LHS.medicine.umich.edu @umichDLHS The Department of Learning Health Sciences, University of Michigan Medical School: A First-of-Its Kind Department Chaired by Charles P. Friedman, PhD Prepared for the MIDAS Symposium, October 6, 2015
LHS.medicine.umich.edu @umichDLHS
The Department of
Learning Health Sciences, University of Michigan
Medical School: A First-of-Its Kind Department
Chaired by Charles P. Friedman, PhD
Prepared for the MIDAS Symposium, October 6, 2015
Content Title A New Basic Science Department The Department of Learning Health Sciences is a new basic science department dedicated to the learning sciences in health, from individuals up to ultra large scale systems that span states and nations. The Department was created in May 2014 as an evolution of the Department of Medical Education.
A New Perspective on Learning Learning is a continuous process of study, reflection, and change leading to improvement. This learning can happen at multiple levels, by: • Individuals • Teams • Organizations • Regional, national, and international
systems.
Individual
Team
Organization
Large Scale System
A Learning Health System is an organization or network of organizations that can continuously study and improve itself. Fundamental to the concept, which was pioneered by the Institute of Medicine in 2007, is the capacity and commitment to reshape every healthcare interaction to rapidly study and adapt the system.
Creating a Scalable and Sustainable Learning Health System
A Learning Health System is based on learning cycles that include data and analytics to generate knowledge and feedback of knowledge to stakeholders, with the goal to change behavior and transform practice.
Creating a Scalable and Sustainable Learning Health System
“A LHS works through the implementation of virtual cycles of studying, learning and improvement. The key to where we eventually want to go, very importantly, needs to be understood as not only including establishing a number of learning cycles going on, but also creating a platform that sits underneath all of them, supports all of them, and makes them efficient.”
Charles P. Friedman
Creating a Scalable and Sustainable Learning Health System
1. Every consenting patient’s characteristics and experience are available for study
2. Best practice knowledge is immediately available to support decisions
3. Improvement is continuous through ongoing study
4. This happens routinely, economically and almost invisibly
5. All of this is part of the culture
Creating a Scalable and Sustainable Learning Health System, where:
Healthcare delivery systems & research networks must run many complete learning cycles simultaneously, each addressing a different problem.
High functioning learning health systems raise many deep scientific challenges.
Enabling learning that is effective, continuous, sustainable, routine, and at any level of scale requires multiple disciplines.
Creating a Scalable and Sustainable Learning Health System
Through its Learning Health System initiatives, the department has research and service partnerships that reach across clinical areas across the medical school, across disciplines across 10 schools and colleges at the University of Michigan, and around the world through partnerships with other health organizations.
Bringing Together Diverse, World-Class Expertise
• Data Science • Machine Learning • Semantics • Knowledge
Representation • Knowledge
Management • Decision Science • Communication • Human Factors
• Organizational Psychology
• Behavior Change • Implementation
Science • Economics • Policy Analysis &
Design • Complexity & System
Science
Bringing Together Diverse, World-Class Expertise in:
The Division of Learning and Knowledge Systems primarily focuses on learning at the organizational and system levels.
The Division of Professional Education primarily addresses learning by individuals and teams in preparation for careers as health educator-leaders.
The Clinical Simulation Center focuses on learning by individuals and teams in environments with advanced simulation technology that model the real world of clinical practice.
Bringing Together Diverse, World-Class Expertise
The department aims to generate and communicate new knowledge that advances the sciences of learning applied to health.
Future Direction: Research
On October 1, 2015, University of Michigan began a three-year contract with PCORI to create a new Clinical Data Research Network called LHSnet with 9 partner organizations across U.S.
Future Direction: Research
A national scale Learning Health System, with meaningful use of electronic medical records, widespread participation by multiple diverse entities, and an appropriate technical architecture can spur the construction of a highly participatory rapid learning system that stretches from coast to coast.
Source: Charles P. Friedman et al., Sci Transl Med 2010;2:57cm29 Published by AAAS
Future Direction: Research
The department aims to prepare a next genera1on of educators and learning scien1sts by developing new graduate level programs and by integra1ng learning sciences into health professional curricula.
Future Direction: Education
The department promotes learning and learning systems at all levels of scale.
Locally, together with the Brehm Center for Diabetes Research, we are engaging individuals across the university to create a scalable and replicable diabetes-‐focused Learning Health System within the University of Michigan Health System. Several clinicians have joined as faculty champions. Topics for learning cycles are in discussion.
Future Direction: Service
Across the state, the department ac1vely supports an ini1a1ve called Learning Health for Michigan, first convened by the Center for Healthcare Research in July 2014. Learning Health for Michigan is a collabora1ve grassroots effort among mul1ple and diverse stakeholders statewide aimed at realizing a state-‐level Learning Health System across Michigan.
Future Direction: Service
“As we were talking to some of our leading authorities [in University of Michigan] on quality-related research [in Diabetes], they expressed frustration at the challenge of getting their findings adopted even at their own institution because there’s no system in place to do that. A learning health system bridges that gap between research and clinical care. We’ll do things that aren’t quite formalized research but will allow our system to learn from patients and enhance our care.”
Dorene Markel
Bridging Research and Clinical Care
Beyond Precision Medicine
“[In our envisioned Learning Health System approach for Diabetes], as more and more patients are tracked, [our app] would discover – based on the last 100 patients like you who had similar levels of activity, blood sugar, and diet – this is the way the correction factor should be modified. Over time the phrase ‘like you’ would become more and more refined… We want to create an interaction where this app is like a trusted friend who delivers messages in way that reinforces a patient’s values and goals for her health.”
Larry An
Learning Systems Beyond Health
“The Learning Health System (LHS) requires a new and significant crossing of capabilities that today are present only in largely disconnected communities… There will be important lessons for how to leverage large amounts of real-world data, mechanisms for learning from such data, feedback components aimed at mobilizing lessons learned to inform decisions and actions, and cyber-social ecosystems - entailing networks of computers, machines, people, and organizations - to improve performance and bring about transformation in many other sectors outside of health.”
Friedman et al. Toward a Science of Learning Systems. JAMIA, Nov. 2014