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https://www.readbyqxmd.com/read/29021335/nonadherence-in-the-learning-healthcare-system-avoiding-a-mountain-by-seeing-the-bumps
#1
EDITORIAL
Andrew E Levy, P Michael Ho
No abstract text is available yet for this article.
October 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28832927/innovation-in-a-learning-health-care-system-veteran-directed-home-and-community-based-services
#2
Melissa M Garrido, Richard M Allman, Steven D Pizer, James L Rudolph, Kali S Thomas, Nina R Sperber, Courtney H Van Houtven, Austin B Frakt
A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with cognitive and functional limitations. We describe the design of a large-scale, stepped-wedge, cluster-randomized trial of the Veteran-Directed Home- and Community-Based Services (VD-HCBS) program. From March 2017 through December 2019, up to 77 Veterans Affairs Medical Centers will be randomized to times to begin offering VD-HCBS to veterans at risk of nursing home placement...
August 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28699948/academyhealth-s-delivery-system-science-fellowship-training-embedded-researchers-to-design-implement-and-evaluate-new-models-of-care
#3
Nisha Kanani, Erin Hahn, Michael Gould, Kimberly Brunisholz, Lucy Savitz, Erin Holve
AcademyHealth's Delivery System Science Fellowship (DSSF) provides a paid postdoctoral pragmatic learning experience to build capacity within learning healthcare systems to conduct research in applied settings. The fellowship provides hands-on training and professional leadership opportunities for researchers. Since its inception in 2012, the program has grown rapidly, with 16 health systems participating in the DSSF to date. In addition to specific projects conducted within health systems (and numerous publications associated with those initiatives), the DSSF has made several broader contributions to the field, including defining delivery system science, identifying a set of training objectives for researchers working in delivery systems, and developing a national collaborative network of care delivery organizations, operational leaders, and trainees...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28687707/validity-of-cardiovascular-data-from-electronic-sources-the-multi-ethnic-study-of-atherosclerosis-and-healthlnk
#4
Faraz S Ahmad, Cheeling Chan, Marc B Rosenman, Wendy S Post, Daniel G Fort, Philip Greenland, Kiang J Liu, Abel N Kho, Norrina B Allen
BACKGROUND: Understanding the validity of data from electronic data research networks is critical to national research initiatives and learning healthcare systems for cardiovascular care. Our goal was to evaluate the degree of agreement of electronic data research networks in comparison with data collected by standardized research approaches in a cohort study. METHODS: We linked individual-level data from MESA (Multi-Ethnic Study of Atherosclerosis), a community-based cohort, with HealthLNK, a 2006 to 2012 database of electronic health records from 6 Chicago health systems...
September 26, 2017: Circulation
https://www.readbyqxmd.com/read/28480475/clinical-data-reuse-or-secondary-use-current-status-and-potential-future-progress
#5
S M Meystre, C Lovis, T Bürkle, G Tognola, A Budrionis, C U Lehmann
Objective: To perform a review of recent research in clinical data reuse or secondary use, and envision future advances in this field. Methods: The review is based on a large literature search in MEDLINE (through PubMed), conference proceedings, and the ACM Digital Library, focusing only on research published between 2005 and early 2016. Each selected publication was reviewed by the authors, and a structured analysis and summarization of its content was developed. Results: The initial search produced 359 publications, reduced after a manual examination of abstracts and full publications...
August 2017: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/28433675/montreal-accord-on-patient-reported-outcomes-use-series-paper-8-patient-reported-outcomes-pro-in-electronic-health-records-can-inform-clinical-and-policy-decisions
#6
S Ahmed, P Ware, W Gardner, J Witter, C O Bingham, D Khairy, S J Bartlett
BACKGROUND: Given that the goal of healthcare systems is to improve and maintain the health of the populations they serve, the indicators of performance must include outcomes that are meaningful to patients. The growth of health technologies provides an unprecedented opportunity to integrate the patient voice into clinical care by linking electronic health records (EHR) to patient-reported outcome (PRO) data collection. However, PRO data must be relevant, meaningful, and actionable for those who will have to invest the time and effort to collect it...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28423763/learning-healthcare-system-for-the-prescription-of-genetic-testing-in-the-gynecological-cancer-risk
#7
Cristina Suárez-Mejías, Alicia Martínez-García, María Ángeles Martínez-Maestre, José Manuel Silvan-Alfaro, Jesús Moreno Conde, Carlos Luis Parra-Calderón
Clinical evidence demonstrates that BRCA 1 and BRCA2 mutations can develop a gynecological cancer but genetic testing has a high cost to the healthcare system. Besides, several studies in the literature indicate that performing these genetic tests to the population is not cost-efficient. Currently, our physicians do not have a system to provide them the support for prescribing genetic tests. A Decision Support System for prescribing these genetic tests in BRCA1 and BRCA2 and preventing gynecological cancer risks has been designed, developed and deployed in the Virgen del Rocío University Hospital (VRUH)...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28421566/precision-global-health-in-the-digital-age
#8
Antoine Flahault, Antoine Geissbuhler, Idris Guessous, Philippe Guérin, Isabelle Bolon, Marcel Salathé, Gérard Escher
Precision global health is an approach similar to precision medicine, which facilitates, through innovation and technology, better targeting of public health interventions on a global scale, for the purpose of maximising their effectiveness and relevance. Illustrative examples include: the use of remote sensing data to fight vector-borne diseases; large databases of genomic sequences of foodborne pathogens helping to identify origins of outbreaks; social networks and internet search engines for tracking communicable diseases; cell phone data in humanitarian actions; drones to deliver healthcare services in remote and secluded areas...
April 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28419657/a-new-approach-to-clinical-research-integrating-clinical-care-quality-reporting-and-research-using-a-wound-care-network-based-learning-healthcare-system
#9
Thomas E Serena, Caroline E Fife, Kristen A Eckert, Raphael A Yaakov, Marissa J Carter
The disparity between ideal evidence from randomized controlled trials and real-world evidence in medical research has prompted the United States Food and Drug Administration to consider the use of real-world data to better understand safety and effectiveness of new devices for a broader patient population and to prioritize real-world data in regulatory decision making. As the healthcare system transitions from volume- to value-based care, there is a growing need to harness the power of real-world data to change the paradigm for wound care clinical research and enable more generalizable clinical trials...
May 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28393467/patient-perspectives-on-the-optimal-start-of-renal-replacement-therapy
#10
Shayna L Henry, Corrine Munoz-Plaza, Jazmine Garcia Delgadillo, Nichole K Mihara, Mark P Rutkowski
BACKGROUND: Healthcare systems and providers are encouraged to prepare their patients with advanced chronic kidney disease (CKD) for a planned start to renal replacement therapies (RRT). Less well understood are the socioemotional experiences surrounding the optimal start of RRT versus suboptimal haemodialysis (HD) starts with a central catheter. OBJECTIVES: To characterise the experiences of patients beginning RRT. DESIGN: Qualitative, semi-structured phone interviews...
September 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28392994/medical-big-data-promise-and-challenges
#11
Choong Ho Lee, Hyung-Jin Yoon
The concept of big data, commonly characterized by volume, variety, velocity, and veracity, goes far beyond the data type and includes the aspects of data analysis, such as hypothesis-generating, rather than hypothesis-testing. Big data focuses on temporal stability of the association, rather than on causal relationship and underlying probability distribution assumptions are frequently not required. Medical big data as material to be analyzed has various features that are not only distinct from big data of other disciplines, but also distinct from traditional clinical epidemiology...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28282257/human-microbiome-and-learning-healthcare-systems-integrating-research-and-precision-medicine-for-inflammatory-bowel-disease
#12
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
https://www.readbyqxmd.com/read/28254835/the-learning-healthcare-system-and-cardiovascular-care-a-scientific-statement-from-the-american-heart-association
#13
REVIEW
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...
April 4, 2017: Circulation
https://www.readbyqxmd.com/read/28139831/cancer-moonshot-data-and-technology-team-enabling-a-national-learning-healthcare-system-for-cancer-to-unleash-the-power-of-data
#14
REVIEW
E R Hsu, J D Klemm, A R Kerlavage, D Kusnezov, W 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.
May 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28129005/interprofessional-clinical-informatics-education-and-practice-essentials-for-learning-healthcare-systems-worldwide
#15
Don Eugene Detmer
No abstract text is available yet for this article.
March 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28128643/uniform-data-collection-in-routine-clinical-practice-in-cardiovascular-patients-for-optimal-care-quality-control-and-research-the-utrecht-cardiovascular-cohort
#16
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...
May 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27805797/data-that-drive-closing-the-loop-in-the-learning-hospital-system
#17
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
https://www.readbyqxmd.com/read/27700477/building-a-learning-health-system-using-clinical-registers-a-non-technical-introduction
#18
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
https://www.readbyqxmd.com/read/27693565/the-learning-healthcare-system-where-are-we-now-a-systematic-review
#19
REVIEW
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
https://www.readbyqxmd.com/read/27683670/introduction-of-an-area-deprivation-index-measuring-patient-socioeconomic-status-in-an-integrated-health-system-implications-for-population-health
#20
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
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