Lael Cranmer Gatewood, PhD, FACMI

Gatewood’s current research is focused on pathology informatics, in particular in incorporating anatomical and surgical pathology into a form of informatics that will allow these fields to be integrated with clinical pathology and laboratory information systems. This work involves bringing informatics to bear in specimen tracking through bar coding including the separation of specimens into paraffin blocks or slides, the staining processes used for specimen analysis, and molecular testing, a rapidly growing area for anatomic as well as clinical pathology. The integration of all diagnostic testing systems reporting through the Epic electronic health record system is vital for providing precise, individualized treatment for patients. Clinicians are calling for pathologists to conduct more molecular tests on site rather than sending specimens to a reference lab and to include results of the tests in their final report.

Clinician requests for molecular testing can affect specimen procurement procedures and tissue quantity provided through core biopsy or fine-needle aspiration. Challenges also exist in accurately conveying pathology testing results via Epic in language that is umambiguous to clinicians. Gatewood and colleagues are developing co-path middleware for Epic that will serve as an “add on” with features to facilitate pathology and  laboratory systems reporting. In time these features will include a genomics information system and a graphics archiving system for whole-slide imaging.

In the education and training arena, pathology and informatics professional organizations and educators including Gatewood are working to elevate pathology informatics and set standards for the rapidly changing field. The Accreditation Council of Graduate Medical Education (ACGME) has set graduation milestones in pathology informatics that will be necessary to meet for further training through fellowships and board certification in the field. The College of Pathology, the Association of Pathology Chairs, and the Association for Pathology Informatics have created PIER (Pathology Informatics Essentials for Residents). PIER is a program designed to provide informatics training to residents and help them meet ACGME informatics milestone requirements.

• Ackerman E, Gatewood LC: Mathematical Models in the Health Sciences: A Computer-Aided Approach. Minneapolis MN: University of Minnesota Press, 1979.
• Huntley SW, Finkelstein SM, Gatewood LC, Moore AA. Computer-aided real-time acquisition of physiological data: Technical design and selection constraints. Med. Inform 6(2): 77-97, 1981.
• National Study Group on Nursing Information Systems: Special report/Computerized nursing information systems: An urgent need. Research in Nursing and Health 6 (3):101-105, 1983.
• Glaser JP,Gatewood LC: A model for training in health information sciences. Medical Informatics 9(3/4):289-297, 1984.
• Baxter J, Gatewood L, Weil G, Gomez-Marin O, Folsom A, Jacobs D, Wu S, Gunderson P: Computerized linkage of regional public health records. Proc 1985 Pub Health Conf on Records and Statistics, Washington DC, pp. 97-101, 1985.
• Canner PL,Gatewood LC, White C, Lachin JM, Schoenfield LG: External monitoring of a data coordinating center: Experience of the National Cooperative Gallstone Study. Controlled Clinical Trials 8(1):1-11, 1987.
• Bender A, Jaeger H, Fraser J, Anderson W, Gatewood L, Larkin S: A feasibility study of a state-wide pathology-based cancer surveillance system in Minnesota. J Med Syst 2(1):25-44, 1987.
• Gatewood LC: Medical informatics: A training program for the medical school. Computers in Health Sciences, Haque (Ed): University of Medicine and Dentistry of New Jersey, Newark, pp. 81-87, 1988.
• Kottke TE, Gatewood LC, Wu S-C, Park H-A: Preventing heart disease: Is treating the high risk sufficient? J Clin Epid 41(11):1083-1093, 1988.
• Kottke TE, Gatewood L, Park H-A: Using serum cholesterol to identify high risk and stimulate behavior change: Will it work? Ann Med 21(3):181-187,1989.
• WHO MONICA Project Principal Investigators. The World Health Organization MONICA Project (MONItoring trends and determinants in CArdiovascular disease): A major international collaboration. J Clin Epid. 41(2): 105-14, 1988.
• Frantz ID Jr, Dawson EA, Ashman PL, Gatewood LC, Bartsch GE, Kuba K, Brewer ER: Test of effect of lipid lowering by diet on cardiovascular risk: The Minnesota Coronary Survey. Arteriosclerosis 9(1):129-135, 1989.
• Held JP, Chute CG, Gatewood LC, Connelly D: A schematic analysis of medical classification systems. Proc American Medical Informatics Association Conference, Spring 1990.
• Yang J, Ackerman E, Gatewood L: Design of a knowledge-based system for sensitivity studies of micropopulation models. Proc Symp on Computer Applications in Medical Care, IEEE, New York, pp. 314-318, 1990.
• Zhuo, Z, Gatewood L, Ackerman E: A Monte Carlo simulation program for coronary heart disease. Proc Symp Computer Applications in Medical Care, IEEE, New York, pp. 303-307, 1990.
• Peterson DP, Willard K, Altmann M, Gatewood L, Davidson G: Monte Carlo simulation of HIV infection in an IV drug user community. J AIDS, 3:1086-1095, 1990.
• The COMS Group: Design and methods of a clinical trial for a rare condition: The Collaborative Ocular Melanoma Study. COMS Report No. 3. Controlled Clinical Trials 14(5):362-91, 1993.
• Zhuo Z, Ackerman E, Gatewood L, Kottke T, Wu S-C, Park H-A: Polychotomous multivariate models for coronary heart disease simulations. I. Tests of a logistic model. II. Comparisons of risk functions. III. Model sensitivities and risk factor interventions. IV. The impact of physiological aging. Int J Biomed Comp 27:133-148, 28:181-204, 28:205-220 (1991); 37:287-96 (1993).
• Ackerman E, Zhuo Z, Altmann M, Kilis D, Yang J-J, Seaholm S, Gatewood L, Peterson D, Hatfield G, Goay MS, Prasad B, Gilbertson D, Altmann M, McGue MK, Rich SS. Simulation of Stochastic Micropopulation Models. I. The SUMMERS simulation shell. II. VESPERS: Epidemiological model implementations for spread of viral infections. III. COGNET: An artificial neural network for visual recognition. IV. SNAPPERS: Model implementation for genetic traits. Comp Biol Med 23:177-198, 23:199-213, 23:215-225 (1993); 25: 519-31 (1995).
• Altmann M, Wee BC, Willard K, Peterson D, Gatewood LC. Network analytic methods for epidemiological risk assessment. Stat in Med 13:53-60, 1994.
• Peterson DR. Srinavasan B. Ma JZ. Gatewood LC. Modeling annual distributions of influenza ourbreaks in nursing homes. Simulation in the Health Sciences. Proc 1994 Western Multiconference. SCS. 1994, pp.17-21. San Diego CA.
• Ong CL, Tsai WT, Altmann M, Gatewood L, Wee BC. Improving reuse in a family of biomedical simulation applications. Simulation in the Health Sciences. Proc 1994 Western Multiconference. SCS. 1994, pp.28-33, San Diego CA.
• Westrich BJ, Buzzard IM, Gatewood LC, McGovern PG. Accuracy and efficiency of estimating nutrient values in commmercial food products using mathematical oprimization. J Food Composition Analysis 7:223-239, 1994.
• Zhuo Z, Tsai Y, Ackerman E, Gatewood L. Evaluation of a Weibull/Cox model for coronary heart disease. Int J Appl Science & Computation 3:68-77, 1996.
• LaVenture M, Wicklin N, Schillo T, Gatewood L. A decentralized, community-based design for statewide immunization registries in Minnesota. AMIA Procs 388-92, 1997.
• Jacobs DR Jr, Kroenke C, Crow R, Deshpande M, Gu DF, Gatewood L, Blackburn H. PREDICT: A simple risk score for clinical severity and long-term prognosis after hospitalization for acute myocardial infarction or unstable angina: The Minnesota Heart Survey. Circ 100(6):599-607, 1999.
• Jaspers MWM, Gardner RM, Gatewood LC et al., IPHIE: An International Partnership in Health Informatics Education. Medical Infobahn for Europe, A. Hasman et al. (Eds.), IOS Press, 2000, pp. 549-553.
• Yasnoff WA et al. A National Agenda for Public Health Informatics. Journal of Public Health Management Practice;7(6):1-21.
• Jaspers MWM, Gardner RM, Gatewood LC, Haux R, Schmidt D, Wetter T, The International Partnership in Health Informatics Education: IPHIE, 5 years of experience and lessons learned. MEDINFO 2004 (in press).
• Fox JP, Elveback L, Scott W, Gatewood L, Ackerman E, Herd immunity: Basic concept and relevance to public health immunization practices. 1971. Am J Epidemiol 1995;141(3): 187-97.
• Zhuo Z, Ackerman E, Gatewood L. An expert system for simulation of coronary heart disease risk factor interventions. Proc Annu Symp Comput Appl Med Care. 1991;674-8.
• Park HA, Peterson D, Gatewood L. Using stochastic simulation to model vaccine effectiveness. J Korean Soc Med Inform 1997;3(2):201-6.
• Gatewood L, Limburg M, Gardner R, Haux R, Jaspers M, Schmidt D, Wetter T. International Master Classes in Health Informatics. Int J Med Inf. 2004;73(2):111-6.