iHT2 Health IT Summit Atlanta 2013 – John Doulis, MD , CIO, MedCare Investment Funds, Former Assistant Vice Chancellor – Health Affairs Chief Operations Officer – Informatics, Vanderbilt University - Case Study: "The Chaos in Health Care Today and
iHT2 Health IT Summit Atlanta 2013 – John Doulis, MD , CIO, MedCare Investment Funds, Former Assistant Vice Chancellor – Health Affairs Chief Operations Officer – Informatics, Vanderbilt University - Case Study: "The Chaos in Health Care Today and the Need for an Analytics Platform"
Paul Coplan, VP, Johnson & Johnson_mHealth IsraelLevi Shapiro
Pesentation, October 19th, 2021: What’s Next in RWE for Medical Devices: The Art of the Possible. Presented by Paul Coplan, ScD, MBA, FISPE, Vice President, Med Device Epidemiology and RWD Sciences, Johnson & Johnson; Adjunct Professor, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Perelman School of Medicine; Fellow of the International Society of Pharmacoepidemiology
- Why RWE is Important for Medical Devices: Challenges with Clinical Trials of Medical Devices (Blinding, Surgeon skill/technique, Hospital process, Product modifications, Long term Follow up, Enrolment challenges)
- Types of Real-World Data Sources (Complaints like MAUDE, Eudramed and Company Databases, Hospital Databases, Electronic Health Records, Claims, Registries, Patient surveys, Surgeon surveys, PROs, Patient Preferences, wearables, sensors, social media, Surgical videos, device generated data, radiographic images)
- FDA CDRH Report on RWE Examples for Regulatory Decisions
- J&J Med Device Epidemiology & Real-World Data Sciences
- US National Evaluation System for Health Technology (NEST)
- RWE for Safety Assessments: Cobalt in Implants and at Work and Risk of Cancer
- Summary of Cobalt Exposure and All-Site Cancer Risk, by Study Type
- Comparative Effectiveness Studies Using RWE
- Summary
a. Use of RWE is important to benefit patients globally and enhance the safety and innovation of medical devices
b. Regulators are interested in using RWE for regulatory decisions but data quality and evidence needs to be regulatory grade
c. NEST has been a useful forum to advance the use of RWE for regulatory decisions in the US
d. RWE can be used for safety assessments, regulatory decisions, comparative effectiveness research, and R&D of products
Biosurveillance: Machine Learning And Disease Surveillance by Kass-Hout Di TadaTaha Kass-Hout, MD, MS
The majority of the designs, analyses and evaluations of early detection (or biosurveillance) systems have been geared towards specific data sources and detection algorithms. Much less effort has been focused on how these systems will "interact" with humans. For example, consider multiple domain experts working at different levels across different organizations in an environment where numerous biosurveillance algorithms may provide contradictory interpretations of ongoing events. We present a framework that consists of a collection of autonomous, machine learning-enabled analytic processes, services and tools that; for the first time, will seamlessly integrate surveillance and response systems with human experts.
Paul Coplan, VP, Johnson & Johnson_mHealth IsraelLevi Shapiro
Pesentation, October 19th, 2021: What’s Next in RWE for Medical Devices: The Art of the Possible. Presented by Paul Coplan, ScD, MBA, FISPE, Vice President, Med Device Epidemiology and RWD Sciences, Johnson & Johnson; Adjunct Professor, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Perelman School of Medicine; Fellow of the International Society of Pharmacoepidemiology
- Why RWE is Important for Medical Devices: Challenges with Clinical Trials of Medical Devices (Blinding, Surgeon skill/technique, Hospital process, Product modifications, Long term Follow up, Enrolment challenges)
- Types of Real-World Data Sources (Complaints like MAUDE, Eudramed and Company Databases, Hospital Databases, Electronic Health Records, Claims, Registries, Patient surveys, Surgeon surveys, PROs, Patient Preferences, wearables, sensors, social media, Surgical videos, device generated data, radiographic images)
- FDA CDRH Report on RWE Examples for Regulatory Decisions
- J&J Med Device Epidemiology & Real-World Data Sciences
- US National Evaluation System for Health Technology (NEST)
- RWE for Safety Assessments: Cobalt in Implants and at Work and Risk of Cancer
- Summary of Cobalt Exposure and All-Site Cancer Risk, by Study Type
- Comparative Effectiveness Studies Using RWE
- Summary
a. Use of RWE is important to benefit patients globally and enhance the safety and innovation of medical devices
b. Regulators are interested in using RWE for regulatory decisions but data quality and evidence needs to be regulatory grade
c. NEST has been a useful forum to advance the use of RWE for regulatory decisions in the US
d. RWE can be used for safety assessments, regulatory decisions, comparative effectiveness research, and R&D of products
Biosurveillance: Machine Learning And Disease Surveillance by Kass-Hout Di TadaTaha Kass-Hout, MD, MS
The majority of the designs, analyses and evaluations of early detection (or biosurveillance) systems have been geared towards specific data sources and detection algorithms. Much less effort has been focused on how these systems will "interact" with humans. For example, consider multiple domain experts working at different levels across different organizations in an environment where numerous biosurveillance algorithms may provide contradictory interpretations of ongoing events. We present a framework that consists of a collection of autonomous, machine learning-enabled analytic processes, services and tools that; for the first time, will seamlessly integrate surveillance and response systems with human experts.
Presentation by David Farber, FDA Life Science Partner at King & Spalding, about US Reimbursement.
I. Introduction
• II. FDA Approval vs. Reimbursement
• a. Different Standards
b. Clinical Evidence Needed
• III. The Three Keys to Reimbursement
A. Coverage
B. Coding
C. Payment
• IV. What’s New for 2019
• V. Reimbursement for MedTech AI Solutions
• VI. Tips for Successful Reimbursement
Theera-Ampornpunt N. Use of electronic health records in U.S. hospitals: a review of Jha et al. (2009). Presented at: Health Informatics Journal Club; 2009 Sep 24; Institute for Health Informatics, University of Minnesota, Twin Cities, MN. Invited speaker.
Based on Jha AK, DesRoches CM, Campbell EG, Donelan K, Rao SR, Ferris TG, Shields A, Rosenbaum S, Blumenthal D. Use of electronic health records in U.S. hospitals. N Engl J Med. 2009 Apr 16;360(16):1628-38. Available from: http://content.nejm.org/cgi/content/full/360/16/1628
Gleecus Whitepaper : Applications of Artificial Intelligence in HealthcareSuprit Patra
In the field of medicine, Artificial Intelligence (AI) goes a long way in strengthening and improvising the communication between Doctors and Patient like never before. The Healthcare industry requires enormous amounts of digitized data to be periodically shared, stored and yet kept secure at the same time. Smart algorithms are powering artificial intelligence (AI) applications in the healthcare sector By enabling intelligent applications to not only speak and listen but also to make decisions in unrivaled ways to nullify human errors.
Read this research paper to know how AI is taking healthcare by storm.
SM2015 is an ambitious project with the Ministry of Health and local support. This presentation outlines the design and activities around the data collection and analysis of the evaluation, as well as the results, conclusions, and future activities.
Presentation by David Farber, FDA Life Science Partner at King & Spalding, about US Reimbursement.
I. Introduction
• II. FDA Approval vs. Reimbursement
• a. Different Standards
b. Clinical Evidence Needed
• III. The Three Keys to Reimbursement
A. Coverage
B. Coding
C. Payment
• IV. What’s New for 2019
• V. Reimbursement for MedTech AI Solutions
• VI. Tips for Successful Reimbursement
Theera-Ampornpunt N. Use of electronic health records in U.S. hospitals: a review of Jha et al. (2009). Presented at: Health Informatics Journal Club; 2009 Sep 24; Institute for Health Informatics, University of Minnesota, Twin Cities, MN. Invited speaker.
Based on Jha AK, DesRoches CM, Campbell EG, Donelan K, Rao SR, Ferris TG, Shields A, Rosenbaum S, Blumenthal D. Use of electronic health records in U.S. hospitals. N Engl J Med. 2009 Apr 16;360(16):1628-38. Available from: http://content.nejm.org/cgi/content/full/360/16/1628
Gleecus Whitepaper : Applications of Artificial Intelligence in HealthcareSuprit Patra
In the field of medicine, Artificial Intelligence (AI) goes a long way in strengthening and improvising the communication between Doctors and Patient like never before. The Healthcare industry requires enormous amounts of digitized data to be periodically shared, stored and yet kept secure at the same time. Smart algorithms are powering artificial intelligence (AI) applications in the healthcare sector By enabling intelligent applications to not only speak and listen but also to make decisions in unrivaled ways to nullify human errors.
Read this research paper to know how AI is taking healthcare by storm.
SM2015 is an ambitious project with the Ministry of Health and local support. This presentation outlines the design and activities around the data collection and analysis of the evaluation, as well as the results, conclusions, and future activities.
Similar to iHT2 Health IT Summit Atlanta 2013 – John Doulis, MD , CIO, MedCare Investment Funds, Former Assistant Vice Chancellor – Health Affairs Chief Operations Officer – Informatics, Vanderbilt University - Case Study: "The Chaos in Health Care Today and
From the Archives, 2008:Clinical and Economic Advantages Implantable Defibril...David Lee Scher, MD
This presentation from 2008 discusses the most early recognized merits of remote patient monitoring as it pertained to implantable defibrillators. It was prsented at the European Cardiac Arrhythmia Society Annual Congress. These advantages of RPM can be extended to monitoring of other conditions today.
Elsevier Medical Graph – mit Machine Learning zu Precision MedicineRising Media Ltd.
Elsevier Health Analytics entwickelt den Medical Knowledge Graph, welcher Korrelationen zwischen Krankheiten und zwischen Krankheiten und Behandlungen darstellt. Auf einem Gesamtdatensatz von sechs Millionen anonymisierten Patienten, beobachtbar über sechs Jahre, haben wir über 2000 Modelle erstellt, welche die Entwicklung von Krankheiten prognostizieren. Jedes Modell ist adjustiert für mehr als 3000 Kovariablen. Dazu kam ein Boosting Algorithmus mit Variablenselektion zum Einsatz. Die Betas der selektierten Variablen wurden extrahiert, getestet hinsichtlich Kausalität und Signifikanz, und daraus wurde die erste Version des Medical Graphen mit über 2000 Krankheitsknoten und 25.000 Effekt-Kanten gebaut. Der Graph wird aktuell in der Praxis getestet, mit dem Ziel, dem Arzt eine patienten-individuelle Entscheidungsunterstützung für die Behandlung zu geben.
This is a presentation from 2011 highlighting the possibilities of IT in private cardiology practice. It is of historical value but touches on early fundamental concepts of digitalization of a private practice in the field of cardiology.
Joseph Dal Molin: Implementing VistA internationally: Myth-busting lessons fr...Nuffield Trust
In this slideshow Joseph Dal Molin, President of the E-cology Corporation and Chairman of WorldVistA, outlines Jordan’s health system and its approach to implementing VistA.
Joseph Dal Molin presented at the Nuffield Trust seminar: Sharing international experience: Is implementing the VA's electronic health record system an option for the NHS? in July 2012.
I gave this talk in the "Presidential Symposium" at the annual meeting of the American Association of Physicists in Medicine, in Annaheim, California. The President of AAPM, Dr. Maryellen Giger, wanted some people to give some visionary talks. She invited (I kid you not) Foster, Gates, and Obama. Fortunately Bill and Barack had other commitments, so I did not need to share the time with them.
Presented at Cambridge Semantic Web Monthly Meetup on September 8, 2015
http://www.meetup.com/The-Cambridge-Semantic-Web-Meetup-Group/events/223161012/
CHC15 - EHR adoption in a european environment and public management hospital...Carlos Sousa
SOURCE:
Invited speaker for CERNER HEALTH CONFERENCE, Educational Session, held during Oct 11-14 in Kansas City (MO) - US.
ABSTRACT:
After 13 years under private management, Hospital Prof. Fernando da Fonseca (HFF) committed to invest a solid EHR strategic approach aligned with best practices, due to management shift as public management hospital within the NHS network. HFF focused on creating a Clinical Commission for information that could support and lead the change on workflow and mindset of the hospital culture. This team combines the knowledge and experience of multidisciplinary roles, designing a EHR model that fully responds to the needs. Thus ensuring a successful phased implementation which started in the emergency department and was then deployed throughout the rest of the hospital. After three years of project, the hospital has achieved a high level (superior to 85%) of EHR adoption and has proven outcomes in the delivery of quality of care and Social ROI (e.g. direct data interoperability with medical emergency before hospital admission, algorithm implementation to improve organ donor and collection, integration with private clinics for outsourcing auxiliary services, including Lab and radiology prescriptions and results/reports). HFF continues to strongly work on this project and are dedicated to implementing their roadmap with the short term aim of achieving HIMSS Stage 6.
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Development and implementation of a system to support prediction of suicide risk in the Department of Veterans Affairs - DR. Robert Bossarte and Paul Bradley
Delivering Micro-Credentials in Technical and Vocational Education and TrainingAG2 Design
Explore how micro-credentials are transforming Technical and Vocational Education and Training (TVET) with this comprehensive slide deck. Discover what micro-credentials are, their importance in TVET, the advantages they offer, and the insights from industry experts. Additionally, learn about the top software applications available for creating and managing micro-credentials. This presentation also includes valuable resources and a discussion on the future of these specialised certifications.
For more detailed information on delivering micro-credentials in TVET, visit this https://tvettrainer.com/delivering-micro-credentials-in-tvet/
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
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How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
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A Strategic Approach: GenAI in EducationPeter Windle
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This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
Pollock and Snow "DEIA in the Scholarly Landscape, Session One: Setting Expec...
iHT2 Health IT Summit Atlanta 2013 – John Doulis, MD , CIO, MedCare Investment Funds, Former Assistant Vice Chancellor – Health Affairs Chief Operations Officer – Informatics, Vanderbilt University - Case Study: "The Chaos in Health Care Today and
1. iHT2 Health IT Summit
Atlanta, GA
April 24, 2013
John Doulis, M.D.
CIO
MedCare Investment Funds
The Chaos in Healthcare Today and
the Need for an Analytic Platform
2. The problem
The science
Examples of the science at
work
Road Map
4. Do the Right Thing
69.1% (1999)1984Cholesterol
Screening
75.5% (2001)1982Mammography
48.1% (2000)1981Diabetic Eye Exam
53% (2000)1977Pneumococcal
Vaccine
64% (2000)1968Flu Vaccine
Current rate of
use
Landmark TrialClinical
Procedure
Balas EA, Boren SA., Managing Clinical Knowledge for Health Care Improvement. Yearbook of
Medical Informatics 2000.
5. Do the Right Thing
Quality of Pneumonia Treatment for Elderly, 2002
63.1 67.9
81
29.6
0
10
20
30
40
50
60
70
80
90
100
Received 1st
dose of
antibiotic within
4 hours of
hospital arrival
Received
recommended
antibiotics
consistent with
current
guidelines
Have blood
cultures
collected before
antibiotics are
administered
Received all
recommended
treatment
regimens
Measure
Percentageofpatients
Source: Centers for Medicare & Medicaid Services, Quality Improvement Organization Program,
2002.
• 81% of Medicare
pneumonia
patients get blood
cultures before
antibiotics
• 68% get the right
antibiotics
• 63% get their
first antibiotic in a
timely manner
• Yet, only 30%
get all of three
recommended
interventions
6. Healthcare & Biomedical IT is HARD
Individuals are highly variable biological systems.
Clinical measurements rarely have precise meaning.
Diagnoses lack clinical detail.
Clinical work is a chaotic, opaque ecosystem.
Perspectives vary by role.
7. Biomedical Informatics
Definition:
Science that deals with information, its structure, acquisition
and use
Cornerstones:
Techniques to structure, discover, visualize & reason
with information content
Approaches to link people, process & technology
together as a system
Methods to evaluate systems and their technology
components
Processes to facilitate change
19. Systems (ADT, Lab,
Rad…)
Dictation/Transcription
Note Capture Tools
Sources
Image (PACS, EKG…)
Fax/Scan
Text
Reports
Externalize
Content as
Documents
Report Header
plus Pointer
to Image
Index each Word or
Number for Cross-
Patient Queries
Electronic
Patient Chart
Assemble “Documents”
By Patient
“Tag” Clinical
Concepts for
Curation and
Decision Support
Clinical Data Repository
22. Evidence-Based Contributions to
Ventilator Management
Ventilator weaning protocol reduces vent time (Ely; NEJM
1996 Dec 19;335(25):1864-9 )
Consistent use of low tidal volume and low airway pressures
reduces mortality by 25% (ARDS Network: NEJM 342: 1301-
8, 2000)
Activated protein C for Sepsis reduces mortality by 20%
(Bernard; NEJM 2001 Mar 8;344(10):699-709)
No need to normalize PCO2, drastic reduction in use of
arterial blood gases (ARDS Network: NEJM 342: 1301-
8, 2000)
PA Catheters not beneficial, 90% reduction in use (ARDS
Network: NEJM 2006;354:2213-24)
Consistent conservative use of fluids shortens ventilator time
by 3 days (ARDS Network: N Engl J Med 2006;354:2564-75)
Wake up and breath; sedation holiday improves survival. (VU
Delirium Group: Lancet 2008 Jan 12;371(9607):126-34)
30. Source: UHC and Vanderbilt Data
3. Mortality for Ventilator
Patients Compare to all
the other Hospitals
– Best in the U.S.
100
150
200
250
300
2005 2006 2007 2008 2009
1. Number of Ventilator
Acquired Pneumonia
(VAP) Cases/Year
Fiscal Year
2009
Results c/w
2008
VAPs
Prevented 108
Deaths
Avoided 16
$ Saved $4.3M
Hospital
Days
Avoided 1055
ICU Days
Avoided 431
2. Impact on Results
Systems Approach to Care
# 1
O/E Vent Mortality
O/E Length of Stay
O/E Cost
34. 1000
FactsperDecision
10
100
1990 2000 2010 2020
Human Cognitive
Capacity
Need for Patient-Specific Decision Support Assistance
Structural Genetics:
e.g. SNPs, haplotypes
Functional Genetics:
Gene expression
profiles
Proteomics and other
effector molecules
Decisions by
clinical
phenotype
i.e., traditional
health care
35. Summary
Automation & connectivity get you only 60%
In addition to automation and connectivity need to view
and leverage clinical systems for Information Liquidity
Need for dashboards and knowledge engines that sit on
top of the information.
Need BI/Analytics Platform that leverage the information.
This architecture is scalable
Managing Risk:
◦ What problems are worth solving (BI)
◦ Key interventions to reliably intervene (dashboards +
automation of decision support)