The document discusses the vision for a learning health system (LHS) as presented by Charles Friedman and Joshua Rubin. Some key points:
- An LHS aims to continuously and routinely study and improve health systems using data from every patient experience.
- It envisions health data being used at large scales across organizations to generate insights, inform best practices, and drive improvements in 17 months vs the traditional 17 years.
- Realizing an LHS requires overcoming challenges like establishing learning cycles across problems, and developing common infrastructure/platforms to support learning at scale across different levels.
- The authors propose establishing departments, programs, and journals to advance the science of learning health and educate a new workforce to develop
This document outlines the evolution of the learning health system over 5 chapters from the 1970s to the present. It discusses early databases and online networks in the 1980s that hinted at a new approach for sharing patient information. Foundations were established in the 1990s through electronic medical records, registries, and decision support tools. A vision for a national health information infrastructure emerged in the 2000s along with policies to promote it. The current focus is on building out this infrastructure through health information exchange platforms and other technologies, though challenges around privacy, standards, and financing remain.
Here are 3 potential barriers that could have caused a delay in implementing the research findings supporting the use of saline over heparin for maintaining peripheral IV catheters:
1. Lack of awareness or accessibility of the existing research evidence among clinicians. Medical research takes time to disseminate into practice.
2. Resistance to change long-standing practices without a compelling clinical practice guideline or recommendation from a major organization. The ASHP policy from 2006 helped address this.
3. Potential economic barriers if hospitals had invested in heparin products and switching to saline-only maintenance required a change in supplies and protocols. Standardizing on the lower cost saline may have faced resistance.
A Role for Mathematical Models in Program Scienceamusten
Mathematical models can help answer key questions in program science by examining disease transmission dynamics at a population level. Program science can also inform mathematical modeling by generating data to validate and refine models, and asking novel questions that require new modeling approaches. Both fields stand to benefit from stronger collaboration, with program science generating diverse data to feed into models, and models providing insights into optimal intervention strategies under uncertainty.
Knowledge mobilization (KMb) is the process of sharing research findings with potential users, including policymakers and practitioners, to enhance social innovation. KMb allows researchers to collaborate with partners outside of academia to apply findings from university research. York University's KMb unit supports over 150 KMb projects through services like knowledge brokers and clear language research summaries. These projects help translate findings into programs and policies to address issues like climate change, youth homelessness, and economic development. Training opportunities exist to help researchers effectively engage non-academic audiences and integrate knowledge mobilization throughout the research process.
This document discusses various methods and tools for collecting, processing, and analyzing nursing data and information. It describes different sources of information like libraries, databases, and search engines. It also discusses ethical issues around copyright and fair use. Common data collection methods in nursing include questionnaires, interviews, and electronic documentation. Quantitative data is analyzed statistically while qualitative data requires identifying themes. Cohort and case-control studies are described as common research designs.
Kate Bukowski
ProCare Health Limited
(Friday, 3.00, Innovation in Practice 3)
Explores two domains which, on the surface, may seem very different – the US policy directing metrics to measure HIT adoption across the nation and the implementation and utilisation of a practice management system auditing tool (Dr Info) within a region of New Zealand’s general practices. Yet, when looked at under a different view, there are similarities which drive the use of HIT to improve results that engage patients in self-management of their health and clinicians in population health management. Both can improve the delivery of healthcare and provide value for money but both also need support and systems that foster innovation at a patient and practice level. This will continue to be an issue as the health workforce ages and becomes smaller. It is therefore crucially important how we utilise and train our workforce, that they have HIT systems that support their work with the approach that through showing results and improving results, clinicians will engage and want to use the technology to improve their practice. At the same time patients will need support to self-manage their conditions through the utilisation of patient portals and other innovative HIT initiatives.
The document discusses the vision for a learning health system (LHS) as presented by Charles Friedman and Joshua Rubin. Some key points:
- An LHS aims to continuously and routinely study and improve health systems using data from every patient experience.
- It envisions health data being used at large scales across organizations to generate insights, inform best practices, and drive improvements in 17 months vs the traditional 17 years.
- Realizing an LHS requires overcoming challenges like establishing learning cycles across problems, and developing common infrastructure/platforms to support learning at scale across different levels.
- The authors propose establishing departments, programs, and journals to advance the science of learning health and educate a new workforce to develop
This document outlines the evolution of the learning health system over 5 chapters from the 1970s to the present. It discusses early databases and online networks in the 1980s that hinted at a new approach for sharing patient information. Foundations were established in the 1990s through electronic medical records, registries, and decision support tools. A vision for a national health information infrastructure emerged in the 2000s along with policies to promote it. The current focus is on building out this infrastructure through health information exchange platforms and other technologies, though challenges around privacy, standards, and financing remain.
Here are 3 potential barriers that could have caused a delay in implementing the research findings supporting the use of saline over heparin for maintaining peripheral IV catheters:
1. Lack of awareness or accessibility of the existing research evidence among clinicians. Medical research takes time to disseminate into practice.
2. Resistance to change long-standing practices without a compelling clinical practice guideline or recommendation from a major organization. The ASHP policy from 2006 helped address this.
3. Potential economic barriers if hospitals had invested in heparin products and switching to saline-only maintenance required a change in supplies and protocols. Standardizing on the lower cost saline may have faced resistance.
A Role for Mathematical Models in Program Scienceamusten
Mathematical models can help answer key questions in program science by examining disease transmission dynamics at a population level. Program science can also inform mathematical modeling by generating data to validate and refine models, and asking novel questions that require new modeling approaches. Both fields stand to benefit from stronger collaboration, with program science generating diverse data to feed into models, and models providing insights into optimal intervention strategies under uncertainty.
Knowledge mobilization (KMb) is the process of sharing research findings with potential users, including policymakers and practitioners, to enhance social innovation. KMb allows researchers to collaborate with partners outside of academia to apply findings from university research. York University's KMb unit supports over 150 KMb projects through services like knowledge brokers and clear language research summaries. These projects help translate findings into programs and policies to address issues like climate change, youth homelessness, and economic development. Training opportunities exist to help researchers effectively engage non-academic audiences and integrate knowledge mobilization throughout the research process.
This document discusses various methods and tools for collecting, processing, and analyzing nursing data and information. It describes different sources of information like libraries, databases, and search engines. It also discusses ethical issues around copyright and fair use. Common data collection methods in nursing include questionnaires, interviews, and electronic documentation. Quantitative data is analyzed statistically while qualitative data requires identifying themes. Cohort and case-control studies are described as common research designs.
Kate Bukowski
ProCare Health Limited
(Friday, 3.00, Innovation in Practice 3)
Explores two domains which, on the surface, may seem very different – the US policy directing metrics to measure HIT adoption across the nation and the implementation and utilisation of a practice management system auditing tool (Dr Info) within a region of New Zealand’s general practices. Yet, when looked at under a different view, there are similarities which drive the use of HIT to improve results that engage patients in self-management of their health and clinicians in population health management. Both can improve the delivery of healthcare and provide value for money but both also need support and systems that foster innovation at a patient and practice level. This will continue to be an issue as the health workforce ages and becomes smaller. It is therefore crucially important how we utilise and train our workforce, that they have HIT systems that support their work with the approach that through showing results and improving results, clinicians will engage and want to use the technology to improve their practice. At the same time patients will need support to self-manage their conditions through the utilisation of patient portals and other innovative HIT initiatives.
Knowledge translation model, tools and strategies for successImad Hassan
The document discusses knowledge translation (KT), which refers to closing the gap between what is known from research and what is practiced. It notes several barriers to KT, including organizational, professional, and social barriers. The document then provides a framework for KT, outlining five essential components: using evidence-based knowledge, implementing change tools scientifically, employing process change skills, redesigning systems, and developing KT competency training for healthcare staff. It emphasizes that both individual and organizational factors must be addressed for successful KT.
This document provides an overview of the national landscape for learning health systems. It discusses the vision of a learning health system where continuous learning and improvement is built into routine healthcare through research and data sharing. It outlines some of the challenges to realizing this vision like fragmentation and misaligned incentives. It also describes the emergence of a multi-stakeholder movement and Learning Health Community working to advance this vision through collaboration. Key initiatives of this movement include establishing core values, enabling standards and structures for learning from health data, and supporting various learning health projects.
Using Case-based Methods for Evaluating Complexity in the Health SectorJSI
Anne LaFond presented as part of a panel at the 2015 Evaluation Conference on using case-based methods for evaluating complexity in the health sector, sharing insights from various JSI case studies.
The document summarizes the work of the Department of Learning Health Sciences at the University of Michigan, which focuses on continuous learning and improvement at both the organizational and individual level in healthcare systems. It describes the concept of a Learning Health System, which uses data and analytics from every patient encounter to rapidly study and adapt the system. The department is working to create a scalable and replicable diabetes-focused Learning Health System within the University of Michigan Health System through engaging stakeholders across the university and convening symposia. The goal is to establish learning cycles and a supporting platform that enables efficient continuous learning and improvement.
> HTA and Real World Evidence (RWE)
> Why RWE? - Limitations with RCT
> RCT v/s RWE
> Definition of RWE
> Sources of RWE
> Advantages of RWE
> Application of Real World Data (RWD) in RWE
> Benefits of RWD in RWE
> Why Data Sharing is Important?
> Important Stakeholders
> How to Encourage Data Sharing?
> Benefits of Data Sharing
> Case Studies
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD/RWE
> Way Forward
This document provides an overview of implementation research. It defines implementation research as using strategies to introduce or change evidence-based health interventions in real world contexts. Implementation research is a multidisciplinary field that seeks to understand and close the gap between evidence and practice. The document discusses conceptual frameworks, methods, outcomes and evidence used in implementation research. It describes both qualitative and quantitative research designs that can be used, including descriptive, analytic, experimental and mixed methods approaches.
This document discusses key reports advocating for changes in nursing education to better prepare nurses for contemporary practice. It summarizes recommendations from organizations like the Institute of Medicine, National League for Nursing, American Association of Colleges of Nursing, and Quality and Safety Education for Nurses initiative. These recommendations call for embracing evidence-based teaching, developing the science of nursing education, emphasizing interprofessional collaboration, and integrating informatics and quality improvement into nursing curricula. The document also provides examples of learning activities educators can use to examine their curriculum and ensure it aligns with these contemporary practice recommendations.
The document discusses key issues in health system development and the Thai experience as an example. It summarizes that Thailand achieved early Millennium Development Goals through sustained action over time to address access barriers, including expanding infrastructure and human resources, gradually increasing financial risk protection, and strengthening community awareness of health programs. This sustained action was enabled by values-based leadership, support from elites, use of evidence, decentralized decision-making, and flexible implementation within a pro-poor, pro-rural ideology.
How can community-based participatory research contribute to Program Scienceamusten
This document summarizes the development and evaluation of a community-based participatory research program called Pouvoir Partager/Pouvoirs Partagés (PP/PP) aimed at empowering women living with HIV to make thoughtful decisions about disclosing or not disclosing their HIV status. Over three cycles from 2002-2011, the program was developed with input from women living with HIV, implemented as a pilot, improved based on evaluation, scaled up provincially, and adapted for other cultural contexts. Evaluation found the program improved participants' ability to disclose their status proactively and their sense of control and self-efficacy around disclosure decisions.
The document provides an overview of the development of the WatLXTM patient experience measurement tool for rehabilitation care. It discusses:
1) The background and objectives in developing WatLXTM, which included a literature review, interviews, and testing to create a parsimonious 10-item survey focused on the patient experience in rehabilitation care.
2) Pilot testing of WatLXTM across 19 Ontario sites with over 1,000 patients which demonstrated high feasibility, reliability, and validity. Qualitative feedback was also positive.
3) Plans to implement WatLXTM more broadly across AHS community rehabilitation clinics using paper surveys or iPads to standardize outcome measurement of patient experience.
This chapter discusses ethics and ethical decision-making in nursing informatics. It introduces various theoretical approaches to healthcare ethics like principlism, casuistry, virtue ethics, and care ethics. New technologies are creating new ethical dilemmas around issues like privacy, confidentiality, and informed consent. The chapter advocates using ethical decision-making models and the nursing code of ethics to navigate these challenges. As healthcare and information technologies continue advancing, it is crucial for professionals to make judicious, ethical decisions.
This document discusses the importance of workflow analysis and redesign when implementing new health technologies. It outlines the key steps in the workflow redesign process, including building an interdisciplinary team, analyzing the current workflow, identifying waste and non-value-added activities, designing an optimal future workflow, managing the change process, and evaluating metrics to measure results. Nursing informatics professionals play a critical role in workflow redesign to help ensure technologies meet clinical needs and improve patient outcomes and safety.
This document summarizes the process of piloting the WILLOW intervention program for HIV-positive women in Ontario. It discusses how the Women's Health in Women's Hands organization selected the WILLOW program after reviewing several effective interventions. They then worked with the Ontario HIV Treatment Network to support training facilitators for the WILLOW program in Toronto. Some lessons learned from the process included that the intervention was too prescriptive, did not address all cultural issues relevant to the Canadian context, and underestimated the skill level required for facilitators. The next steps will be to pilot the intervention, evaluate it, adapt it as needed, and then scale it up more broadly.
Here are some thought-provoking questions about using public health informatics and data to address community health issues:
- What public health data would have been used to determine the need for a mass inoculation program against a new strain of influenza? Data on previous flu seasons like hospitalizations and deaths, current flu activity in the population, characteristics of the new strain, and susceptibility in the community based on previous vaccination coverage could all factor into determining if a mass program is needed.
- What data will be collected to determine the success of such a program? Data that could be collected includes numbers of individuals vaccinated, demographic information on who was vaccinated, monitoring disease surveillance systems for cases and outbreaks associated with the new strain, tracking severe
This chapter provides an overview of nursing informatics, including key definitions and concepts. Nursing informatics integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. The goal of nursing informatics is to improve population health by optimizing information management and communication. It focuses on representing nursing data and assisting with managing and communicating nursing information in the broader context of health informatics.
As populations increase, health resources shrink, and access and quality of life equity differences widen, the clarion call for innovation in healthcare is growing louder around the world. Both international groups such as the World Health Organization and national groups, e.g., ministry of health, continue to set aggressive goals and billions have been spent to design and implement global health innovations.
Many global health innovations (GHI) have set high goals but had limited success in implementation or never scaled to serve a wider population. The barriers to implementing global healthcare innovations include policies or political priorities, lack of commitment, limited infrastructure, and limited healthcare staff. Some health entrepreneurs have overcome such barriers; Yet other, well intentioned and planned GHI have not met expectations.
Although some articles provide suggestions for avoiding, overcoming and addressing these barriers, few offer new models for global health innovation. In this research, we offer a four component model that considers the adoptive community, implementation team, the delivery strategy and the delivery approach as key enablers for successful GHI. This model is supported by the literature and in-depth case studies in Uganda, Ghana, Mozambique, and Haiti.
This document discusses the use of simulation in nursing informatics education. It describes how simulated electronic health records (EHRs) can be incorporated into nursing education to allow students to actively use informatics in a realistic learning context. There are two main approaches: EHRs created specifically for simulation or using a real EHR system from a healthcare facility or vendor. The document outlines challenges and opportunities to further integrate informatics tools into education to better prepare nursing students.
The Future of Medical Education From Dreams to Reality (VR, AR, AI)SeriousGamesAssoc
With three decades of e-learning experience, Dr. Levy will present innovations in technology-enhanced education from the past, present, and into the future. He will highlight some of his medical education inventions and advances including some of the first laser discs, CD-ROMs, online case-based education, 3-D anatomical and procedural animations, robotic-assisted surgery, and virtual reality surgical simulation. He will describe the role of artificial intelligence and machine learning in medical education and clinical decision support and some future work in augmented reality. It is true that what were once dreams are now reality, but there are certainly more dreams to come.
This document summarizes a presentation on proposed changes to the informed consent process. The key proposed changes include shortening consent forms to only include the most relevant details, publicly posting consent documents for clinical trials, and allowing for broad consent for secondary use of biospecimens including de-identified samples. The goals of the proposed changes are to build more trust in the consent process and make it more meaningful. However, it is unclear if the changes will fully achieve these goals given challenges such as the open-ended nature of consent agreements. The presentation also discusses empirical studies conducted on community perspectives and issues regarding public health biobanks and consent.
The document summarizes the evolution of the Department of Medical Education at UMMS into the new Department of Learning Health Sciences. The new department broadens the scope to focus on learning at different scales from individual to organization-wide. It aims to advance the science of learning applied to health through research, education, and promoting continuous learning and improvement within health systems to make them "learning health systems". Realizing this vision requires overcoming challenges through new learning sciences and building collaborations across different fields.
Knowledge translation model, tools and strategies for successImad Hassan
The document discusses knowledge translation (KT), which refers to closing the gap between what is known from research and what is practiced. It notes several barriers to KT, including organizational, professional, and social barriers. The document then provides a framework for KT, outlining five essential components: using evidence-based knowledge, implementing change tools scientifically, employing process change skills, redesigning systems, and developing KT competency training for healthcare staff. It emphasizes that both individual and organizational factors must be addressed for successful KT.
This document provides an overview of the national landscape for learning health systems. It discusses the vision of a learning health system where continuous learning and improvement is built into routine healthcare through research and data sharing. It outlines some of the challenges to realizing this vision like fragmentation and misaligned incentives. It also describes the emergence of a multi-stakeholder movement and Learning Health Community working to advance this vision through collaboration. Key initiatives of this movement include establishing core values, enabling standards and structures for learning from health data, and supporting various learning health projects.
Using Case-based Methods for Evaluating Complexity in the Health SectorJSI
Anne LaFond presented as part of a panel at the 2015 Evaluation Conference on using case-based methods for evaluating complexity in the health sector, sharing insights from various JSI case studies.
The document summarizes the work of the Department of Learning Health Sciences at the University of Michigan, which focuses on continuous learning and improvement at both the organizational and individual level in healthcare systems. It describes the concept of a Learning Health System, which uses data and analytics from every patient encounter to rapidly study and adapt the system. The department is working to create a scalable and replicable diabetes-focused Learning Health System within the University of Michigan Health System through engaging stakeholders across the university and convening symposia. The goal is to establish learning cycles and a supporting platform that enables efficient continuous learning and improvement.
> HTA and Real World Evidence (RWE)
> Why RWE? - Limitations with RCT
> RCT v/s RWE
> Definition of RWE
> Sources of RWE
> Advantages of RWE
> Application of Real World Data (RWD) in RWE
> Benefits of RWD in RWE
> Why Data Sharing is Important?
> Important Stakeholders
> How to Encourage Data Sharing?
> Benefits of Data Sharing
> Case Studies
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD/RWE
> Way Forward
This document provides an overview of implementation research. It defines implementation research as using strategies to introduce or change evidence-based health interventions in real world contexts. Implementation research is a multidisciplinary field that seeks to understand and close the gap between evidence and practice. The document discusses conceptual frameworks, methods, outcomes and evidence used in implementation research. It describes both qualitative and quantitative research designs that can be used, including descriptive, analytic, experimental and mixed methods approaches.
This document discusses key reports advocating for changes in nursing education to better prepare nurses for contemporary practice. It summarizes recommendations from organizations like the Institute of Medicine, National League for Nursing, American Association of Colleges of Nursing, and Quality and Safety Education for Nurses initiative. These recommendations call for embracing evidence-based teaching, developing the science of nursing education, emphasizing interprofessional collaboration, and integrating informatics and quality improvement into nursing curricula. The document also provides examples of learning activities educators can use to examine their curriculum and ensure it aligns with these contemporary practice recommendations.
The document discusses key issues in health system development and the Thai experience as an example. It summarizes that Thailand achieved early Millennium Development Goals through sustained action over time to address access barriers, including expanding infrastructure and human resources, gradually increasing financial risk protection, and strengthening community awareness of health programs. This sustained action was enabled by values-based leadership, support from elites, use of evidence, decentralized decision-making, and flexible implementation within a pro-poor, pro-rural ideology.
How can community-based participatory research contribute to Program Scienceamusten
This document summarizes the development and evaluation of a community-based participatory research program called Pouvoir Partager/Pouvoirs Partagés (PP/PP) aimed at empowering women living with HIV to make thoughtful decisions about disclosing or not disclosing their HIV status. Over three cycles from 2002-2011, the program was developed with input from women living with HIV, implemented as a pilot, improved based on evaluation, scaled up provincially, and adapted for other cultural contexts. Evaluation found the program improved participants' ability to disclose their status proactively and their sense of control and self-efficacy around disclosure decisions.
The document provides an overview of the development of the WatLXTM patient experience measurement tool for rehabilitation care. It discusses:
1) The background and objectives in developing WatLXTM, which included a literature review, interviews, and testing to create a parsimonious 10-item survey focused on the patient experience in rehabilitation care.
2) Pilot testing of WatLXTM across 19 Ontario sites with over 1,000 patients which demonstrated high feasibility, reliability, and validity. Qualitative feedback was also positive.
3) Plans to implement WatLXTM more broadly across AHS community rehabilitation clinics using paper surveys or iPads to standardize outcome measurement of patient experience.
This chapter discusses ethics and ethical decision-making in nursing informatics. It introduces various theoretical approaches to healthcare ethics like principlism, casuistry, virtue ethics, and care ethics. New technologies are creating new ethical dilemmas around issues like privacy, confidentiality, and informed consent. The chapter advocates using ethical decision-making models and the nursing code of ethics to navigate these challenges. As healthcare and information technologies continue advancing, it is crucial for professionals to make judicious, ethical decisions.
This document discusses the importance of workflow analysis and redesign when implementing new health technologies. It outlines the key steps in the workflow redesign process, including building an interdisciplinary team, analyzing the current workflow, identifying waste and non-value-added activities, designing an optimal future workflow, managing the change process, and evaluating metrics to measure results. Nursing informatics professionals play a critical role in workflow redesign to help ensure technologies meet clinical needs and improve patient outcomes and safety.
This document summarizes the process of piloting the WILLOW intervention program for HIV-positive women in Ontario. It discusses how the Women's Health in Women's Hands organization selected the WILLOW program after reviewing several effective interventions. They then worked with the Ontario HIV Treatment Network to support training facilitators for the WILLOW program in Toronto. Some lessons learned from the process included that the intervention was too prescriptive, did not address all cultural issues relevant to the Canadian context, and underestimated the skill level required for facilitators. The next steps will be to pilot the intervention, evaluate it, adapt it as needed, and then scale it up more broadly.
Here are some thought-provoking questions about using public health informatics and data to address community health issues:
- What public health data would have been used to determine the need for a mass inoculation program against a new strain of influenza? Data on previous flu seasons like hospitalizations and deaths, current flu activity in the population, characteristics of the new strain, and susceptibility in the community based on previous vaccination coverage could all factor into determining if a mass program is needed.
- What data will be collected to determine the success of such a program? Data that could be collected includes numbers of individuals vaccinated, demographic information on who was vaccinated, monitoring disease surveillance systems for cases and outbreaks associated with the new strain, tracking severe
This chapter provides an overview of nursing informatics, including key definitions and concepts. Nursing informatics integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. The goal of nursing informatics is to improve population health by optimizing information management and communication. It focuses on representing nursing data and assisting with managing and communicating nursing information in the broader context of health informatics.
As populations increase, health resources shrink, and access and quality of life equity differences widen, the clarion call for innovation in healthcare is growing louder around the world. Both international groups such as the World Health Organization and national groups, e.g., ministry of health, continue to set aggressive goals and billions have been spent to design and implement global health innovations.
Many global health innovations (GHI) have set high goals but had limited success in implementation or never scaled to serve a wider population. The barriers to implementing global healthcare innovations include policies or political priorities, lack of commitment, limited infrastructure, and limited healthcare staff. Some health entrepreneurs have overcome such barriers; Yet other, well intentioned and planned GHI have not met expectations.
Although some articles provide suggestions for avoiding, overcoming and addressing these barriers, few offer new models for global health innovation. In this research, we offer a four component model that considers the adoptive community, implementation team, the delivery strategy and the delivery approach as key enablers for successful GHI. This model is supported by the literature and in-depth case studies in Uganda, Ghana, Mozambique, and Haiti.
This document discusses the use of simulation in nursing informatics education. It describes how simulated electronic health records (EHRs) can be incorporated into nursing education to allow students to actively use informatics in a realistic learning context. There are two main approaches: EHRs created specifically for simulation or using a real EHR system from a healthcare facility or vendor. The document outlines challenges and opportunities to further integrate informatics tools into education to better prepare nursing students.
The Future of Medical Education From Dreams to Reality (VR, AR, AI)SeriousGamesAssoc
With three decades of e-learning experience, Dr. Levy will present innovations in technology-enhanced education from the past, present, and into the future. He will highlight some of his medical education inventions and advances including some of the first laser discs, CD-ROMs, online case-based education, 3-D anatomical and procedural animations, robotic-assisted surgery, and virtual reality surgical simulation. He will describe the role of artificial intelligence and machine learning in medical education and clinical decision support and some future work in augmented reality. It is true that what were once dreams are now reality, but there are certainly more dreams to come.
This document summarizes a presentation on proposed changes to the informed consent process. The key proposed changes include shortening consent forms to only include the most relevant details, publicly posting consent documents for clinical trials, and allowing for broad consent for secondary use of biospecimens including de-identified samples. The goals of the proposed changes are to build more trust in the consent process and make it more meaningful. However, it is unclear if the changes will fully achieve these goals given challenges such as the open-ended nature of consent agreements. The presentation also discusses empirical studies conducted on community perspectives and issues regarding public health biobanks and consent.
The document summarizes the evolution of the Department of Medical Education at UMMS into the new Department of Learning Health Sciences. The new department broadens the scope to focus on learning at different scales from individual to organization-wide. It aims to advance the science of learning applied to health through research, education, and promoting continuous learning and improvement within health systems to make them "learning health systems". Realizing this vision requires overcoming challenges through new learning sciences and building collaborations across different fields.
The University of Michigan Medical School established the Patient Safety and Quality Leadership (PASQUAL) Scholars Program to create a community of clinical partners who can effectively collaborate with engineers and safety professionals to improve patient safety and quality of care. The program provides faculty and staff an 8-month curriculum covering quality improvement, patient safety, leadership, teaching and scholarship. Scholars identify an existing or new quality/safety project and work in interprofessional teams. Graduates are well positioned to lead quality/safety initiatives and collaborate with engineering professionals to positively impact healthcare outcomes.
Caren Stalburg, MD, MA presented to the 2016 annual Snow meeting of the Michigan Section of the American Congress of Obstetricians and Gynecologists (ACOG) about her program to train Michigan providers about the new Breast Density Notification Law (http://www.midensebreasts.org/).
Dr. Stalburg is Division Chief and Clinical Assistant Professor in the Division of Professional Education in the Department of Learning Health Sciences and Assistant Professor of Obstetrics and Gynecology in the University of Michigan Medical School.
This document summarizes a presentation by Joshua Rubin on realizing a learning health system. It discusses the concept of a learning health system where every health experience and decision helps to improve health. It outlines key components like assembling relevant data, analyzing it, disseminating results, and changing practice. Stakeholders in this system include patient groups, insurers, universities, delivery networks, and the tech industry. Over 100 organizations have endorsed the core values of a learning health system. The presentation closes by emphasizing collaboration as a driver of better health outcomes through technology, policy, people and culture working together.
This document discusses transcending health information exchange (HIE) by envisioning Michigan as a "Learning Health State". It introduces the concept of a Learning Health System (LHS) which aims to continuously improve health and healthcare by generating new knowledge from care experiences. The document outlines core components of an LHS including infrastructure, governance, and data sharing/analysis. Building an LHS at national and state levels could enable benefits like rapid drug safety updates and epidemic surveillance. The document advocates for Michigan to endorse LHS values and join the emerging Learning Health Community.
Joshua Rubin, Program Officer for Learning Health System Initiatives within the Department of Learning Health Sciences, was an invited speaker at Techweek Detroit 2015 at Ford Field. (http://techweek.com/schedule/detroit/).
For more about the department, go to http://LHS.medicine.umich.edu/
The Large Data Demonstration Project aims to create a timely and workable national health data network design through a test project. It seeks to concurrently address governance issues and demonstrate improvements in care. The project intends to validate the temporal and cost efficiencies of such a network system. Overall, the demonstration project explores building the foundation for a national Learning Health System to improve American healthcare through increased data sharing and analysis.
Partnering with practice based research networks (pbrn)Marissa Stone
This document discusses partnering with practice-based research networks (PBRNs) to conduct research. It describes PBRNs as groups of primary care practices that collaborate to research questions related to community practice. There are over 150 PBRNs across the US involving nearly 17,000 practices. The document highlights the Oregon Rural Practice-Based Research Network as an example, which involves 49 practices caring for over 235,000 patients. It emphasizes that PBRNs allow important questions about real-world clinical practice and quality improvement to be studied using communities as laboratories.
The Department of Learning Health Sciences, University of Michigan Medical School: A First-of-Its Kind Department
Chaired by Charles P. Friedman, PhD
Prepared for the MIDAS Symposium, October 6, 2015
ODF III - 3.15.16 - Day Two Morning SessionsMichael Kerr
Slide presentations delivered during morning sessions of Day Two of the California Statewide Health and Human Services Open DataFest - March 14 - 15, 2016, Sacramento, CA
BUILDing Multi-Sector Collaborations to Advance Community HealthPractical Playbook
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
Building Capacity to Improve Population Health using a Social Determinants of...Practical Playbook
The Practical Playbook
National Meeting 2016
www.practicalplaybook.org
Bringing Public Health and Primary Care Together: The Practical Playbook National Meeting was at the Hyatt Regency in Bethesda, MD, May 22 - 24, 2016. The meeting was a milestone event towards advancing robust collaborations that improve population health. Key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – and across the country came together at the National Meeting to help catalyze a national movement, accelerate collaborations by fostering skill development, and connect with like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.
The National Meeting was also a significant source of tools and resources to advance collaboration. These tools and resources are available below and include:
Session presentations and materials
Poster session content
Photos from the National Meeting
The conversation started at the National Meeting is continuing in a LinkedIn Group "Working Together for Population Health" and Twitter. Use #PPBMeeting to provide feedback on the National Meeting.
The Practical Playbook was developed by the de Beaumont Foundation, the Duke University School of Medicine Department of Community and Family Medicine, the Centers for Disease Control and Prevention (CDC), and the Health Resources & Services Administration (HRSA).
Improving the Health Outcomes of Both Patients AND PopulationsCHC Connecticut
NCA Clinical Workforce Development, Team-Based Care 2019 Webinar Series
Webinar broadcast on: May 23, 2019 | 2 p.m. EST
In this webinar experts will share their journey in planning, preparing and launching a population health initiative. With the goals of impacting population health outcomes while ensuring cost effectiveness, our experts designed interventions to eliminate gaps in care, particularly among special populations.
Joshua Rubin's presentation for the Lilly sponsored AMIA Clinical Decision Support Working Group on August 25, 2015.
https://www.amia.org/education/webinars/learning-health-system-informing-clinical-decisions-learning-every-patient-every
Strengthening health systems in Sub-Saharan Africa requires health policy and systems research and analysis (HPSR+A). HPSR+A takes a multidisciplinary approach to understand how health systems function and how to improve them. It also examines how to influence health policies and implement policies effectively to strengthen systems. Some priorities for HPSR+A include conducting mixed-method longitudinal studies, using theory, and thinking outside disease-specific approaches to consider the broader health system issues. Several HPSR+A studies provided examples of how health systems can be strengthened by taking a systems perspective rather than just focusing on individual programs or diseases.
Going Where the Kids Are: Starting, Growing, and Expanding School Based Healt...CHC Connecticut
Webinar broadcast on: June 28 | 3 P.M. EST
This webinar will address the benefits, challenges, and strategic advantages of a school based health center program from a clinical, data, quality, operational viewpoint, communications, and community engagement perspective. Experts will share the strategy for integrating oral health and behavioral health to ensure the best outcomes for patients.
This document discusses evidence-based public health (EBPH). It defines EBPH as the development, implementation, and evaluation of effective programs and policies through applying scientific reasoning principles. The key steps of EBPH include quantifying the public health issue, conducting a literature review, developing and prioritizing program options, creating an action plan, and evaluating programs and policies. EBPH relies on diverse sources of evidence, both quantitative and qualitative research. It differs from evidence-based medicine in its focus on populations rather than individuals and emphasis on environmental and social factors.
Engines of Success for U.S. Health Reform?
Eric B. Larson, MD, MPHVice President for Research, Group Health Executive Director, Group Health Research Institute
The document discusses factors that influence people in New Zealand to use complementary and alternative medicine (CAM). CAM is broadly defined as health practices outside of mainstream medicine in a given society. The New Zealand health system uses a definition of CAM as practices intended to prevent or treat illness or promote well-being that are self-defined as such by users. While New Zealand lacks recent data on CAM use, past surveys show little is known about the social and psychological reasons behind why people choose CAM. More research is needed to better understand people's motivations for using CAM in New Zealand.
Join us for a discussion of methods and tools that can be used to support evidence-informed decision making in the context of health equity. Learn about resources to help you apply health equity principles to planning processes that contribute to evidence informed public health.
Guest speakers from Niagara Region Public Health discussed the use of the 10 promising practices to address health equity. This included the results of a qualitative study to identify barriers and facilitators, and provided recommendations for strengthening planning and implementation practice to improve health equity.
This webinar is jointly produced by the National Collaborating Centre for Methods and Tools (NCCMT) and the National Collaborating Centre for Determinants of Health (NCCDH), and is supported through funding from the Public Health Agency of Canada.
The National Collaborating Centre for Methods and Tools is funded by the Public Health Agency of Canada and affiliated with McMaster University. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.
NCCMT is one of six National Collaborating Centres (NCCs) for Public Health. The Centres promote and improve the use of scientific research and other knowledge to strengthen public health practices and policies in Canada.
Similar to The Learning Health System: Democratizing Health Together (20)
The document outlines an agenda for a University of Michigan Learning Health System Collaboratory event. The agenda includes: welcome remarks, introductions and background on the LHS Collaboratory, a discussion of its vision, mission, value and opportunities, a closing activity, and adjournment. Testimonials will be provided by representatives from various UM schools. The LHS aims to link discovery to better health outcomes through continuous learning and knowledge sharing between data, knowledge and practice. Realizing this vision poses sociotechnical challenges that require cross-disciplinary collaboration and leadership.
This document discusses the potential for mobile health technologies to improve care for cardiovascular disease. It provides an overview of advances in mobile devices and their capabilities. A model is presented where mobile technologies can support care by enabling risk assessment, monitoring of conditions like blood pressure and sodium intake, and remote patient monitoring for conditions like heart failure. Two case studies are described that used mobile apps to help lower sodium intake through location-based alerts and remote monitoring in heart failure patients. The conclusion is that mobile technologies provide new opportunities for just-in-time interventions and passive monitoring of pre-clinical disease states.
The document discusses the Michigan Surgical Quality Collaborative (MSQC), which aims to establish a learning health system for improving surgical care in Michigan. It describes the MSQC learning health system cycle, which involves collecting data, analyzing it, learning from it, disseminating best practices, and evaluating and supporting continuous quality improvement. It provides details on how the MSQC works, including the data it collects, how sites are analyzed and monitored, and how knowledge is shared. It discusses the MSQC's focus on reducing surgical site infections in colectomy patients and the initiatives developed from analyzing the data. Finally, it outlines the MSQC's future plans to further leverage technology, anchor care around patients, and create an epicenter
This document discusses the history and current uses of simulation-based education for training family medicine physicians. It outlines how simulation has been used to teach technical skills like central line placement. Studies show this training improves physicians' skills and knowledge, and leads to better patient outcomes like fewer infections. Future trends may include more system-based training using simulations of electronic health records. Training is also expected to focus more on non-technical skills like communication and decision-making. Overall, simulation-based education is poised to play a growing role in technical and non-technical skills training for family medicine.
Simulation-based education is increasingly being used to train technical skills. Current applications include using simulators to improve skills like central line placement and lumbar punctures. Research shows this approach can help address gaps in skills, improve patient outcomes, and reduce costs. Future trends may include more targeted simulators for specific specialties or procedures, and expanding training to areas beyond technical skills like communication. Barriers like cost and faculty time may be addressed through self-directed online training modules.
1) The document discusses a briefing on learning health systems presented at an AMIA symposium.
2) It outlines the challenges of realizing a learning health system that can continuously learn from all patient data and experiences to rapidly improve practices.
3) The briefing describes efforts by the Learning Health Community coalition of 91 organizations to develop standards and governance to enable learning health systems, and proposes that realizing these systems may require a new field of "cyber-social learning systems."
The document outlines strategies for transforming educational efforts into scholarship. It discusses defining educational scholarship, identifying opportunities to turn teaching work into scholarship projects, and sharing strategies for success, including considering dissemination venues and planning next steps. The document provides an overview of developing scholarly projects, from refining a study question to selecting appropriate designs, methods, and outcomes.
This document provides an overview of the national Learning Health Community framework and Learning Health for Michigan. The objectives are to understand the evolving national framework, become familiar with the vision and core values, learn about stakeholders working toward the shared vision, and gain insight into how research networks can integrate with health data sharing infrastructure. It acknowledges contributions from various individuals and organizations. It discusses how a learning health system platform can support multiple simultaneous learning cycles through common infrastructure. It emphasizes that such a platform needs capabilities for both gathering and applying knowledge (not just gathering). Specific platform elements discussed include mechanisms for communities of interest, use cases, standard components, and refinement/testing. The document outlines functions needed for a "brain" within the system to organize, manage
This document summarizes a presentation about a prototype primary care EHR system called Small Brain Project. The system aims to increase patient engagement and capture more objective clinical data while reducing clinician documentation burden. It allows patients and providers to jointly manage health problems, goals, and tasks. Encounters are recorded through multimedia and problems are updated based on patient inputs. The system was tested with 375 patients and showed benefits like improved safety, efficiency and patient trust. Next steps discussed were integrating with other systems through FHIR and Dartmouth projects to advance the open source project.
On April 15, 2015, Professor Deb Rooney presented about validity in the current framework used to evaluate evidence and how we gather /evaluate validity evidence from a simulator and it’s associated measures. Her talk was part monthly brown bag series hosted by the University of Michigan Medical School Clinical Simulation Center.
For more about the Department of Learning Health Sciences or the Clinical Simulation Center, see http://LHS.medicine.umich.edu/.
Presentation by Allen Flynn, Johmarx Patton, and Jodyn Platt at the 48th Annual at the Hawaii International Conference on System Sciences (HICSS) in January 2015 (http://kholden7.wix.com/hicss).
Flynn, Patton, and Platt were all core member of Learning Health System Third Century Initiative Phase 1 Project and continue to participate in other Learning Health System Initiatives led by the Department of Learning Health Sciences.
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By offering a variety of massage services, our Ajman Spa Massage Center can tackle physical, mental, and emotional illnesses. In addition, efficient identification of specific health conditions and designing treatment plans accordingly can significantly enhance the quality of massaging.
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As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
Ensure the highest quality care for your patients with Cardiac Registry Support's cancer registry services. We support accreditation efforts and quality improvement initiatives, allowing you to benchmark performance and demonstrate adherence to best practices. Confidence starts with data. Partner with Cardiac Registry Support. For more details visit https://cardiacregistrysupport.com/cancer-registry-services/
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NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
Emphysema is an abnormal permanent enlargement of the air spaces distal to terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema of lung is defined as hyper inflation of the lung ais spaces due to obstruction of non respiratory bronchioles as due to loss of elasticity of alveoli.
It is a type of chronic obstructive
pulmonary disease.
It is a progressive disease of lungs.
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
Cancer treatment has advanced significantly over the years, offering patients various options tailored to their specific type of cancer and stage of disease. Understanding the different types of cancer treatments can help patients make informed decisions about their care. In this ppt, we have listed most common forms of cancer treatment available today.
Types of Cancer Treatments | Forms of cancer treatment
The Learning Health System: Democratizing Health Together
1. Joshua C. Rubin, JD, MBA, MPH, MPP
Josh@JoshCRubin.com
@JoshCRubin
The Learning
Health System:
Democratizing
Health Together
Thursday, April 21, 2016
2. • Program Officer for Learning Health System
Initiatives, Department of Learning Health
Sciences, University of Michigan Medical
School
• Member of the Interim Steering Committee,
Learning Health Community
• Vice President of the Board of Directors,
Joseph H. Kanter Family Foundation
Disclosures
3. Some portions of this presentation were adapted from the
work of my colleague and boss, Dr. Charles P. Friedman.
Preliminary Acknowledgement
4. From left: Donald Kemper, Janet Marchibroda, David
Dieterich, George Mitchell, Joe Kanter, Karen Fox, Bob
Dole, Sean Tunis, David Kibbe, Gary Filerman, Paul Elwood
54. “What if your data did not have to die in dusty
paper files and unconnected electronic silos?
What if many private institutions, non-profit
organizations, research centers, government
entities and individual patients decided to
share data? What if we could do this over a
span of years creating an ever larger data
set? That data set could be accessed by the
many in a timely fashion that will enable both
the individual and the organization to make
informed health decisions.”
– Regina Holliday at the Learning Health
System Summit, 2012
A Patient Activist’s Perspective…
55. “… one in which progress in science, informatics,
and care culture align to generate new
knowledge as an ongoing, natural by-product of
the care experience, and seamlessly refine and
deliver best practices for continuous
improvement in health and health care.” (IOM)
Learning Health System (LHS)
56.
57. • Every (consenting) patient’s characteristics and
experiences are, in principle, available for study.
• Best practice knowledge is immediately available to
support decisions.
• Improvement is continuous through ongoing study.
• This learning happens routinely, economically, and
almost invisibly.
• All of this is part of the culture.
A Health System That Learns (Studies Itself)
A System of Health Learners…
65. The LHS Must Do This…
Assemble
Relevant Data
Take Action to Change
Practice
Interpret
Results
Analyze
Data
Deliver Tailored
Message
A Problem of
Interest
Decision to Study
66. Not This…
Assemble
Relevant Data
Take Action to Change
Practice
Interpret
Results
Analyze
Data
Deliver Tailored
Message
A Problem of
Interest
Decision to Study
Journals?
69. • At Any Level of Scale
• Effective, Continuous, Routine, and Sustainable
The New Science of Learning Systems
Semantics, Knowledge
Representation, and
Management
Decision Science
Communication and
Behavior Change
Implementation Science
Complexity & System
Science
Economics
Policy Science
Data Science
Machine Learning
&
Analytics
83. 99 Endorsements of the LHS Core Values*
(As of 4/18/2016)
The Center for Learning Health Care
Siemens Health Services
GE Healthcare IT
*To be included on the www.LearningHealth.org website.
SecureHealthHub, LLC
Department of Primary Care
and Public Health
Program in Health
Informatics, SONHP
Veterans Health Administration
Office of Informatics & Analytics
Division of Health and
Social Care Research
87. “In closing, the Learning Health Community movement and perhaps a number of the
other multistakeholder organizations implicitly envision as one of their key goals
interoperation (as opposed to interoperability, which is a capability versus an
outcome) as a driver of better human health. These organizations are about working
together to collaboratively realize an infrastructure built upon the fusion of
technology, policy, people, and culture that leads to a national system for sharing
health data to enable useful and rapid exchange that is governed, organized and
operated by different levels of public and private multi-stakeholder collaborations.”
– Timothy Pletcher, DHA
www.LearningHealth.org
98. “… for those of us who have battled against the
weariness and ennui most change agents face in the
institutions of government and the healthcare industrial
complex, we know that this change has been a long
time coming, and it’s too late to stop now.”
– Hunt Blair, 2015
www.LearningHealth.org