Patricia Gogniat is used to receiving blank stares when she describes her work (especially when the phrases “data architecture” or “relational database” come up), and while she’d like to change that, she is content knowing that what she does has a direct impact on improving medical decision-making.
“I was at an MLA conference chatting with another medical librarian. When the woman found out where I worked, she gushed about VisualDx and shared a personal story about her husband,” Patricia recounts. “He had been misdiagnosed while having a febrile rash illness. He wasn’t improving, so she turned to VisualDx desperate for answers. She built a differential with her husband’s symptoms and rash presentation, compared rash photos of possible conditions, and saw something that the doctors had not yet considered: scarlet fever. It turns out she was right. It was because of what she found in VisualDx that her husband was able to get a correct diagnosis and begin his treatment.”
Patricia is the manager of the Medical Data and Library Research Department at VisualDx. It’s a job that she admits doesn’t sound glamorous but truly is critical and exciting work to develop the backbone of how medical information is served up to providers.
In recognition of Medical Librarian Month, we’re taking the opportunity to learn more about the work of Patricia and the Clinical Informatics team at VisualDx.
Q: What does it mean to be a medical librarian at a software company?
It means we have really meaningful jobs and get to work with doctors and engineers to develop a product that directly impacts patient care and medical education. We spend our days researching how diseases present and creating data relationships that power how the VisualDx differential building capabilities work.
Q: Who works with you on the clinical informatics team?
JT Finnell, MD, an emergency medicine physician and a clinical informaticist, leads the Clinical Informatics team at VisualDx. In the Clinical Informatics department, we have a machine learning engineer who works on our augmented intelligence (AI) algorithms, and then three separate sub-departments that create the medical content in VisualDx.
I manage the Medical Data & Library Research Department, which includes five medical librarians and one physician. Our role is to research, create, and review medical data relationships that power the back-end functionality of the VisualDx search engine and differential-building capabilities. This data engine includes more than 201,000 relationships between 3,900 searchable findings and 3,400 searchable diagnoses.
All these relationships are backed by evidence from the medical literature, so it’s an enormous amount of research and maintenance to keep this data accurate and current.
The Editorial Department has a team of five medical editors who work with hundreds of physician contributors to develop our textual content—all the 3,400 (and growing!) disease topics in VisualDx. Our medical texts go through a rigorous medical review process with multiple rounds of physician review, and our editors work diligently to move things along through this process and keep our texts up to date and build new content.
And lastly—and what we’re most known for—is our Imaging Department. This includes our image collection manager, a medical image technician, and a medical illustrator. They curate and develop our comprehensive medical image and illustration collection, working with hundreds of medical contributors throughout the world. Our comprehensive collection in VisualDx includes nearly 47,000 images, of which 29% reflect presentations on darker skin tones, and variations in disease presentation.
Q: How does the data you work on in the software affect what a user experiences?
Building the relationships between findings and diagnoses, meaning mapping how findings are related to diseases, is our core department task. The librarian team creates the concepts that users can search; findings, diagnoses, etc, as well as the workup questions to build differentials.
Any time a user searches for something in VisualDx they are using data built by our librarian and data team.
We also create the Sympticons™, add references, code standards such as ICD and SNOMED, and manage other miscellaneous data types that are part of our differential engine.
Q: What are some of the challenges that the COVID-19 pandemic has brought on over the past two years?
We work heavily with clinical contributors who work with us on a part-time contract basis between their clinical schedules. As we all know, the burden on healthcare workers has been enormous, so we had less contributors available to work on reviewing content. At the same time, we wanted to keep our information as current as possible and increase the frequency of our data updates, so it was a challenge to do that while many of us were also dealing with lack of childcare, working remotely in a new environment, etc.
Q: Why is it so important to have such a thorough review process of clinical information?
It is imperative that we include accurate clinical information that is reviewed by experts in their fields.
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