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"learning health system"

Sage R Myers, Brendan G Carr, Charles C Branas
No abstract text is available yet for this article.
October 10, 2016: JAMA Pediatrics
Aizhan Tursunbayeva, Raluca Bunduchi, Massimo Franco, Claudia Pagliari
OBJECTIVE: This systematic review aimed to: (1) determine the prevalence and scope of existing research on human resource information systems (HRIS) in health organizations; (2) analyze, classify, and synthesize evidence on the processes and impacts of HRIS development, implementation, and adoption; and (3) generate recommendations for HRIS research, practice, and policy, with reference to the needs of different stakeholders. METHODS: A structured search strategy was used to interrogate 10 electronic databases indexing research from the health, social, management, technology, and interdisciplinary sciences, alongside gray literature sources and reference lists of qualifying studies...
October 5, 2016: Journal of the American Medical Informatics Association: JAMIA
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and comparison of the development and use of clinical registries, drawing on participants' experience and published and unpublished research.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
Erin Holve, Samantha Weiss
In September 2015 the EDM Forum hosted AcademyHealth's newest national conference, Concordium. The 11 papers featured in the eGEMs "Concordium 2015" special issue successfully reflect the major themes and issues discussed at the meeting. Many of the papers address informatics or methodological approaches to natural language processing (NLP) or text analysis, which is indicative of the importance of analyzing text data to gain insights into care coordination and patient-centered outcomes. Perspectives on the tools and infrastructure requirements that are needed to build learning health systems were also recurrent themes...
2016: EGEMS
Wayne Psek, F Daniel Davis, Gloria Gerrity, Rebecca Stametz, Lisa Bailey-Davis, Debra Henninger, Dorothy Sellers, Jonathan Darer
INTRODUCTION: Healthcare leaders need operational strategies that support organizational learning for continued improvement and value generation. The learning health system (LHS) model may provide leaders with such strategies; however, little is known about leaders' perspectives on the value and application of system-wide operationalization of the LHS model. The objective of this project was to solicit and analyze senior health system leaders' perspectives on the LHS and learning activities in an integrated delivery system...
2016: EGEMS
Harlan M Krumholz, Sharon F Terry, Joanne Waldstreicher
No abstract text is available yet for this article.
September 26, 2016: JAMA: the Journal of the American Medical Association
Mona Fiuzat, Robert M Califf
Cardiovascular medicine has led the drive for creativity and innovation with a culture that has been at the forefront of evidence generation. However, we are functioning at only a fraction of our evidence generation capacity. Despite the leadership of cardiovascular medicine, very few guideline recommendations are supported by high levels of evidence, and the proportion of recommendations for which there is no conclusive evidence is substantial. Clinical research has proven to be too slow, unreliable, and expensive as conducted in the past...
August 31, 2016: JAMA Cardiology
Linda P Lowes, Garey H Noritz, Amy Newmeyer, Peter J Embi, Han Yin, William E Smoyer
AIM: The convergence of three major trends in medicine, namely conversion to electronic health records (EHRs), prioritization of translational research, and the need to control healthcare expenditures, has created unprecedented interest and opportunities to develop systems that improve care while reducing costs. However, operationalizing a 'learning health system' requires systematic changes that have not yet been widely demonstrated in clinical practice. METHOD: We developed, implemented, and evaluated a model of EHR-supported care in a cohort of 131 children with cerebral palsy that integrated clinical care, quality improvement, and research, entitled 'Learn From Every Patient' (LFEP)...
August 22, 2016: Developmental Medicine and Child Neurology
Corrine E Munoz-Plaza, Carla Parry, Erin E Hahn, Tania Tang, Huong Q Nguyen, Michael K Gould, Michael H Kanter, Adam L Sharp
BACKGROUND: Despite reports advocating for integration of research into healthcare delivery, scant literature exists describing how this can be accomplished. Examples highlighting application of qualitative research methods embedded into a healthcare system are particularly needed. This article describes the process and value of embedding qualitative research as the second phase of an explanatory, sequential, mixed methods study to improve antibiotic stewardship for acute sinusitis. METHODS: Purposive sampling of providers for in-depth interviews improved understanding of unwarranted antibiotic prescribing and elicited stakeholder recommendations for improvement...
2016: Health Research Policy and Systems
Kirk Roberts, Mary Regina Boland, Lisiane Pruinelli, Jina Dcruz, Andrew Berry, Mattias Georgsson, Rebecca Hazen, Raymond F Sarmiento, Uba Backonja, Kun-Hsing Yu, Yun Jiang, Patricia Flatley Brennan
The field of biomedical informatics experienced a productive 2015 in terms of research. In order to highlight the accomplishments of that research, elicit trends, and identify shortcomings at a macro level, a 19-person team conducted an extensive review of the literature in clinical and consumer informatics. The result of this process included a year-in-review presentation at the American Medical Informatics Association Annual Symposium and a written report (see supplemental data). Key findings are detailed in the report and summarized here...
August 7, 2016: Journal of the American Medical Informatics Association: JAMIA
Luciana Garbayo, James Stahl
Guidelines orient best practices in medicine, yet, in health care, many real world constraints limit their optimal realization. Since guideline implementation problems are not systematically anticipated, they will be discovered only post facto, in a learning curve period, while the already implemented guideline is tweaked, debugged and adapted. This learning process comes with costs to human health and quality of life. Despite such predictable hazard, the study and modeling of medical guideline implementation is still seldom pursued...
August 6, 2016: Medicine, Health Care, and Philosophy
Erin Holve
"Open science" includes a variety of approaches to facilitate greater access to data and the information produced by processes of scientific inquiry. Recently, the health sciences community has been grappling with the issue of potential pathways and models to achieve the goals of open science-namely, to create and rapidly share reproducible health research. eGEMs' continued dedication to and milestones regarding the publication of innovative, useful, and timely research to help contribute to the push towards open science is discussed, as well as the EDM Forum's new data sharing platform, CIELO...
2016: EGEMS
Sandy Weininger, Michael B Jaffe, Tracy Rausch, Julian M Goldman
In this article, we describe the role of "clinical scenario" information to assure the safety of interoperable systems, as well as the system's ability to deliver the requisite clinical functionality to improve clinical care. Described are methods and rationale for capturing the clinical needs, workflow, hazards, and device interactions in the clinical environment. Key user (clinician and clinical engineer) needs and system requirements can be derived from this information, therefore, improving the communication from clinicians to medical device and information technology system developers...
July 6, 2016: Anesthesia and Analgesia
Rashmi P Bhandari, Amanda B Feinstein, Samantha E Huestis, Elliot J Krane, Ashley L Dunn, Lindsey L Cohen, Ming C Kao, Beth D Darnall, Sean C Mackey
The pediatric adaptation of the Collaborative Health Outcomes Information Registry (Peds-CHOIR) is a free, open-source, flexible learning health care system (LHS) that meets the call by the Institute of Medicine for the development of national registries to guide research and precision pain medicine. This report is a technical account of the first application of Peds-CHOIR with 3 aims: (1) to describe the design and implementation process of the LHS; (2) to highlight how the clinical system concurrently cultivates a research platform rich in breadth (eg, clinic characteristics) and depth (eg, unique patient- and caregiver-reporting patterns); and (3) to demonstrate the utility of capturing patient-caregiver dyad data in real time, with dynamic outcomes tracking that informs clinical decisions and delivery of treatments...
September 2016: Pain
Margarete L Zalon
No abstract text is available yet for this article.
June 1, 2016: Journal of Continuing Education in Nursing
R S Evans
OBJECTIVES: Describe the state of Electronic Health Records (EHRs) in 1992 and their evolution by 2015 and where EHRs are expected to be in 25 years. Further to discuss the expectations for EHRs in 1992 and explore which of them were realized and what events accelerated or disrupted/derailed how EHRs evolved. METHODS: Literature search based on "Electronic Health Record", "Medical Record", and "Medical Chart" using Medline, Google, Wikipedia Medical, and Cochrane Libraries resulted in an initial review of 2,356 abstracts and other information in papers and books...
2016: Yearbook of Medical Informatics
Richard Platt, Joakim Ramsberg
No abstract text is available yet for this article.
May 12, 2016: New England Journal of Medicine
John F Steiner, Michael R Shainline, Mary Christine Bishop, Stan Xu
BACKGROUND: Collaborations between clinical/operational leaders and researchers are advocated to develop "learning health systems," but few practical examples are reported. OBJECTIVES: To describe collaborative efforts to reduce missed appointments through an interactive voice response and text message (IVR-T) intervention, and to develop and validate a prediction model to identify individuals at high risk of missing appointments. RESEARCH SUBJECTS AND DESIGN: Random assignment of 8804 adults with primary care appointments to a single IVR-T reminder or no reminder at an index clinic (IC) and 7497 at a replication clinic (RC) in an integrated health system in Denver, CO...
July 2016: Medical Care
Mike English, Grace Irimu, Ambrose Agweyu, David Gathara, Jacquie Oliwa, Philip Ayieko, Fred Were, Chris Paton, Sean Tunis, Christopher B Forrest
Mike English and colleagues argue that as efforts are made towards achieving universal health coverage it is also important to build capacity to develop regionally relevant evidence to improve healthcare.
April 2016: PLoS Medicine
Manesh R Patel, W Schuyler Jones
No abstract text is available yet for this article.
April 11, 2016: JACC. Cardiovascular Interventions
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