Creating a learning healthcare system in surgery: Washington State’s Surgical Care and Outcomes Assessment Program (SCOAP) at 5 years

Kwon, Steve; Florence, Michael G.; Grigas, Peter; Horton, Marc; Horvath, Karen D.; Johnson, Morrie; Jurkovich, Gregory; Klamp, Wendy; Peterson, Kristin; Quigley, Terence M.; Raum, William J.; Rogers, T.; Thirlby, Richard C.; Farrokhi, Ellen; Flum, David R.

doi:10.1016/j.surg.2011.08.015

Cited by 79 publications

(41 citation statements)

References 13 publications

(13 reference statements)

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“…SCOAP surveillance is linked to a learning system activity called CERTAIN aimed at identifying emerging targets for Quality Improvement. 12 CERTAIN employs a state of the art survey center that allows for patient-centered comparative effectiveness research and conducts implementation science activities to bring evidence into practice. Spine SCOAP's developmental process and progress in spine care surveillance refl ects the opportunities and challenges in this approach.…”

Section: Discussionmentioning

confidence: 99%

The Spine Surgical Care and Outcomes Assessment Program (Spine SCOAP)

Lee

Shonnard

Farrokhi

et al. 2015

Spine

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Section: Discussionmentioning

confidence: 99%

The Spine Surgical Care and Outcomes Assessment Program (Spine SCOAP)

Lee

Shonnard

Farrokhi

et al. 2015

Spine

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“…The most common are cost,32 , 92 , 93 data interoperability and standardisation,94 – 96 poor data quality and integrity,63 , 97 , 98 informed consent and ethics review complications,99 – 101 privacy and security issues70 , 95 and slow technology adoption 95 , 102 , 103. These issues are seen in the same context for adopting EHR/EMR.…”

Section: Discussionmentioning

confidence: 99%

The Heimdall framework for supporting characterisation of learning health systems

McLachlan¹,

Potts

Dube

et al. 2018

BMJ Health Care Inform

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BackgroundThere are many proposed benefits of using learning health systems (LHSs), including improved patient outcomes. There has been little adoption of LHS in practice due to challenges and barriers that limit adoption of new data-driven technologies in healthcare. We have identified a more fundamental explanation: the majority of developments in LHS are not identified as LHS. The absence of a unifying namespace and framework brings a lack of consistency in how LHS is identified and classified. As a result, the LHS ‘community’ is fragmented, with groups working on similar systems being unaware of each other’s work. This leads to duplication and the lack of a critical mass of researchers necessary to address barriers to adoption.ObjectiveTo find a way to support easy identification and classification of research works within the domain of LHS.MethodA qualitative meta-narrative study focusing on works that self-identified as LHS was used for two purposes. First, to find existing standard definitions and frameworks using these to create a new unifying framework. Second, seeking whether it was possible to classify those LHS solutions within the new framework.ResultsThe study found that with apparently limited awareness, all current LHS works fall within nine primary archetypes. These findings were used to develop a unifying framework for LHS to classify works as LHS, and reduce diversity and fragmentation within the domain.ConclusionsOur finding brings clarification where there has been limited awareness for LHS among researchers. We believe our framework is simple and may help researchers to classify works in the LHS domain. This framework may enable realisation of the critical mass necessary to bring more substantial collaboration and funding to LHS. Ongoing research will seek to establish the framework’s effect on the LHS domain.

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“…125 In fact, payers who funded provider participation in registry-based initiatives of quality improvement saw the cost per appendectomy decrease from $16,000 to $14,000, whereas those who did not participate had an in cost increase from $17,000 to $20,000 per case. 81 Furthermore, the financial cooperation builds trust between payers and providers. In the long run, payer financing of clinical registries could serve as a means of decreasing cost and gaining provider buy in for initiatives in quality improvement.…”

Section: Discussionmentioning

confidence: 99%