Internet2 Health Sciences: CUDI Application discussion on medical discipline

Internet2 Health Sciences: CUDI Application discussion on medical discipline

Mary Kratz, MT(ASCP)

Internet2 Health Sciences Program Manager

Mkratz@internet2.edu

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• info@internet2.edu• Ana Preston• Apreston@internet2.edu• Mary Kratz• Mkratz@internet2.edu

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