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"Learning healthcare system"

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https://www.readbyqxmd.com/read/29881737/framework-to-guide-the-collection-and-use-of-patient-reported-outcome-measures-in-the-learning-healthcare-system
#1
Patricia Franklin, Kate Chenok, Danielle Lavalee, Rebecca Love, Liz Paxton, Courtney Segal, Erin Holve
Background: Web-based collection of patient-reported outcome measures (PROMs) in clinical practice is expanding rapidly as electronic health records include web portals for patients to report standardized assessments of their symptoms. As the value of PROMs in patient care expands, a framework to guide the implementation planning, collection, and use of PROs to serve multiple goals and stakeholders is needed. Methods: We identified diverse clinical, quality, and research settings where PROMs have been successfully integrated into care and routinely collected and analyzed drivers of successful implementation...
September 4, 2017: EGEMS
https://www.readbyqxmd.com/read/29678076/learning-healthcare-systems-scaling-up-integrated-care-programs
#2
Violeta Gaveikaite, Dimitris Filos, Helen Schonenberg, Remco van der Heijden, Nicos Maglaveras, Ioanna Chouvarda
Current healthcare systems are struggling with rising costs and unbalanced quality of care. Integrated care (IC) is a worldwide trend in healthcare reforms designed to tackle these problems. ACT@Scale is a partnership of leading European regions, industry and academia which aims to identify, transfer and scale-up existing integrated healthcare practices. In this context, participating programs are applying iterative process improvement cycles using collaborative methodologies. The vision of learning health systems (LHS) is similar to IC, but it focuses on IT means as a change enabler for rapid and continuous knowledge integration into better outcomes...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29659009/state-of-the-science-interprofessional-approaches-to-aging-dementia-and-mental-health
#3
Timothy W Farrell, Marilyn K Luptak, Katherine P Supiano, James T Pacala, Rosalind De Lisser
Interprofessional education (IPE) is essential to develop the healthcare workforce of the future. Geriatrics healthcare professionals have long championed innovations in IPE and patient care, but there is increased urgency to address challenges in aging, dementia, and geriatric mental health in America. In 2010, the Partnership for Health in Aging multidisciplinary competencies and a related position statement in the Journal of the American Geriatrics Society addressed interdisciplinary team (IDT) training in geriatrics...
April 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29566696/how-do-nhs-organisations-plan-research-capacity-development-strategies-strengths-and-opportunities-for-improvement
#4
Melanie Gee, Jo Cooke
Research that is integral into a 'learning healthcare system' can promote cost effective services and knowledge creation. As such, research is defined as a 'core function' in UK health service organisations, and is often planned through research and development (R&D) strategies that aim to promote research activity and research capacity development (RCD). The discussion focuses around the content of ten R&D strategies for healthcare organisations in England and Scotland, with respect to RCD. These organisations were engaged with a research interest network called ACORN (Addressing Organisational Capacity to do Research Network) that included two Scottish Health Boards, four community and mental health trusts, two provincial district hospitals, and two teaching hospitals...
March 22, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29478331/transitioning-from-learning-healthcare-systems-to-learning-health-care-communities
#5
C Daniel Mullins, La'Marcus T Wingate, Hillary A Edwards, Toyin Tofade, Anthony Wutoh
The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. Despite progress in advancing and implementing LHS approaches, low levels of participation from patients and the public have hampered the transformational potential of the LHS model. An enhanced vision of a community-engaged LHS redesign would focus on the provision of health care from the patient and community perspective to complement the healthcare system as the entity that provides the environment for care...
February 26, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29453548/-big-data-from-clinical-routine
#6
REVIEW
U Mansmann
BACKGROUND: Over the past 100 years, evidence-based medicine has undergone several fundamental changes. Through the field of physiology, medical doctors were introduced to the natural sciences. Since the late 1940s, randomized and epidemiological studies have come to provide the evidence for medical practice, which led to the emergence of clinical epidemiology as a new field in the medical sciences. Within the past few years, big data has become the driving force behind the vision for having a comprehensive set of health-related data which tracks individual healthcare histories and consequently that of large populations...
April 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29444787/randomised-controlled-pragmatic-clinical-trial-evaluating-the-effectiveness-of-a-discharge-follow-up-phone-call-on-30-day-hospital-readmissions-balancing-pragmatic-and-explanatory-design-considerations
#7
Maame Yaa A B Yiadom, Henry Domenico, Daniel Byrne, Michele Marie Hasselblad, Cheryl L Gatto, Sunil Kripalani, Neesha Choma, Sarah Tucker, Li Wang, Monisha C Bhatia, Johnston Morrison, Frank E Harrell, Tina Hartert, Gordon Bernard
INTRODUCTION: Hospital readmissions within 30 days are a healthcare quality problem associated with increased costs and poor health outcomes. Identifying interventions to improve patients' successful transition from inpatient to outpatient care is a continued challenge. METHODS AND ANALYSIS: This is a single-centre pragmatic randomised and controlled clinical trial examining the effectiveness of a discharge follow-up phone call to reduce 30-day inpatient readmissions...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29438072/using-a-network-organisational-architecture-to-support-the-development-of-learning-healthcare-systems
#8
Maria T Britto, Sandra C Fuller, Heather C Kaplan, Uma Kotagal, Carole Lannon, Peter A Margolis, Stephen E Muething, Pamela J Schoettker, Michael Seid
The US National Academy of Sciences has called for the development of a Learning Healthcare System in which patients and clinicians work together to choose care, based on best evidence, and to drive discovery as a natural outgrowth of every clinical encounter to ensure innovation, quality and value at the point of care. However, the vision of a Learning Healthcare System has remained largely aspirational. Over the last 13 years, researchers, clinicians and families, with support from our paediatric medical centre, have designed, developed and implemented a network organisational model to achieve the Learning Healthcare System vision...
February 5, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29425639/natural-language-processing-of-clinical-notes-for-identification-of-critical-limb-ischemia
#9
Naveed Afzal, Vishnu Priya Mallipeddi, Sunghwan Sohn, Hongfang Liu, Rajeev Chaudhry, Christopher G Scott, Iftikhar J Kullo, Adelaide M Arruda-Olson
BACKGROUND: Critical limb ischemia (CLI) is a complication of advanced peripheral artery disease (PAD) with diagnosis based on the presence of clinical signs and symptoms. However, automated identification of cases from electronic health records (EHRs) is challenging due to absence of a single definitive International Classification of Diseases (ICD-9 or ICD-10) code for CLI. METHODS AND RESULTS: In this study, we extend a previously validated natural language processing (NLP) algorithm for PAD identification to develop and validate a subphenotyping NLP algorithm (CLI-NLP) for identification of CLI cases from clinical notes...
March 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29396321/conceptual-endophenotypes-a-strategy-to-advance-the-impact-of-psychoneuroendocrinology-in-precision-medicine
#10
REVIEW
Dirk Hellhammer, Gunther Meinlschmidt, Jens C Pruessner
Psychobiological research has generated a tremendous amount of findings on the psychological, neuroendocrine, molecular and environmental processes that are directly relevant for mental and physical health, but have overwhelmed our capacity to meaningfully absorb, integrate, and utilize this knowledge base. Here, we reflect about suitable strategies to improve the translational success of psychoneuroendocrinological research in the era of precision medicine. Following a strategy advocated by the National Research Council and the tradition of endophenotype-based research, we advance here a new approach, termed "conceptual endophenotypes"...
March 2018: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29369013/children-s-perspectives-of-the-benefits-and-burdens-of-research-participation
#11
Claudia Barned, Jennifer Dobson, Alain Stintzi, David Mack, Kieran C O'Doherty
BACKGROUND: Participation in research is associated with benefits and burdens for individual research participants. Children living with a chronic illness are considered particularly vulnerable as they are already burdened with symptoms of their illness. In particular contexts, such as learning healthcare systems (LHS), where research and clinical care are integrated, children with chronic illnesses may be asked to participate in research related to their illness. A growing body of literature has focused on children's perspectives as research subjects; however, a relatively understudied aspect concerns children's experiences of research in clinics where they are also patients...
January 25, 2018: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/29368179/recent-approaches-to-improve-medication-adherence-in-patients-with-coronary-heart-disease-progress-towards-a-learning-healthcare-system
#12
REVIEW
Andrew E Levy, Carrie Huang, Allen Huang, P Michael Ho
PURPOSE OF REVIEW: Non-adherence to medications for the secondary prevention of myocardial infarction (MI) is a major contributor to morbidity and mortality in these patients. This review describes recent advances in promoting adherence to therapies for coronary artery disease (CAD). RECENT FINDINGS: Two large randomized controlled trials to "incentivize" adherence were somewhat disappointing; neither financial incentives nor "peer pressure" successfully increased rates of adherence in the post-MI population...
January 24, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29310442/idea4ps-the-development-of-a-research-oriented-learning-healthcare-system
#13
Susan Moffatt-Bruce, Timothy Huerta, Alice Gaughan, Ann Scheck McAlearney
Leveraging opportunities to learn and then improve the delivery of care using experiences throughout the health care system is essential in efforts to transform health care delivery. The authors present the approach of one academic medical center in becoming a research-oriented Learning Healthcare System (ro-LHS). By reframing the role of research in improving outcomes, the organization was able to move beyond its focus on quality improvement to foster a culture in which feedback informs practice and research drives improvement...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29261187/early-cancer-diagnoses-through-brca1-2-screening-of-unselected-adult-biobank-participants
#14
Adam H Buchanan, Kandamurugu Manickam, Michelle N Meyer, Jennifer K Wagner, Miranda L G Hallquist, Janet L Williams, Alanna Kulchak Rahm, Marc S Williams, Zong-Ming E Chen, Chaitali K Shah, Tullika K Garg, Amanda L Lazzeri, Marci L B Schwartz, D'Andra M Lindbuchler, Audrey L Fan, Rosemary Leeming, Pedro O Servano, Ashlee L Smith, Victor G Vogel, Noura S Abul-Husn, Frederick E Dewey, Matthew S Lebo, Heather M Mason-Suares, Marylyn D Ritchie, F Daniel Davis, David J Carey, David T Feinberg, W Andrew Faucett, David H Ledbetter, Michael F Murray
PurposeThe clinical utility of screening unselected individuals for pathogenic BRCA1/2 variants has not been established. Data on cancer risk management behaviors and diagnoses of BRCA1/2-associated cancers can help inform assessments of clinical utility.MethodsWhole-exome sequences of participants in the MyCode Community Health Initiative were reviewed for pathogenic/likely pathogenic BRCA1/2 variants. Clinically confirmed variants were disclosed to patient-participants and their clinicians. We queried patient-participants' electronic health records for BRCA1/2-associated cancer diagnoses and risk management that occurred within 12 months after results disclosure, and calculated the percentage of patient-participants of eligible age who had begun risk management...
April 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29182889/learning-healthcare-systems-will-protect-patients-from-unscientific-practice-variation
#15
Paul J Young
No abstract text is available yet for this article.
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29138126/promoting-secondary-analysis-of-electronic-medical-records-in-china-summary-of-the-plagh-mit-critical-data-conference-and-health-datathon
#16
Peiyao Li, Chen Xie, Tom Pollard, Alistair Edward William Johnson, Desen Cao, Hongjun Kang, Hong Liang, Yuezhou Zhang, Xiaoli Liu, Yong Fan, Yuan Zhang, Wanguo Xue, Lixin Xie, Leo Anthony Celi, Zhengbo Zhang
Electronic health records (EHRs) have been widely adopted among modern hospitals to collect and track clinical data. Secondary analysis of EHRs could complement the traditional randomized control trial (RCT) research model. However, most researchers in China lack either the technical expertise or the resources needed to utilize EHRs as a resource. In addition, a climate of cross-disciplinary collaboration to gain insights from EHRs, a crucial component of a learning healthcare system, is not prevalent. To address these issues, members from the Massachusetts Institute of Technology (MIT) and the People's Liberation Army General Hospital (PLAGH) organized the first clinical data conference and health datathon in China, which provided a platform for clinicians, statisticians, and data scientists to team up and address information gaps in the intensive care unit (ICU)...
November 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29021335/nonadherence-in-the-learning-healthcare-system-avoiding-a-mountain-by-seeing-the-bumps
#17
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
#18
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...
November 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
#19
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
#20
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
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