north locality spoke stakeholder event professor t.n. arvanitis - 29/11/2013 how to innovate in...

North Locality Spoke Stakeholder EventProfessor T.N. Arvanitis - 29/11/2013

How to innovate in healthcare through digital technologies and informatics

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Theodoros N. Arvanitis, RT, DPhil, CEng, MIET, MIEEE, AMIA, FSIM, FRSM

Professor of e-Health InnovationInstitute of Digital Healthcare, WMG, University of Warwick

Birmingham Children’s Hospital NHS Foundation Trust


Digital Healthcare

• Digital healthcare is the application of appropriate digital technologies to the promotion of – wellbeing & prevention; – management of disease; – and delivery of health services that are

effective, efficient and of high quality

• Challenges– Healthcare is the slowest adopter of

digital technology– Big Data is coming – West Mids

population 5.6m.– Fragmented landscape: many

standalone digital applications from academia, industry, NHS

– Need for interoperability– Need for translation and adoption

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WM AHSN Digital Work Streams

• On-line Healthcare and Clinical Delivery– real and tangible impact by delivering crucial on-line healthcare interventions

• Digital Innovation Management– an environment within which all innovations can be efficiently researched,

prototyped, invested in, evaluated, commercialised and distributed • Enabling Digital Communications

– leverage the skills and abilities of its various partners, customers and consumers at scale

• Enabling Technology and Informatics– local, national and international innovations

• Digital investment, Commercial and Wealth Management– ability to attract new finance for digital investment, as well as create innovative

partnerships

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Exemplars of healthcare innovation

• Two local exemplars with international impact

• Translating research knowledge to practice– TRANSFoRm

• Working with Big Data– Multimodal Imaging for Childhood Cancer Research and

Practice

• Institute of Digital Healthcare

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The Institute of Digital Healthcare

• A world-class £4M 5-year funded partnership between the NHS, WMG, WMS and other relevant organisations

• Aims: to improve people’s health and wellbeing through the use of innovative digital technologies and methodologies

• We do this through high quality research, education and training capabilities

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Our USP

WMG: Industry

engagement

WMS: Clinical

need and relevance

NHS: Reality check & ‘needs’

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IDH – innovation and research I

Biomedical & Health Informatics

Clinical & Public Health Knowledge

Clinical Trial Systems

Patient & Population DataDeri

ving New Knowledge & Measure Performance

Clinical Guidance & Decision Support Systems

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Brain imaging

Clinical Imaging methodology and trials

Neuro-imaging statistics

ModellingMeta-analysisfMRI clinical trials

In vivo metabolomics &

Functional Imaging

(childhood cancer, metabolic disease)

Neuro-degenerative disease

(epilepsy,

sleep disorders)

Human Brain Connectome

IDH – innovation and research II

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Healthcare Technologies

Biomedical Signal Processing

Visualisation, Modelling and simulation

Brain Electro-physiology (EEG) & BCI

Physiological Monitoring – Healthcare Sensors

IDH – innovation and research III

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eHealth Innovation

Apps & Social Media

Telehealth

Evaluation

Implementation

IDH – innovation and research IV

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Health Systems Engineering & Modelling

Care QualityService Delivery Improvements

Impact of Pathway Variation Analysis on Quality Threshold

Impact of Pathway Variation Analysis on Patient Care

Impact of Pathway Variation Analysis on cost: Hospital Operation

IDH – innovation and research V

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• Development of Clinical Trial Management Systems that provide, through an integrated infrastructure, a wide-ranging set of modular, interoperable and standards based tools designed to meet the needs of clinical trials

• Objectives of e-trials system implementation– To define a “computable” model representation that

supports the entire life-cycle of clinical trials protocol,

– To develop appropriate tools that use the model representation.

translating research into clinical practice

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Specific research

knowledge

Actionable knowledge

Routinely collected

knowledge

knowledge in healthcare

• Clinical trials• Controlled populations• Well-defined questions

• EHR systems• Wide coverage• Vast quantity• May lack in

detail and quality

• Distilled scientific findings

• Usable in clinical practice

• Decision support

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ePCRN and TRANSFoRm: US/UK perspective

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Informatics tower of Babel: the grand challenge

• Overwhelming volume of data• Multitude of sources • Each part of the health

community speaks its own scientific “dialect” (e.g. lab values, genetic profile, clinical data)

• Lack of consensus on common standards and terms

• Lack of coordination across, and collaboration within, the cancer research enterprise

• Integration is critical to achieve promise of molecular medicine (personalised medicine)

Slide courtesy of caBIG™

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TRANSFoRm Itegrated VS

• The TRANSFoRm Integrated Vocabulary Service is designed to allow end users to search and retrieve clinical vocabulary concepts and associated content – a web interface and a web service API– the service uses the LexEVS (version 5.1)

technology to access a backend UMLS vocabulary database

– the service uses direct Java Database Connectivity (JDBC) to access other vocabulary databases (e.g. Read Codes V2, ICPC2)

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RCD v2/ICPC2• Read Codes (RCDv2) and International

Classification of Primary Care (ICPC2) corpus of terms and their associated mappings– created to cater for the initial need of the

existence of specific primary care oriented terminologies.

• The UK NHS Connecting for Health Terminology Centre - mappings from Read Codes version 2 to SNOMED CT.

• The Read Codes v2 database in Transform VS is set up based on this mapping so that Read Codes 2 concepts can be linked to a UMLS search. Similar approach for ICPC2.

• ICPC2-ICD10 Thesaurus and mappings - Transition Project @ University of Amsterdam

• The TRANSFoRm team is updating the ICPC2-ICD 10 mapping and Thesaurus

• ICPC3: new initiative

UMLS Metathesaurus

Read Codes v2 Codes

SNOMED CT Codes

ICPC2 Codes

ICD-10 Thesaurus/Codes

UMLS Metathesaurus

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TRANSFoRm Integrated VS Server Architecture

TRANSFoRm Integrated VS Server

Query Service

Read Codes v2Database

Metro JAX-WS Web Service

LexEVS Runtime

GWTRPC Servlet

UMLS Database

Lucene IndexGWT Ajax Web

Client

Web Services Client

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A screenshot of the vocabulary service web-based interface

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Finding prevalent cases for trials

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acknowledgments: TRANSFoRm Consortium

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BIG Data: multi-modal imaging

Investigating children’s cancer using functional

imaging

Metabolite maps

Metabolite profiles Diffusion imaging

Tractography

Perfusion

Quantitative imaging

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Powerful Computation

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large data sets

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HR-MAS

NAA

Cho

Cr

mI Lip+Lac

w2 1H

w1

13C

1H-13C HSQC


agent-based classifiers

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acknowledgments: cancer research

• Investigators– Andrew Peet – UB PI, oncology,

MRS– Theo Arvanitis – UW bio-informatics– Richard Grundy – UN oncology,

biology– Martin Leach – ICR MR Physics,

perfusion– Chris Clark – ICH MR Physics,

diffusion– Franklyn Howe – StGUL MR

Physics, MRS

Collaborators• Professor Dr Dorothee Auer University of

Nottingham • Dr Thomas Barrick St George's Hospital Medical

School • Mr David Collins Royal Marsden Hospital • Dr Daniel Ford University Hospital Birmingham• Dr Darren Hargrave Royal Marsden Hospital• Mr Donald Macarthur Nottingham University

Hospitals NHS Trust • Dr Lesley MacPherson Birmingham Children’s

Hospital NHS Trust • Dr Paul Morgan University of Nottingham • Dr Kal Natarajan University Hospital

Birmingham• Dr Oystein Olsen Great Ormond Street Hospital• Dr Geoffrey S Payne The Institute of Cancer

Research • Professor Andy Pearson Royal Marsden

Hospital • Dr Sucheta Vaidya St George's Hospital Medical

School • Dr Tim Jaspan, University Hospital, Nottingham• Dr Dawn, Saunders, Great Ormond Street

Hospital

Research Group: Nigel Davies, Martin Wilson, Kal Natarajan, Yu Sun, Eleni Orphanidou, Lisa Harris, Greg Reynolds, Sim Gill, Alex Gibb, M. Saleh, Suchada Tantisatirapong, Ben Babourina-Brooks, Jan Novak

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Digital HealthcareEvaluate & generate evidence

Support innovation

research and innovation

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realising our imagination: facing challenges

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"Leave the beaten track occasionally and dive into the woods. Every time you do so, you will be certain to find something that you have never seen before. Follow it up, explore all around it, and before you know it, you will have something worth thinking about to occupy your mind. All really big discoveries are the result of thought."

Alexander Graham Bell: "electrical speech machine" of 1876

http://www.chatsubo.com/fitzgerald/bell/inventor.html


Thank you

[email protected]

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north locality spoke stakeholder event professor t.n. arvanitis - 29/11/2013 how to innovate in...

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