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

2. 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.

3. 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.

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

5. 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 $$.

6. 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

7. Center for Surgical Innovation
Courtesy: HaiVision

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

9. Map of Upper and Core Middleware Land

10. 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

11. 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)

12. 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

13. 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)

14. 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

15. 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

16. Some specialties disappearing

17. 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

18. 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

19. 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

20. The Real Challenge
Policies and Regulations
Culture and Trust
Benefits
Credibility

21. End Slide