UTHealth School of Biomedical Informatics Dean Jiajie Zhang, Ph.D., talks about the future
The School of Biomedical Informatics at the University of Texas Health Science Center at Houston (UTHealth), the first free-standing of its kind in the nation, will officially open in January 2019. The 44,709-square foot building will feature open-concept offices and an innovation lab equipped with state-of-the-art technology as well as a media lab and classrooms for students and faculty members to collaborate.
Jiajie Zhang, Ph.D., dean of the School of Biomedical Informatics, discusses the significance of the new building, the rapid growth of the biomedical informatics field and how information technology is reshaping the health care industry. Zhang, who holds the school’s Glassell Family Foundation Distinguished Chair in Informatics Excellence, was among the dignitaries who cut the ribbon to officially open the new facility on Dec. 19, 2018 in the Texas Medical Center.
Q | Tell me more about the new UTHealth School of Biomedical Informatics building.
A | A little bit of history. Our school started in 1998. When we started, the entire faculty could fit into a minivan. We went out for lunch every Friday and that was our faculty meeting. We talked about business, school, and plans in the car and in the restaurant. It was about six or seven faculty members at that time. We had about less than 10 students.
Today, we have 50 faculty members and close to 300 graduate students. Over the past 20 years, we’ve grown very fast. We took whatever space we could find in this existing, 26-story building. At one point, we had people on the first, sixth, eighth, 14th, 18th and 19th floors, but we did not actually own any entire floor, just a piece of each. We had two locations—one here and the other on the south campus—because we grew so fast and could not find any space, so we divided, but it was a bad idea. When people are not physically together, that’s a problem. We brought everyone back here.
With the support of the president’s office, Dr. [Giuseppe N. Colasurdo, M.D.] started to give us a home for the school. We’re one of six schools at UTHealth and the only one that did not have a home, a building.
The support came from the tuition revenue bonds from the state. With support from the legislative session two sessions ago, [the tuition revenue bonds] were passed and now we’re building up.
The reason we have this building now is because this area has grown so fast.
Q | Do you think the new facility is a symbol of UTHealth and the medical community embracing biomedical informatics?
A | Absolutely. Our school is the biggest program in the country for biomedical informatics. We are still the only one in the state of Texas that has degrees in biomedical informatics. There are small pockets of specialized informatics in centers and groups, but I think we’re still the only one in the state of Texas to offer a degree. We train most of the high-level informatics leaders in the TMC and across Texas.
The impact for Texas is definitely huge. That’s why we’re here. With the new building, it’s an indication that our field has been recognized by the university and by the state of Texas.
Q | What is contributing to the rapid growth of this field?
A | The iPhone started 10 years ago, but it changed pretty much everything on earth. Information technology, big data and artificial intelligence have altogether fundamentally disrupted most of the major industries but health care. Health care is being disrupted, but it’s not there yet.
If you want to get an answer for any common question, you could do a Google search on your phone. You can pretty much get the right answer on the first page. For me, it’s more than 95 percent of the time for common questions. In the older days, you’d have to go to a library. Google is now the world’s largest library. Google fundamentally changed the industry of information, storage and retrieval and knowledge.
Now look at communication. In the older days, 20 or 25 years ago, when you wanted to communicate with your relatives or parents who are not local, you’d have to write a letter. It would take days … and not really real time. Today, you can do everything—text, email, video chat, audio chat—all in real time. Technology fundamentally disrupted the communication industry.
Even driverless cars are pretty mature now. Five years ago, it was unthinkable, but because of the data, computing power and new algorithms that took place over the past few years, suddenly, the hard problems in the past—like image processing, speech recognition—became real and even surpassed human performance. That’s a big tipping point. Suddenly, everything is possible.
The last [industry] is health care, which is the most complicated. It’s getting disrupted now, but the tipping point is not there yet. That’s why I think we are in a very interesting time doing things for a very interesting industry. Health care is 18 percent of the GDP in the U.S., so what we’re trying to do is use technology to change all of this.
We are trying to change things here in health care. Our school is educating students who will be the leaders in research, technology transfer and innovation.
Technology is changing health care. For instance, I have an Apple watch. If you have one of those wearable devices, it can do a lot of things. It can record my EKG in real time and is FDA-approved. This is just the beginning. It’s going to be able to do more and more things down the road.
Q | Health care is an extremely complex and intricate system. Why do you think it has been slow to adopt new information technology?
A | The knowledge base [for medicine] is so big. When you finish college, you go to medical school for another four years. You go through residency for another two to three years, then maybe specialize afterwards. Once one is ready to practice, he or she is in his or her 30s. That’s because the medical field is so complex.
That complexity is the problem. Machines can only do simple tasks, not complex things yet. We’re getting there more though.
Patient safety is another reason. I would not want a machine to operate on me. Technology will never replace physicians, but it can do a lot of basic things for the physicians, nurses and other health care professionals, so they can spend time on doing more advanced tasks.
Q | We’re talking about the meteoric rise of information technology that has taken place over the past two decades. What do the next five to 10 years look like for this field?
A | There are a lot of predictions out there. [PricewaterhouseCoopers] has a research report on the impact of artificial intelligence overall. This year, the contribution of artificial intelligence to the global GDP is roughly 2 to 3 percent. By 2030, which is 11 years down the road, the contribution of AI to the global GDP is going to be 15 to 20 percent. That’s a huge number. It’s going to transform every industry.
Some jobs will disappear, but new jobs will be created.
It’s going to be accelerating very fast, changing everything.
For health care, it’s the last major industry that has not been fundamentally changed yet, but my prediction is that it’s going happen.
Q | How is biomedical informatics being integrated into the medical curriculum?
A | We’re doing this in several ways, so far as outsiders. It’s not part of the core curriculum yet. We have an M.D./M.S. program. A student can work on her M.D. in medical school and, at the same time, spend one year getting her master’s degree from our school.
Next March, we’re going to meet with our medical school team to streamline the joint M.D./M.S. program to make it four years, instead of five years. It’ll be more realistic for the medical school students.
We’re working on a tighter integration of informatics into the medical school’s main curriculum, which is hard but I think it’s essential. It’s going to happen.
You see the chicken and egg problem though. The medical school students have to go through exams, but if informatics questions are not part of that, they don’t have the motivation to study that because it’s already a crazy schedule for them.
For our student body, about 40 percent are from health care backgrounds. We have health professionals who are physicians, as well as nurses, pharmacists and public health people. For physicians, their curriculum is so rigid, but for others—like nursing—informatics is a big component for them. We have many joint programs in nursing informatics.
Q | Electronic health records are integral to today’s health care system. What do you consider the challenges of the current status of EHRs?
A | EHRs are not like Microsoft Word, which is simple. EHRs are a million times more complex. Without full understanding of this, you cannot use it efficiently for your job, even if you’re a practicing physician.
We have a lot of data, but how do you use the data to deliver something meaningful to the patients? It’s not a technology problem. If we have all the data together, we can do lots of different things, but data sharing is a major problem across institutions and also for individual patients and patient privacy. The regulations and rules are in place, but it’s more of a psychological problem.
Patients are getting used to data being used for research and patient care. It’s good for them, but it’s the data sharing across institutions that is still a major barrier.
The biggest problem is financial. Imagine you’re the CEO of Methodist and I’m the CEO of Memorial Hermann. If I can see all of your patients, I can steal your patients.
Patient records are like a gold mine. It’s an asset. It’s money. You don’t want to give your bank account to other people, right?
Q | What role will biomedical informatics play in shaping the future landscape of health care?
A | The Texas Medical Center is the biggest medical center in the world. I think our total research and development expenditure is comparable or even bigger than Boston or San Francisco, but the technology transfer is only a small fraction of even San Diego.
We know that a lot of leaders here are trying to make it happen. TMCx, JLabs, AT&T Foundry and the new TMC3, when it happens, are all moving in the right direction, but we still don’t have the critical mass to get us to the tipping point. We have so much [intellectual property] here, but it’s not fully used.
One potential breakthrough could come from informatics. The new drugs and biomedical devices are everywhere, but our school—which is the biggest one in the country—we have critical mass here. That’s something we’re actively working toward.