J. Marc Overhage, MD, PhD, Director, Medical Informatics, Regenstrief Institute Dr. Overhage is also Professor of Medicine, Indiana University School of Medicine and President and CEO of the Indiana Health Information Exchange (IHIE).  He has spent over 25 years developing and implementing scientific and clinical systems and evaluating their value.  In collaboration with Dr. Clement McDonald, he has created an electronic patient record (called the INPC) containing data from many sources including laboratories, pharmacies and hospitals in central Indiana.  The system currently connects nearly all acute care hospitals in central Indiana and includes inpatient and outpatient encounter data, laboratory results, immunization data and other selected data.  In order to create a sustainable financial model, he helped create IHIE, a not-for-profit corporation.  Over the last five years, he has played a significant regional and national leadership role in advancing the policy, standards, financing and implementation of health information exchange.

Dr. Overhage is also an expert in clinical decision support, including inpatient and outpatient computerized physician order entry and the underlying knowledge bases to support them.

Dr. Overhage is a member of the fellowship program’s executive committee, and meets with the fellows weekly.  Dr. Overhage provides mentoring for fellows' developmental projects and will aid in all efforts that require use of the Gopher workstations as the platform for the intervention and/or for obtaining data from physicians.

Michael Barnes, MD Dr. Barnes is an associate professor of family medicine, IU School of Medicine; and Regenstrief Research Scientist.  Dr. Barnes developed the STAR medical record system at the University of Missouri. The STAR system was the third EMR that Dr. Barnes designed and implemented.  He also completely re-worked the look and feel, navigation and some of the content of the Web-based RMRS in addition to adding a number of features.  He is an expert in JAVA, object-oriented programming, relational databases and human interface design.  He has 33 years of experience with computer systems development. 

Dr. Barnes has developed the DOCS4DOCS program that delivers reports from the all of the hospital systems within INPC to more than 800 practices and 3200 physicians – representing more than 85% of active central Indiana practitioners.  He is interested in improving the physician’s diagnostic and treatment skills through the use of computers.  Dr. Barnes will provide the lectures to the fellows on JAVA, software engineering and system design.

Paul Biondich, MD, MS Dr. Biondich is an assistant professor of pediatrics, IU School of Medicine; and Regenstrief Research Scientist.  Dr. Biondich is a medical informatics researcher whose research interests include decision support systems and controlled medical vocabularies.  As a practicing pediatrician, he has significant experience in the design, implementation and installation of multiple decision support systems, particularly within outpatient settings.  Dr. Biondich is the co-creator of the Child Health Improvement through Computer Automation (CHICA) system, which is designed to improve the process of outpatient pediatric preventive care.  He is active nationally in pediatric vocabulary and guideline developmental efforts.  Much of this work with the American Academy of Pediatrics involves the disambiguation and active revision of pre-existing clinical guidelines, along with the ultimate development of supporting standardized vocabularies.  He also has extensive experience with clinical repository development, having co-developed the AMRS, an open source repository designed to support HIV care in sub-Saharan Africa.

He interacts regularly with medical informatics fellows through a series of lectures on various topics involving enterprise database modeling, HIT standards development and decision support systems.  He provides mentorship to all of the fellows on these various topics and assists with manuscript creation and grant writing/study design issues.  He has co-author several peer reviewed informatics articles written by fellows.

Paul Dexter, MD  Dr. Dexter is an associate professor of clinical medicine, IU School of Medicine, Chief Medical Information Officer and Director of Clinical Applications, Wishard Hospital; and Regenstrief Research Scientist. Dr. Dexter is an officer at the closely affiliated Wishard Hospital (site of the majority of Regenstrief Informatics trials); and research scientist, Regenstrief Institute.  Dr. Dexter has implemented several large randomized trials of computer reminders and computer “standing orders" related to preventive care and advance directives.  He subsequently published the results of these trials as first author in articles appearing in the New England Journal of Medicine, JAMA and Annals of Internal Medicine.  Finally, he is the direct supervisor over the programmers responsible for the production of Regenstrief systems, the RMRS and Gopher order entry.  Given his research background, leadership role at Wishard Hospital and management of the programmers, he has been able to facilitate many of the informatics-related fellows' projects.

Stephen Downs, MD  Dr. Downs is co-director of the NLM-funded Medical Informatics Fellowship Program  Dr. Downs is the director of general pediatrics and the Children’s Health Services Research Program at the Indiana University School of Medicine, associate director for decision sciences at the Regenstrief Institute, and Former Director of the Duke-UNC NLM Medical Informatics Training Program.  His research interests include computer-based decision support systems for primary care, expected utility theory, decision analysis and cost-effectiveness analysis and their application to guideline development and computer based decision support.  He teaches most of the decisions sciences component of the fellowship program.  Dr. Downs has served as a primary mentor for Paul Biondich, providing laboratory facilities and programmers for his project.  The result was two joint publications during Dr. Biondich's fellowship and several since.  He also teaches in the didactic portion of the curriculum and has been a secondary mentor to many of the fellows.

Shaun Grannis, MD  Dr. Grannis is an assistant professor of family medicine, IU School of Medicine; and Regenstrief Research Scientist. Dr. Grannis’s research interests include developing, implementing and studying technology to overcome the challenges of integrating data from distributed systems for use in health care delivery and research.  Dr. Grannis developed a patient record linkage algorithm using cryptographically de-identified demographic data for use in distributed clinical data networks. The goal of the linkage algorithm is to maintain patient confidentiality while providing researchers with access to clinically meaningful data.  He further extended and characterized this linkage methodology using robust probabilistic techniques. 

Dr. Grannis is also actively involved in bio-terrorism detection and syndromic surveillance.  He is currently involved in multi-year studies that explore multiple facets of disease detection and syndromic surveillance challenges, including geographical de-identification, understanding temporal-spatial disease trends and establishing syndromic surveillance data standards.  He is technical lead in a four-year project integrating data flows from over 110 hospitals in the state of Indiana for use in disease surveillance and clinical research.  Dr. Grannis contributes lectures to the fellowship curriculum and provides key guidance to fellows’ research projects.

John T. (JT) Finnell, MD, MSc  Dr. Finnell is associate professor of emergency medicine, and director, informatics division, IU School of Medicine at Indiana University, and research scientist at Regenstrief Institute.  He is site principal investigator of an NLM-funded grant with Dr. James Cimino of Columbia University, entitled “Infobuttons to Improve Information Access in Order Entry.” This research explores ways that health information can be used to improve the use of clinician order entry systems. 

Dr. Finnell joined the Institute in 2002 as an NLM-funded medical informatics fellow.  During his fellowship, Dr. Finnell earned a master’s degree in the NIH-funded CITE program.  His research activities focused on building the infrastructure necessary to capture emergency department visit data. The departmental tracking system known as "WizErD" began capturing visit data on July 15, 2003.

His first publication entitled "Community Clinical Data Exchange for Emergency Medicine Patients" explored the pattern of emergency healthcare delivery across Indianapolis over a one year period. They found that one-fourth of the emergency department patients with more than one visit also visited one of the other five hospital systems. These patients could potentially benefit the most from a shared clinical data network.

Currently Dr. Finnell is working on standardizing emergency department data in order to implement treatment guidelines established by ACEP, the American College of Emergency Physicians, which are initiated by the patient's chief complaint and triage data. He plans to augment the standard order set with "suggested" orders defined by these guidelines, and customized to the patient through their electronic medical record.

Burke Mamlin, MD Dr. Mamlin is Assistant Professor of Clinical Medicine, IU School of Medicine; and Regenstrief Research Scientist.  Dr. Mamlin is a software engineering expert and a practicing internist for Indiana University School of Medicine.  His research interests include computerized-physician order entry (CPOE) systems and electronic medical record development for developing countries. He is the primary author of the AMRS software.

Dr. Mamlin was chief medical resident at Indiana University School of Medicine prior to starting his NLM-funded medical informatics fellowship in June 2000.  During his fellowship, Dr. Mamlin developed a Java-based physician order entry and note writing tool to replace the DOS-based but very successful Medical Gopher order entry tool in the third generation Regenstrief Medical Records System. He presented his findings as a poster at an AMIA meeting at the beginning of the second year of his fellowship.

Other work during his fellowship included a study of a natural language processing system for automated coding of findings within chest X-ray reports. He presented these findings at AMIA 2003, along with a poster for an XML-annotation toolkit he developed in the process.

During his fellowship, Dr. Mamlin collaborated with fellows from other disciplines in a study of clinical characteristics associated with early renal insufficiency in HIV patients. In another study, he worked with past and current fellows to show the efficacy of text scrubbing tool for removing all patient and person identifiers from pathology reports and to highlight voice interpretation processing errors.

Dr. Mamlin presented his fellowship research entitled, “The Uses Of Gopher Order Entry System Assist In Clinic Research,” at the 2000 Annual NLM Fellows Conference, July 2000.

Marc Rosenman, MD  Dr. Rosenman is Research Scientist, Regenstrief Institute and Assistant Professor of Pediatrics, Indiana University School of Medicine.  He completed a combined informatics and health services research fellowship at the Institute.  His research interests involve clinical epidemiologic studies using the Regenstrief Medical Records System (RMRS) and other large databases (such as Medicaid claims).  As director of the Health Data and Epidemiology Section at Regenstrief, he helps supervise six data analysts and helps advise fellows who are extracting data from the RMRS.  He also coordinates RMRS research by other Indiana and Purdue University faculty and has been a research mentor for medical students and residents.

Gunther Schadow, MD, PhD  Dr. Schadow is an Associate Professor, IU School of Informatics at IUPUI; and Regenstrief Research Scientist.  Dr. Schadow has led much of the development effort for HL7 version 3. He has been the  lead organizer and developer of the Unified Service Action Model (USAM), a part of the overall HL7 version 3 reference information model. The USAM unifies the modeling of master files, clinical data content and decision support rules. Dr. Schadow has also developed the HL7 version 3 data types standard, a uniform, comprehensive and elegant definition of the data types required for clinical information systems. He has also developed the most complete and systematic approach to units’ standardization and interconversion.

Dr Schadow has special expertise in security and privacy mechanisms and developed the low cost Free BSD (UNIX) based router/encryptor we used in the NGI telemedicine project. He has a long-term interest in medical record systems, decision support, and natural language processing. He developed an information extraction system for free text surgical pathology reports which extracts structured data of specimens, their tissue type and collection procedures and a UMLS coded diagnoses. Dr. Schadow's primary appointment is at the School of Informatics and he holds an adjunct appointment at the School of Medicine. He is a member of the Indiana University's Cancer Center and the Center for Computational Diagnostics where he works on tissue banking and high-throughput experimental data annotation resources with the national NCI Cancer Bioinformatics Grid (caBIG) project. Much of the fellowship curriculum has been organized by Dr. Schadow, and he provides a large part of the lecture content for the Part 2 curriculum.

William Tierney, MD  Dr. Tierney is Chancellor's Professor in the Department of Medicine of the Indiana University School of Medicine. He is also a Senior Investigator at the Regenstrief Institute where he also serves as the Director of the Regenstrief Center for Healthcare Improvement and Research. He has studied the effects of innovative, computer-based interventions to improve health care quality and lower costs. He is also Director of Research for the Indiana University Kenya Program where he is responsible for a major HIV/AIDS research program in collaboration with Moi University. This research collaboration currently includes 15 U.S. universities collaborating with universities and other institutions in East Africa. He is the leader of the team of Americans and Kenyans that created and implemented the first ambulatory electronic medical record system in sub-Saharan Africa that now contains more than 800,000 visit records supporting 29 urban and rural primary care and HIV clinics in Kenya. Dr. Tierney is leading the team implementing this open-source medical record system (OpenMRS) in HIV/AIDS clinics in Tanzania and Uganda.  OpenMRS has also been implemented in more than a dozen other countries on three continents.

Dr. Tierney was the Founding Director of the Agency for Healthcare Research and Quality's National Resource Center for Practice-Based Research Networks (PBRNs). In addition to the research network he has established in the above-mentioned HIV/AIDS clinics in Kenya, Dr. Tierney also directs ResNet, a PBRN within IU Medical Group-Primary Care's 27 inner-city and suburban primary care practice sites, with more than 250 physicians and 150,000 adult and pediatric patients who make more than 400,000 visits per year to IUMG-PC sites.

In addition to informatics-based health services research, he has also performed dozens of epidemiologic studies utilizing the clinical data stored in the clinical data repositories created by Indiana University in Indianapolis and Kenya.

Daniel Vreeman, PT, DPT  Dr. Vreeman is Assistant Research Professor at the IU School of Medicine and Regenstrief Research Scientist.  Dr. Vreeman is a past Regenstrief Medical Informatics Fellow.  His primary research interests are the use of standardized clinical vocabularies including LOINC to support electronic health information exchange for clinical practice and research.  Dr. Vreeman is co-director of the LOINC development efforts at Regenstrief. Dr. Vreeman teaches in the didactic portion of the fellowship curriculum and is available to serve as a mentor to fellows interested in issues related to controlled terminologies.

Atif Zafar, MD  Dr. Zafar is an associate professor of clinical medicine at the IU School of Medicine. He is the IT Director for the AHRQ National PBRN Resource Center and a key staff member of the AHRQ National Resource Center for Health Information Technology. His research involves studying the human-computer interface and is currently working with Purdue engineers to design an EMR application for mobile devices. He also is interested in electronic technologies for clinical education. He has lead numerous national teleconferences on health information exchange and helped to architect the new AHRQ Health IT Web Resource located at http://healthit.ahrq.gov.

Dr. Zafar was an NLM-funded Health Services Research fellow in 1997.  He conducted a trial of the accuracy and usability of voice recognition in a general medicine clinic setting. This research was divided into two phases.  Phase I involved the integration of current generation voice recognition technology with an enterprise level medical record system.  Phase II involved testing this technology in actual use.

Dr. Zafar compared the effectiveness of voice recognition as a data entry tool compared with typing. Outcome variables included total time to type or dictate a note, accuracy of the note (error rates), completeness of the note, error correction rates and acceptability of the system to physicians. Dr. Zafar presented his work entitled “Continuous Speech Recognition in a Medical Enterprise Setting” at the 1999 Annual NLM Fellows Conference, July 1999, Arden House, New York.

Following completion of his training, Dr. Zafar was administrator of a web-based program/curriculum for Indiana University School of Medicine research faculty and staff which provided pre-tests in order to gauge knowledge base, learning materials, and links to additional and more advanced learning materials.