Assessing the feasibility of the Learning Healthcare System toolbox

Patient transition through healthcare services often includes various treatments delivered by GPs, hospitals and homecare. Every step in this process generates information, which is important for further treatment of the patient. However, to the current date, sharing of such data is limited to referral letters and discharge letters exchanged between primary, secondary and homecare. The format and content of the information about the patient is given, often prevents clinicians from efficiently getting a holistic view of the treatment helping to optimize the recovery of patients. While clinical information on the treatment is collected by the healthcare services, the patient often has his/her own goals, preferences and expectations for the recovery process (for example, to be able to hike his/her favorite mountain again). These factors can be very important motivational factors, especially for the patients with chronic conditions. Healthcare services are often unaware of patient's position towards recovery, as it is not documented. This project aimed to provide a holistic view of treatment (GPs, hospitals and homecare) and its compliance with the goals, preferences and expectations of the patient. Experience from collaborating research projects show that bringing clinical data from all collaborating healthcare institutions together help tailoring the treatment strategies according to the patient goals and maximize the personalization of care. This reduces morbidity and cost. The project has designed, implemented and deployed an IT infrastructure that in the coming years, if supported, will enable evaluating the effect and the feasibility of learning healthcare system tools and interventions on the health service on a large scale.

Den tekniske infrastruturen dette prosjektet har utviklet videreføres som IT infrastrukturen for PraksisNett - den nasjonale forskningsinfrastrukturen for primærhelestjenesten. Denne infrastrukturen muliggjør en tettere kobling mellom forskning og klinisk praksis og gjør det mulig å evaluere intervensjoner på primærhelstjenesten i stor skala. Se mer detaljer i resultatrapporten.

Learning Healthcare System (LHS) is an emerging paradigm that promotes reuse of electronic health data collected in clinical practice to generate knowledge and fast feedback to the clinicians in form of guidelines and decision support. This project aims to create a LHS infrastructure that provides the healthcare service with a holistic view of patient care using data collected in hospitals, GP offices, and homecare (clinical perspective). In addition, we propose patient self-reported profiles, representing personal health-related goals, outcomes, preferences and experiences (patient-reported perspective). Minimizing potential gaps between the two perspectives is the main goal of the project. The project is structured as a loop, starting with extraction of clinical practice and patients` reporting. Data analysis and visualization enables comparison of the clinical and patient perspectives of health. The discovered trends are presented to focus groups of clinical experts for qualitative evaluation, then fed back to clinical practice, starting a new iteration, refining the models from the previous one. The proposal combines the experiences from a number of ongoing research initiatives: distributed extraction and processing of healthcare data, secure multiparty computation, archetype-based modeling and transformation, development of collaboration mechanisms within healthcare. National and international experts are putting together their effort and knowledge to develop an innovative healthcare system in Norwegian municipalities. The project serves as a pilot study, evaluating the response of the current healthcare service to the novel paradigms. It delivers the premises for implementing LHS on a national scale.