smart platform and api for clinical genomic apps gil alterovitz director, biomedical cybernetics...

SMART Platform and API for Clinical Genomic Apps

Gil AlterovitzDirector, Biomedical Cybernetics LaboratoryAssistant Professor, Harvard Medical School

100 Most Influential People of the Millennium

1 Johann Gutenberg (mass media- movable type) 2 Isaac Newton (gravity) 3 Martin Luther (Protestant Reformation) 4 Charles Darwin (evolutionist writer) 5 William Shakespeare (Renaissance playwright) 6 Christopher Columbus (explorer) 7 Karl Marx (19th c. political writer) 8 Albert Einstein (physicist) 9 Nicolaus Copernicus (astronomy) 10 Galileo Galilei (astronomy)

Movable type

• Allows for large populations to be able to absorb knowledge via books, newspapers, etc.

Vendor-specific apps: calendar, calculator, etc.

Apps did not work with other systems and did not evolve much over time.

No long-tail/custom applications- e.g. family history app

Independent apps

Developer and user community is engaged

Long-tail apps available

Plug does not fit

Issues in Communicating Genetic Information

• No simple standard API (Application Programming Interface)

• Contents are essentially the sameo Sequences (ATGC..) and genetic files

• But, data are structured differently

• Different approaches of authentication

SMART Provides a Solution

• Substitutability Medical Applications Reuseable Technology

• Simple design of APIo Geared toward developers and users

• Integration with clinical data

What is SMART? • Substitutable Medical Apps Reusable

Technology

• Accelerate medical application innovation and research

• Develop medical app community

• Remove developer roadblocks

Substitutability = Re-Use

SMART - AMIA 2012 - 04Nov2012

Got Statins?

CardiacRisk

BP Centiles

SMART-EnabledPCHR

SMART-EnabledEMR

SMART-EnabledHIE

Substitutable Apps Needs

SMART - AMIA 2012 - 04Nov2012

APIResource oriented, everything a URL

Data ModelContext (container, user, patient)Medical (problems, allergies, …)

AuthenticationConsistent delegation, web standards (OAuth)

UIStandards-based integration (HTML5)

Platform

App

SMART-Enabling i2b2

SMART - AMIA 2012 - 04Nov2012

Ontology

SMARTCell

MapperCell

i2b2 Hive

CRC

AnySMART

App

Patient-Centric View App

Add: SMART cellMapper cellPatient-Centric

View app

Cerner EMR

SMART - AMIA 2012 - 04Nov2012

Boston Children’s Hospital

16 Months

SMART Genomics API

• Enables integration of genomic data from heterogeneous sources

• Enables integration of clinical and genomic data

• Re-usability eliminates developer barriers

• Promotes the use of genetic data for research

SMART Genomics Platform

SMART Genomics Advisor App Integration 24Oct2012

Top-Level Genomics Advisor Displays

Pop-Up→

SMART Genomics Advisor App Integration 24Oct2012

Genomics Advisor: Detailed Pop-Up

SMART - AMIA 2012 - 04Nov2012

Example App: Dbear SMART EMRProblem: High cost of chronic disease management

and issues with long-term patient compliance in

diabetes, especially in pediatric cases.

Solution: Increase compliance by integrating toy

bear from Sproutel with SMART EMR for physicians

and to provide parent/child feedback.

Details: Integrated bear with the Telecare glucose

meter / pump technology to provide clinical data to

SMART EMR

* Provides kids with a “fun” way to measure glucose

and take insulin. Provide live data for

clinicians/patients to view.

* Interactive bear avatar gives feedback to patients.

* Engages patients to increases their likelihood to

comply with their diabetes treatment.

iPad Apps

DB EMRFirst program to integrate genomic, device, EMR/Personal Health Record information.

First program to integrate patient, patient devices (e.g. bear/glucose meter), care giver, and physician data into a unified view to facilitate collaboration on patient care.

First mobile app to integrate genomics/sequence information and clinical information.

Genomics Advisor

• Another app using the SMART API

• Gives analysis based on genetics