Medical Informatics Research Laboratory
Main Objectives
This research focuses on understanding and promoting effective organization, analysis, management, and use of information in healthcare.
- The medical informatics laboratory has two principle focus areas:
- The use of standardized clinical vocabularies to support electronic health information exchange
- Investigation of medical informatics applications to improve healthcare delivery and research.
Research Environment
The medical informatics laboratory operates in association with the Regenstrief Institute, Inc., an internationally recognized healthcare research organization dedicated to improving health through research that enhances the quality and cost-effectiveness of care. Regenstrief investigators are international leaders in medical informatics standards and electronic medical record systems, and have established the Indiana Network for Patient Care, one of the nation's oldest and largest community-wide information exchanges.
Current Projects
Creation, Maintenance and Distribution of Logical Observation Identifiers Names and Code (LOINC®)
Investigators
Paul Dexter, MD (Indiana University School of Medicine and Regenstrief Institute, Inc)
Daniel J. Vreeman, PT, DPT (Indiana University and Regenstrief Institute, Inc)
Summary
The Regenstrief Institute has been a leader and active participant in medical informatics standards development. IU/Regenstrief Institute initiated the LOINC® vocabulary standards for laboratory and clinical observations. LOINC has been adopted by the largest commercial laboratories and most Federal agencies (CDC, DOD, CMS). This project is focused on the creation, maintenance, and distribution of the LOINC vocabulary.
Funding Sources
National Library of Medicine
Automated Mapping of Local Clinical and Laboratory Terms to LOINC
Investigators
Daniel J. Vreeman, PT, DPT (Indiana University and Regenstrief Institute, Inc)
Clement J. McDonald, MD (Indiana University School of Medicine and Regenstrief Institute, Inc)
Summary
The goal of anywhere, anytime medical information exchange is impeded by the plethora of local conventions for identifying health data in separate electronic systems. Mapping local terms to a standardized vocabulary such as LOINC bridges the many islands of health data that exists and facilitates data aggregation. But, mapping terms is a complex, labor-intensive process. Automating the process of mapping local terms to LOINC has the potential to improve the efficiency and consistency of the mapping process.
Funding Sources
National Library of Medicine
Centers for Disease Control and Prevention
Publications
Vreeman DJ and McDonald CJ. Automated mapping of local radiology terms to LOINC. AMIA Annu Symp Proc. 2005;769-773. [Medline]
Vreeman DJ and McDonald CJ. A Comparison of Intelligent Mapper and document similarity scores for mapping local radiology terms to LOINC. AMIA Annu Symp Proc. 2006;809-813. [Medline]
Vreeman DJ. Keeping Up with Changing Source System Terms in a Local Health Information Infrastructure: Running to Stand Still. Medinfo. 2007. (in press).
Use of Controlled Vocabularies to Support Electronic Health Information Exchange
Investigators
Daniel J. Vreeman, PT, DPT (Indiana University and Regenstrief Institute, Inc)
Summary
Interoperable health information exchange is hindered by the myriad idiosyncratic conventions for identifying similar data in separate electronic systems. Clinicians, administrators, and researchers all need a complete set of clinical information, coalesced from all of the various sources that produce health data. Mapping local observation codes to a universal, controlled terminology provides a bridge across those islands of data, yet this work is challenging and resource intensive. The goal of this work is describe and understand the challenges and develop tools to overcome them.
Funding Sources
None
Publications
Vreeman DJ. Keeping Up with Changing Source System Terms in a Local Health Information Infrastructure: Running to Stand Still. Medinfo 2007. In Press.
Presentations
Vreeman DJ. Maintaining Mappings from Source Systems in a Local Health Information Infrastructure. AMIA Annu Symp Proc. 2006; 1131. [Medline]
Evidence for Electronic Health Record Systems in Physical Therapy
Investigators
Daniel J. Vreeman, PT, DPT (Indiana University and Regenstrief Institute, Inc)
Samuel J. Taggard, PT, DPT (Portsmouth Regional Hospital)
Michael D. Rhine, PT, DPT (Concentra Medical Centers)
Teddy W. Worrell, PT, EdD, SCS, ATC, FACSM (Duke University)
Summary
With burgeoning pressures to better manage clinical information through information technology, this project sought to investigate the role of Electronic Health Records (EHRs) in physical therapist practice. This project identified, reviewed, and summarized the benefits, barriers, and key factors for success in implementing EHRs in physical therapist practice.
Funding Sources
National Library of Medicine
Publications
Vreeman DJ, Taggard SL, Rhine MD, Worrell TW. Evidence for electronic health record systems in physical therapy. Phys Ther. 2006;86-434-449. [Medline]
Vreeman DJ. A Physical Therapist's Guide to the National Health Information Network. PT Magazine. 2006;16(4):28-33.
Vreeman, DJ. Clinical Prediction Rules. Phys Ther. 86(5). [Medline]
Presentations
Vreeman DJ, Taggard SL, Rhine MD, Worrell TW. Implementation of Electronic Health Record Systems in Physical Therapy: A Systematic Review. APTA Annual Conference 2005, Boston, MA. [Phys Ther Abstract Index]
Vreeman DJ, Taggard SL. On the Road to a National Health Information Network: Implications for Physical Therapy. APTA Combined Sections Meeting 2006, San Diego, CA.
Vreeman DJ, Eng J, Herbold J. Using Information Technology to Develop and Implement Evidence-based Practice. APTA Combined Sections Meeting 2007, Boston, MA.
Creating an Indiana-Ohio Center for Traumatic Amputation Rehabilitation Research
Investigators
Mark S. Sothmann, PhD (Indiana University, Indiana Center for Rehabilitation Sciences and Engineering Research)
Daniel J. Vreeman, PT, DPT (Indiana University and Regenstrief Institute, Inc)
Bradley Doebbeling, MD (Indiana University School of Medicine, Regenstrief Institute, Inc, and Richard L. Roudebush Veterans Administration Medical Center)
Paul Dougherty, MD (Henry Ford Hospital)
Neil Oldridge, PhD (University of Wisconsin-Milwaukee)
Stephen Wilson, PhD (The Ohio State University)
Deborah S. Larsen, PhD (The Ohio State University)
Summary
Rehabilitation represents the interface of technology and therapeutic interventions to promote increased function and quality of life. The Iraq and Afghan conflicts have highlighted the dearth of information on the long term outcomes of military personnel experiencing traumatic amputation from conflict. This project proposes to establish an Indiana-Ohio Center for Traumatic Amputation Rehabilitation Research (Indiana-Ohio Center) to promote outcomes research on a population with potentially unique rehabilitation needs for long-term health and welfare. Phase I will create the Indiana-Ohio Center and will establish a nation-wide database of Vietnam veterans with traumatic amputation as phase 1 of a multiple year, three phase approach to fully testing the overarching hypothesis. Phases 2 and 3 will focus on collecting data pertaining to key outcomes indicators.
Research Environment
This project seeks to establish the Indiana-Ohio Center which will be administered by the Indiana Center for Rehabilitation Sciences and Engineering Research (ICRSER). ICRSER is housed in the Indiana University School of Health and Rehabilitation Sciences which is one of seven collaborating schools on the Indiana University Purdue University (IUPUI) campus, the Richard L. Roudebush Veterans Affairs Medical Center (VAMC), and the Rehabilitation Hospital of Indiana. The Indiana-Ohio Center will establish research priorities and will serve as an organizational structure through which subsequent research proposals will be submitted for competitive funding of outcomes studies conducted to give direction to the unique rehabilitation needs of those experiencing traumatic amputation arising from conflict.
Project Website: https://www.vietnamwaramputee.org/
Funding Sources
Department of Defense
Comliance with Guidelines for ADHD: A Pilot Study of an Evaluation Tool
Investigators
Rachel C. Vreeman, MD (Indiana University School of Medicine)
Kristine A. Madsen, MD, MPH (University of California, San Francisco)
Daniel J. Vreeman, PT, DPT (Indiana University and Regenstrief Institute, Inc)
Aaron E. Carroll, MD, MS (Indiana University School of Medicine and Regenstrief Institute, Inc)
Stephen M. Downs MD, MS (Indiana University School of Medicine and Regenstrief Institute, Inc)
Summary
The goal of this project was to develop and test a chart abstraction tool for describing the quality of pediatric ADHD care using computer-interpretable paper forms. Our simple, reliable chart abstraction tool for evaluating compliance with ADHD guidelines will be useful in future quality improvement efforts. In pilot data, few charts documented compliance.
Funding Sources
None
Publications
Vreeman RC, Madsen KA, Vreeman DJ, Carroll AE, Downs SM. Compliance with Guidelines for ADHD: A Pilot Study of an Evaluation Tool. J Pediatric. 2006;149(4):568-571. [Medline]