While wonderful new medical discoveries and innovations are in the news every day, doctors struggle daily with using information and techniques available right now while carefully adopting new concepts and treatments. As a practicing doctor, I deal with uncertainties and unanswered clinical questions all the time….At the moment, a report from the National Academy of Medicine tells us, most doctors base most of their everyday decisions on guidelines from (sometimes biased) expert opinions or small clinical trials. It would be better if they were from multicenter, large, randomized controlled studies, with tightly controlled conditions ensuring the results are as reliable as possible. However, those are expensive and difficult to perform, and even then often exclude a number of important patient groups on the basis of age, disease and sociological factors.
Part of the problem is that health records are traditionally kept on paper, making them hard to analyze en masse. As a result, most of what medical professionals might have learned from experiences was lost – or at least was inaccessible to another doctor meeting with a similar patient.
A digital system would collect and store as much clinical data as possible from as many patients as possible. It could then use information from the past – such as blood pressure, blood sugar levels, heart rate and other measurements of patients’ body functions – to guide future doctors to the best diagnosis and treatment of similar patients.
Industrial giants such as Google, IBM, SAP and Hewlett-Packard have also recognized the potential for this kind of approach, and are now working on how to leverage population data for the precise medical care of individuals.
Collaborating on data and medicine
At the Laboratory of Computational Physiology at the Massachusetts Institute of Technology, we have begun to collect large amounts of detailed patient data in the Medical Information Mart in Intensive Care (MIMIC). It is a database containing information from 60,000 patient admissions to the intensive care units of the Beth Israel Deaconess Medical Center, a Boston teaching hospital affiliated with Harvard Medical School. The data in MIMIC has been meticulously scoured so individual patients cannot be recognized, and is freely shared online with the research community.
But the database itself is not enough. We bring together front-line clinicians (such as nurses, pharmacists and doctors) to identify questions they want to investigate, and data scientists to conduct the appropriate analyses of the MIMIC records. This gives caregivers and patients the best individualized treatment options in the absence of a randomized controlled trial.
Bringing data analysis to the world
At the same time we are working to bring these data-enabled systems to assist with medical decisions to countries with limited health care resources, where research is considered an expensive luxury. Often these countries have few or no medical records – even on paper – to analyze. We can help them collect health data digitally, creating the potential to significantly improve medical care for their populations.
This task is the focus of Sana, a collection of technical, medical and community experts from across the globe that is also based in our group at MIT. Sana has designed a digital health information system specifically for use by health providers and patients in rural and underserved areas.
At its core is an open-source system that uses cellphones – common even in poor and rural nations – to collect, transmit and store all sorts of medical data. It can handle not only basic patient data such as height and weight, but also photos and X-rays, ultrasound videos, and electrical signals from a patient’s brain (EEG) and heart (ECG).
Partnering with universities and health organizations, Sana organizes training sessions (which we call “bootcamps”) and collaborative workshops (called “hackathons”) to connect nurses, doctors and community health workers at the front lines of care with technology experts in or near their communities. In 2015, we held bootcamps and hackathons in Colombia, Uganda, Greece and Mexico. The bootcamps teach students in technical fields like computer science and engineering how to design and develop health apps that can run on cellphones. Immediately following the bootcamp, the medical providers join the group and the hackathon begins…At the end of the day, though, the purpose is not the apps….(More)