“Innovation” by Russ Waitman: Breaking the Barriers on Medical Information at KUMC
To most of us, heron is a freshwater bird. However, to Russ Waitman, Assistant Vice Chancellor for Enterprise Analytics at University of Kansas Medical Center, HERON (Healthcare Enterprise Repository for Ontological Narration) is a medical records system unlike any other.
It began as a strategy for the KUMC’s National Institutes of Health Clinical and Translational Science Award grant application, but Waitman says the real value of HERON lies in its ability to give “doctors better knowledge and patients, better health.”
Based on the NIH-funded i2b2 platform, the HERON system offers users the opportunity to look through billions of de-identified medical data pieces, a true feat with today’s HIPAA privacy requirements. To accomplish this, KUMC’s system removes the 18 personal identifiers specified by HIPAA and randomly shifts dates by up to 365 days. “All the dates are randomly shifted, but there’s still enough information there that can answer a lot of scientific questions,” he said.
This vast information repository merges medical and billing records with health outcomes information that doctors, researchers, students, and KUMC staff can access. The HERON database also allows these users to view other frequent guests, promoting collaboration among colleagues and proving vital to medical advancement.
“At one level, if you hide your data you don’t realize the full benefit of the data to help advance health,” Waitman said. “So it’s really looking at the different people who interact with the data, who can gain from the data, and working together to build trust so that different people can accomplish the goals they have for health.”
In a matter of seconds, a simple query search in HERON returns thousands of results. This amount of data presents a challenge in system maintenance. In fact, one month of doctors’ visits sometimes generates as many as fifty million facts. To keep the system fresh, KUMC created a method for updating the system without causing significant downtime. This process involves the addition of new functionality, such as linking data across clinical and financial sources, and the regular addition of new data. It also includes upgrades to HERON that allow for the incorporation of new types of data like family history and microbiology.
Currently, the system is exclusive to KUMC, but it offers the capability of expansion to other research institutions allowing the Kansas City area to play a large role in the overall advancement of healthcare.
“A lot of what we have focused on here has been building a relationship between the doctors and the clinics, the hospital personnel, and the university to bring the data together and de-identify the data… but there is still enough information there that can answer a lot of scientific questions,” Waitman said. “So we are actually working through these processes at the University of Kansas Medical Center, and we are working with Children’s Mercy. Then ultimately, we want to work across the region so we can learn about health in the Kansas City area so that we can compare it with data on health in Iowa, or Nebraska or Minnesota, and ultimately across the whole country.”