Cecchetti Alfred A, Bhardwaj Niharika, Murughiyan Usha, Kothakapu Gouthami, Sundaram Uma
Department of Clinical and Translational Science, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States.
JMIR Med Inform. 2020 Oct 14;8(10):e17962. doi: 10.2196/17962.
The Appalachian population is distinct, not just culturally and geographically but also in its health care needs, facing the most health care disparities in the United States. To meet these unique demands, Appalachian medical centers need an arsenal of analytics and data science tools with the foundation of a centralized data warehouse to transform health care data into actionable clinical interventions. However, this is an especially challenging task given the fragmented state of medical data within Appalachia and the need for integration of other types of data such as environmental, social, and economic with medical data.
This paper aims to present the structure and process of the development of an integrated platform at a midlevel Appalachian academic medical center along with its initial uses.
The Appalachian Informatics Platform was developed by the Appalachian Clinical and Translational Science Institute's Division of Clinical Informatics and consists of 4 major components: a centralized clinical data warehouse, modeling (statistical and machine learning), visualization, and model evaluation. Data from different clinical systems, billing systems, and state- or national-level data sets were integrated into a centralized data warehouse. The platform supports research efforts by enabling curation and analysis of data using the different components, as appropriate.
The Appalachian Informatics Platform is functional and has supported several research efforts since its implementation for a variety of purposes, such as increasing knowledge of the pathophysiology of diseases, risk identification, risk prediction, and health care resource utilization research and estimation of the economic impact of diseases.
The platform provides an inexpensive yet seamless way to translate clinical and translational research ideas into clinical applications for regions similar to Appalachia that have limited resources and a largely rural population.
阿巴拉契亚地区的人口具有独特性，不仅在文化和地理方面，在医疗保健需求上也是如此，该地区面临着美国最严重的医疗保健差异问题。为满足这些独特需求，阿巴拉契亚医疗中心需要一系列分析和数据科学工具，并以集中式数据仓库为基础，将医疗保健数据转化为可实施的临床干预措施。然而，鉴于阿巴拉契亚地区医疗数据的碎片化状态，以及将环境、社会和经济等其他类型数据与医疗数据整合的需求，这是一项特别具有挑战性的任务。
本文旨在介绍阿巴拉契亚地区一家中等规模学术医疗中心综合平台的开发结构和过程及其初步用途。
阿巴拉契亚信息学平台由阿巴拉契亚临床与转化科学研究所临床信息学部开发，由4个主要组件组成：集中式临床数据仓库、建模（统计和机器学习）、可视化以及模型评估。来自不同临床系统、计费系统以及州或国家级数据集的数据被整合到一个集中式数据仓库中。该平台通过适当地使用不同组件对数据进行管理和分析，来支持研究工作。
阿巴拉契亚信息学平台已投入使用，自实施以来已支持了多项研究工作，其目的多种多样，例如增进对疾病病理生理学的了解、风险识别、风险预测、医疗保健资源利用研究以及疾病经济影响评估。
该平台为资源有限且人口大多为农村人口的类似阿巴拉契亚地区，提供了一种将临床和转化研究理念转化为临床应用便宜且无缝衔接的方式。
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