scholarly journals Value-Based Health Care Supported by Data Science

2018 ◽  
pp. 193-212 ◽  
Author(s):  
Tiffany I. Leung ◽  
G. G. van Merode
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Health System ◽  
Healthcare System ◽  
Patient Outcomes ◽  
Data Science ◽  
Costs Of Care ◽  
Learning Health System ◽  
Measuring Outcomes ◽  
Cost Measurement

AbstractThe value agenda involves measuring outcomes that matter and costs of care to optimize patient outcomes per dollar spent. Outcome and cost measurement in the value-based health care framework, centered around a patient condition or segment of the population, depends on data in every step towards healthcare system redesign. Technological and service delivery innovations are key components of driving transformation towards high-value health care. The learning health system and network-based thinking are complementary frameworks to the value agenda. Health care and medicine exist in a data-rich environment, and learning about how data can be used to measure and improve value of care for patients is and increasingly essential skill for current and future clinicians.

scholarly journals An Analysis of the Learning Health System in Its First Decade in Practice: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Jodyn E Platt ◽  
Minakshi Raj ◽  
Matthias Wienroth
Keyword(s):  
Health Care ◽  
Health System ◽  
Thematic Analysis ◽  
Scoping Review ◽  
Rapid Learning ◽  
The Past ◽  
Learning From Data ◽  
Learning Health System ◽  
Over Time ◽  
Value Of Health

BACKGROUND In the past decade, Lynn Etheredge presented a vision for the Learning Health System (LHS) as an opportunity for increasing the value of health care via rapid learning from data and immediate translation to practice and policy. An LHS is defined in the literature as a system that seeks to continuously generate and apply evidence, innovation, quality, and value in health care. OBJECTIVE This review aimed to examine themes in the literature and rhetoric on the LHS in the past decade to understand efforts to realize the LHS in practice and to identify gaps and opportunities to continue to take the LHS forward. METHODS We conducted a thematic analysis in 2018 to analyze progress and opportunities over time as compared with the initial <i>Knowledge Gaps and Uncertainties</i> proposed in 2007. RESULTS We found that the literature on the LHS has increased over the past decade, with most articles focused on theory and implementation; articles have been increasingly concerned with policy. CONCLUSIONS There is a need for attention to understanding the ethical and social implications of the LHS and for exploring opportunities to ensure that these implications are salient in implementation, practice, and policy efforts.

Advancing health care quality and safety through action learning

2017 ◽  
Vol 30 (2) ◽  
pp. 148-158 ◽  
Author(s):  
Simon Mathews ◽  
Sherita Golden ◽  
Renee Demski ◽  
Peter Pronovost ◽  
Lisa Ishii
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Quality ◽  
Design Methodology ◽  
Action Learning ◽  
Care Quality ◽  
Quality And Safety ◽  
Content Type ◽  
Learning Health System ◽  
Academic Medical

Purpose The purpose of this study is to demonstrate how action learning can be practically applied to quality and safety challenges at a large academic medical health system and become fundamentally integrated with an institution’s broader approach to quality and safety. Design/methodology/approach The authors describe how the fundamental principles of action learning have been applied to advancing quality and safety in health care at a large academic medical institution. The authors provide an academic contextualization of action learning in health care and then transition to how this concept can be practically applied to quality and safety by providing detailing examples at the unit, cross-functional and executive levels. Findings The authors describe three unique approaches to applying action learning in the comprehensive unit-based safety program, clinical communities and the quality management infrastructure. These examples, individually, provide discrete ways to integrate action learning in the advancement of quality and safety. However, more importantly when combined, they represent how action learning can form the basis of a learning health system around quality and safety. Originality/value This study represents the broadest description of action learning applied to the quality and safety literature in health care and provides detailed examples of its use in a real-world context.

scholarly journals Service Delivery and Patient Outcomes in Ryan White HIV/AIDS Program–Funded and –Nonfunded Health Care Facilities in the United States

2015 ◽  
Vol 175 (10) ◽  
pp. 1650 ◽  
Author(s):  
John Weiser ◽  
Linda Beer ◽  
Emma L. Frazier ◽  
Roshni Patel ◽  
Antigone Dempsey ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Service Delivery ◽  
Patient Outcomes ◽  
The United States ◽  
Health Care Facilities ◽  
Ryan White ◽  
Care Facilities ◽  
Aids Program ◽  
Hiv Aids

scholarly journals Patients as Agents in Behavioral Health Research and Service Provision: Recommendations to Support the Learning Health System

2019 ◽  
Vol 10 (05) ◽  
pp. 841-848 ◽  
Author(s):  
Hannah K. Galvin ◽  
Carolyn Petersen ◽  
Vignesh Subbian ◽  
Anthony Solomonides
Keyword(s):  
Health Care ◽  
Health System ◽  
Behavioral Health ◽  
Health Care System ◽  
Health Research ◽  
Information Technologies ◽  
Care Delivery ◽  
Learning Health System ◽  
Behavioral Health Research ◽  
Care System

AbstractAuthentic inclusion and engagement of behavioral health patients in their care delivery and in the process of scientific discovery are often challenged in the health care system. Consequently, there is a growing need to engage with and better serve the needs of behavioral health patients, particularly by leveraging health information technologies. In this work, we present rationale and strategies for improving patient engagement in this population in research and clinical care. First, we describe the potential for creating meaningful patient–investigator partnerships in behavioral health research to allow for cocreation of knowledge with patients. Second, in the context of behavioral health services, we explore the utility of sharing clinical notes to promote patients' agency in care delivery. Both lines of inquiry are centered in a Learning Health System model for behavioral health, where patients are agents in enhancing the therapeutic alliance and advancing the process of knowledge generation. Recommendations include genuinely democratizing the health care system and biomedical research enterprise through patient-centered information technologies such as patient portals. In research and technology development, we recommend seeking and tailoring behavioral health patients' involvement to their abilities, promoting patient input in data analysis plans, evaluating research and informatics initiatives for patients and clinicians, and sharing success and research findings with patients. In clinical practice, we recommend encouraging patients to read behavioral health notes on portals, engaging in proactive communication regarding note content, assessing outcomes including stress and anxiety in response to note content, and working with technology providers to support note-sharing governance and deployment.

scholarly journals Status Update on Data Required to Build a Learning Health System

2020 ◽  
Vol 38 (14) ◽  
pp. 1602-1607 ◽  
Author(s):  
Monica M. Bertagnolli ◽  
Brian Anderson ◽  
Kelly Norsworthy ◽  
Steven Piantadosi ◽  
Andre Quina ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Large Scale ◽  
Point Of Care ◽  
Health Care Systems ◽  
Clinical Care ◽  
Real World Data ◽  
Learning Health System ◽  
Care Systems ◽  
Data Elements

Wide adoption of electronic health records (EHRs) has raised the expectation that data obtained during routine clinical care, termed “real-world” data, will be accumulated across health care systems and analyzed on a large scale to produce improvements in patient outcomes and the use of health care resources. To facilitate a learning health system, EHRs must contain clinically meaningful structured data elements that can be readily exchanged, and the data must be of adequate quality to draw valid inferences. At the present time, the majority of EHR content is unstructured and locked into proprietary systems that pose significant challenges to conducting accurate analyses of many clinical outcomes. This article details the current state of data obtained at the point of care and describes the changes necessary to use the EHR to build a learning health system.

Revisiting the Common Rule and Continuous Improvement in Health Care: A Learning Health System Perspective

2015 ◽  
Vol 5 (12) ◽  
Author(s):  
Richard Platt ◽  
◽  
Christopher Dezii ◽  
Barbara Evans ◽  
Jonathan Finkelstein ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Continuous Improvement ◽  
System Perspective ◽  
Common Rule ◽  
Learning Health System ◽  
The Common ◽  
Health System Perspective

scholarly journals Iranian’s healthcare system challenges during natural disasters: the qualitative case study of Kermanshah earthquake

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mohammadtaghi Mohammadpour ◽  
Omid Sadeghkhani ◽  
Peivand Bastani ◽  
Ramin Ravangard ◽  
Rita Rezaee
Keyword(s):  
Service Delivery ◽  
Health System ◽  
Natural Disasters ◽  
Healthcare System ◽  
Developed Countries ◽  
Lessons Learned ◽  
Main Theme ◽  
Snowball Sampling ◽  
Policy Makers ◽  
Scene Management

Abstract Background In order to the significance of lessons learned from the natural disasters for health care systems particularly in developing and under-developed countries, the main purpose of this study was to identify challenges and limitations in light of the earthquake experience in Kermanshah Province. Methods The present study was conducted in 2019 as a qualitative research using content analysis method. In this regard, 19 key informants were selected using snowball sampling. To enhance the accuracy of the study, the four validation criteria for qualitative studies in data coding developed by Guba and Lincoln including credibility, transferability, dependability and confirmability were used. Data was analyzed applying Graneheim and Lundman (2004) approach for analyzing the qualitative content of an interview text. Results Analysis of the data led to the identification of 2 main themes, 5 sub- themes and 17 main categories. The first main theme was health system oriented challenges containing challenges of medication supply and preparation, structural challenges, challenges in crisis-scene management and challenges of service delivery and the second main theme was non-health system oriented challenges including social and psychosocial challenges. Conclusion According to the results, along with health system oriented challenges with the inter-sectoral or intra-sectoral nature, the non-health system oriented challenges the same as social, cultural and psychological factors can be considered as the major challenges of Iran’s healthcare system in the face of crises. This complicated context can shed the light to policy makers that not only attention to the medicine and medical equipment supply chain, manpower preparation and service delivery system can be considered as an emergency, but also careful attention to the structural challenges and crisis-scene management should be planned and considered as a priority. Besides, the policy makers and the local managers should try to plan and act in a contingent situation according to the social and cultural characteristics of the region and the psychological condition and the mental needs of the people.

Afghan refugees’ experience of Iran’s health service delivery

2016 ◽  
Vol 9 (2) ◽  
pp. 75-85 ◽  
Author(s):  
Abbas Heydari ◽  
Rana Amiri ◽  
Nahid Dehghan Nayeri ◽  
Vedadhir AboAli
Keyword(s):  
Health Care ◽  
Health Service ◽  
Service Delivery ◽  
Health System ◽  
Health Care Providers ◽  
Medical Science ◽  
Health Service Delivery ◽  
Care Providers ◽  
Content Type ◽  
Afghan Refugees

Purpose – The purpose of this paper is to explore experiences of Afghan refugees from health service delivery in Mashhad, Iran. Design/methodology/approach – This is a descriptive study with contextual and qualitative design. Semi-structured interview conducted with 19 Afghan refugees and their caregivers and a focus group session were held with Afghan medical science students. Purposive sampling technique was used to select participants. Data were analysed by qualitative content analysis of Graneheim and Lundman. Lincoln and Guba’s criteria were implemented to ensure trustworthiness. Findings – The results with the core concept of “position of immigrants in the health system” were presented at four themes of “perceived discrimination”, “snowed with loneliness”, “feeling inferior”, and “gratitude”. Research limitations/implications – This study has some implications for researchers and practitioners. The present study is the first study that was done on the health of Afghan refugees in Iran, therefore it can be a ground for further research. In addition, it has valuable results regarding the Afghan immigrants’ experience of health care system of Iran. Practical implications – It can be useful for improving the condition of immigrants in Iran and for improving Iran’s health system. In order to improve the health system in Iran, authorities should pay much attention to transcultural caring and needs of minorities. Furthermore, health workers should be trained to appropriately take care of all patients, without prejudice. Originality/value – Overall the study revealed that there is inequity in access to health services among Afghan refugees in Iran. The findings, although not generalized, offer important insights into health care providers in Iran which should be delivering health service without prejudice. The authors recommended that policies of public medical insurance and assistance programme should be implemented for providing affordable health care services for Afghan refugees.

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