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

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” st...

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Detalles Bibliográficos
Autores principales: Marsolo, Keith, Margolis, Peter A., Forrest, Christopher B., Colletti, Richard B., Hutton, John J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AcademyHealth 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562738/
https://www.ncbi.nlm.nih.gov/pubmed/26357665
http://dx.doi.org/10.13063/2327-9214.1168
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author Marsolo, Keith
Margolis, Peter A.
Forrest, Christopher B.
Colletti, Richard B.
Hutton, John J.
author_facet Marsolo, Keith
Margolis, Peter A.
Forrest, Christopher B.
Colletti, Richard B.
Hutton, John J.
author_sort Marsolo, Keith
collection PubMed
description 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.
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spelling pubmed-45627382015-09-09 A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research Marsolo, Keith Margolis, Peter A. Forrest, Christopher B. Colletti, Richard B. Hutton, John J. EGEMS (Wash DC) Articles 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. AcademyHealth 2015-08-17 /pmc/articles/PMC4562738/ /pubmed/26357665 http://dx.doi.org/10.13063/2327-9214.1168 Text en All eGEMs publications are licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License http://creativecommons.org/licenses/by-nc-nd/3.0/
spellingShingle Articles
Marsolo, Keith
Margolis, Peter A.
Forrest, Christopher B.
Colletti, Richard B.
Hutton, John J.
A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research
title A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research
title_full A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research
title_fullStr A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research
title_full_unstemmed A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research
title_short A Digital Architecture for a Network-Based Learning Health System: Integrating Chronic Care Management, Quality Improvement, and Research
title_sort digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562738/
https://www.ncbi.nlm.nih.gov/pubmed/26357665
http://dx.doi.org/10.13063/2327-9214.1168
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