The Learning Health System: Democratizing Health Together
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Joshua Rubin's, JD, MBA, MPP, MPH HIMSS Spring 2016 HIE Community Roundtable presentation. http://lhs.medicine.umich.edu/people/joshua-c-rubin
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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
- 16. 73 Days 50X
- 28. “e-Patient Dave” Defines Empowerment
- 31. $750B 1/3
- 37. 3% 11%
- 39. (Brailer, 2015)
- 50. The Blame Game…
- 52. Too Big to Heal?
- 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)
- 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…
- 58. Infrastructure…
- 61. 61 61 Patient Groups Governance Engagement Data Aggregation Analysis Dissemination Pharma Universities Government/Public Health All-Inclusive Decentralized Research Institutes Reciprocal Large Scale Tech Industry
- 62. LHS Infrastructure: A Single Sociotechnical Platform Supports Multiple Simultaneous Learning Cycles
- 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?
- 67. • Technology • Policy • Process • People The Sociotechnical LHS Platform
- 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
- 94. © CDISC 2015 Learning Cycle – From Concept to Framework to Entities and Activities Healthcare Providers Raw Data Analytic Data Inference Guidance Observe, Record Aggregate, Transform Analyze PackageInform Reality Learning Knowledge Representation 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
- 99. Thank You! Joshua C. Rubin, JD, MBA, MPH, MPP Josh@JoshCRubin.com @JoshCRubin