Posts Tagged ‘EMR’

Better Bioinformatics, Volume 2 (Volume Two: Latest in Genomics Methodologies for Therapeutics: Gene Editing, NGS and BioInformatics, Simulations and the Genome Ontology), Part 1: Next Generation Sequencing (NGS)

Better bioinformatics

Larry H. Bernstein, MD, FCAP, Curator



Big data in biomedicine: 4 big questions

Eric Bender  Nature Nov 2015; S19, 527.     http://dx.doi.org:/10.1038/527S19a


Gathering and understanding the deluge of biomedical research and health data poses huge challenges. But this work is rapidly changing the face of medicine.




1. How can long-term access to biomedical data that are vital for research be improved?

Why it matters
Data storage may be getting cheaper, particularly in cloud computing, but the total costs of maintaining biomedical data are too high and climbing rapidly. Current models for handling these tasks are only stopgaps.

Next steps
Researchers, funders and others need to analyse data usage and look at alternative models, such as ‘data commons’, for providing access to curated data in the long term. Funders also need to incorporate resources for doing this.

“Our mission is to use data science to foster an open digital ecosystem that will accelerate efficient, cost-effective biomedical research to enhance health, lengthen life and reduce illness and disability.” Philip Bourne, US National Institutes of Health.


2. How can the barriers to using clinical trial results and patients’ health records for research be lowered?

Why it matters
‘De-identified’ data from clinical trials and patients’ medical records offer opportunities for research, but the legal and technical obstacles are immense. Clinical study data are rarely shared, and medical records are walled off by privacy and security regulations and by legal concerns.

Next steps
Patient advocates are lobbying for access to their own health data, including genomic information. The European Medicines Agency is publishing clinical reports submitted as part of drug applications. And initiatives such as CancerLinQ are gathering de-identified patient data.

“There’s a lot of genetic information that no one understands yet, so is it okay or safe or right to put that in the hands of a patient? The flip side is: it’s my information — if I want it, I should get it.”Megan O’Boyle, Phelan-McDermid Syndrome Foundation.


3. How can knowledge from big data be brought into point-of-care health-care delivery?

Why it matters
Delivering precision medicine will immensely broaden the scope of electronic health records. This massive shift in health care will be complicated by the introduction of new therapies, requiring ongoing education for clinicians who need detailed information to make clinical decisions.

Next steps
Health systems are trying to bring up-to-date treatments to clinics and build ‘health-care learning systems’ that integrate with electronic health records. For instance, the CancerLinQ project provides recommendations for patients with cancer whose treatment is hard to optimize.

“Developing a standard interface for innovators to access the information in electronic health records will connect the point of care to big data and the full power of the web, spawning an ‘app store’ for health.” Kenneth Mandl, Harvard Medical School.


4. Can academia create better career tracks for bioinformaticians?

Why it matters
The lack of attractive career paths in bioinformatics has led to a shortage of scientists that have both strong statistical skills and biological understanding. The loss of data scientists to other fields is slowing the pace of medical advances.

Next steps
Research institutions will take steps, including setting up formal career tracks, to reward bioinformaticians who take on multidisciplinary collaborations. Funders will find ways to better evaluate contributions from bioinformaticians.

“Perhaps the most promising product of big data, that labs will be able to explore countless and unimagined hypotheses, will be stymied if we lack the bioinformaticians that can make this happen.” Jeffrey Chang, University of Texas.


Eric Bender is a freelance science writer based in Newton, Massachusetts.

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A medical record folder being pulled from the ...

A medical record folder being pulled from the records (Photo credit: Wikipedia)

Designer Fund and the White House’s Health Design Challenge

Larry H. Bernstein, MD, FCAP

The winners of Designer Fund and the White House’s Health Design Challenge have created beautiful, comprehensible, mobile versions. Soon, a combination of the best of the submissions will be open-sourced and implemented as the record format for the Veterans Affair Administration and its 6 million patients.

The challenge was launched in November by the White House and a new community of philanthropic angel investors called Designer Fund. Directed by five-year Facebook designer Ben Blumenfeld and 500 Startups founding team member Enrique Allen, Designer Fund aims to advise and back designer-led startups with a positive social impact.

The Health Design Challenge to redesign the electronic medical record (EMR) was a huge success, pulling in

  • 230 submissions
  • compared to 80 submissions in a previous White House health challenge.

Blumenfeld says that “from a quantity standpoint it was amazing, but from a quality standpoint too. People thought through all sorts of ways for the electronic medical record

  • to expand and live on mobile, and
  • have preventative care in there too.”

The overall winner  solved many of the biggest problems with the existing EMR. Those include

  • medication plans that are tough to understand,
  • unintuitive formatting,
  • impersonal statistics, and
  • the general feel of a decades-old print-out.

It will be the basis of the open-sourced final version of the downloadable medical record that other healthcare providers could adopt.

Nightingale creates an obvious hierarchy for all your health info, and uses styling to make it easy to read.
Patients are shown their statistics on a scale from concerning” to “doing well instead of as raw numbers

Rather than only showing your latest lab results, Nightingale puts them in context of your past tests to show how you’re trending. That’s critical, because

  • if your latest results says your cholesterol is too high but
  • the trend shows it’s coming down quickly,
  • you’re actually taking the right steps and shouldn’t make drastic changes.

Graphical timetables in Nightingale make it obvious when to take which medications. Nightingale is

  • accessible from mobile so
  • you can always check your dosage schedule,
  • which will help people make sure they take the meds on schedule.
  • set email and phone alerts to remind you it’s pill-popping time.

Mobile was a big theme among the top submissions.

Studio TACK, which took second place,

  • laid out ailments on a body map that could be viewed on your phone.

Josh Hemley’s M.ed won best medication design by creating a browsable deck of mobile medicine cards.

The challenge’s winners will split $50,000 in cash. Beyond that, Blumenfeld says healthcare companies he’s talked to are calling the winner’s showcase

  • “the perfect place to recruit from.”

But hopefully the winners see the real prize is helping 6 million VA patients and more truly understand their health

An electronic medical record example

An electronic medical record example (Photo credit: Wikipedia)

Image representing Enrique Allen as depicted i...

Image by Enrique Allen via CrunchBase

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