Developing a sustainability model for the Integrating Biology and the Bedside project, or i2b2, should be a national priority as federal funding comes to an end, according to an article published this month in eGEMS.
Over the past 10 years, more than 110 hospitals have use i2b2 for research. The software allows researchers to conduct direct, self-serve queries to look for cohorts of patients that meet a certain criteria.
Children's Hospital Boston, for instance, uses it internally, but through the Shared Health Research Information Network (SHRINE), it can query partner institutions, as well.
This open-source platform has a community of developers that are continuously enhancing its analytic capacities and inventing new functionalities.
It originated with Partners HealthCare System and was funded starting in 2004 as one of four initial National Centers for Biomedical Computing, but its 10-year funding is ending.
Looking back over the previous 10 years, the paper notes two lessons:
- People have great creativity in using i2b2 in different ways. Medical Imaging Informatics Bench to Bedside (mi2b2), for instance was an externally funded project that ties medical images from a picture archiving and communications system (PACS), a system that can be used in conjunction with i2b2. The Substitutable Medical Applications, Reusable Technologies (SMART) Platforms project developed app technology to construct a mosaic of patient-data visualization tools, according to the paper's authors.
- All those innovative uses have helped make the system more robust. Its users tend to hit upon its limitations, but because they tend to be technically skilled people, they help develop solutions to those problems, as well.
While core development on the system has been undertaken by six employees at Partners, its future remains uncertain. Among the potential solutions:
- Find an industry partner. The authors worry that its mission might not align with researchers', however, once financial pressures mount. They note that return on investment can be elusive in research or difficult to measure.
- Create a foundation as central authority for the project with a rotating group of directors. While that would require an initial investment, it could be directly influenced by its academic users and their goals. The authors note, however, that's unlikely to sustain i2b2 over the long term.
Institutional users have funded their own projects, which expanded uses of i2b2, and it has held events and challenges, including a de-identification challenge to redact personal health information from records.
To learn more:
- read the article (.pdf)