Buffalo, NY (May 5-6, 2006) – A group of physicians, educators, and informaticians gathered in Buffalo this weekend to explore ways to develop and facilitate use of treatment guidelines to dramatically improve patient care at the Invitational Symposium on Diffusion, Adoption, and Maintenance of Psychiatric Treatment Algorithms. According to The First National Report Card on Quality of Health Care in America (Rand Corporation, 2006), only 50% of patient care in general medicine is optimal. The Symposium, co-sponsored by the International Psychopharmacology Algorithm Project (IPAP) and the School of Informatics, University at Buffalo SUNY, focused on opportunities to improve these outcomes through easy access to high quality treatment guidelines available at the point-of-care.
“The main purpose of the Symposium was to share knowledge, expertise, and learning across disciplines with the intent of improving algorithms and their usefulness to care providers,” said Dr. Ken Jobson (IPAP) and co-host of the Symposium, “and proved to be a deeply rewarding experience for attendees.” Dr. W. David Penniman, University at Buffalo, and co-host agreed that “this conference has heightened awareness among disparate, yet complementary disciplines, thereby fostering a ‘community of interest,’ significantly increasing opportunities for success in achieving our goals.”
Dr. Dave Davis, Professor of Family Medicine and Health Policy, Management and Evaluation, University of Toronto noted that the clinician’s trying to consider all of the information available about patient treatment is “like putting a fire hose in one’s mouth to get a drink: the sheer volume of information (medical and otherwise) is unmanageable without computer/digital assistance.” Dr. Jobson agreed that “past progress on treatment guidelines has also been slow because the approaches to addressing the information overload have largely been discipline-based instead of problem-based. Collaboration among experts in informatics, treatment algorithm development, cognitive psychology, clinical medicine, innovation diffusion, persuasion technology, and medical administration fills an unmet need.”
The symposium suggested two revolutions which both involve changing how to medical information can be used to advantage:
§ Providing convenient algorithms and other decision support for guiding care based on evidence-based medicine, and
§ Providing continuing medical education connected to practice-based point-of-care computerized decision support systems.
Each of these revolutions brings advantage to the doctor and patient at point-of-care, and both must be tailored to how medicine is practiced in the specific venue.
Keynote speaker, Dr. Edward Shortliffe, Professor and Chair of the Department of Bioinformatics, College of Physicians and Surgeons, Columbia University, also stressed the shared cautionary view that such guidelines are valuable as input but “they are not ‘cookbook recipes’ for care. Their optimum use is ‘to guide.’ The final decision rests with the clinician and a particular patient at a particular time.”
The Symposium was also a working session to inform algorithm and guideline development. Participants discussed the power and importance of guidelines formulated with a feedback loop and integrated for easy access with point-of-care technology. This integration can further enable the physician to review options and choices both for reminders and as tools to frame deeper research into available knowledge about treatment options and outcomes; improves physician access to new knowledge; and, can also be used to inform physician-patient communications. Members of the Symposium also cited the importance of using the algorithms as part of electronic decision support systems (DSS) so care providers would have both patient information and guidelines at their fingertips at the point-of-care. Participants shared best practices in keeping current, evidence-based guidelines available.
The participants discussed many related usage topics such as the need to consider algorithms and care guidelines for multiple audiences, including psychiatrists, primary care physicians, and healthcare professionals with emphasis on those in low-resource countries, and, of course, patients.
During the course of the two-day Symposium, participants also gained an appreciation of new ways symposium participants could work together in future. Consensus among participants was that Symposium was the beginning of a significant, new, cross-disciplinary collaboration and community.
Attendees represented the fields of informatics, bioinformatics, psychiatry, psychology, Continuing Medical Education, persuasion technology, human/computer studies, innovation diffusion, health and human resource consulting. They came from the University of Buffalo, Columbia University, Duke University, Harvard University, Stanford University, the Universities of Michigan, Rochester, Tennessee, Toronto, Vanderbilt University, the American Psychiatric Association (APA) and the Veterans Administration (VA). There were algorithm and guideline developers from the Canadian Psychiatric Association, Harvard Psychopharmacology Algorithm Project, Infectious Disease Association of America (IDAA), APA, Collegium Internationale Neuro-Psychopharmacologicum (CINP) and from the hosting organizations of IPAP and UB. Participants also included representatives from Cerner Corporation, CRIS, Eclipsys, IBM, Medical Decision Logic, PKC, and n. Dr. Jose Manoel Bertelote of the World Health Organization (WHO) in Geneva was an honored guest.
Funding was provided by the Dean Foundation, Welch-Allyn and Blue Cross Blue Shield.
FOR ADDITIONAL INFORMATION:
Dr. Kenneth Jobson, MD
Chairman of IPAP Board
Dr. David Penniman, PhD
Dean, School of Informatics
University at Buffalo
(716) 645-6481 x1176
International Psychopharmacology Algorithm Project (IPAP) (www.ipap.org)
IPAP is a not-for-profit corporation established with the purpose of bringing together experts in psychiatry, psychopharmacology, and algorithm design to enable, enhance, and propagate the use of algorithms for the systematic treatment of major Axis I psychiatric disorders. The approach is polythetic with a central psychiatric focus, utilizing other relevant fields including data modeling, information science (informatics) cognitive science and general medicine. In furtherance of its objectives, IPAP has held or participated in various conferences (1993, National Institutes of Mental Health (NIMH); 1996, Vienna; 1997 Web Conference; 1999 Meta-Conference; the Japanese Psychopharmacology Algorithm Project’s 1998 Yokohama Forum; the CPAP/IPAP 2000 Beijing Conference; CPAP/IPAP 2002 Beijing Conference; and 2005 ADD/ADHD Conference in Beijing) and symposia (2002 Collegium Internationale Neuro-Psychopharmacologicum in Montreal, 2002 World Congress of Psychiatry in Yokohama).
University at Buffalo, SUNY (www.informatics.buffalo.edu)
The University at Buffalo is a premier research-intensive public university, the largest and most comprehensive campus in the State University of New York. The School of Informatics, the newest School at the University at Buffalo, and one of two such schools in the United States, is educating the next generation of information professionals, knowledge workers and communication and information researchers. The shared principle that information serves the purposes of human communication and is enhanced by technological systems is at the core of its curriculum and research. The School of Informatics is concerned with harnessing communication and information theory to develop best practices, analyze policy, and conduct basic research. Its focus is on the nexus of people, information, and technology in a variety of domains including healthcare, education, national security, and community-based information systems.