application for continuous improvement. â« 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
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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.
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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
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Three Critical Factors for Success 1) Systems Thinking 2) Translation 3) Patient (consumer) Engagement
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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)
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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
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Many Unknowns ( = Opportunities) ! Role of emergent technologies ! HIEs ! PHRs ! Sensor technologies ! Others…
! Policy and funding reform ! Healthcare delivery ! Research
! Education ! Human Factors and Culture
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Towards a Solution: A Systems Approach to Biomedicine HIT & Biomedical Informatics “Fabric”
Clinical Encounters
Data Generation
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Research
Knowledge Generation
Thank you for your time and attention! •
[email protected] • http://bmi.osu.edu/~payne
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