The learning healthcare system - WordPress.com

19 downloads 183 Views 10MB Size Report
application for continuous improvement. ▫ Engineering sciences associated ... Major goal is to avoid development of un
Learning From and Engaging Every Patient: The Learning Healthcare System Philip R.O. Payne, Ph.D.

WISH 2012

Overview !  The vision for a Learning Healthcare System !  Implications for chronic disease management

!  The role of Biomedical Informatics in the Learning Healthcare System !  Critical factors for success !  Systems Thinking !  Translation !  Patient (consumer) engagement

!  Discussion

2

What is a Learning Healthcare System? !  The goal of a learning healthcare system is to deliver the best care every time, and to learn and improve with each care experience. !  This goal is attainable only through system-wide changes of the sort that have been successfully undertaken in certain activities of the manufacturing sectors. !  Data collection and monitoring are increasingly important components of health care, but much remains to be done in their application for continuous improvement. !  Engineering sciences associated with system design could contribute to a learning healthcare system that applies the best-known evidence, encourages continuous learning, and allows for knowledge generation as a natural by-product of patient care delivery. !  A fully functional system of this sort would advance quality; improve patient and provider safety, in turn delivering increasing value to consumers; and ensure that the care that is delivered is centered on the best outcome for each patient. Source: IOM (http://www.ncbi.nlm.nih.gov/books/NBK61953/) 3

A Virtuous Cycle of Research and Practice Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary

THE LEARNING HEALTH SYSTEM SERIES ROUNDTABLE ON VALUE & SCIENCE-DRIVEN HEALTH CARE

ENGINEERING A LEARNING HEALTHCARE SYSTEM A Look at the Future Workshop Summary

Claudia Grossmann, W. Alexander Goolsby, LeighAnne Olsen, and J. Michael McGinnis

Copyright © National Academy of Sciences. All rights reserved.

4

Implications for Chronic Disease Management !  Improved ability to collect, reason upon, and utilize longitudinal data !  Integration of currently disparate sources of information and knowledge !  Systems-level approach to decision making: !  Team coordination !  Transitions !  Risk profiling and management

!  Engagement of all stakeholders !  Patients no longer relegated to the role of passive consumers of healthcare services 5

What is the Role of BMI in a Learning Healthcare System? Clinical Informatics Public Health Informatics

Instrument Patient Encounters

Translational Bioinformatics Clinical Research Informatics

(Data + Tissue)

Improve Patient Care (Quality + Outcomes)

Generate Hypotheses

Learn from every patient encounter so that we can improve their care, their family’s care, and their community’s care Verify and Validate Hypotheses

Apply Evidence

Formalize Evidence

6

Three Critical Factors for Success 1)  Systems Thinking 2)  Translation 3)  Patient (consumer) Engagement

7

Systems Thinking !  Systems thinking is the process of understanding how things influence one another within a whole !  Approach to problem solving where "problems" are viewed as parts of an overall system !  Major goal is to avoid development of unintended consequences as a result of solving problems in isolation !  Promotes organizational communication at all levels in order to avoid the “silo” effect Source: Wikipedia (http://en.wikipedia.org/wiki/Systems_thinking)

8

Translation

Basic Science

Knowledge Generation

T1

Common information needs, including: "  Data collection and management "  Integration "  Knowledge management "  Delivery "  Presentation

Clinical Research

Continuous Cycle

T2 Clinical and Public Health Practice

Application 9

Empowering Patients (consumers) Emotional and Logical “Drivers”

Relevant Information Resources

Engagement and Paticipation

Critical Issues: "  Workflows that enable continuous and contextual engagement "  Understanding of complex socio-cultural and human factors "  Facilitation (not replacement) of communication and collaboration pathways "  Iterative, continuous engagement of patients and their families in all aspects of systems design and evaluation Biomedical Informatics ≠ Engineering Systems-level Approaches To Usability Are Essential

10

Many Unknowns ( = Opportunities) !  Role of emergent technologies !  HIEs !  PHRs !  Sensor technologies !  Others…

!  Policy and funding reform !  Healthcare delivery !  Research

!  Education !  Human Factors and Culture

11

Towards a Solution: A Systems Approach to Biomedicine HIT & Biomedical Informatics “Fabric”

Clinical Encounters

Data Generation

12

Research

Knowledge Generation

Thank you for your time and attention! •  [email protected] •  http://bmi.osu.edu/~payne

13