Leveraging the Electronic Health Record for Clinical Research

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Leveraging the Electronic Health Record for
Clinical Research

• John P. Glaser, PhD
• Vice President and CIO
• Partners HealthCare
• July 21, 2008

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A Vision for Personalized Medicine
EMR with clinical decision support

• Facilitated translational research leading to
• Diagnostic discovery
• Drug development

Improved individualized medicine pre /
post symptomatic disease management
Integrated genomic and phenotypic data repository
Genomic research with high capacity IT
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Partners Personalized Medicine Infrastructure
Clinical
Research
I2B2(HIVE / RelNet /Pharmacologic Surveillance)
Clinical Decision Support Rules Engine
Shared Pathology Information Network (SPIN)
Computational Cluster and Storage Resources
Electronic Health Record (EHR)
EnterpriseTissue Banking Infrastructure
Genomic Variant Interpretation Engine (GVIE)
Consent Tracking System (CTS)
Genomic Knowledge Base (GeneInsight)
Enterprise LIMS Superstructure (GIGPAD /
PowerPath)
Research Patient Data Registry (RPDR)
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i2b2 Hive
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Can SSRI Response be Predicted?
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Costs of High Throughput Clinical Research
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Post Market Medication Surveillance
Brownstein, PLoS ONE, 2007
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Fully Genetics Enabled EHR Architecture
Clinician Systems
Enterprise Service Bus
Decision Support
LMR
Event/Workflow Engine
Patient Data Warehouse
CPOE
Genetics Runtime Services
Patient Genome Browser
Data Access
Assessment Engine
Knowledge Access
Result Receiver
Master Order Catalog Genetic Test Coverage
Patient Genetic Profile
Genetics Reference Authoring Svcs.
PEPR Family History, Genetic-based Problems
GVIE
PEAR Genetic-based Drug Allergies
Bus. Rules Mgmt. Sys.
Gene Insight
Ensemble
CDR Genetic Test Reports
VariantWire
State Mgmt. Genetic Assessments
To Pt Data Warehouse
GMR Genetic Markers
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Organization

• Harvard Partners Center for Genetics and Genomics
• Scientific leadership
• Laboratory operations
• Initiated with 50M Harvard Medical
  School/Partners commitment
• Informatics for Integrating Biology and the
  Bedside
• Medical informatics and bioinformatics core
• 20M/5 Year NIH funding
• Partners Information Systems
• Software development
• Research Patient Data Registry
• 5M annual operating budget
• Industry sponsorship
• HP
• Affymetrix

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Governance

• HPCGG
• Scientific Director reports to the Dean, HMS and
  CEO, Partners
• External Advisory Board
• Information Technology
• Quarterly meeting with Partners CEO, VP
  Academic Affairs, and CEO, Physician Network
• Bi-monthly IT operations meeting