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Health records and breakthroughs in medicine

Kenneth S. Polonsky, MDKenneth S. Polonsky, MD

Recent advances in computing have transformed nearly every aspect of our lives, and health care is no exception. Indeed, medical records such as results of laboratory tests, radiological images or biopsies are no longer stored in paper charts but on computers. These electronic records of medical histories are playing a central role in the health care system and efforts to improve patient care.

In addition to making health information more accessible to physicians, electronic medical records are becoming an invaluable source of information to detect unexpected patterns that predict disease risk and side effects of drugs. Putting all this complex information together and making sense of it requires physicians and medical researchers to collaborate with computer scientists.

Such collaborations already are producing exciting results. Radiologists and software engineers have developed programs that scan X-ray images to flag potentially cancerous lesions. Researchers have analyzed databases of health care claims to identify more effective, cost-saving treatments for a variety of chronic diseases.

At the University of Chicago Medicine's Center for Personalized Therapeutics, the 1200 Patients Project conducts preemptive testing of enrolled subjects to identify those who are genetically predisposed to developing adverse reactions or who may not respond to particular drugs. Their physicians can use this information to help select medications less likely to cause side effects or to find alternatives when a patient has failed to respond.

The University's Silvio O. Conte Center, funded by federal and local grants, is part of a national effort to advance the treatment of neuropsychiatric disorders and the first such initiative to focus on the development of software that searches millions of electronic medical records, genetic databases, and adverse drug-event databases to identify novel treatments and more effective individualized care.

While the combination of medical research and advanced computing presents exciting opportunities, it also raises concerns about patient privacy and proper physician oversight.

The sheer scale and complexity of information will require increasing reliance on automated data processing, which can reach speeds once unimaginable in health care. We must balance this speed with the right amount of physician oversight. As experiences with high-speed trading software and computer models used on Wall Street have revealed, the shift from human-decision processes can transform an industry, or bring it to its knees.

It also is essential to respect patient confidentiality by ensuring this data is secure and that sensitive information is accessed only with written, informed consent.

These concerns are being addressed by the health care community and companies that develop electronic medical record software. Software companies, which must adhere to guidelines in the Health Insurance Portability and Accountability Act, are continually refining their products according to industry standards for computer security adopted by the government and financial industry. And medical professional societies have been revising their ethical guidelines for genetic testing to account for patient confidentiality and privacy.

The health care and biomedical research communities are just beginning to scratch the surface of technology that can unlock the knowledge housed in vast stores of medical information being collected daily. Because of the enormous potential to improve our understanding and treatment of disease and enhance the delivery of care, this country needs to support such research through continued government funding and innovative public-private partnerships. The University of Chicago, with a critical mass of expertise in biomedicine and advanced computation, intends to help lead in this effort.

Kenneth S. Polonsky, MD
Executive Vice President for Medical Affairs, University of Chicago
Dean, Biological Sciences Division and Pritzker School of Medicine