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Institute of Medicine (US); Olsen LA, Saunders RS, McGinnis JM, editors. Patients Charting the Course: Citizen Engagement and the Learning Health System: Workshop Summary. Washington (DC): National Academies Press (US); 2011.
Patients Charting the Course: Citizen Engagement and the Learning Health System: Workshop Summary.
Show detailsPatients Charting the Course: Citizen Engagement and the Learning Health System
A Learning Health System Activity
IOM Roundtable on Value & Science-Driven Health Care
April 1–2, 2010
Keck Center of the National Academies
Washington, DC 20001
Motivating issues and assumptions underlying the discussion
- Advances. Progress in medical science, basic research, information technology, and operations research offers the potential for immediate, continuous, and transformative improvement in health care.
- Performance. In terms of both effectiveness and efficiency, the nation’s healthcare system is underperforming. The United States has the highest health expenditures per capita—twice the per capita average for other developed countries—yet consistently rates no better than the middle tier of developed nations on such key indicators as infant mortality, life expectancy, and overall health system performance.
- Core aim. The core aim of health care is improved outcomes: to maintain or enhance patient status with respect to disease, injury, functional status, or sense of well-being. Yet often the dominant characteristics are more oriented to clinician preferences or interests, and economic rewards for volume over value.
- Anchor foci. The primary foci of care in a manner that emphasizes outcomes should be on the mutually dependent aims of patient-centeredness, better science, better value, and continuous improvement.
- Key elements. Efforts of the IOM and others have fostered a better understanding of the foundation stones of the Learning Health System, and, as discussions continue on health reform, special consideration is warranted on the current priorities and strategies to accelerate progress.
- Communication. Central to progress are the communication strategies necessary to inform and engage the public and patient communities as understanding advocates, partners, and change agents.
Objectives
- Identify the state of play with respect to the foundation stones of the Learning Healthcare System, and the most important priorities and policy levers necessary to accelerate progress.
- Explore and clarify the integral links among the three key aims of care delivered: science-driven, patient-centered, and value-enhancing.
- Discuss communication and public engagement strategies important to improving awareness and action necessary for transformation to a Learning Health System.
DAY ONE
| 9:00 | Keynote: the learning health system—now and to come Overview of the nature and promise of the learning healthcare system for advancing a culture of patient-centeredness, science, and value. Discuss approaches to the key challenges and identify health reform priorities to make a learning healthcare system possible. Harvey Fineberg, Institute of Medicine |
| 9:30 | Session 1: Clinical research, patient care, and learning that is real-time and continuous What is needed to improve the efficiency, effectiveness, and volume of clinical research; and, how might capacity be structured to support a system of real-time and continuous learning that anticipates research needs and produces and applies evidence that is timely, relevant, and applicable to real-world care? Chair: Joel Kupersmith, Veterans Health Administration
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| 11:00 | Session 2: Clinical data as a public good for discovery What is meant by the notion of clinical data as a public good, what is the potential, and how can issues such as de-identification, data integrity, and privacy and security concerns be best addressed? What strategies are needed to better engage patients and the public as advocates? Chair: Karen Smith, AstraZeneca
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| [Lunch 12:30–1:00] | |
| 1:00 | Session 3: Engaging patients to improve science and value in the Learning Health System What is meant—theoretically and practically—by patient engagement in health care, how might health systems better learn from patient participation across health system activities—as consumers, actors and research subjects—and what are the implications related to clinical science, healthcare delivery, and patient engagement strategies? Chair: Myrl Weinberg, National Health Council
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| 2:30 | Session 4: Health information technology as the engine for learning What are the trends and strategies for HIT adoption and how can this infrastructure resource be developed simultaneously as a knowledge engine, a tool for care improvement, and a portal for practical patient engagement? Chair: Murray Ross, Kaiser Permanente
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| 4:00 | Session 5: Patients, clinical decisions, and health management in the information age What lessons can be learned about patient/caregiver needs and expectations from efforts to support active engagement of patients in their healthcare decisions and management; and how might these factors inform priorities and strategies for improving patient involvement and investment in health care? Chair: Michael Fordis, Eisenberg Center and Baylor College of Medicine
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| 5:30 | WRAP-UP COMMENTS |
| 5:45 | RECEPTION |
DAY TWO
| 9:00 | Session 6: Applying evidence for patient-centered care—standards and expectations How do the key precepts of patient-centered care, personalized medicine, and evidence-based medicine interplay and complement each other to yield care that is more effective and efficient; and, what are the implications for shaping a health system to meet these expectations? Chair: William Novelli, Georgetown University
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| 10:30 | Session 7: Team-based care and the learning culture What is meant by team-based care, how might it look in a learning healthcare system, and should, or how should, caregiver culture and practice vary by circumstance? What are the implications for health professions education and training? Chair: J. Michael McGinnis, Institute of Medicine
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| [Lunch 12:00–12:30] | |
| 12:30 | Session 8: Incentives aligned with value and learning What are the key opportunities to better align incentives with elements important for care that is effective, efficient, and adds to learning? Chair: Helen Darling, National Business Group on Health
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| 2:00 | Session 9: Strategies and priorities moving forward A policy-oriented panel to pull together and discuss key themes from workshop presentations on next steps, public perception and opinion and reflect on key opportunities, possible messages, and approaches to encourage greater public engagement in driving system improvements Moderator: J. Michael McGinnis, Institute of Medicine
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- Workshop Agenda - Patients Charting the CourseWorkshop Agenda - Patients Charting the Course
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