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News and Events

 

Chair’s Message

pth-use-this-oneWe are moving toward our vision with a number of activities across our various programs. We have updated our strategic plan in response to the 10-year academic program review that we recently completed. For our research-oriented MS and PhD programs, we have recently added a specialization in Data Science. We are completing a curriculum revision for our on line applied clinical informatics MS which will be effective Fall 2020. The work of our fellows in the clinical informatics fellowship program has received plaudits from clinical administrators and faculty, and we are currently recruiting a new faculty member in our department to assist with this program (view position description).  We are also recruiting a faculty member in medical education to start Summer 2020 (view position description). This is the beginning of a new cycle of admissions to our graduate programs, and we look forward to another productive year, and new growth in our department.

Cordially,

Peter Tarczy-Hornoch, MD
Chair and Professor, Department of Biomedical Informatics and Medical Education


The University of Washington Welcomes New Chief Research Information Officer 

The University of Washington is delighted to announce Dr. Shawn Murphy, MD, PhD will be joining the University of Washington as a core faculty in Biomedical Informatics and Medical Education (BIME) with a joint appointment in Neurology. In addition to being a core BIME faculty member and attending in an outpatient neurology clinic, he will be serving as UW Medicine Chief Research Information Officer in IT Services, informatics lead of the Institute for Translational Health Sciences (ITHS) Data Science Core, and the Director of the Institute for Medical Data Sciences (IMDS).

“I am honored and excited to join the Data Science workforce at the University of Washington.  I have always admired the closeness UW students have to the top teachers in the tech industry.  I am hoping to enable Clinical and Informatics Research to use this and take Data Science and AI to a new level at UW,” said Dr. Murphy.

Dr. Murphy is currently the Chief Research Information Officer at Mass General Brigham and a Professor of Neurology. Over the past 30 years, he has been an integral leader and innovator in supporting research data and technology there.  He is the creator of the Research Patient Data Registry (RPDR) and co-founded i2b2 (used in > 300 sites globally) enabling scalable, audit-ready clinical data access for the research community nationally and internationally.  Shawn has also been a leading scientific collaborator and principal investigator on numerous multi-institutional NIH grants, including RECOVER, eMerge, ACT, AoU, PCORI, SHRINE and other major award programs that helped elevate MGB into a leader in translational informatics. His work has shaped standards for privacy-preserving data sharing, cohort discovery tools, and clinical data harmonization, influencing research data operations across Mass General Brigham hospitals and enabling thousands of studies per year.

“We are delighted to have Dr. Murphy join UW, bringing decades of expertise in informatics and data science research and operational work around instrumenting the health care enterprise for discovery in the course of clinical care,” said Dr. Peter Tarczy-Hornoch, Chair of BIME and Interim Director for IMDS.

“ITHS welcomes Dr. Murphy to this crucial role.   He is exactly the right person to take on the new informatics challenges of clinical and translational research,” said Dr. John Amory, Principal Investigator of ITHS and Associate Dean of Translational Sciences. 

Dr. Murphy will be bringing this rich and deep expertise to his UW roles as BIME faculty, Neurology faculty, UW Medicine CRIO, ITHS informatics lead and Institute for Medical Data Science Director.

“I am excited to welcome Dr. Murphy to UW Medicine and confident that his decades of leadership in research informatics at Mass General Brigham will significantly advance our research, data science, and innovation efforts,” said Eric Neil, UW Medicine Chief Information Officer.

Dr. Murphy’s position begins effective February 1, 2026.

 

Biomedical Informatics and Medical Education Newsletter

 

April 20, 2026 – April 24, 2026

UPCOMING LECTURES AND SEMINARS
BIME 590
Presenter:  Shawn Murphy, MD, PhD,
Thursday, April 30th – 11-11:50 am
850 Republican Street, Building C, Room 123 A/B
Zoom Information: https://washington.zoom.us/my/bime590
Speaker will present In-Person

Title: Enhancing the Digital Representation of the Patient using Computational Phenotypes and Generative AI

Abstract: The use of real-world electronic health record data for research has enabled massive advances in how we understand health and disease in our patients.   However, use of the data should always be done with the understanding that it is often not collected for research and therefore may be fraught with inconsistencies.   Enabling the “digital twin” of the patient often involves applying complex algorithms and AI paradigms to result in a highly accurate digital representation.

 

Speaker Bio: Shawn Murphy serves as the Chief Research Information Officer at UW Medicine and as Professor of Biomedical Informatics and Medical Education and Professor of Neurology.  Over his prior 30 years he has been an integral leader and innovator at Massachusetts General Hospital.  His work has shaped standards for privacy-preserving data sharing, cohort discovery tools, and clinical data harmonization, influencing research data operations across hospitals and enabling thousands of studies per year to use real world data for science.

 

PAPERS, PUBLICATIONS & PRESENTATIONS
On Tuesday, April 21st, Oliver Bear Don’t Walk participated in a panel organized by Sámi University of Applied Sciences, Sámi Parliament in Norway, Norwegian Ministry of Local Government and Regional Development!

The panel was during a Side Event at the 25th Session of the United Nations Permanent Forum on Indigenous Issues. His talk was titled “Artificial Intelligence and Indigenous Health Knowledge”.

Event Details:
AI Opportunities for Indigenous Health: Realizing benefits and addressing risks

New health AI applications for diagnosis, treatment, and care will reshape healthcare systems, and they offer major opportunities to reduce inequities faced by Indigenous Peoples by enabling new services that better support Indigenous languages and cultures. However, if Indigenous Peoples are absent from training and evaluation data, AI tools can underperform, contributing to poorer decision support, misprioritization, and unequal access to timely care. Therefore, urgent actions are needed to remove barriers to inclusion, especially access to relevant data, robust evaluation for Indigenous Peoples’ populations, and accountability in how health AI is designed, developed, and used for Indigenous Peoples.

Speakers
Prof. Lars Ailo Bongo, Sámi AI Lab, Sámi University of Applied Sciences
Maren B. N. Storslett, Member of Governing Council, Sámi Parliament in Norway
Sigrid Ina Simonsen, State Secretary, Norwegian Ministry of Local Government and Regional Development
Dr. Oliver J. Bear Don’t Walk IV, University of Washington
TBA, Member of UNPFII
Risten Rajala, Sámi Path Finders, Sámi University of Applied Sciences.

 

UPCOMING EXAMS

General Exam
Title: A unified framework for early detection, disease trajectory analysis and equitable prediction of autoimmune disease using longitudinal clinical text and patient records
Student: Aparajita Saha
Date/Time: Monday, May 4, 11-1pm PT
In-person location: Institute for Systems Biology, Room- 432
Zoom: https://isbscience.zoom.us/j/88432669777?pwd=aEQBOhkzKiLqbbXcNKhIxld7kWT2Hq.1
Meeting ID: 884 3266 9777
Passcode: 507282

Abstract: Autoimmune diseases are often difficult to diagnose early because symptoms emerge gradually and vary widely across patients. Delayed diagnosis can lead to prolonged patient suffering and irreversible organ damage. Early manifestations are frequently documented in longitudinal clinical notes and electronic health records long before formal diagnosis, yet these signals remain underutilized by current diagnostic or predictive models. This general exam proposes a longitudinal framework for identifying early disease signals from electronic health records using large language models and time-aware machine learning approaches. The work focuses on detecting pre-diagnostic patterns from clinical notes, characterizing disease and comorbidity trajectories over time, examining outcome-wide associations across these trajectories and developing robust evaluation methods for longitudinal prediction. While centered on autoimmune diseases, this framework may also inform earlier detection and trajectory modeling for other chronic systemic conditions.

 

April 13, 2026 – April 17, 2026

UPCOMING LECTURES AND SEMINARS
BIME 590
Presenter:  Uba Backonja, PhD, MS, RN
Thursday, April 23rd – 11-11:50 am
850 Republican Street, Building C, Room 123 A/B
Zoom Information: https://washington.zoom.us/my/bime590

Speaker will present Via Zoom

Title: Applying user-centered design principles to develop HL7® FHIR® resources for post-acute care data interoperability

Abstract: Data silos are a major issue across healthcare, especially in post-acute care (PAC) like skilled nursing facilities and home health. These silos can negatively impact patient outcomes due to lack of complete healthcare data available to healthcare providers. To address this silo issue, the Centers for Medicare & Medicaid Services (CMS) and MITRE have partnered to create HL7® Fast Healthcare Interoperability Resources (FHIR®) for health IT developers so there can be a standardized way to collect and transfer data across settings (https://pacioproject.org). To create these resources, MITRE applies user-centered design (UCD) principles to collaborate with providers, vendors, and other PAC partners to understand and address interoperability gaps that can be addressed via FHIR. This talk will describe FHIR basics, unique data needs for PAC settings, and how MITRE uses UCD to collaborate with partners throughout the FHIR resource development lifecycle.

 

Speaker Bio: Dr. Uba Backonja (pronounced “OO-ba BAHch-ko-nya”) is a researcher with expertise in health informatics, UCD, community and public health nursing, anthropology, data visualization, and other topics. She completed her training at the University of Wisconsin-Madison, was a Predoctoral Fellow @the NIH/NICHD, and a Postdoctoral Fellow @BIME. Before MITRE, Dr. Backonja was faculty @UW Tacoma School of Nursing and Healthcare Leadership and conducted research with BIME faculty and the UW’s Northwest Center for Public HeDalth Practice (e.g., https://sharenw.nwcphp.org). You can find her on LinkedIn and PubMed.

PAPERS, PUBLICATIONS & PRESENTATIONS

  • DeconDTN-Toolkit: A Library for Evaluation and Enhancement of Robustness to Provenance Shift. Yongsen Tan, Zhecheng Sheng, Xiruo Ding, Serguei V. S. Pakhomov, Trevor Cohen. Accepted: 7th Annual Conference on Health, Inference, and Learning (CHIL). Seattle, WA. 2026.

 

  • SocialLM: Using LLMs and contextual aggregation to track patient-provider communication. Manas Bedmutha, Feng Chen, Andrea L Hartzler, Trevor Cohen, Nadir Weibel.  Accepted: 7th Annual Conference on Health, Inference, and Learning (CHIL). Seattle, WA. 2026.

 

 

ANNOUNCEMENTS
Please join us in congratulating Danner Peter who successfully passed his General Exam!

Title: Responsible Predictive Modeling for Tribal Health: Integrating Fairness Evaluation and Indigenous Data Governance

Abstract: Predictive modeling has the potential to support health equity in Tribal communities, yet most models are developed using data that underrepresent American Indian and Alaska Native (AIAN) populations and are rarely evaluated for fairness or validity in Indigenous health contexts. This dissertation addresses a critical gap at the intersection of Tribal health priorities, algorithmic fairness, and Indigenous Data Governance (IDGov) by asking: under what conditions can predictive modeling be responsibly and beneficially used to support Tribe-identified health priorities? This dissertation pursues three aims: (1) in collaboration with the Northwest Tribal Epidemiology Center (NWTEC), identify community-defined health priorities suitable for predictive analytic approaches; (2) develop and evaluate predictive models with explicit AIAN fairness assessment using the NIH All of Us dataset; and (3) assess governance-informed readiness for predictive modeling within a Tribal Epidemiology Center. Together, these aims integrate technical evaluation with IDGov principles to determine not only how models perform, but when their use is appropriate or inadvisable. This work contributes structured, governance-aligned criteria that Tribes and Tribe-serving organizations could use to evaluate the feasibility and community impacts of predictive modeling.

______________________________________________

Are you interested in research on digital health, social media data, patient experiences, and the criminal legal system? I am looking for a graduate student collaborator to work together on qualitative coding of Reddit posts examining substance use and health behaviors among individuals under community supervision (e.g., probation, parole).

Objective: The goal of this project is to better understand how individuals describe their experiences with community supervision and how these experiences shape substance use, recovery, and broader health-related behaviors. Findings from this work aim to improve understanding of patient experiences and inform public health research and policy for criminal legal–involved populations.

The graduate student collaborator will:

  • Conduct qualitative coding of Reddit posts using a semi-structured coding framework
  • Participate in regular meetings to discuss coding decisions and refine code definitions
  • Contribute to interpretation of findings and potential manuscript development

This is a collaborative opportunity with potential for authorship, continued involvement, and participation in future related projects. Our team includes myself, Dr. Annie Chen, and Dr. Mandy Owens.

Preferred Background:

  • Graduate student
  • Experience with qualitative coding or qualitative research methods
  • Interest in digital health, substance use, or criminal legal system research

Time Commitment:

  • Approximately 5–7 hours per week
  • Minimum duration of ~10 weeks for coding (please note the possibility of an extended timeline if necessary)
  • Includes a weekly meeting plus independent coding time

If you’re interested or would like more information, please send an email to mamagid@uw.edu.

 

UPCOMING EXAMS

General Exam
Title: A unified framework for early detection, disease trajectory analysis and equitable prediction of autoimmune disease using longitudinal clinical text and patient records
Student: Aparajita Saha
Date/Time: Monday, May 4, 11-1pm PT
In-person location: Institute for Systems Biology, Room- 432
Zoom: https://isbscience.zoom.us/j/88432669777?pwd=aEQBOhkzKiLqbbXcNKhIxld7kWT2Hq.1
Meeting ID: 884 3266 9777
Passcode: 507282

Abstract: Autoimmune diseases are often difficult to diagnose early because symptoms emerge gradually and vary widely across patients. Delayed diagnosis can lead to prolonged patient suffering and irreversible organ damage. Early manifestations are frequently documented in longitudinal clinical notes and electronic health records long before formal diagnosis, yet these signals remain underutilized by current diagnostic or predictive models. This general exam proposes a longitudinal framework for identifying early disease signals from electronic health records using large language models and time-aware machine learning approaches. The work focuses on detecting pre-diagnostic patterns from clinical notes, characterizing disease and comorbidity trajectories over time, examining outcome-wide associations across these trajectories and developing robust evaluation methods for longitudinal prediction. While centered on autoimmune diseases, this framework may also inform earlier detection and trajectory modeling for other chronic systemic conditions.

 

April 6, 2026 – April 10, 2026

UPCOMING LECTURES AND SEMINARS
BIME 590
Presenter:  Christopher Longhurst, MD, MS
Thursday, April 16th – 11-11:50 am
850 Republican Street, Building C, Room 123 A/B
Zoom Information: https://washington.zoom.us/my/bime590
Speaker will present In-Person

Title: Fostering Patient-Centered Communication in Clinical Note Writing

Abstract:
Details to come next week!

Speaker Bio:
As CEO of Seattle Children’s, Dr. Christopher Longhurst, MD, MS leads a world-class team of healthcare providers, researchers, and staff who are united by Children’s mission to provide hope, care and cures to help every child live the healthiest and most fulfilling life possible.

A practicing pediatrician for the past 25 years, Dr. Longhurst joined Seattle Children’s in 2026 after serving in a dual role as chief medical officer (CMO) and chief digital officer (CDO) at UC San Diego Health, as well as Professor of Biomedical Informatics and Pediatrics at UC San Diego School of Medicine. Combining a passion for innovation with the drive to improve quality, safety, equity and patient experience, Longhurst was instrumental in securing a philanthropic gift to establish the Joan & Irwin Jacobs Center for Health Innovation where he served as the center’s founding executive director leading the AI portfolio across the system.

Dr. Longhurst now serves as an affiliate Professor of Pediatrics and Biomedical Informatics at the University of Washington and continues to contribute thought leadership and scholarship in care quality, patient safety and health informatics. He has published over 150 peer-reviewed articles in journals like the New England Journal of Medicine, JAMA and Pediatrics, and serves on the National Academy of Medicine steering committee for Patient Safety in the AI Era.

Before joining UC San Diego Health, Dr. Longhurst spent 15 years at Stanford University, serving as chief medical information officer for Stanford Children’s Health, where he led efforts to improve children’s health and provider workflow using information technology. He also founded and led the nation’s first accredited clinical informatics fellowship at Stanford, where he was a clinical professor of pediatrics and biomedical informatics.

Dr. Longhurst is an elected fellow of the prestigious American College of Medical Informatics. He earned his medical degree and Master of Science in Medical Informatics from UC Davis, completed his residency at Stanford University, and holds a Bachelor of Science from UC San Diego.

 

PAPERS, PUBLICATIONS & PRESENTATIONS

 

UPCOMING EXAMS
General Exam
Title: Responsible Predictive Modeling for Tribal Health: Integrating Fairness Evaluation and Indigenous Data Governance
Student: Danner Peter
Date/Time: Thursday April 16, 8-10 am PT
In-person location: 850 Republican St., Building C, Room C122
Zoom: https://washington.zoom.us/my/peter.th

Abstract: Predictive modeling has the potential to support health equity in Tribal communities, yet most models are developed using data that underrepresent American Indian and Alaska Native (AIAN) populations and are rarely evaluated for fairness or validity in Indigenous health contexts. This dissertation addresses a critical gap at the intersection of Tribal health priorities, algorithmic fairness, and Indigenous Data Governance (IDGov) by asking: under what conditions can predictive modeling be responsibly and beneficially used to support Tribe-identified health priorities? This dissertation pursues three aims: (1) in collaboration with the Northwest Tribal Epidemiology Center (NWTEC), identify community-defined health priorities suitable for predictive analytic approaches; (2) develop and evaluate predictive models with explicit AIAN fairness assessment using the NIH All of Us dataset; and (3) assess governance-informed readiness for predictive modeling within a Tribal Epidemiology Center. Together, these aims integrate technical evaluation with IDGov principles to determine not only how models perform, but when their use is appropriate or inadvisable. This work contributes structured, governance-aligned criteria that Tribes and Tribe-serving organizations could use to evaluate the feasibility and community impacts of predictive modeling.

 

March 30, 2026 – April 3, 2026

UPCOMING LECTURES AND SEMINARS
BIME 590
Presenter:  Raina Langevin, PhD
Thursday, April 9th – 11-11:50 am
850 Republican Street, Building C, Room 123 A/B
Zoom Information: https://washington.zoom.us/my/bime590
Speaker will present Via Zoom

Title: Fostering Patient-Centered Communication in Clinical Note Writing

Abstract:
In healthcare, effective communication between providers and patients is critical for delivering high-quality care and ensuring patient satisfaction. One aspect of this communication is the ability of providers to write clinical notes in a way that is understandable to patients. These skills are even more important due to the “open notes provision” of the 21st Century Cures Act which dictates that patients should be able to access their electronic records without delay. This talk will explore how patient-centered note writing could be supported through health informatics and AI research. The talk will focus on our ongoing research to design a rubric for patient-centered clinical note writing, and to create an annotation dataset to use in large language model (LLM) evaluation of patient-centeredness in clinical notes.

 

Speaker Bio:
Raina Langevin is a National Library of Medicine Postdoctoral Fellow in Biomedical Informatics and Medical Education at the University of Washington. She earned her Ph.D. and M.S. in Human Centered Design & Engineering from the University of Washington, where she designed and evaluated conversational user interfaces for healthcare applications. Prior to joining UW, she received her Bachelor’s degrees in Computer Science and Studio Arts from the University of Rochester. Her research interests include human-computer interaction (HCI), conversational user interface (CUI) design, machine learning, and health informatics. During her PhD, she contributed to the development of validated usability heuristics for conversational user interfaces, development of a chatbot for social needs screening and resource provision for emergency department patients, and design of a culturally tailored chatbot to improve breast cancer screening outreach. Her current research aims to improve the design of patient-centered technologies, by understanding the needs of patients and healthcare providers and how they could be supported by technology.

 

ANNOUNCEMENTS
Greetings everyone – Our next BIME social hour is Thursday, April 9 at 4pm, and will be over in the glamorous Crow’s Nest room (354) in the SOCC building .

We’ll be playing some drawing games (similar to Pictionary) and snacking on some late-afternoon treats. Dina will also be serving wonderful spring mocktails!

 

PAPERS, PUBLICATIONS & PRESENTATIONS

  • Sihang Zeng, Youngwon Kim, Wilson Lau, Ehsan Alipour, Ruth Etzioni, Meliha Yetisgen, Anand Oka, Jay Nanduri. Predicting multi-cancer risk from EHR data using multi-agent LLMs. 2026 ASCO Annual Meeting (Oral).
  • Wilson Lau, Ehsan Alipour, Youngwon Kim, Sihang Zeng, Anand Oka, Jay Nanduri. Development of an oncology generative AI foundation model trained on over a million longitudinal patient journeys across the United States. 2026 ASCO Annual Meeting (Poster).

March 23, 2026 – March 27, 2026

UPCOMING LECTURES AND SEMINARS
BIME 590
Presenter:  Eric Rose, MD
Thursday, April 2nd – 11-11:50 am
850 Republican Street, Building C, Room 123 A/B
Zoom Information: https://washington.zoom.us/my/bime590
Speaker will present In-Person

Title: When information models collide: Challenges in adapting real-world health data for research use

Abstract: Data collected during routine patient care, i.e. “real-world data” (RWD), is increasingly used for clinical research.  Research teams often need RWD transformed into specific information models.  This requires reconciling differences in atomicity, cardinality, terminology, and other characteristics.  This talk will discuss the discordances between HL7 Fast Healthcare Interoperability Resources (FHIR) and the Study Data Tabulation Model of the Clinical Data Interchange Standards Consortium (CDISC SDTM), provide illustrative examples, and suggest approaches to handle them.

Speaker Bio: Dr. Eric Rose is a family physician and clinical informaticist.  His introduction to informatics came nearly 30 years ago as the clinician lead on the initial Epic go-live at UW Medicine, a 4-week assignment that lasted 7 years.   At that point, he joined the EHR industry, with a hopefully-not-entirely-foolhardy belief in the ability of clinicians to help improve clinical software.   This led to a focus on clinical terminology, where Dr. Rose spent 8 years leading the terminology team at a commercial provider of terminology content.  With the advances in standards and regulations promoting health interoperability, and the growing interest in use of EHR data to support clinical research, Dr. Rose’s informatics focus shifted from shoving data into clinical databases to yanking data out of them.  He currently serves as Chief Medical Informatics Officer at Crescendo Health, a clinical research informatics startup.

 

UPCOMING EXAMS
General Exam For Zina Xu Postponed
New date to be announced soon

 

March 16, 2026 – March 20, 2026

UPCOMING LECTURES AND SEMINARS
BIME 590 – On break until April 2nd

ANNOUNCEMENTS
Please join us in congratulating Ray Chung who successfully passed his PhD General Exam!

Abstract: This dissertation investigates how responsible, trust-calibrated AI collaborators can extend patient–clinician collaboration beyond the clinic to support decision-making. Grounded in stakeholder-informed design, this work identifies barriers to collaborative care, examines how AI interface and behavioral features influence trust calibration in health contexts, and translates these insights into the design of a deployable AI collaborator. Through a field study, the research evaluates how the AI collaborator can responsibly support continuous care, enhance patient experience, and strengthen patient-clinician collaboration outside in-clinic settings. Specific aims include:

    • Aim 1: Identify barriers to collaborative decision-making and decision-maker-informed design requirements for decision-support technologies through co-design workshops with youth with chronic kidney disease, caregivers, and clinicians.
    • Aim 2: Investigate how AI interface design and behavioral features influence trust calibration in health contexts and establish design requirements for responsible health-oriented AI systems.
    • Aim 3: Deploy an agentic AI collaborator in an outpatient dietitian–patient setting to assess its impact on patient–clinician interactions, agent autonomy preferences, and user experience.

 

UPCOMING EXAMS

General Exam
Title: Enabling context-sensitive health decisions for youth through lived experience capture and representation
Student: Zina Xu
Date/Time: Wednesday, April 8, 3-5 pm PT
In-person location: Mary Gates Hall, 015H
Zoom: https://washington.zoom.us/my/wanda.pratt

Abstract: Youth with chronic kidney disease (CKD) must constantly navigate complex health-related decisions in their daily lives, as managing their condition requires balancing medication regimens, personal goals, and life demands during a critical period of developing autonomy and communication skills. Despite the increasing emphasis on patient-centered care and shared decision-making, most decision-support approaches remain oriented toward clinician–caregiver interactions within clinical settings, neglecting the everyday contexts in which many health decisions unfold for youth. Because youth are transitioning to become the primary agents managing and experiencing their health decisions, capturing and representing their lived experiences of health decisions in shareable forms may enable meaningful reflection, foster shared understanding, and guide context-sensitive support.

In this research, I investigate lived-experience capture and representation as a mechanism for understanding and supporting youth in navigating health decision-making. For Aim 1, I developed a conceptual framework that captures health decision navigation patterns characterized by the dynamic interplay of changing contextual conditions, response styles, and the level of goal alignment toward increased satisfaction regarding the decisions made in everyday contexts. I then map opportunities for informatics interventions onto these patterns to inform context-sensitive support that adapts to patients’ changing circumstances. Building on this conceptual foundation, for Aim 2, I will design a lived experience capture and reflection system that translates key decision-making concepts derived (decision contexts, goals, values, beliefs, challenges, feelings) into concrete, observable, and measurable visual and narrative representations. For Aim 3, I will deploy and evaluate this system in real-world contexts to examine its impact on reflection and collaborative conversation among youth, caregivers, and potentially providers, exploring its role in enabling shared understanding, collective learning, and context-sensitive support. This work contributes a youth-narrative-grounded framework for understanding youth health decision-making experiences in daily life, serving as a foundation to guide context-sensitive informatics interventions. It further advances a methodological pipeline that translates lived experiences into structured representations that help youth to meaningfully reflect on, ultimately promoting shared understanding, enabling context-sensitive decisions, and supporting adaptive care improvement over time.