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Anchalee Phataralaoha: Welcome to our podcast, Technology Conversations, where we discuss technology-related topics, from how to find resources for your technology needs, to how technology can impact our lives. I'm your host, Anchalee Phataralaoha, and today we have a pleasure to speak with Brittney Manning, Director of Research and Operations with OneFlorida Clinical Research Network. Hi, Brittney.

Brittney Manning: Thank you so much for having me today.

Anchalee Phataralaoha: And thank you for being here. And to start, could you introduce yourself and tell us a little about your background?

Brittney Manning: I would be happy to. So my name is Brittany Roth-Manning, and I'm the Director of Research and Operations for OneFlorida Plus Clinical Research Network. I have a Master's in public health with a concentration in epidemiology, and I'm also a certified clinical research professional. And my background is primarily in biomedical informatics research as well as pragmatic clinical trials and as well as community-based research. So it's a really, really unique and dynamic experience.

Anchalee Phataralaoha: Sounds good. Now, what is your role with OneFlorida and what are your primary responsibilities?

Brittney Manning: Yes, so as the director of research and operations for OneFlorida Plus, I oversee all of the day-to-day operations for each of our three core teams, as well as work with our OneFlorida Plus principal investigators, Dr. Betsy Shenkman and Dr. Mei Liu, in order to develop strategic planning as well as outreach and to our partner sites as well as ensuring that our funder, PCORI, the Patient-Centered Outcomes Research Institute, we're meeting our contractual goals for them as well.

Anchalee Phataralaoha: So for people who might not be very familiar with your area, what are some of the key services that you offer?

Brittney Manning: Yes, thank you so much for asking that question. So before I get into that, I just want to give a little bit of background on what a clinical research network is. So again, we are funded by PCORI, which is the Patient-Centered Outcomes Research Institute. PCORI funds PCORnet, or the Patient-Centered Outcomes Research Network, which in turn funds 8 clinical research networks. So it's a bit of an umbrella or stepstone model there. So the 8 clinical research networks spanned across the country. And OneFlorida Plus, our primary oversight is obviously in the state of Florida as well as the southeast region. So we have electronic health record information from every county in the state of Florida. And we also have partnerships at the University of Alabama, Birmingham, Emory University in Atlanta, Georgia, the University of Medical Sciences in Arkansas in Little Rock, as well as the University of Minnesota and University of California, Irvine. So we lean very heavily on the plus in OneFlorida. And within OneFlorida, in our clinical research network, we have three main services. So we have our administrative team, or what I call our front door team, which helps investigators and study teams develop grant applications. We provide letter support. We do budget estimation, as well as help develop research questions and methods in which to answer your research question using our network. We also have our front door programming team embedded into that that can do query development as well as cohort discovery and see what type of eligible numbers we have within the network. We also have a clinical trials arm that conducts pragmatic clinical research, community-based research, anything that involves patient involvement or working with patients, we oversee that. And then kind of our crown jewel is our data trust, which is a HIPAA limited data set. We have dates and zip codes in the data trust, and that is a centralized data set where all 18 of our partners actually submit their full electronic health record information from 2012 to present and that is collated and cleaned and stored at the University of Florida. The University of Florida is the coordinating center for OneFlorida and we are located in the Department of Health Outcomes and Biomedical Informatics in the College of Medicine at UF.

Anchalee Phataralaoha: So these services are open to everyone or people got to be within your network to use that?

Brittney Manning: So they are open to any investigator that is affiliated with a OneFlorida Plus partner, which is a very broad definition. So that means anyone at the University of Florida is open to use the OneFlorida network. We, within the state of Florida, we actually have the University of Miami, the University of South Florida, FSU, Florida State University, as well as several health systems like Advent Health Orlando, Orlando Health, BayCare. So we really have a broad, and that's just a little bit of our Florida, state of Florida partners. We also have more. But I mention that because a lot of people don't even realize they're affiliated with OneFlorida because they work for those institutions and don't realize we're a resource. But the other really cool part about OneFlorida as well is we do a lot of partnership and collaboration matching. So if you're an investigator at the University of Florida and perhaps you need expertise in a certain area or help with a patient population, part of my job is to then match you with someone at another institution or university that can help fulfill those goals and needs for your project.

Anchalee Phataralaoha: So for those who are not in the network I guess…

Brittney Manning: Yeah, that's a great question. So as I mentioned previously, OneFlorida is one of eight clinical research networks. And so the other clinical research networks have similar affiliation practices where you have to be affiliated with their partner institutions. But the great thing about PCORnet in general is anyone can apply to use PCORnet. And they will pair you with a partner institution or find an affiliation for you. And so while to use the OneFlorida-based services, you do need to have an affiliation with a partner institution. If you want to use PCORnet in general, that is open to the public.

Anchalee Phataralaoha: To everyone.

Brittney Manning: To everyone.

Anchalee Phataralaoha: Okay, so how old is this network? Because I haven't heard of it actually.

Brittney Manning: That's a great question. Yeah, so actually we are in year 11. It's been going on for, yes, 10 plus years at this point. We established in 2015. This actually came out of a really wonderful collaboration through the CTSI, through a partnership between Florida State University and the University of Florida called Health Impacts. And then from there, the University of Miami joined us and we realized we had this really amazing opportunity to make a statewide impact on research. And as PCORI has grown and become, I think, more well known, we've also had other sites reach out organically and asked to join the network as well as trying to reach out and making sure we have strategic opportunities to ensure those who are previously underrepresented and research are included and that we have a really diverse group of a really diverse population represented within OneFlorida as well.

Anchalee Phataralaoha: So it sounds like it's growing.

Brittney Manning: Yes, so we're actually we just added a new partner. I think we're at I think that's at 19. And we continue to have a partner or other organizations reach out to be interested in joining OneFlorida, which is fantastic. Another really cool collaboration that we have right now is the Medical University of South Carolina, which is in Charleston, South Carolina. They actually approached us and we were able to form using OneFlorida, the Southeast AI Consortium. So the state of South Carolina, their legislator, actually gave MUSC a very large amount of money to develop them into an AI prominent institution, and they wanted to partner with UF and specifically OneFlorida on that. MUSC is also a part of the Star Network, which is also a clinical research network that's led by Vanderbilt. So like I said, even if you might not be affiliated with OneFlorida Plus Partners, you are probably affiliated with some CRN somewhere out there. You just don't realize it.

Anchalee Phataralaoha: So if someone’s interested, do you have any particular, let's say, requirement, criteria to join?

Brittney Manning: In order to join as a partner, so it would be an institution, we count the institution as partners. So in order to become a partner, we obviously look for scientific collaboration and partnership. And we also, the institution has to be comfortable sending us a copy of the limited data set of their electronic health record information. Something that really sets OneFlorida apart is that we are a centralized data repository where other CRNs tend to be federated. But the centralization aspect allows us to run research at a much faster level than other institutions and at a higher volume. So we can run queries and cut data sets that cut across a much larger patient population than if you were going to an individual site. So if anyone out there that's listening is interested in learning more about becoming a OneFlorida partner, please feel free to reach out to me and I'm happy to have that discussion.

Anchalee Phataralaoha: So you mentioned that you host a lot of data, right?

Brittney Manning: Yes.

Anchalee Phataralaoha: And what kind of infrastructure?

Brittney Manning: Yes, this is a great question and I'm so happy you asked this because this is something I've actually been working on quite a lot over the last year. So because we have so much data, so currently we have over 33 million individual patient records. And the reason why we have so much data is because this is patient records going back to 2012, right? So that is just, that's a lot of data. Some people, most people aren't active in the health systems anymore, but we still have that information. And as you can imagine, the storage for that is astronomical. We were previously using UF Health IT's Academic Health Center servers. We had bought on-premise servers. But to be more nimble and also to be able to facilitate joining in more partners, we recently moved to Microsoft Azure, so a cloud-based storage platform. And then we also are now using Snowflake as our primary database. And those two changes have increased, or actually I should say decreased our processing time, I believe by half. It's been a huge improvement, which has been really interesting because someone who does not have a technology background, again, my background's in epidemiology, it's been really interesting to learn about.

Anchalee Phataralaoha: So this sounds like a great organization and infrastructure, everything in one place.

Brittney Manning: We try. Yes. We try very hard to be a one-stop shop for researchers. You know, whether that is you're looking for data for an observational or retrospective study, we have that. Or perhaps a mixed method study or even, you know, a prospective either clinical trial or data collection with surveys from patients. We can do everything. And I like to say that, you know, even if we haven't done it yet, we can try to figure out a way to do it.  

Anchalee Phataralaoha: Right. Definitely. So, if anyone would like to get more information or maybe to join your network even.

Brittney Manning: Yes, please feel free to reach out to me at my e-mail, which is B R O T H 4 2 3 at ufl.edu. You can also look me up in the UF Directory under Brittney Roth Manning. We also have a website which is onefl.net. So O N E F L dot N E T. And it has our contact information there as well. On the website we also have links to a few different things I just want to briefly highlight. One is a consultation request which we check daily, so you can always submit a consultation request through our OneFlorida website, a full research application, and then if you are at the University of Florida or a partner site, and if you're listening to this, I'm assuming you're at least at UF, you can actually sign up for an I2B2 account, which is free, and that allows you to look at all of the OneFlorida data in an aggregate. So you can actually query using I2B2, if you're looking for a type 1 diabetes cohort, you can actually see how many patients are in OneFlorida currently using I2B2.

Anchalee Phataralaoha: And they can do that through your website, right?

Brittney Manning: Yes.

Anchalee Phataralaoha: Okay, there'll be a link on there.

Brittney Manning: Yes, you have to request access, but once you request access, it usually takes about two weeks for access to be granted. And then you can use I2B2 very similarly how the Health Science Center has I2B2 available for UF Health as well.

Anchalee Phataralaoha: Okay, any final thoughts or anything you would like to add?

Brittney Manning: Yeah, so the one last thing I just want to mention is this is not, even though I keep saying electronic health record information, talking about clinical trials, this is not a College of Medicine only resource or Health Science Center only resource. You know, we've had investigators from all over the university, you know, come to us asking research questions. We've had groups from the Department of Geography, the Department of Statistics. We have, the data we have is so vast. We also have exposome data, including census tract and zip code information. But the data can also be used for large language models, machine learning, AI algorithm development. That's a lot of requests we're seeing recently. So this isn't just meant for the Health Science Center or the College of Medicine. This is really meant to be a resource that any investigator can use.

Anchalee Phataralaoha: Thank you very much, Brittney.

Brittney Manning: Yes, thank you so much for having me.

Anchalee Phataralaoha: And that's it, everyone. And we will see you next time for a topic of interest in IT.