CLINICAL THEORETICAL INSTITUTES

Institute of Medical Informatics, Biometry, and Epidemiology Chair of Medical Informatics

Address Process support through health ground, we are concerned with all aspects of Wetterkreuz 13 information systems the use of software as a medicinal product. 91058 Erlangen One of the major challenges in the design, es- Phone: +49 9131 8526720 tablishment, and management of health infor- Evaluation of health information Fax: +49 9131 8526754 mation systems (HIS) is the intersectoral inter- systems www.imi.med.fau.de operability which is important to optimize the When introducing new information technolo- cooperation of the various health service gies, it is essential to evaluate their effect on user Director providers across institutional boundaries in out- satisfaction, work processes, and process costs Prof. Dr. biol. hum. Hans-Ulrich Prokosch patient and inpatient care in order to deliver the to avoid adverse effects of these technologies best patient care. For an additional reduction of on medical care. Successful use of IT in Contact patient risks, we integrate clinical decision sup- medicine may be hindered by negative user at- Prof. Dr. biol. hum. Hans-Ulrich Prokosch port functionalities into HIS. Clinical information titudes, user-unfriendly interfaces, and insuffi- Phone: +49 9131 8526721 flow and communication functionalities should cient usability in general. In numerous evalua- Fax: +49 9131 8526754 ultimately involve and benefit patients, e.g. by tion studies, we have applied methods, such as [email protected] the application of medication plans or by the usability questionnaires, observations, thinking aloud, and cognitive walkthrough, to both op- Research focus use of a personal electronic health record. In ad- • Process support through health information dition to grant funded projects, the Chair also timize and evaluate the acceptance of different systems pursues and supports several innovative pilot kinds of IT artefacts. In cooperation with the De- • Medical ontologies and medical knowledge projects embedded in the SOARIAN® HIS envi- partment of Anesthesiology, as well as further processing ronment of UK Erlangen (e.g. a complete clini- German anesthesiologists and the foundation • Evaluation of health information systems cal cancer documentation embedded in a com- German anesthesiology (“Stiftung Deutsche • Analysis, assessment, and visualization of prehensive clinical data reuse concept). The di- Anästhesiologie”) we perform usability analysis medical data rect integration of the patient by means of an of different levels of prototypes and mockups • IT-infrastructure applications for medical re- online-based capturing of follow-up information for a computerized emergency checklist. Fur- search and the idea of a patient portal which is inte- ther, we cooperate with the Department of Pe- • Translational cancer research grated into HIS and its IHE (Integrating the diatrics and Adolescent Medicine in the step- Healthcare Enterprise)-based integration with a wise development and usability analysis of a Structure of the Chair patient s personal electronic health record com- web-based medication information system to plete the range of research on this focus. support drug therapy for children. Moreover, in Professorship: 1 the context of different master theses a tool for Personnel: 19 Medical ontologies and medical calculating percentiles and an Arden dashboard • Doctor (of Medicine): 1 knowledge processing have been evaluated for the Department of Pe- • Scientists: 14 (thereof funded externally: 11) In our projects, providing knowledge process- diatric and Adolescent Medicine and the inter- • Graduate students: 8 ing systems in medicine always comprises disciplinary operative ICU of UK Erlangen, re- knowledge modeling and the implementation spectively, in terms of their efficacy and effi- Research of standardized knowledge modules for exam- ciency in clinical routine.

ple to support drug therapy and drug prescrip- Various working groups are concerned with the tion or to reduce patient risks within intensive Analysis, assessment, and visualization development and the introduction of electronic care units (ICU). Within the patient data man- of medical data medical records, the integration of clinical de- agement system of an ICU, a clinical decision An increasing amount of data is documented cision support functions into hospital informa- support system has been integrated to monitor electronically in clinical IT systems during routine tion systems (HIS), the modelling and optimiza- the exceedance of threshold values or to moni- patient care. To avoid information overload or tion of clinical workflows, both data warehouse tor critical trends of various laboratory values overlooking of essential facts, appropriate and and data mining applications, the evaluation of and, as a consequence, to have a direct feed- flexible visualization methods are required. We the effect of health technology interventions on have been creating a learning health system by processes and persons involved in the health back sent as a text message to the DECT tele- system, the use of mobile technologies in phone of the clinician on duty. Further use cases reusing such data for research projects. In coop- medicine and the development of IT infrastruc- comprise the automated patient-individual eration with Harvard University Medical Center, tures for research and teaching. The integration monitoring of the expiratory tidal volume to the i2b2 (informatics for integrating biology and of clinical and research data within hospitals and avoid lung injury in patients under mechanical the bedside) platform has been integrated with data sharing within large networks, e.g. in the ventilation as well as the implementation of UK Erlangen Clinical Data Warehouse and en- context of the German Medical Informatics Ini- cross-patient dashboards and their integration hanced with semantic ontology annotations as tiative and the German Biobank Alliance, are a into the existing computer system with a paral- well as timeline-based visualization methods. It particular focus of our research activities. lel evaluation and optimization of their usability. has been established as a research integration Prof. Dr. H.-U. Prokosch is as Chief Information In a second project we have initiated a user cen- platform for several projects at UK Erlangen, but Officer also responsible for the strategic devel- tered design process for the development of a also within national collaborations. The project opment of information processing at UK Erlan- computer-based guideline to support intraop- “Klinische Datenintelligenz“ (clinical data intelli- gen. erative emergency situations. Against this back- gence) aims at integrating both structured and

52 free-text data as well as images and genomic Translational cancer research Maier C, Lang H, Storf H, Vormstein P, Bieber R, Bernarding data for research. Complex algorithms are pro- A special research focus for the reuse of clinical J, Herrmann T, Haverkamp C, Horki P, Laufer J, Berger F, Höning G, Fritsch HW, Schüttler J, Ganslandt T, Prokosch cessed on the basis of Big Data technologies (e.g. data in research as well as for quality manage- HU, Sedlmayr M. Towards implementation of OMOP in a Hadoop) and can be analyzed in interactive ap- ment purposes is the efficient IT support in the German university hospital consortium. Appl Clin Inform. 2018 Jan;9(1):54-61 plications (e.g. tranSMART). Furthermore, we context of cancer care and translational cancer have provided the tranSMART platform for dif- research. We have designed and established a Kraus S, Toddenroth D, Prokosch HU, Bürkle T. Using Arden Syntax Medical Logic Modules to reduce overutilization of ferent research groups at our Faculty for the pur- comprehensive single source framework of IT laboratory tests for detection of bacterial infections – suc- pose of integrating genomic data into clinical components supporting tissue banking, multi- cess or failure? Artif Intell Med. 2018 Nov;92:43-50 data. In this context the Chair is evaluating both center cancer trials, cancer registration, and Sedlmayr B, Schöffler J, Prokosch HU, Sedlmayr M. User- the use and the usability of the platform for its routine cancer care documentation. While in- centered design of a mobile medication management. In- application in the fields of cohort identification formatics for health and social care. Inform Health Soc terfacing the new cancer registry database of Care. 2018 Mar 5:1-12 and data exploration. In the MIRACUM consor- UK Erlangen s Comprehensive Cancer Center tium (Medical Informatics in Research and Care (CCC; compare own report) with our EHR sys- International cooperations in University Medicine; compare own report), we tem, we designed a reference model for cancer Prof. Dr. E. Ammenwerth, Private Universität für Medizinis- evaluate and enhance the translational platform documentation comprising a set of elementary che Informatik und Technik (UMIT), Innsbruck: Austria cBioPortal (originally developed at the Memorial documentation packages, related processes Prof. Dr. T. Bürkle, Berner Fachhochschule, Biel: Switzer- Sloan Kettering Cancer Center, New York, USA), within patient care, quality assurance and re- land which aims at integrating and visualizing clinical search, respective information systems as well Prof. Dr. I. Kohane, National Center for Biomedical Com- findings and genomic analysis data. The final as interfaces to be established. A further aspect puting, Boston: USA goal is to thus provide an optimized information of research in this field was the draft and the es- Prof. Dr. C. Sawyers, Dr. A. Zehir, Memorial Sloan Kettering presentation for enhanced IT supported therapy tablishment of a study registry for CCC, which Cancer Center, New York: USA decisions in molecular tumor boards. provides the basis for all study-related analyses and reports, for the official listing of studies on IT-infrastructure applications the CCC homepage, and, at the same time, for for medical research the study assignment within HIS ‘Soarian Clini- Today, medical research is often pursued within cals’ for the patients of UK Erlangen. networked multi center structures, which require efficient and safe IT-infrastructures. The Chair Teaching has designed and provided such web-based electronic data capture systems for many med- The Chair of Medical Informatics is involved in ical multicenter research projects, such as the the education of students of Medicine, in the Polyprobe Study, the nation-wide registry for degree programs of informatics (minor subject: chronic kidney diseases (GCKD), and the medical informatics) of the Faculty of Engineer- CONKO-007 study on radiochemotherapy for ing as well as in the interdisciplinary degree pro- pancreatic cancer. Moreover, current activities gram Medical Process Management and in the comprise IT infrastructures to support biobank- cross-faculty courses of the degree programs in ing especially the national (German Biobank medical engineering. In all these courses, the Node, German Biobank Alliance) and interna- innovative laboratory for medical informatics tional (BBMRI Common Service IT/ADOPT) link- and eHealth which is an established feature at age of biobanking. A further focus was laid on the Chair of Medical Informatics is used as the the single-source reuse of patient data for clini- Erlangen laboratory of medical informatics cal and translational research. The Chair is (“EMIL”) in the form of a Skills Lab and in the member and active partner in many projects context of an innovative teaching concept. and working groups of the TMF (German tech- nology and methods platform for networked Selected publications medical research) and leads the GMDS working Hinderer M, Boeker M, Wagner SA, Binder H, Ückert F, group “Reusing electronic patient records for Newe S, Hülsemann JL, Neumaier M, Schade-Brittinger C, clinical research”. We lead the MIRACUM con- Acker T, Prokosch HU, Sedlmayr B. The experience of physi- cians in pharmacogenomic clinical decision support within sortium, in which we currently design, develop, eight German university hospitals. Pharmacogenomics and implement an ecosystem of open source 2017, 18.,8: 773-785 software tools (MIRACOLIX: e.g. ID-manage- Christoph J, Knell C, Bosserhoff A, Naschberger E, Stürzl M, ment, consent-management, federated authen- Rübner M, Seuss H, Ruh M, Prokosch HU, Sedlmayr M. Us- tification, several research data repositories, ability and suitability of the Omics-integrating analysis plat- form tranSMART for translational research and education. long term archiving for research data), which Appl Clin Inform. 2017, 8,4: 1173-1183 form the building blocks for the establishment Prokosch HU et al. MIRACUM: Medical Informatics in Re- of data integration centers at each of the uni- search and Care in University Medicine. Methods Inf Med. versity hospitals. 2018 Jul;57(S 01):e82-e91

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