医疗保健中的大数据

2014.12.29.SeongBeomCho,M.D.,Ph.D.DivisionofBiomedicalInformaticsNationalInstituteofHealth,KCDCBigDatainHealthcare•What’sbigdata?•BigData&Healthcare•BigData&Genomics&MedicineTableofContents•BigData?–Volume,Variety,Velocity–“largevolumesofhighvelocity,complex,andvariabledatathatrequireadvancedtechniquesandtechnologiestoenablethecapture,storage,distribution,managementandanalysisoftheinformation”(U.S.congressreport,2012)•BigDatainhealthcares–Volume:Xbytes?–Variety:sensors,imaging,tests(includinggenetictests)–Velocity:real-timestreamingdata(ex.ICU)–Veracity?•BigDatainGenomics–Highthroughputgenomicdata(wholegenomesequencingdata)Whatisbigdata?•Whybigdatainhealthcareindustry?–About$165~300Billionsavings!Forwhat?•Potentialbenefits–Detectingdiseasesatearlierstages–Managingspecificindividualandpopulationhealthand–Detectinghealthcarefraudmorequicklyandefficiently.•Anotherpotentials–Patientswhowillchooseelectivesurgery–Patientswholikelywillnotbenefitfromsurger–Patientsatriskformedicalcomplications–Patientsatriskforsepsis,MRSA,C.difficile,orotherhospital-acquiredillness;illness/diseaseprogression;–Patientsatriskforadvancementindiseasestates–Causalfactorsofillness/diseaseprogression–Possiblecomorbidconditions(EMCConsulting).Forwhat?•Requiredtechnologiesforbigdata(&diseasemanagementsystem)BigDataAnalytics&TechnologiesBigDataAnalytics&Technologies•What’srelated?BigData&DiseaseManagement•What’srelated?BigData&DiseaseManagement•Bigdatainaction!BigData&DiseaseManagement•PredictionofreadmissionduetoCHFBigData&DiseaseManagementBigDataAnalyticsExamples•ColumbiaUniversityMedicalCenter–Totreatcomplicationsproactivelyratherthanreactivelyforbrain-injuredpatients.–48hoursearlierthantraditionalmethodsinpatientswithableedingstrokefromarupturedbrainaneurysm.–real-timedatastreamsandpersistentdatafrompatientswithbleedingstrokes•Detecthiddenpatternsthatindicatedthelikelihoodofcomplications.BigData&MedicalDevicesMobilecomputingbasedtelecardiologyBigdata&MedicalDevicesAglobalECGandimagecloudservicefortele-consultation,research,andeducationBigData&MedicalDevicesCloudwave:DistributedProcessingof“BigData”fromElectro-physiologicalRecordingsforEpilepsyClinicalResearchUsingHadoopBigData&MedicalDevicesBigData&MedicalDevices•STRIDEBigData&DiseaseInformationSystemSTRIDE–AnIntegratedStandards-BasedTranslationalResearchInformaticsPlatformBigData&DiseaseInformationSystem•STRIDEexampleBigData&DiseaseInformationSystem•Expectwhat?BigData&Genomics&Medicine•Wholegenomesequencing&predictionBigData&Genomics&Medicine•Wholegenomesequencing&predictionBigData&Genomics&Medicine•Wholegenomesequencing&predictionBigData&Genomics&Medicine•PersonalomicsprofilingexampleBigData&Genomics&Medicine•eMERGEnetworkBigData&Genomics&Medicine•eMERGEnetworkBigData&Genomics&Medicine•What’sgoingon?BigData&Genomics&Medicine•Challenges&potentialsolutions–Limitedevidenceandconflictinginterpretationofbenefit/value–Lackofinstitutionalandclinicianacceptance–Limitedaccesstogenomicmedicineexpertiseandtesting–Lackofstandardsforgenomicapplications–EMRintegrationofgenomicresultsandclinicaldecisionsupport–Follow-upofgenotypedpatients–Outreachtoat-riskfamilymembers–Consent–Understandingbypatients,clinicians,public–Lackofaccesstocomparison“control”sequencedataandbankingresources–LackofresearchfundingandreimbursementBigData&Genomics&MedicineImplementationroadmapforgenomicmedicineThankYou!