Curriculum Vitae            

 

Part I: General Information

 

Date prepared: February 14th 2005

 

Name Hamish S F Fraser

 

Office address:           643 Huntington Avenue

Boston, MA 02115

(T) 617-432-3930

(F) 617-432-6045       

 

Home Address:          16 Hill Street

Somerville, MA, 02144

 

Email: hamish_fraser@hms.harvard.edu        

          

Education:

1991                 MSc                                                         Edinburgh University, Knowledge Based Systems

1990                 MRCP                                                     Royal College of Physicians, Medical Boards

1986                 MB ChB,                                                             Edinburgh University, Medicine

1984                 B.Sc.                                                                     Edinburgh University, Medical Science


Postdoctoral training:

1995-1999       Research/Clinical Fellow                      New England Medical Center, Boston

                                                                                             & MIT Laboratory for Computer Science,

                                                                                             Cambridge, MA

1992-1995       Career Registrar in Cardiology            Edinburgh Royal Infirmary and

Falkirk and District Royal Infirmary, UK

1992 (6/12)     Locum Registrar in Cardiology           The Freeman Hospital, Newcastle, UK 

1989-1990       Senior House Officer in Medicine      Northern General Hospital, Sheffield, UK      

1988-1989       Senior House Officer in Medicine      Stirling Royal Infirmary, Stirling, UK      

1987-1988       Senior House Officer in Medicine      Falkirk and District Royal Infirmary, UK 

1986-1987       Internship                                                Western General Hospital, and          

The Royal Infirmary, Edinburgh, UK

 

Licensure and certification:

1987                               Full medical license, United Kingdom

1998                               Massachusetts medical license (limited, dependent on visa type)

 

Academic appointments:

 

2003 – present                          Instructor in Medicine, Harvard Medical School, Boston, MA

1999 – 2003                 Instructor in Pediatrics, Harvard Medical School

 

1995 – present                          Research Affiliate, MIT Laboratory for Computer Science, Cambridge, MA

 

Hospital appointments :

2004 – present             Research Associate, Division of Social Medicine and Health Inequalities, Brigham and Women’s Hospital

2000 – 2004                 Research Associate, Informatics Program, Children’s Hospital, Boston

 

Major administrative responsibilities:

 

2002 – present               Director of cardiology                                                                Zamni Lasante, Haiti

2000 – present               Director of Informatics and Telemedicine,                                         Partners In Health,

Boston, MA

2000 – present   Oversight of medical informatics and telemedicine            Partners In Health,

projects                                                                                         Socios En Salud, Peru, Zanmi Lasante

1996 – 1999      Boston Informatics Research Trainees joint lectures          Harvard/MIT/Tufts

                                                                                                                                                                                Informatics Groups

Major Committee Assignments:

 

2003                 Scientific program committee Helina2003     member            International Medical

Informatics Association

 

2002 – present             Curriculum committee, Medical Informatics MS program   University of

KwaZuluNatal, Durban

South Africa

 

2001 – 2002    Informatics working group for MDR-TB      member            Harvard/WHO/CDC

 

2001 – 2002    Working group on DOTS-PLUS                     member            WHO/CDC/HMS

 

Professional societies:

 

1996- present               American Medical Informatics Association                 Member

1990- present               Royal College of Physicians, Edinburgh                      Collegiate member

1987 - 2001                  British Medical Association                                            Member

1990                               British Medical Association                                            Official representative

 

 

  

Editorial Boards:

 

2003                               American Medical Informatics Association Conference        Reviewer

2002                               Journal of Telemedicine and Telecare                                      Reviewer

2002                               International Journal of Medical Informatics                                        Reviewer

1998                             British Medical Journal                                                                 Reviewer

 

 

 

 

Part II:            research, teaching, and clinical contributions

 

Current Project:

 

I direct the development of web-based medical record systems and data analysis tools to support the treatment of drug resistant Tuberculosis in Peru, Haiti and Russia. The system currently supports the management and monitoring of nearly 2000 patients in treatment in Peru and 50 in Haiti. We have developed tools to search for patterns in the bacteriology results for these patients and to graph this data on the web. Extensive tools are provided to track the use of medication and predict future requirements medication requirement, the largest single cost of the treatment project. The system also provides tools to manage clinical data and digital images of X-rays. I am performing clinical evaluation studies of the system, including the impact of medication order entry by nurses on data quality, and have shown a significant reduction of medication errors with this approach (see bibliography). 

 

A related project (TeleMedMail), with my colleague and former student Darius Jazayeri, is a system to facilitate store and forward telemedicine in developing countries. It allows users to import images, modify them and add clinical data. These cases are then compressed, encrypted and emailed to the specialist. Alternatively, the archive can be sent to a server, the specialist then views the case over a secure web connection. This system is operating in South Africa and a pilot project of its use for HIV management is being set up. I have also performed an evaluation of the diagnostic quality of digital images of X-rays acquired using a low cost digital camera with my former student Agnieszka Szot. (see bibliography).

 

I am now developing a Web based medical record system to support the treatment of HIV patients in rural Haiti. The system is now operational and collecting data in very remote sites via satellite link. Physicians are entering clinical data and medications directly into the system, over 600 full records have been entered in the last 6 months. Warning emails are generated nightly for low CD4 counts.

 

Informatics fellowship project (MIT/NEMC)      

I designed, set up and performed a clinical trial of the Heart Disease Program with physicians (mainly residents) at the New England Medical Center.  We developed the user interface as a Web site to allow physicians to access the program over the Internet. 114 cases were directly entered by participating physicians and 50 entered over the Internet from around the world, many by cardiologists. The program showed better sensitivity than the resident physicians who entered the cases. I also developed new software tools and analyses to allow comparison of the performance of programs such as the Heart Disease Program that produce differential diagnoses (see bibliography and included papers).

 

Machine Learning/Data Analysis

Several of my projects have used tools from machine learning and statistics to develop decision support tools from data. I started this area of work with Prof. Lee Kennedy in Edinburgh in 1992, developing models to predict the diagnosis of myocardial infarction in patients with chest pain. I continued this work with Bill Long and Chris Tsien at MIT exploring ways to optimise decision trees induction, improve generalization of models over data collected in different countries and to deal with missing data.

 

Patient Directed Decision Support Tools

During 1998-99 I was funded by a grant from the National Heart Attack Alert Program, an organization funded by the NIH to explore ways to assist patients with myocardial infarction to recognise and act quickly on their symptoms. I have assessed the performance of current patient guidelines on data from Edinburgh and Boston to determine whether patients are receiving optimum advice and developed new guidelines from data.

 

 

B.         Funding information

 

2004 – 2009                 NIH                  Co-Invest: “ITGH Program in Sub-Saharan Africa”

(Fogarty training grant)

 

2004                               CDC                 PI: “Implementing a medical record for MDR-TB

management in the Philippines”

 

2003- 2006                  NIH                  Co-Invest: “Ensemble for Self-Scaling Systems for Health”

 

2001 – 2004                 NIH                  Faculty: “ITMI Program in Sub-Saharan Africa”

(Fogarty training grant)

2000 2005                 Gates Fdn.       “Project for the eradication of MDR-TB in Peru”

                                                                  Primary Investigator on the informatics sub-project

 

1999 – 2000                 DARPA           Co-Invest: “High-Performance Knowledge Bases Project”

 

1999 2000                 NLM                 Co-Invest: “MAITA Project”

 

 

1998 – 1999                 Pfizer Inc.        Co-Invest: “Detection of adverse events in clinical trial data”

 

1998 – 1999                 NIH/NHLBI    Co-Invest: “Informatics for the National Heart Attack Alert

 program”

 

1995 – 1998                 NIH/NHLBI    Fellow: “Clinical Evaluation of the Heart Disease Program”

 

 

 

 

 

C.         Current research activities

 

the treatment of MDR-TB and HIV in developing countries

 

in developing countries

 

systems for developing countries

 

 

programs

 

            

 

D.         Report of teaching

 

1.  Local Contributions

 

2003-2004

City University, London, UK

Co-Supervised a Master of Medical Informatics student

2 hours/week

 

2002-2003

University of Colorado, Communications

Supervised a Master of Engineering/Communications student

5 hours/week

 

2001-2002

Harvard/MIT HST

Supervised a Master of Medical Informatics student

5 hours/week

 

2000-2002

MIT, Engineering

Supervised Master of Engineering student

5 hours/week

 

 

d. Invited teaching presentations (as lecturer)

 

1999 –2004 

Guest lecturer for the HST graduate course on medical computing at MIT

2 hours per course plus preparation time.

 

November 1999

MIT graduate course on Artificial Intelligence 6.034

Recitation: “Evaluating Medical Differential Diagnosis Programs”

2 hours

 

March 1999

Medical Computing Course 6.872, MIT

Lectured on "Clinical Evaluation of Medical Computing Systems"

2 hours

 

February 1998

Medical Computing Course 6.872, MIT

Lectured on “Developing Medical Decision Support Tools with Logistic Regression”

2 hours

 

e. Advisory and supervisory responsibilities

 

2002

University of Natal, Durban, South Africa.

Designing and teaching a short course on medical informatics for medical and research staff

60 hours

 


1998-1999      

Cardiovascular Imaging Laboratory at New England Medical Center, Boston

Teaching digital video production and editing

1 hour per week

 

 

1997 – 1999

Tufts University Medical School

Teaching clinical skills to medical students

2 hours per week

 

 

1988-1991      

Edinburgh University Medical School           

Teaching students and residents clinical skills and procedures

10 hours per month

 

 

Current

 

2003 - 2004                     

University and Natal, Durban, South Africa

Designing and serving as educational director of the first Masters degree course in Medical Informatics in Africa

160 hours/year

 

1. Regional, National or International Contributions

 

a. Invited presentations

 

November 2004

WHO Ministerial Summit on Health Research, Mexico City, Mexico

Invited speaker and panelist

 

April 2004                          

Harvard/MIT Hippocratic society meeting on International Health, Cambridge, MA

“Improving healthcare in developing countries with good information”

Invited lecture

 

March 2004

HIV Patient ART Monitoring Meeting – WHO, Geneva, Switzerland

Invited expert.

 

October 2003

Helina2003: Communication and Information Technology In the Global Fight against HIV/AIDS, Johannesburg, South Africa.

Two invited plenary lectures

 


April 2003                          

Haiti Workshop on Expanding Aids Treatment, Care, and Prevention in Resource Poor Settings

(sponsored by the NIH Office of AIDS Research and the Rockefeller Foundation), Cange, Haiti

Invited lecture


February  2003                              

Partnership for treatment of drug resistant Tuberculosis, Lima, Peru,
Invited lecture

 

May 2001                          

The AMIA spring symposium, Atlanta, GA

Informatics for Public Health. Invited expert

 

June 2002                          

International Society for Equity in Health (ISEqH) Second Annual Conference, University of Toronto,

invited lecture/workshop “ICTs for Disease Prevention and Management: Beyond National

Boundaries” Invited workshop leader

 

May 2002                          

The AMIA spring symposium, Scotsdale Arizona,

 “The Role of Informatics in Drug Supply Management in Developing Countries”  
Invited plenary lecture            

     

June 2001                          

eHealth in Developing Countries, the Future of Health Care? Cambridge, MA

Conference chair

 

2000 and 2001           

The Future of Health Technology Meeting, MIT Media Lab, Cambridge, MA

Invited lectures

 

July 2000                           

Internet Society Annual Meeting, Yokohama, Japan

“Security and Confidentiality of Medical Data on the Internet”. Invited lecture

 

April 2000

World Bank President James Wolfenson and the staff of the “Infodev” program.

Invited to present ideas for the use of information systems in healthcare in developing countries

 

March 2000                       

Harvard/MIT Hippocratic society meeting on International Health, Cambridge, MA

“Informatics and Telemedicine in Sub-Saharan Africa”.

Invited lecture

 

July 1999

Fogarty International Center ITMI program

Teaching short course on the use of the Internet in African medicine in Durban, South Africa,

Invited lectures


Bibliography

 

Original Articles

 

1) Kennedy RL, Burton AM, Fraser HSF,  McStay LN, Harrison RF.

Early Diagnosis of Acute Myocardial Infarction Using Clinical and Electrocardiographic Data at Presentation: Derivation and Evaluation of Logistic Regression Models

European Heart Journal, Vol. 17, August 1996, p1181 – 91

 

2) Kennedy RL, Harrison RF, Burton AM, Fraser HS, Hamer WG, MacArthur D, McAllum R,

Steedman DJ.

An Artificial Neural Network System For Diagnosis Of Acute Myocardial Infarction (AMI) In The Accident And Emergency Department: Evaluation And Comparison With Serum Myoglobin Measurements.

Comput Methods Programs Biomed 1997 Feb;52(2):93-103

 

3) Fraser HSF, Kohane IS, Long WJ.

Using the Technology of the World Wide Web to Manage Clinical Information

British Medical Journal, No 7094 Volume 314 Saturday 31 May 1997 P 1600-4

 

4) Long WJ, Fraser HSF, Naimi S.

Reasoning Requirements for Diagnosis of Heart Disease.

Artificial Intelligence in Medicine 10 (1997) pp. 5 – 24


5) Tsien CL, Fraser HS, Kohane IS.

LRTree: a hybrid technique for classifying myocardial infarction data containing unknown attribute values. Research and Development in Knowledge Discovery and Data Mining.  Wu X, Kotagiri R, Korb KB, Eds., Lecture Notes in Artificial Intelligence 1394.  Berlin Heidelberg: Springer-Verlag 1998: 409-411.

 

6) Hauskrecht M, Fraser HS.

Planning treatment of ischemic heart disease with partially observable Markov decision processes.

Artificial Intelligence in Medicine, vol. 18, pp. 221-244, 2000

 

7) Wang SJ, Ohno-Machado L, Fraser HS, Kennedy RL.

Using Patient-Reportable Clinical History Factors to Predict Myocardial Infarction

Comput Biol Med. 2001 Jan 1;31(1):1-13.

 

8) Lober WB, Karras BT, Wagner MM, Overhage MJ, Davidson AJ, Fraser HSF, Trigg LJ, Mandl KD, Espino JU, Tsui FC.

Roundtable on Bioterrorism Detection: Information System-based Surveillance.
J Am Med Inform Assoc. 2002 Mar-Apr;9(2):105-15.

 

9) Marques EP, Marin HF, Massad E, Fraser H, Ohno-Machado L.

Training in health informatics in Brazil.

Stud Health Technol Inform. 2002;90:757-60.

 

10) Fraser HSF, Long WJ, Naimi S.

Evaluation of a Cardiac Diagnostic Program in a Typical Clinical Setting. 

J Am Med Inform Assoc. 2003; Jul-Aug;10(4):373-81

 

11) Fine AM, Wong JB, Fraser HSF, Fleisher GR, Mandl KD.

Is It Influenza or Anthrax? A Decision Analytic Approach to the Management of Patients with Influenza-Like Illnesses.

Ann. of Emerg. Med. 2004; 43(3): 318-328

 

11) Szot A, Jacobson F, Munn S, Jazayeri D, Nardell E, Harrison D, Drosten R, Ohno-Machado L, Smeaton LM, Fraser HSF.

Diagnostic Accuracy of Chest X-rays Acquired Using a Digital Camera for Low-Cost Teleradiology. Int. J. Med. Inform. 2004; 73(1): 65-73

 

13) Fraser HSF, Jazayeri D, Nevil P, Karacaoglu Y, Farmer PE, Lyon E, Smith-Fawzi MK, Leandre F, Choi S, Mukherjee JS.

An information system and medical record to support HIV treatment in rural Haiti.

British Medical Journal, 2004; 329;1142-1146

 

14) Laserson KF, Thorpe LE, Leimane V, Weyer K, Mitnick C, Riekstina V, Zarovska E, Rich ML, Fraser HSF, Alarcon E, Cegielski JP, Grzemska M, Gupta R, Espinal M.

Speaking the Same Language: Treatment Outcome Definitions for Multidrug-Resistant Tuberculosis.

International Journal of Tuberculosis and Lung Disease, in press

 

 

Proceedings of Meetings (all peer reviewed papers)

 

1) Long WJ, Fraser HSF, Naimi S,

A Web Interface for the Heart Disease Program

AMIA Fall Symposium, 1996, October ; Washington, DC. Hanley and Belfus; 1996. p. 762-6

 

2) Tsien CL, Fraser HS, Long WJ, Kennedy RL,

Using Classification Tree and Logistic Regression Methods to Diagnose Myocardial Infarction

MEDINFO 98, Seoul, Korea, August 1998; Pt 1:493-7.

 

3) Fraser HSF, Long WJ, Naimi S.

Differential Diagnoses of the Heart Disease Program have better Sensitivity than Resident Physicians.

AMIA Fall Symposium on Computer Applications in Health Care, 1998 November 7-11. Orlando, Florida; Hanley and Belfus; 1998, p 622-26

 

4) Hauskrecht M, Fraser HSF

Modelling Treatment of Ischemic Heart Disease with Partially Observable Markov Decision Processes.

AMIA Fall Symposium on Computer Applications in Health Care, 1998 November 7-11. Orlando, Florida; Hanley and Belfus; 1998, p 538-42

 

5) Ohno-Machado L, Fraser HS, Ohrn A

Improving Machine Learning Performance by Removing Redundant Cases in Medical Data Sets

AMIA Fall Symposium on Computer Applications in Health Care, 1998 November 7-11. Orlando, Florida; Hanley and Belfus; 1998, p 523-27


 

6) Fraser HSF, Long WJ,  Naimi S

New Approaches to Measuring the Performance of Programs that Generate Differential Diagnoses using ROC Curves and Other Metrics.

Proc AMIA Symp. 2000;:255-9.

 

7) Fraser HS, Jazayeri D, Bannach L, Szolovits P, McGrath SJ.

Telemedmail: free software to facilitate telemedicine in developing countries.
Medinfo. 2001;10(Pt 1):815-9. 

 

8) Fraser HSF, Jazayeri D, Mitnick CD, Mukherjee JS, Bayona J

Informatics Tools To Monitor Progress And Outcomes Of Patients With Drug Resistant Tuberculosis In Peru.

Proc AMIA Symp. 2002: 270-274, San Antonio, Texas

 

9) Choi S, Jazayeri D, Mitnick C, Chalco K, Pachao F, Bayona J, Fraser HSF.

A Web-based Nurse Order Entry System for Multidrug-Resistant Tuberculosis Patients in Peru.

Proc. Medinfo2004, 11: 202-206

 

Theses

 

Fraser HSF, “Comparative Physiology of the Basal Ganglia” [BSc Dissertation]

Edinburgh University, Edinburgh, UK 1983.

 

Fraser HSF., "Qualitative Modelling of the Heart and Circulation [MSc Dissertation].

Edinburgh University, Edinburgh, UK, 1991.

 

Reviews, Chapters, and Editorials

 

Fraser HSF Medinfo-92 [conference report], The Lancet, vol. 340: Sept. 26, 1992, pp 784.

 

Fraser HSF, McGrath JD

Information Technology and Telemedicine in Sub-Saharan Africa [editorial]

BMJ. 2000 Aug 19-26;321(7259):465-6

 

Fraser HSF. Clinical information and decision-support systems [book chapter]

In: Bruce McKenzie, editor. Medicine and the Internet (third edition)

Oxford: Oxford University Press; 2002  p. 103 – 114.

 

Fraser HSF, Jazayeri D, Nevil P, Karacaoglu Y, Léandre F, Farmer PE, Mukherjee J.  [book chapter]. In: Joia S. Mukherjee, editor. The PIH Guide to the Community-Based Treatment of HIV in Resource-Poor Settings

Boston: Partners In Health; 2004 p. 155 - 169

 

Letters in medical journals

  1. Hamish Fraser, “Academic physicians are affected by specific failures of postgraduate training”. BMJ  2005;330:363

 

Letters in newspapers

  1. Hamish Fraser,  “Haiti needs help”, The Observer Newspaper, London, 1/4/04
  2. Hamish Fraser, “Democrats are not out the game”, Guardian Newspaper,  London, 11/20/04

 

 

Abstracts

 

Yasin Z, Choi S, Fraser HSF Improving Access To TB Medical Records In Remote Clinics In Peru Using A Personal Digital Assistant Based Application

Proc AMIA Symp. 2002, San Antonio, Tx, Hanley and Belfus; 2002 p 1207

 

Ohno-Machado L, Marin H, Marques EP, Masssad E, Abrahao M, Fraser HSF

Training in Medical Informatics in Northeastern Brazil

Proc AMIA Symp. 2002, San Antonio, Tx, Hanley and Belfus; 2002 p 1118

 

Jazayeri D, Farmer P, Nevil P, Mukherjee JS, Leandre F, Fraser HS

An Electronic Medical Record System to Support HIV Treatment in Rural Haiti.

Proc AMIA Symp. 2003;:878.

 

Development and evaluation of software to support prescribing and drug supply management in the treatment of MDR-TB in Peru

Fraser HSF, Choi S, Jazayeri D, Kempton K, Bayona J

Second International Conference on Improving the Use of Medicines, Chiang Mai, Thailand, March 30th – April 2nd 2004

 

McGraph SD, Fraser HSF, Herbst K

Electronic Medical Record (EMR) systems for HIV care in resource poor

settings: report from an international workshop

XV International AIDS Conference, Bangkok Thailand, 11-16 2004

 

Scale-up of an HIV treatment program in rural Haiti

Ivers LC, Jerome G, Joseph K, Fraser HS, Farmer PE, Mukherjee J, Leandre F

XV International AIDS Conference, Bangkok Thailand, 11-16 2004

 

A System For Modeling Medication Requirements For the Management of Drug
Resistant Tuberculosis In Developing Countries

Fraser HSF, Jazayeri D, Kempton K, Mosely M, Choi S, Pachao F, Bayona J

11th World Congress on Medical Informatics, San Francisco, September 7 – 11, 2004

Proc. Medinfo2004,11: 1603