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Summing up and moving ahead David Ingram, University College London Director, UCL Centre for Health Informatics and Multiprofessional Education, CHIME.

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Presentation on theme: "Summing up and moving ahead David Ingram, University College London Director, UCL Centre for Health Informatics and Multiprofessional Education, CHIME."— Presentation transcript:

1 Summing up and moving ahead David Ingram, University College London Director, UCL Centre for Health Informatics and Multiprofessional Education, CHIME UKRDS, Royal Society, February 26 th 2009

2 The current scene – drawing on context of medicine and health care Science is being transformed bioinformatics is core discipline of biology – Royal Society 2005 14 years to sequence HIV genome; SARS took 31 days Research and practice are increasingly information intensive information is the heart of medicine – BMA 1994 Multiple legacy information systems are in use supporting and linking health care, research and industry Government is creating pervasive new ICT infrastructure and core services Other national and international initiatives are creating relevant infrastructures and standards

3 Escher: Order and Chaos Data - are often messy and disorganised Use and reuse of data need to be careful and context aware

4 number of procedures performed in relation to hospital admissions From Shortliffe and Perault, 1989 Growth of Standard Nomenclature of Medicine (SNOMED) Information explosion: in health care

5 Berkeley study estimated that after taking 300,000 years to generate 12 Exabytes, data is now accumulating at about 5 Exabytes per annum, reflecting shrinking costs of physical storage devices Transferring at 100 Megabytes per second, 1Petabyte will take 116 days to stream Data explosion Tera10 12 10TbUS Library of Congress print collection Peta10 15 5 years of EOS data Exa10 18 5Eball words ever spoken by human beings Zetta10 21 ( radius Milky Way ~ 1Zm; Pacific ~ 1Zl ) Yotta10 24 ( earth ~ 1Yl ) From web site of Roy Williams, CalTech

6 philosophy mathematics information sciences systems, measurement physical science life science environment medicine education social structure demography politics law economics industry, commerce language, literature arts religion The Circle of Knowledge: encyclopaedia, Ranganathan, 1950 UNESCO, The Basic System of Order rationalisation abstraction meaning, context Librarians were worried about this trend 50 years ago – where to place the books on the shelves! The Circle of Knowledge

7 Dimensions of challenge faced - aiming to enhance and sustain quality and utility of data Diversity – of research requirements and supporting data management systems Discipline and standards – of data description, modelling and management Scale - of data capture, storage, processing and long-term curation Evolution over time – of requirements and available, proven technologies Willingness and capacity to engage – of research community Education and capacity – at all levels Business case/ cost-benefit – metrics for measuring and sustaining success Implementation – priority, resource, timescale

8 Dilemmas to be explored and resolved – stakeholder values and perspectives Shareable v shared - motivation Commonality v diversity - requirements Confidential/restricted v public – access Competition v cooperation – modus operandi Global v local – implementation, capacity, organisation, resources Standardised for general applicability v optimised for particular purposes – approach, what will work

9 Direction of travel – some guiding principles The problem is urgent– data management and markets risk going the same way as money management and markets, for not dissimilar reasons Research requirements should drive data standards and shared services Research communities must value and own outcomes expected from shared services Practical experience of implementation should guide and determine policy, strategy and investment in shared services Rigorously controlled scope, scale and timing of innovation in shared services is essential

10 Information technology The one and only horizontal technology; a technology that pervades each and every part of social life and all the other technologies as well. W. Ch. Zimmerli, in Human Genetic Information: Science, Law and Ethics, Ciba Foundation, 1990 IT has led us to aspire to, and enabled us to create, broad ranging data environments which we now struggle to tame

11 Achieving a constructive balance of top down and bottom-up initiative Escher: Ascending and descending

12 In summary A lot of work to be done Needs culture of collaboration, built on rigour, engagement and trust Needs both top down and bottom up focus and resource Requires an experimental approach, guided by practical implementation experience – the pathfinder project Solutions will not be handed down; they will evolve Realistic incentives and rewards are essential Thankyou

13 Slow penetration of IT in health care New systems are cumbersome to install and make use of. This is nothing new. The Times wrote in 1834 that it was unlikely that the medical profession would ever start to use the stethoscope because its beneficial use requires much time and gives rise to a fair amount of difficulties From The Economist, Feb 28, 1998


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