Informatics in the Round

Live from the studio, it's Informatics in the Round! Okay, we aren't technically live, but we are bringing you an extra special episode from the Penn Engineering Online studio! Since all our guests are from the University of Pennsylvania, we thought we would sit down in-person to enjoy this lively discussion. Today we are talking all about chatbots and the future of generative AI in medicine. We discuss topics such as what chatbots are, whether they present the markers of true artificial intelligence, what innovations we are looking forward to, and the benefits and barriers to integrating them into our healthcare settings. 

First, we had Dr. Angela Bradbury, an Associate Professor of Medicine and a medical ethicist at the University of Pennsylvania. She is also founder of the Penn Telegenetics Program, a national program using telehealth and digital tools to increase access to genetic medicine. Her research program has been developing patient-centered digital tools, including chatbots, to address the use of genetics in medicine and a limited genetics workforce. As a medical ethicist, she is particularly interested in how we responsibly deploy digital tools and generative AI in medical practice to improve patient outcomes.

We also had Lyle Ungar, a Professor of Computer and Information Science at Penn. He researches the psychological dimension of natural language processing and artificial intelligence. His research group of psychologists and computer scientists study what language reveals about physical and mental well-being. They are building culturally aware chatbots for mental health support and teaching "soft skills" to high school students.

Finally, we had Chris Callison-Burch, a Professor of Computer and Information Science whose AI course at Penn has one of the highest enrollments at the university with about 750 students. His research focuses on applications of large language models to address long-standing challenges in artificial intelligence. He’s a leading expert on AI and has appeared in front of Congress as well as on many podcasts to discuss the future of generative AI and intellectual property. We are so grateful to have all these expert guests on this episode and in the room with us!

Oh, and we had a guest star hosting this episode—Ellie Shuert, our production assistant, stepped out from behind the scenes. She is freshly graduated from the University of Pennsylvania with a degree in English and Linguistics. Her curiosity about AI and natural language processing gave our guests lots to think about, and it was so fun to let her direct an episode.

Thank you so much to Penn Engineering Online for hosting us in your beautiful studio space! It was the perfect place to enjoy this conversation. If you are listening, we suggest maybe going over to our YouTube channel to watch us film in such a cool space!

This is truly one of our favorite episodes of the year, and we are so excited to share it with you!

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Welcome, everyone, to your introductory course in public health informatics! On today's episode, we discuss all things public health, including what it is, how it varies on a state and national level, and how health departments respond to public health crises. We demystify some of our misconceptions about how the public health system works, like how state departments are separate from the CDC, how we share disease statistics such as during the COVID-19 pandemic, and how our medical history may or may not travel with us from state to state. Of course, our question always is, why does informatics matter in this conversation? Our guests have many ideas about how we can utilize informatics to create more efficient means of sharing data and, by extension, improving our overall public health.

Dr. Bryant Thomas Karras is the Chief Medical Informatics Officer at the State of Washington Department of Health and a faculty member at the University of Washington's School of Public Health. He is a physician, biomedical engineer, and informatician who uses his multifaceted experience to promote interoperability and help various agencies utilize new technologies in their public health efforts. He's advised health departments on a local, state, and national level, including the Center of Disease Control and Prevention and the U.S. Department of Health and Human Services.

Dr. Jessie Tenenbaum is an Associate Professor at Duke University School of Medicine, and she recently concluded a five-year tenure as the Chief Data Officer for the North Carolina Department of Health and Human Services. Her work focuses on enhancing data-driven decision-making to improve public health outcomes and finding AI methods to improve whole person health. She's served on the editorial board for the Journal of Biomedical Informatics, on AMIA's Board of Directors, and on the Board of Scientific Counselors for the National Library of Medicine, all while advocating for women in STEM and precision medicine efforts. We were so thankful to have both of these experts on this episode!

Last but not least, we were joined by a new guest—Lauren Malloy joined us as a co-host for this episode. Lauren is the administrative coordinator for the Artificial Intelligence for Ambulatory Care Innovation Laboratory at the University of Pennsylvania, which investigates how technology can address healthcare challenges. Her insights into how public health issues manifest in our daily lives were invaluable, and we were honored to have her as a guest star!

We hope you enjoy this episode as much as we did filming it!

"Cheat Sheet" to the acronyms discussed in this episode:

-AMIA: American Medical Informatics Association

-APHL: Association for Public Health Laboratories

-CDC: Center for Disease Control and Prevention

-CDO/CIO/CMIO: Chief Data Officer, Chief Information Officer, Chief Medical Informatics Officer

-ECR: electronic case reporting

-EHR: electronic health record

-EIS: Epidemic Intelligence Service

-IIS: Immunization Information System

-IPS: International Patient Summary (Canada)

-HHS: Department of Health and Human Services

-NPI: National Patient Identifier, also National Provider Identifier

-PPRL: Privacy Protecting Record Linkage

-VCI: verifiable clinical information

Make sure to follow our Instagram, Twitter, Threads, and TikTok accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd. You can find us wherever you typically get your podcasts. Thanks for listening!

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It’s no secret that handling medical data is complicated and time-consuming. Of course, the goal is to address the patient buried beneath the in-depth patient notes, multiple EHRs, and drug prescriptions. Perhaps technology can make that a bit easier! In this episode, we have the special privilege of hearing the research of two graduate students who have found the biggest pain points in our primary healthcare system and have brainstormed ways that technology, especially emerging AI, can help address these issues. Every listener will find a way to relate to the stories shared in this episode, and we hope our discussion about the short-term and long-term goals for the application of AI in medicine makes you optimistic about the future of primary healthcare!

Trevor Martinez is a current master’s student at the University of Pennsylvania pursuing an MSE in bioengineering. He is primarily interested in the fields of biomedical data science, healthcare, and medical devices. Pavan Patel is a graduate student at the University of Pennsylvania pursuing a dual MBA/MA from the Wharton School and the Lauder Institute, and he is also a computer science student at Penn Engineering. Previously, he worked in healthcare at Hazel Health and in private credit and equity at Bain Capital and CI Capital. It was great to hear what these young minds came up with, and they graciously shared some of the visuals they created to explain information silos. If you want to view the visuals along with the podcast, make sure to watch via our YouTube channel!

We also had Dr. Ross Koppel hop on this episode. Dr. Koppel is a professor of sociology and medical informatics at the University of Pennsylvania, a Senior Fellow at Penn’s Center for Public Health Initiative, and a Senior Fellow at Penn’s Institute for Biomedical Informatics. His hundreds of articles focus on the cybersecurity, usability, and ethics of healthcare information technology and has greatly impacted the field’s understanding of how we can improve human-computer interactions and better integrate HIT into hospital workflow. He was the perfect person to chime in on Trevor and Pavan’s research!

Finally, we had the great pleasure of welcoming a new co-host to our podcast! Dr. Stacy Iannone is the project manager for Dr. Johnson’s lab, which researches computationally-enhanced healthcare. She brings with her an extensive background in clinical research. We were so excited to have her share her insights and experiences on this episode! 

We really enjoyed discussing these students’ insightful research and debating how we see AI entering the conversation. We hope you enjoy listening!

Mentioned in this episode:

-”5 Tactics to Break Down Silos and Support Cross-Functional Collaboration” by Rhonda Stewart

Check out Rhett McDaniel's newest album Rhett McDaniel's Contribution to the Noise Floor

Make sure to follow our Instagram, Twitter, Threads, and TikTok accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd. You can also find us wherever you typically get your podcasts. Thanks for listening!

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What happens when you bring together three previous heads of biomedical informatics departments? A lot of reflection, storytelling, and joking around! In this episode, we bring together guests who have previously run informatics departments and are still involved in various ways, whether through research, teaching, or creating content to educate the public. We get the inside scoop into all the administrative responsibilities of these department chairs, their favorite parts of the job, and how they hope to see the field respond to modern technological developments like AI.

We had some fantastic guests on this episode.  Dr. William (Bill) Hersh is a Professor in the Department of Medical Informatics & Clinical Epidemiology (DMICE) in the School of Medicine at Oregon Health & Science University (OHSU). Dr. Hersh served as the inaugural Chair of DMICE from its inception in 2003 through 2022. He also served as Director of OHSU's Biomedical Informatics Graduate Program, from its inception in 1996 through 2023. Dr. Hersh also conceptualized and implemented the first offering of the American Medical Informatics Association (AMIA) 10x10 ("ten by ten") program; his course has been completed by more than 3000 individuals since 2005. In addition, he serves as Editor of the textbook, Health Informatics: Practical Guide, 8th Edition. Since stepping down as department chair, Dr. Hersh has maintained his research and teaching activities, and writes the Informatics Professor blog.

Dr. George Hripcsak is the Vivian Beaumont Allen Professor at Columbia University's Department of Biomedical Informatics. He led Columbia University's informatics department for 15 years. He currently leads the Observational Health Data Sciences and Informatics coordinating center, which organizes the health records of almost one billion patients. He has authored over 350 scientific papers, serves as the PI for Columbia's recruitment center for the All of Us precision medicine program, and focuses his research on developing the next generation of health record systems.

Finally, our host turned guest for this episode! Dr. Kevin Johnson is the David L. Cohen University Professor of Pediatrics, Biomedical Informatics, and Science Communication at the University of Pennsylvania. Before Penn, he was the Chair of the Department of Biomedical Informatics at Vanderbilt University from 2012-2022. He currently researches how to integrate advanced technology and artificial intelligence with health documentation systems. And, of course, he loves sharing informatics with a wider audience whether through his children's books, his documentary projects, or this podcast!

Thanks to our host Harris Bland and our production assistant Ellie Shuert for leading us through this discussion. We loved reminiscing together, and we hope you enjoy getting an inside look into informatics departments!

Make sure to follow our Instagram, Twitter, Threads, and TikTok accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd and @htbland21. You can also find us wherever you typically get your podcasts. Thanks for listening!

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How does social media challenge or reinforce our own biases? On this episode, we sat down with the University of Pennsylvania's Desmond Upton Patton to discuss his research on social media and adolescence. We talk about the many roles social media has for young people and how they have taken advantage of social media as a storytelling mechanism and a tool for navigating safety. We discuss how social media can also be reductionist, reinforce negative stereotypes, and even perpetuate misinformation, revealing the flaws in AI and similar technologies. Desmond talks us through all these facets of social media in relation to his work and challenges us to think about what it would look like to recognize social media as increasingly integrated into our reality.

We were so excited to have Dr. Desmond Upton Patton with us for this episode. Desmond is not only a great friend, but an incredible scholar. As a social worker, researcher, and professor at the University of Pennsylvania, Desmond has published groundbreaking research on the linkage between grief and aggressive behavior on social media platforms, and now his research focuses on the topics such AI, social media, machine learning, empathy, and race with the goal to create unbiased and culturally conscious algorithms. In addition, he serves on the research and safety advisory boards of Twitter, Spotify, and TikTok, and he has been chosen as part of the inaugural cohort of Obama Foundation Leaders for his research. Now, he is the director for the research initiative known as SAFELab at the Annenberg School for Communication, a project we will hear more about in this episode!

We also had with us songwriters Alissa Abeler and Hannah Smith from the Americana duo The Daily Fare. They shared amazing insights not just on their own experiences with social media, but also on songwriting and the storytelling process.

We were so thankful to have this group of people in discussion with us, and we hope you enjoy the episode!

Mentioned in this episode: 

-Sing Me a Story

-AIDS Memorial Quilt

-Follow SAFELab on Twitter

Make sure to follow our Instagram, Twitter, Threads, TikTok, and Facebook accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd and @htbland21. You can also find us wherever you typically get your podcasts. Thanks for listening!

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Is every clinical trial created equal? In this episode, we learn some shocking information about the proportions of populations normally included in clinical trials. We specifically cover recent treatments for Alzheimer’s disease to discuss how we may have failed to consider minority populations in our research and how we can use precision medicine to create more equitable clinical trials. We also discuss how we can redevelop trust in scientific institutions in the wake of the pandemic and how health professionals can adapt their research techniques to include data from historically underrepresented populations.

We had a wonderful cast join us for this episode. We had Stephanie Monroe, Vice President and Senior Advisor of Health Equity and Access for UsAgainstAlzheimer’s, a national advocacy group that aims to diversify the movement to cure Alzheimer’s disease. After working on Capitol Hill and holding the position of Assistant Secretary of Education for Civil Rights for three years, Stephanie’s work has focused on raising awareness about the disparate impact of Alzheimer’s disease on communities of color and women.

We also had Consuelo Wilkins, Senior Vice President and Senior Associate Dean of Health Equity and Inclusive Excellence, and a Professor of Medicine at Vanderbilt University Medical Center. She is an elected member of the National Academy of Medicine and works with the All of Us Research Program, a national precision medicine project. She is also the Principal Investigator of three NIH-funded centers which aim to decrease health disparities for communities of color and create new approaches to recruiting marginalized communities for clinical trials. 

This conversation was so fun and yielded so many valuable insights regarding how we can create more equitable research for communities of color. We hope you enjoy the episode!

Interested in how misinformation circulates? Listen to our previous podcast episode with guest Evan Thornburg.

Make sure to follow our Instagram, Twitter, Threads, TikTok, and Facebook accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd and @htbland21. You can also find us wherever you typically get your podcasts. Thanks for listening!

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In this episode, we tackle an all-too-familiar topic: misinformation. Since the COVID-19 pandemic, we have seen how technology and social media can be used to both spread health information awareness and popularize misinformation. The question remains: in the age of technology, how can we be sure about the validity of the information we are receiving online, and how can we all be vigilant against the spread of misinformation?

To help us, we had the wonderful Evan Thornburg join us for today's podcast. Evan is a bioethicist and health equity officer for the City of Pennsylvania's Department of Public Health. In the past, they've also worked in the Philadelphia Mayor's Office as Deputy Director of LGBT. After completing a Master's of Arts in Urban Bioethics at Temple University's Lewis Katz School of Medicine and writing their thesis on the spread of misinformation, Evan took to TikTok, utilizing the platform to share their knowledge about bioethics, comment on current health news, and challenge the online community to be discerning about how they absorb and converse about health information. You can find Evan on TikTok at EVN the (Bio) Ethicist.

We loved talking with Evan, and we hope you come out of this episode with some practical tools to help you filter the information you see on social media!

Learn more about ethical research conduct from government websites such as the National Institutes of Health, the National Science Foundation, and the American Psychological Association. 

Check out what the American Board of Internal Medicine has to say about the rise of misinformation:

-https://blog.abim.org/an-update-on-our-efforts-to-address-medical-misinformation/

-https://blog.abim.org/new-paper-recommends-creating-a-durably-funded-infrastructure-for-media-monitoring-and-effective-coordinated-responses-to-medical-misinformation/

Learn more about the work Desmond Upton Patton is doing with SAFELab here: https://www.asc.upenn.edu/research/centers/safe-lab

Make sure to follow our Instagram, Twitter, Threads, TikTok, and Facebook accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd and @htbland21. You can also find us wherever you typically get your podcasts. Thanks for listening!

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In this episode, we look at the genetic basis for different psychiatric disorders, the interconnectedness of psychological and physical symptoms, and how they apply to our ongoing conversation regarding health equity. For this episode, we welcomed back some of our previous guests:

Lea Davis Ph.D. is an Associate Professor in the Division of Genetic Medicine in the Department of Medicine at Vanderbilt University Medical Center. Her work explores the genomic architecture of complex traits, defined as the type, frequency, and function of DNA variants en masse that contribute to the genetic predisposition of a given trait.

We also welcomed back the talented Jane Bach, a successful songwriter from Nashville, to help us dissect how exactly gene inheritance works and share her stories and music with us! Ellie Shuert, our new production assistant from the University of Pennsylvania, also joined in for the discussion. They both made our conversation so lively and fun, and they really helped us dig deep into the fundamentals of genetics and the importance of listening intentionally to patients' stories and symptoms.

We have new social media pages! Make sure to follow our new Facebook, Twitter, TikTok, Instagram, and Threads accounts so you can stay up to date on all our new content. Also don't forget to follow us on Twitter @kbjohnsonmd and @htbland21. Thanks for listening!

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In this episode, we talk a bit about the recent advances in large language models, also known as GPT/ChatGPT.  We have two wonderful guests:

Christoph U. Lehmann, M.D., is a Professor of Pediatrics, Population and Data Sciences, and Bioinformatics at UT Southwestern, where he directs the Clinical Informatics Center. In addition, Chris was the first chair of the Examination Committee of the American Board of Preventive Medicine, Subcommittee for Clinical Informatics. Dr. Lehmann’s research focuses on improving clinical information technology and clinical decision support.

Yaa Kumah-Crystal Crystal MD, MPH, MS is an Assistant Professor of Biomedical Informatics and Pediatric Endocrinology at Vanderbilt University Medical Center. Yaa’s research focuses on studying communication and documentation in healthcare and developing strategies to improve workflow and patient care delivery. Yaa works in the Innovations Portfolio at Vanderbilt HealthIT on the development of Voice Assistant Technologies to improve the usability of the EHR through natural language communication.

Chris and Yaa bring very complementary perspectives to the topic of our future. Yaa's research focuses on how we can innovate to improve the use of technology in medicine. Chris is also internationally known as the Editor in Chief of Applied Clinical Informatics,

as well as one of the leaders in our clinical informatics board certification work.  He is intimately familiar with the potential uses of this technology beyond clinical care, but, as an actively practicing neonatologist, more than holds his own when it comes to how medicine can benefit from--or be harmed by--new technologies such as AI. 

We leave it to you to decide both which direction we're heading, and how we can put up the guardrails to keep us on the preferred track. And, I suspect this won't be our last discussion about AI in Medicine!----more----

By the way, in case you want to learn more about topics we brought up in this episode:

Belmont principles include autonomy

• Beneficence:  AI is designed explicitly to be helpful to people, who use it or on whom it is used, and to reflect the ideals of compassionate, kind, and considerate human behavior

• Autonomy:  Context AI: operates without human oversight.  Context Ethics: “protecting the autonomy of all people and treating them with courtesy and respect and facilitating informed consent”

Artists and AI:  

• https://www.buzzfeednews.com/article/chrisstokelwalker/art-subreddit-illustrator-ai-art-controversy

TikTok voiceover person:   https://www.theverge.com/2021/9/29/22701167/bev-standing-tiktok-lawsuit-settles-text-to-speech-voice

GPT and test performance:  https://www.cnn.com/2023/01/26/tech/chatgpt-passes-exams/index.html, https://www.medrxiv.org/content/10.1101/2023.03.05.23286533v1.full

Deepfake concerns: 

• https://www.forbes.com/sites/jessedamiani/2019/09/03/a-voice-deepfake-was-used-to-scam-a-ceo-out-of-243000/?sh=292f03982241

MidJourney and bias:

• https://uxdesign.cc/midjourney-is-incredible-but-you-can-see-there-are-definite-existing-biases-in-its-dataset-4b1131fb0533.

Amazon AI Tool Bias: https://www.reuters.com/article/us-amazon-com-jobs-automation-insight/amazon-scraps-secret-ai-recruiting-tool-that-showed-bias-against-women-idUSKCN1MK08G

Apple credit biased against wives: https://www.wired.com/story/the-apple-card-didnt-see-genderand-thats-the-problem/

AMIA document about ethical principles around AI: https://amia.org/news-publications/amia-position-paper-details-policy-framework-aiml-driven-decision-support

AI in Medicine JAMA Viewpoint: https://pubmed.ncbi.nlm.nih.gov/36972068/

Sophia:  https://en.wikipedia.org/wiki/Sophia_(robot)

This episode is going to introduce the concepts of health equity and biomedical informatics. We'll revisit this theme multiple times in 2023 but ST and I wanted to kick off the year with this overview that will also serve to provide a framework for some of what we will be discussing as we revisit this theme. We are really lucky to have two guests, both of whom are great colleagues and friends, whose careers have focused on this topic from two very different disciplines.

Lea Davis Ph.D. is an Associate Professor in the Division of Genetic Medicine in the Department of Medicine at Vanderbilt University Medical Center. Her work explores the genomic architecture of complex traits, defined as the type, frequency, and function of DNA variants en masse that contribute to the genetic predisposition of a given trait.

Consuelo H. Wilkins, MD, MCSI, is a nationally recognized physician-scientist leader in health equity research focused on integrating social, cultural, and environmental factors into clinical and translational research. Dr. Wilkins is a Professor of Medicine in the Division of Geriatric Medicine within the Department of Medicine at Vanderbilt University Medical Center. She is Senior Vice President, Health Equity and Inclusive Excellence, VUMC; and Senior Associate Dean, Health Equity and Inclusive Excellence, Vanderbilt University School of Medicine.

 We also welcome back The Daily Fare Northern-born songwriters Alissa Abeler and Hannah Smith who’ve joined creative forces to form a musical duo with a unique sound and look for Nashville performers. The pair grew up on opposite sides of the music world with influences ranging from Judy Garland and Adele to Beethoven and Bach, with a healthy dose of Broadway, punk cabaret, and 80s ballads sprinkled in the mix.  They also share a story common with many newish groups breaking into the music biz that makes the topic of today one they relate to in ways you’ll readily appreciate.

St and I tried to keep this at high level, but we also weren’t afraid to push our friends to explain some difficult concepts. It was as important a discussion as it was enlightening and engaging, and I’m glad to be able to share it with the world.