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A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research.

Marsolo K, Margolis PA, Forrest CB, Colletti RB, Hutton JJ - EGEMS (Wash DC) (2015)

Bottom Line: Additional standards are needed in order for this vision to be achieved, however.We have successfully implemented a proof-of-concept Learning Health System while providing a foundation on which others can build.We have also highlighted opportunities where sponsors could help accelerate progress.

View Article: PubMed Central - PubMed

Affiliation: Cincinnati Children's Hospital Medical Center.

ABSTRACT

Introduction: We collaborated with the ImproveCareNow Network to create a proof-of-concept architecture for a network-based Learning Health System. This collaboration involved transitioning an existing registry to one that is linked to the electronic health record (EHR), enabling a "data in once" strategy. We sought to automate a series of reports that support care improvement while also demonstrating the use of observational registry data for comparative effectiveness research.

Description of architecture: We worked with three leading EHR vendors to create EHR-based data collection forms. We automated many of ImproveCareNow's analytic reports and developed an application for storing protected health information and tracking patient consent. Finally, we deployed a cohort identification tool to support feasibility studies and hypothesis generation. There is ongoing uptake of the system. To date, 31 centers have adopted the EHR-based forms and 21 centers are uploading data to the registry. Usage of the automated reports remains high and investigators have used the cohort identification tools to respond to several clinical trial requests.

Suggestions for future use: The current process for creating EHR-based data collection forms requires groups to work individually with each vendor. A vendor-agnostic model would allow for more rapid uptake. We believe that interfacing network-based registries with the EHR would allow them to serve as a source of decision support. Additional standards are needed in order for this vision to be achieved, however.

Conclusions: We have successfully implemented a proof-of-concept Learning Health System while providing a foundation on which others can build. We have also highlighted opportunities where sponsors could help accelerate progress.

No MeSH data available.


Functional Architecture of the Learning Health System that Supports the ImproveCareNow NetworkNote: The components that support data input are listed on the left and the components that support research and analytics on the right. All tools are accessible from the same user interface. The labeled ovals correspond to the subheading of the Implementation section where a more detailed description can be found. The informatics components described in Table 1 that support patient engagement are not shown.
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f1-egems1168: Functional Architecture of the Learning Health System that Supports the ImproveCareNow NetworkNote: The components that support data input are listed on the left and the components that support research and analytics on the right. All tools are accessible from the same user interface. The labeled ovals correspond to the subheading of the Implementation section where a more detailed description can be found. The informatics components described in Table 1 that support patient engagement are not shown.

Mentions: With funding from the Agency for Healthcare Research and Quality’s (AHRQ’s) Enhanced Registry program, we designed a technical architecture that aimed at overcoming the burdens that limited the ability of clinicians, patients, and researchers to participate and contribute to the Learning Health System. This architecture is illustrated in Figure 1, and its individual components are discussed further in the Implementation section below.


A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research.

Marsolo K, Margolis PA, Forrest CB, Colletti RB, Hutton JJ - EGEMS (Wash DC) (2015)

Functional Architecture of the Learning Health System that Supports the ImproveCareNow NetworkNote: The components that support data input are listed on the left and the components that support research and analytics on the right. All tools are accessible from the same user interface. The labeled ovals correspond to the subheading of the Implementation section where a more detailed description can be found. The informatics components described in Table 1 that support patient engagement are not shown.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4562738&req=5

f1-egems1168: Functional Architecture of the Learning Health System that Supports the ImproveCareNow NetworkNote: The components that support data input are listed on the left and the components that support research and analytics on the right. All tools are accessible from the same user interface. The labeled ovals correspond to the subheading of the Implementation section where a more detailed description can be found. The informatics components described in Table 1 that support patient engagement are not shown.
Mentions: With funding from the Agency for Healthcare Research and Quality’s (AHRQ’s) Enhanced Registry program, we designed a technical architecture that aimed at overcoming the burdens that limited the ability of clinicians, patients, and researchers to participate and contribute to the Learning Health System. This architecture is illustrated in Figure 1, and its individual components are discussed further in the Implementation section below.

Bottom Line: Additional standards are needed in order for this vision to be achieved, however.We have successfully implemented a proof-of-concept Learning Health System while providing a foundation on which others can build.We have also highlighted opportunities where sponsors could help accelerate progress.

View Article: PubMed Central - PubMed

Affiliation: Cincinnati Children's Hospital Medical Center.

ABSTRACT

Introduction: We collaborated with the ImproveCareNow Network to create a proof-of-concept architecture for a network-based Learning Health System. This collaboration involved transitioning an existing registry to one that is linked to the electronic health record (EHR), enabling a "data in once" strategy. We sought to automate a series of reports that support care improvement while also demonstrating the use of observational registry data for comparative effectiveness research.

Description of architecture: We worked with three leading EHR vendors to create EHR-based data collection forms. We automated many of ImproveCareNow's analytic reports and developed an application for storing protected health information and tracking patient consent. Finally, we deployed a cohort identification tool to support feasibility studies and hypothesis generation. There is ongoing uptake of the system. To date, 31 centers have adopted the EHR-based forms and 21 centers are uploading data to the registry. Usage of the automated reports remains high and investigators have used the cohort identification tools to respond to several clinical trial requests.

Suggestions for future use: The current process for creating EHR-based data collection forms requires groups to work individually with each vendor. A vendor-agnostic model would allow for more rapid uptake. We believe that interfacing network-based registries with the EHR would allow them to serve as a source of decision support. Additional standards are needed in order for this vision to be achieved, however.

Conclusions: We have successfully implemented a proof-of-concept Learning Health System while providing a foundation on which others can build. We have also highlighted opportunities where sponsors could help accelerate progress.

No MeSH data available.