Yearb Med Inform 2017; 26(01): 96-102
DOI: 10.15265/IY-2017-020
Section 3: Clinical Information Systems
Survey
Georg Thieme Verlag KG Stuttgart

Grappling with the Future Use of Big Data for Translational Medicine and Clinical Care

S. Murphy1, 2, 4, V. Castro2, K. Mandl3, 4
  • 1Massachusetts General Hospital Laboratory of Computer Science, Boston, MA, USA
  • 2Partners Healthcare Research Information Science and Computing, Somerville, MA, USA
  • 3Boston Children’s Hospital Computational Health Informatics Program, Boston, MA, USA
  • 4Harvard Medical School Department of Biomedical Informatics, Boston, MA, USA
Further Information

Publication History

Publication Date:
11 September 2017 (online)

Summary

Objectives: Although patients may have a wealth of imaging, genomic, monitoring, and personal device data, it has yet to be fully integrated into clinical care.

Methods: We identify three reasons for the lack of integration. The first is that “Big Data” is poorly managed by most Electronic Medical Record Systems (EMRS). The data is mostly available on “cloud-native” platforms that are outside the scope of most EMRs, and even checking if such data is available on a patient often must be done outside the EMRS. The second reason is that extracting features from the Big Data that are relevant to healthcare often requires complex machine learning algorithms, such as determining if a genomic variant is protein-altering. The third reason is that applications that present Big Data need to be modified constantly to reflect the current state of knowledge, such as instructing when to order a new set of genomic tests. In some cases, applications need to be updated nightly.

Results: A new architecture for EMRS is evolving which could unite Big Data, machine learning, and clinical care through a microservice-based architecture which can host applications focused on quite specific aspects of clinical care, such as managing cancer immunotherapy.

Conclusion: Informatics innovation, medical research, and clinical care go hand in hand as we look to infuse science-based practice into healthcare. Innovative methods will lead to a new ecosystem of applications (Apps) interacting with healthcare providers to fulfill a promise that is still to be determined.