As a board-certified ophthalmologist and glaucoma specialist, I have more than 15 years of clinical experience caring for patients with different types and complexities of glaucoma. In addition to my clinical experience, as a health services researcher, I have developed experience and expertise in several disciplines including performing analyses using large health care claims databases to study utilization and outcomes of patients with ocular diseases, racial and other disparities in eye care, associations between systemic conditions or medication use and ocular diseases. I have learned the nuances of various data sources and ways to maximize our use of these data sources to answer important and timely questions. Leveraging my background in HSR with new skills in bioinformatics and precision medicine, over the past 2-3 years I have been developing and growing the Sight Outcomes Research Collaborative (SOURCE) repository, a powerful tool that researchers can tap into to study patients with ocular diseases. My team and I have spent countless hours devising ways of extracting electronic health record data from Clarity, cleaning and de-identifying the data, and making it linkable to ocular diagnostic test data (OCT, HVF, biometry) and non-clinical data. Now that we have successfully developed such a resource here at Kellogg, I am now collaborating with colleagues at > 2 dozen academic ophthalmology departments across the country to assist them with extracting their data in the same format and sending it to Kellogg so that we can pool the data and make it accessible to researchers at all of the participating centers for research and quality improvement studies. I am also actively exploring ways to integrate data from SOURCE into deep learning and artificial intelligence algorithms, making use of SOURCE data for genotype-phenotype association studies and development of polygenic risk scores for common ocular diseases, capturing patient-reported outcome data for the majority of eye care recipients, enhancing visualization of the data on easy-to-access dashboards to aid in quality improvement initiatives, and making use of the data to enhance quality of care, safety, efficiency of care delivery, and to improve clinical operations. .
Joseph A. Himle, PhD, is the Associate Dean for Research and the Howard V. Brabson Collegiate Professor of Social Work, School of Social Work, and Professor of Psychiatry, Medical School, at the University of Michigan, Ann Arbor.
The goal of Prof. Himle’s research is to design, develop and test a inconspicuous, awareness-enhancement and monitoring device (AEMD) which will assist the treatment of trichotillomania (TTM), a disorder involving recurrent pulling of one’s hair resulting in noticeable hair loss. TTM is associated with significant impairments in social functioning and often has a profound negative impact on self-esteem and well being. Best practice treatment for TTM involves a form of behavioral therapy known as habit reversal therapy (HRT). HRT requires persons with trichotillomania to be aware of their hair pulling behaviors, yet the majority of persons with TTM pull most of their hair outside of their awareness . HRT also requires TTM sufferers to record the frequency and duration of their hair pulling behaviors yet it is obviously impossible for a person to monitor behaviors that they are unaware of. Our Phase I efforts have produced a prototype device (AEMD) that solves these two problems. The prototype AEMD signals the TTM sufferer if their hand approaches their hair, thereby bringing pulling-related behavior into awareness. The prototype AEMD also logs the time, date, duration, and user classification of hair pulling related events and can later transfer the logged data to a personal computer for analysis and data presentation. He continues to refine this device and seek to integrate it with smart-phones to better understand activities and locations associated with hair pulling or other body-focused repetitive behaviors (e.g., skin picking). In the future, he seeks to pool data from users to get a better sense of common situations and other factors associated with elevated pulling rates. He intends to develop other electronic tools to detect, monitor and intervene with other mental disorders in the future.