Data Integration in Learning Health Care Systems for Traumatic Brain Injury Proceedings of a Workshop (2024) / Chapter Skim
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4 Use of Learning Health Care Systems to Improve Care for Traumatic Brain Injury
4 Use of Learning Health Care Systems to Improve Care for Traumatic Brain Injury
Pages 27-36
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From page 27... ...
• The U.S. Department of Veterans Affairs strives to offer inte grated, individualized, and interdisciplinary delivery of quality, long-term TBI care that maximizes patient outcomes.
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From page 28... ...
Innovation Center's role in testing, learning, and scaling approaches for more effective care delivery and payment; the digital and analytic infrastructure needed to develop and maintain LHSs, examples of operationalizing LHS principles at New York University Langone Health, and how the Department of Veterans Affairs models the concept of an LHS for veterans with TBI. Participants explored the use of such systems to identify gaps, barriers, and strategies to effectively address institutional needs, including how their organizations use data and innovation to improve health care delivery.
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From page 29... ...
Innovation in care delivery is not limited to tested models, and CMMI's learning and diffusion group and evaluation teams work to examine, understand, and enable innovative practices that benefit patients. As innovators develop practices that increase the patient experience of affordability, coordination, and access, CMMI considers the payment models needed to encourage these practices.
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From page 30... ...
Each September, NYU Langone Health activates an electronic alert instructing nurses to administer flu shots to patients. Several years ago, Horwitz and colleagues realized that the flu shot alert was initiated 22 times per patient per day, and was ignored 99.5 percent of the time, even though it resulted in 90 percent of eligible patients receiving the vaccination prior to discharge.
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From page 31... ...
A feedback loop could collect and analyze such data to inform TBI care. The ability to generate readily and rigorously evaluable data is not reliant on receiving large grants, said Horwitz, noting that her team at NYU Langone Health has conducted approximately 30 randomized trials in the absence of funding from the National Institutes of Health.
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From page 32... ...
The LHS strategies of building feedback loops, capturing higher-quality data, and conducting randomized trials help illustrate opportunities applicable to advancing learning systems for TBI care. Veterans Affairs Washington, D.C., Health Care System Joel Scholten, executive director of Physical Medicine & Rehabilitation at the Department of Veterans Affairs (VA)
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From page 33... ...
Partnering with external stakeholders, CMS capitalizes on its ability to use payment models for point-of-care innovation while learning from care delivery experts about practices that improve patient outcomes. To that end, CMMI is building feedback loops with providers, patients, and patient organizations to better understand what patients need and, in turn, establish incentives to shift practice toward meeting those needs.
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From page 34... ...
TBI teams communicate these stories to the community clinics where many veterans receive treatment. Given the 1,000 points of care delivery within the VA system, medical records can span numerous care locations.
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From page 35... ...
Scholten replied that VA uses virtual care in helping address inequity in the geographical availability of TBI care centers and that the federal nature of VA enables nationwide use of virtual care, regardless of state boundaries. Davidson noted that CMMI recently analyzed penetration of value-based care to identify types of providers and geographical areas that these models have not yet reached.
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From page 36... ...
These simple methods are not formal randomized trials but can be used to test different options in a wide range of settings with limited research budgets, including rural care settings. She added that NYU Langone Health has a toolkit available on its website to assist with this process.2 2 See https://med.nyu.edu/centers-programs/healthcare-innovation-delivery-science/sites/default/files/chids-toolkit.pdf (accessed January 3, 2024)
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