Fueling Clinical and Translational Research in Appalachia: Informatics Platform Approach

Abstract

Background: The Appalachian population is distinct, not just culturally and geographically but also in its health care needs, facing the most health care disparities in the United States. To meet these unique demands, Appalachian medical centers need an arsenal of analytics and data science tools with the foundation of a centralized data warehouse to transform health care data into actionable clinical interventions. However, this is an especially challenging task given the fragmented state of medical data within Appalachia and the need for integration of other types of data such as environmental, social, and economic with medical data.

Objective: This paper aims to present the structure and process of the development of an integrated platform at a midlevel Appalachian academic medical center along with its initial uses.

Methods: The Appalachian Informatics Platform was developed by the Appalachian Clinical and Translational Science Institute's Division of Clinical Informatics and consists of 4 major components: a centralized clinical data warehouse, modeling (statistical and machine learning), visualization, and model evaluation. Data from different clinical systems, billing systems, and state- or national-level data sets were integrated into a centralized data warehouse. The platform supports research efforts by enabling curation and analysis of data using the different components, as appropriate.

Results: The Appalachian Informatics Platform is functional and has supported several research efforts since its implementation for a variety of purposes, such as increasing knowledge of the pathophysiology of diseases, risk identification, risk prediction, and health care resource utilization research and estimation of the economic impact of diseases.

Conclusions: The platform provides an inexpensive yet seamless way to translate clinical and translational research ideas into clinical applications for regions similar to Appalachia that have limited resources and a largely rural population.

Keywords: Appalachian region; data mining; data science; data visualization; data warehousing; electronic health records; health care disparities; machine learning; medical informatics.

Figure 1

Appalachian informatics platform.

Figure 2

Tableau dashboard displaying patterns and trends in charges for non-traumatic dental ER visits at Cabell Huntington Hospital between 2010 and 2018. ER: emergency room.