Yes. Institutions are now accepting that data are some of their most valuable assets, and the use and misuse and protection of data can make or break an academic medical center. So institutions are working hard to put together programs—governance programs, analytics programs, data warehousing—that are needed. And these will be needed in ways that doesn’t exist in most places. For example, we’re building out our governance structure to make sure the data being used are the best data possible. I’m leading those efforts, because I have a background in understanding what data governance is. The other physicians involved are very smart and experienced, but don do not have the background or formal training in biomedical informatics. Having this kind of formal training can really help a lot.
Another good example is the way people see research data: if you’re collecting data for a research study and have no background in how to collect data and store it, you can find out at the end that you should have done things differently.
Is this the first program of its kind in the country?
There are programs already established elsewhere. There’s a page on the AMIA [American Medical Informatics Association] website that shows the accredited programs, and we’re aggressively going to pursue accreditation. But there are a number of programs nationwide.
What core elements are common to these programs?
Most programs will focus on the core curriculum, as defined by AMIA, including information on electronic medical records (EMRs), and how the EMR requires integration, interoperability, and governance. Also important are issues of meaningful use and other governmental regulations. And someone headed towards a CMIO career will need a healthy dose of understanding how those systems work. The backgrounds of the students are diverse. You might have someone coming in who works for Epic but has very little clinical experience—so trying to teach them what happens on rounds might not be that easy. Likewise, someone coming from a clinical background—a cardiologists, for instance—may have had little or no information technology background. So we’re trying to “level the playing field” by offering the right kinds of courses and “boot camps.” In addition, we’re requiring a formal computer programming course to give our students a solid background in coding.
So a part of this involves taking clinicians and teaching them some core informatics skills, correct?
We are enrolling both clinicians and those with backgrounds in statistics and computer programming. One needs to be careful about the how clinical scenarios are presented, so that the technical students can follow along. But by exposing both groups to technology and clinical practice, we’ll create a next generation of people skilled in both things.
Hybridizing people, then?
Yes, and some organizations have created two tracks; we’re trying to get everybody on the same page to start with.
What developments on both the research and patient care sides do you want to help people prepare for?
Great question. The collection of the data is really becoming commoditized. There’s more data than ever before. The key in the next ten years will be understanding how to use and apply data. You can now have a genomic panel test to see which drugs are likely to be more effective for a patient or you might be able to learn about how quickly a patient may metabolize a drug. So, that’s one extremely important, active area, and I’d be surprised if clinicians aren’t soon offering genomic panel testing done in conjunction with the delivery of your routine medical care. The real explosion right now is in cancer genomics. It’s very common to have a tumor biopsy sent for panel testing. The thing is, we’re great at sequencing tumors and quite good at the analysis of those data (lining up the sequence data and understanding where the variations are), but you can get those results, and then a pathologist needs to come up with a set of recommendations that will help the patient.
There is so much rich information now, and trying to link these variations in the genome to prognosis and patient care is key. For example, a little boy I take care of has a desmoid tumor, and we got a lot of information back from that sequencing. The choice was difficult, then, because there were plenty of drugs you could apply to the situation, but the actual data about which drugs will be effective is still missing. Additionally, we’re using sequencing information to help learn what drives the development of tumors. So until we get enough evidence on which drugs would help, it’s still very empiric on how to personalize the treatment. Our group just developed a suite of software tools to aid molecular pathologists in generating their findings and reports. This platform allows our pathologists to record their findings and then propagate those data forward to subsequent reports, where appropriate. This will facilitate another level of study, whereby we can learn about the effects of mutations over entire populations.
Have you developed the full curriculum?
Yes, we’ve fleshed out the core curriculum and the courses, and we’re securing the instructors. Here’s a link. We’re also trying to build some courses that leverage specific strengths of the University of Chicago, such as ethics and legal issues in biomedical informatics.
What should our audience understand about where all of this is headed?
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