Big data in clinical information systems has enormous potential for tomorrow’s healthcare. Medical research based on the reuse, aggregation and analysis of medical data increasingly enables the development of new, improved treatments, pharmaceuticals and technologies. The consortium Smart Medical Technology for Healthcare – SMITH for short – is addressing this issue by bringing together heterogeneous data sources from patient care into an interoperable structure. Research and care data are linked across locations and made optimally available. SMITH’s work is geared to the current challenges of digitization and the introduction of e-health measures in the healthcare sector. Diagnoses, medication and types of treatment can thus be tailored even better to patients in the future. Data protection and data security have top priority.
In a first step, seven of the ten university hospitals participating in the consortium, are establishing Data Integration Centers (DIC). In close cooperation with the Universities of Aachen, Jena and Leipzig, as well as two non-university research institutions and four industrial partners, the IT infrastructure is being further developed in such a way that a cross-site linkage of information systems from care and research is created. The newly established Data Integration Centers hold data and documents for processing and analysis based on internationally standardized communication and security procedures and enable cross-institutional data exchange. Data and samples collected in the course of patient care can be made usable for clinical research. At the same time, the DICs create the conditions for newly acquired research findings to be fed back into healthcare. The prerequisite for this is the patients’ informed consent to the use of their data for research purposes.
The Consortium demonstrates the functionality and effectiveness of the Data Integration Centers through one methodological use case and two clinical use cases in the areas of intensive care and infectious disease medicine. The methodological Use Case PheP supports the establishment, qualitative enrichment and evaluation of the existing clinical dataset by establishing a phenotyping pipeline. The clinical Use Cases ASIC and HELP are designed to take advantage of the medical expertise at the sites. ASIC promotes the improvement of care for patients with acute lung failure through the use of routine clinical data. The HELP use case addresses the guideline-based use of antibiotics to target specific bacterial infections. Both use cases integrate mobile applications (apps) into everyday clinical practice at the participating sites. The SMITH Service Platform enables the use of the consortium’s results by other networking partners.
In order to strengthen education, training and the deployment of specialist staff in the context of the data integration planned throughout Germany, new professorships and the extensive, structured expansion of courses in medical informatics are planned at all locations.
SMITH is one of four consortia of the Medical Informatics Initiative (MII) funded by the German Federal Ministry of Education and Research (BMBF). The goal of the Medical Informatics Initiative (MII) is to improve research opportunities and patient care through innovative IT solutions. These should enable the exchange and use of data from patient care, clinical and biomedical research across the boundaries of institutions and locations. The German Federal Ministry of Education and Research (BMBF) is funding the MII with circa 180 million euros through 2022. In the four consortia DIFUTURE, HiGHmed, MIRACUM and SMITH, all university medicine institutions in Germany at more than 30 locations are working together with research institutions, companies, health insurance companies and patient representatives to develop the framework conditions to ensure a direct transfer of research findings to patients. A coordination office is responsible for the national coordination of developments within the MII, which the Technology, Methods and Infrastructure for Networked Medical Research e.V. (TMF) operates jointly with the Medical Faculty Association (MFT) and the Society Of University Clinics of Germany e.V. (VUD) in Berlin.