When your doctor diagnoses a condition and recommends a course of treatment, she relies on her extensive training, guidelines from professional medical organizations and previous experience with thousands of other patients.

But what if your diagnosis and treatment could be further informed by the experience of millions of other patients, including those who not only had similar symptoms, but perhaps also were your age, gender, ethnicity — and with similar medical history? That’s among the benefits coming soon from health analytics and informatics.

Using massive data sets, machine learning, and high-performance computing, health analytics and informatics is drawing us closer to the holy grail of health care: precision medicine, which promises diagnosis and treatment tailored to individual patients. The information, including findings from the latest peer-reviewed studies, will arrive on the desktops and mobile devices of clinicians in health care facilities large and small through a new generation of decision-support systems.

“There are massive implications over the coming decade for how informatics will change the way care is delivered, and probably more so for how care is experienced by patients,” said Jon Duke, M.D., director of Georgia Tech’s Center for Health Analytics and Informatics. “By providing data both behind the scenes and as part of efforts to change behavior, informatics is facilitating our ability to understand patients at smaller population levels. This will allow us to focus our diagnostic paths and treatments much better than we could before.”

At Georgia Tech, health informatics researchers are partnering with both public and private-sector organizations to develop and apply transformative technology that will connect incompatible systems and analyze vast data sets. This technology also will help clinicians track the latest research, potentially shortening the time required to move health care advances into practice.

Georgia Tech’s health informatics effort combines academic researchers in computing and the biosciences, practitioners familiar with the challenges of the medical community, extension personnel who understand the issues private companies face, and engineers and data scientists with expertise in building and operating secure networks tapping massive databases.

Advice from millions of patients

The availability of millions of claims records produced by doctors, clinicians, hospitals, pharmacies, and others presents a unique opportunity for providing decision support to individual physicians, who often have less and less time to treat patients whose conditions are more and more complicated.

Finding information useful to doctors within claims records — and electronic health records — offers a challenge much greater than the proverbial needle in a haystack. For one thing, the decision-support system must find that needle quickly enough — in a matter of seconds — to give doctors the information they need while they’re working with patients.

Some of the ways Georgia Tech is addressing those challenges are as follows:

• Associate Professor Jimeng Sun and his graduate students in Georgia Tech’s School of Computational Science and Engineering are using advanced algorithms, machine learning, and high-performance computing to find subtle signals in the data sets. One of the additional challenges: The data they’re using was gathered to help medical providers gain reimbursement — not to aid in diagnosis.

Sun’s team has worked with Children’s Healthcare of Atlanta to develop models for treating asthma and medically complex patients using electronic health record information. Sun’s team has also worked with Sutter Health in predicting heart failure, and with Vanderbilt University and Northwestern University on automatic phenotype discovery.

• EmployersLikeMe is a Georgia Tech-facilitated initiative that brings together the state’s major employers to discuss common issues such as health care – and share data that could help participants identify trends and best practices.

"We are working to get data from dozens of private companies, all of whom have different pieces of data in different formats with different third-party administrators,” said Don Betts, an extension specialist who leads ELM in Georgia Tech’s Enterprise Innovation Institute. “Employers have a lot of data, and their data is from the private-pay, real-world that’s very different from Medicaid or Medicare information.”

• Georgia Tech researchers, with support from the CDC’s National Center for Health Statistics (NCHS), are looking at death certificate data both to see what can be learned and to support efforts to create an improved and uniform reporting system. While there is a national standard death certificate, 57 different reporting jurisdictions — corresponding to each state and some municipalities — may collect additional data elements.

May Dongmei Wang, a professor in the Department of Biomedical Engineering at Georgia Tech and Emory University, is leading an effort on using up to 40 years of National Vital Statistics System (NVSS) public use death records data published by NCHS, along with data provided by states, to assist in the design of a next-generation electronic death registration system. The system will be based on Fast Healthcare Interoperability Resources (FHIR), the emerging health data interoperability standard. 

• Georgia Tech researchers Nicoleta Serban and Julie Swann are addressing how individual state’s policymakers evaluate health care priorities and goals by studying billions of transaction records from the nation’s Medicaid program. Medicaid largely addresses the needs of children, whose issues differ dramatically from those of private-sector workers and older Americans. The Georgia Tech researchers have access to eight years of complete records from 50 million patients, 38 million of them children.

"People want to make informed decisions, and we can help them make decisions based on data,” said Serban, an associate professor in Georgia Tech’s Stewart School of Industrial and Systems Engineering. “Health care policies have often been set by clinicians or public health agents who are making decisions based on their experience. We can add a layer of data and health analytics to that.” 

• In Georgia Tech’s School of Interactive Computing, faculty members are working toward a course concentration in health informatics, building a group of students who are highly sought-after by organizations now developing and implementing real-world health informatics systems and tools.

"We are well on our way to having a significant concentration with a heavy emphasis on analytics and big data,” said Mark Braunstein, M.D., a professor of the practice who teaches health informatics as an elective graduate seminar in the college and in the Online Master of Science in Computer Science (OMSCS) program. 

• Health informatics applications couldn’t operate without extensive and secure infrastructure. Myung Choi and Richard Starr work behind the scenes for all these projects as part of Georgia Tech’s Institute for People and Technology (IPaT) and the Interoperability and Integration Innovation Lab (I3L).

They make sure data storage is available, provide security, help faculty members navigate approval processes, and make sure research projects comply with data use agreements and federal rules such as HIPAA.

What’s ahead

Beyond working with existing information, Georgia Tech researchers are looking ahead to integrate genomics data, which could provide a more complete description of each patient. Doing that will require a new set of collaborators at Georgia Tech, Emory University and other leading institutions.

One major project under way, led by Rushing, supports the U.S. Department of Veterans Affairs (VA) as it plans a new digital health platform (DHP) to replace its pioneering electronic health records system — the country’s first. As a neutral third party, Georgia Tech is building the VA a scalable, proof-of-concept DHP model.

“The VA is looking for a flexible, future-focused health platform and architecture focused on a services-based model,” said Duke, whose research center is funded jointly by GTRI and the College of Computing. “They are taking a really ambitious approach to it, and this could have a tremendous impact on care for veterans as well as on health systems more broadly.”

The project illustrates the role Georgia Tech can play because it doesn’t have a medical school or hospital and isn’t tied to any specific technology platform.

“When we are working with health systems, we’re neither a competitor nor a vendor,” Duke noted. “We approach each problem from a ‘white hat’ perspective, working to find the right data and infrastructure needed, often using open-source platforms.”

Health informatics is also bringing Georgia Tech units together with industry and government to work on common issues in unique ways. The new Coda building, a mixed-use facility featuring a high-performance computing center scheduled for construction in Georgia Tech’s Technology Square, will bring industry and academics together to help spur the health care revolution many are expecting.

This article first appeared in Issue 3, 2016 of Georgia Tech’s Research Horizons magazine.