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iHT² CMIO & Physician & Executive Summit “Using Big Data to Shift from Evidence-based Practice to Practice-based Evidence” with Christopher Longhurst
1. Using Big Data to Shift from Evidence-based
Practice to Practice-based Evidence
Christopher Longhurst, MD, MS
Chief Medical Information Officer, Stanford Children’s Health
Associate Professor of Pediatrics and Medicine, Stanford University
2. 2
Stanford Children’s Health
• Opened in 1991
• Mission: To provide extraordinary family-centered care
• 311 bed pediatric/obstetric tertiary-care facility
• Hospital stats
• 4200 Deliveries
• 13k Discharges
• 300k Clinic visits
21. Social Data – Silicon Valley
Full disclosure: I serve on
the medical advisory
board for Doximity.
22. This infographic shows a
snapshot of Northern
California doctors and their
referrals, where each doctor
is represented by a blue dot
and the connecting lines
represent a referral.
23. US primary care connections
70% of PCP Colleagues
are within 100 miles
25. 25
AHRQ, 2007
“Information technology must be deployed
and reengineered to overcome growing
problems associated with information
overload. Finally, and most importantly,
patients will have to be engaaged on
multiple levels to become ‘coproducers’
in a safer practice of medical diagnosis.”
26. 26
“Big Data” Signals in Biomedicine & Healthcare
• Physiologic signals (remote monitoring, quantified self)
• Images (radiology, pathology, dermatology, ophthalmology)
• Omics (genomics, microbiomics, proteonomics)
• Social data (network analysis, crowdsourced)
• EMR data (structured and unstructured)
29. 29
Finding Labs and Events that
Predict Harm
2
True Positive Rate
and False Positive
Rate
Best performing labs
and events
Best sensitivity: urea nitrogen
Best specificity: feeding tube
response
Best overall: indirect bilirubin
30. 30
IEEE Intelligent Systems, April 2009
“The first lesson of web-scale learning is
to use available large-scale data rather
than hoping for annotated data that
isn’t available.”
34. How do we ensure our healthcare system learns
from every patient, at every visit, every time?
35. Christopher Longhurst, MD, MS
clonghurst@stanfordchildrens.org
"We make a living by what we get, we make a life
by what we give." - Winston Churchill
36. Upon this gifted age, in its dark hour,
Rains from the sky a meteoric shower
Of facts…they lie unquestioned, uncombined.
Wisdom enough to leech us of our ill
Is daily spun, but there exists no loom
To weave it into fabric…
Edna St. Vincent Millay, Upon this age, that never speaks its mind.
In: Colleted Sonnets, 1939.