F
Workshop Agendas
Digital Infrastructure for the Learning Health System:
The Foundation for Continuous Improvement in Health and Health Care
An Institute of Medicine Workshop Series
Sponsored by the Office of the National Coordinator for
Health Information Technology
Series objectives
- Foster a shared understanding of the vision for the electronic infrastructure for continuous learning and quality-driven health and healthcare programs.
- Explore current capacity, approaches, incentives, and policies; and identify key technologic, organizational, policy, and implementation priorities.
- Discuss the characteristics of potentially disruptive, breakthrough developments.
- Consider strategy options and priorities for accelerating progress on the approach to the infrastructure, and for moving beyond to a more seamless learning enterprise.
Issues motivating the discussion
- Rapid developments in information technology that substantially facilitate potential use of health data for knowledge generation, and expedited application of new knowledge for clinical care.
- Policy initiatives that will lead in the near future to the electronic capture and storage of virtually all clinical data, as well as data from several related areas of health—health care, public health, clinical research—to realize the system’s full potential for individuals and populations.
- Promising potential in federated/distributed approaches that allow data to remain local while still enabling querying and pooling of summary data across systems.
- Ongoing innovation in search technologies with the potential to accelerate use of available data from multiple sources for new insights.
- Meaningful use criteria and health reform provisions that provide starting points and incentives for the development of a learning system for quality improvement and population health, while underscoring the need to be strategic on issues and opportunities, while maintaining flexibility to accommodate breakthrough capacities.
- Need for careful attention to limiting the burden for health data collection to the issues most important to patient care and knowledge generation.
- Requirement for governance policies that foster the data utility for the common good, cultivate the trust fabric with the public and between data sharing entities, and accelerate collaborative progress.
- Availability of standards for aggregation of large pools of data for purposes such as CER, biomarker validation, disease modeling, and improving research processes.
WORKSHOP #1: OPPORTUNITIES, CHALLENGES, PRIORITIES
July 27–28, 2010
Venable Conference Facility
575 Seventh Street NW, Washington, DC 20001
Day One: Tuesday, July 27
8:00am | Coffee and light breakfast available |
8:30am |
Welcome, introductions, and overview o Michael McGinnis (Institute of Medicine) o Charles Friedman (Office of the National Coordinator for Health IT) o Laura Adams (Planning Committee Chair, Rhode Island Quality Institute) |
9:00am |
Session 1: Visioning perspectives on the electronic health utility Individual andpatient perspective Adam Clark (Lance Armstrong Foundation) Practicing clinician perspective James Walker (Geisinger) Quality and safety perspective Janet Corrigan (National Quality Forum) Clinical research perspective Christopher Chute (Mayo Clinic) Population health perspective Martin LaVenture (Minnesota Department of Health) OPEN DISCUSSION |
11:00am |
Session 2: Technical strategies: data input, access, use—and beyond Building on the foundation of meaningful use Doug Fridsma (Office of the National Coordinator for Health IT) Interoperability for the learning healthcare system Rebecca Kush (Clinical Data Interchange Standards Consortium) Grids, federations, and clouds Jonathan Silverstein (University of Chicago) Querying heterogeneous data Shaun Grannis (Regenstrief Institute) |
A panel of responders from the quality, clinical research, and population health communities to respond to presentations, share their experiences, and propose solutions. Ida Sim (University of California, San Francisco) John Halamka (Beth Israel Deaconess Medical Center) Robert Kahn (Corporation for National Research Initiatives) OPEN DISCUSSION |
|
1:00pm |
Lunch |
1:30pm |
Session 3: Ensuring engagement of population and patient needs Transparency on cost/outcomes at individual and population levels Mark McClellan (Brookings Institution) Integrated use of personal and population-wide data sources Kenneth Mandl (Harvard University) Optimizing chronic disease care and control Sophia Chang (California HealthCare Foundation) Targeting population health disparities Christopher Gibbons (Johns Hopkins University) A panel of responders to respond to presentations, share their experiences, and propose solutions. Don Kemper (Healthwise) OPEN DISCUSSION |
3:30pm |
Session 4: Weaving a strong trust fabric |
Facilitating and chronicling data use for better health/health care Edward Shortliffe (American Medical Informatics Association) Privacy and consent strategies Deven McGraw (Center for Democracy and Technology) HIPAA and a learning healthcare system Bradley Malin (Vanderbilt) System security Ian Foster (Argonne National Lab) A panel of responders from ongoing collaborative efforts and experts with big-picture perspectives to respond to presentations, share their experiences, and propose solutions. Robert Shelton (Private Access, Inc.) Kristen Rosati (Coppersmith Schermer & Brockelman PLC) Richard Platt (Harvard Pilgrim) OPEN DISCUSSION |
|
5:30pm |
Concluding Keynote David Blumenthal (National Coordinator for Health IT) |
6:00pm |
Adjourn to reception |
Day Two: Wednesday, July 28 |
|
8:30am | Welcome and Recap of First Day |
9:00am |
Session 5: Stewardship and governance in the learning health system Governance coordination, needs, and options Laura Adams (Rhode Island Quality Institute) |
Harmonizing compliance, and enforcement requirements Theresa Mullin (Food and Drug Administration) Research access and prioritization issues Shawn Murphy (Partners Healthcare) A case study in governance: The National Information Governance Board for Health and Social Care (UK) Harry Cayton (National Information Governance Board) A panel of responders from ongoing efforts and experts with big-picture perspectives to respond to presentations, share their experiences, and propose solutions. Rachel Nosowsky (University of California) OPEN DISCUSSION |
|
11:00am |
Session 6: Fostering the global dimension of the health data trust Transform Brendan Delaney (Kings College London) HealthGRID/SHARE Tony Solomonides (University of the West England, Bristol) Global collaborative safety strategies Ashish Jha (Harvard University) Global public health strategies David Buckeridge (McGill University) OPEN DISCUSSION |
12:30pm |
Lunch |
1:00pm |
Session 7: Perspectives on Innovation |
meeting’s discussions, respond to questions, and offer unique insights and novel perspectives on innovation strategies for the electronic infrastructure supporting continuous learning and improvement in health and health care. Daniel Friedman (Population and Public Health Information Services) OPEN DISCUSSION |
|
2:30pm |
Session 8: Breakout sessions |
4:00pm |
Session 9: Reporting back to the group OPEN DISCUSSION |
5:30pm |
Summary, Next Steps, and Concluding Remarks |
6:00pm |
Adjourn |
WORKSHOP #2: THE SYSTEM AFTER NExT
September 7–8, 2010
Keck Center, The National Academies
500 Fifth Street NW, Washington, DC 20001
Day One: Tuesday, September 7
8:00am | Coffee and light breakfast available |
8:30am |
Welcome, introductions, and overview o Harvey Fineberg (Institute of Medicine) o Charles Friedman (Office of the National Coordinator for Health IT) o Laura Adams (Planning Committee Chair, Rhode Island Quality Institute) o Michael McGinnis (Institute of Medicine) |
9:30am |
Three breakout groups: patient and public, technical issues, governance |
12:00pm |
Lunch/Poster session |
1:00pm |
System requirements for technical advancement and innovation |
processing models, vocabulary value sets, human–computer interaction, and security frameworks. Progress is dependent not only on identifying and engaging the specific elements within each set, but on achieving the right balance between the potential for facilitative standardization and the need for adaptive flexibility and innovation. The session will begin with a 10- to 15-minute presentation from a representative from the “Technical advancement and innovation” breakout group. Moderated discussion based on the prioritized questions and solutions presented will follow, including, if/as appropriate, brief input from resource people for the case studies identified. OPEN DISCUSSION |
|
3:00pm |
Break |
3:15pm |
Requirements for establishment of stewardship and governance OPEN DISCUSSION |
5:30pm |
Concluding comments |
6:00pm |
Adjourn to reception |
Day Two: Wednesday, September 8
8:30am |
Welcome |
9:00am |
Requirements for patient and public engagement OPEN DISCUSSION |
11:00am |
Summary, next steps, and concluding remarks |
12:00pm |
Adjourn |
WORKSHOP #3: STRATEGY SCENARIOS
October 5, 2010
House of Sweden
2900 K Street NW, Washington, DC 20007
Tuesday, October 5
8:00am |
Coffee and light breakfast available |
8:30am |
Welcome, introductions, and overview Welcome, framing of the meeting and workshop series, agenda overview |
o Charles Friedman (Office of the National Coordinator for Health IT) o Laura Adams (Planning Committee Chair, Rhode Island Quality Institute) o Michael McGinnis (Institute of Medicine) |
|
9:00am |
Review of strategic options from Workshops 1 and 2 Technical and knowledge generation issues and options Individual engagement issues and options Governance issues and options |
OPEN DISCUSSION | |
10:00am |
Review of practical considerations Emerging communities of excellence Emerging drivers of interoperability, scale, and utility Implications inherent ULS system dynamics Levers for government and ONC as change agent OPEN DISCUSSION |
11:00am |
Breakout groups For their respective areas, groups are asked to —Propose basic principles for approach |
—Consider and revise, as indicated, strategic options from overview, including alternative scenarios —Identify key stakeholders and responsibilities —Postulate timetables and expectations—and related assumptions |
|
12:30pm |
Lunch |
1:00pm |
Technical options, responsibilities, and expectations OPEN DISCUSSION |
2:00pm |
Knowledge generation and use options, responsibilities, and expectations OPEN DISCUSSION |
3:00pm |
Break |
3:15pm |
Governance options, responsibilities, and expectations OPEN DISCUSSION |
4:15pm |
Individual engagement options, responsibilities, and expectations OPEN DISCUSSION |
5:15pm |
Concluding comments |