Center for. Clinical Informatics. Clinical Informatics. Mission Statement

Transcription

1 Clinical Informatics Center for Clinical Informatics Clinical Informatics transforms health care by analyzing, designing, implementing, and evaluating information and communication systems that enhance individual and population health outcomes, improve patient care, and strengthen the clinician-patient relationship. * Henry Lowe M.D. Associate Professor of Pediatrics Director, Center for Clinical Informatics Senior Associate Dean for Information Resources and Technology * Gardner RM et al Core Content for the Subspecialty of Clinical Informatics J Am Med Inform Assoc Mar-Apr;16(2): Mission Statement The Center for Clinical Informatics fosters the use of innovative information technology solutions to improve human health. Isabel Costa, Todd Ferris MD, Gomathi Krishnan PhD, Jay Lee MBA, Peter Lin, Yuan Lin MS, Henry Lowe MD, Andrew Martin PhD, Sanjay Mulanjkar, Garrick Olsen, Tanya Podchiyska, Nara Ramamoorthy, Tina Seto MS, Susan Weber PhD, Lee Ann Yasukawa MS 3 4

2 Advisory Committee Todd Ferris MD, MS Privacy Officer School of Medicine Jennifer Frankovich MD Instructor in Pediatrics (Rheumatology) Michael Halaas Chief Technology Officer School of Medicine Christopher Longhurst MD, MS Assistant Professor Pediatrics Chief Medical Information Officer Lucile Packard Childrenʼs Hospital Pravene Nath MD Assistant Professor Surgery Chief Medical Information Officer Stanford Hospital and Clinics Nigam Shah MD, PhD Assistant Professor of Medicine (Biomedical Informatics Research) Brent Tan MD, PhD Assistant Professor Pathology Associate Medical Director, Informatics, Dept. of Pathology Richard Whyte MD, MBA Professor, Cardiothoracic Surgery 5 Partnership with SPECTRUM Center Goals The Application of Innovative Informatics to SPECTRUM is the home of Stanford s Clinical and reduce barriers to effective Clinical and Translational Research (CTR) Translational Science Award (CTSA) NIH grant Harry Greenberg (PI) Connect the Stanford CTR Community to Data, The Center for Clinical Informatics is home to the Technology and Expertise through a Free Informatics Consultation Service CTSA Translational Informatics Program, collaborating with other SPECTRUM programs, such as Biostatistics Using the Stanford Community s Needs to Drive Innovative Applied Clinical Informatics Research and Development Projects Center participates in a national CTSA Informatics community from 60 Academic Centers 6 7 8

3 Informatics Consultation Service Consultation Topics 200 Access to Clinical Data 150 Research Data Management 100 Privacy & Security (//$#0$123&3.2$ # 4+,$ Misc Informatics &3.2$6(/(6.@$ 9(.:63#<B.0)C23&.($ 2(68&'$ 9#:D<$ (&6022)(&#$ >(?(662$ ED:.80&$ =,$ F#@(6$ A=,$ (&#$ 9:6;(<$ =,$ # %&'()(&#$ *+,$ Up to five hours of free Informatics consultation time for researchers 563&3&'$ 4,$ 78(&#$ >('3/#6<$ Over 200 substantial consultations in 2010 out of a total of 330 Anesthesia Cancer Center CT Surgery CV Institute Dermatology Genetics HRP Medicine Neurology Neurosurgery OB-Gyn Ophthalmology Orthopedic Surgery Otorhinolaryngology Pathology Pediatrics Psychiatry Radiology Surgery Urology Hospitals Engineering Biodesign SoM Dean s Office 9 10 Department of Medicine 2010 Informatics Consultations N= Informatics Consultations by Group Bone Marrow Transplant Biomedical Informatics CV Medicine Endocrinology Gastroenterology Internal Medicine Hematology Immunology & Rheumatology Infectious Disease Nephrology Oncology Pulmonary & Critical Care SPRC

4 Impact on Scholarly Activities Department of Pediatrics 2010 Informatics Consultations N= consultation survey (96 of 170 responded - 56%) Cardiology CHRP Impact on Publication* Impact on Research Impact on Teaching Endocrinology Gastroenterology Not Helpful 5% General Pediatrics Not Helpful 5% Not Helpful 9% Hematology/Oncology Infectious Disease Neonatology Helpful 91% Helpful 95% Pulmonary Rheumatology Helpful 95% >50 Publications & Abstracts Stem Cell Transplant % of respondents said they would use the service again STRIDE The STRIDE Platform Stanford Translational Research Integrated Database Environment Stanford Translational Research Integrated Database Environment STRIDE Privacy Officer Review Patient Cohort Discovery 1. Secondary Use of SUMC Clinical Information - patient cohort identification, research alerting, review of clinical data, customized clinical data extraction and secure clinical data processing for research purposes Clinical Data Review Clinical Data Extraction Investigator 2. Secure Research Data Management Services Development and deployment of secure research data management solutions, including REDCap SUMC Clinical Data 3. Biospecimen data management - Registration, Tracking, Searching and Linkage (to clinical data) of biospecimens Privacy Officer Review 15 Research Databases: STRIDE REDCap Other Clinical Data Warehouse Adult EHR (Epic) Pediatric EHR (Cerner) STRIDE Secure Workbench 16

5 STRIDE Secure Workbench STRIDE Clinical Data Warehouse Combined Adult & Pediatric Data - May 2011 Observation Type 1,>-$%&='C.'DE:%,.' F&+=')E.,*$%&' G*9<)>'4%,'>)=-B),/'.%',)#),*5),' (1IMCD' G;M'%&')&>3+#),#U'*%P:+.),' ;%#.)>'(%=+$%&#' N)838#)>'**)##' O,).'#*=8-=-./' J-P-.)>'4+&*$%&=-./' ()*+,)'2)838#)>'**)##' L=%+>38#)>'#%=+$%&' Q(G((R'IR'?S*)T' C.'#./#'#)*+,)'&>' (1IMCD' 8*9)>3+:'.'=='$P)#' ()*+,)'B-,.+='>)#9.%:#'B-' (1IMCD'()*+,)'N%,98)&*5' #$%&'()*+,-./'0%&)' 12%34*.%,'+.5)&$*%&' 6,)7+)&.'8*9+:#' ;-<5=/',)#.,-*.)>'**)##' Count Patient Demographics 1994-present 1.64 mi(ion Clinical Encounters 1994-present 16 mi(ion ICD9 Coded Diagnoses 1994-present 26 mi(ion ICD9 & CPT Coded Procedures 1994-present 17.7 mi(ion (1IMCD' (1IMCD'()*+,)'N%,98)&*5' Coverage (.&4%,>'' A).2%,9' (HA).'I)7+-,)>' J%<<-&<'K'L%&.,%='?:)&'@**)##' A%'=%&<),'8=)'.%'.,*9' A%'*%&.,%='%B),'**)##' Surgical Pathology Reports 1995-present 1.1 mi(ion Radiology Reports 2004-present 2.5 mi(ion Full Text Clinical Notes 2000-present 6.1 mi(ion Laboratory Test Results 2000-present 120 mi(ion Inpatient Pharmacy Orders 2006-present 7.3 mi(ion Social Security Death Index 1962-present 100,

6 REDCap Research Electronic Data Capture A secure Web-based research data management system developed at Vanderbilt and supported via a consortium of 200+ institutional global partners Easy to use, self-service and integrates with many data analysis environments (SPSS, SAS, Stata, R, Excel) Over 200 active research databases and 500+ active users in the Center s REDCap system - Use is Free REDCap databases are secure, backed-up and sensitive data is not resident on local computers 21 REDCap 22 STRIDE Biospeciman Database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

7 Linking Patient Records in De-identified Multi-site Patient Registries Innovation Examples Developed as part of the OncoShare project STRIDE Self-Service Tools for Research (Stanford-PAMF) breast cancer outcomes study Cohort Identification and Clinical Data Review Sites share an algorithm that creates an unbreakable Algorithmic merging of drug data from our patient-specific code used to exchange de-identified data while supporting secure re-identification on-site pediatric and adult Electronic Health Records Secure method for sharing and linking patient Stanford data between multi-site research registries PAMF Real-time research alerting system based on Continuous Event Processing of SUMC Clinical Data feeds 25 Collaborations STRIDE Research Alerting System Real-time monitoring and analysis of clinical data to detect potential research participants at SUMC Used in ongoing studies of Animal Bites (Surgery), Sepsis (Anesthesiology) and Neonatology #$%#&'( 1#2( >5+&( 3$#-4&$+567-( 48$9+&84( :-;8$<#&8(8-.+-8( >31(>-.+-8( A3?:B>(=0+-+&#0(B#;#( C#$87D48( )*%+,-.( /+00+-.( 26 =0+-+&#0()08$6-.(>-.+-8( Anesthesia Research Registry, Sepsis Biomedical Informatics Oncoshare, Data Mining, Genome-Phenome Cancer Center CCRD, Biospecimens, Cancer Genetics Cardiothoracic Surgery Integrated CTS Research Database Dermatology Prescribing patterns, MMRD Emergency Medicine Research Alerting Genetics Personalized Medicine Project Infectious Disease Antimicrobials & Obesity Neonatology CPQCC, HRIF, Prematurity Center Orthopedics Joint Replacement Registry, Sports Med Psychiatry Sleep Center /#;&(=0+-+&#0( )08$6-.(>-.+-8( 27 28

8 Future Directions Continue almost everything we are currently doing Increased outreach especially to Basic Sciences Catalyze new research at Stanford on secondary use of health information: Data-driven clinical decision support Knowledge discovery through clinical data mining Personalized medicine applications Social Networking technologies in Biomedicine 29 30