(written by John Shreve)
April 1, 2014
- Dennis Domer (KU)
- John Shreve (KU)
- Russell Waitman (KUMC)
- George Chronis (Proactive Sense)
- Greg Corpier (Telecare Global)
- Katie Boyer (Telecare Global)
- Marjorie Skubic (MU)
1) Dennis, John and Marjorie met Russ Waitman, KUMC Director of Medical Informatics, in his office at the KUMC campus, where Russ provided an overview of a $7 million project that they were awarded in January: an exciting translational research contract with the new Patient-Centered Outcomes Research Institute (PCORI).
2) Russ explained that they are part of the new national network for patient-centered outcomes research, and that the network of ten Midwestern universities is coordinated out of KUMC. A press release describing the project details and participants may be found at: http://www.kumc.edu/news-listing-page/pcori-grant-awards.html.
3) PCORI is supporting the development of PCORnet, the National Patient-Centered Clinical Research Network, to create a large, highly representative, national network for conducting clinical outcomes research. The PCORI website provides a good overview and details of the initiative, at: http://www.pcornet.org/.
4) As described in a recent article (http://www.nejm.org/doi/full/10.1056/NEJMp1313061) , PCORI has established distinctive pathways for funding and conducting practical research and a solid foundation of funded studies. The PCORI board of governors has adopted three strategic goals to meet its mandate under the Affordable Care Act. These goals are to increase the quantity, quality, and timeliness of usable, trustworthy comparative research information; to accelerate the implementation and use of research evidence; and to exert influence on research funded by others to make it more patient-centered and useful.
5) During the meeting, Russ explained a high-level organization of the project, and also demonstrated its powerful capabilities by testing a number of queries and scenarios with the input of Dennis, John, and Marjorie.
6) Relating their experience with Cerner to the PCORI project, Marjorie expressed some challenges that MU is facing with Cerner, in their management of electronic health records (EHRs); for more info on this program, see: http://www.tiger-institute.org/ and http://medicine.missouri.edu/news/0166.php. A particular concern is the difficulty in persuading Cerner to provide the raw data to MU so that it may be utilized for various research applications. Marjorie also raised the issue of incorporating nursing/doctor notes (and “natural language processing”) as another way of harvesting data and information. Russ agreed that this is a good supplement to the informatics approach, but also commented that it does not always “cross-reference to discrete spots” with EHR data.
7) Russ mentioned that Children’s Mercy Hospital in Kansas City has also developed a similar agreement with Cerner and is facing similar issues that Marjorie mentioned, and expects to have more definitive feedback on the program later in the summer.
8) Russ also pointed out that while Cerner (http://www.cerner.com/) dominates the community sites for health care data software, Epic tends to dominate academic sites (http://www.epic.com/). He also explained two other important informatics sources: i2b2 is an NIH-funded center that has developed a scalable informatics framework (https://www.i2b2.org/), while the Healthcare Enterprise Repository for Ontological Narration (HERON) integrates clinical and biomedical data for translational research (https://informatics.kumc.edu/work/wiki/HERON).
9) Russ’ project began in March of this year, with an 18-month timeframe, so he and his colleagues are working at a rapid pace to achieve their goals and plan for a potential second phase. In addition to the impressive informatics platform that they are working on, the team is also investigating several interesting avenues for developing the network, including the ability for cheap cloud computing services via Amazon Web Services (http://aws.amazon.com/), and also sponsoring alternative approaches such as the recent “Greater Plains Collaborative Hackathon” (http://frontiersresearch.org/frontiers/sites/default/files/frontiers/documents/GPCHackathonFeb242014v2.pdf).
10) One area of inquiry that appears promising for relevance to the I-70 Network on Aging was the possibility of introducing more in-depth geospatial data with the clinical/billing data from the PCORI database. Occupational therapy criteria do give an indication of certain physical qualities of patients’ household and socio-economic status, derived from census data. With much of this information de-identified to protect resident privacy, the information was relatively general in nature. An architecture-based research project could leverage much of the PCORI system that Russ and his team are developing, and may also lead to valuable insights that connect patient outcome with a variety of environmental characteristics. Dennis and John agreed to follow up separately with Russ on this topic.