[Translate to EN:] © UKE/Ronald Frommann

Medical Informatics Initiative: the SMITH consortium

Prof. Dr. Markus Löffler leads SMITH, which is one of the four consortia of the Medical Informatics Initiative (MII) selected for funding by the German Federal Ministry of Education and Research (BMBF). SMITH stands for “Smart Medical Information Technology for Healthcare” and the consortium comprises 19 partners from academia and industry. Markus Löffler is also Director of the Institute for Medical Informatics, Statistics and Epidemiology (IMISE) at Leipzig University and heads the Leipzig Research Centre for Civilization Diseases (LIFE) as well as the Leipzig study centre for the NAKO Health Study. The Leipzig Medical Biobank, which was set up for LIFE, is a partner of the German Biobank Alliance (GBA). In an interview with GBN, Prof. Löffler reports on the SMITH consortium’s approach and the role biobanks play in MII.

What goals are you pursuing within MII?
Markus Löffler: We are working together within MII to make hospital data available for research purposes. My personal interest lies in clinical epidemiology and I would like to see improved access to information on the state of patient care. Unfortunately, most hospital data has not been structured. I would like it to be easy to ascertain how many obese patients have been treated in a year and what drugs they were given, for example. This is not possible at the moment.

Could you please share further details of the initial situation?
Löffler: Doctors’ letters, which hospitals often save as PDF files, are a prime example of the dilemma. From a medical informatics perspective, these letters are a nightmare. It is impossible to search them systematically for two reasons: firstly, they are often exclusively stored in patients’ files. This means that searching them isn’t even an option. Even if this were possible, though, we would have the problem that a search for “heart attack” would also bring up documents containing “suspected heart attack” or “suspected heart attack ruled out”. In order to make such data “mineable” – so to render it accessible to a certain degree – we need intelligent solutions in medical informatics.

And which solutions can you offer here?
Löffler: Within all of the consortia, we are building new digital infrastructures known as data integration centres (DICs). We transfer relevant data from the hospital information systems to these DICs and structure it there. This will allow us to share data between the consortia in the future when certain conditions are met. At the same time, we are working within SMITH on computer linguistics procedures to render the documents readable for our purposes. Keywords are needed, for instance, but other terms must at the same time remain hidden in order to ensure privacy. Ultimately, searches should function in a similar manner to a Google query.

Which clinical use cases is the SMITH consortium looking at?
Löffler: We are working on two clinical use cases. The first concerns the algorithmic surveillance of patients in intensive care units. We collect their vital signs and use artificial intelligence to analyse anomalies. An automatic reporting system is thus created that allows doctors to react quickly if need be. Our second use case focuses on antibiotic stewardship. We are also in the data collection phase here. The aim is to be able to administer the most suitable antibiotics more quickly than in the past if a patient contracts a bacterial infection with a high mortality risk, while at the same time avoiding the administration of unnecessary antibiotics. We need the DICs for both use cases and at the same time demonstrate with them that the DICs work.

What is the third use case about?
Löffler: It is a methodical use case. The tools we have developed help to research and improve processes in patient care. It is for example necessary to be able to ask a system questions like the one I mentioned earlier – about specific patient groups and their medications. Or whether it is possible to use laboratory parameters to detect critical situations for patients at an early stage.

What comes next, after the current funding phase?
Löffler: We don’t actually know yet. This will probably change next year, though, when all four of MII’s consortia are officially reviewed. Each consortium takes a very different approach. SMITH puts great emphasis on the participation of industry to ensure our solutions meet an industrial standard and avoid any liability issues. Other consortia have consciously decided against doing just this. MII’s concept of taking four different approaches to achieve the same goals also acts as a safeguard: should individual consortia fail, there are still alternative, functioning concepts.
Either way, all consortia have begun working on cross-cutting use cases – while applying their respective technical methods. One example is a use case on rare diseases involving around 20 universities. Then there’s a use case in which 13 partners from all consortia are working on aspects of drug safety. The outcomes of these use cases will also be available next year and demonstrate the interoperability between the consortia.

What role do biobanks play in SMITH?
Löffler: With 27,000 test persons for the LIFE study and 10,000 for the NAKO health study, biobanking is considered very important here in Leipzig. The participants in these epidemiological studies have nothing to do with medical care.
However the hospital remains the platform for SMITH. Samples collected during patient care (i.e. from oncological or cardiological interventions) are of course added to the biobanks. The corresponding linking of records is absolutely crucial for us. The cooperation with the German Biobank Alliance (GBA) is extremely important when it comes to the core data sets for samples. GBA already has these core data sets – we now need to “integrate” them into the MII consortia.


The interview was conducted by Verena Huth.

Visit the SMITH website

 

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