Luis Kun
| Global Health Transformation through true Interoperability |  |
| Luis Kun | |
| Senior Research Professor of Homeland Security – IRM College, National Defense University, USA |
Abstract
In this XXI Century and as the Health Care and Public Health infrastructure intersect deeper into the many Information Technology (IT) subfields, abundant and formidable changes can occur that will allow society to shift current systems into some where wellness and disease prevention will be the focus. Many changes can affect positively medical and cost effective outcomes as well as the elimination of medical errors and patient safety for example. In these arenas, with the convergence of science, technology and with Information Technology acting as a catalyst for change, health care systems around the world are slowly shifting from “hospital based” ones into distributed systems that include: hospitals, clinics, homecare systems with treatment and management of chronic diseases for the elderly via Internet, etc. In order to achieve such visions, multiple efforts have been tried for creating electronic health record as well as the information highway for their use. In the US the health system is very scattered and most hospital systems do not contain for example mental health, dental health and or vaccine registry information. On one hand through major medical research the emergence of clinical and health data repositories or “Intelligent Data Warehouses” that not only include traditional clinical data, but also advanced imaging, molecular medicine, tissue micro-array analysis and other bioinformatics information is available. These increasingly multi-modality data warehouses are constantly updated, continuously expanded and populated with millions of records. Although these repositories of electronic information can be leveraged not only to improve point of care clinical decision-making for individual patients, they can also support population health chronic and infectious disease analytics (i.e., epidemiology and surveillance), cost efficient multi-center (e.g., and multi-country) clinical trials, and comprehensive post-market pharmacovigilance.. On the other hand the integration of healthcare and public health is a major concern as well. Globalization (i.e., the interdependencies that each country has with many others) for example has raised the sense of awareness through “the information highway”. During and since 2007 the US public has learnt through successive media stories related to: the death of pets due to food-import contamination, children’s toys imports containing lead paint, food contamination, drug contamination, drug ingredients contaminated, etc. During 2008 we heard about: People getting very sick from fish containing the ciguatera toxin and Tab / drinking water containing about 36 different medications, e.g., antibiotics, antidepressants, etc. As the northern hemisphere prepares currently for the second wave of the 2009 H1N1 Flu Pandemic (which will probably start around October 2009) all nations could have benefited by having epidemiology and surveillance data from all southern hemisphere nations available for the production of more “accurate” vaccines. Still the perfect opportunity to transform our health care systems to a strategy of disease prevention and wellness is in the horizon. Using information technology as an enabler, we can encompass a wide range of opportunities that can start at the cellular, molecular and genetics levels and go as far as population health. Initial immunization studies show the level of antibody titers against viral diseases depends on the circadian time of inoculation. The concepts of chronobiology and chronotherapeutics can be used to generate disease prevention strategies based on these circadian-rhythm dependencies. The public will also be better protected against environmental threats and food borne diseases through the use of remote sensing data and a worldwide food enterprise architecture.
BIOGRAPHICAL SKETCH
Dr. Kun is a Professor of Systems Management at the IRMC of the National Defense University, where he is the Course Manager for Homeland Security. He graduated from the Merchant Marine Academy in Uruguay; and has a BSEE, MSEE and Ph.D. in Biomedical Engineering all 3 degrees from UCLA. His extensive background on Information Technology, Medical and Public Health Informatics, includes 14 years with IBM where he: developed the first six clinical applications for the IBM PC; was one of the pioneers on bedside terminals for Intensive Care and developer of a semi-expert, real-time, clinical decision support system; was the technical manager of the Nursing Point of Care System; the biomedical engineer in the team of 4 that developed the first Teleradiology system and the first Picture Archival and Communications Systems, to run on an IBM platform. He was Director of Medical Systems Technology and Strategic Planning at Cedars Sinai Medical Center in LA. As Senior IT Advisor for the Agency for Health Care Policy and Research (1996-98) he formulated the IT vision and was the lead staff for HPCC program and Telehealth. Co-author of the Reports to the Congress on Telemedicine (1997) and on HIPAA Security. He was an invited speaker to the White House, highly responsible for the Telemedicine portion of the Balanced Budget Act of 1997. Kun represented the DHHS Secretary at a Pan American Forum of Health Care Ministers on Telecommunications and the Health Care Industry in Mexico in 1997. He was a Distinguished Fellow at the CDC (1999-2001) Senior Computer Scientist for the Health Alert Network for Bioterrorism and as the Acting Chief Information Technology Officer he formulated the IT vision for the National Immunization Program (NIP) (10/2000). Since 1980, Dr. Kun had academic adjunct appointments at: UCLA, UT (Arlington, Dallas and Galveston), at Rutgers University and at Emory University. In the past 30 years he has written and edited a large number of editorials, articles, book chapters / sections, and books and has lectured on medical and public health informatics, information technology and biomedical engineering in over 75 countries. He is in the IEEE Distinguished Visitor Program for the Computer Science (for both the US and Latin America) as well as the Engineering Medicine and Biology Society and is/was in the advisory board of many magazines, professional journals and board of directors of several organizations including AAES, AIMBE, ICMCC, IFMBE, IEEE-SSIT, etc. He has served as an invited: Conference, track or session chair, tutorial, special symposia, and/or publications, invited speaker / keynote speaker and in conference scientific committees, etc. over 300 times. He was conference chairman of the Health Care Information Infrastructure (HCII) conference in 1995 and the Interoperability Summit on Health Care Transformation of 2009 at the National Academy of Sciences. He is the founding Chair of the IEEE-USA Critical Infrastructure Protection Committee (2007); the Bioterrorism & Homeland Security WG and the Electronic Medical Record and High Performance Computers and Communications Subcommittee (1991). He chairs the IFMBE’s Global Citizen Safety and Security WG. Dr. Kun received many awards and recognition including the 2009 first ever AIMBE Fellow Advocate Award, the “2002 - IEEE-USA Citation of Honor Award”: “For exemplary contributions in the inception and implementation of a health care information technology vision in the United States.” In 1999 he was inducted as a Fellow of the American Institute for Medical and Biological Engineering: “For outstanding leadership and contributions in the creation, development, and implementation of the health care information infrastructure and related policies." He is a Fellow of AIMBE and the IEEE.
