The CCC co-sponsored and co-organized the Discovery and Innovation in Health IT Workshop in San Francisco on October 29 and 30, 2009 (http://cra.org/ccc/visioning/visioning-activities/2012-activities/health-it/ ).

The Discovery and Innovation in Health IT Workshop was an attempt to make further inroads on productive collaboration between healthcare and computing, exploring and defining fundamental computing research challenges and opportunities in healthcare IT in both the near- and long-term and identifying a range of “model” proof-of-concept, integrative systems that might serve as motivating and unifying forces to drive fundamental research in healthcare IT.

Highlights of the workshop included plenary presentations by William Stead of Vanderbilt and Richard Bucholz of St. Louis University School of Medicine. Stead  argued that the “increasing complexity and amounts of biomedical information will overwhelm individual experts, leading to the need to move beyond expert-based medicine.”   (For more information see: Beyond Expert-based Practice, William W. Stead, M.D., and John M. Starmer, M.D.  http://courses.mbl.edu/mi/2009/pubs/Fall_Stead_Expert.pdf )

Bucholz, who is a computationally-savvy neurosurgeon and inventor of the StealthStation, a neurosurgical navigational system, described linking the cutting edge (literally) of neurosurgery and computing to create integrated realtime intra-operative delivery of information via navigational systems, images, 3D visualizations, EEG and other information sources.

Chris was particularly interested in the biomedical aspects of the workshop.  He says:
Healthcare and biomedical research have become increasingly intertwined with computing.  The status, goals, and impediments for 21st century biomedicine were well summarized in the 2004 NIH Roadmap. The Roadmap noted that computing has become absolutely essential to progress in biomedicine, stating:  “The success of computational biology is shown by the fact that computation has become integral and critical to modern biomedical research.”

However, the report also noted that both the substantial and substantive challenges biomedical researchers face in embracing and applying cutting-edge computing research, as well as those faced by computing researchers in understanding current and future biomedical computing needs, have inhibited biomedical research:  “Because computation is integral to biomedical research, its deficiencies have become significant limiters on the rate of progress of biomedical research.”

The productive synergies between these two fields can accelerate research in both, but only if we address these challenges through cooperative effort.  The agencies and the communities, in other words, must work together to enhance frontier or cutting edge research at the interface.  The Discovery and Innovation in Health IT Workshop was an attempt to make further inroads on productive collaboration between healthcare and computing, exploring and defining fundamental computing research challenges and opportunities in healthcare IT in both the near- and long-term and identifying a range of “model” proof-of-concept, integrative systems that might serve as motivating and unifying forces to drive fundamental research in healthcare IT.

Let’s hope that the healthcare, biomedical, and computing research communities  take this as a further opportunity to  overcome current roadblocks by moving across traditional disciplinary boundaries and truly engage computing and biomedical researchers.

Beth’s take-away was somewhat different.  She says:

I also attended the Discovery and Innovation in Health IT Workshop.  With so many obvious shortcomings in the current healthcare system, it is tempting to focus on near-term challenges.  In fact the discussions in the press and on Capitol Hill orient to current inefficiencies in the healthcare system as well as the poor health outcomes that stem from misaligned incentives.

However this workshop allowed space for the discussion of long term challenges that, when addressed, could also solve many short-term deficiencies.

As detailed in the NAS report, “Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions,” (http://www.nap.edu/catalog.php?record_id=12572) current health IT is deployed as a transactional system instead of supporting workflow, decision making and collaboration.  Furthermore the practice of healthcare is dramatically shifting along a number of dimensions including:

• the overwhelming cost and impact of chronic disease (e.g. diabetes, heart disease, obesity)
• the abundance of information that is available but not utilized by health care practitioners (sensor data, research reports, population data)
• the advent of new diagnostic techniques, based on genomic data, that could enable disease diagnosis years before the disease is detectable by traditional means.

Many of the breakout groups at the workshop honed in on approaches for patient-centered care, chronic disease management and prevention, and distributed, collaborative care.  These approaches mirror the reality of healthcare now and for the foreseeable future.  They also call for deep and challenging computing research including:

• Ubiquitous computing technologies for chronic disease management, including technologies that enable behavior change
• Workflow and decision support systems that actively incorporate health outcome data
• Security and privacy models for distributed, patient-centered care
• Machine learning techniques to predict future health trends and treatment complications
• Organizational modeling and simulation to anticipate economic repercussions in future healthcare approaches

Contributed by Chris Johnson, Director of the Scientific Computing and Imaging Institute, University of Utah (www.sci.utah.edu) and Beth Mynatt, CCC Member and Director, GVU Center at Georgia Tech (www.gvu.gatech.edu)