A Prototype of Translational Informatics in Action - Translational Informatics: Realizing the Promise of Knowledge-Driven Healthcare - page 23

academic health center (AHC) this is involved in additional teaching and research
activities. Further, there is network of community based primary and specialty
(including oncology) care providers, operating in small practices that are loosely
aligned with the preceding integrated healthcare delivery organizations. Within
this community, there is also a health information exchange (HIE), which allows
for the fl ow of basic diagnostic and treatment history data between and among the
Electronic Health Record (EHR) systems used by all of these care providers.
Finally, the AHC includes a Biomedical Informatics department or center, as well
as a genomic sequencing and bio-specimen collection/storage facility, which col-
lectively are capable of retrospective and prospective sequencing and analysis of
complex patient-specifi c genotypes for both research and clinical decision making
purposes.

2.2.3 Patients, Families and Communities

Given the increased incidence rate of colon cancer introduced previously, it is likely
the case that individuals, their families and various sub-parts of the community in
this city will be concerned about the number of colon cancer cases surrounding
them, the likelihood that they or their family members or friends might have such a
diagnosis, and the need for more aggressive measures to identify individuals at risk
or exhibiting the disease as early as possible in order to ensure optimal treatment
outcomes and survival. Further, those individuals in the community who do have a
diagnosis of, are undergoing treatment for, or have survived colon adenocarcinoma,
may have an even more signifi cant concern about the potential familial or genetic
components of the disease that could put their family members at risk of similar
diagnoses. As such, we can expect that individuals, affected families and commu-
nity groups, such as churches or social entities, may engage in both information
seeking and/or advocacy activities intended to address concerns surrounding the
preceding high incidence of colon cancer, and the need for both early detection and/
or better treatment options.

2.2.4 Putting the Pieces Together

In our prototypical (and idealized) setting, a number of measures and initiatives
could be establish under the auspices of a TI paradigm, which can be aligned into
the major categories detailed below:

￿ Applying the emerging central dogma of Biomedical Informatics : Given the

confl uence of public interest at the individual and community levels, as well as
the capabilities of the incumbent AHC and regional HIE, and fi nally the desire of
evidence and policy generators to take proactive measures to address the