Informatics Research Seminar: A Platform for Healthcare Innovation

October 21 @ 4:00 – 5:00 pm

 

Speaker: Ricky Bloomfield, MD
Presented from Duke University

Broadcast Link : Seminar

 

Abstract:

Healthcare innovation is essential to improve patient care, reduce cost, and increase efficiency. There are many technologies available today to level the playing field and allow more innovators to participate, including Apple’s HealthKit, SMART on FHIR, wearable technologies and the Internet of Things. I will demonstrate how these technologies can be used to improve what we do.

Biosketch:

Dr. Bloomfield joined Duke in 2013 to oversee mobile technology initiatives within the healthcare system. In addition to rolling out mobile applications associated with the Epic EHR, he is collaborating with multiple entities both inside and outside Duke to establish an open technology platform for mobile health innovation. During his residency, Dr. Bloomfield founded a successful software company creating health and social networking apps for iOS devices that has enjoyed over 13 million downloads to date.

Dr. Bloomfield led the integration of HealthKit at Duke in August 2014 and is helping facilitate its use among interested faculty for both clinical and research purposes. He also provides guidance to other key initiatives across the health system, including telemedicine, a health accelerator, secure messaging, custom apps, clinical decision support, ResearchKit, and integration of the open SMART platform. Duke is the first Epic-based hospital system to incorporate SMART. He still practices clinically as a Pediatric and Internal Medicine hospitalist.

Prior to joining Duke, Dr. Bloomfield completed his Internal Medicine and Pediatrics residency at UNC Hospitals in Chapel Hill, NC, followed by a Pediatric Chief Resident year. A native of eastern North Carolina, he’s never found a good enough reason to permanently leave his home state. In his spare time, he enjoys playing jazz saxophone in a local big band, competitive swimming, writing iOS and Android apps, volunteering in a local Hispanic free clinic, and spending time with his wife and two 9 year-old daughters.

You can follow him on Twitter @rickybloomfield or on his blog at www.rickybloomfield.com.

 

Informatics Research Seminar: Genomic Data Based Drug Discovery/Repurposing for Complex Diseases

October 14 @ 4:00 – 5:00 pm

 

Speaker: Di Wu, PhD
Presented from UNC-CH

Broadcast Link: Seminar

 

Abstract:

A major challenge in human genetics is to devise a systematic strategy to integrate disease datasets with diverse genomic biological and drug datasets in order to provide insight into disease mechanism and guide drug discovery. To achieve this, Dr. Wu will discuss two areas of her research.

First, Dr. Wu will demonstrate how to identify the “cells of origin” for breast cancer sub-types using mammary gland cell sub-population data and publicly available data. This helps find potential drug targets. A variety of statistical methods are developed and used, including defining gene signature scores for each sample and some novel gene set testing methods. Gene set tests are valuable for increasing statistical power, rotation gene set test, ROAST, overcomes the limitation of sample size and inter-gene correlation. ROMER and CAMERA gene set tests test different statistical hypotheses.

Dr. Wu will then discuss another major work: to integrate Genome-wide association study (GWAS) risk SNPs with public drug databases to repurpose drugs for complex traits, e.g., cancer and autoimmune diseases. Although a large amount of identified risk variants may well capture the characteristics of the diseases, there is still a bottleneck of developing new therapeutics. Drug repurposing is to assess whether the available drugs of certain diseases can be re-used for the treatment of other diseases. It is cost effective and has fewer safety issues. Two main goals are achieved in Dr. Wu’s study; the genetics based drug repurposing pipeline and evaluation of how much genetics “guides” drug discovery/repurposing. How to infer the drug sensitivity across lung cancer subtypes may also be mentioned.

Biosketch:

Dr. Wu is a biostatistician working in the bioinformatics field. She completed her PhD in statistical bioinformatics at the Walter and Eliza Hall Institute (WEHI) of Medical Research, University of Melbourne, Australia. She completed a postdoc at Harvard University, jointly in the statistics department and the medical school. In the past, Dr. Wu worked primarily on statistical methods to analyze genomic data and data integration of genomic data and drug database, applied in cancer research and autoimmune disease research for precision medicine and drug repurposing. Dr. Wu joined UNC-Chapel Hill a few months ago and is developing a data integration strategy with Electronic Medical Records (EMR) for drug repurposing. She is also working on omics data integration (microbiome, metabolomics and DNA/RNA levels) in oral biology.

Informatics Research Seminar: Consumer Health Informatics: An innovative technology for self-management of chronic disease

October 7 @ 4:00 – 5:00 pm

 

Speaker: Constance Johnson, PhD, RN, FAAN
Presented from Duke University

Broadcast Link: Seminar

 

Abstract:

Many forces are driving the need for new media to assist patients in chronic illness self-management: the need to eliminate barriers to healthcare; to accommodate limited health literacy; and provide sustainable, cost-effective patient education and support.  Internet interventions have the potential to capture the dynamics of the patient-provider interaction, but to date internet health interventions have remained “flat” and unidirectional with asynchronous communication. Virtual environments (VEs) are a potential means of capturing the dynamics between patient and provider. This medium provides ongoing interaction, synchronous communication, knowledge application, and social networking, creating an immersive experience to potentially change and/or sustain behavior. This presentation will review the results of a pilot study that tested a theoretically grounded, technologically based, bio-behavioral intervention using a virtual environment to facilitate self-management and control of diabetes. Preliminary findings of the pilot study showed statistically significant changes in self-efficacy, social support, and foot care.  Based on the successful feasibility study, Dr. Johnson will also present on the progress of her currently funded randomized controlled trial that will determine whether participation in Learning in a Virtual Environment (LIVE), will be associated with positive changes in health behaviors and metabolic outcomes in adults with type 2 diabetes.

Biosketch:

Dr. Constance Johnson  is an Associate Professor with tenure, Health Informatician, and Faculty Coordinator of the Informatics, Education and Leadership Programs in the Duke University School of Nursing. She has a secondary appointment in Community and Family Medicine at Duke University and is adjunct faculty at the University of Texas at Houston Health Science Center, School of Biomedical Informatics. She earned her Bachelor’s from the University of Connecticut and her Master’s of Science and PhD from the University of Texas at Houston, School of Biomedical Informatics. Her career has been devoted to changing the way information is presented to clinicians and patients to improve the decision-making that impacts health.  Her work in human-computer interaction has significantly contributed to a new vision using novel technological tools that assist patients to engage in the self-management of chronic illnesses. As a Primary Investigator, she has received funding from the National Library of Medicine, the National Cancer Institute, the Agency for Health Care Research and Quality and the National Heart, Lung and Blood Institute. She is also a Co-Investigator and Co-Primary Investigator on several other funded grants. Dr. Johnson additionally serves as an expert on the Health Level 7 International Standards Usability Working Group, now developing usability standards for the electronic health record.  Dr. Johnson has numerous publications and presentations at national conferences and mentors both masters and doctoral students.

 

PPT-Johnson

Informatics Research Seminar: A Graphical and Analytics Approach to Understanding Hospital Re-admissions in North Carolina

September 30 @ 4:00 – 5:00 pm

 

Speaker: William Saunders, PhD
Presented from UNC-C

Broadcast Link: Seminar

Abstract:

Hospitals will be penalized and lose revenue if they do not meet readmission quality targets (CMS quality metrics).  Commercial payers are also implementing risk-based contracts, and health systems must take on additional risk.  Recent contracts are transitioning healthcare from a fee-for-service delivery system to a risk-sharing pay for performance system where 1) Quality is measured and hospitals are forced to assume some of the risk associated with poor quality care; 2) Risk sharing is measured as readmissions within 30 days post-discharge (marker for poor quality); and 3) Readmissions rates beyond determined thresholds will generate reductions in total Medicare payments to the facility.  The purpose of this analysis was to examine readmission rates across the state of North Carolina, with a focus on heart failure, pneumonia, acute MI, hip & knee replacements, and COPD, using discharge data from North Carolina hospitals from the Healthcare Utilization Project (HCUP) (administered by the Agency for Healthcare Research & Quality (AHRQ)).  In the past year, we’ve presented 3 posters at American Public Health Association, and continue to perform data analytics as hospitals continue to transition to a risk-based delivery model which allows them to take on risk, deliver high quality care and maintain profit margins.  In addition, we will highlight counties areas where readmission is a problem and examine high-risk patients in relation to additional variables related to severity as well as travel time to the hospital.

Biosketch:

Dr. Bill Saunders came to the Department of Public Health Sciences at UNC Charlotte as an Assistant Professor after extensive research work in private sector. He received his PhD in Epidemiology and MPH (Biostatistics) from UNC Chapel Hill.  Dr. Saunders has led research teams at several companies, including GE Healthcare, Premier, Inc., and GlaxoSmithKline.  He continues to be a researcher and analytic consultant with an interest in the application of varied data sources to outcomes research studies, as well as 1) factors related to hospital readmission and 2) risk factors and drug utilization of diabetic and obese populations. Other research interests include delivery of health care to patients with mental illness and cystic fibrosis. Teaching specialties include Epidemiology, Biostatistics, Healthcare Informatics, Outcomes Research, Quality Measurement, and Pharmacoeconomics. Bill is currently the Director of the Health Informatics PSM and Certificate programs at UNC Charlotte.

 

 

Informatics Research Seminar: Efforts to Improve the Capture of Structured Device Information at the Point of Care

January 7 @ 4:00 – 5:00 pm


Speaker: Terrie L. Reed, MSIE
Presented from Duke University

Broadcast Link: Seminar

 

Abstract:

There are multiple national efforts focused on advancing the science and efficiency of medical product decision making by improving the structure and quality of initial data capture, leveraging electronic infrastructure that overlaps with clinical care, professional society, federal and other data systems and registries.  This presentation will provide an overview of those efforts with a particular focus on efforts to adopt Unique Device Identifiers and a standard core set of data elements to allow clear identification of regulated medical devices through distribution and use.  The discussion will include an overview of a new FDA Public Private Partnership called MDEpiNet, that has DCRI as its coordinating Center and about an MDEpiNet-sponsored Informatics Think tank to be held in February that will be addressing the need to strike the right balance between making sufficient changes to the quality of data at initial data capture to improve downstream clinical information without requiring such extensive change that costs in money, systems and resources pose too high a barrier to be realistically implemented or sustained.

Biosketch:

Terrie Reed, MSIE works as a senior Clinical Research Informatics Project Leader at Duke Clinical Research Institute, where she provides informatics subject matter expertise and support to device-related projects and programs such as the MDEpiNet (Medical Device Epidemiology Network) public-private partnership. Formerly, Terrie was the Associate Director of Informatics at the Food and Drug Administration (FDA), Center for Devices and Radiological Health (CDRH), Office of Surveillance and Biometrics (OSB), where she led the implementation of the UDI Final Rule including the development and population of the Global Unique Device Identification Database (GUDID) as a master source of device information. Over the course of her 12 years at the FDA she led several data-management initiatives, including a joint project between the National Cancer Institute (NCI) and FDA CDRH focused on improving and simplifying the device and patient problem codes used to code medical device adverse event reports. Prior to working in academia and government, she worked for 13 years at a healthcare facility in Indianapolis in various positions as a process engineer, quality analyst, and medical information specialist.

Informatics Research Seminar: Iterative Methodology and Usability Improvement for Clinical Decision Support

January 14 @ 4:00 – 5:00 pm


Speaker: Fei Yu, PhD
Presented from UNC-CH

Broadcast Link: Seminar

 

Abstract:

MindsEye is a visual-based interactive clinical decision support (CDS) tool and is currently undergoing phased usability testing. Simultaneously, an iterative methodology for evaluating the usability of CDS user-interfaces (UI) is being developed and refined. Phase I of the project developed and evaluated a UI. Results revealed methodological challenges and the need to better align the UI with clinical workflows. The Phase II UI is improved based on the lessons learned from Phase I. This presentation will introduce the Phase II evaluation results and findings.

Biosketch:

Fei Yu, PhD is currently working as a Research Associate at the Lab of Applied Informatics Research in the School of Information and Library Science at UNC-Chapel Hill. She is also an enrolled CHIP program student who started pursuing a certificate in Clinical Health Informatics and then continued to seek a Master degree in Biomedical and Health Informatics at UNC-Chapel Hill. Dr. Yu completed her doctoral study in 2006 at the Department of Library and Information Science at the University of Pittsburgh. Her dissertation was the evaluation of users’ emotional and material satisfaction — at both micro and macro levels — with an academic library system. After she graduated, Dr. Yu worked for a non-profit technology company in Pittsburgh for several years. One of her job responsibilities was conducting routine usability testing for the web OPAC, which was shared by 85 public libraries in Allegheny County. She developed an interest in healthcare and electronic health records in 2012 when her family moved to North Carolina and plans to continue study in this highly interdisciplinary field and to pursue research opportunities by collaborating with both academia and industry.

Informatics Research Seminar: Exploring the Data on Salt-induced Hypertension

January 28 @ 4:00 – 5:00 pm

 

Speaker: Mildred Pointer, PhD
Presented from NCCU

Broadcast Link: Seminar

 

Abstract:

End-stage kidney disease is a major public health concern with a mortality rate that exceeds that for cancer and heart attacks (241/1,000 patient years at risk compared to 137/1,000 and 116/1,000 for cancer and heart attacks, respectively).  There are limited treatment options, and the options that are available currently cost $50 billion annually (Medicare and non-Medicare).  This cost is even greater if lost wages due to illness and treatment are considered. In addition to the economic burden of ESRD, there is an accompanying psychosocial burden that includes poor quality of life and strained social relationships.

African Americans (AAs) have a four-fold greater risk for ESRD compared to whites. Although AA make up approximately 12% of the general population, they make up more than one-third of the dialysis patents. The reason for this disparity in ESRD is not definitively known.  We hypothesize that the type of hypertension may account for some of this disparity.  African Americans with hypertension are generally characterized as salt-sensitive. This type of hypertension is known to have associated with it more aggressive and sever kidney injury. We reason that a better understanding of the mechanism of salt-sensitive hypertension will lead to the development of improved treatment and prevention interventions for this type of hypertension, and in return will lead to reduced progression to end-stage renal disease. This presentation will discuss the use of population and large databases used in the research.

Biosketch:

Mildred Pointer, PhD is the Director of Cardio-metabolic Research, Julius L. Chambers Biomedical/Biotechnology Research Institute (BBRI), and an Associate Professor in Biology at North Carolina Central University, Raleigh, NC.

Dr. Pointer is a founding member of the American Society of Hypertension, and a fellow in the American Heart Association High Blood Pressure Council. She has contributed to the field of salt-sensitive hypertension using known animal models of salt-sensitivity and establishing new models of African American hypertension-associated kidney disease. Her work has, in recent years, turned to African American population studies and large open access databases to confirm her findings from the animal models.

Informatics Research Seminar: Visualization and Analysis of the Emergence, Evolution, and Spread of Pathogens

January 21 @ 4:00 – 5:00 pm


Speaker: Daniel Janies, PhD
Presented from UNC-C

Broadcast Link: Seminar

 

Abstract:

Science has used molecular phylogenetics in many ways to understand the spread of pathogens and their features, which can include the place of isolation, host, or tropism of a pathogen, or genotypes that confer phenotypes such as drug resistance. One issue that often arises is the difficulty in interpreting features mapped onto a large phylogeny. The presentation will demonstrate several workflows designed to enhance the understanding of phylogenetic data, including projection of a phylogeny and its features in a geographic information system, and calculation of a between-ness graph for a phylogeny and its features. The projection is akin to a weather map for infectious diseases. The between-ness graph allows users to understand the relative flow of related pathogens among several geographical places or various hosts. Use cases with public health significance will be discussed.

Biosketch:

Daniel Janies, PhD joined the faculty of the University of North Carolina-Charlotte as The Carol Grotnes Belk Distinguished Professor of Bioinformatics and Genomics, Director of Bioinformatics Research, and Director of Graduate Global Research and Educational Programs in 2012.

After receiving a Bachelor of Science degree in Biology from the University of Michigan and a PhD in Zoology from the University of Florida, Dr. Janies worked as a postdoctoral fellow (1996-1999) and a principal investigator (2000-2002) at the American Museum of Natural History in New York City. In 2001, he led a team that used off-the-shelf PC components to build one of the world’s largest computing clusters. Most recently, Dr. Janies was a tenured faculty member in the College of Medicine at the Ohio State University.

Dr. Janies is a national principal investigator in the Tree of Life program of the National Science Foundation. He also focuses on the evolution and spread of pathogens. He has developed the theory and practice of mapping pathogen genetic data in concert with geography and host animals. His results are akin to weather maps for infectious diseases that allow public health scientists to visualize when and where pathogens jump from animals to humans and evolve to resist drugs. Dr. Janies has advised the White House and Pentagon, and testified to both Houses of Congress on emerging infectious diseases.

Informatics Research Seminar: NC-STeP: Using Telepsychiatry to Improve Access to Evidence-Based Care

February 4 @ 4:00 – 5:00 pm


Speaker: Sy Atezaz Saeed, MD, MS, FACPsych
Presented from ECU

Broadcast Link: Seminar

 

Abstract:

At a time when treatment for psychiatric illness has never been more effective, many people with mental health disorders do not have access to psychiatric services due to a shortage and misdistribution of providers, especially psychiatrists. This has resulted in patients going to hospital emergency departments (ED) to seek services, producing long lengths of stay and boarding of psychiatric patients in hospital EDs. A growing body of literature suggests that telepsychiatry be used to mitigate the workforce shortage and improve access to care, especially in remote/underserved areas. The North Carolina Statewide Telepsychiatry Program (NC-STeP), launched in 2014 by a large collaborative of key stakeholders and awarded $4 million in public/private funding, is designed to assure that individuals experiencing an acute behavioral health crisis can enter a hospital ED anywhere statewide and receive timely, evidence-based psychiatric treatment.

Based at East Carolina University’s Center for Telepsychiatry, the program is not only addressing the problems associated with access to mental health care, but also helping North Carolina face a pressing and difficult challenge: integration of science-based treatment practices into routine clinical care. In the program’s first 11 months, it has connected 50 of the projected 85 hospitals, completed over 6,000 patient encounters, and implemented a web portal combining scheduling, EMR, HIE functions, and data management systems—meeting or exceeding all of its legislatively defined timelines. The seminar will provide full-year data on the length of stay, dispositions, IVC status, and other parameters for ED patients who received NC-STeP services. It will demonstrate how well positioned the program is to build capacity by taking care of patients in community-based settings and by creating collaborative linkages across continuums of care. By doing so, the program implements evidence-based practice to make recovery possible for patients that it serves.

Biosketch:

Sy Atezaz Saeed, MD, MS, FACPsych has chaired East Carolina University’s Department of Psychiatric Medicine since 2004. He also is Director of ECU’s Center for Telepsychiatry, Director of the North Carolina Statewide Telepsychiatry Program (NC-STeP), and Chief of Psychiatry at Vidant Medical Center in Greenville. Dr. Saeed has published extensively in the areas of evidence-based practices; anxiety and mood disorders; telepsychiatry; cross­ cultural issues; psychiatric administration; and psychiatric treatment integration. His scholarly and research interest areas include study of the process and impact of implementing evidence-based practices in mental health settings; telepsychiatry; and systems approach to psychiatric administration and management.

Informatics Research Seminar: Text-based Disease Classification of Medical Literature

February 11 @ 4:00 – 5:00 pm


Speaker: Angela Zoss
Presented from Duke University

Broadcast Link: Seminar

 

Abstract:

This project explored ways to use natural language terms and phrases to detect broad disease categories in the titles of articles from the PubMed database. An early attempt, the project classifies four million papers written in five different languages over the last 50 years into nine broad disease categories, visualizing the results as flows and streams to explore the changing focus of medical research over time. The visualization received an award as a top student submission to the ACM Web Science 2014 Conference data visualization challenge. Future work will include refining disease detection with more sophisticated text and data mining, as well as developing new visual interfaces to the results.

Biosketch:

Angela Zoss began work as Duke University’s first Data Visualization Coordinator in the summer of 2012. While helping to develop this new position at Duke, she has created new library workshops on visualization; hosted an annual student data visualization contest; consulted with students, researchers, and faculty members on research projects; and helped to introduce visualization concepts and tools into several undergraduate and graduate courses.  She co-organizes a weekly talk series on visualization topics and is collaborating within and outside the Duke community to improve instructional and technical support for visualization projects. She holds a Master of Science in Communication from Cornell University and is pursuing a doctorate in Information Science from Indiana University, where she taught a semester-long graduate course in Information Visualization. Her research interests include scientometrics, network analysis, computational linguistics, and literacy issues surrounding information visualization.