Cyberinfrastructure for CHOIS a Global Health initiative for obesity surveillance and control

1. Cyberinfrastructure for CHOIS a Global Health initiative for obesity surveillance and control Arun K. Datta1, Victoria Jackson2, Radha Nandkumar3, and Weimo Zhu4 1National University 2Illinois Department of Human Services 3National Center for Supercomputing Applications 4University of Illinois at Urbana-Champaign

2. NU Community Research Institute (NUCRI) (http://nucri.nu.edu) NUCRI is an outreach to the Community for National University • National School Board (NCC/FRC) • HASTAC (higher education)/HASS grid • UC Humanities Research Institute • K12 (AmeriCorps) • ARTCA • Illinois Department of Public Health • NCSA/University of Illinois at Urbana-Champaign • SmileHealthy, SIU, SALTRA, etc. focused on digital technology need based Research for the community

3. NU Community Research Institute (NUCRI) (http://nucri.nu.edu) Tools and Technologies i-Dataware – web based integrated database system for providing social services ezSRB– web based interface for managing data through Storage Resource Broker (SRB) middleware; used in HASSgrid deployment VCMSS – virtual collaboratory tool for working on collaborative projects FastApps – web based software system for grant management CyberEdWorld – immersive 3D space for virtual classroom Open source software technologies (Portal Technology, Content management Software/Drupal, audio/video communication software/Access Grid, PHP, MySQL…)

4. https://ncc.nu.edu/

5. CHOIS Electronic Medical Record System Supported by CI Childhood Obesity Informatics System

6. Electronic Medical Record By 2014, all the citizens should have an access to his/her Electronic Medical Record. Communications of the ACM, Nov 2009, Vol 52 (11), 18-20. EMR are widespread in Europe, Australia, and elsewhere, but only 4% of American doctors have a fully functional system. New England J. med., 356, 24, June 14, 2007, 2527 – 34.

7. Information flow commonly present

8. Implementing Electronic Medical Record • Benefits are obvious • Reduction of clerical errors • Clinical-decision support • Furthering medical research • Economic Incentives to doctors • Economic Incentives to Hospitals • Regulations – HIPAA, FERPA • Standards (HL 7, ISO, DICOM, etc.) • Data Integration • Data exchange Communications of the ACM, Nov 2009, Vol 52 (11), 18-20.

9. Data Integration Electronic Medical Record Hematology Oral Pathology Histopathology Electronic Healthcare Record Blood tests Image of acute arterial embolism X-ray Transmission electron microscopy Microarray Scanning Tunneling Microscopy Atomic force microscope (AFM) CT finding, Epithelial carcinoma of the ovary Heart surgery

10. Electronic Devices for capturing the data Smart Phone Echocardiography (EKG) Tablet-PC

11. CI in Healthcare Management • EHR will be in place by 2014 • Health information exchange policy will be in place • Medical devices will be standardized to send the data to the EHR and ‘connect’ to each other • Patient will have a greater control over his/her health data • Patients will have more control over surveillance system • More meaningful reports can be generated using CI • Users needs to be trained for appropriate use of EHR

13. Obesity – a Global Concern Since last two decades, it has become so common that in 1997 the World Health Organization (WHO) formally recognized it as a global epidemic. U.S. National Health and Nutrition Examination Survey suggests almost 1/3 of children and adolescents are overweight or obese and 11.3% of children and adolescents are very obese.

14. The economic impact of this condition is staggering: in 2008, it has been estimated that more than 147 billion dollars were spent just in the United States for medical costs related to obesity and this estimation does not include the time lost from work. If this trend continues, it has been projected that nearly one-fifth of the healthcare budget in US alone may have to be used for obesity control [1,2]. Due to all these, obesity has become a major concern in US. The present administration under President Obama has recently established a task force on childhood obesity (White house, February 09, 2010). • Wang Y, Beydoun MA, Liang L, Caballero B, Kumanyika SK. Obesity, 16 (2008), 2323-30 • Hammond RA. Prev Chronic Dis. 6 (2009). Retrieved on February 14, 2010 from http://www.cdc.gov/pcd/issues/2009/jul/09_0017.htm.

15. A 2006 review identified ten possible contributors to the recent increase of obesity [1]. Obesity is the result of interplay between genetic and environmental factors. Polymorphisms in various genes controlling appetite and metabolism predispose to obesity when sufficient calories are present. As of 2006, more than 41 of these sites have been linked to the development of obesity when a favorable environment is present [2]. A sedentary lifestyle obviously plays a significant role in obesity. 1. Keith, T. Genetic Engineering and Biotechnology News, 27 (2), Jan 15 2007 2. Poirier P, Giles TD, Bray GA, et al. Arterioscler. Thromb. Vasc. Biol. 26 (2006), 968–76.

16. http://nucri.nu.edu/obesity/index.php

17. Three-Tier Architecture Grid and Web Protocols JDBC, Local, or Remote Connection Portal Client Stub Database Service Database Portal User Interface Portal Client Stub Grid Resource Broker Service HPC or Compute Cluster Portal Client Stub Information and Data Services Grid Information Services, SRB Three-tiered service oriented architecture is accepted standard for accessing Grid and other services

18. Open Grid Service Architecture Layer Distributed Grid and Web Services Launch, configure And control • Application Interface Workflow service Grid Portals App Instance App Instance App Instance Data Management services Registries and Name Binding Policy security logging Account services Event/Mesg Services Reservations and Scheduling Administrating & Monitoring Grid Orchestration Open Grid Service Infrastructure (web service component model) Resource layer (slide by Dennis Gannon, modified)

19. Data grid deployment

20. Visualization of SRB SQL server/Oracle/MySQL Any platformDistributed Server Supercomputers Mainframes

22. CHOIS–Childhood Obesity Informatics System http://nucri.nu.edu/DHS/login.php

23. CHOIS–Childhood Obesity Informatics System Features of CHOIS - Web based forms * BMI, Asthma, etc * Genomic info - Combination of federated and central databases - Reports are available from anywhere anytime - Role based accessibility - Regulatory compliance (HIPAA, FERPA) - Mobile version is available - CMS, Drupal - Data integrator & DSS Cyberintegrator, MotifNetwork, etc. - Alert system - Cyberenvironments

24. Child Health and Obesity Informatics System Tools Web application Alert system CyberIntegrator DSS Nutrigram CHOIS Activitygram Training materials Immersive 3D Space International Collaboration Research *Accessible through computers and smart phones

25. demo

26. CHOIS–Child Health and Obesity Informatics System Incorporating Genomic Information

27. CHOIS–Content Management System, Drupal http://nucri.nu.edu/DHS/drupal/

28. CHOIS PRAGMA Thank You