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Harvard Catalyst SHRINE

Harvard Catalyst SHRINE. October 13, 2010. Douglas MacFadden & Andrew McMurry catalyst.harvard.edu cbmi.med.harvard.edu

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Harvard Catalyst SHRINE

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  1. Harvard Catalyst SHRINE October 13, 2010 Douglas MacFadden & Andrew McMurry catalyst.harvard.edu cbmi.med.harvard.edu Created with the support of Harvard Catalyst | The Harvard Clinical and Translational Science Center (NIH Grant #1 UL1 RR 025758-01 and financial contributions from Harvard University and participating academic health care centers).

  2. Foundational Work • I2b2 - Clinical Data Repository • Zak Kohane, Shawn Murphy et al. • Turning everyday clinical encounters into huge research cohorts • Star-schema database with associated ontology • JavaScript Web Client (Griffin Weber) • SPIN - cross hospital query model • Andy McMurry et al. • Federated query of autonomous/independent hospitals • Abstract away the differences of each data repository enabling on the fly query translation

  3. Harvard Catalyst SHRINE Objective • Query Clinical Data Across Multiple Harvard Teaching Hospitals • Increase Data Set Size • Demonstrate Cooperation Across Competing Institutions • Develop Data Sharing Infrastructure

  4. Architecture

  5. I2b2 features leveraged for SHRINE Webclient, Project Management, Ontology, Data Repository

  6. I2b2 features leveraged for SHRINE:Webclient • Webclient speaks to the broadcaster aggregator as if it were another i2b2 Clinical Data Repository • Minor enhancements to support additional auditing/monitoring of SHRINE queries • Griffin Weber, Nicholas Benik

  7. I2b2 features leveraged for SHRINE:Project Management Cell • Authenticate local investigators • Pointers to “Cells in the Hive” • Location for the Ontology • Location of the Data Repository • URLs for all i2b2 cells

  8. I2b2 features leveraged for SHRINE:Ontology Cell Handles deep “nested” hierarchies like Diagnoses\Neoplasms\Cancer of breast • Demographics • Age • Gender - HL7 Administrative Gender • Language - ISO 639-1 • Marital Status - HL7 Marital Status • Religion - HL7 Religious Affiliation • Race and Ethnicity - CDC Race & Ethnicity Code Sets • Diagnoses - ICD-9-CM and CCS hierarchy • Medications - RxNorm and NDF-RT hierarchy • Lab Tests (demo) - LOINC

  9. I2b2 features leveraged for SHRINE:Data Repository Cell • Star Schema design concurrently supports multiple ontologies (local ontology and SHRINE ontology) • SHRINE works with CRC v1.3 and v1.4 • Use your existing i2b2 deployment, no code or data changes required! • Shawn Murphy et al.

  10. Challenges • Organizational • Informatics • Usability

  11. Challenges: Organizational • Ground rules: contribute data to play, all users must “belong” to participating institutions • Regulatory Buy In • Management Buy In • Controls • Query Topics • User Agreement • Audit Trails • Consequences for Bad Behavior

  12. Challenges: Informatics • Implement Local Data Warehouse and ETL from Operational Systems • Server/Network security • Design and Development of Core Ontology • Perform Local Mapping to Core Ontology • Implementation of Network and Systems at each Site • Implement Required Controls • Prevent Re-identification

  13. Challenges: Usability • Ease of Access • Easy Query Creation • Understanding of Query Results • Understanding the Limitations of Data Coding from Operational Systems

  14. Phase 1 • 6MPatients • 1B Facts • 4 Ontology Categories, 18K Terms • 10K Potential Users • 4 IRBs • 4 major competing hospitals, 3 sites • Partners Health Care (BWH, MGH) • Children’s Hospital Boston • Beth Israel Deaconess Medical Center

  15. SHRINE queries(Actual Patient Counts) • Comorbidity of Breast and Cervical Cancers • Acute Myocardial Infarction with Gender Breakdown • Pediatric Rhematoid Arthritis (rare) • Countless more secondary uses of electronic medical records…

  16. Where We Are Today • Now: • Second Round of Beta Test • 1.7 + Saved Query • Expanding to include Dana Farber • Plan: • SHRINE 2.0 – Limited Data Sets • Opportunity: • Regional and National Networks

  17. Regional and National Networks • Agree to a common policy/understanding for all sites • Implement i2b2 platform & SHRINE technology • Develop local Ontology mappings • Implement network security infrastructure • Join the network

  18. The Team • Zak Kohane (SHRINE PI / HMS) • Alexa McCray (CBMI Director / HMS) • Andrew McMurry (Architect / SPIN / HMS) • Bill Simon (Informatics/ HMS) • Charles McGow (Informatics / Children’s) • David Hardwick (Quality Assurance / HMS) • Doug MacFadden (Informatics / CBMI Informatics Director / HMS) • Griffin Weber (Informatics / HMS CTO / BIDMC) • Joanna Brownstein (Project Manager /HMS) • John Orechia (Informatics / DFCI) • Mike Mendis (Informatics / i2b2 / Partners) • Nich Wattanasin (Informatics / i2b2 / Partners) • Phillip Trevvett (Ontology / HMS) • Shawn Murphy (Informatics / i2b2 / Partners) • Susanne Churchill (Regulatory / i2b2 Executive Director / Partners)

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