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Kenneth D. Mandl, MD, MPH
Director, Intelligent Health LaboratoryChildrens Hospital
Informatics Program
Center for Biomedical Informatics, Harvard
Next-Generation Registries:Fusion of Data for Care and
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US Spending per capita vs. Life Expectancy
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Rapid Learning Network: Evidence Generated
from a Well-Instrumented Health System
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As per the previous National Coordinator . . .
l New England Journal of Med 2008: Low uptake ofHIT in
ambulatory setting
l New England Journal of Med 2009 Low uptake in ofHIT in
hospitals
Conclusion: $48Binvestment, pushingthe technology
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Intelligent Health Lab
Yearly trends in MI
Partners Healthcare (1997-2005)
PLoS One 2007
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Monthly trends in Myocardial Infarction:
Sudden Increase
Introduction of COX-2 Inhibitors
18.5% Increase
PLoS One 2007
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Signal Detection
First signal:
l 1 year afterCelecoxib
l 8 months afterRofecoxib
PLoS One 2007
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l For every millionprescriptions, 0.5%
increase in MI(95%CI 0.1 to 0.9)
l 50.3% of thedeviance explained
PLoS One 2007
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What do we not know?
l Full medication listl Complete history from across sites of
carel Symptoms/effects not resulting in a healthcare visitl
Functional status improvement for patients on COX-2l Pain relief
for patients on COX-2
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Intelligent Health Laboratory | Childrens Hospital
Informatics
Program
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lAmbient data from the health care systemlData acquired directly
from patientslMeticulously collected data
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Stephen Edge, MDRoswell Park Cancer Center
Marc D. Natter, MD, MPH
Boston Childrens Hospital
Chad Malone, MD
Remedy Informatics
Keith Marsolo, PhD
Cincinnati Childrens Hospital Medical Center
