Proposal to establish a Department of Biomedical Informatics at the ...

Proposal to establish a Department of Biomedical Informatics

at the

University of California San Diego School of Medicine

Table of Contents

A. EXECUTIVE SUMMARY

1

B. RATIONALE AND BACKGROUND

4

History of the unit

8

Vision/Goals

18

C. THE PROPOSAL

20

1. Research Projects/Grants/Contracts

20

Research by the Numbers

20

Summary of Research Areas

22

Foundations

22

Applied informatics

24

2. Education Plan, Curriculum, Courses

27

Biomedical Informatics Basic Areas of Specialization

33

3. Recruitment and Retention Plan to Enhance Diversity

48

Inaugural Member of the University of California Hispanic Serving Institutions Doctoral Diversity Initiative 49

DBMI faculty leadership in Diversity, Equity and Inclusion (DEI)

50

4. Services

53

Biomedical Informatics Clinical Service

53

Clinical Research Informatics

56

Cybersecurity

57

D. SPACE ALLOCATION

59

E. EQUIPMENT

62

F. ORGANIZATIONAL CHARTS

63

G. FACULTY APPOINTMENTS AND COMMITMENT

65

H. FINANCIAL PACKAGE

66

Five-Year Projected Fiscal Plan based on Current Status

66

I. TRANSITION PLANS

67

J. CONTRIBUTIONS TO THE UNIVERSITY, THE STATE, AND THE COMMUNITY

68

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CONCLUSION

71

REFERENCES

72

APPENDICES

APPENDIX 1 ? FACULTY PROFILES

83

APPENDIX 2 ? JOINT AND AFFILIATED FACULTY PROFILES

95

APPENDIX 3 ? CURRENT FACULTY EXTRAMURAL SUPPORT AS OF DECEMBER 3, 2021

111

APPENDIX 4 ? NIH/NLM T15 TRAINING PROGRAM PROGRESS REPORT 2017 - 2021

114

APPENDIX 5 ? PROGRAMS IN SIMILAR DEPARTMENTS AT OTHER INSTITUTIONS

128

APPENDIX 6 ? CRITERIA FOR ACADEMIC APPOINTMENTS AND PROMOTIONS

129

APPENDIX 7 ? REVIEW BY EXTERNAL EVALUATORS

144

APPENDIX 8 ? LETTERS OF SUPPORT

150

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A. Executive Summary

The current Division of Biomedical Informatics in the Department of Medicine (DBMI) seeks to transition to a new Department of Biomedical Informatics in the University of California (UC) San Diego School of Medicine. Our request for conversion to Departmental status is based on the unique academic mission of Biomedical Informatics and the need to appropriately position UC San Diego (UCSD) relative to other top Biomedical Informatics programs around the country. DBMI has been financially independent from the Department of Medicine since 2018. Biomedical Informatics is a full Department at the best academic institutions across the nation. This status is important to succeed in highly competitive faculty searches, to evaluate our faculty according to benchmarks for our field, to enhance DBMI's visibility at the national level, to collaborate with other departments at a peer level, and to help obtain additional grants and other funds for our growing training programs.

The Faculty in Biomedical Informatics at UCSD currently operates as a single academic unit. We have a diverse teaching, research, and service portfolio, and we have established an international reputation for the work we do. Biomedical Informatics at UCSD also has a history of fiscal stability with steady and consistent growth throughout its history and a strong future business plan. Based on this academic and fiscal success, DBMI now has an opportunity to leverage its strengths and take the first steps towards becoming the premier academic Biomedical Informatics Department in the nation, thus benefiting the discipline, the School of Medicine, UCSD, UC, our region, the state of California, and the country.

We seek to become an academic department for several reasons: 1. Recognized and distinct medical specialty and training program: Biomedical informatics has been recognized as a medical specialty by the Accreditation Council for Medical Education (ACGME), and it has distinct areas of operation in relation to other medical specialties. It has its own foundational base of knowledge, and it has applications in all medical specialties, similar to departments such as Radiology and Pathology. This is attested by the fact that we have collaborative projects with many departments in Health Sciences, as well as with departments and organized research units on the main campus. Faculty with full appointments in DBMI are dedicated to informatics as their specialty area. We also teach the future informatics leaders from other specialties: we have had postdoctoral trainees (typically physicians, and some PhDs) in our training grant program who came from the departments of medicine, pediatrics, emergency medicine, surgery, anesthesia, ophthalmology, and preventive medicine, and many have become faculty at UCSD with a joint appointment in DBMI. In addition, we have affiliated faculty who are informatics directors in various clinical services. Some of our affiliated faculty are practicing physicians in internal medicine, pediatrics, and other clinical specialties. DBMI provides critical mass to discuss novel informatics ideas, share best practices, and informatics mentoring from experienced faculty.

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2. Enhanced national visibility and reputation: Biomedical informatics is a medical school department in many of the medical centers awarded by the Clinical and Translational Science Awards (CTSA) from the National Institute of Health (NIH), which are considered among the best in the country. Many have their own biomedical informatics/data science Departments (e.g., Columbia, Stanford, Vanderbilt, Harvard, University of Washington). Academic Department status is a natural evolution of our growth and stature. DBMI is the catalyst for biomedical informatics activities in several departments and schools at UCSD, but it needs enhanced national visibility to compete in attracting outside talent. DBMI is among the top federally funded informatics units in the country, and its research portfolio matches or exceeds the funding of many departments at UCSD.

3. Faculty retention and recruitment: School of Medicine department status is important for faculty retention and recruitment. Many divisions of biomedical informatics have difficulty recruiting leaders, and conversion of existing divisions to additional departments is happening across the country (e.g., Yale School of Medicine). There is concern among biomedical informatics faculty nationally that divisions are not responsible for their own future and may or may not be adequately supported by their general department chairs over time, leading to uncertainty. The long-term existence of academic divisions may end at the will of another department chair, without recourse to processes that apply to academic departments. Additionally, particularly in institutions that have a disproportionate number of senior faculty, academic appointments in informatics are not always well understood by clinical or basic science departmental faculty trained in an era in which computers and big data were not central to biomedical sciences. Biomedical informatics department status enhances researchers' and educators' engagement and satisfaction. Faculty expect compensation and promotion discussions with the biomedical informatics leader, not with the leader of another department, with whom they may have little interaction.

4. Improved representation and visibility of biomedical informatics needs at the institutional level: This is a critical issue and an important reason to transition to a department at UCSD. The UCSD community should be able to identify where to go for their informatics needs. Since the department serves the tripartite mission of service, research, and teaching, it is important that it be viewed as an asset to the whole institution and not limited to a single department. National and regional competition is another motivation. The main academic competitor in our region, UC Los Angeles, organized a multidisciplinary task force convened to create a vision for the future of biomedical informatics. The recommendations were to: "(1) Establish a new department that builds upon the current Department of Biomathematics and includes three divisions (Clinical Informatics, Bioinformatics, and Mathematical Biology); (2) Foster a coherent Departmental culture and leverage strengths of departments and institutes outside [the school of medicine] on the main UCLA campus; (3) Catalyze translational informatics research and training; (4) Ensure active collaboration between informatics leadership in the Health System with faculty in the new Department." While we currently outnumber UCLA in terms of trained informatics faculty, they have an institutionally supported

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clinical informatics fellowship program and they have ongoing searches for biomedical informatics faculty. This document is structured to relay Biomedical Informatics' vision, provide information on the successes of its teaching, community service and research missions, and to address potential issues/concerns with a transition from Division to Department status. A fiscally responsible plan is presented.

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B. Rationale and Background

DBMI in the Department of Medicine is applying to become an academic department in the School of Medicine to be able to develop educational degree programs in biomedical informatics, apply its own specific criteria for appointments and promotions in biomedical informatics, and to be recognized as an independent department at the same level as those already existing at Harvard, Stanford, Columbia, Vanderbilt, and other renowned universities around the world. DBMI has been financially independent from the Department of Medicine since 2018, and it has always kept a balanced budget. Its outstanding academic production, research revenue, and service contributions over 12 years reflect the caliber of its faculty, staff and trainees, and these metrics compare favorably to existing departments at UCSD. DBMI is one of the most successful biomedical informatics academic units in the United States today, with an unprecedented >$150M of extramural funding over its 12-year history. It is also one of the most prolific in academic productivity, with more than 900 peer-reviewed articles.

Biomedical informatics is a new medical specialty. Medicine, as most fields, has witnessed an exponential growth in electronic data that can be used to assist in prevention, diagnosis, mitigation, treatment, and monitoring for a large variety of diseases. Methods to collect, organize, standardize, index, analyze, share, and effectively utilize these data to design interventions that can result in better human health are within the scope of biomedical informatics and biomedical data science.1

DBMI has a tripartite mission of conducting innovative biomedical informatics research, training, and service in a highly diverse environment.

Research: We develop, implement, and evaluate new informatics algorithms and tools for accelerating health sciences discoveries, improving healthcare, and monitoring and preventing disease. We promote fairness in artificial intelligence models and privacypreserving data sharing.

Training: We educate the future leaders in our field for academic, industry, and government careers, with emphasis on equity and diversity, and we promote professional development of our staff and faculty.

Service: We implement and support informatics tools that make a difference in health sciences research and in clinical practice, collaborate with other departments and institutions in implementing programs that help health sciences researchers or healthcare professionals work towards decreasing health inequities.

Biomedical informatics sits at the intersection of health sciences/health services and computer science/statistics. It is a specialty that requires specific expertise, and that, much like radiology or pathology, serves in a critical support role for clinicians, staff and patients in medical centers

1 The field of biomedical informatics includes biomedical data science, but we make the distinction here because the latter has been frequently associated with activities that directly relate to data but not necessarily with data collection and knowledge representation, the study of workflows and human-computer interfaces before data systems are implemented, cost-benefit analyses of systems, etc.

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around the world. The field emerged around the same time as computer science and it has an established professional society, the American Medical Informatics Association (AMIA),2 as well as departments in many medical schools around the world. DBMI has internationally known biomedical informatics faculty who drive educational programs, provide services to the community, and who have an extensive portfolio of research grants and contracts. Without an academic department, it is difficult to

recruit and promote faculty according to BMI criteria, develop and get approval for new educational programs, raise funds, be represented in university-wide initiatives.

Recognizing DBMI as an independent academic department in the School of Medicine will help remove these barriers so the unit can realize its full potential.

DBMI has reached the proper level of intellectual and financial maturity and has over the years attracted a substantial amount of extramural funding (>$150M) for teaching and research. Its teaching, research and service components are strong and aligned with those of the School of Medicine. If granted an academic department status, DBMI will be able to fairly compete with large departments in other institutions to attract additional world class faculty, students, and funds, and it will continue to promote a highly diverse environment for all its members and for the people it serves.

DBMI should align with the national standard. The clinical and academic scope of biomedical informatics is a unique body of knowledge. The unique demands on biomedical informatics faculty rely on training and skills within multiple medical and non-medical disciplines such as medicine, nursing, computer science and, evidently, biomedical informatics. Therefore, the faculty of biomedical informatics are better served by an independent department rather than embedded in only one clinical department. UC San Diego must align with this national standard to be able to communicate our strengths among peers and better recruit and retain faculty in a competitive national system. Its faculty can have joint appointments with several other clinical departments, depending on the specialty of their clinical practice. Of note, the UC system lags behind the times in terms of developing academic units in biomedical informatics. DBMI at UCSD was the first in the UC system to have an official academic status in which all primary appointments are done via a single department (Medicine). Years later, UC Davis followed this model and embedded a Division of Health Informatics within the Department of Public Health. UCLA created a department from what was previously called the Department of Biomathematics, with most faculty already hired in the system. All other informatics units at UCSD are institutes or centers with academic appointments made by different departments, depending on the clinical background or research interest of its member(s). This results in fragmentation that prevents these other campuses from having an NIH training grant, or to successfully compete for informatics center grants. DBMI developed over the past 12 years and has all the needed pillars

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