Titus Schleyer, DMD, PhD

on biomedical informatics and health information technology

Tag Archives: Indiana University

Help us improve healthcare … by joining the Regenstrief Team!

IMG_20130618_080807As some of you may know, the Regenstrief Center for Biomedical Informatics (CBMI) is recruiting for several faculty positions. I thought the new year might be a nice moment to tell you about the top 10 reasons to work at CBMI – and maybe get you or a colleague/friend of yours to check us out ;-). Even if you yourself are not interested in a faculty position here, maybe you know someone who would be. If so, please tell them about it!

  1. Improving healthcare is our heritage … and our future. Many people are familiar with the Regenstrief name in the context of informatics, but few are aware of our original roots in manufacturing. Sam Regenstrief, colloquially named the “Dishwasher King,” at one point produced 40 percent of the world’s Eskenazi Hospitaldishwashers. He got there through rigorous application of operations management and process improvement principles. One day, he had to go to (what was then) Marion County General Hospital (now Eskenazi Health) for a physical. What he saw in the crowded waiting room and elsewhere sparked the idea for the Regenstrief Foundation, which he endowed a short time later. Its mission: “to bring to the practice of medicine the most modern scientific advances from engineering, business, and the social sciences, and to foster the rapid dissemination into medical practice of the new knowledge created by research.” The Regenstrief Institute has stayed true to this mission since its founding. The CBMI supports this mission primarily through informatics and information technology research and development.
  2. We apply and evaluate informatics interventions in real-world settings. At CBMI, informatics is not just theory. We continually apply it in the real world. A strong and enduring (nearly half a century) partnership with Eskenazi Health has produced a long string of seminal advances in health information technology. In addition, our work with the Department of Veterans Affairs Medical Center, and four large integrated delivery networks with multiple hospitals and ambulatory care settings provide access to real-world clinical environments for conceiving, implementing and evaluating informatics solutions.
  3. Jeff Warvel and Gopher retirement partyRegenstrief offers a unique set of informatics resources. Here is a partial list of our core informatics assets and competencies:
    • the country’s largest health information exchange: The Indiana Network for Patient Care (INPC), established in 1995,  includes clinical data from over 90 hospitals, public health departments, local laboratories and imaging centers, and a few large-group practices. It is used by approx. 7,000 clinicians daily and carries over 4.7 billion pieces of clinical data for over 14.7 million unique patients.
    • The (new) Gopher: Built upon Regenstrief’s legendary Medical Gopher system, the new Gopher is a comprehensive computer-based physician order entry system. Designed by clinicians for clinicians, it is a platform for not only clinical data entry and management, but also for clinical decision support, electronic data capture for research and visualization of clinical data.
    • CareWeb: CareWeb is a Web-based results retrieval and reporting tool for clinical data from the INPC. Central Indiana clinicians access this system on average 200,000 times a day.
    • Data epidemiology: Through our clinical data repositories, we have extensive experience with the capture, curation, storage and analysis of clinical data.  These data have been and are a central resource for prospective and retrospective research, including clinical and pharmaco- epidemiology studies.
    • Interested in additional informatics research and application projects? Check out our Website.
  4. We live and breathe innovation: Our faculty innovate broadly across a variety of healthcare disciplines and domains. But, we do not stop there. Regenstrief has an internal Quarterly Innovation Challenge, open to everyone, which has funded over 15 projects during the last two years. Many of these projects are initiated by staff and several are on track to become fully-scale research projects. In addition, Indiana itself is innovation- and entrepreneur-friendly. BioCrossroads is a catalyst for the continued growth of Indiana’s robust life sciences industry. Among its many activities, BioCrossroads informs and educates; raises and invests venture capital funds in promising new companies; and builds business collaborations by bridging gaps across academia and industry.
  5. Explore exciting new directions with us. One reason I assumed the position of director of the CBMI are the vast potential opportunities that exist at Regenstrief. For me, the top ones include:
    • integration of genomic, proteomic and related information with electronic health records: Some people say “CPOE is so 20th Century.” For me, it is one of the continuing challenges in informatics. Think about this: The information that clinicians must take into account to make clinical decisions is growing day by day. New results from genetic and other tests, detailed data about a patient’s medication compliance, exercise habits, health literacy and environmental factors, and local population health trends – where does it end? CPOE and clinical decision support will become even more crucial to helping clinicians make optimal decisions in the future.
    • consumer health and personal health records: With the Indiana Network for Patient Care, we have a huge resource of clinical data generated in healthcare settings. However, BMI_pagethere is a large and growing complement of patient- (or people-) related data. Patient-recorded activity/exercise data? Glucose and blood pressure readings? Standardized assessments of average daily living functions? Much of these data can be highly valuable in healthcare and integrating them with the INPC would be a powerful combination.
    • data analytics and visualization: Data analytics has been one of our “bread and butter” activities for the last several decades. However, I think we can accelerate and be more efficient in how we create knowledge from the large databases we are sitting on. My boss, Bill Tierney, always says: “We could write thousands of papers based on the INPC data.” I say: “Ok, let’s do it.”
    • implementation science: The Regenstrief Institute and IU School of Medicine recently established the Center for Innovation and Implementation Science (CIIS), an organization dedicated to the development of methods to promote the systematic uptake of research findings and other evidence-based interventions into routine practice. Informatics tools are a key intervention and the CBMI is working closely with the CIIS to bring about real change in how clinicians practice.
    • cognitive systems engineering/human computer interaction (HCI): Those of you who know me will not be surprised that I am making this area a focus. Much of my own research has been on HCI aspects of clinical systems in dentistry. And, I have seen firsthand where approaches such as user-centered design and cognitive systems engineering can take us in terms of usefulness and usability of systems.
  6. Join a world-class team of faculty, staff and fellows. Many of our approximately 18 faculty are leaders in their fields/research areas, such as computer-based decision support, computer-based physician order entry, drug safety informatics, clinical data analytics, automated patient record matching, informatics standards, public and global health informatics applications, and dental informatics. Our faculty have a variety of backgrounds, such as internal medicine, medical specialties, dentistry, physical therapy, statistics and computer science. Five of our faculty are members of the American College of Medical Informatics and two of the Institute of Medicine. Two of our faculty, Clem McDonald and Bill Tierney, have received the prestigious Morris F. Collen Award of Excellence from the American Medical Informatics Association. Our staff consists of a dynamic and enthusiastic group of software engineers, database developers, project managers and administrative assistants. Recently infused with engineering talent from a variety of industries, our team possesses expertise in healthcare informatics; contemporary Web architectures, user interface and user experience methodologies; system integration; clinical decision support; and big data storage and retrieval. CBMI typically has between two and four fellows enrolled in its training program.
  7. Regenstrief is connected to Indiana University’s vast computational and academic resources. I have worked at two major universities (Temple and Pitt) and I am happy to say that every time I upgraded my experience with information technology support in academia. At Indiana University (IU), I have topped my experience to date. IU University Information Technology Services is a national leader in IT support among major universities, earning it a Computerworld’s 100 Best Places to Work in IT award in 2010 and 2011. Not only does UITS serve the everyday computing needs of the campus, it also supports research in and application of high performance computing, advanced networking and the evolving international cyberinfrastructure. Digital textbooks, virtual software delivery, and innovative learning environments support IU’s mobile students. IU is also a global partner in creating sustainable models for the collaborative development of teaching, learning, research and enterprise software.carnival
  8. We are a fun family. A lot of faculty and staff have commented to me that they like working at CBMI “because it feels like family.” Having been here for six months now, I have become part of that family. One of the best aspects of Regenstrief is that the kind of chasm between faculty and staff that you usually find in academia doesn’t really exist. Faculty and staff interactions are characterized by mutual respect, many close working relationships, a plethora of ideas and an easy, continual exchange. Plus, we know how to have fun! In the second half of 2013 alone, we had the Regenstrief Carnival, the RIFresh Initiative (which is, among other things, designed to inject fun into the workplace) and a wonderful holiday party.
  9. Indianapolis is a great place to live. I have lived in quite a variety of places in my life, ranging from Wildflecken, a small village in the Rhön mountains in Bavaria, to the metropolis of Philadelphia. I always had been wondering about what it would be like to move to the Midwest given the various comments I heard about it. I IMG_20130615_093039have to say I love it here. Indianapolis is a very compact and understandable city. It has a variety of interesting neighborhoods, plenty of great restaurants (some of my favorites include Bluebeard, Chef Joseph’s, Iozzo’s Garden of Italy, Meridian and, of course, the Rathskeller‎) and great cultural attractions. It is easy to get around – the local joke (essentially true) is that it is takes only about 20 minutes to go from anywhere to anywhere in Indy (ok, slightly longer on a bicycle). Of the nine miles of my bicycle commute, seven are alongside a canal and the White River. And, most importantly, the people are friendly and welcoming. One of our neighbors gave us a few home-cooked meals when we were moving in, a very welcome gesture. Another set of neighbors had a welcoming party in our honor.
  10. Make a difference … : We all know that the healthcare system in the United States is in deep trouble. We also know that informatics and information technology are two key ingredients in turning the situation around. We are looking for a few people who want to make a real difference. And, Regenstrief is one of the places where you can do that best!

Interested? Take a look at http://bit.ly/RCBMI_Faculty, and then send me email or give me a call!

Titus


Titus Schleyer, DMD, PhD
Clem McDonald Professor of Biomedical Informatics
Director, Center for Biomedical Informatics
Regenstrief Institute, Inc., 410 West 10th Street, Suite 2000, Indianapolis, IN 46202-3012
Skype: titus.schleyer, Ph: (317) 423-5522 (direct), cell: (412) 638-3581, E-mail: schleyer (at) regenstrief.org
Web: http://www.regenstrief.org/cbmi/, Blog: https://titusschleyer.wordpress.com, General: http://about.me/titusschleyer

Informatics giant Clem McDonald honored with endowed chair in biomedical informatics

Yesterday, Indiana University School of Medicine and the Regenstrief Institute  held a ceremony establishing an endowed chair to honor Clement McDonald, M.D., a pioneer and innovator in the use of health information to improve patient care and outcomes.

Dr. McDonald, Distinguished Professor Emeritus and Regenstrief Professor Emeritus of Medical Informatics at the IU School of Medicine and former director of the Regenstrief Institute, is currently director of the National Library of Medicine’s Lister Hill Center for Biomedical Communications.

A distinguished clinician-researcher and one of the nation’s most accomplished experts in the field of electronic health record systems Dr. McDonald has inspired and trained scores of junior faculty and fellows at Regenstrief and IU. He developed the Regenstrief Medical Record System and for decades directed its use in clinical studies of innovations in medical informatics; many were conducted at Wishard-Eskenazi Health, one of the largest safety net public health care systems in the United States. This work has illuminated the ways in which electronic medical records can improve the quality and efficiency of patient care and its outcomes.

Schleyer McDonald Tierney at presentation of McDonald chair to it's first occupant Schleyer

Clem McDonald and Bill Tierney present endowed chair to its first occupant, Titus Schleyer

Today the Regenstrief Medical Record System is one of the longest continually operational electronic medical record systems in existence. Dr. McDonald also created the Indiana Network for Patient Care for the largest and most comprehensive regional health information exchange in the country, involving more than 90 hospital systems in Indiana and more than 19,000 physicians.

Dr. McDonald is also an internationally recognized pioneer in the development of health data standards. He is the developer of Logical Observation Identifiers, Names, Codes, an identification system for tests and results that is a clinical data standard used across the nation and around the globe. A member of the Institute of Medicine, Dr. McDonald is a recipient of the President’s Medal for Excellence from IU, the highest honor an IU president can bestow.

I have the good fortune and high honor to have been named the first Clem McDonald Chair of Biomedical Informatics.  It is hard to put into words what this means to me. The following  is the text of my remarks at the ceremony:

“Dear collagues and friends,

Thank you very much for being here today. It means a lot to me.

So, what do you say when you are honored with the title ‘Clem McDonald Professorship of Biomedical Informatics?’ Well, my first reaction was to be speechless.

My second one was: ‘They must have made a mistake. They cannot possibly mean me.’ Eventually, I realized that they were serious about it and that is why we are all here today.

Of course, then the problem becomes to say something meaningful in response. So, this has become the shortest speech in my life about which I have deliberated for the longest time. I even wrote it down, which is something I never do.

To be honored with a named professorship is profoundly humbling. I consider this the most important achievement in my life to date. Actually, that is not quite correct. My most important achievement is having married my wife Alida. So, this is the most important achievement in my professional life.

Second, I see this honor not as much as a recognition for past accomplishments but a challenge for the future. In science, we are used to ‘standing on the shoulders of giants.’ The preceding remarks have driven home exactly what kind of giant Clem McDonald really is. So, the question becomes: How do we prove ourselves worthy of Clem’s legacy? The named professorship is not just an honor and challenge for me, it is one for all of us.

The Center for Biomedical Informatics is a storied institution with a rich history of accomplishments. That is good, but more is asked of us than to rest on our laurels.

McDonald Schleyer 7-8-13 handshake

Clem McDonald and Titus Schleyer

After I gave my Work in Progress presentation a few weeks ago, Tom Inui came up to me and introduced himself. It was the first time I met him. He asked me a simple question: ‘Why did Sam Regenstrief fail?’ I’m thinking: ‘Wow, here comes the real interview.’ So, I am wracking my brain, trying to remember Sam’s biography that I had read more than a year ago. So I say: ‘Sears wanted to diversify from more than one supplier for dishwashers.’ Tom shakes his head. ‘Somebody offered him the design of the first microwave to build, but he didn’t take it.’ Well, I am not sure how many of us would have chosen to build microwaves in an age when their widespread use was unimaginable! Tom shakes his head again. Then he says quietly: ‘He kept doing what he was always doing.’

At a fundamental level, Sam did not change his ways in a changed environment.  It is a lesson that we would do well to heed.

Biomedical informatics operates in an environment radically different from what we had historically. Not anymore is informatics the domain of the few bright pioneers. Not anymore can it be content with producing stellar innovations confined to local settings. Not anymore does it exist in a vacuum.

No, informatics is now alive in the daily practice of healthcare. Its fruits are at work in every practice, hospital and health system. In short, it not only affects healthcare, it is healthcare.

That puts a particular burden on us. In keeping with Sam’s charge, we must ensure that informatics continues to improve healthcare.

I always like to joke that biomedical informatics is still in the Stone Age. Some people may scoff at that, but I think it is true. Many years ago, Paul David wrote in the American Economic Review:

‘Radically new technologies diffuse gradually, because it takes a long time for companies to learn how to use the new resources effectively. … Truly revolutionary applications often require major reorganizations of production, which may take a long time to discover.’ (P. David, The dynamo and the computer: A historical perspective on the modern productivity paradox, American Economic Review, 1990).

I think the same is true in healthcare. We have not even begun to discover how to use informatics to its full potential in healthcare.

Participating in and helping drive that discovery is one of our core responsibilities at CBMI. Sam Regenstrief charged us with improving healthcare. We have done that and will do it even better in the future.

But, I cannot do this alone. I need your help. In the process, we will have to work hard. We will need to do things in ways we haven’t done them before. We will need to reach out to others in unprecedented ways. But, most importantly, we will do it together.

In the process, one thing we will do is to honor Clem and his legacy. And, I can imagine few things as worthwhile as doing that.

So, I have been working here for four weeks and one day now. I’m sure many of you are asking yourself: ‘Well, what is Titus thinking? Does he like it here? Does he like us?’ I have to tell you: I love it here.  Coming to work here was like coming home. I know that we can achieve great things together. I see it in your loyalty to the Institute. I see it in the ways you think, decide and act. I see it in your eyes. For me, the fact that we can do it means we will do it.

With that, let us raise our glasses to Clem: For what we owe to you and for what we will achieve in your honor.

Thank you very much.”

PS: Official press releases:

PPS: Recording (.wav file, 40 min.) of remarks at the ceremony by:

  • Bill Tierney, President and CEO, Regenstrief Institute
  • Charles Bantz, Chancellor, Indiana University-Purdue University Indianapolis
  • Chris Callahan, Director, Indiana University Center for Aging Research
  • Clem McDonald, Director, NLM Lister Hill National Center for Biomedical Communications
  • Titus Schleyer, Director, Center for Biomedical Informatics, Regenstrief Institute