A Judicious Combination of Commerce and Philanthropy

Raj Shah of CTIS, Inc.

After congestive heart failure that put him in intensive and critical care in 2007, Raj Shah has been diligent about living under a protocol with proper diet and exercise. But even more important than his lifestyle choices that include meditation and the regimen of drugs he takes throughout the day, he says, is the personal electronic health record he carries. In the event of another medical emergency, responders can see his medical history in an instant and know how to contact the doctors who manage his chronic disease.

For Raj Shah, Chairman of Capital Technology Information Services, Inc. (CTIS) in Rockville, Maryland, information sharing is critical to effective health care, and technology holds the key, especially for chronic disease patients like him. Among the many applications of health IT are proper data collection, data management, data mining, clinical trials management, patient tracking, secure information sharing and messaging using handheld and other convenient devices for patients and family with healthcare providers.

"Information between patients, physicians, health providers and health workers needs to be shared for better care management," Mr. Shah says. "You cannot do that without interoperable health IT, and it can happen anywhere in the world."

Educated in chemistry, process engineering and business management, Mr. Shah spent the first part of his business career focused on management consulting for energy and the environment. But after three of his aunts died of cancer within a three-year span, the IT expert decided to move into health care. He purchased a small company within Montgomery County's Technology Corridor in 1986 and began servicing the informatics needs of the National Institutes of Health. In subsequent years Mr. Shah developed an increasing interest in international health, which led to his relationship with the International Network for Cancer Treatment and Research (INCTR); he became a member of its Governing Council in March 2004.

Mr. Shah has a keen interest in addressing health disparity issues, both in the United States and abroad. His company has built the informatics systems for the National Cancer Institute, National Heart Lung and Blood Institute and National Institute of Allergy and Infectious Diseases. CTIS customizes and donates the software, after suitable modification, to support cancer and other chronic disease research in developing countries. Over the last several years, INCTR's Clinical Trials Office, has used this Web-based software for managing data collected by the leukemia study group in India.

"Regulatory compliance is key," says Mr. Shah. "Because of what we did for NIH, we had already developed the best practice and standards to support in-depth clinical research, including those related to patient safety, clinical practice management, adverse event reporting, and how to store and protect data. Now it is being applied to developing countries."

Mr. Shah would like to see INCTR benefit further from his efforts. "We have $400 million invested through our NIH contracts, in the systems we've built, and they are all reusable," he says. "Everyone conducting clinical research needs health IT. A judicious combination of commerce and philanthropy may be the best way to move quickly forward. India, in particular, provides new opportunities of this kind. Who would have thought ten years ago that India would be as advanced in IT as it is today?"

In addition to providing software training and support, CTIS has funded several small projects such as palliative care in Nepal and a communication portal for all INCTR offices. Most recently, in a joint project with several other organizations, CTIS worked with INCTR as lead in the area of cancer education known as the Open Educational Resources for Cancer (OREC), which will help provide online educational materials to cancer health professionals in developing countries.

Over the last ten years, counting in-kind donations and real dollars, CTIS has contributed nearly $10 million to support international cancer research and to INCTR more than $1 million. But Mr. Shah's assistance is not confined to finance and applications. His counsel is also of great value. Mr. Shah has advised Tata Memorial Hospital, Rajiv Gandhi Cancer Institute, Bhagwaan Mahaveer cancer hospital and research center, The Gujarat Cancer & Research Institute and other cancer institutes in his native India, smoothing bureaucratic bottlenecks in the Ministry of Health and the Indian Council of Medical Research. He is a member of the Health IT group for the Indian Knowledge Commission.

His office walls are covered with awards recognizing his community service activities in the United States and abroad. Among his pet projects is Community Ministry of Rockville and MobileMed, a nonprofit organization that provides medical care to the uninsured of Montgomery County. Healthcare professionals from several local hospitals volunteer their services, and CTIS supports the IT system that maintains the electronic health records of nearly 40,000 patients.

"This is my model approach to health care in the developing world," says Mr. Shah. "The idea is to start at a grass-roots level and get local professionals to make a commitment and bring in some funds."

As part of a similar program in India, health care workers are being trained to operate mobile clinics in rural areas where there are no doctors. Trained workers will provide basic services and refer patients to government hospitals, as needed. Just as importantly, they will be able to keep track of their patients via health IT.

"The truth is that in the years ahead personalized medicine will become a reality and prevention will be a key in successfully managing healthcare costs," promises Mr. Shah. "The desire is that human beings will all come together to find solutions to our medical challenges. When a drug is developed in the U.S., Europe or India, for instance, researchers have to understand that it's needed worldwide. If patient cohorts from developing countries are not included in clinical trials, it's just not good science."

Marcia Landskroener for INCTR