University of Michigan Twitter davidhanauer2 AMIA2019 EMERSE electronic medical record search engine Panel The National Cancer Institutes Informatics Technology for Cancer Research Program Building A Community of Practice in Cancer Informatics ID: 813031
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David Hanauer, MD, MS University of Michigan Twitter: @davidhanauer2 #AMIA2019
EMERSE: electronic medical record search enginePanel – The National Cancer Institute’s Informatics Technology for Cancer Research Program: Building A Community of Practice in Cancer InformaticsS34
Slide2DisclosureI and my spouse/partner have no relevant relationships with commercial interests to disclose.2AMIA 2019 Annual Symposium | amia.org
Slide3What is EMERSE?
Self-service search tool for the medical record free text notes the 80% not captured in structured dataHelps people abstract the phenotype, for non-coded data e.g., metastatic ductal
vs. metastatic lobular breast cancer
Easy to use for typical research staff
finds cohorts or highlights notes within a cohort
Scales well
Secure and regulatory compliant (audit logs, etc)
Simple—it’s not full NLP, but often NLP isn’t needed: “augmented intelligence”
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structured
unstructured
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Slide8Goals of the EMERSE projectDevelop new functionality for the software • Improved query suggestion
• Networking across sites (“SHRINE-like”)Create the infrastructure for dissemination of an enterprise-level search tool • Build the community • Documentation for end-users and implementers • Training materials
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Slide9Engaging with usersTwo kinds of “users”:System implementers (who have many local challenges)engagement with ITCR supportbuilding the community2. Standard usersengagement through training sessions (group and 1:1) usability interviews
users often approach us with requests for features 9AMIA 2019 Annual Symposium | amia.org
Slide10EMERSE Sites10AMIA 2019 Annual Symposium | amia.org
live
implementing
Slide11What ITCR support meansThe ability to scale up from a local effort to a national oneThe ability to build the infrastructure needed for broad disseminationProtected time to engage with other sites, provide demos, etcProtected time to engage with usesDeveloper effortA peer/mentoring network of ITCR software developers11
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Slide12Developing software in academic settingPros:understand the challenging environment in which the software must existaccess to the dataregulatory concernsprioritization of projects with limited resourcessecurityCons:shifting between local work vs national focus based on dual funding streamsother academic demands (teaching, publishing, etc)
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Slide13SecurityQuickly becoming a major concern and priority of medical centersThe days of installing any software in the clinical environment are goneRigorous security reviews are required before allowed to operateAdds a major amount of time/effort/expenseCan never fall behind – otherwise, the plug gets pulledReviews designed for vendor software, doesn’t work as well for open source13
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Slide14Security14AMIA 2019 Annual Symposium | amia.org
cybersecurity
technical design
stakeholders document
penetration
testing
software security code review
information system contingency plan
vulnerability
scans
shared responsibility agreement
risk assessment
interconnect document
firewall change request
vendor security assessment
This is a
l
ot of work!
Slide15AcknowledgementsITCR (NIH NCI): U24CA204863MICHR (NIH CTSA): UL1TR000433 and UL1TR002240U of Michigan Rogel Cancer Center (NIH NCI): P30CA046592EMERSE Development Team: James Law,
Ritu Khanna, Kellen McClain, Raghu Tadi, Rachael Hodder, Doran Steele, Long ZhangEMERSE Partners: Jill Barnholtz-Sloan, Mark
Beno
, James Champion,
Bront
Davis,
Guilherme
Del
Fiol
, Eric Durbin, Oksana Gologorskaya, Daniel Harris, Brett Harnett,
Kensaku Kawamoto, Benjamin May, Eric Meeks, Emily Pfaff, Janie Weiss, Kai Zheng15
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Slide16Learn more about EMERSE 16AMIA 2019 Annual Symposium | amia.org
hanauer@umich.eduproject-emerse.org