National Institute of Biomedical Imaging and Bioengineering A Case for Data Sharing Belinda Seto, Ph.D. Deputy Director National Institute of Biomedical Imaging and Bioengineering

Case Study Healthy 62 year-old woman with no history of smoking, drinking or drug abuse experienced abdominal pain. Believed it was an ulcer and treated with medication. Her symptoms got worse and were accompanied by a 15 lb weight loss. Sent to a community radiology clinic for an abdominal CT scan. Scan revealed a mass in the pancreas and others in the liver.

Case Study (con’t) Sent home with a CD of the image and was referred to a hospital for further evaluation. Physicians at the hospital were not able to read the CD. Returned to the radiology clinic, provided another CD. Returned to the hospital and this time the CD was readable.

Case Study Issues: Transmission and sharing of patient image data between the clinic and the hospital Clinical decision support in health information system Optimizing procedure ordering

Questions What role does health information exchange play in this patient’s care? How might image data sharing be implemented? Broadly, how might clinical decision support systems improve health care value?

Data Sharing to Support Better Decisions

President Obama’s Health IT Vision A secure, nationwide, interoperable health information infrastructure that will connect providers, consumers, and others involved in supporting health and healthcare

Nationwide Health Information Network Improve coordination of care across providers Ensure that consumers’ health information is secure and confidential Enable consumers control and decision making Reduce risks from medical errors Enable evidence-based decision support systems Lower health care costs

Image Data Sharing: NIBIB Activities Contract awarded to Radiological Society of North America: Image Sharing Network, PI: Dr. David Mendelson Grant awarded to Wake Forest University Grant awarded to University of Alabama

Wake Forest Project Develop a patient controlled platform for medical image sharing Test a model using electronic keys to access data Integrate image data with electronic health records Include imaging facilities in rural and urban southeast U.S.

Alabama Project Establish regional health image exchange system among hospitals in Alabama Design a web accessible point for physicians and patients to view images Adopt standards of National Health Information networks, 2007 Initially focusing on trauma patients Scalable

Health Information Technology: Integration is the Key

Health Information Technology (HIT): the Means toward Better Care “HIT is not the end itself but a means to improving quality of health care”, Dr. David Blumenthal Data is the fuel that drives HIT

Decision Support in Health Information Systems Patient data needs to be integrated and assessed to provide real-time, point-of-care information regarding the right care Improves clinical decision support with enriched data Develop algorithms to use comparative effectiveness findings to optimize outcomes

Comparative Effectiveness Research Purpose: to improve health outcomes by providing evidenced-based information to patients and providers Mandate: to conduct study of outcomes and to derive conclusions to inform medical choices/decisions.