EHRs, Digital Biomarkers, and Big Data

electronic health records

EHRs, Digital Biomarkers, and Big Data

With the rise of digital biomarkers, its role in precision medicine has become an important area of interest, something which is destined to continue due to Electronic Health Records (EHR). It’s important to keep in mind the limitations and problems that appear on the horizon. Among these problems are geo-differentiation and ethnic balance, generation of protocols for sharing digital information, and transferability of different record types (structured and non-structured).

There are emerging critical aspects concerning digital biomarkers. These indicators of physio-pathological and behavioral conditions are measurable in non-traditional ways, i.e. through new medical devices, mobile technologies and software tools delivering digital records directly. One immediate link established by digital biomarkers is between P4 medicine (predictive, preventive, personalized and participatory) and Big Data. Of interest is the reasoning over sufficiency of information in specific EHRs and using this as a starting point of analysis.

A model which is likely to be sustainable in future may be based on integrated cross-linked digital records available to doctors for timely and effective patients care and cure. Ultimately, by looking at organized, standardized and curated data, the quality of care will improve. Nonetheless, the process of democratization enabled by EHRs is far from being achieved at this time.

Enrico CapobiancoOne new role in this process is patients having an active role in influencing relevant factors that are not directly under doctors’ control (i.e. lifestyle, technology and social factors). Patients will benefit from a better understanding and further expansion of their knowledge base. In turn, a plethora of non-clinical sources of information will bring about a call for integration with clinical records, to what extent is still unclear.

Social implications determine the role of digital biomarkers, a natural consequence of the fact that it’s a complex underlying generative process and is subject to variation in time and space, at both individual and community scales.

Novel uses of social media are inspiring completely new assessments of health and disease, in terms of interactions (care and cure), perception of conditions (self-quantified), remote delivery or monitoring (telemedicine), and community models. Collectively, these will open up limitless opportunities. One example is the impact nutrition and fitness is having on disease prevention. Their role can be better explicated from biases to emphasize key factors enabling significant lifestyle modifications, thus shaping epigenetic risk markers. The focus goes, therefore, to the verification of how digital biomarkers may determine linkages from heterogeneous data, and promote advances in prevention and diagnostics, risk assessment, and therapy.


Dr. Enrico Capobianco is author of the recently published paper, Immunomediated Pan-cancer Regulation Networks are Dominant Fingerprints After Treatment of Cell Lines with Demethylation, available for download now in Cancer Informatics.