Internet2 Health Sciences: CUDI Application discussion on medical discipline Mary Kratz, MT(ASCP) Internet2 Health Sciences Program Manager [email protected] CUDI meeting in Manzanillo, Colima
Dec 25, 2015
Internet2 Health Sciences: CUDI Application discussion on medical discipline
Mary Kratz, MT(ASCP)
Internet2 Health Sciences Program Manager
CUDI meeting in Manzanillo, Colima
Referral Doctor
Doctor 2
Hospital Admission
Doctor 1
Why should we care?
XX
XX
XXMedical
records are not shared
Medical records are not shared
Medical
Record
PatientPatient
Medical
Record
Medical
Record
Medical
Record
XX
XX
XX
XX
One Physician’s Story
#1 Problem: TOO MANY MISTAKES• NRC Report “To Err is Human”
No ill will, simply a very badly undesigned non-system
Costs are EXPLODING!Current medical science is not consistently available to caregivers
30,000 medical journals …. no one can keep up!
Healthcare is…
An information-dependent profession with crippled access to information
Slow to adopt change• Five-year lead time from proven new science to 50 percent usage (Jim Reinertson, MD)
Procedures done in some medical specialties do not have validated data demonstrating effectiveness and value.
Evidence-Based Medicine
“...Evidence-based medicine de-emphasizes intuition, unsystematic clinical experience, and patho-physiologic rationale as sufficient grounds for clinical decision making and stresses the examination of evidence from clinical research.”
• Evidence-Based Medicine Working Group, JAMA (1992)
In the absence of data, decisions are made based on professional judgment…inconsistent and fraught with error.
The Doctor (1891), Fildes, Sir Luke
Yesterday and Today
Medicine used to be simple, ineffective and relatively safe. Now it is complex, effective and potentially dangerous.
Sir Cyril Chantler, Lancet 1999
The Solution: Electronic Medical Networks
What is needed in health care are pioneers in using the computer to make a real difference
No other option offers anything with comparable potential for either quality improvement or value
Core Functions for Electronic Medical Networks
Exploit data, turn it into information and extract the value
Produce knowledge from a world of partial, confused and unstructured information
Transfer the right information into the hands of the right person at the right moment
Objectives
Develop a strong infrastructure and support services which facilitate clinical care, education and research
Target specific areas • Imaging • TeleHealth• Bioinformatics
Promote professional development of faculty and technical personnel
CLINICAL: Why Physicians Participate in Internet2
Extend the provision of better healthcare• TeleHealth (eHealth)• Develop Clinical Skills and Assessment
Distributed data sharing• Electronic Health Record• Presence and Integrated Communications (VoIP, RFID)• Advanced visualization Computer Assisted Surgery• Computer Aided Diagnosis
Collaboration independent of boundaries• Geography• Time• Cognition: Knowledge Management
Educators: Why Faculty Participate in Internet2
Rich resources from student endpoints to centralized powerful computation and large storage
Students absorb multiple channels of information
lecture
Second
screenDynamic
charts
messaging
Communal
note taking
Slide courtesy:
Parvati Dev, Stanford University
RESEARCHERS:Why Scientists Participate in Internet2
Internet2 doesn't only save time, it allows interactivity in places where that was not possible before. I'd call it a quantum leap, if I didn't know that physics defines that as the smallest change a system is capable of... Timothy Poston, Bangladesh
Health Science Grand Challenge
<Person-----Organ-----Tissue-----Cell-----Protein-----Atom>
(1m) (10-3m) (10-6m) (10-9m) (10-12m) (10-15m)
Systems models Continuum models (PDEs) ODEs Stochastic models Pathway models Gene networks
Courtesy: Peter Hunter, University of Auckland
The Wizard GAP: Translational Research
DisciplineCommunity
CS, Math,CSE
Discipline Community
Network of Research
CS, Math,CSE
He a
lth
care
Li f
e S
cien
ces
Slide courtesy Chris Johnson, SCI
NIH Roadmap: http://nihroadmap.nih.gov/
What are today’s most pressing scientific challenges?
What are the roadblocks to progress and what must be done to overcome them?
Which efforts are beyond the mandate of one or a few…but are the responsibility of (NIH as) a whole?
E. Zerhouni, M.D.Director, National Institutes of Health
NIH Roadmap: Implementation Themes
New Pathways to Discovery• National Technology Centers• Bioinformatics• Nanotechnology
Research Teams of the Future
Reengineering the Clinical Research Enterprise
• Integration/Interoperability• Clinical Trials• Translational Research
Cyberinfrastructure Definition
Medical content focus/driverHigh bandwidthInter-institutional connectivity via Internet2Uniformly consistent security modelGrid computingDistributed (federated) file management and computational servicesPerformance and resiliency for databasesIntegrated visualization and analysis tools
What is Internet2?
Pathway to Progress: The Patient
CUDI and Internet2 Translational research collaborations
• Scientific discovery• Product development• Clinical trials
What should be done for patients• Access to services• Efficiencies of production• Improve quality of care
Core Functions for Electronic Medical Networks
Support ongoing and future management decisions
Broadband electronic communication and connectivity
Population health monitoring and reporting
Its not about Technology!*From 6 Competencies ( ACGME)
Knowledge Acquisition
(technology scouting)
Integrated Systems Approach
Active Learning
(didactic and procedural)
InterpersonalCommunication
(knowledge transfer)
ProfessionalismProject Based
Learning & Improvement
(Demonstrations)
Community(systems based practice-
Production Services)
Translational Research
Electronic Health Records
• Quality Heathcare for PATIENTS
• Access to use and interpret data
• Computational functionality
• Engineering infrastructure to support system distribution
• Deployment of scalable technology choices
Electronic Medical Networks
• Quality Heathcare for PATIENTS
• Access to use and interpret data
• Computational functionality
• Engineering infrastructure to support system distribution
• Deployment of scalable technology choices
More Information
On the Web• www.internet2.edu• Health.internet2.edu
Email• [email protected]• Ana Preston• [email protected]• Mary Kratz• [email protected]
Research Team of the Future:Cancer Biomedical Informatics Grid
Global Cancer Research Community
Grid deployment to Cancer Centers
Bioinformatics infrastructure
Public data sources
Funded by: NCI/NIH
http://cabig.nci.nih.gov/David States, MD, PhD
ONCOMINE
http://141.214.6.14:8080/Array1/
Funded by: Univ of Michigan Pathology, Pew Scholars Program, American Cancer Society, and V Foundation
Arul M. Chinnaiyan, MD, PhD
Cancer Microarray Database containing close to 50 million datapoints
Data mining tools to efficiently query genes and datasets of interest
Meta-analyze groups of studies
Remote, Real-time Simulation for Teaching Human Anatomy and Surgery
Demonstrate remote, real-time teaching of human anatomy and surgery
Deliver real-time simulation and visualization technologies
Network-based architecture allows for multiple high-resolution stereo-graphic displays and haptic devices
Stanford University School of Medicine Stanford, CA
Surgical Planning
Pipelines for Morphometric Analysis
Surgical Planning
Interoperative segmentation
Brain atlas
fMRI
Funded by NCRR/NIH
Ron Kikinis, M.D., Steve Pieper, Ph.D., Simon Warfield, Ph.D.
Brigham and Women’s Hospital, Harvard Medical School
Telemammography:National Digital Mammography Archive
Storage and retrieval of complete clinical record• Mammographic images • Radiology images (DICOM)• Pathology reports and related patient information
Standard formats using standard protocols Multi-layered security Input and retrieval from multiple locations Measurement Criteria: Saving lives!
University of Pennsylvania, Philadelphia, PAY12 National Security Complex in Oak Ridge, Oak Ridge, TNUniversity of Chicago, Chicago, ILUniversity of North Carolina at Chapel Hill, Chapel Hill, NCUniversity of Toronto, Toronto, Canada
Center for Biologic Nanotechnology
Bring together the multiple disciplines to develop nanotechnology from conception to human trials.
Nanotechnology will impact communications, information storage, materials sciences and other non-biologic applications offering limitless opportunities for miniaturization.
http://nano.med.umich.edu/
Funded by: NIH, DOE, NSF, DARPA
James Baker, MD