Overview	People	Research	Course	Publications	Resources	Links
	Research Projects Increasing Inner-City Access to Health Information Project (Funded By NLM Systems Grant. PI: Maxine Rockoff, New York Academy of Medicine.) The New York Academy of Medicine (NYAM) and the Columbia University Department of Biomedical Informatics (DBMI) working with a consortium of community-based organizations to promote inner-city access to health information in order to reduce disparities in access to health information experienced by disadvantaged inner-city residents. This recently funded project adds a health information outreach component to existing social services programs in community-based organizations (CBO). The specific aims are to: 1. Develop bilingual train-the-trainer health information outreach program and tailor it to senior centers and Head Start programs. 2. Create a web site and listservs to enable Head Start and senior center program participants, staff and volunteers to contribute to the continuing development and enhancement of the health information outreach program. 3. Characterize patterns of health-information seeking behavior of participating seniors and Head Start parents before and after the health information outreach program using a combination of quantitative and qualitative techniques. Train-the-trainer classes are based on NYAM's "Health Information on the Internet" course with a focus on bilingual consumer health resources available from the National Library of Medicine and NOAH - New York Online Access to Health (a bilingual health information portal maintained by NYAM). Over the course of the ongoing study, 24 CBO staff and 84 program participants will receive training, with 1/3 having Spanish as their primary language. (Research Team: David Kaufman, Luiz Pereila) CIQR (Seeker): Context-Initiated Question and Response (Funded By NIH/NLM. PI: Eneida Mendonca) During the process of patient care, clinicians frequently experience the need for information about treatment, diagnostic workup, disease progression and other aspects of patient management. In most of these situations, it is difficult or impossible for the clinician to immediately access appropriate information resources. Most information needs are never adequately articulated or recorded, and consequently are forgotten by the end of the day. Moreover, when clinicians do recall information needs, they often don't act on them, due to the significant limitations of current retrieval systems and the exigencies of clinical practice. CIQR is the outgrowth of several years of research in information retrieval with the goal of finding out what information the user really wants to know and delivering it when and where it is needed. A unique aspect of the approach is that the user submits open-ended, multi-sentence questions, not just key words. This enables the user to provide contextual background related to the question, such as pertinent characteristics of the patient, the purpose of the query, and the kind of materials the user is seeking. These items provide vital clues for constructing search strategies that are better tuned to the user's environment and emergent goals. The approach is predicated on a cognitive process model of information seeking and has given rise to a range of cognitive studies. These studies can be conceptualized from understanding information needs articulation to characterizing expert search strategies. The project also includes a significant human-computer interaction component related to the selection of mobile tools for recording of information needs in situ and receiving responses in a format that is comprehensible. (Research Team: Eneida Mendonca, Stephen Johnson and David Kaufman) Evaluating Mobile Health Devices as tools for Patient Self Management In recent years, mobile devices such as PDAs, cell phones and smart watches have become vital resources for communication and personal information management. These devices have increasingly permeated the health care arena enabling clinicians with rapid access to patient data as well as providing patients with powerful self-management tools. There has recently been a proliferation of new glucose meters that offer a wide range of enhanced functions including extensive storage capacity and the ability to upload data to a computer. These devices also afford users the ability to record and review a range of information pertaining to diet, medications, exercise, and doctor visits. Although the enhanced functionality of these meters is a promising development for the burgeoning diabetes population, relatively little is known about their usability. We have completed a usability evaluation of a multifaceted glucose meter that provides a range of resources for assisting patients in the management of their condition. The evaluation included a cognitive task analysis and usability testing with five older adults varying in their levels of computer experience and literacy. The purpose of evaluation is to identify aspects of a device that facilitate or impede its productive use. A related objective is to ascertain whether patients could develop a basic mastery of the system, as reflected in the extent to which they can autonomously perform or learn to perform the range of tasks that the device supports. In general, mobile health devices offer great promise for both patients and clinicians. However, this promise maybe attenuated by suboptimal design that adds to task complexity and user frustration. (Research Team: David Kaufman, Justin Starren, Charlyn Hilliman, Jenia Pevzner, Albert Lai) Cognition and Instruction in Health Sciences Education (PI: Vimla L. Patel) Components of problem-based education, such as small group teaching, are being implemented in diverse health curricula. Implementation, however, is often motivated by the intuitive appeal of many problem-based learning components, when what is needed is the detailed examination of how these components support students' integration of knowledge as well as continuity of their learning experiences. To this end, we have investigated the effect of curricular change on knowledge integration and reasoning processes during explanation-based problem solving by medical students; the relationship between lecture and small group teaching (SGT) in a medical curriculum; and problem-solving performance of house staff with undergraduate medical training in either conventional or problem-based schools. Our results have shown that problem-based small group discussions appear to facilitate knowledge integration using elaborations and hypothesis-driven strategies and that carefully designed small group sessions serve the purposes of 1) illustrating broader concepts in lectures to case-specific, clinically relevant problem-solving and 2) promoting knowledge integration from diverse sources of information. Further, our work has suggested that house staff trained in a conventional curriculum (CC) focused on patient information, separated biomedical from clinical knowledge, and used data-driven strategies. House staff from problem-based learning curricula (PBLC) organized their knowledge around generated inferences, integrated biomedical and clinical knowledge, and used hypothesis-driven strategies. Data-driven reasoning appears to be impeded in PBLC, suggesting that PBLC students have difficulties in acquiring problem schemata. We are exploring these results in relation to assumptions in health professional curricula about the adequacy of hypothetic-deductive methods of reasoning as teaching mechanisms and the need for clinical and biomedical knowledge integration. (Research Team: José F. Arocha (University of Waterloo), Tim Branch (McGill University) and Daniel R. Karlin)