mhealth israel_washington university in st louis / bjc healthcare, institute for informatics,...

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


• 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


• 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


• 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


• 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


CreatingaHomeforInformaticsatWashingtonUniversity:TheInstituteforInformatics(I2)

ü TranslationalBioinformatics:Leveragingourbasicsciencecapabilitiestogenerateanactionableprecisionmedicineknowledge-baseinhighprioritydiseaseareas

ü LearningHealthcareSystems:Connectingactionableknowledgetohighthroughputandfidelityphenotypesderivedfromanexceptionallydiversepopulationandhealthcaredeliverynetwork

ü PopulationHealthInformatics:Scalingprecisionmedicinetosupportthehealthandwellnessofat-riskorunderservedpopulationsthroughdata-driveninterventionstrategies.

TranslatingDataIntoKnowledge


TheinstituteforinformaticswillhelpfocustheinformaticslandscapeattheSchoolofMedicineasweseekwaystotransformresearch,educationandpatientcare,especiallyinsupportofprecisionmedicineandeffortstoimprovethequalityofhealthcareandpublichealthinitiativeslocally,nationallyandworldwide.

Source:DavidH.PerlmutterMD,ExecutiveViceChancellorforMedicalAffairsandDeanoftheWashingtonUniversitySchoolofMedicineinSt.Louis


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


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


TranslatingDataIntoAction:PositioningInformaticsasanInterventionalDiscipline

PaynePR,Lussier Y,ForakerRE,Embi PJ.Rethinkingtheroleandimpactofhealthinformationtechnology:informaticsasaninterventionaldiscipline.BMCmedicalinformaticsanddecisionmaking.2016Mar29;16(1):1.


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


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


PhilipR.O.Payne,PhD,[email protected]@prpayne5www.slideshare.net/prpayne5

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