Internet2 Health Sciences:
CUDI Application
discussion on medical
discipline
Mary Kratz, MT(ASCP)
Internet2 Health Sciences Program Manager
Mkratz@internet2.edu
CUDI meeting in Manzanillo, Colima
Why should we care?
Medical
records are
not shared
Doctor 1
X
X
X
Referral Doctor
X
X
X
Doctor 2
Hospital Admission
Patient
One Physician’s Story
#1 Problem: TOO MANY MISTAKES
• NRC Report “To Err is Human”
No ill will, simply a very badly
undesigned non-system
Costs are EXPLODING!
Current medical science is not
consistently available to caregivers
30,000 medical journals …. no one can
keep up!
Healthcare is…
An information-dependent profession
with crippled access to information
Slow to adopt change
• Five-year lead time from proven new science to 50
percent usage (Jim Reinertson, MD)
Procedures done in some medical
specialties do not have validated data
demonstrating effectiveness and value.
Evidence-Based Medicine
“...Evidence-based medicine de-emphasizes
intuition, unsystematic clinical experience,
and patho-physiologic rationale as sufficient
grounds for clinical decision making and
stresses the examination of evidence from
clinical research.”
• Evidence-Based Medicine Working Group, JAMA (1992)
In the absence of data, decisions are made
based on professional judgment…inconsistent
and fraught with error.
Yesterday and Today
The Doctor (1891), Fildes, Sir Luke
Medicine used to
be simple,
ineffective and
relatively safe.
Now it is
complex,
effective and
potentially
dangerous.
 Sir Cyril Chantler, Lancet 1999
The Solution:
Electronic Medical Networks
What is needed in health
care are pioneers in
using the computer to
make a real difference
No other option offers
anything with
comparable potential for
either quality
improvement or value
Core Functions for
Electronic Medical Networks
Exploit data, turn it into information and
extract the value
Produce knowledge from a world of
partial, confused and unstructured
information
Transfer the right information into the
hands of the right person at the right
moment
Objectives
Develop a strong infrastructure and
support services which facilitate clinical
care, education and research
Target specific areas
• Imaging
• TeleHealth
• Bioinformatics
Promote professional development of
faculty and technical personnel
CLINICAL:
Why Physicians Participate in Internet2
Extend the provision of better healthcare
• TeleHealth (eHealth)
• Develop Clinical Skills and Assessment
Distributed data sharing
•
•
•
•
Electronic Health Record
Presence and Integrated Communications (VoIP, RFID)
Advanced visualization Computer Assisted Surgery
Computer Aided Diagnosis
Collaboration independent of boundaries
• Geography
• Time
• Cognition: Knowledge Management
Educators:
Why Faculty Participate in Internet2
Rich resources from student endpoints to
centralized powerful computation and large storage
Students absorb multiple channels of information
Dynamic
charts
Second
screen
lecture
Communal
note taking
messaging
Slide courtesy:
Parvati Dev, Stanford University
RESEARCHERS:
Why Scientists Participate in Internet2
Internet2 doesn't only save time, it allows
interactivity in places where that was not possible
before. I'd call it a quantum leap, if I didn't know
that physics defines that as the smallest change a
system is capable of... Timothy Poston, Bangladesh
Health Science Grand Challenge
<Person-----Organ-----Tissue-----Cell-----Protein-----Atom>
(1m)
(10-3m)
(10-6m)
(10-9m)
(10-12m)
(10-15m)
Courtesy: Peter Hunter, University of Auckland
The Wizard GAP:
Translational Research
Discipline
Community
CS, Math,
CSE
Network of Research
CS, Math,
CSE
Discipline
Community
Slide courtesy Chris Johnson, SCI
NIH Roadmap:
http://nihroadmap.nih.gov/
What are today’s most pressing
scientific challenges?
What are the roadblocks to
progress and what must be done
to overcome them?
Which efforts are beyond the
mandate of one or a few…but
are the responsibility of (NIH as)
a whole?
E. Zerhouni, M.D.
Director, National Institutes of Health
NIH Roadmap:
Implementation Themes
New Pathways to Discovery
• National Technology Centers
• Bioinformatics
• Nanotechnology
Research Teams of the Future
Reengineering the Clinical
Research Enterprise
• Integration/Interoperability
• Clinical Trials
• Translational Research
Cyberinfrastructure
Definition
Medical content focus/driver
High bandwidth
Inter-institutional connectivity via Internet2
Uniformly consistent security model
Grid computing
Distributed (federated) file management and
computational services
Performance and resiliency for databases
Integrated visualization and analysis tools
What is Internet2?
Pathway to Progress:
The Patient
CUDI and Internet2 Translational research
collaborations
• Scientific discovery
• Product development
• Clinical trials
What should be done for patients
• Access to services
• Efficiencies of production
• Improve quality of care
Core Functions for
Electronic Medical Networks
Support ongoing and
future management
decisions
Broadband electronic
communication and
connectivity
Population health
monitoring and
reporting
Its not about Technology!
*From 6 Competencies ( ACGME)
Knowledge
Acquisition
Active
Learning
(technology scouting)
(didactic and procedural)
Community
(systems based practiceProduction Services)
Project Based
Learning
& Improvement
(Demonstrations)
Integrated
Systems
Approach
Interpersonal
Communication
(knowledge transfer)
Professionalism
Translational Research
Electronic Health
Records
• Quality Heathcare for
PATIENTS
• Access to use and
interpret data
• Computational
functionality
• Engineering infrastructure
to support system
distribution
• Deployment of scalable
technology choices
Electronic Medical
Networks
• Quality Heathcare for
PATIENTS
• Access to use and
interpret data
• Computational
functionality
• Engineering infrastructure
to support system
distribution
• Deployment of scalable
technology choices
More Information
 On the Web
• www.internet2.edu
• Health.internet2.edu
 Email
•
•
•
•
•
info@internet2.edu
Ana Preston
Apreston@internet2.edu
Mary Kratz
Mkratz@internet2.edu
Research Team of the Future:
Cancer Biomedical Informatics Grid
Global Cancer
Research
Community
Grid deployment
to Cancer Centers
Bioinformatics
infrastructure
Funded by: NCI/NIH
http://cabig.nci.nih.gov/
David States, MD, PhD
Public data
sources
ONCOMINE
 Cancer Microarray Database
containing close to 50 million
datapoints
 Data mining tools to efficiently query
genes and datasets of interest
 Meta-analyze groups of studies
http://141.214.6.14:8080/Array1/
Funded by: Univ of Michigan Pathology, Pew Scholars Program,
American Cancer Society, and V Foundation
Arul M. Chinnaiyan, MD, PhD
Remote, Real-time Simulation for Teaching
Human Anatomy and Surgery
 Demonstrate remote, real-time
teaching of human anatomy
and surgery
 Deliver real-time simulation
and visualization technologies
 Network-based architecture
allows for multiple highresolution stereo-graphic
displays and haptic devices
Stanford University
School of
Medicine
Stanford, CA
Surgical Planning
Pipelines for
Morphometric Analysis
Surgical Planning
Interoperative
segmentation
Brain atlas
fMRI
Funded by NCRR/NIH
Ron Kikinis, M.D., Steve Pieper, Ph.D., Simon Warfield, Ph.D.
Brigham and Women’s Hospital, Harvard Medical School
Telemammography:
National Digital Mammography
Archive
 Storage and retrieval of complete clinical
record
• Mammographic images
• Radiology images (DICOM)
• Pathology reports and related patient information




Standard formats using standard protocols
Multi-layered security
Input and retrieval from multiple locations
Measurement Criteria: Saving lives!
University of Pennsylvania, Philadelphia, PA
Y12 National Security Complex in Oak Ridge, Oak Ridge,
TN
University of Chicago, Chicago, IL
University of North Carolina at Chapel Hill, Chapel Hill,
Center for Biologic
Nanotechnology
Bring together the multiple
disciplines to develop
nanotechnology from
conception to human
trials.
Nanotechnology will
impact communications,
information storage,
materials sciences and
other non-biologic
http://nano.med.umich.edu/
applications offering
Funded by: NIH, DOE, NSF, DARPA
limitless opportunities for
James Baker, MD
miniaturization.