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  • We have many source systemsWe have users using applicationsOne way is to have web services that hit the source systems in real time, collecting necessary data, combine, then give back to application/user. (SOA architecture). Pros:Always up to date informationNo ETLCons:Hitting a live clinical system. Depending on the query this can have unpredictable effect on the performance of such clinical systems.More points of failure – if any one of the systems is offline for maintenance, user has to wait.The other way is to integrate data into a data warehouse.Pros:Centralized data managementNot impacting clinical systemProdictible data availability Better performanceCons:Need expertise on data ETLData Delays – depending on update frequency.

Transcript

  • 1. IT Support Tools and Personalized Medicine
    Phyllis Teater, Chief Information Officer
    The Ohio State University Medical Center
  • 2. Fundamental Objective of Informatics and Healthcare IT
    Delivering timely and contextually appropriate data, information, and knowledge in support of basic science, clinical and translational research, clinical care, and public health.
  • 3. Computers are incredibly fast, accurate and stupid.Human beings are incredibly slow, inaccurate and brilliant.Together they are powerful beyond imagination. -Albert Einstein
  • 4. Goal = Move Expert Knowledge and new Discoveries to the Point of Care
  • 5. IT Tools for P4 Medicine
  • 6. EHR: Necessary but not Sufficient
    EHR Functionality
  • 7. EMR Adoption
  • 8. Eligible Hospital Status Must Meet All
  • 9. Eligible Hospital Status Must Meet 5
    Meet 4
    Meet 1
  • 10. Eligible Provider StatusMust Meet All
  • 11. Eligible Hospital Status Must Meet 5
    Meet 4
    Meet 1
  • 12. MU: Quality Measures
    The Final Rule identifies quality measures that eligible providers and hospitals will be required to report on as evidence of Meaningful Use.
    • For eligible providers, 44 measures are identified.
    • 13. All EPs must report on the three measures in the core measure group or, if they see no patients for which the core measures apply, on three alternative measures.
    • 14. All EPs must also choose an additional 3 measures to report on from the remaining list.
    • 15. For hospitals, 15 measures are identified. Each hospital must report on all 15 measures.
  • Meaningful Use at OSUMC
  • 16. The Need for Structured Data: Beyond Meaningful Use
  • 17. Structured Data Collection
  • 18. OSUMC Historical Automation
  • 19.
  • 20. OSUMC Integrated EHR Implementation
  • 21. Ambulatory EHR Metrics
  • 22. OSUMyChart Adoption
  • 23. Secure Patient / Physician Communications
  • 24. Results Released / Viewed
  • 25. Timeline for “BIG BANG”
  • 26. Medical Grade Network
  • 27. Historical trends in storage prices vs DNA sequencing costs
    “Next generation” sequencing technologies in the mid-2000s changed the trends and now threatens the conventional genome informatics ecosystem
    Notice: this is a logarithmic plot – exponential curves appear as straight lines.
    Lincoln D Stein Genome Biology 2010, 11:207
  • 28. The Need for Data Integration and Analytics
    Data integration is a pervasive challenge faced in applications that
    need to query across multiple autonomous and heterogeneous data sources. Data integration is crucial in large enterprises that own a multitude of data sources, for progress in large-scale scientifc projects, where data sets are being produced independently by multiple researchers, … …
    Halevy A, Rajaraman A, Ordille J; “Data Integration: The Teenage Years. VLDB `06, September 12­15, 2006, Seoul, Korea.
    Radiology
    Appl
    Icat
    ions
    Web Services
    Lab
    EMR
    Pathology
    IW
  • 29. Information Warehouse Overview
    ADT
    Lab
    Respiratory
    Blood
    Endoscopy
    Cardiology
    Siemens Img
    Multi-Dimensional Analysis & Data Mining
    Real
    time
    Ad-hoc Query
    Meta Data
    CPOE
    OR system
    Patient Mgmt
    Dictated reports
    Pathology reports
    Daily
    Text Mining, NLP
    Patient Billing
    Practice Plans
    Weekly
    Pt Satisfaction
    Monthly
    Image Analysis
    Web Scorecards & Dashboards
    Cancer Genetics
    Wound
    Images
    Tissue
    Pulmonary
    Genomic Data
    De-Identification
    Honest Broker
    Web
    Research
    Benchmarking
    Error Report
    Information Warehouse
    User Access
    Acquisition
    Transfer
    DATAINTEGRATION
    Clinical
    Business
    Research
    External
    Wound Center
  • 30. Constant Evolution in Technologies for Patients, Clinicians and Researchers
    1950-60’s: Specialized computing facilities, programming languages, decision support, bibliographic databases, basic clinical documentation systems, first training programs
    Today: Tele-health, mobile computing, widespread EHR adoption, service-oriented architectures, genomic and personalized medicine applications, translational research