CTSA Profile: Promoting Informatics to Improve Human Health

Vivian West, PhD, Associate Director for the Duke Center for Health Informatics (DCHI)

June 16, 2016

Ask Vivian West, PhD, what her daily routine is like and she’ll laugh. "I don’t like routine," she says. "I’m always interested in anything new."

That’s a useful attitude for someone involved in health informatics, the burgeoning, interdisciplinary field that includes everything from data mining, human interface design, decision support, databases, to algorithms for analyzing and visualizing massive amounts of data, all in the service of improving healthcare.

Here, in her own words, are some reflections from West on the path that has led her to serve as the Associate Director for the Duke Center for Health Informatics (DCHI) [pronounced "dee-chee"], a program supported in part by the Duke CTSA.


What is your role at Duke?

My main focus, as associate director for DCHI, is to promote informatics research and education at Duke. I am also a clinical associate at the School of Nursing, where I teach an informatics research course to students working towards a master’s degree in nursing.


What is DCHI?

DCHI’s mission is to promote informatics education and information at Duke.

The educational informatics programs at Duke are designed for physicians, nurses, healthcare administrators and others in the field with expertise in aggregation, analysis, and use of informatics to improve human health. We have an arm around everyone who has an informatics interest whether they are within Duke Health or on the University campus. We work closely with the School of Nursing, which offers an informatics specialty at the masters and doctoral level as well as an online certificate of health informatics. We also work with the School of Medicine, which offers the Master of Management in Clinical Informatics, a one-year course, and I teach an elective course in informatics for fourth year medical students. DCHI has created a short course on informatics designed for companies that we are hoping to adapt as an online course for individuals. And since 2011, we’ve been investigating the possibility of developing a PhD in health informatics at Duke.

We also work beyond Duke. For example, we have an informatics research seminar that rotates speakers from five universities: Duke, UNC, North Carolina Central University, UNC-Charlotte, and East Carolina University. Those of us at Duke gather in the Hock auditorium to listen to a live speaker (if they are from Duke) or to participate in the live video stream from the other campuses. Last year when I was at the American Medical Informatics Association (AMIA) Annual Symposium, someone from the government told me she is on our mailing list and often invites other people at DHHS to listen in. And Ed Hammond, our director, is well known nationally and internationally, so we have an international reach as well.


How did you end up in informatics?

I’ve always been interested in anything new, and I like keeping data organized. I’ve been like that all my life.

When I was the head nurse of an ambulatory surgery unit I was the first person in the hospital to get a computer, and then used an old software program called dBase to develop a scheduling system for my staff and patients. People were fascinated by the technology! In the 1990s I was director of nursing for a national infusion therapy company in Boston that had 129 sites. The coordinators who conducted field visits mailed paper hand-written reports to me every week—until I convinced administration that computers were much more efficient. When the company decided to invest in a data warehouse, I was the clinical representative to the group responsible for its development. I also remember evaluating the very first glucometer that transmitted data through a telephone line, and trying to help people understand the difference it would make if we invested in infusion therapy pumps where the nurse could change the drip rate via telephone. When the Director of Finance asked me to do a cost effectiveness analysis of some of this technology, I realized I needed to go back to school.

I worked at the Telemedicine Center at East Carolina University while pursuing my PhD at UNC in Chapel Hill. I was the Clinical Project Director for a grant funded by the National Library of Medicine, conducting research on the use of telemedicine and the NGI (next generation internet) with electromyograms, mobile devices, pediatric heart sounds, and echocardioagrams. My dissertation was also in this field, investigating why the technology failed in a homecare program in eastern NC.


How did you end up at Duke and DCHI?

I came to Duke in 2006 to work in the electrophysiology department. I worked there for a year and then moved to the Duke Clinical Research Unit. While at the DCRU I met Meredith Zozus as we were considering computerizing DCRU trials. In 2011 she took me out for coffee at the Mad Hatter. She spent the whole time talking about DCHI, but it didn’t dawn on me until the end that DCHI might be a good fit for me! She set up a meeting for me with Ed Hammond the next week and I was sold.


What are you currently spending your time on?

I’m in the midst of writing a grant to identify phenotypes and their subpopulations using visual analytics with EHR data. This is a continuation of a Department of Defense-funded grant we completed at the end of last year using novel visualization of health related data. I’m also working on a manuscript as a result of that work.


What do you do when you aren’t at Duke?

For the past few months I’ve been spending most of my free time helping my daughter and son-in-law with my grandson, Leo. He is an adorable baby with the cutest personality, but he fights sleeping, so we are all spending a lot of energy to care for him!

When I have some free time to myself, I like to play classical piano. I started studying piano at age 5. I have a Steinway baby grand piano at home that I just had refurbished. It is fantastic to play.


What has been a memorable moment for you at Duke?

It is hard to narrow down, but one of the things that I have appreciated most is working with Ed Hammond. He is truly an international star in informatics, and it is a privilege to have an association with him.