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I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
PushingtheBoundsofMedicineandImprovingHealthAroundtheWorld:
WashingtonUniversity,BJCHealthcare,andtheInstituteforInformatics(I2)
PhilipR.O.Payne,PhD,FACMIRobertJ.TerryProfessorandDirector,InstituteforInformatics
WashingtonUniversitySchoolofMedicineProfessorofComputerScienceandEngineering
WashingtonUniversitySchoolofEngineeringandAppliedScience
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
• The greater St.Louisarea ishometo2,916,447people
• In2006,St.Louisreceived the WorldLeadership Award forurban renewal
• >40colleges,universities,andtechnicalschools
• The Cortext InnovationCommunityserves aregional bio-tech,lifescience,andinformation technology (IT)start-up hub• Generating >3,800tech-related jobs and>500
million ininvestment inthe last 14years• Multiple incubators,venture funds,and
innovation assets
• St.Louisranked #1onthe list ofAmerica's "fastest-growing cities fortech jobs"according toFortuneMagazineandamong the top10mostcost-effective todo businessamonglarge metropolitan areas inthe USaccording toKPMG
• Hometonine Fortune 500companies:ExpressScripts,EmersonElectric,Monsanto,ReinsuranceGroupofAmerica,Centene,Peabody Energy,Ameren,Graybar Electric,andEdwardJonesInvestments.
St.Louis,Missouri
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
• Established in1853
• Consistentlyrankedamongstthetop25universitiesglobally
• 7graduateandundergraduateschools• 14,385 students• 3,759faculty
• 645.6millioninannualresearchfunding
• 24NobelLaureates
• 140,188alumni
• 4thrankingamong largestemployers inSt.Louis– St.LouisBusinessJournalBook ofLists 2016
• Motto:PerVeritatem Vis (StrengthThroughTruth)
WashingtonUniversityinSt.Louis
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
• 125-yearhistory• Mostselectivemedicalschoolinthe
UnitedStates(US)• Comprehensivehealthcareprofessional
andgraduatedegreeprograms• LargestMD/PhDprogramintheUS
• Consistentlyrankedasoneofthetop5research-intensivemedicalschoolsinthecountry• >500Million(USD)annually
• ServesasacatalystfortheSt.Louisbiotechandstartupscene,includingtheCortexInnovationDistrict
• ExclusiveclinicalpartnershipwithBJCHealthcare
• HometobothanNCI-designatedComprehensiveCancerCenter(CCC)andNCATS-designatedClinicalandTranslationalResearchAward(CTSA)
• AlsohometotheElizabethH.andJamesS.McDonnellGenomeInstitute,oneofthetop3large-scalegenomecentersintheUS
WashingtonUniversityinSt.LouisSchoolofMedicine
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
• In1993BarnesandJewishHospitalsjoinedwithChristianHealthServicestoformtheBJCHealthSystem
• ExclusivepartnershipwithWashingtonUniversityPhysicians
• Oneofthelargestnot-for-profitintegrateddeliverynetworksintheUnitedStates,andthelargestintheStateofMissouri• 15hospitals(urban,regional,
rural)• Primarycarenetwork• Specialtynetwork• Provider-of-choiceforHSA/HRA• >5.4Mcoveredlives• >4.8billion(USD)inrevenue
(2016)
• BJCHealthCarehospitalsranksontheU.S.News&WorldReportHonorRollofAmerica'stopHospitalsandBestChildren'sHospitals
BJCHealthcare
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
CreatingaHomeforInformaticsatWashingtonUniversity:TheInstituteforInformatics(I2)
ü TranslationalBioinformatics:Leveragingourbasicsciencecapabilitiestogenerateanactionableprecisionmedicineknowledge-baseinhighprioritydiseaseareas
ü LearningHealthcareSystems:Connectingactionableknowledgetohighthroughputandfidelityphenotypesderivedfromanexceptionallydiversepopulationandhealthcaredeliverynetwork
ü PopulationHealthInformatics:Scalingprecisionmedicinetosupportthehealthandwellnessofat-riskorunderservedpopulationsthroughdata-driveninterventionstrategies.
TranslatingDataIntoKnowledge
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
TheinstituteforinformaticswillhelpfocustheinformaticslandscapeattheSchoolofMedicineasweseekwaystotransformresearch,educationandpatientcare,especiallyinsupportofprecisionmedicineandeffortstoimprovethequalityofhealthcareandpublichealthinitiativeslocally,nationallyandworldwide.
Source:DavidH.PerlmutterMD,ExecutiveViceChancellorforMedicalAffairsandDeanoftheWashingtonUniversitySchoolofMedicineinSt.Louis
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
I2 Pillars:“PuttingthePiecesTogether”
Innovation Education SupportAcceleratingDiscoveryand
Translation
CreatingLearningHealthcareSystems
ScalingtoPopulation Health
EvidenceGeneration
HealthcareDelivery“AtScale”
In-CareerLearners
Practice(Certificate,MS)
K-12&UG“Pipeline”
Investigators(PhD)
CompetencyBasedCurricu
lum
AdvancedAnalytics
Research DataMgmt
Bioinformatics Pipelines
SecondaryuseandInstrumentationofEHR
SharedInfra
structure&Project
Desig
n/Mgm
t
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
PhilipPayne,PhD,FACMIDIRECTOR
• Knowledge-basedapproachestothediscoveryandanalysisofbio-molecularandclinicalphenotypesandtheensuingidentificationofprecisiondiagnosticandtherapeuticstrategiesincancer
• Interventionalapproachestotheuseofelectronichealthrecordsinordertoaddressmodifiableriskfactorsfor diseaseandenablepatient-centereddecisionmaking
• Thestudyofhumanfactorsandworkflowissuessurroundingtheoptimaluseofhealthcareinformationtechnology
AlbertM.Lai,PhDCHIEFRESEARCHINFORMATIONOFFICER
• Clinicalresearchinformatics• Clinicalinformatics• Consumerhealthinformatics
• Telemedicine• Usability• Naturallanguageprocessing• Mobilehealth
Po-YinYen,RN,PhDASSISTANTPROFESSOR,CLINICALINFORMATICS
• Usability• Technologyacceptance• Humancomputerinteraction
• Literaturemining• Datavisualization• Workflowanalysis• Timemotionstudy
RandiForaker,MA,PhD,FAHAASSOCIATEPROFESSOR,DEPARTMENTOFMEDICINE,DIVISIONOFGENERALMEDICALSCIENCES
• Approachesfortheintegrationofsocioeconomicandpatient-reportedoutcomedatawithelectronichealthrecorddata
• Interventionalapproachestotheuseofelectronic
• healthrecordsinordertoaddressmodifiableriskfactorsfordiseaseandenablepatient-centereddecisionmaking
• Studydesignmethodologyanddataanalysis
S.JoshuaSwamidass,MD,PhDASSISTANTPROFESSOROFPATHOLOGY&IMMUNOLOGYLABORATORY&GENOMICMEDICINE
• Metabolism• Machinelearning• Bioinformatics
• Biostatistics• Chemicalinformatics• Drugandtargetdiscovery• Drugdesign
TiffaniJ.Bright,PhDDIRECTOR,INFORMATICSDEVELOPMENT
• clinicaldecisionsupport(CDS)• knowledgerepresentation• userneedsassessment
• mobilehealthtechnology(mHealth)• patient-centeredoutcomesresearch
(PCOR),• andusabilityevaluation
LeadersinInformaticsScienceandPractice
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
TranslatingDataIntoAction:PositioningInformaticsasanInterventionalDiscipline
PaynePR,Lussier Y,ForakerRE,Embi PJ.Rethinkingtheroleandimpactofhealthinformationtechnology:informaticsasaninterventionaldiscipline.BMCmedicalinformaticsanddecisionmaking.2016Mar29;16(1):1.
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
ResearchWithImpact:FromMoleculestoPopulations
Viewpoint
Enabling Open Science for Health Research: CollaborativeInformatics Environment for Learning on Health Outcomes (CIELO)
Philip Payne1, PhD; Omkar Lele2, MS, MBA; Beth Johnson3, MPH; Erin Holve4, MPH, MPP, PhD1Institute for Informatics, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States2Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States3AcademyHealth, Washington, DC, United States4Department of Health Care Finance, Government of the District of Columbia, Washington, DC, United States
Corresponding Author:Philip Payne, PhDInstitute for InformaticsSchool of MedicineWashington University in St. Louis660 South Euclid AvenueMS 8102-13-610St. Louis, MO, 63110United StatesPhone: 1 314 747 6119Fax: 1 314 747 6119Email: [email protected]
AbstractBackground: There is an emergent and intensive dialogue in the United States with regard to the accessibility, reproducibility,and rigor of health research. This discussion is also closely aligned with the need to identify sustainable ways to expand thenational research enterprise and to generate actionable results that can be applied to improve the nation’s health. The principlesand practices of Open Science offer a promising path to address both goals by facilitating (1) increased transparency of data andmethods, which promotes research reproducibility and rigor; and (2) cumulative efficiencies wherein research tools and the outputof research are combined to accelerate the delivery of new knowledge in proximal domains, thereby resulting in greater productivityand a reduction in redundant research investments.Objectives: AcademyHealth’s Electronic Data Methods (EDM) Forum implemented a proof-of-concept open science platformfor health research called the Collaborative Informatics Environment for Learning on Health Outcomes (CIELO).Methods: The EDM Forum conducted a user-centered design process to elucidate important and high-level requirements forcreating and sustaining an open science paradigm.Results: By implementing CIELO and engaging a variety of potential users in its public beta testing, the EDM Forum has beenable to elucidate a broad range of stakeholder needs and requirements related to the use of an open science platform focused onhealth research in a variety of “real world” settings.Conclusions: Our initial design and development experience over the course of the CIELO project has provided the basis fora vigorous dialogue between stakeholder community members regarding the capabilities that will add the greatest value to anopen science platform for the health research community. A number of important questions around user incentives, sustainability,and scalability will require further community dialogue and agreement.
(J Med Internet Res 2017;19(7):e276) doi:10.2196/jmir.6937
KEYWORDShealthcare research; information dissemination; open access to information; social networking; reproducibility of results
J Med Internet Res 2017 | vol. 19 | iss. 7 | e276 | p.1http://www.jmir.org/2017/7/e276/(page number not for citation purposes)
Payne et alJOURNAL OF MEDICAL INTERNET RESEARCH
XSL•FORenderX
Active Use of Electronic Health Records (EHRs) and Personal Health Records (PHRs) for Epidemiologic Research: Sample Representativeness and Nonresponse Bias in a Study of Women During Pregnancy
Julie K Bower, PhD, MPH;i Claire E. Bollinger;ii Randi E. Foraker, PhD;i Darryl B. Hood, PhD;ii Abigail B. Shoben, PhD;iii
Albert M. Lai, PhDiv
iDivision of Epidemiology, The Ohio State University College of Public Health, iiDivision of Environmental Health Sciences, The Ohio University
College of Public Health, iiiDivision of Biostatistics, The Ohio State University College of Public Health, ivInstitute for Informatics, Washington
University School of Medicine
Introduction: With the growing use of electronic medical records, electronic health records (EHRs), and
personal health records (PHRs) for health care delivery, new opportunities have arisen for population
health researchers. Our objective was to characterize PHR users and examine sample representativeness
and nonresponse bias in a study of pregnant women recruited via the PHR.
Design: Demographic characteristics were examined for PHR users and nonusers. Enrolled study
participants (responders, n=187) were then compared with nonresponders and a representative sample
of the target population.
Results: PHR patient portal users (34 percent of eligible persons) were older and more likely to be
White, have private health insurance, and develop gestational diabetes than nonusers. Of eligible
persons (all PHR users), 11 percent (187/1,713) completed a self-administered PHR based questionnaire.
Participants in the research study were more likely to be non-Hispanic White (90 percent versus 79
percent) and married (85 percent versus 77 percent), and were less likely to be Non-Hispanic Black (3
percent versus 12 percent) or Hispanic (3 percent versus 6 percent). Responders and nonresponders
were similar regarding age distribution, employment status, and health insurance status. Demographic
characteristics were similar between responders and nonresponders.
Discussion: Demographic characteristics of the study population differed from the general population,
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cost-effectiveness.
ABSTRACT
Generating Evidence & Methodsto improve patient outcomes
eGEMs
1
Bower et al.: PHR Use for Epidemiologic Research
Published by EDM Forum Community, 2017
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
PartneringAroundtheGlobe:MDClone andI2
• Establishinganewparadigmforinternalandexternaldatasharingandanalyticscapabilitiesatoneofthelargestresearch-intensiveacademichealthcentersintheUnitedStates
• ”Democratizing”dataaccessinordertospeedinsightanddiscoverywhilereducingriskstopatientprivacyandconfidentiality
• Threepilotusecases:1) Integratedanalysisofmulti-modal
ICUdata2) Predictionofpatienttrajectories
duringtransitionsincare3) Generationofpopulationhealth
dashboards
CreatingaCultureof“Data Entrepreneurs”toAchieveaVisionofPreciseandKnowledge-DrivenHealthcareand WellnessPromotion:
HarnessingResearch,TranslatingintoPractice,ScalingtoPopulations
I N S T I T U T E F O R I N F O R M A T I C S | W A S H I N G T O N U N I V E R S I T Y S C H O O L O F M E D I C I N E
PhilipR.O.Payne,PhD,[email protected]@prpayne5www.slideshare.net/prpayne5
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