INFORMATICS GRAND ROUNDS
"ADVANCED INFORMATICS FOR QUALITY IMPROVEMENT AND RESEARCH: ENHANCED REGISTRIES TO CREATE A LEARNING HEALTH CARE SYSTEM"
Richard B. Colletti, MD (Department of Pediatrics, University of Vermont; Vermont Children's Hospital, Fletcher Allen Health Care)
Keith Marsolo, PhD (Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati)
Date/Time:
Tuesday, December 14th, 2010
4:00 PM – 5:00 PM
Location:
Medical Education Center Room 300 (Reardon Classroom)
(For remote attendees: http://jadeweb.streamguys.com/~uvm/jwplayer/live.html)
Abstract:
We will describe a project that was recently funded by the Agency for Healthcare Research and Quality (AHRQ). A learning healthcare system comprises a community of front-line clinicians, patients, and scientists who view each clinical encounter as an opportunity to learn and to improve patient outcomes. In its most advanced state, it combines comparative effectiveness (CE) research with quality improvement (QI) science to ensure the delivery of new knowledge at the point of care. Electronic health records have the potential to become the tool for learning at the point-of-care, although most are patient-focused and do not natively support the population management required by a learning healthcare system. Registries are designed to do this, but generally operate independently of institutional EHRs. Over the next 3 years, we will work to change this by building upon existing open-source software to create a modular, versatile, and scalable registry that can be populated by EHRs. We will test its ability to support QI and CE research within the ImproveCareNow practice-based research and improvement initiative. Our specific aims are to: (Aim 1) enhance an existing registry to support a learning healthcare system for pediatric inflammatory bowel disease (IBD) by capturing needed data directly from electronic health records, improving the quality of collected data using new tools we have developed for recording clinical data during a patient encounter, and facilitating interventions to improve the quality of care for children; (Aim 2) use quality improvement methods to implement enhanced IBD-registry features to enable management of IBD care center populations and increase patient participation in care; (Aim 3) use data from the enhanced registry to compare the effectiveness of alternative treatment strategies for pediatric Crohn's Disease patients, with a special focus on timing of biologic agents; (Aim 4) develop governance structures for the network that engages patients and provides oversight of privacy, confidentiality, and data access, as well as scientific and technical concerns. The project will form a unique community of children, families, clinicians, informaticians, QI specialists, and CE researchers who work together to improve patient outcomes using learning healthcare system principles. Our long-term goal is to extend this work to other chronic disease communities devoted to advancing the health of children.
Speaker Bios:
Dr. Richard B. Colletti is the Vice-Chair for Clinical and Research Affairs and Professor of Pediatrics at the University of Vermont, and the Associate Chief of Vermont Children's Hospital at Fletcher Allen Health Care. He is a graduate of the University of Pittsburgh School of Medicine, and completed his residency at Yale University and his fellowship at Texas Children's Hospital, Houston. He is actively engaged in quality improvement and research in pediatric Crohn's disease and ulcerative colitis, and is the Network Director of the national ImproveCareNow Collaborative. He has been the President of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), on the Board of Directors of the Children's Digestive Health and Nutrition Foundation, and Secretary-Treasurer of the Federation of International Societies for Pediatric Gastroenterology, Hepatology and Nutrition. He has co-authored over 90 papers, book chapters and monographs, including five evidence-based clinical practice guidelines, and has given over 140 national and international presentations.
Dr. Keith Marsolo is an Assistant Professor of Pediatrics at Cincinnati Children's Hospital Medical Center and is the Director of Data Warehousing and Software Development in the Division of Biomedical Informatics. He holds a PhD in computer science from The Ohio State University and is an expert in data mining and biological data modeling. Dr. Marsolo is leading the implementation of a research data warehouse at Cincinnati Children's based on the i2b2 informatics framework, as well as development efforts to expand the capabilities of i2b2 to make it a suitable platform for patient registries. As head of Software Development, Dr. Marsolo and his team focus primarily on developing systems for electronic data capture and reporting, creating collaborative Web sites for clients within the Research Foundation, and developing applications in support of grant-funded research.
Other Links:
Informatics Grand Rounds is a joint initiative between the University of Vermont (Center for Clinical and Translational Science Informatics Unit, Continuing Education, and Dana Medical Library), Fletcher Allen Health Care, and the State of Vermont.
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