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"Learning healthcare system"

Kim H Chuong, David R Mack, Alain Stintzi, Kieran C O'Doherty
Healthcare institutions face widespread challenges of delivering high-quality and cost-effective care, while keeping up with rapid advances in biomedical knowledge and technologies. Moreover, there is increased emphasis on developing personalized or precision medicine targeted to individuals or groups of patients who share a certain biomarker signature. Learning healthcare systems (LHS) have been proposed for integration of research and clinical practice to fill major knowledge gaps, improve care, reduce healthcare costs, and provide precision care...
March 10, 2017: Omics: a Journal of Integrative Biology
Thomas M Maddox, Nancy M Albert, William B Borden, Lesley H Curtis, T Bruce Ferguson, David P Kao, Gregory M Marcus, Eric D Peterson, Rita Redberg, John S Rumsfeld, Nilay D Shah, James E Tcheng
The learning healthcare system uses health information technology and the health data infrastructure to apply scientific evidence at the point of clinical care while simultaneously collecting insights from that care to promote innovation in optimal healthcare delivery and to fuel new scientific discovery. To achieve these goals, the learning healthcare system requires systematic redesign of the current healthcare system, focusing on 4 major domains: science and informatics, patient-clinician partnerships, incentives, and development of a continuous learning culture...
March 2, 2017: Circulation
Elizabeth R Hsu, Juli D Klemm, Anthony R Kerlavage, Dimitri Kusnezov, Warren A Kibbe
The Cancer Moonshot emphasizes the need to learn from the experiences of cancer patients to positively impact their outcomes, experiences, and qualities of life. To realize this vision, there has been a concerted effort to identify the fundamental building blocks required to establish a National Learning Healthcare System for Cancer, such that relevant data on all cancer patients is accessible, shareable, and contributing to the current state of knowledge of cancer care and outcomes. This article is protected by copyright...
January 31, 2017: Clinical Pharmacology and Therapeutics
Don Eugene Detmer
No abstract text is available yet for this article.
January 27, 2017: Journal of Interprofessional Care
Folkert W Asselbergs, Frank Lj Visseren, Michiel L Bots, Gert J de Borst, Marc P Buijsrogge, Jan M Dieleman, Baukje Gf van Dinther, Pieter A Doevendans, Imo E Hoefer, Monika Hollander, Pim A de Jong, Steven V Koenen, Gerard Pasterkamp, Ynte M Ruigrok, Yvonne T van der Schouw, Marianne C Verhaar, Diederick E Grobbee
Background Cardiovascular disease remains the major contributor to morbidity and mortality. In routine care for patients with an elevated cardiovascular risk or with symptomatic cardiovascular disease information is mostly collected in an unstructured manner, making the data of limited use for structural feedback, quality control, learning and scientific research. Objective The Utrecht Cardiovascular Cohort (UCC) initiative aims to create an infrastructure for uniform registration of cardiovascular information in routine clinical practice for patients referred for cardiovascular care at the University Medical Center Utrecht, the Netherlands...
January 1, 2017: European Journal of Preventive Cardiology
Vincent X Liu, John W Morehouse, Jennifer M Baker, John D Greene, Patricia Kipnis, Gabriel J Escobar
The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture to drive improvements in the quality of health care. The inpatient setting, one of the most costly and impactful domains of healthcare, is an ideal setting in which to use data and information technology to foster continuous learning and quality improvement. The rapid digitization of inpatient medicine offers incredible new opportunities to use data from routine care to generate new discovery and thus close the virtuous cycle of learning...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
John Ovretveit, Eugene Nelson, Brent James
Purpose The purpose of this paper is to describe how clinical registers were designed and used to serve multiple purposes in three health systems, in order to contribute practical experience for building learning healthcare systems. Design/methodology/approach Case description and comparison of the development and use of clinical registries, drawing on participants' experience and published and unpublished research. Findings Clinical registers and new software systems enable fact-based decisions by patients, clinicians, and managers about better care, as well as new and more economical research...
October 10, 2016: Journal of Health Organization and Management
Andrius Budrionis, Johan Gustav Bellika
BACKGROUND AND OBJECTIVE: The Learning Healthcare System paradigm has attracted the attention of researchers worldwide. The great potential originating from high-scale health data reuse and the inclusion of patient perspectives into care models promises personalized care, lower costs of health services and minimized consumption of resources. The aim of this review is to summarize the attempts to adopt the novel paradigm, putting emphasis on implementations and evaluating the impact on current medical practices...
December 2016: Journal of Biomedical Informatics
Andrew J Knighton, Lucy Savitz, Tom Belnap, Brad Stephenson, James VanDerslice
INTRODUCTION: Intermountain Healthcare is a fully integrated delivery system based in Salt Lake City, Utah. As a learning healthcare system with a mission of performance excellence, it became apparent that population health management and our efforts to move towards shared accountability would require additional patient-centric metrics in order to provide the right care to the right patients at the right time. Several European countries have adopted social deprivation indices in measuring the impact that social determinants can have on health...
2016: EGEMS
G Hirsch, M Trusheim, E Cobbs, M Bala, S Garner, D Hartman, K Isaacs, M Lumpkin, R Lim, K Oye, E Pezalla, P Saltonstall, H Selker
The current system of biomedical innovation is unable to keep pace with scientific advancements. We propose to address this gap by reengineering innovation processes to accelerate reliable delivery of products that address unmet medical needs. Adaptive biomedical innovation (ABI) provides an integrative, strategic approach for process innovation. Although the term "ABI" is new, it encompasses fragmented "tools" that have been developed across the global pharmaceutical industry, and could accelerate the evolution of the system through more coordinated application...
December 2016: Clinical Pharmacology and Therapeutics
Christopher A Harle, Gloria Lipori, Robert W Hurley
INTRODUCTION: Advances in health policy, research, and information technology have converged to increase the electronic collection and use of patient-reported outcomes (PROs). Therefore, it is important to share lessons learned in implementing PROs in research information systems. CASE DESCRIPTION: The purpose of this case study is to describe a novel information system for electronic PROs and lessons learned in implementing that system to support research in an academic health center...
2016: EGEMS
Terri Jackson
Hospitals are data-rich but information-poor. To develop a ‘continuous-learning health care system’ we need to harness our myriad information sources so that every patient encounter becomes the basis for new evidence of what works.
2014: HIM Journal
Geoffrey M Anderson
No abstract text is available yet for this article.
2016: HealthcarePapers
Rachael M Moloney, Ellen S Tambor, Sean R Tunis
No abstract text is available yet for this article.
March 2016: Journal of Comparative Effectiveness Research
Daniel M Trifiletti, Timothy N Showalter
Several advances in large data set collection and processing have the potential to provide a wave of new insights and improvements in the use of radiation therapy for cancer treatment. The era of electronic health records, genomics, and improving information technology resources creates the opportunity to leverage these developments to create a learning healthcare system that can rapidly deliver informative clinical evidence. By merging concepts from comparative effectiveness research with the tools and analytic approaches of "big data," it is hoped that this union will accelerate discovery, improve evidence for decision making, and increase the availability of highly relevant, personalized information...
2015: Frontiers in Oncology
William Gardner
Pierre-Gerlier Forest and his colleagues make a strong argument for the need to expand policy capacity among healthcare actors. In this commentary, I develop an additional argument in support of Forest et al view. Forest et al rightly point to the need to have embedded policy experts to successfully translate healthcare reform policy into healthcare change. Translation of externally generated innovation policy into local solutions is only one source of healthcare system change. We also need to build learning healthcare systems that can discover new health solutions at the frontline of care...
2015: International Journal of Health Policy and Management
Jeffrey G Klann, Lori C Phillips, Alexander Turchin, Sarah Weiler, Kenneth D Mandl, Shawn N Murphy
BACKGROUND: Interoperable phenotyping algorithms, needed to identify patient cohorts meeting eligibility criteria for observational studies or clinical trials, require medical data in a consistent structured, coded format. Data heterogeneity limits such algorithms' applicability. Existing approaches are often: not widely interoperable; or, have low sensitivity due to reliance on the lowest common denominator (ICD-9 diagnoses). In the Scalable Collaborative Infrastructure for a Learning Healthcare System (SCILHS) we endeavor to use the widely-available Current Procedural Terminology (CPT) procedure codes with ICD-9...
2015: BMC Medical Informatics and Decision Making
Grace E Hsiung, Fizan Abdullah
The role of the healthcare organization is shifting and must overcome the challenges of fragmented, costly care, and lack of evidence in practice, to reduce cost, ensure quality, and deliver high-value care. Notable gaps exist within the expected quality and delivery of pediatric healthcare, necessitating a change in the role of the healthcare organization. To realize these goals, the use of collaborative networks that leverage massive datasets to provide information for the development of learning healthcare systems will become increasingly necessary as efforts are made to narrow the gap in healthcare quality for children...
December 2015: Seminars in Pediatric Surgery
Cherriday G Joson, Shayna L Henry, Sue Kim, Mandy Y Cheung, Prajakta Parab, Antoine C Abcar, Steven J Jacobsen, Donald E Morisky, John J Sim
OBJECTIVE: The purpose of this study was to determine the influence of patient-reported medication adherence and phosphorus-related knowledge on phosphorus control and pharmacy-reported adherence to phosphorus binding medication among patients on maintenance hemodialysis. DESIGN: Retrospective, cross-sectional cohort study. SUBJECTS: Seventy-nine hemodialysis patients (mean age 64.2 years, SD = 14 years; 46.8% female) in a stand-alone hemodialysis unit within an integrated learning healthcare system...
May 2016: Journal of Renal Nutrition
Li-Tzy Wu, Kathleen T Brady, Susan E Spratt, Ashley A Dunham, Brooke Heidenfelder, Bryan C Batch, Robert Lindblad, Paul VanVeldhuisen, Shelley A Rusincovitch, Therese K Killeen, Udi E Ghitza
BACKGROUND: The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms that employ EHRs in research are needed to produce clinical evidence in real-world medical settings for informing learning healthcare systems. Adults with comorbid diabetes and substance use disorders (SUDs) tend to use costly inpatient treatments; however, there is a lack of empirical data on implementing behavioral healthcare to reduce health risk in adults with high-risk diabetes...
January 2016: Contemporary Clinical Trials
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