Last October Peter Embi, M.D., M.S., announced he was leaving his post as interim chair of the Department of Biomedical Informatics and associate dean for research informatics at Ohio State University to become the new president and chief executive officer of the Regenstrief Institute Inc. The Indianapolis-based nonprofit organization is dedicated to improving healthcare through innovations and research in biomedical informatics, health services, and aging. This week Healthcare Informatics spoke to Dr. Embi about his new role.
Regenstrief has a strong reputation in informatics research. Tell me a little more about its history and some things that drew you to your new position there?
Embi: Regenstrief has been in existence for more than 30 years and is affiliated with Indiana University (IU). Investigators are all faculty at IU, mostly in the school of medicine, but also in public health, informatics and other schools. We have more than 200 employees. The Institute did groundbreaking work in what we now think of as electronic medical record solutions, standards and decision support.
Over the years, we have added to our expertise in the areas of health services research, aging research and implementation science. Now it is a really robust institute with three centers and programs focused fundamentally on how do we improve healthcare by leveraging IT and best practice approaches and evaluation of systems to re-engineer the healthcare enterprise to keep people healthier. It was an opportunity was one I couldn’t pass up.
Your predecessor, Bill Tierney, M.D., left to become chair of population health for the Dell Medical School at The University of Texas at Austin? Those are big shoes to fill, aren’t they?
Embi: Absolutely huge shoes to fill. It is an honor to have this position because I am following in the footsteps of giants — people I have looked up to my entire career. And we are doing what we do because of the work of people like Bill Tierney, Clem McDonald and Tom Inui and the other previous leaders of this organization. I have already spoken to Bill several times and have bent his ear. He left to pursue another opportunity in Austin, but still has great affection for this place and still does work with folks here.
Is a big part of your job deciding where to focus resources? Are there areas of research that are becoming more important such as precision medicine or genomics?
Initially I have been getting the lay of the land and understanding what our strengths are. I knew what a lot of those strengths were already, but one of the things I am learning about is not just the great expertise within the institute, but also the opportunities that exist at IU, IUPUI, Purdue and around Indianapolis with our affiliated health systems. We have relationships with the VA; Eskanazi Health, which is a longtime partner of Regenstrief; and IU Health, which is tightly connected to IU and is one of the largest health systems in the country.
In fact, besides being president and CEO of Regenstrief, I also hold the position of vice president for learning health systems at IU Health. They want to leverage health information technology and new processes and approaches to be able to take better care of people. We also have a very tight partnership with the Indiana Health Information Exchange, which evolved from the Regenstrief Institute into what it is — the premier health information exchange in the country. So we have an unparalleled set of data and relationships that allow us to do impactful work.
In addition, IU has made a big investment in precision health. A portion of that requires bringing more precise and impactful information to the right person at the right place at the right time based on molecular and personal information and their phenotype. That kind of work is something Regenstrief is going to be very directly involved in and it will inform our recruitment going forward. Part of my job is to work across our departments to do recruiting in a number of areas, including precision health, data science and areas in population health that we need to grow into.
We have interviewed Regenstrief’s Brian Dixon about leveraging the HIE to enable secondary use of clinical and administrative data to improve public health surveillance.
Embi: Yes, Brian and other faculty members in the school of public health have been doing fantastic work at looking at different types of data. The opportunity moving forward is to not just look at the data we have in the healthcare system and how we can use that to better take care of patients, but also there are emerging data sets that have great potential. Only a tiny fraction of the information relevant to a person’s health is in our databases. There are genomic elements, but beyond that there is increasingly a lot of environmental information, information about people’s fitness, that we really don’t know. How do you make sense of that and integrate it with the rest of the information about somebody and help them be healthier and keep them out of the hospital in the first place.
You mentioned that Indiana has had a strong statewide HIE for many years. Is there a strong culture of collaboration about health IT in Indiana that you don’t see in other states or did they just get started earlier?
Embi: I do get the sense there is a strong sense of collaboration. I don't know if I can put my finger on what led to that here, except that some of it was being early. The IHIE and a lot of the health IT that is now implemented either came from Regenstrief or was informed by work done here. There is a long history of really impactful leaders that have continued to build this out, so we have a robust environment here. I see Regenstrief as a continuing innovator and that is going to lead to innovations that make their way out into the world, perhaps in the form of new companies.
Hasn’t Regenstrief been involved in global health and the dissemination of EHRs in developing countries?
Embi: Absolutely. Some very impactful work is being done by people like Burke Mamlin and Paul Biondich. They and others are actively working on systems such as open source medical records and open source HIEs used to care for populations in parts of Africa and Asia. They get support from the likes of the Gates Foundation…..The population health lessons learned from that research is often applicable to what we need to do in some of our own communities in the United States — whether it is how to apply new decision support or some other technology developed to assist with care. A lot of the standards work is applicable across the space as well. Contributions are bidirectional there.
As if you were not busy enough already, you were also named chair-elect of the board of directors of AMIA. What are some things you want to work on in that role?
I have served on the board and know AMIA pretty well, but now I get to act as more as an apprentice under the current chair, Tom Payne. That is the way they designed this chair-elect position, which is great because I get a year to learn more about the chair’s role. I will be involved in questions of policy. I will be thinking about how we can position AMIA to influence the improvements needed in the healthcare system. That involves continuing to advocate for systematic learning and research and how to continue the work on how to make the practice of medicine more effective, efficient and less cumbersome for the users of the systems.
Has anything surprised you in your first few weeks on the job?
Embi: I think the pleasant surprise is how many real opportunities there are for more collaboration and connection and how many resources there are beyond Regenstrief. For instance, the Regenstrief Foundation also supports a center for healthcare engineering at Purdue. We are excited about collaborating even more with them. There is so much untapped potential in terms of what we can bring to the healthcare environment and the providers in the region, including pharmaceutical companies and technology vendors. There is just a lot of exciting growth happening in Indianapolis that I think we are going to be able to participate in.