Duke University is one of 13 institutions that have been awarded funds by the American Association of Medical Colleges (AAMC) through the Learning Health System Challenge and Planning Awards. These awards go to institutions with proposals for innovative, system-wide processes that improve the opportunity for research within quality improvement, health equity, and research using data from electronic health records.
Duke will use its award to create the Duke University Hospital Learning Health System Training Program (LHSTP), said Amy Abernethy, MD, PhD, associate professor of medicine (Medical Oncology) and director of the Center for Learning Health Care.
“A Learning Health System is an environment in which practice analysis and integration of best available evidence in clinical practice are intertwined to provide optimal patient care,” said Abernethy.
The learning health system, explained Abernethy, can exist at multiple levels, including within individual provider practices, hospitals, health systems and on a national level through mechanisms of data sharing and analysis with the goal of improving health care. Data from the routine clinical care of individual patients will be aggregated and evaluated to better understand routine clinical care. "This will allow trainees to better understand how their current practice compares to the existing evidence base, to incorporate their understanding of their own patients’ clinical outcomes as a result, and to alter their practice to improve their individual care of patients," said Abernethy.
The Duke LHSTP will develop and pilot a graduate medical education curriculum to prepare physician trainees for this new model of health care.
“The LHSTP will train resident physicians in the skills needed to become physicians who are able to understand and obtain individual patient and clinician practice level data from the LHS as data scientists, analyze the data to inform current clinical questions and processes, integrate findings with published research evidence to practically solve clinical problems,” said Aimee Zaas, MD, MHS, program director for the Duke Internal Medicine Residency Program.
Through this program, trainees will acquire the skills to use data from their own practices to support ongoing, practical improvement, and ultimately transform individual and system-wide clinical practice patterns to realize the goal of providing high-value care that seeks to provide the best care to the individual patient without unnecessary costs to the patient or the health system.
In an initial pilot, the LHSTP will implement a novel educational program to train high-level users of the LHS. These individuals, referred to as “Trailblazers,” will be equipped with the skills necessary to build evidence and advance LHS-based initiatives across their disciplines and the Duke University Health System. Trailblazers will receive intensive training in clinical data structure, informatics, data visualization and statistics. This training will prepare trainees to better understand existing patterns of care and to alter clinical practice to improve quality and patient outcomes.
The LHSTP Trailblazers, who will begin in January 2014, are:
The learning health system, explained Abernethy, can exist at multiple levels, including within individual provider practices, hospitals, health systems and on a national level through mechanisms of data sharing and analysis with the goal of improving health care. Data from the routine clinical care of individual patients will be aggregated and evaluated to better understand routine clinical care. "This will allow trainees to better understand how their current practice compares to the existing evidence base, to incorporate their understanding of their own patients’ clinical outcomes as a result, and to alter their practice to improve their individual care of patients," said Abernethy.
The Duke LHSTP will develop and pilot a graduate medical education curriculum to prepare physician trainees for this new model of health care.
“The LHSTP will train resident physicians in the skills needed to become physicians who are able to understand and obtain individual patient and clinician practice level data from the LHS as data scientists, analyze the data to inform current clinical questions and processes, integrate findings with published research evidence to practically solve clinical problems,” said Aimee Zaas, MD, MHS, program director for the Duke Internal Medicine Residency Program.
Through this program, trainees will acquire the skills to use data from their own practices to support ongoing, practical improvement, and ultimately transform individual and system-wide clinical practice patterns to realize the goal of providing high-value care that seeks to provide the best care to the individual patient without unnecessary costs to the patient or the health system.
In an initial pilot, the LHSTP will implement a novel educational program to train high-level users of the LHS. These individuals, referred to as “Trailblazers,” will be equipped with the skills necessary to build evidence and advance LHS-based initiatives across their disciplines and the Duke University Health System. Trailblazers will receive intensive training in clinical data structure, informatics, data visualization and statistics. This training will prepare trainees to better understand existing patterns of care and to alter clinical practice to improve quality and patient outcomes.
The LHSTP Trailblazers, who will begin in January 2014, are:
- Lynn Howie, MD, MA, PGY 5, Fellow, Division of Medical Oncology and Duke Clinical Research Institute
- Angela Lowenstern, MD, PGY 2, Internal Medicine Resident
- Aaron Mitchell, MD, PGY 3, Internal Medicine Resident
- Krish Patel, MD, PGY 5, Chief Resident of Internal Medicine for Duke University Hospital
- Kevin Shah, MD, MBA, PGY 3, Internal Medicine Resident, Management and Leadership Pathway
- Nicholas Wysham, MD, PGY 4, Fellow, Pulmonary and Critical Care Medicine
- Aimee Zaas, MD, MHS, Associate Professor, Division of Infectious Diseases, Program Director, Internal Medicine Residency Program
- Amy Abernethy, MD, PhD, Associate Professor, Division of Medical Oncology, Director, Center for Learning Health Care, Duke Clinical Research Institute
- Greg Samsa, PhD, Associate Professor of Biostatistics and Bioinformatics, Duke University School of Medicine
- Jonathan Bae, MD, Assistant Professor, Division of Hospital Medicine, Associate Director for Quality, Duke Hospital Medicine, Associate Program Director for Quality and Safety, Duke Medicine Residency Program
- Alex Cho, MD, MBA, Assistant Professor, Division of General Internal Medicine, Associate Program Director for Ambulatory Medicine, Internal Medicine Residency Program
- Bradford Hirsch, MD, MBA, Assistant Professor, Division of Medical Oncology, Center for Learning Health Care, Duke Clinical Research Institute
- Thomas LeBlanc, MD, MA, Assistant Professor, Division of Cellular Therapy, Center for Learning Health Care, Duke Clinical Research Institute
- Lynn Howie, MD, MA, Fellow, Divisions of Hematology, Medical Oncology and Cellular Therapy, Center for Learning Health Care, Duke Clinical Research Institute
- Matthew Harker, MBA, MPH, Operations Director, Center for Learning Health Care, Duke Clinical Research Institute
- Nrupen Bhavsar, PhD, Center for Learning Health Care, Duke Clinical Research Institute
- Thomas Kaminski, MBA, Executive Director, Duke Institute for Health Innovations
- Chelsea Bernheisel, Administrative Coordinator, Center for Learning Health Care, Duke Clinical Research Institute