Challenges of ultra large scale integration of biomedical computing systems

The NCRI Informatics Initiative is overseeing the implementation of an informatics framework for the UK cancer research community. The framework advocates an integrated multidisciplinary method of working between scientific and medical communities. Key to this process is community adoption of high quality acquisition, storage, sharing and integration of diverse data elements to improve knowledge of the causes, prevention and treatment of cancer. The integration of the complex data and meta-data used by these multiple communities is a significant challenge and there are technical, resource-based and sociological issues to be addressed. In this paper we review progress aimed at establishing the framework and outline key challenges in ultra large scale integration of biomedical computing systems

Health informatics domain knowledge analysis: An information technology perspective

Health Informatics is an intersection of information technology, several disciplines of medicine and health care. It sits at the common frontiers of health care services including patient centric, processes driven and procedural centric care. From the information technology perspective it can be viewed as computer application in medical and/or health processes for delivering better health care solutions. In spite of the exaggerated hype, this field is having a major impact in health care solutions, in particular health care deliveries, decision making, medical devices and allied health care industries. It also affords enormous research opportunities for new methodological development. Despite the obvious connections between Medical Informatics, Nursing Informatics and Health Informatics, most of the methodologies and approaches used in Health Informatics have so far originated from health system management, care aspects and medical diagnostic. This paper explores reasoning for domain knowledge analysis that would establish Health Informatics as a domain and recognised as an intellectual discipline in its own right

Reinforcement machine learning for predictive analytics in smart cities

The digitization of our lives cause a shift in the data production as well as in the required data management. Numerous nodes are capable of producing huge volumes of data in our everyday activities. Sensors, personal smart devices as well as the Internet of Things (IoT) paradigm lead to a vast infrastructure that covers all the aspects of activities in modern societies. In the most of the cases, the critical issue for public authorities (usually, local, like municipalities) is the efficient management of data towards the support of novel services. The reason is that analytics provided on top of the collected data could help in the delivery of new applications that will facilitate citizens’ lives. However, the provision of analytics demands intelligent techniques for the underlying data management. The most known technique is the separation of huge volumes of data into a number of parts and their parallel management to limit the required time for the delivery of analytics. Afterwards, analytics requests in the form of queries could be realized and derive the necessary knowledge for supporting intelligent applications. In this paper, we define the concept of a Query Controller ( QC ) that receives queries for analytics and assigns each of them to a processor placed in front of each data partition. We discuss an intelligent process for query assignments that adopts Machine Learning (ML). We adopt two learning schemes, i.e., Reinforcement Learning (RL) and clustering. We report on the comparison of the two schemes and elaborate on their combination. Our aim is to provide an efficient framework to support the decision making of the QC that should swiftly select the appropriate processor for each query. We provide mathematical formulations for the discussed problem and present simulation results. Through a comprehensive experimental evaluation, we reveal the advantages of the proposed models and describe the outcomes results while comparing them with a deterministic framework

Outlook Magazine, Summer 2018

https://digitalcommons.wustl.edu/outlook/1204/thumbnail.jp

Patient Access to Electronic Health Records: Strengths, weaknesses and what’s needed to move forward

Electronic health records (EHRs) are desired by both physicians and patients, but the transition to and acceptance of sensitive health information online has been slow. This paper reviews the current literature on EHR adoption and outlines barriers, advantages and explicit steps for moving toward the EHR ubiquity. Potential benefits of EHRs to patients and physicians include reduced costs for patients, hospitals and insurance providers, patient empowerment, less errors in records and better health outcomes, but security and privacy concerns, cost of implementation and poor electronic records management system design have proved barriers to adoption

Towards an interoperable healthcare information infrastructure - working from the bottom up

Historically, the healthcare system has not made effective use of information technology. On the face of things, it would seem to provide a natural and richly varied domain in which to target benefit from IT solutions. But history shows that it is one of the most difficult domains in which to bring them to fruition. This paper provides an overview of the changing context and information requirements of healthcare that help to explain these characteristics.First and foremost, the disciplines and professions that healthcare encompasses have immense complexity and diversity to deal with, in structuring knowledge about what medicine and healthcare are, how they function, and what differentiates good practice and good performance. The need to maintain macro-economic stability of the health service, faced with this and many other uncertainties, means that management bottom lines predominate over choices and decisions that have to be made within everyday individual patient services. Individual practice and care, the bedrock of healthcare, is, for this and other reasons, more and more subject to professional and managerial control and regulation.One characteristic of organisations shown to be good at making effective use of IT is their capacity to devolve decisions within the organisation to where they can be best made, for the purpose of meeting their customers' needs. IT should, in this context, contribute as an enabler and not as an enforcer of good information services. The information infrastructure must work effectively, both top down and bottom up, to accommodate these countervailing pressures. This issue is explored in the context of infrastructure to support electronic health records.Because of the diverse and changing requirements of the huge healthcare sector, and the need to sustain health records over many decades, standardised systems must concentrate on doing the easier things well and as simply as possible, while accommodating immense diversity of requirements and practice. The manner in which the healthcare information infrastructure can be formulated and implemented to meet useful practical goals is explored, in the context of two case studies of research in CHIME at UCL and their user communities.Healthcare has severe problems both as a provider of information and as a purchaser of information systems. This has an impact on both its customer and its supplier relationships. Healthcare needs to become a better purchaser, more aware and realistic about what technology can and cannot do and where research is needed. Industry needs a greater awareness of the complexity of the healthcare domain, and the subtle ways in which information is part of the basic contract between healthcare professionals and patients, and the trust and understanding that must exist between them. It is an ideal domain for deeper collaboration between academic institutions and industry

Increasing the Capacity of Primary Care Through Enabling Technology.

Primary care is the foundation of effective and high-quality health care. The role of primary care clinicians has expanded to encompass coordination of care across multiple providers and management of more patients with complex conditions. Enabling technology has the potential to expand the capacity for primary care clinicians to provide integrated, accessible care that channels expertise to the patient and brings specialty consultations into the primary care clinic. Furthermore, technology offers opportunities to engage patients in advancing their health through improved communication and enhanced self-management of chronic conditions. This paper describes enabling technologies in four domains (the body, the home, the community, and the primary care clinic) that can support the critical role primary care clinicians play in the health care system. It also identifies challenges to incorporating these technologies into primary care clinics, care processes, and workflow