Unmet

Challenges
in Clinical
inClinical
Research
Informatics
FacilitatedDiscussionofHandsOnPractitioners
f
BobDiLaura AMIANow!SpringConference
ClevelandClinicalandTranslational May2527,2010
ScienceCollaborative Phoenix,AZ
 WillWeEverKeepUp?

LeotLeydesdorffshowedthatknowledge
increasedfrom1933to2001byafactorof
approximately27milliontimes.
pp y Alittle
mathematicalanalysisshowsthatthis
representsadoublingofknowledgeitself
aboutevery2.75years.
Source:HunterL,CohenKB.BiomedicalLanguage
Processing:What'sBeyondPubMed?MolecularCell,21(5);
Source:http://www.xenodochy.org/gs/hmod.html 3March2006,589594.
 WhoLearnsfromPublications?
Over10yearsofexperienceinseveral
European countries showed that there were
Europeancountriesshowedthattherewere
superiorwaystoteachbiomedical
informatics genomics and bioinformatics to
informatics,genomicsandbioinformaticsto
healthcareprofessionals.Specific
recommendations were given to help others
recommendationsweregiventohelpothers
andshortenthelearningcurveforsuchwork.

Source:Traininghealthprofessionalsinbioinformatics.Experiencesandlessonslearned.LopezCamposG,Lopez
g p p p p , p
AlonsoV,MartinSanchezF.MethodsofInformationinMedicine.2010;49(3):299304.
 TwoYearIdeasfortheCTSAs
Strategic2yrITplan(draft3/30/2009)
CTSAwidesurvey&recommendations
CTSA wide survey & recommendations
Basicsuggestions
Simplify
Si lif
Betransparent
Enableusercontrol
Enable user control
Adaptandevolve

Source:DraftTwoYearStrategicInformationTechnologyPlan.Dr.DixieBaker,CTO,HealthSolutions,SAIC,March2009.
FormatforThis Discussion
 InformaticsField FarandWide
BiomedicalInformatics
MedicalInformatics Biostatistics
ClinicalInformatics Mathematics Computer
HealthInformatics Clinical Science
Nursing Informatics
NursingInformatics Research Medicine
ImagingInformatics Technology ? Physics
HealthInformatics Laboratories Pathology
gy
PublicInformatics Biochemistry Radiology
Neuroinformatics Systems Molecular
CardiacInformatics
di f i Biology Library Biology
Science
Translational
Bioinformatics
 Terms&Definitions BMI

Source:http://ncicb.nci.nih.gov/NCICB/
 Terms&Definitions CRI

ClinicalResearchInformatics(CRI)isthesubdomainof
Clinical Research Informatics (CRI) is the subdomain of
biomedicalinformaticsconcernedwiththedevelopment,
application,andevaluationoftheories,methods,and
systemstooptimizethedesignandconductofclinical
researchandtheanalysis,interpretation,and
disseminationoftheinformationgenerated.
f f g

Source:ClinicalResearchInformatics:Challenges,OpportunitiesandDefinitionforanEmergingDomain,byEmbiPand
PayneP.JAmMedInformAssoc.2009;16:316327.DOI10.1197/jamia.M3005.
 InformaticsSpectrum

Source:ClinicalResearchInformatics:Challenges,OpportunitiesandDefinitionforanEmergingDomain,byEmbiPand
PayneP.JAmMedInformAssoc.2009;16:316327.DOI10.1197/jamia.M3005.
HowWeDoinSoFar?
 BiomedicalInformaticsCompetencies
Acquireprofessionalperspective:Summarizeandexplainthehistoryandvaluesofthe
disciplineanditsrelationshiptorelatedfieldswhiledemonstratinganabilitytoread,interpret,
andcritiquethecoreliterature
Analyzeproblems:
Analyze problems: Analyze,understand,abstract,andmodelaspecificbiomedical
Analyze understand abstract and model a specific biomedical
problemintermsofdata,informationandknowledgecomponents
Producesolutions:Usetheproblemanalysistoidentifyandunderstandthespaceof
possiblesolutionsandgeneratedesignsthatcaptureessentialaspectsofsolutionsandtheir
components t
Articulatetherationale:Defendthespecificsolutionanditsadvantageovercompeting
options
Implement,evaluate,andrefine:
p , , Demonstrateanabilitytocarryoutthesolution,to
y y
assessitsvalidity,anditerativelyimproveitsdesign
Innovate:Createnewtheories,typologies,frameworks,representations,methods,and
processestoaddressbiomedicalandinformaticsproblems
Workcollaboratively:
Work collaboratively: Demonstratetheabilitytoteameffectivelywithpartnersfrom
Demonstrate the ability to team effectively with partners from
diversedisciplines
Disseminateanddiscuss:Communicateeffectivelytoaudiencesinmultipledisciplinesin
persuasivewrittenandoralform

Source:AMIAAcademicForumsubcommitteeonBMICompetencies,2010.
 BMICompetenciesDRAFT

To view the document:

Toviewthedocument:
https://www.amia.org/files/shared/e_Competencies_
_Definition_and_Competencies.pdf

Tocommentonthedocument:
http://www.surveymonkey.com/s/2JHGQWF
AMIANow!CRI2010Survey
OurSurvey ResponseCloud

Source:http://www.tagcrowd.com/
 Survey AnotherCloudView

Source:http://www.wordle.net/
 Survey FinalView

Source:http://www.wordle.net/
 Survey TopFutureChallenges
1. Funding,staffandinfrastructureresourcesforCRI
2. EMRresearchintegrationofworkflow&data
3. Standardizationofdata,protocols,processes&HIE
HowWeDoinSoFar?
CTSAPgmGoals&KeyFunctions

Source:http://www.ctsaweb.org/index.cfm?fuseaction=quicklink.showSGC
 The800lbGorilla(patientHIT)
(p )

Source:http://www.healthypeople.gov
 PatientHITfromONC

Source:http://healthit.hhs.gov
 ThemesfortheFutureofBMI
1. Buildouttheenterpriseresearchinfrastructure
2. Researchprocessdesign,portals&workflowmgt
p g p g
3. Datastorage,accessandsecurity
4. Systemintegration&researchinfo/dataexchange
5. EHRCRconnections(technical,policy,legal)
6. Knowledgemanagement
7 Ongoingtrainingandeducationjusttokeepup
7. O i t i i d d ti j t t k
8. More/better/fastercommunication,collaborations
9 Relationshipmgt
9. Relationship mgt old,currentandnew
old current and new
10. Informaticsleadership
HowWeDoinSoFar?
 InformaticsCareerPaths
Academic
Scientist
Technologist
g
 Metrics&Evaluation
Howdoweknowwhatwe aredoing?
Howdowe definevalue orgoals?
Whatdoesour datasay?y
Howdowe targetorquantifyimprovement?
Value of co opetition*andcomparisons
Valueofcoopetition and comparisons

If ignorance is bliss, why aren't more people happy?

Thomas Jefferson

Source: Brandenburger A, Nalebuff B. 1996. Co-Opetition: A revolution mindset that combines competition and cooperation.
 BMIMetricsProcessandPlan
Strategic goals
Areas of importance
p
Key performance indicators
Metrics plan
Goals & evaluations
Reporting and improvements
Ongoing metrics adjustments

Areinvestigators
satisfiedwith
f h
informaticssupport
theyreceive? Source:DraftTwoYearStrategicInformationTechnologyPlan.
Dr.DixieBaker,CTO,HealthSolutions,SAIC,March2009.
, , , ,
HowWeDoinSoFar?
1. - Accessibility and Web-enabled technologies
2.
3.
4.
-
-
-
Analytics applied to direct and remote clinical care
Assistive and adaptive ubiquitous computing technologies
Bio-surveillance
Association for Computing
5.
6.
7.
-
-
-
Brain computer interface
Cleaning, preprocessing, and ensuring quality and integrity of medical records
Comparative effectiveness research
(ACM) 1st Int
Machinery (ACM), Intll Health
8. - Computational support for patient-centered and evidence-based care
9.
10.
-
-
Consumer and clinician health information needs, seeking, sharing and use
Consumer health and wellness informatics applications
Informatics Symposium (IHI)
11. - Continuous monitoring and streaming technologies
12.
13.
14.
-
-
-
Data management, privacy, security, and confidentiality
Display and visualization of medical data
E-commerce in health informatics
CALL FOR PAPERS
15
15. - E
E-communities
iti andd networks
t k ffor patients
ti t andd consumers
16.
17.
18.
-
-
-
E-healthcare infrastructure design
E-learning for spreading health informatics awareness
Engineering of medical data
IHI 2010, November 11-12,
19. - Evaluation of health information system
20.
21.
-
-
E-visit system
Experience of building health information system
2010, Arlington, Virginia
22. - Health informatics education
23. - Health information system framework and enterprise architecture in the developing world
24
24.
25.
-
-
Health IT project management
Health software design
http://ihi2010 sighi org
http://ihi2010.sighi.org
26. - Health system simulation
27. - High-performance computing in healthcare
28. - Human-centered design of health informatics systems
29. - Information retrieval for health applications
30. - Information technologies for the management of patient safety and clinical outcomes
31. - Innovative applications in electronic health records (e.g., ontology or semantic technology, using continuous biomedical signals to trigger alerts)
32. - Intelligent medical devices and sensors
33
33. - Issues involving interoperability and data representation in healthcare delivery
34. - Keyword and multifaceted search over structured electronic health records
35. - Knowledge discovery for improving patient-provider communication E-commerce in health informatics
36. - Large-scale longitudinal mining of medical records
37. - Medical compliance automation for patients and institutions
38.
39.
-
-
Medical recommender system (e.g., medical products, fitness programs)
Multimodal medical signal analysis
E-learning for informatics awareness
40. - Natural language processing for biomedical literature, clinical notes, and health consumer texts
41. - Novel health information systems for chronic disease management
42. - Open-source
Open source software in healthcare Health IT p
project
j management
g
43. - Optimization models for planning and recommending therapies
44. - Personalized predictive modeling for clinical management (e.g., trauma, diabetes mellitus, sleep disorders, substance abuse)
45.
46.
-
-
Physiological modeling
Public health informatics
Open-source software in healthcare
47. - Quality assurance
48. - Semantic Web, linked data, ontology, and healthcare
49. - Sensor networks and systems for pervasive healthcare User-interface design issues in
50. - Social studies of health information technologies
51. - y and related methods for estimatingg hazard functions
Survival analysis y
medical devices and systems
52. - System software for complex clinical studies that involve combinations of clinical, genetic, genomic, imaging, and pathology data
53. - Systems for cognitive and decision support
54. - Technologies for capturing and documenting clinical encounter information in electronic systems
55. - Telecare
56. - Telemedicine
57. - User-interface design issues applied to medical devices and systems
WordTagofAMIABMICompetencies
 ThankYou

SSpecialthankstoPaulHarrisfor
i l h k P lH i f
conceptualdevelopmentofthe
ClinicalResearchInformaticstrackin
AMIANow!,aswellasthissession
,

This presentation was made possible by the Case Western Reserve

University/Cleveland Clinic CTSA Grant Number UL1 RR024989 from the
National Center for Research Resources (NCRR), a component of the
National Institutes of Health and NIH roadmap for Medical Research.