Leveraging the Electronic Health Record for Clinical Research

John P. Glaser, PhDVice President and CIO

Partners HealthCare

July 21, 2008

A Vision for Personalized Medicine

EMRwith clinical

decision support

Genomic research

with high capacity IT

Integratedgenomic and

phenotypic data repository

Facilitated translational

research leading to

• Diagnostic discovery

•Drug development

Improvedindividualized

medicine&

pre / postsymptomatic

disease management

Consent Tracking System (CTS)

Research Patient Data Registry (RPDR)

Enterprise LIMS Superstructure (GIGPAD / PowerPath)

Genomic Knowledge Base (GeneInsight)

Genomic Variant Interpretation Engine (GVIE)

EnterpriseTissue Banking Infrastructure

Electronic Health Record (EHR)

Clinical Decision Support Rules Engine

Shared Pathology

Information Network (SPIN)

ClinicalResearch

I2B2(HIVE / RelNet /

Pharmacologic Surveillance)

Computational Cluster and Storage Resources

Partners Personalized Medicine Infrastructure

i2b2 Hive

Can SSRI Response be Predicted?

Costs of “High Throughput” Clinical Research

Post Market Medication Surveillance

Brownstein, PLoS ONE, 2007

Patient Genetic Profile

GMRGenetic Markers

State Mgmt.Genetic Assessments

Clinician Systems Enterprise Service Bus

Genetics Reference & Authoring Svcs.

Genetics Runtime Services Patient Genome Browser

CPOE

Decision Support

CDRGenetic Test Reports

LMR

Fully Genetics Enabled EHR Architecture

PEARGenetic-based Drug Allergies

Data Access

Assessment Engine

Knowledge Access

Bus. RulesMgmt. Sys.

Event/Workflow Engine

GeneInsight

Ensemble

VariantWire

Result Receiver

PEPRFamily History, Genetic-based Problems

GVIE

Master Order CatalogGenetic Test Coverage

PatientData

Warehouse

To Pt Data Warehouse

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

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