Internet2 Health Sciences Networking Title Slide Indian Health Service Michael McGill, Ph.D. January 11, 2007

The scope of the Internet2 Health Science Initiative includes medical and related biological research, education, and advances in clinical practice. In January 2000 (with the new millennium) Internet2 launched its first domain activity in the Health Sciences. As is typical for academic medical centers the Internet2 Health Science initiative focuses on the “three legged stool” of clinical care, research and education.

Key Health Science Members 112 Academic Medical Colleges (AAMC) and their medical centers 130 Health Science related colleges Public Health, Nursing, Dentistry, Pharmacy Affiliate Members NIH, NSF, NASA, NOAA Howard Hughes Medical Institute Pharmaceutical Companies Johnson & Johnson, Pfizer, Eli Lilly Industry Prous Science, Cisco, IBM, Microsoft, SUN, Polycom, Haivision Partnership with Health Information Management Systems Society (HIMSS) Cross-section of Academic Medical Centers with the Internet2 membership topography. Ford Motor Company story; spending more on health costs than the materials to build cars. Thank you to the UAW and the fact that the population increasingly is living longer.

More than a backbone… It’s the system! Applications Middleware Network Security Policy Community is key

Why Physicians/ Pharmacists Participate in Internet2 Clinical: Why Physicians/ Pharmacists Participate in Internet2 Distributed data sharing Electronic Health Record National Health Initiatives (ONCHIT) Remote and Assisted Surgery Remote Instrumentation Real time access to remote images Collaboration independent of boundaries Geography: Second Opinion Networks Time: Learning Technology (Distance Education) Computation: Knowledge Management Center of Excellence New techniques and procedures Surgical Planning Digital Anatomy Applied clinical research, making clinical services available to a national and international footprint. The key here is that there is money for those that are doing things in new ways. There is a potential for doing things differently and more efficiently that will allow better quality or save $$.

Remote Pathology Consult Using DVTS (Digital Video Transport System) at 30 Mbps, Multicast Pathology faculty across four regional hospitals can conduct regular virtual consults with superior high quality images and minimal delay in transmitted slide manipulation Dr. Michael Feldman, UPENN

Center for Surgical Innovation Courtesy: HaiVision

Clinical Network requirements Quality of Service Capacity Reliability Minimal / No Congestion Capacity Then --- Security and Privacy Plus -- Services that make it easier

Map of Upper and Core Middleware Land

Why Scientists Participate in Internet2 Research: Why Scientists Participate in Internet2 Need for continually increasing bandwidth to support the increasingly finer resolution of data resources To address policy issues such as the security and privacy requirements that must be met for the use of information that originates with or about a patient To remove roadblocks as they confront the increasing need to collaborate across political (including state and federal government), academic, defense and security, and commercial boundaries

Biotech Data's BIG BANG It's like Moore's Law on steroids: The total volume of biological data worldwide, having doubled every 18 months in recent years, is now doubling every half a year to three months. And this isn't a momentary spike, but a long-term trend that may require new ways to measure, analyze and mine biological databases. Chappell Brown EE Times (04/25/2005)

Health Science’s Grand Challenge     <Person-----Organ-----Tissue-----Cell-----Protein-----Atom> (1m) (10-3m) (10-6m) (10-9m) (10-12m) (10-15m)     Systems models Continuum models (PDEs) ODEs Stochastic models Pathway models Gene networks     From the NIH Roadmap: In the human body, all biological components—from individual genes to entire organs—work together to promote normal development and sustain health. This amazing feat of biological teamwork is made possible by an array of intricate and interconnected pathways that facilitate communication among genes, molecules and cells. While some of these biological pathways already have been discovered, many more remain to be found. Further research is also needed to understand how these pathways are integrated in humans and other complex organisms, as well as to determine how disturbances in these pathways may lead to disease and what might be done to restore disturbed pathways to their normal functions. What generally follows in the Internet2 presentation is then examples of applications at each level in this graphic. Would love to have examples from NCRR funded research! Following that is the tie to inter-disciplinary importance, which is the lead into cyberinfrastructure and the NSF report. Courtesy: Peter Hunter, University of Auckland

Comparisons must be made across several image sets EACH BRAIN REPRESENTS A LOT OF DATA So, let’s take a moment for a simple business justification for why Internet2 capacity of required. This is from the Neurology collaboratory of the Biomedical Informatics Research Network (BIRN) project. Where is this? It is a national collaboratory. Coordination Center is at UCSD, but 20 sites all over the nation. This slide is from Arthur Toga’s work out of UCLA. Added UCLA to the slide. I put the BIRN geography for sites on the next slide. A brain is 1500 cubic cm in volume Chart reveals that one mm sections generates 15 MB of data (this is today’s MRI or CT) Current technologies of fMRI can provide 10 micron voxel slices, generating 3-5 Terabytes of data Current research is generating fMRI images at 1 micron voxel slices, generating 3-5 Petabytes of data! Doing the math: 4.5 MB = 0.8 seconds to download brain image at MM voxel over Internet2 4.5 TB = 4.5 PB Comparisons must be made across several image sets Slide courtesy of Arthur Toga (UCLA)

Research Team of the Future: Cancer Biomedical Informatics Grid Global Cancer Research Community Grid deployment to Cancer Centers Bioinformatics infrastructure Public data sources Funded by: NCI/NIH http://cabig.nci.nih.gov/

Why Faculty Participate in Internet2 Education: Why Faculty Participate in Internet2 Increasingly specialized information Access to expertise at remote locations Multiple learning modalities Access to resources not otherwise available Dynamic charts Second screen lecture Communal note taking messaging Slide courtesy: Parvati Dev, Stanford University

Some specialties disappearing

The Vision (tenants) Health is a discipline comprised of: Research Education Clinical Care Patients deserve the best care we can afford Advanced communications technologies have proven their ability to allow change processes and cultures

Vision for the Health Community A ubiquitous national health network Integrating regional or sub-networks Strategically managed by the Health Community Interconnected with Research and Education

Options for achieving the vision Dedicated Resource (Lambda) Secure, Reliable, Expensive Dedicated portion of a Resource (sub-Lambda) Not as secure, Reliable, Not as expensive MPLS Tunnel Less Secure, Reliable, Least Expensive

The Real Challenge Policies and Regulations Culture and Trust Benefits Credibility

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