barbara Bennett's practice focuses on health care transactions and strategic business advice, with a concentration on health care technology and bioscience clients along with traditional health care businesses. She also counsels businesses on data protection and data analytics issues, including compliance with the Health Insurance Portability and Accountability Act (HIPAA) privacy and security rules, consumer protection strategies and intellectual property laws.

Barbara's health care experience includes representation of technology and information services companies, health care providers and payors, investment banks, and management service companies in transactions involving life sciences companies, information technology services businesses, physicians, hospitals and academic medical centers, health maintenance organizations (HMOs), and other managed care entities. She also counsels both early-stage and established technology and biotechnology clients.

Barbara has spoken extensively on health care legal issues and was editor of the 2002 BNA treatise E-Health Business and Transactional Law. She is trained in dispute resolution and served on the approved panel for court-appointed mediators in Tennessee state courts. Barbara was appointed to and served on both the Tennessee Supreme Court Commission on Alternative Dispute Resolution and the Civil Justice Reform Act Advisory Committee for the U.S. District Court for the Middle District of Tennessee.

Prior to joining Hogan & Hartson in 1997, Barbara was general counsel and corporate secretary of an HMO management company, TriPoint Health Group. There she was responsible for the overall management of the internal and external legal and regulatory affairs of the company and its subsidiaries.

Prior to that, from 1986-1995, she was associate general counsel of Vanderbilt University, representing the University’s Health Sciences Center for managed care issues and transactions matters, and representing the university overall for intellectual property and technology transfers, cost accounting (including audit and negotiation), and insurance and risk management. She created and implemented policy and strategy, as well as evaluated and structured joint ventures and other business opportunities for the university in health care, technology, and other areas.

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Elizabeth Mynatt, GVU Center Director, Georgia Institute of Technology
Pervasive Technology for Chronic Disease Management

Abstract
Healthcare for chronic disease is the dominant cost for many healthcare systems, now and for the foreseeable future. The unique capabilities of pervasive technologies have the potential to transform chronic healthcare practices by shifting care from acute to home settings, by enabling continuous data capture and analysis, by creating a network of communication channels, and by helping individuals engage in their own care. However this transformation requires rethinking the processes surrounding healthcare. Trying to substitute new technology into old processes will not work. In this talk, I will discuss a set of research projects that tackle challenges in creating pervasive technologies for chronic healthcare including  how cancer treatment can be improved via technologies in the home, how individuals can manage diabetes through mobile technologies, and how the treatment of autism can be informed by technologies deployed in elementary school classrooms. Through the lens of these research projects, I will identify common themes in technology and interface design particularly salient to health care and wellness.
Biography
Elizabeth Mynatt photo

Elizabeth D. Mynatt is the GVU Center Director, past HCC Ph.D. Program Faculty Coordinator, and an Associate Professor in the College of Computing at the Georgia Institute of Technology. There, she directs the research program in Everyday Computing — examining the human-computer interface implications of having computation continuously present in many aspects of everyday life. Themes in her research include supporting informal collaboration and awareness in office environments, enabling creative work and visual communication, and augmenting social processes for managing personal information. Dr. Mynatt is one of the principal researchers in the Aware Home Research Initiative; investigating the design of future home technologies, especially those that enable older adults to continue living independently as opposed to moving to an institutional care setting.

Dr. Mynatt is an internationally recognized expert in the areas of ubiquitous computing and assistive technologies. Prior to her current position, she worked for three years at Xerox PARC — the birthplace of ubiquitous computing — alongside its inventor, Mark Weiser. Her research explored how to augment everyday places and objects with computational capabilities. She has chaired multiple conferences on computer interface technologies and auditory displays, published numerous articles, and is an active leader in her field.

Dr. Mynatt is a Sloan Research Fellow. Her research is supported by multiple grants from the National Science Foundation including a five-year NSF CAREER award. Other honorary awards include the 2001 College of Computing's Junior Faculty Research award and the 2003 College of Computing's Dean's Award. Dr. Mynatt received her Ph.D. in computer science at Georgia Tech under the guidance of Dr. James Foley. Her dissertation work pioneered creating nonspeech auditory interfaces from graphical interfaces to enable blind computer users to work with modern computer applications. Her M.S and undergraduate degrees in computer science were granted from Georgia Tech and North Carolina State University respectively. A native of Knoxville, Tennessee, Dr. Mynatt resides in Atlanta, Georgia with her husband and two children.

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