Making a commitment to connect people through technology

Justin Starren, MD, PhD, lost his father when he was 13 years old. His father had an undefined collagen vascular disease that resembled rheumatoid arthritis at a time when some doctors were overprescribing steroids. 

“It was medical ignorance,” Starren said. “It was before doctors understood the damage caused by chronic high-dose steroids. Eventually, he needed surgery for a collapsed lung and died of pneumonia shortly after the operation.”

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At that early age, Starren committed himself to becoming a doctor to prevent similar tragedies for other people. He went on to earn his medical degree, but in the process, discovered he had a natural proclivity for data science and technology. Eventually, he decided he could help more people by practicing in a field that uses computers, technology and data to improve health outcomes and care.

“With biomedical informatics, real people get real medical care with what you build. So instead of helping one patient at a time, your work can help hundreds or thousands at a time,” he said. 

Earlier this year, Starren joined the University of Arizona Health Sciences as the director of the Center for Biomedical Informatics and Biostatistics and a professor of medical imaging at the College of Medicine – Tucson.

“What really excites me these days is building systems that will outlast me and make a difference long after I’m gone,” Starren said. “I think I will be able to do that here.”

The Center for Biomedical Informatics and Biostatistics is an in-house resource for scientists who want to transform their data into knowledge that benefits patients and the public. The center supports and advances clinical research with several tools and service lines, including electronic data management, biospecimen management and statistical consultation.

Starren has a vision for using the center as a launch pad for advancing research in several areas, including solving health disparities impacting Native American and Hispanic communities.

Pursuing a passion for programming

Starren knew almost nothing about computers before getting accepted to a combined MD-PhD program at Washington University School of Medicine in the 1980s. It wasn’t until he found himself with some unexpected free time during a lab rotation that he got into programming.

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“I worked in an immunogenetics lab. We would do an experiment, and then need to wait six weeks before getting back into the lab. Then we’d do some work and wait another four weeks. I needed to find something to fill my time,” he said. “So, I walked down the hall to visit with a computer science graduate student who was in charge of the new departmental computer and said, ‘Hey, I think computer programming is going to be important someday. How do I learn this?’” 

The student recommended a few books on coding and suggested to Starren that a great way to learn programming was through designing video games. 

“He said games need to be clean, fast and efficient with a good user interface. So, in addition to writing data handling programs for the lab, I ended up writing a light cycle game like the movie ‘Tron,’” Starren said. “Ultimately, I followed  my passion for programming to work as a programmer developing 3D imaging software for nuclear cardiac imaging. The software was adopted by a global technology company.” 

That experience led Starren to choose radiology as his specialty in medical school because it was the most computer intensive. He completed an internship in internal medicine at UCLA Sepulveda, then pursued a radiology residency at Columbia-Presbyterian Hospital in New York. Ultimately, he decided not to pursue board certification as a physician in favor of a position at a high-tech consulting firm where he could help turn ideas into tangible products.

After a couple years in the private sector, the nascent field of biomedical informatics lured Starren back to academia. He earned the first doctoral degree in biomedical informatics from Columbia University and later became a member of the faculty at Columbia’s Vagelos College of Physicians and Surgeons.

As Starren fine-tuned his research focus, he reached a turning point when he launched a series of projects that focused on the person at the other end of the computer.

“It became about making the technology work for the person, not the other way around,” Starren said, explaining he was drawn to solving problems that required connecting experts in different areas and building bridges over technological barriers.

“I have spent much of my career getting systems and organizations that don’t trust each other and don’t like each other very much to work together for the greater good. I am especially proud of and have a passion for doing this in underserved areas and for those who have not had the same advantages many people take for granted.” 

Focusing on people 

In 1995, while pursuing his doctorate in biomedical informatics, Starren was asked to take over a research study project in a low-income community where many doctor’s offices had not yet adopted computers. The project connected physicians in East Harlem to Columbia-Presbyterian Medical Center so they could look up electronic medical records and prescribe treatments and tests for patients. 

He received national recognition for his work as co-principal investigator and chief technology architect on the Informatics for Diabetes Education and Telemedicine, or IDEATel, project at Columbia University. The eight-year, $60 million clinical trial focused on electronic management of elderly patients with diabetes in underserved urban and rural areas of New York.

“This meant bringing technology to people who had never had it before. We were building tools for people who had never touched a computer mouse,” Starren said. “We found that despite those challenges, telemedicine can still be effectively used to manage diabetes.” 

He is also recognized for his work on his work on the Electronic Medical Records and Genomics, or eMERGE project, which focused on the integration of genomic data into the electronic health record to support precision medicine. 

“What really excites me these days is building systems that will outlast me and make a difference long after I’m gone.”
— Justin Starren, MD, PhD

“Doctors in a busy practice want actionable information. It has to be fast, and it has to be in the workflow,” he said. “We flipped the way our clinical genomic decision support worked so that instead of focusing on the genotype and linking back to what you should do about it, we started with the action.”

His current research involves exploring the ethical issues involved with technology-enabled research data collection during clinical encounters. At the University of Arizona Health Sciences, Starren is identifying ways he can leverage the tools of bioinformatics, biostatistics and data science to have a positive impact on underrepresented populations in Arizona and beyond. 

“One of the things that drew me here is the great work that has been done with the Native nations,” Starren said. “After talking to tribal leaders and partners at the university, one of the challenges we’ve identified is that people on tribal lands have limited access and control of their health data. I want to change that.”

Starren has begun work start a master’s degree program in health informatics with a focus on Indigenous data governance and data ethics. His long-term plan involves funding scholarships for tribal members to pursue the degree without having to pay tuition. His plans also include recruiting 10 new Biomedical Informatics faculty over the next five years.

Starren hopes to add his experience connecting different systems and organizations to the rich spirit of collaboration at the University of Arizona in addressing the health problems of underserved populations. Certainly, his focus on the people at the other end of the computer will continue to be a priority for him and the Center for Biomedical Informatics and Biostatistics for many years to come.