We talk a lot about different areas of health research, and how that research may lead to treatments. Today we're talking about research into healthcare itself, and how systems can be improved to deliver better outcomes and better healthcare. Our guest today is Dr. Peter Embi, MD, who is president and CEO of the Regenstrief Institute at the IU School of Medicine. He'll tell us about the Institute's work, and how making positive changes to how care is delivered on an institutional level can change care for millions of patients.
The Healthcare Triage podcast is sponsored by Indiana University School of Medicine whose mission is to advance health in the state of Indiana and beyond by promoting innovation and excellence in education, research and patient care.
IU School of Medicine is leading Indiana University's first grand challenge, the Precision Health Initiative, with bold goals to cure multiple myeloma, triple negative breast cancer and childhood sarcoma and prevent type 2 diabetes and Alzheimer's disease.
Dr. Aaron Carroll: Welcome back to the Healthcare Triage Podcast. This month, we're going to be talking with Dr. Peter Embi about Medical Informatics and the Regenstrief Institute and all kinds of good stuff.
This Healthcare Triage Podcast is sponsored by Indiana University School of Medicine, whose mission is to advance health in the State of Indiana and beyond by promoting innovation and excellence in education, research and patient care.
IU School of Medicine is leading Indiana University's first grand challenge, the Precision Health Initiative, with bold goals to cure multiple myeloma, triple negative breast cancer and childhood sarcoma and prevent Type 2 diabetes and Alzheimer's research. One of the key components to doing all of those wonderful things is being able to use all of the information we might gather and put it in places and turn it into things that people can use. To do that, we need to talk about informatics, and that's why today's guest is going to be so helpful to us.
Peter Embi is the CEO and President of the Regenstrief Institute, where I actually also happen to be Vice President for Faculty Development. Let's just get that out there. He's also Associate Dean for Informatics and Health Services Research for our School of Medicine, and he's the Vice President for Learning Health Systems for IU Health.
Tell me about some of these things. What do all those things mean? Let's start with, why don't we start at the back? What is Vice President for Learning Health Systems at IU Health?
Dr. Peter Embi: Well, thanks. Well, thanks for having me. Yeah, Vice President for Learning Health Systems at IU Health, that's a really exciting role. When I first got here to Indiana and came for the role at the Regenstrief Institute in the IU School of Medicine, we also immediately engaged with IU Health, which is one of the major, actually the major, health system partner to the School of Medicine and actually worked with their leadership to see how we could more closely tie the work that we do at the Institute to the work that the health system is trying to do to improve health and healthcare. And to try to operationalize this concept that we can talk more about of the learning health system, where through the course of practice and in what we do in healthcare, we're trying to systematically learn. We want to learn from every one of our experiences. We want to take all the data and learn from that and be able to improve health and healthcare for everyone.
So we created this role at IU Health, where I lead a group and an initiative to see how do we turn our IU Health into a true learning health system.
Dr. Aaron Carroll: So that just seems like common sense.
Dr. Peter Embi: It does.
Dr. Aaron Carroll: Why don't we have that already?
Dr. Peter Embi: It's absolutely common sense. If you talk to most people, I think most people would say, "Isn't that already what we do?" As you know, shockingly and surprisingly, it is unfortunately not. We don't do enough to actually learn from every single patient, every one of our experiences so that we can take better care of people tomorrow and the next day and next year and after that. We should be. It's certainly the goal. It's certainly what we want to do. As we have gotten to a health system where we increasingly have things like electronic health records and we're collecting all this information, it makes it that much easier to think, "Well, gosh, we should really be taking advantage of each of these opportunities to learn."
Now, why don't we? There's probably a lot of reasons for that. One of them at least is that we really have a health system that has evolved over time to be still tracked to what it used to be, which is really taking care of one patient at a time. That's still primarily what we do as physicians, right? We primarily think about, "How do I take care of the patient who's sitting in front of me, give them the best possible care I can give them today and then move on to the next patient and do that for them?" That is great. We should definitely do that, and we should be enabling that kind of individual care to be better and more precise, et cetera.
But it also means that if we design a health system that way we aren't necessarily also designing it to learn for better taking care of the next person and being able to manage populations. We have to be deliberate about that. We have to think about that, and we have to actually organize the system that way. So about 15 years ago now ... I may be wrong about the exact date ... But a good while ago, the Institute of Medicine now, the National Academy of Medicine, published some of the initial books and publications on this idea of creating a learning health system, where our system should, in fact, take advantage of all these opportunities to learn and improve. While people have been writing about that and thinking about that for a long time, there are relatively few places that have actually done that. We wanted to try and do it.
Dr. Aaron Carroll: We should be clear that this is not a failing of Indiana. This is everybody is trying to ... But again, I almost want to push for, it just seems like we should be able to do this.
Dr. Peter Embi: For sure.
Dr. Aaron Carroll: So what's standing in the way. Why is this not easy?
Dr. Peter Embi: Yeah. I think there are a number of factors and a lot of them, I know your audience knows because you talk about these things. But some of them are not so obvious. Some of it is cultural. I think some of it is the way we've sort of organized medicine historically in healthcare in terms of again, taking care of one patient at a time.
Some of that translates into the way we pay for healthcare, where we don't actually pay for learning. We don't actually pay for being able to take better care of people in the future. We pay for taking care of, "What does Aaron have today when he comes to my office and needs to see me for his rheumatoid arthritis or whatever he might have?" That's what I'm being paid to do. Not necessarily to learn how to better take care of patients with rheumatoid arthritis tomorrow. Some of it is about the way that, that concept and that kind of paradigm of healthcare has also translated into all of our other systems, not just the payment systems, but the regulatory systems that we have and what they say about what we should and shouldn't be doing with information, the actual information systems, the way we've built them, the way we've implemented them. Again, very targeted, typically toward taking care of one patient at a time, not with an eye toward also looking at all of the information to say, "How do we systematically learn from this?" While there are a lot of examples of trying to do that, they tend to be exceptions, not the system.
Dr. Aaron Carroll: I don't want to be a pessimist, but sometimes even those exceptions wind up being more promise than reality. I mean, it feels like people talk a big game and there's all these big ... But I do research and medical informatics as well. And sometimes I get a little down in the sense that we've been talking about electronic medical records for decades. We've been talking about making these things easier, and you watch huge leaps forward in technology and we still can't seem to get some of these things correctly. I know our viewers or our listeners have heard me rant about these things before, but what do you think are the roadblocks to getting some of this stuff done?
Dr. Peter Embi: I mean, some of that is what we've talked about, but there's more. We, first of all, have the underlying ways in which we organize and pay for health care. That really can't be overstated in terms of the importance of that. Because if you look at examples around the world, or even here in the United States where we've done this a little better, not perfectly, but a little better, they tend to be places where we pay for things differently, where we think about more holistically the whole system rather than the more individual practice-based fee for service kind of environment that we've traditionally had. We don't often think about it this way, but the implications of that kind of a system have then led to the tools and the regulations and the processes and procedures that we have that really reinforce that kind of individual care paradigm as opposed to the more holistic view of how do we improve things.
But if you look at examples around the world where there's, let's say single payer systems, where these sort of financial incentives are aligned with trying to contain costs for the purposes of getting the best value out of care, where you're taking better care of a population with limited resources, then there's a reason to invest in things like large registries or other kinds of underlying infrastructure that allows you to then say, "Well, let's really learn about how to better manage the really expensive care we have to provide to our population." There are places in Europe and the Norwegian countries and others that have done this quite well.
In the United States some of the best examples of that, where we do have that, are some of our large managed organizations like Kaiser Permanente and groups like that, that have done a very nice job, because again, they have to basically cover all the costs, take care of a population that they're responsible for and so if they can do that less expensively with better outcomes that result in fewer people getting hospitalized and having bad outcomes and costing the organization more money, they can spend their resources instead on prevention and other things. That's not necessarily the alignment that we have when we look across the traditional environment of the US healthcare system.
Dr. Aaron Carroll: No, you're exactly correct. So given that most parts of the US healthcare system don't look like that, how do we drive them to care about these things?
Dr. Peter Embi: Well, I think what's happening now is, and again, you and your listeners know this well, we're getting to a point now where we just can't afford to keep going in the direction in which we've been going. That led over a decade ago now to some of the incentives that were put in place to encourage people to adopt electronic medical records, so-called meaningful use incentives. Now those didn't necessarily have the intended effect, and we can talk about that. But one of the effects that was intended was widespread adoption of these systems and that happened, and it really, really accelerated the adoption and use of electronic health records. So now we've got that in place. I think what's becoming more and more clear is at some point we just can't keep seeing the percentage of GDP go up in terms of what we're spending on healthcare. We've got to bend that curve to have it be more affordable and provide better value, better care, better outcomes for lower cost.
The only way we're going to be able to do that, whether you're an individual health system like IU Health, or whether you're a large health system or individual practitioner is you're going to have to get more efficient and effective at taking care of your population so that with the more limited resources you have to be able to manage a population, you can actually keep them healthier. That is going to increasingly require us to think about how do we learn better ways to keep people healthy, keep them out of the hospital and take care of them so that they don't end up getting sicker.
Dr. Aaron Carroll: Clearly one of the ways that you do that is with better uses of information and data, which will get into medical informatics. I'd love for you to talk to us a bit about that. What is your definition or understanding of medical informatics?
Dr. Peter Embi: Yeah, it's a great question. There's as many definitions as there are people, but I'll tell you mine. I try to keep it pretty simple. Essentially what we do in healthcare and in medicine in particular, but also in nursing, pharmacy, really all across healthcare is we manage information. I mean, that's really what we do. Whether it's taking a history from a patient or documenting a procedure or reviewing the literature, we're basically information managers and then we take that information and we turn it into something that we ultimately do on behalf of a patient or to a patient in terms of a procedure or what have you.
There's a science, there's a discipline that is focused on how do you optimally manage information in healthcare and that field is called informatics. Health informatics, biomedical informatics is what we tend to call it in the US. Across the rest of the world, it's mostly health informatics. But it's the same thing. The idea is how do we take this intersection of disciplines that draw from information science, data science, statistics, epidemiology, some business processes in terms of organizational behavior and management, and of course, computer science and the like, pull them together into this field of informatics that allows us to then organize information in a way that it gets to the right person in the right way at the right moment to make the right decision. That's what we're trying to achieve.
Dr. Aaron Carroll: Let's turn to the Regenstrief Institute. So, I mean, all cards on the table, one of the reasons I actually came to Indiana after I graduated from fellowship was that I was doing health services research as it intersected with informatics and pediatrics. There were not as many places doing that across the country as you might think and one was Regenstrief. So tell me about Regenstrief Institute.
Dr. Peter Embi: It's a very special place. I've also known about Regenstrief my entire career because it is that storied institution. Actually, we're celebrating our 50th anniversary this year, which is unbelievable. This is one of the first such institutes in the world, really, to focus in this area, first of informatics, and then health services research, and aging research, and other areas that we now focus on that started in 1969. It was actually launched by an industrialist and philanthropist from Indiana, Sam Regenstrief and his wife Myrtie, who-
Dr. Aaron Carroll: Talk about, because this story is always fascinating to me.
Dr. Peter Embi: It's so great.
Dr. Aaron Carroll: So tell us about him.
Dr. Peter Embi: Sam was really just an incredible person and amazing industrialist. He actually was known as the Dishwasher King. So Sam Regenstrief, Connersville, Indiana at one point was making over half of the dishwashers in the world. He invented the seal that was required to basically develop the front-loading dishwasher. Before that time, you had to load dishwashers from above, and it really fundamentally changed the efficiency and the cost of these devices so that they could become something that we all now take for granted and have in our homes and have everywhere. There was a time where in his plan, he was cycling through and one day they would do a run for, I don't know, Kenmore, and the next day it was Whirlpool and they were essentially creating most of the dishwashers for the world.
Well, you can imagine how his mind worked as really an early industrial engineer to think about efficiency and management. He had an experience later in his life where, as all of us do eventually, he got sick and was engaged with the health system and was so frustrated with what he saw at that time in terms of it being so inefficient that he thought, "There's got to be a better way." He happened to have some family that were connected to healthcare. They said, "Well, Sam, why not start a foundation where we could actually basically create an Institute that would study this? That would figure out how do we improve healthcare? How do we take those principles that you think about in terms of having an efficient operation for creating dishwashers and bring that kind of thinking of efficiency and improvements to healthcare?"
That was really the birth of the Regenstrief Institute. He worked to establish this foundation and working together with Indiana University created the Regenstrief Institute in 1969. The Regenstrief Institute went on under the leadership of some luminaries in our field, including doctors Clem McDonald and Marc Overhage and Bill Churney and many others to develop some of the earliest electronic medical records in the world.
Dr. Aaron Carroll: Yeah. I'm always amazed by that and that so few people know that.
Dr. Peter Embi: It's incredible. It's like this-
Dr. Aaron Carroll: One of the earliest electronic medical records was the one used at Wishard. It was Wishard?
Dr. Peter Embi: That's right. It was Wishard Hospital at the time and now Eskenazi Hospital. Truly one of the first truly comprehensive electronic health records in the world, as well as a lot of the underpinnings of modern day electronic health records were invented here, like the standards that we think of in terms of how we manage the information. A very important international standard called LOINC and early work in what we call clinical decision support systems. So systems to be able to actually help clinicians make the right decisions at the point of care. I could go on and on. I mean, major improvements, not just in technologies, but always with an eye toward, how do we use technology and information to address a healthcare problem? To improve healthcare? That continues to be the focus of the Institute is pragmatic applied research to figure out how we take the knowledge we have from these different domains and bring it to improvements in health and healthcare.
Dr. Aaron Carroll: So what do you think are the most exciting things that we're working on right now, or where the biggest advances might be seen?
Dr. Peter Embi: There are a number of them and probably too many, and I'm sure I'll miss some, but probably some of the greatest ones relate to this whole business of how do we leverage data to be able to use data for good, not just for nefarious activities. We certainly don't want to do that. So we think about how do we actually leverage data for good and how do we take all of these data that we are increasingly surrounded by and actually be able to learn? How do we take better care of people? How do we use artificial intelligence methods and machine learning capabilities and other kinds of approaches, natural language processing, et cetera, to come up with solutions that can help people remain healthy or get healthy if they get sick and better manage their own care and do that in conjunction with their clinicians.
That whole transformation that we're witnessing right now in terms of the paradigm of healthcare and how increasingly it's really being changed through the democratization, availability of data, I think is huge. As part of that, while places like the Regenstrief Institute have really been pioneers in managing healthcare data, we're increasingly looking at social and behavioral determinants of health and how we can bring those together with our methods to be able to improve the kind of healthcare that gets delivered.
I would say beyond that, there's a lot of research that needs to be done in different models of care. How do we actually change the way we practice, whether it's in the hospital, whether it's in the clinic or as some of our researchers are leading, whether it's in nursing homes or even at home. We have a Center for Aging Research, for instance, that does remarkable work in that space to figure out how do we take a lot of the principles of health services research informatics, and implementation science, and really bring that to improvements across that spectrum. So we're doing a lot of work.
Dr. Aaron Carroll: You mentioned implementation science. What is that?
Dr. Peter Embi: Good question. Implementation science is a rather new discipline relative to the others. These are all relatively young, but implementation science is really the science of how do we take discoveries that should have an impact in the real world and not only implement them and deploy them, but then scale them and go through cycles where we determine how they can actually be refined and improved to be able to have the intended effect. So an example might be taking a discovery of a decision support intervention, let's say where we might say, "There's a particular tool that could help a clinician make a better decision at the point of care. How do we not just figure out whether that works in one clinic or amongst a group of doctors or nurses in a particular hospital, but how do we take and scale that across the entire enterprise in a way that's actually going to be adopted and effective and sustainable." So there's a science to that that is different than the discovery of whether it works. It's really about how do you get uptake and how do you actually get it used everywhere?
Dr. Aaron Carroll: Would you say it's sort of similar to sort of the difference between efficacy and effectiveness or-
Dr. Peter Embi: Yeah. Yeah. I think there's an analogy there. Yeah. We can test efficacy and effectiveness without implementation science, but then there's the effectiveness, if you will, across the enterprise.
Dr. Aaron Carroll: Absolutely. I'm always amazed because when I talk about some of these things with people, they think they're common sense. They think, "Well, of course we should be able to do these things." But we've spent decades trying and not doing it as well as we would like. There's clearly so much to be done. Even when I hear things about artificial intelligence, I just feel like I keep seeing in the news advances that turn out not to be as productive as the initial move seemed to be. So what do you think we need to do to be better at all of this? Is it we're overselling? Is it we're not doing enough groundwork?
Dr. Peter Embi: There is a risk of that. There's this concept that we think about of sort of a hype curve, where when new technologies and new inventions come along, we get very excited about them. That's sort of human nature. To some extent it's good. It drives us to continue doing that kind of work, but there definitely needs to be some healthy skepticism about a lot of these things when they're first starting out, because they do need to be proven. While there's incredible promise ... I heard an analogy once to the early airline industry, where there was no question when we started to fly as human beings that, that was going to change the world. Individual airlines were going to be successful eventually, but which airline company should you have bet on in the early days? Who knows?
A lot of them came and went. The airline industry has had a huge effect and has been quite successful, but individual airlines, that's tough. If you take that analogy to what we do in artificial intelligence and a lot of these technologies, there's no question this is going to change our lives. It already is and it's going to continue to, and we've got to do the science and the research to figure out what works, what doesn't work. Be rigorous about that, be sober about it. And eventually some of those things will lead to solutions that will in fact persist and others are going to fall by the wayside. That's sort of natural.
We do have to be a little cautious about it, but I think part of what happens as you go, and we sort of understand this in research innately is, not everything that you study is going to work out. That's sort of the nature of research. But that's okay. It's part of the process. We just have to make sure we're doing that properly. The most dangerous thing is to get so excited about a technology or an intervention, whether it's, I don't care what it is, a drug or a technology or a device, and get so excited about it and be so sure about it that you deploy it without testing it.
Dr. Aaron Carroll: Right. And that's always what's fascinated me because I feel like for a time we did that with a lot of information systems and everything else. We just sort of said, "This is clearly an unequivocal good. Let's just roll it out and see what happens." But it almost gets back to, I think what we were talking about the learning health system at the beginning, we need to learn about these things as we use them so that we advance the field and do better tomorrow than we do doing today.
Dr. Peter Embi: We do. I don't want to get too hokey, but it really comes down to kind of having an ethical sort of approach to this. Where it is really important and ethically right to continue to innovate and try to improve health and healthcare. But it's also just as important to evaluate what it is you're doing. We wouldn't think about rolling out a new therapy, a new drug or a new device without doing rigorous testing and getting FDA approval and making sure that, that all works. Yet we've been historically a little bit more comfortable doing that with technology. When in fact, you could have a very significant effect, and it's been demonstrated that you could have a very significant detrimental effect if you're not careful about what you do to a very complex system when you introduce a new technological intervention.
So the importance of evaluation and checking to make sure that the effect you're going to have really works ... And by the way, when you prove it in one place and you take it to another place and you then deploy it there, making sure it works there is another important thing. So hence the importance of this concept of a learning health system. We have to be vigilant when we do this work. Because I'm excited about it, it doesn't keep us from needing to do the work and innovate. It just makes it more important to realize that we have to do it correctly. When we do it correctly, our investments in these things should actually be more fruitful.
Dr. Aaron Carroll: How did you get interested in all of this? Was it always, or before medical school, in medical school, later?
Dr. Peter Embi: It's funny. It wasn't always, actually. I did know from my early days that I wanted to be a doctor. I used to dress up for Halloween as a doctor.
Dr. Aaron Carroll: I did too. [crosstalk 00:23:34]
Dr. Peter Embi: I'm of Cuban descent. My father's from Cuba and my mother was born in New York, but she's also Cuban. So the joke of course, is that if you're a Cuban boy, you're either going to be a baseball player or a doctor. I was a pretty lousy baseball player. So I had to be a doctor. But I always thought about that, and I played with computers when I was a kid. I had my Commodore 64 and that sort of thing. I did some of that work, but when I went to to college, I really wasn't a computer geek. I wasn't really doing that work.
It wasn't really until I got to medical school and I had a break between my first and second year of medical school ... I had gone straight through high school, college, medical school and decided, "I don't want to go work in a lab like everybody else. I want to sort of take a little break." I bought my first real computer at that point, an early MacBook 160, I think, and the worldwide web had basically just come online. You could still count the number of websites at that time. I got online with my very 14.4 Baud modem, and I started to browse this thing called the worldwide web, which was still mostly text at that time. I sort of reverse engineered how those websites were built and taught myself how to build websites.
That was what I did that summer. That just really got me excited about the possibility of ... Some of the early websites were also medical ... And it got me excited about the possibilities of that. That was also around the same time that handheld computers like the Palm Pilot were around.
Dr. Aaron Carroll: That was my introduction.
Dr. Peter Embi: I actually had a Newton MessagePad first. I started to actually, by my fourth year of medical school, I was asked by one of my professors to actually give lectures to the students on how to use handheld computers in healthcare. When I went to my residency, I went to the medical school at the University of South Florida, and then I went to Oregon Health Sciences for my internal medicine residency. I picked it in part because it was one of the few places in the country at that time that had a fellowship like the one we have here at Regenstrief now in medical informatics. I just thought, "Well, that's something I might want to study."
But even at that time, I finished my residency, I did my fellowship, I got my Master's Degree in medical informatics in Oregon, and I still didn't think that was going to be a full-time job. I went to the Cleveland Clinic for my rheumatology and immunology fellowship, and I figured I was going to be a rheumatologist who dabbled in informatics. Very soon thereafter, I took my first faculty position in Cincinnati at the university. I started to get grants and do this work. It was just a right moment in time where things just exploded in the field.
I started the Center for Health Informatics there, and I became an informatician who dabbled in rheumatology. Before you knew it, I was there for about seven years, and I went to the Ohio State University where I was the Vice Chair of a Department of Biomedical Informatics. We continued to do this work. How do we use tools and resources to improve care? To improve research? One thing led to another, and eventually three years ago, I had the opportunity to come here and lead the Regenstrief Institute. That's how I got here.
Dr. Aaron Carroll: What are the things you're most excited about that are happening around here right now?
Dr. Peter Embi: I would say I really see a lot of opportunity for us to ... We sort of moved from the area of figuring out a lot of kinds of technical solutions and tooling to how do we actually really capitalize on them. How do we really now not just focus on what is the next cool widget? But how do we actually take that and change peoples' lives? I know that sounds a little hokey, but it's absolutely true.
Dr. Aaron Carroll: I remember ... I'm sure we did it in a video ... I think it was ... I mean, it's an old paper, but it was Chuck Friedman's Fundamental Theorem of Informatics where it just stresses that the tool plus the person has to be good in the person, and the person is so important. And yet I see too often that we focus too much on the tool.
Dr. Peter Embi: Absolutely. There are huge problems that we've been trying to solve for a long time that we now have such powerful tools, such an amazing amount of data assets, and such incredible expertise and connections between our traditional academic environment and the operational health system, that if we bring those things together we really do have an opportunity now to change things. Not just do them in a more sort of standard way of quality improvement initiatives here and there, but actually fundamentally change practice with that principle in mind.
There was a time when the thinking back in the '80s was not decision support tools where the computer plus the doctor is better than each by themselves, but that the computer will replace the doctor. We have pretty quickly abandoned that and I think rightly so, because I really am one of those people who believes that never say never, but it's going to be a heck of a long time before we don't need human beings in this equation. The role of clinicians, whether they're physicians or nurses or pharmacists or physical therapists, whomever they happen to be, in taking care of patients and the humanism part of what it is we do will always be critically important when you're talking about sick people.
Dr. Aaron Carroll: When I was a second-year resident, I was this close to quitting. I was going to finish residency, but I was going to give up. I was in Seattle. I thought, "I'll apply to Microsoft and I'll do something." I was very lucky that, I think I was on NICU or ICU, but my attending happened to be an informaticist. And he's like, "You could totally make a career out of doing this." I was like, "I had no idea. That sounds great." I'm always amazed that without being exposed to certain individuals at certain times, some of these fields no one knows they exist.
Dr. Peter Embi: Yeah, you're exactly right.
Dr. Aaron Carroll: I'd say informatics is one. It's just unless you're at a place where it's a big deal or you happen to come across an informaticist while you're in training, no one knows about it, so-
Dr. Peter Embi: I would love for little kids to dress up this year as informaticians for Halloween, but it's not going to happen.
Dr. Aaron Carroll: No, no. I feel the same about health services researchers too, although it's all sort of merged together. But it's important to know it's a viable career option. There's so much work that needs to be done.
Dr. Peter Embi: It is getting better. I mean, people are learning about it, but we have to do a better job of letting people know. What's interesting too ... I'll tell you another little fun anecdote about my family ... I actually found out one of my, actually my great-great-grandfather graduated from the University of Pennsylvania Medical School. He was in-
Dr. Aaron Carroll: Where I went to medical school.
Dr. Peter Embi: Yeah. He was in Cuba. He came up here because at the time, if you wanted to get a good medical degree, you went to Penn if you were in this hemisphere, and he did that. Then he went back to Cuba and his thesis work was actually on how do we improve sort of the healthcare system. I thought, "Oh my gosh. So maybe it's in my blood." I mean, because what you're really talking about, whether it's informatics or health services research or any of this, it's really about not just taking care of patients, but improving the system.
If you do that, and this is what gets us so excited, I think about this ... If you do that well, the impact that you and I can have seeing patients every day is great. We can take very good care of individuals, and we can affect the lives of hundreds or thousands of people by doing that and that's critically important. If we actually help improve the entire system, we can affect millions of people in a positive way. That's the kind of power you have when you do this kind of research and practice in informatics and health services research. That's pretty exciting.
Dr. Aaron Carroll: Absolutely. Preaching to the choir for me. Absolutely. Are there any things going on in Indiana that you're excited about?
Dr. Peter Embi: Yeah, absolutely. In fact, as you alluded to, you knew about the Regenstrief Institute most of your career. So did I. The opportunity to do things right here in Indiana has always been a really great one. For instance, the Regenstrief Institute did the early work that led to still one of the largest and most robust health information exchanges in the country, the Indiana Health Information Exchange. We continue to now work very closely with our partners there to have access to information from across the state and improve the lives of Hoosiers.
Some of the things we're working on right now that are really important and exciting include for instance, projects related to addressing the opioid crisis, where we're doing work with our partners at the level of the state government, at the level of all the different health systems in the state and other research partners like the Indiana Clinical and Translational Science Institute, the Indiana University School of Medicine, and all of Indiana University, our colleagues at Purdue, our colleagues at Notre Dame, to really work across the state on solutions that can allow us to address major health issues in the state, including with our partners increasingly not only in the academic sector, but in industry, the biopharmaceutical sector with some big players obviously right here in our backyard that are critically important to our environment. Eli Lilly, Roche Diagnostics, Cook Medical and others.
We're really excited about how do we bridge these worlds between academia, healthcare, and industry to really be able to make great discoveries building on the history of the great assets that we have built here over the last 50 years at the Regenstrief Institute. I think that excites me every day. It presents us with a unique opportunity to really do some wonderful things. This fabric we have here of not only trust in Indiana that's led to the development of these resources, but the academic collaboration between all of our different organizations with the medical school and the CTSI that have connected everyone really puts us in a unique position to be able to not only help our local population, but then learn from that and spread that across the world. That's pretty exciting.
Dr. Aaron Carroll: Well, we'll expect big and better things from you.
Dr. Peter Embi: Thanks so much.
Dr. Aaron Carroll: This has been another episode of the Healthcare Triage Podcast, which is sponsored by Indiana University School of Medicine, whose mission is to advance health in the State of Indiana and beyond by promoting innovation and excellence in education research, and patient care. IU School of Medicine is leading Indiana University's first grand challenge, Precision Health Initiative, with bold goals to cure multiple myeloma, triple negative breast cancer and childhood sarcoma and prevent Type 2 diabetes and Alzheimer's disease.
As always, remember that you too can support the Healthcare Triage Podcast at patreon.com/healthcaretriage, where along with our research associate Joe Sevits and our Surgeon Admiral Sam, you can support the show and help make it bigger and better.