In the Information Age, big data carries big value, especially in the healthcare arena, where there’s more information available than ever. Just think of what harnessing this data could mean to health outcomes. The problem is figuring out how to combine it all — from the details in health records to research about air pollution to genetic information — and make it usable for providers and actionable for patients.
Randi Foraker, PhD, an epidemiologist who recently joined Washington University’s School of Medicine as an associate professor in the Institute for Informatics, is tackling that problem. “We’re developing tools that are workflow aware and usable for both healthcare and public health professionals,” she says. “Keeping in mind the human element is critical, though. We don’t want it to be all about cool tools we develop in a lab. It should really move the needle on health.”
Her team is currently using data from multiple sources, including electronic health records and publicly available health data. Eventually they hope to be able to also capture information culled from fitness trackers, such as blood pressure, blood glucose and heart rate. “With informatics, we’re learning how to integrate all of this information and make sense of the entire health picture for a given population, which might be the residents of a county or the patients in a particular clinic,” Foraker says.
Having this wealth of information available gives providers more context when treating patients, such as the environment they’re living in or their socioeconomic situation, Foraker says. “We can feed the data back to the patient themselves to help them make positive changes. We can also use it from a health system standpoint to target different subpopulations that may be hotspots of illness in the community to better design outreach to those areas.”
At-Risk Cardiovascular Patients Benefit from Interactive Tools
Foraker and her team have developed an interactive tool called SPHERE (Stroke Prevention in Healthcare Delivery Environments) that is nested within the electronic health record and visualizes data in the doctor’s office, especially as it relates to cardiovascular health.
“Using slider bars and buttons, it allows the provider to show the patient how changes in various risk factors, such as quitting smoking, lowering blood pressure or losing weight, can impact their health,” Foraker explains. “It really helps providers guide the conversation with patients around prevention and how to be healthier.”
It also facilitates shared decision-making where patients and doctors can work together to decide what to do next. A study she authored that was published in Preventive Medicine Reports in 2016 showed that using a tool like SPHERE helped at-risk women improve their cardiovascular health via weight loss and reduced blood glucose.
“These same kinds of tools can be used for clinical decision support in a variety of settings, not just for prevention,” Foraker says. “It may help when deciding which medication to prescribe for a patient or, down the road, incorporating genomic information into a clinical practice setting. When you’re dealing with genomic information, the provider may not be an expert, so figuring out how to deliver those data using informatics tools at the point of care will be very important.”
Ultimately, Foraker hopes to use informatics to map out the entire health trajectory of a patient. “Right now that’s complicated if a patient moves to a different city or goes to a different clinic that doesn’t collect and store data that’s readily sharable,” Foraker explains. “We hope to develop and leverage a repository of patient data along with environmental, socioeconomic and mobile health information to get a more comprehensive picture of our population, which will in turn guide us to help make them healthier.”
“We’re developing tools that are workflow aware and usable for both healthcare and public health professionals.”