What if a cure for cancer already exists, but it is buried on a hard drive in a research lab?
Every year, drug companies test untold thousands of new compounds, clinicians turn up intriguing clues from patient tests, and investigators reveal novel targets to attack disease. “But that data needs to be analyzed, and the quantity of it is overwhelming,” says Jonas Almeida, Ph.D., director of UAB’s new Division of Informatics. The division was formed in 2011 to develop new methods to extract meaning from research findings—and give clinicians access to new tools for care.
In July 2012, the UAB team launched a first-of-its-kind medical app known as ImageJS. The program runs in an ordinary Internet browser, which means that it can be used anywhere and won’t be blocked by hospital security software. "We created a new kind of computational tool that promises to make patient data more useful where it's collected,” Almeida says. (Learn more about ImageJS in this story from UAB News and download a copy in the Google Chrome Web Store.)
In its first iteration, ImageJS allows pathologists to drag laboratory slides into the browser to get a quick analysis of cancer cell growth. New modules are already in the works that let the software tackle other tasks, and Almeida says he hopes clinicians will adapt the code to expand its capabilities still further. The lessons learned developing this app have since inspired an ongoing initiative in the Division of Informatics for data mining of the Cancer Genome Atlas, he adds. This NIH public repository of patient and tumor data has generated over 300,000 data files, a number that doubles approximately every seven months.
Preparing for the Digital Health Boom
Advances in technology and new statistical techniques could help researchers connect the dots that lead to new medical breakthroughs. They could also help doctors make the right diagnosis in tough cases, track unexpected drug reactions in certain groups of patients, and even allow patients themselves to track their health records and treatment progress through something as simple as a smartphone app. (See “Future Health.”)
Within five to 10 years, each of these innovations could be in regular use, benefiting patients and creating thousands of jobs, says Eta S. Berner, Ed.D., director of the new Center for Health Informatics for Patient Safety/Quality in the Department of Health Services Administration at the UAB School of Health Professions.
UAB is a leader in training health informatics professionals, Berner says. “UAB was one of five sites to develop a national curriculum for training students in health information technology” that is now in use in more than 60 countries, she explains. Berner teaches in UAB’s Master of Science in Health Informatics Program, which prepares graduates for senior- and executive-level roles in the health-care information technology industry. The program has been in existence for over twenty years, Berner says, but it is continually evolving to meet the rapid changes in the health IT field.
Health informatics “is not just computers or programming or statistics,” Berner says. “You have to have the clinical knowledge of what practicing health-care workers need, and how to design software in a way that people will use it. You also need to know how to motivate people to use it in the first place.”
Of Games and Health Care
Almeida, who is training doctoral and postdoctoral students in informatics within the Department of Pathology, says the specialty attracts people “who believe that medicine isn’t just body fluids and broken bones—they see medicine as an information-rich environment.”
Some students come from a medical background, Almeida says, but others come from business, computer science, and statistics. The best kinds of students are ones with both a broad curiosity and the ability to intensely focus on an area of research for a long time, he adds.
The field is underpopulated, but a new generation of students is perfectly placed to take advantage of its opportunities, Almeida says. “They come from the Nintendo and Xbox world” of online gaming, he explains. “They are already used to playing collaboratively and digitally, and they understand it makes sense to do the same thing for the practice of medicine.”
“Health care and information technology are two of the fastest-growing fields in the job market,” adds Berner. “When you put them together, you open up an awful lot of opportunities.”
—Written by Tara Hulen
A Preview of Personalized Medicine
By Eta S. Berner, Ed.D.
A patient comes to her primary-care doctor with a new problem. The doctor pulls up the patient’s electronic chart so that he can review the patient’s past history, and the notes and prescriptions from any specialists the patient has seen.
The system immediately reminds the doctor that the patient needs to get her annual mammogram, so he tells the patient to go online when she gets home and schedule the appointment at a convenient time for her.
The doctor makes a diagnosis, doing a quick check on a diagnostic-decision support system to make sure he has considered all the patient’s information properly, and then uses the system to write electronic prescriptions for two medications so that they will be ready for the patient when she arrives at her local pharmacy. But when the first prescription is entered, the system says the patient is currently taking medications that will interact and cause problems with one he is prescribing. In response, the doctor changes the prescription. When he enters the second prescription, the system alerts him that patients who have a particular genomic marker will respond badly to the drug he prescribed—and the patient has that marker. The system suggests an alternative, which the doctor prescribes.
This scenario involves a wide range of systems, including electronic health records, health information exchange with the other specialists, clinical decision support in the form of reminders for preventive screening tests, self-service scheduling applications for patients, and e-prescribing with clinical decision support. Behind this software are the genetics and bioinformatics research on biomarkers and research on medication outcomes that involves analyzing the clinical and genomic data of large numbers of patients (facilitated by being available electronically), coupled with clinical-decision support that uses that knowledge at the point of care.
It will still be several years before these advances are in widespread use, but all of the different applications are available today.