Eric Snyder says he’s “out to change the world” — and he’s only half joking. At the very least, the director of Informatics at the Wilmot Cancer Institute wants to change the nation’s thinking around information technology, commonly known as IT, in health care.
Snyder made headway recently when the biggest professional organization in the field invited him to make three presentations at the Healthcare Information and Management Systems Society (HIMSS) 2022 annual meeting. The organization marketed one of Snyder’s presentations as a high-priority talk; another on virtual reality was deemed one of the most innovative sessions at the meeting.
Snyder’s mantra is to simplify the complex, and speed up the process by which data can be made useful for physicians and scientists.
In academic medicine, for example, billions of bytes of data gathered from patient services and research are stored in vast warehouses. To update it, programmers typically copy and upload entire data warehouses each day, capturing new data from the past 24 hours with the old.
Snyder found a different way. He wrote a complex script that ingeniously searches through Wilmot’s warehouse continuously, only seeking and highlighting new information. He then set up programs that allow analysts to readily see those changes in real time and act upon anything that needs attention.
“It’s really fascinating to me how IT has become so necessary and such an important driver of innovation,” Wilmot Director Jonathan Friedberg, M.D., M.M.Sc., said. “Five years ago, a lot of us thought IT was who you called when your computer didn’t work. Now, it’s absolutely critical to the function of the cancer center.”
In fact, Snyder’s presence at Wilmot was born out of necessity. Cancer center leaders were seeking up-to-date, accurate data for their application to the National Cancer Institute to become designated as one of the nation’s top centers. Snyder’s initial goals were to build tools to allow them to know at their fingertips the status of enrollment in all cancer clinical trials, for example, or the rate of colorectal cancer among underserved individuals to aid Wilmot’s community outreach efforts.
He’s done that, and much more. Snyder’s team includes Wilmot IT co-leader Erika Ramsdale, M.D., an oncologist with a master’s degree in data science. (Ramsdale was one of the first data science students at UR to complete an advanced degree part-time; while accomplishing this feat she was also seeing cancer patients, conducting research, providing mentorship, and had just given birth to her second child, Millie.)
Among the Wilmot team’s most signification achievements:
- A geospatial mapping tool called CANVAS, designed for the layman. To study Wilmot’s patient population and its unmet needs, Snyder and colleagues merged and refined data from many sources and created customized maps of the 27 counties in western aachind central New York from which Wilmot draws patients. The maps are color-coded and visible with the click of a mouse, painting a clear picture of trends such as spikes in lung cancer rates in certain counties or hospital readmissions.
- User-friendly clinical innovations. Snyder and team developed 30-40 new apps for physicians; a nursing platform and dashboard that provides a real-time roundup of patient visits, broken down by diseases and by Wilmot’s 12 locations; and a unique data governance system.
- Homegrown, high-performance virtual reality software. A physician can be sitting in an office across campus wearing special 3D headsets, connected by a computer to Snyder, who is sitting in his own office wearing another headset. Together they can view and discuss complex data on a screen — say, for example, the social determinants of health (where people live and work and how those factors may impact disease) for Wilmot patients. Custom animation allows doctors, with the wave of a hand near the computer screen, to zoom in and out of neighborhoods, down to street-level views. A partnership with Microsoft, which provided technology for the headsets, helped Snyder and his team develop this unique tool.
Trade publications covering the HIMSS meeting noted that Wilmot’s virtual reality approach is the way of the future. Advanced platforms like this are similar to “going from a car to a plane,” Snyder said. “Both are still useful, but sometimes you want to go faster and you need to get on a plane.”
Connected to a Larger Enterprise
Wilmot is part of the University of Rochester and its Medical Center (URMC), a health care system with IT infrastructure that connects education and research facilities, six hospitals, long-term and home care, and outpatient services. As URMC has grown, so has the larger IT enterprise. As part of “running the business,” the IT team at URMC serves 30,000 users of the “eRecord” electronic medical record system, manages patient data and billing for 2.5 million ambulatory visits and 600,000 inpatient days annually, responds to 250,000 customer service calls, provides clinicians access to billions of diagnostic images, and protects the institution from cybersecurity threats.
Close coordination between URMC and Wilmot helps both entities to expand capabilities, said James Forrester, M.S, associate vice president of IT Technology and chief technology officer at URMC.
“While meeting the IT needs of a growing institution, we are at the same time deploying digital technologies across the clinical enterprise that connect patients to care providers more conveniently,” Forrester said. “Supporting teams like the one Eric Snyder leads is part of our institutional IT strategy, fostering innovative solutions in targeted areas that can serve as models across URMC and at other academic medical centers. We are proud of Eric’s groundbreaking work.”
Wilmot’s IT solutions employ enterprise-level data, including electronic medical records for cancer patients, and data from other Medical Center sources such as pathology. Snyder and his team have created applications and interface tools to streamline the patient records for use by cancer clinicians and researchers.
Snyder negotiated with Dell so that Wilmot could establish its own servers for storing and maintaining cancer-related data. He also doubled down on data protection, designing a custom security framework that sits atop the URMC’s already robust IT security measures. Access to Wilmot data is highly restricted, requiring enhanced log-in procedures by job description. Every action is monitored, no matter how small, Snyder said, and he built comprehensive auditing tools that are reviewed weekly.
Designing New Solutions from Scratch
Having the support from Wilmot leadership to construct IT platforms from scratch is what sets Wilmot’s group apart from others, according to Snyder and Ramsdale.
Every new piece of technology was designed with the goal of improving cancer patient care and research, in line with NCI expectations.
For example, by studying the social determinants of health, doctors can anticipate what additional services Wilmot patients might need before they even step in the door. New initiatives are already in place in surgical oncology and at Wilmot’s Clinical Trials Office, based on data analysis.
More typically in health care, IT groups must take a “Frankenstein approach” and patch problems as they arise, Ramsdale said. For example, many health-care software products focus on a single task or one type of user and may not talk well to other software products. “Everyone is dealing with this interoperability challenge in different ways,” she said.
Snyder and Ramsdale also play key roles as translators between their innovations and health care workers.
“Data alone is not knowledge,” Ramsdale said. “People may not understand that many decisions have to be made about how to handle data before they can be used to generate knowledge. And these decisions — which are often invisible to data users — can affect the quality of conclusions, can introduce bias, and inhibit our ability to reproduce research.”
Snyder has conducted extensive literature reviews and has spoken to representatives at huge health systems such as Kaiser Permanente in the South and West, and the Dana Farber Cancer Institute in Boston. He has not been able to find any place with the platforms and methodology that Wilmot uses.
“Eric’s willingness to take on any IT challenge serves as the cornerstone to his commitment to the University and to Wilmot,” said Brian Martin, associate director for administration and finance at Wilmot. “He has an unparalleled drive and dedication for his work, and to making Wilmot and the UR better.”
Because the IT profession is mostly a world of white men, diversity in hiring practices was another hot topic at HIMSS — and Snyder was invited to address that issue.
It’s not necessary, he said, to have a team stacked only with high-salaried IT professionals who have four-to-eight years of advanced education. Creativity can result from broadening or altering the usual skill set required for health care IT jobs — particularly in light of “The Great Resignation” and an unprecedented demand to fill open positions, he said.
The Wilmot IT team includes a math professor from a regional college, a machine-learning engineer with artificial intelligence expertise, and an individual with a Silicon Valley background in imaging processing. The team has a flat hierarchy, with an emphasis on collaboration and diversity of thought. The math professor’s fresh perspective, for example, led to writing a “spectacular new code” and a cleaner process for building the platform on social determinants of health, Snyder said.
IT professionals from across the U.S. have reached out to Snyder for advice on how to build a technical empire that looks like Wilmot’s, he said.
“Real data in real time — most people cannot do this but they’re trying to get there,” Snyder said.