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Integrated Medical Records (IMR)

Healthcare & Life Sciences

Proof of concept (POC)

The proof-of-concept (POC) is implemented within three clinical categories: radiology, bone-morrow transplantation (BMT), and genomics. However, IMR in general, can have any number of categories.

IMR POC 2001

Bone Marrow Transplantation (BMT)

The BMT data used by IMR includes information such as:

  • Disease that caused the need for transplantation
  • Donor HLA-phenotype
  • Patient HLA-phenotype
  • Conditioning - the process of preparation for transplantation including chemotherapy and radiation
  • Graft - either autologous (the donor is the patient), syngeneic (the donor and patient are identical twins), or allogeneic (otherwise)
  • Engraftment - the process in which the graft reach its target locations and start producing normal and functioning blood cells
  • Survival status
  • Complications

The IMR team submitted a proposal to HL7 for CDA levels 2 and 3 in the BMT domain.

Radiology

The radiology data used by IMR is based on the Digital Imaging and Communication in Medicine (DICOM) standard. DICOM is the accepted standard in the Radiology domain and ensures that digital imaging information can be shared between different platforms and vendors. It models the radiology domain into a patient object that has one or more study objects. The study object has one or more series objects and the series object has one or more image objects. DICOM is implemented for many modalities including MRI, CT (Computed Tomography), CR (X-Rays), US (ultrasound), etc.

The radiology data includes information such as:

  • Study - including details such as study date, study identification, and referring physician name.
  • Series - including details such as modality, series identification, and body part examined.
  • Equipment - including details such as manufacturer, device serial number, and software version.
  • Image - including details on how the image was generated, the compression, image identification, samples per pixels, bits allocated, etc.

The IMR team submitted a proposal to HL7 for CDA level 3 in the Radiology domain based on the DICOM information.

Genomics

The work on the genomics clinical category is being carried out by Barry Robson (IBM Lab in Watson ) and his team. The human genome has been sequenced and the research community is working on correlating patient diseases with the patient genes to discover new treatments and develop personalized medications. The EHR object model will include the patient genomic information to facilitate such treatments. As yet, none of the standards have addressed the challenge of encoding DNA, proteins, and polymorphism features in the EHR.

Applications

In the POC, IMR will be used by the following applications:

  • A visualization application will visually indicate the success of various BMT protocols. The work on visual analysis application is done by Bernice Rogowitz (IBM Lab in Watson, see http://www.research.ibm.com/visualanalysis/biology.html) and her team
  • A mobile application will display some information from the patient's lifetime record
  • The IBMTR application will register data taken from the BMT department, Hadassah hospital, Jerusalem, Israel into the International BMT Registry
  • The GMS (Genomics Messaging System) will correlate clinical data and genomics data. This work is carried out by Barry Robson