成人VR视频

成人VR视频.CA / Department of Emergency Medicine / Education / Fellowship / Health Informatics

Journal Club & Academic Half Day

The Emergency Medicine Health Informatics Fellowship Journal Club and Academic Half Day is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.

The Emergency Medicine Health Informatics Fellowship Journal Club and Academic Half Days take place on a bi-weekly basis from September until June on Thursdays from 9am to 12:00 pm via MS Teams.

For more information on upcoming sessions, please see the details below.听听

Contacts:

Antony Robert, SPC Member, EM Health Informatics Fellowship, antony.robert [at] mcgill.ca

Marc B茅ique, Chair, EM Health Informatics Fellowship, marc.beique [at] mcgill.ca

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Date

Theme

Speakers

Learning Objectives

24-Feb-2022

@ 10am

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FHIR APIs and EMR integration

Thanos Melisiotis, MD

  • Chief Medical Information Officer of QiiQ
  • Associate Professor at University of Pennsylvania Health System

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CCOMTL Digital Health Overview

Justin Cross, MD

  • Chief Digital Health Officer for the Integrated Health and Social Services University Network for West-Central Montreal

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FHIR APIs and EMR integration

  1. Deep dive into the integration technologies, exploration of modern EMR integrations and what kind of solutions you can create

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CCOMTL Digital Health Overview

  1. Understand operational challenges with the creation of a clinical informatics team in a large health system in Quebec
  2. Understand strategy development for digital transformation in a large health system in Quebec

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Previous Lectures

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Date

Theme

Speakers

Educational Objectives

24-Aug-2020

Welcome Lecture

Not applicable.

Review of needs, objectives and expectations for the academic year.

24-Sep-2020

Health Systems, Organizations and EHR

Healthcare Systems, Organizations and EHR
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Antony Robert MDCM, FRCPC(EM), MASc., B.Eng.

  • Assistant Professor, FMD Ultrasound Content Lead, Health Informatics Fellowship SPC Member, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, MUHC



CT scan utilization in the ED: A Case Study
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Bernie Unger MD, CCFP(EM), FCFP, CSPQ

  • Associate Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Associate Director, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al

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Impact of Electronic Health Records in the Emergency Department: A Case Study
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Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

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Health IT and Patient Safety: Building Safer Systems for Better Care
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Antony Robert MDCM, FRCPC(EM), MASc., B.Eng.

  • Assistant Professor, FMD Ultrasound Content Lead, Health Informatics Fellowship SPC Member, Faculty of Medicine and Health Sciences,听Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, MUHC

Healthcare Systems, Organizations and EHR

  1. Describe the different components of the Canadian and Quebec Healthcare System
  2. List the goals of the major Health, Safety, Research and Informatics Organizations (CIHI, CHI, CIHR, DHC, CPSI, CADTH, MSSS/ RAMQ)
  3. Understand the role of health informatics and electronic patient records
  4. Describe the Quebec governmental plan of digital transformation 2019-2023


CT scan utilization in the ED: A Case Study

  1. Describe the importance and pitfalls of standardized administrative data.
  2. Describe the steps of reviewing an ad-hoc analysis conclusion.
  3. List the different factors that impact CT studies in the emergency department.


Impact of Electronic Health Records in the Emergency Department: A Case Study

  1. Describe the definition and functionality of an electronic health record (EHR)
  2. List positive impacts on task-oriented and patient-oriented outcomes by using EHRs in the emergency department
  3. List potential negative impacts on emergency department efficiency and patient care with the use of EHRs


Health IT and Patient Safety: Building Safer Systems for Better Care

  1. Describe the sociotechnical system that is health IT
  2. List the important features of health IT that can improve patient care and patient safety

1-Oct-2020

Data Standards and Governance

Health Data Standards
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Antony Robert MDCM, FRCPC(EM), MASc., B.Eng.

  • Assistant Professor, FMD Ultrasound Content Lead, Health Informatics Fellowship SPC Member, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, MUHC


Data Governance, Data Quality & Electronic Documentation: The MUHC Experience
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Mr. No茅 Djawn White, M.Sc., Adm.A., LSSBB

  • Associate Director, Integrated Information Management, Performance and Continuous Improvement Quality, Evaluation, Performance and Ethics, MUHC

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Electronic Documentation and 'Tenue de dossier鈥� at the MUHC
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Ms Marie-Jos茅e Bilodeau

  • Assistante-chef, Accueil-admission et archives m茅dicales, Direction de la qualit茅, de l鈥櫭﹙aluation, de la performance et de l鈥櫭﹖hique, CUSM

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Clinical Charting with O-Word

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Mr. Jeff Smith

  • Manager, Admitting and Registration, Medical Records Services and Transcription, Directorate of Quality, Evaluation, Performance and Ethics, MUHC

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An Analysis of Patient Safety Incident Reports Associated with Electronic Health Record Interoperability: A Critical Appraisal
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Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

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Health Data Standards

  1. Describe the role of data standards and terminologies
  2. List the different clinical data standards and their application


Data Governance, Data Quality & Electronic Documentation: The MUHC Experience

  1. Explain the data governance and related aspects of cadre normative
  2. Explain the importance of policies for data access, data quality and security
  3. Describe some of the core databases used at the MUHC, how reports are generated and how data quality is ensured.


Electronic Documentation and 'Tenue de dossier鈥� at the MUHC

  1. Souligner l鈥檌mportance de la signature des m茅decins.
  2. Expliquer les lois et les modalit茅s d鈥檃cc猫s au dossier des usagers


Clinical Charting with O-Word

  1. View an example of O-Word for electronic documentation.
  2. Have an understanding of the functionality of O-Word
  3. Use O-Word


An Analysis of Patient Safety Incident Reports Associated with Electronic Health Record Interoperability: A Critical Appraisal

  1. Describe the patient safety implications that arise from challenges with the interoperability between EHRs and other health IT
  2. Describe the prevalence of reported interoperability challenges and their impact on patient care

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8-Oct-2020

Databases and Datawarehouse

Generating Value through the Secondary use of Clinical Data

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The CODA-19 Registry Project: A Case Study

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David Buckeridge, MD, PhD

  • Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, 成人VR视频
  • Senior Scientist, Metabolic Disorders and Complications Program, Centre for Outcomes Research and Evaluation, RI-MUHC

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Application of process mining to assess the data quality of routinely collected time-based performance data sourced from electronic health records by validating process conformance: A Critical Appraisal

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Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

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Covid-19 Databases at the MUHC : A Case Study
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Mr. No茅 Djawn White, M.Sc., Adm.A., LSSBB

  • Associate Director, Integrated Information Management, Performance and Continuous Improvement Quality, Evaluation, Performance and Ethics, MUHC

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Generating Value through the Secondary use of Clinical Data

  1. Understand database systems used in the hospital (relational vs NoSQL)
  2. Understand data warehousing

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The CODA-19 Registry Project: A Case Study

  1. To appreciate how observational patient cohorts assembled from routine clinical data can be used to answer questions related to clinical practice and health systems management;
  2. To understand the challenges and opportunities in conducting research using clinical data extracted from multiple health care institutions.

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Application of process mining to assess the data quality of routinely collected time-based performance data sourced from electronic health records by validating process conformance: A Critical Appraisal

  1. Understand how process mining can be used to assess the data quality of time-based ED performance metrics for a large dataset
  2. Identify process areas that cause or contribute to collection of poor-quality data

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Covid-19 Databases at the MUHC : A Case Study

  1. List the steps relevant metrics that need to be reported for Covid-19
  2. Explain the challenges of reporting Covid-19 cases

22-Oct-2020

Security and Privacy

Data Management: Privacy and security

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Privacy and security Case study #1: SMH ED Communication Project

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Rick Mah MD, CCFP, CCFP(EM)

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Department of Emergency Medicine, St. Mary's Hospital Center

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Case study#2: Single Sign-On: one password to rule them all?

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Evaluation of Secure Messaging Applications for a Health Care System: A Case Study

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Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

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Data Management: Privacy and security

  1. Define privacy, confidentiality, and security
  2. Understand the types of data breaches in healthcare
  3. Describe the type of data management controls

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Privacy and security Case study #1: SMH ED Communication Project

  1. Assess privacy concerns related to this project
  2. Enumerate potential security threats and how to mitigate them
  3. Discuss some of the challenges in rapidly deploying an informatics project

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Case study#2: Single Sign-On: one password to rule them all?

  1. Understand the benefits of using single sign-on to improve workflow in the healthcare setting
  2. Describe a structured approach and variables to consider when implementing single sign-on in the emergency department

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Evaluation of Secure Messaging Applications for a Health Care System: A Case Study

  1. Understand secure messaging functionalities offered by various applications for use in the healthcare setting
  2. Become familiar with an evaluation framework designed to assess secure messaging applications

5-Nov-2020

Administrative Data Use

ED data elements and ED metrics

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Change of practice impacting the CTAS Code 2 response time: Case Study #1

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Bernie Unger MD, CCFP(EM), FCFP, CSPQ

  • Associate Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Associate Director, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al


Measuring Staff Performance: Case Study #2

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Design, Implementation and Evaluation of an Architecture based on the CDA R2 Document Repository to Provide Support to the Contingency Plan: A Critical Appraisal

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Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

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ED data elements and ED metrics

  1. Understand the scope of data elements
  2. Understand the impact ED data metrics
  3. Understand the limitations of data elements and metrics
  4. List the necessary factors for proper usage of analysis of ED data elements and metrics

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Change of practice impacting the CTAS Code 2 response time: Case Study #1

  1. Understand the importance and pitfalls of triage analysis
  2. Understand the impact of protocol changes based on triage data results
  3. List the different factors that impact triage response times

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Measuring Staff Performance: Case Study #2

  1. Identify key metrics to evaluate when measuring ED staff performance.
  2. Describe useful strategies for delivering individual performance reports.

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Design, Implementation and Evaluation of an Architecture based on the CDA R2 Document Repository to Provide Support to the Contingency Plan: A Critical Appraisal

  1. Describe a strategy that can be used to allow for continued access to clinical information during electronic health record (EHR) downtime.
  2. Identify key clinical elements that are subject to discrepancies in the event of EHR downtime and use of a contingency plan

19-Nov-2020

Clinical, QI and Research Data Use

Machine Learning: The Engine of Modern Artificial Intelligence

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Machine Learning to predict adverse outcomes after syncope: A re-analysis of the Canadian Syncope Risk Score data (Case Study #1)

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Lars Grant MD, PhD, CCFP(EM)

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al
  • Investigator, Lady Davis Institute



Emergency Department Patient Disposition Support Tool (Case Study #2)

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Embedded Clinical Decision Support in Electronic Health Record Decreases Use of High Cost Imaging in the Emergency Department: EmbED study (Critical Appraisal)

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Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

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Machine Learning: The Engine of Modern Artificial Intelligence

  1. To appreciate the central role of machine learning in most modern artificial intelligence applications.
  2. Be able to list some challenges in the development or deployment of AI tools that are particular to the healthcare environment.
  3. Be able to list some potential applications of machine learning in the ED.

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Machine Learning to predict adverse outcomes after syncope: A re-analysis of the Canadian Syncope Risk Score data (Case Study #1)

  1. Be able to list the essential steps in predictive machine learning model development.
  2. Understand the difference between discrimination and calibration. Be able to interpret and ROC curve and a calibration curve.

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Emergency Department Patient Disposition Support Tool (Case Study #2)

  1. Describe the database structure, tables and relationships required to build a patient disposition support tool in the emergency department.
  2. Understand key data fields that are required to properly decide on a patient鈥檚 disposition.

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Embedded Clinical Decision Support in Electronic Health Record Decreases Use of High Cost Imaging in the Emergency Department: EmbED study (Critical Appraisal)

  1. Describe the impact of evidence-based clinical decision support tools integrated into provider workflow on utilization of CT imaging.
  2. Understand the limitations associated with integrated clinical decision support tools.

3-Dec-2020

AI, Big Data and Population Health Informatics

Guide to the swampland: Machine learning in medicine literature

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Algorithmic Accountability

Lars Grant MD, PhD, CCFP(EM)

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al
  • Investigator, Lady Davis Institute

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Site Project Update: MUHC Triage Reorientation Tool

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Early Prediction of Acute Kidney Injury in the Emergency Department With Machine-Learning Methods Applied to Electronic Health Record Data: A Critical Appraisal

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

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Guide to the swampland: Machine learning in medicine literature

  1. Have increased comfort reviewing emergency medicine literature describing the development of predictive machine learning models.
  2. Awareness of reproducibility problems in the current machine learning literature.

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Algorithmic Accountability

  1. Awareness of accountability issues in the use of machine learning tools in emergency medicine.
  2. Awareness of potential for bias in the implementation of machine learning tools in emergency medicine.

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Site Project Update: MUHC Triage Reorientation Tool

  1. Become familiar with the process of patient reorientation from triage at the MUHC emergency departments.
  2. Describe limitations of the current tool and features that can be implemented to improve reorientation rates.

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Early Prediction of Acute Kidney Injury in the Emergency Department With Machine-Learning Methods Applied to Electronic Health Record Data: A Critical Appraisal

  1. Understand how machine learning can be used to accurately predict ED patients who are likely to develop AKI within 72 hours.
  2. Identify important predictors for AKI in ED patients.

17-Dec-2020

Basics of IT

High Level Basics and Principles of IT

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Housing EMR cloudbased/outside institution: A Case Study

Stephen Rosenthal MD, CCFP, CSPQ

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Assistant Director and Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al

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Emergency Department Mobile Cart Solution: Getting in Gear to Drive Up Efficiency

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Validation of a wearable biosensor device for vital sign monitoring in septic emergency department patients in Rwanda: A Critical Appraisal

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

High Level Basics and Principles of IT

  1. List the Potential Deployment strategies for IT infrastructure
  2. List potential organograms and IT departmental structures
  3. List particular key infrastructure components in ED

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Housing EMR cloudbased/outside institution: A Case Study

  1. List the Benefits and Negatives of outside housing of systems
  2. List the Potential Risks

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Emergency Department Mobile Cart Solution: Getting in Gear to Drive Up Efficiency

  1. Describe essential features to include in a mobile cart to ensure ease of use and improve efficiency in the emergency department.
  2. Identify drawbacks and barriers to consider when implementing a mobile cart solution.

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Validation of a wearable biosensor device for vital sign monitoring in septic emergency department patients in Rwanda: A Critical Appraisal

  1. Become familiar with innovative technology that allows for wireless monitoring of patient vital signs in the emergency department.
  2. Understand current limitations and future avenues for this technology.

31-Dec-2020

Holiday Break

No lectures

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14-Jan-2021

Clinical Information Systems 1 - Review of Core ED Systems

Clinical Information Systems (Part 1)

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Electronic Documentation in the ED 鈥� Paperless journey: A Case Study

Stephen Rosenthal MD, CCFP, CSPQ

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Assistant Director and Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al

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Dealing with IT crashes: A Case Study

Marc Beique, MD, FRCPC(EM)

  • Associate Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and ED IT Director, Department of Emergency Medicine, MUHC

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Improving ECG workflow in the ED: A Case Study

Antony Robert MDCM, FRCPC(EM), MASc., B.Eng.

  • Assistant Professor, FMD Ultrasound Content Lead, Health Informatics Fellowship SPC Member, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, Department of Emergency Medicine, MUHC

Clinical Information Systems (Part 1)

  1. At the conclusion of this presentation, participants will be able to understand the options for system choices of institution/department
  2. At the conclusion of this presentation, participants will be able to plan for integration of systems into hospital environment
  3. At the conclusion of this presentation, participants will be able to elaborate deployment strategies for new systems

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Electronic Documentation in the ED 鈥� Paperless journey: A Case Study

  1. At the conclusion of this presentation, participants will be able to consider different deployment options
  2. At the conclusion of this presentation, participants will be able to strategize for buy-in strategies

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Dealing with IT crashes: A Case Study

  1. Be able to list potential crash scenarios.
  2. Describe strategies to cope with IT failures.

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Improving ECG workflow in the ED: A Case Study

  1. Understand the current workflow for generating ECG in the ED.
  2. List the advantages and disadvantages of using Bar Code scanning of patient bracelets.

28-Jan-2021

Clinical Information Systems 2 - Review of Core ED Systems

Fundamentals of ED Information Systems

Adrian Florea MD

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, St. Mary鈥檚 Hospital Centre

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The quest for the perfect EMR. Epic as a Case Study.

Rafael Aroutiunian MD

  • Faculty Lecturer, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al

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Forecasting Emergency Department Flow Using Machine Learning

Devin Hopkins, MDCM, CCFP(EM)

  • Faculty Lecturer, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Department of Emergency Medicine, JGH and CH du Suro卯t (Valleyfield, QC)
  • Chief MD at CHSLD St-Margaret (Westmount, QC)

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Fundamentals of ED Information Systems

  1. Understand the role and application of Human Factors and Ergonomics in designing clinical information systems
  2. Analyze the design, implementation and effects on workflow of ED specific clinical information systems
  3. Discuss the scope and influence of integrated Clinical Decision Support in the Emergency Department

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The quest for the perfect EMR. Epic as a Case Study.

  1. Gain insight into one of the most robust and used EMRs in the world.
  2. Appreciate the complexity and potential benefits involved in implementing such system on a province wide or national level

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Forecasting Emergency Department Flow Using Machine Learning

  1. Develop a basic understanding of the statistical methods behind time series forecasting
  2. Learn to apply these methods to predict flow in the Emergency Department

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11-Feb-2021

Software integration in the clinical workflow

Implementation and Deployment of Health Informatics Solutions

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Med-Urge deployment at the MUHC: A case study

Marc Beique, MD, FRCPC(EM)

  • Associate Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and ED IT Director, Department of Emergency Medicine, MUHC

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Computerized Physician Order Entry (CPOE): Challenges and Strategies for Implementation

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A usability and safety analysis of electronic health records: A multi-center study

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Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

Implementation and Deployment of Health Informatics Solutions

  1. Be able to describe various steps in the deployment of HI solutions
  2. Identify major obstacles to the deployment of HI solutions

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Med-Urge deployment at the MUHC: A case study

  1. Illustrate elements of success described in previous in presentation
  2. Describe and identify IT barriers to deployment

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Computerized Physician Order Entry (CPOE): Challenges and Strategies for Implementation

  1. Identify challenges faced when implementing a CPOE system in an emergency department.
  2. Describe strategies that can be used to facilitate CPOE implementation.

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A usability and safety analysis of electronic health records: A multi-center study

  1. To characterize and quantify the variability in usability and safety of EHRs from two vendors across four healthcare systems.
  2. Understand the importance of EHR implementation processes and their impact on end-product functionality.

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25-Feb-2021

Clinical decision- support systems

Clinical Decision Support (CDS) 鈥� Have we entered the age of Watson?

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Recent Implementations of Clinical Decision Support

Adrian Florea MD

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, St. Mary鈥檚 Hospital Centre

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ER Physician Performance Analytics (Project Update)

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Clinical decision support increases diagnostic yield of computed tomography for suspected pulmonary embolism: A Critical Appraisal

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

Clinical Decision Support (CDS) 鈥� Have we entered the age of Watson?

  1. Understand the drivers for implementing CDS
  2. Understanding the architecture of CDS
  3. Discuss standards and their role in establishing CDS

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Recent Implementations of Clinical Decision Support

  1. Discuss and Review recent implementations of Clinical Decision Support
  2. Discuss limitations and possibilities for failure of CDS

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ER Physician Performance Analytics (Project Update)

  1. Describe various quantitative and qualitative metrics that can be used to assess performance at the physician level.
  2. Identify challenges and key elements to consider when attempting to model several performance metrics.

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Clinical decision support increases diagnostic yield of computed tomography for suspected pulmonary embolism: A Critical Appraisal

  1. Describe the impact of evidence-based clinical decision support (CDS) on the diagnostic yield of CTPE.
  2. Describe the impact of CDS on utilization rates of CTPE studies.

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11-Mar-2021

March Break

No lectures

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25-Mar-2021

Emerging Technologies 鈥� Big Data and Artificial intelligence 1

Speech Recognition in the ED: Past, present and future

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Applied AI / ML: A voice-activated smart assistant in the ED

Rafael Aroutiunian MD

  • Faculty Lecturer, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al

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Using Speech Recognition to Facilitate EHR Interactions and Improve Patient
Care in the Emergency Department

and

Efficiency and safety of speech recognition for documentation in the electronic
health record: A Critical Appraisal

Adam Gossack MD, FRCPC, BSc.

Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

Speech Recognition in the ED: Past, present and future

  1. Gain appreciation into how Speech Recognition has evolved and how Machine Learning has been involved in its evolution.
  2. How ML-enhanced Speech Recognition can be applied in the ED setting.

Applied AI / ML: A voice-activated smart assistant in the ED

  1. Gain a better understanding of what a smart assistant is and how it can be used in the ED.
  2. What is the current state of technology with respect to using voice-activated smart assistants in the ED.

Using Speech Recognition to Facilitate EHR Interactions and Improve Patient
Care in the Emergency Department

  1. Describe how speech recognition can facilitate various clinical tasks when caring for patients in the ED.
  2. Describe key EHR features that are necessary to have for speech recognition to operate at its full potential.

Efficiency and safety of speech recognition for documentation in the electronic
health record: A Critical Appraisal

  1. Describe differences in efficiency and safety with respect to EHR documentation using a keyboard and mouse versus speech recognition as the primary input modality.
  2. List different types of EHR documentation errors and their potential impact on patient safety.

8-Apr-2021

Emerging Technologies 鈥� Big Data and Artificial intelligence 2

Image Interpretation and Deep Learning

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Proposal for a chest X-ray nodule finder: A Case Study

Lars Grant MD, PhD, CCFP(EM)

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al
  • Investigator, Lady Davis Institute

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Rapid Triage and Prioritization of Pending CTs in the Emergency Department Using Artificial Intelligence

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Promoting head CT exams in the emergency department triage using a machine learning model: A Critical Appraisal

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

Image Interpretation and Deep Learning

  1. Get a look at artificial neural networks, deep learning and understand how it relates to other machine learning methods.
  2. Overview of current state of automated image interpretation

Proposal for a chest X-ray nodule finder: A Case Study

  1. Understand the steps required in building a deep learning image classifier.
  2. Appreciate challenges that occur related to labeling the training and test set data appropriately.

Rapid Triage and Prioritization of Pending CTs in the Emergency Department Using Artificial Intelligence

  1. Describe how artificial intelligence can aid in the prioritization of ED patients with pending CT exams.
  2. Identify variables that are most likely to predict the need for urgent CT.

Promoting head CT exams in the emergency department triage using a machine learning model: A Critical Appraisal

  1. Describe a novel prediction model that identifies patients in need of a non-contrast head CT exam during ED triage.
  2. Identify limitations of the current study.

22-Apr-2021

Understanding Software and Technology Innovation

Introduction to software development lifecycle

Antony Robert MDCM, MHI, FRCPC(EM), MASc., B.Eng.

  • Assistant Professor, FMD Ultrasound Content Lead, Health Informatics Fellowship SPC Member, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, MUHC

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Lean Lessons in Software Innovation

Mike Gozzo, B.Eng (Electrical), MBA

  • Vice President, Product Management @ Zendesk

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Innovation in Healthcare

Irene Pylypenko, MSc.

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The story of Vital Tracer 鈥� a novel smartwatch to monitor all vital signs continuously

Azadeh Dastmalchi, PhD.

  • CEO, Co-founder of VitalTracer

听

The MedSafer project 鈥� how we went from idea to product

Todd Lee, MD

  • Associate Professor, Faculty of Medicine and Health Sciences, Department of Medicine, Division of Experimental Medicine, 成人VR视频

听

Introduction to software development lifecycle

  1. List the steps towards the development of a software product
  2. Explain how software requirements can be gathered

Lean Lessons in Software Innovation

  1. Understand the 鈥渓ean鈥� approach to identifying opportunities for innovate
  2. Understand the realities and process around seizing these opportunities

Innovation in Healthcare

  1. At the conclusion of this presentation, participants will be able to understand innovation concepts in the healthcare industry.
  2. At the conclusion of this presentation, participants will be able to understand different approaches to building a healthcare startup.

The story of Vital Tracer 鈥� a novel smartwatch to monitor all vital signs continuously

  1. What are steps to take an idea, create it and make it into a commercialized product
  2. What certifications are required to sell products as medical devices

The MedSafer project 鈥� how we went from idea to product

  1. Understand some of the processes required in taking an idea through to deliverable product
  2. Appreciate some of the challenges in working with coded and uncoded data sources

6-May-2021

Project Management in Healthcare

Introduction to Project Management

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

Evaluation of a Patient & Caregiver Centered Mobile Application to Enhance Medication Management Following Hospital Discharge

Santiago M谩rquez Fosser MD, MSc

  • Post-Doctoral Fellow, 成人VR视频 Clinical & Health Informatics (MCHI)

听

Le circuit prescription dispensation des m茅dicaments 鈥� de la vision 脿 la r茅alisation

Louise Fortin, M.A.P

  • Directrice de la mise en 艙uvre des projets de transformation num茅rique (DMOPTN), Direction des technologies de l鈥檌nformation (DGTI), Minist猫re de la Sant茅 et des Services sociaux (MSSS)

et

脡lisabeth Bourassa, B.Pharm, MSc.

  • Pharmacienne affili茅e au CHU de Qu茅bec 鈥� Universit茅 Laval
  • Responsable affaires du Programme de circuit prescription-dispensation du m茅dicament (CPDM) 脿 la Direction de la mise en 艙uvre des projets de transformation num茅rique (DMOPTN), Direction des technologies de l鈥檌nformation (DGTI), Minist猫re de la Sant茅 et des Services sociaux (MSSS)

听

Innovation Practices in Health Technology

David Schacter

  • Director of Health Innovation, Dialogue Health Technologies Inc.

Introduction to Project Management

  1. List the phases of the project management life cycle.
  2. Describe an approach to elaborate a health IT project in the ED.

听

Evaluation of a Patient & Caregiver Centered Mobile Application to Enhance Medication Management Following Hospital Discharge

  1. To describe the SAM (Smart about Meds) application, its usability, and user perception.
  2. To discuss the best opportunities that heath informatics can bring to manage medications using new technologies.

听

Le circuit prescription dispensation des m茅dicaments 鈥� de la vision 脿 la r茅alisation

  1. D茅crire sommairement comment le programme de Circuit prescription-dispensation du m茅dicament (CPDM) a 茅t茅 con莽u et en quoi il consiste.
  2. Comprendre la compl茅mentarit茅 du CPDM avec le projet de Dossier sant茅 num茅rique DSN
  3. Conna卯tre l鈥檃pproche choisie pour int茅grer les aspects cliniques et technologiques

听

Innovation Practices in Health Technology

  1. Appreciate and recognize the real-world risks and challenges in successful development and launch of innovative healthcare solutions
  2. Identify and apply practices and risk minimization strategies to increase the odds of success in identifying and developing effective innovation initiatives

20-May-2021

CIHI Session 1: Introduction to CIHI and their data

Time Changed to 13h00-16h00

Canadian Institute for Health Information (CIHI) Overview

Kinga David

  • Manager, Quebec Regional Office, CIHI

听

National Ambulatory Care Reporting System

Isabel Tsui

  • Manager, Clinical Administrative Databases 鈥� Development and Expansion, CIHI

and

Anne Forsyth

  • Program Lead, Clinical Administrative Databases 鈥� Development and Expansion, CIHI

听

Classifications and Terminologies

Sharon Baker

  • Manager 鈥� Classifications and Terminologies 鈥� Development, CIHI

听

CIHI future directions for modernizing data collection in an increasingly digitized environment

Isabel Tsui

  • Manager, Clinical Administrative Databases 鈥� Development and Expansion, CIHI

and

Sharon Baker

  • Manager 鈥� Classifications and Terminologies 鈥� Development, CIHI

Canadian Institute for Health Information (CIHI) Overview

  1. To provide an overview of CIHI, its mandate, vision and strategic goals.
  2. To provide a brief overview CIHI鈥檚 data holdings and reporting tools, highlighting where Qu茅bec is present.

听

National Ambulatory Care Reporting System (NACRS)

  1. To provide information on NACRS, its submission levels and submission processes.
  2. To describe the benefits of pan-Canadian ED data and current coverage.

听

Classifications and Terminologies

  1. To provide information on classification standards, Canadian coding standards and ED picklists.
  2. To describe the role of health information management professionals in clinical coding.

听

CIHI future directions for modernizing data collection in an increasingly digitized environment

  1. To describe opportunities for improvement with current data collection processes.
  2. To provide information on future directions CIHI will pursue in relation to modernizing data collection approaches.

3-Jun-2021

Data Analytics

听

ED Information Systems and Technologies 鈥� A Comparison of 3 成人VR视频 Sites

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

听

Data Analytics: Core Lecture

Antony Robert MDCM, FRCPC (EM), MASc., B.Eng.

  • Assistant Professor, FMD Ultrasound Content Lead, Health Informatics Fellowship SPC Member, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, MUHC

听

Fonctionnement d鈥檜n PMO : Le processus d鈥檃pprobation d鈥檜n projet

脡lo茂se De Bellefeuille, PMP

  • Manager by Interim, Project Management Office, Information Services, MUHC

听

ED Information Systems and Technologies 鈥� A Comparison of 3 成人VR视频 Sites

  1. Describe the IT setup and EHR environment at 3 成人VR视频 ED sites.
  2. List the advantages and disadvantages specific to each site.

听

Data Analytics: Core Lecture

  1. Understand the architecture for data analytics
  2. List different tools that can be used to develop an analytics dashboard

听

Fonctionnement d鈥檜n PMO : Le processus d鈥檃pprobation d鈥檜n projet

  1. Comprendre le processus minist茅riel et organisationnel derri猫re les demandes de projets.
  2. Int茅grer les facteurs de succ猫s cl茅s dans ses futures demandes de projets.

17-Jun-2021

Change Management

Change Management: A People鈥檚 Perspective

Marc Beique, MD, FRCPC(EM)

  • Associate Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and ED IT Director, Department of Emergency Medicine, MUHC

听

Put Your Money Where Your Mouse Is 鈥� EHR Implementation and Physician Change Management, the BC Experience

Eric Grafstein MD, FRCPC

  • Clinical Professor, Department of Emergency Medicine, Faculty of Medicine, University of British Columbia

听

Emergency Department Descriptive Analytics Using Med-Urge: Site Project Presentation

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

Change Management: A People鈥檚 Perspective

  1. Familiarize the attendees with the various theories of change management
  2. Identify common steps to the various models

听

Put Your Money Where Your Mouse Is 鈥� EHR Implementation and Physician Change Management, the BC Experience

  1. Review project governance and understand the importance of having a clinically led project.
  2. Understand key principles for managing scope.
  3. Discuss key essential components of the EHR implementation 鈥� hint 鈥� it鈥檚 not the software.
  4. Discuss the key ways to enhance physician engagement and avoid physician problems during electronic health record implementation
  5. Review key elements of the educational process for onboarding physicians.

听

Emergency Department Descriptive Analytics Using Med-Urge: Site Project Presentation

  1. Understand the process of extracting and cleaning data from the Med-Urge Analyzer Module using Power BI.
  2. Describe the results of this ED analytics project and next steps.

9-Sep-2021

听

Review of the Healthcare Organization and MSSS Cadre Normatif SIGDU - on which Emergency Department information systems are based

and

Review of general indicators part of the STAT (Soutien, Transformation, Acc猫s, Terrain) 鈥� and how we can improve using HI

and

Funding sources for Health Informatics projects

Antony Robert MD, FRCPC(EM), CPHIMS-CA, MHI, MASc., B.Eng.

  • Assistant Professor and Academic Director of Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, MUHC

听

Review of the Healthcare Organization and MSSS Cadre Normatif SIGDU - on which Emergency Department information systems are based

  1. List various federal organization pertaining to healthcare informatics
  2. List some key data elements required by the MSSS from ED information systems
  3. Question: What drove the development of both SIURGE, Med-Urge?

听

Review of general indicators part of the STAT (Soutien, Transformation, Acc猫s, Terrain) 鈥� and how we can improve using HI

  1. Understand the various metrics the Ministry reports on for ED Services
  2. Explain how health informatics can improve ED Services

听

Funding sources for Health Informatics projects

  1. Explain the different types of projects amenable for funding
  2. Understand the sources of funding for digital health projects

23-Sep-2021

听

Why do we need data governance?

and

JC article - The impact of adoption of an electronic health record on emergency physician work: A time motion study

Antony Robert MD, FRCPC(EM), CPHIMS-CA, MHI, MASc., B.Eng.

  • Assistant Professor and Academic Director of Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, MUHC

听

A case study in the use of data from the Banque de donn茅es communes des urgences

Rick Mah MD, CCFP, CCFP(EM)

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Department of Emergency Medicine, St. Mary's Hospital Center

Why do we need data governance?

  1. List the elements of a data governance plan
  2. List the goals / outcomes of data governance

听

A case study in the use of data from the Banque de donn茅es communes des urgences

  1. Understand the process to request and use data from the government for the purpose of emergency medicine research
  2. Appreciate how information governance is practically applied when using administrative data from the government

听

JC article - The impact of adoption of an electronic health record on emergency physician work: A time motion study

  1. Define what is a time motion study
  2. Evaluate the impact of a new EHR on physician work

听

7-Oct-2021

听

Creating a predictive machine learning model to reprioritize code 3 patients in the ED: Site Project Presentation

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

听

HL7 Data Exchange Standards

Finnie Flores, MPH, MAEd, CPHIMS-CA

  • Program Consultant (Standards), Enterprise Architecture & Standards, Canadian Institute for Health Information (CIHI)

听

Physician Workflow in Two Distinctive Emergency Departments: An Observational Study by Patel et al, 2021

Antony Robert MD, FRCPC(EM), CPHIMS-CA, MHI, MASc., B.Eng.

  • Assistant Professor and Academic Director of Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and Assistant Director of ED IT, MUHC

听

Creating a predictive machine learning model to reprioritize code 3 patients in the ED: Site Project Presentation

  1. Understand the steps required to develop a predictive machine learning model for use in the emergency department.
  2. Describe several patient-centered outcomes that could aid in prioritizing Code 3 patients for initial physician assessment.

听

HL7 Data Exchange Standards

  1. Identify some of the data exchange standards used in health informatics
  2. Have a deeper understanding of HL7 standards particularly version 2.x and FHIR
  3. Understand some considerations when implementing a data exchange interface

听

Physician Workflow in Two Distinctive Emergency Departments: An Observational Study by Patel et al, 2021

  1. Describe the various activities part of a typical ED workflow
  2. Describe 2 type of activities/situations that can increased cognitive load in the ED

21-Oct-2021

听

Performance analytics for EM physicians at the RVH: Capstone Project

Adam Gossack MD, FRCPC, BSc.

  • Fellow in Emergency Medicine Health Informatics, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频

听

Data and Information Governance

Janine Kaye

  • Manager, Data Governance and Standards Office, Canadian Institute for Health Information (CIHI)

听

Information Quality at CIHI

Joanne Sefton

  • Consultant, Canadian Institute for Health Information (CIHI)

听

听

Performance analytics for EM physicians at the RVH: Capstone Project

  1. Describe quantitative and qualitative metrics that can be used to assess performance at the physician level.
  2. Identify challenges and key elements to consider when modelling several performance metrics.

听

Data and Information Governance

  1. Understand what data and information governance is and the best sources of information for healthcare data
  2. Identify the core principles for a mature data governance program and how CIHI is incorporating these into their work
  3. Know what questions to ask when setting up governance and management of your EDIS data for research and analysis internally and externally

听

Information Quality at CIHI

  1. Gain an understanding of key quality principles.
  2. At a high level, understand CIHI鈥檚 Information Quality Framework and related components of the Data Source Assessment Tool.
  3. Learn about some current quality activities related to NACRS Emergency Department data.

4-Nov-2021

听

Overview of Security and Privacy

Rafael Aroutiunian MD

  • Faculty Lecturer, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al

听

Why SNOMED CT?

Alana Lane

  • Classification Specialist, Canadian Institute for Health Information (CIHI)

听

Outbreaks in the virtual world: Cybersecurity in Medium and Large Healthcare Organizations

Rick Mah MD, CCFP, CCFP(EM)

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Department of Emergency Medicine, St. Mary's Hospital Center

and

Adrian Florea MD

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff, Emergency Department, St. Mary鈥檚 Hospital Centre

听

Overview of Security and Privacy

  1. Common security and Privacy challenges
  2. Techniques to overcome security and privacy challenges.

听

Why SNOMED CT?

  1. Understand the differences between SNOMED CT and classifications
  2. Identify practical use cases for SNOMED CT in the healthcare system
  3. Understand the benefits of SNOMED CT in an electronic health record system

听

Outbreaks in the virtual world: Cybersecurity in Medium and Large Healthcare Organizations

  1. Introduce examples of recent cyberattacks affecting Health Care Organizations and understand consequences data breaches to patient safety, data integrity and availability
  2. Understand the difference between threats and vulnerabilities and analyze the basic aspects of the most common threats in healthcare
  3. Introduce a framework for incident response to cyberattacks in healthcare

听

18-Nov-2021

听

Optimal Leveraging of EMHI for Admin / QI needs: Making sure the data tail doesn鈥檛 wag the project dog

Eddy Lang, MD

  • Professor and Department Head, Emergency Medicine, Cumming School of Medicine, Alberta Health Services

听

The National COVID Cohort Collaborative (N3C): A social experiment in collaborative research

Christopher G Chute, MD DrPH

  • Bloomberg Distinguished Professor of Health Informatics, Johns Hopkins University, Baltimore, MD, USA

听

Privacy Fundamentals

Patrick Lo, CISSP, CIPP/C.

  • CEO, Privacy Horizon Inc.

Optimal Leveraging of EMHI for Admin / QI needs: Making sure the data tail doesn鈥檛 wag the project dog

  1. Develop an approach that yields high impact quality of care initiatives in the ED
  2. Consider the pros and cons of public reporting of quality of care measures
  3. Examine the use of health information data as a tool for MD practice enhancement

听

The National COVID Cohort Collaborative (N3C): A social experiment in collaborative research

  1. The scope, content, and creation of the N3C;
  2. Efforts to promote team science and broad attribution

听

Privacy Fundamentals

  1. Understand the language of privacy
  2. Understand the principles and legislation that applies to their organizations.

2-Dec-2021

听

Optimal Leveraging of EMHI for Research: Balancing Curiosity Feasibility and Complexity

Eddy Lang, MD

  • Professor and Department Head, Emergency Medicine, Cumming School of Medicine, Alberta Health Services

听

CODA19: Analyse collaborative des donn茅es pour am茅liorer les soins cliniques chez les patients atteints de COVID-19

Dr Micha毛l Chass茅, MD, PhD, FRCPC

  • Principal Scientist, CHUM Research Centre and Centre d'int茅gration et d'analyse de donn茅es m茅dicales (CITADEL) and Associate Professor, Department of medicine, University of Montreal

and

Pascal St-Onge, M.Sc.

  • Medical Data Science Program Manager,

Optimal Leveraging of EMHI for Research: Balancing Curiosity Feasibility and Complexity

  1. Develop an approach for developing impactful research using EMHI as the laboratory
  2. Consider strategies for designing and implementing research within an electronic health record
  3. Describe the gamut of opportunities that can allow for research to be conducted through EMHI or within an HER

听

CODA19: Analyse collaborative des donn茅es pour am茅liorer les soins cliniques chez les patients atteints de COVID-19

  1. Solution technologique permettant la recherche sur les donn茅es de sant茅.
  2. M茅thode d'analyse d茅centralis茅e

16-Dec-2021

听

Facilitating work with computers, the present and the future

and

Real-time localization; experience and opportunities

Marc Beique, MD, FRCPC(EM)

  • Associate Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Attending Staff and ED IT Director, Department of Emergency Medicine, MUHC

听

When things just don鈥檛 work

Stephen Rosenthal, MD, CCFP, CSPQ

  • Assistant Professor, Faculty of Medicine and Health Sciences, Department of Emergency Medicine, 成人VR视频
  • Assistant Director and Attending Staff, Emergency Department, Jewish General Hospital CIUSSS du Centre-Ouest-de-l鈥櫭巐e-de-Montr茅al

Facilitating work with computers, the present and the future

  1. Understand why hardware configuration is important
  2. Name 3 hardware set up that can facilitate work

听

When things just don鈥檛 work

  1. How to prepare for downtimes -planned or unplanned
  2. Challenges in best of bread environment

听

Real-time localization; experience and opportunities

  1. Be able to list 2 challenges with deployment of localization devices
  2. List at least one future application for such devices

10-Feb-2022

@ 10am

听

Identify And Organizing Data To Be Included In An Integrated Healthcare Delivery Organization's Enterprise Data Warehouse

Philip M. Troy, Ph.D.

  • Senior Analytics Advisor, CIUSSS Centre Ouest Montreal, Adjunct Professor of Surgery, 成人VR视频

听

How useful is patient reported pain at triage?

Lars Grant, MD, PhD, CCFP(EM)

  • Associate Chair Research, Department of Emergency Medicine, 成人VR视频
  • Attending Physician, Jewish General Hospital

Identify And Organizing Data To Be Included In An Integrated Healthcare Delivery Organization's Enterprise Data Warehouse

  1. How you should go about identifying the data they need for process improvement and/or clinical research
  2. How you would want that information to be presented to them for that research

听

How useful is patient reported pain at triage?

  1. Understand the use of CTAS in Canadian EDs and the way in which it is implemented in Med-Urge
  2. Understand the use of ROC analysis to assess the discrimination of prognostic predictions.
  3. Appreciate the significance of patient reported pain as a triage element.

听
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