Midwest Hospital Cloud Forum

September 9, 2013Closing the Loop in Healthcare Analytics - Correlating

Clinical and Administrative Systems with Research Efforts to Deliver Clinical Efficiency in Real Time

John Sharp, MSSA, PMP, FHIMSSCleveland Clinic

Learning Healthcare System

• Adaptation to the pace of changeStronger synchrony of effortsCulture of shared responsibilityNew clinical research paradigmClinical decision support systemsUniversal electronic health recordsTools for database linkage, mining, and useNotion of clinical data as a public goodIncentives aligned for practice-based evidencePublic engagementTrusted scientific brokerLeadership

Grand Challenges in Clinical Decision Support

• Improve the human-computer interface• Disseminate best practices in CDS design, development, and implementation• Summarize patient-level information• Prioritize and filter recommendations to the user• Create an architecture for sharing executable CDS modules and services• Combine recommendations for patients with co-morbidities• Prioritize CDS content development and implementation• Create internet-accessible clinical decision support repositories• Use free text information to drive clinical decision support• Mine large clinical databases to create new

Big Data To Knowledge – BD2K

• NIH initiative

• http://commonfund.nih.gov/bd2k/

• aims to facilitate broad use of biomedical big data, develop and disseminate analysis methods and software, enhance training for disciplines relevant for large-scale data analysis, and establish centers of excellence for biomedical big data.

IBM Watson

• Clinical Decision support

• Artificial intelligence

• add a natural language and semantic layer on top of a search engine

• evaluates each potential answer based on evidence it can gather through refined secondary search

• http://www.ibm.com/developerworks/library/os-ind-watson/

Query Health

• http://wiki.siframework.org/Query+Health

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Distributed Queries

• Distributed Query Challenges• Absence of standards• Integrating each data source is a heavy lift• cross-organizational governance

• Yet, path-breaking work is underway• ISDS Distribute• Primary Care Information Project• FDA’s Mini-sentinel• HMO Research Network• MDPHNet• i2b2 / SHRINE networks• DARTNet• OMOP• CDC’s BioSense 2.0

• Questions that return population measures (aggregate results) related to disease outbreaks, post-market surveillance, prevention, quality performance, etc.

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Distributed Query ExampleMini-Sentinel & PopMedNet

• PopMedNet is proven across several distributed query networks, including Mini-Sentinel

• Uniquely supports the policy guidance from HIT Policy Committee

• Targeting full implementation of the Query Health proposed standards

A Vision for Broader Use of Electronic Health Information in Evidence Development

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