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"Learning healthcare system"

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and comparison of the development and use of clinical registries, drawing on participants' experience and published and unpublished research.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...
September 28, 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 re-engineering 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. While the term ABI is new, it encompasses fragmented "tools" that have been developed across the global pharmaceutical industry, and that could accelerate the evolution of the system through more coordinated application...
September 14, 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
Jerry J Zimmerman, Kanwaljeet J S Anand, Kathleen L Meert, Douglas F Willson, Christopher J L Newth, Rick Harrison, Joseph A Carcillo, John Berger, Tammara L Jenkins, Carol Nicholson, J Michael Dean
OBJECTIVES: Excellence in clinical care coupled with basic and applied research reflects the maturation of a medical subspecialty, advances that field, and provides objective data for identifying best practices. PICUs are uniquely suited for conducting translational and clinical research. In addition, multiple investigations have reported that a majority of parents are interested in their children's participation in clinical research, even when the research offers no direct benefit to their child...
January 2016: Pediatric Critical Care Medicine
Guan Wang, Kenneth Jung, Rainer Winnenburg, Nigam H Shah
OBJECTIVE: Adverse drug events (ADEs) are undesired harmful effects resulting from use of a medication, and occur in 30% of hospitalized patients. The authors have developed a data-mining method for systematic, automated detection of ADEs from electronic medical records. MATERIALS AND METHODS: This method uses the text from 9.5 million clinical notes, along with prior knowledge of drug usages and known ADEs, as inputs. These inputs are further processed into statistics used by a discriminative classifier which outputs the probability that a given drug-disorder pair represents a valid ADE association...
November 2015: Journal of the American Medical Informatics Association: JAMIA
Sarah R Deeny, Adam Steventon
Socrates described a group of people chained up inside a cave, who mistook shadows of objects on a wall for reality. This allegory comes to mind when considering 'routinely collected data'-the massive data sets, generated as part of the routine operation of the modern healthcare service. There is keen interest in routine data and the seemingly comprehensive view of healthcare they offer, and we outline a number of examples in which they were used successfully, including the Birmingham OwnHealth study, in which routine data were used with matched control groups to assess the effect of telephone health coaching on hospital utilisation...
August 2015: BMJ Quality & Safety
Jose Azar, Nadia Adams, Malaz Boustani
In the United States, it is estimated that 75,000 deaths every year could be averted if the healthcare system implemented high quality care more effectively and efficiently. Patient harm in the hospital occurs as a consequence of inadequate procedures, medications and other therapies, nosocomial infections, diagnostic evaluations and patient falls. Implementation science, a new emerging field in healthcare, is the development and study of methods and tools aimed at enhancing the implementation of new discoveries and evidence into daily healthcare delivery...
2015: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Jean K Soler, Derek Corrigan, Przemyslaw Kazienko, Tomasz Kajdanowicz, Roxana Danger, Marcin Kulisiewicz, Brendan Delaney
BACKGROUND: Analysis of encounter data relevant to the diagnostic process sourced from routine electronic medical record (EMR) databases represents a classic example of the concept of a learning healthcare system (LHS). By collecting International Classification of Primary Care (ICPC) coded EMR data as part of the Transition Project from Dutch and Maltese databases (using the EMR TransHIS), data mining algorithms can empirically quantify the relationships of all presenting reasons for encounter (RfEs) and recorded diagnostic outcomes...
2015: BMC Family Practice
Michael A Stoto
No abstract text is available yet for this article.
2013: EGEMS
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