The Future of Pathology Informatics:
The Biomedical Informatics
Department Model
Michael J. Becich, MD PhD
Chairman and Professor
Department of Biomedical Informatics
http://www.dbmi.pitt.edu
University of Pittsburgh School of Medicine
becich@pitt.edu
Disclosures by MJB
 Corporate Support for API and APIII
–
750K projected for 2010 [Cerner, Misys, GE, IBM, IMPAC, McKesson - Cisco, Verizon,
CAP Today - Aperio, Apollo, Applied Imaging, De-ID Corp, GE Medical Systems/Triple G, Nikon,
Olympus, SCC Soft, Sysmex, SNOMED, PSA, ThermoFisher, Zeiss, multiple others]
 Corporate Sponsored Research Agreements
200K in 2010 [Amgen and General Electric/Omnyx]
 Startup/Public Companies (Royalties, Licensing or Stock - MJB):
– Omnyx – Joint Venture with UPMC and GE
(http://www.omnyx.com)
– iKaryos Diagnostics (pending) – Scientific Advisory Board
(http://www.ikaryos.com/)
– CBL Path (pending)
– De-ID (licensing payments to DBMI and DBMI staff/faculty)
–
 Consultancy
ThermoFisher – Physician Advisory Board (paid)
GE Global Vision and Lab Vision (speaker honorarium)
Pathology Education Consortium (PEC) with Bruce Friedman (volunteer)
Cancer Center Consulting – MD Anderson, Moffit Cancer Center, NFGC, U Buffalo,
UMDNJ, U CO, VCU (honorarium)
– CTSA Consulting – Northwestern, U AK, UC Davis, UCLA, U KY, U MD, U MN, UAB,, UC
Slide 2
Davis, U WI/Marshfield, Wash U (honorarium)
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Objectives
• To understand the Biomedical Informatics
Department model and its impact on Future of
Pathology Informatics (case history from Pitt)
• To outline why an academic department
enables greater impact than a division in a
department
• To understand how these two models work
effectively together and understand the
limitations and strengths of each model
The “Big 3” problems facing Pathology
Informatics Today (the Yin BUT the Yang)
• Pathology Informatics (PI) through Pathology
Informatics 201X (formerly APII and Lab InfoTech
Summit) and the Association for Pathology Informatics
(API) has a bright future BUT PI needs more research
and development resources to scale up the mission
• Training programs in Pathology Informatics are growing
in number BUT we need to train dozens of leaders per
year to be able “transform” Pathology (and Medicine)
• Pathology Informatics has been somewhat successful
at working with industry BUT far more work needs to
be done to improve our impact on shaping the future
through corporate and Health Information Technology
(HIT) companies, licensing agreements and
intellectual property development.
Why the Biomedical Informatics Department
Model is the Answer to Pathology Informatics
“Big 3” – Here’s the punch line!!!
• PathoIogy Informatics (PI) needs more research and development
resources to scale up the mission
– Biomedical Informatics (BMI) Departments can develop a research mission that
financially supports infrastructure for PI (independent of clinical or basic
science/pathobiology mission)
– This alleviates the dynamic tension of Pathology finances today @ beyond
• PI needs to train dozens of leaders per year to be able “transform”
Pathology (and Medicine)
– BMI have several training program grants available to them (N=41 @ Pitt)
– This alleviates the dynamic tension seen with clinical/basic Pathology training
• Far more work needs to be done to improve our impact on shaping the
future through corporate and Health Information Technology (HIT)
companies, licensing agreements and intellectual property development
– This is a harder problem but the resources from the R&D mission can be
focused on this very important problem facing all of medicine
Mission Statement for DBMI
• Three major goals:
• To provide national and regional leadership in
innovation through research in Informatics
• To provide the highest quality of support for the
clinical practice of medicine through regional and
nationally recognized leadership in Clinical
Informatics.
• To provide the highest quality of instruction in
Informatics. This is supported by leadership in
national member organizations and national
educational forums with deep commitments to
training and education.
Slide 9
Department’s Resources
• Key metrics
MEASURES
Grants
FY07
FY08
FY09
FY10
% FY
% FY Projected Change
Change
FY11
Projected
Directs
$6,562,074 $6,759,038 $5,729,614 $7,305,726
28%
$8,419,160
15%
Indirects
$1,941,667 $2,107,549 $2,003,681 $2,628,997
31%
$3,202,896
22%
Total Grants $8,503,741 $8,866,587 $7,733,296 $9,934,723
28%
$11,622,057
17%
Publications
44
49
69
68
-1%
FTE Faculty
15
14
15
13.5
-10%
Revenue/FTE
$571,488
$674,265
$588,083
$735,905
25%
Pubs/FTE
2.9
3.5
4.6
5
9%
Indirect support (after rent/faculty “taxes”) means 70% goes to the Department mission!!!
Slide 10
Why the Biomedical Informatics Department
Model is the Answer to Pathology Informatics
• PathoIogy Informatics (PI) needs more research
and development resources to scale up the
mission
– Biomedical Informatics (BMI) Departments can develop
a research mission that financially supports
infrastructure for PI (independent of clinical or basic
science/pathobiology mission)
– This alleviates the dynamic tension of Pathology finances
today @ beyond
Understanding how training is
accentuated by a Department
• A division (usually) is unable to support infrastructure
to grant degrees or certificates
– Currently offer certificates, Masters and PhDs
– Most importantly have research and faculty projects to
support post-docs with program to train them to write grants
• Critical mass of faculty to have training program
– Currently 17 faculty and 35 affiliated faculty
• Training program grants need a critical mass of faculty
and science
– NLM T15 and ARRA supplements (equipment, curriculum
development)
– Doesn’t compete with clinical and basic science of “home”
department
Current Trainees – 41 this year!!!
3 certificates, 9 MS, 24 PhDs, 5 post docs
Training Program Recruitment 2010
3 NLM predoc
1 NLM/ NICDR predoc
2 NLM ARRA postdoc
2 NLM ARRA predoc
2 Fogarty
2 GSR predoc
44 applicants
18 accepted
12 total slots to fill
14 accepted us
1 NLM ARRA postdoc
slot still open
11 funded by us
28
15
22
28
US
16 International
Local
13 Non-local
Doctoral 11 MS 4 Cert
Pre-doc 16 Post-doc
4 students rejected us, went to:
Stanford
BIRT/BI-Deaconess
OHSU
Dayton-Robotics (ISP)
3 self funded (1 with own K funding,
1 with own Fulbright,1 with foreign
governmental funding)
Why the Biomedical Informatics Department
Model is the Answer to Pathology Informatics
• PI needs to train dozens of leaders per year to be
able “transform” Pathology (and Medicine)
– BMI have several training program grants available to
them (N=41 @ Pitt)
– This alleviates the dynamic tension seen with
clinical/basic Pathology training
– Ability to support Pis mission is greatly enhanced by
Department infrastructure
• Administrative Support
• Financial Support and workflows
DBMI FY10 Highlights
Education and Outreach
• Training Program underwent External Review by U Pitt – OhnoMachado and Szolovitz participated and now have joined DBMI EAB
• Continue to invest in high quality post-docs
– Successful in creating “pipeline” of K-funded junior faculty (Jiang, Beckhuis, others
moving in rank)
• On-Line Curriculum Development
– Plan certificates in Biomedical and Dental Informatics – feeder for training
program recruits for MS and PhD students
• APIII merged with LITS; rebranded as Pathology Informatics 201X (in
Boston) – will be most successful meeting ever
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Over 90 abstract submitted – previous high 74 (2009)
Non-restricted educational support (grants) total $280,000 – previous high $155,000
Registrations – predicting nearly 400 – previous high 285
Planning Pathology Informatics certificate program in collaboration with DBMI
Launched new Journal of Pathology Informatcs – open source, soon PubMed Indexed
Next step merger of national member organization (Assoc Path Info) into 501c3
Slide 16
Association for Pathology Informatics (API)
http://www.pathologyinformatics.org
“…to advance the field of pathology informatics as an
Slide 17
academic and a clinical subspecialty of pathology…”
Why the Biomedical Informatics Department
Model is the Answer to Pathology Informatics
• Far more work needs to be done to improve our
impact on shaping the future through corporate and
Health Information Technology (HIT) companies,
licensing agreements and intellectual property
development
– This is a harder problem but the resources from the R&D
mission can be focused on this very important problem
facing all of medicine
– DBMI has several successful commercial ventures but we are
only scratching the surface
– We will be focusing on this a another part of our contribution
to Pathology Informatics
Baobab Health - founder Gerry Douglas –
T.E.D. Award Winner and newest faculty @ Pitt DBMI
http://baobabhealth.org/about/
Baobab Health – 10 years of work in Malawi
Based on “open EMR” and CDA
16 SITES DEPLOYED AND
7 SITES IN DEPLOYMENT
New sites (2011)
Existing sites
CENTRAL REGION
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KCH
Lighthouse Trust
Martin Preuss
M’bangombe
Dedza DH
Salima DH
Kasungu
N’goni HC
Ntcheu DH
St. Gabriel MH
Mangochi DH
Matawale HC
Bwaila Hospital
 Queen Elizabeth
 Machinga DH
 Zomba CH
20
KEY RESULTS
ACHIEVED
• ~1,300,000
patients
registered
• 40,000 lab
tests across 3
sites
• 185,000 XRay/Ultraso
und
investigations
• 50,000
patients on
ART therapy
across 9 sites
• 160,000 HIV
testing and
counseling
sessions
across 5 sites
VISION &
VALUES
Baobab vision is
to use
technological
innovation to
improve the
delivery of
healthcare in the
developing world
Founded in 2000
46 employees of
whom 43 are
Malawian
De-ID Data Corp - http://www.de-idata.com/
Omnyx – http://www.omnyx.com
Conclusions
• Departments of Biomedical Informatics must partner
with Pathology to foster strong multifaceted Pathology
Informatics Divisions
• We need to focus on developing more academic
pathology informatics trainees to head Departments of
Biomedical Informatics
– Computational Pathology fellowships (research fellowships)
starting at Pittsburgh
• Three Departments of Biomedical Informatics (of 15) are
headed by Pathologists today
• The Director of the National Library of Medicine – Don
Lindberg, MD is a pathologist
– Major funding source of Biomedical Informatics research
and training
• Need to get more involved in the commercialization of
technologies to impact Pathology Practice
End of Talk – e-mail me at becich@pitt.edu if you have
questions/clarifications not covered in the discussion.
NOTE: E-mail me if you want PDFs of articles or presentation.
HOLD THE DATES:
Pathology Informatics 2011 – October 4-7th
Pittsburgh, PA
Pathology Informatics 2012 – Chicago, IL
Featuring a “Whole Slide Imaging (WSI)” Bake-Off
Real Time Use of WSI systems by Pathologists