PatientsChartingCourse

Appendix A

Workshop Agenda

Patients 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

1.Advances. Progress in medical science, basic research, information technology, and operations research offers the potential for immediate, continuous, and transformative improvement in health care.

2.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.

3.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.

4.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.

5.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

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ØCommunicating with patients about their concerns, preferences, and expectations–evidence translation, dissemination, application

Karen Sepucha, Harvard Medical School

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

ØMeaningful use of health information technology

David Blumenthal, Office of the National Coordinator for HIT

ØData linkage, distributed data networks, and infrastructure for clinical research

Daniel Masys, Vanderbilt University

ØHIT and Web 2.0 as a vehicle for patient engagement—at the clinical encounter and beyond

Joseph Kvedar, Center for Connected Health

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

ØPublic and patient information access and use as a core care component

George D. Lundberg, former editor-in-chief (JAMA, eMedicine, and MedScape)

ØHIT-based approaches to care management and shared decision-making

Paul Tang, Palo Alto Medical Foundation

ØHealth and disease management outside the clinic doors

Doriane Miller, University of Chicago Medical Center

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

ØThe role of evidence in patient-centered care—“whatever the patient wants”?

Dale Collins Vidal, Dartmouth Institute for Health Policy and Clinical Practice

ØEvidence standards and application approaches that help get the right care to the right patient at the right time

Clifford Goodman, The Lewin Group

ØTranslation and communication needs for care under evidence uncertainty

Fran Visco, National Breast Cancer Coalition

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

ØPractical experience with collaborative models in the health professions

Allan Frankel, Brigham and Women’s Hospital

ØMeasures and strategies for clinical excellence and continuous improvement

Joyce Lammert, Virginia Mason Medical Center

ØCare cooperation and continuity across clinicians, facilities, and systems

Alice Bonner, Massachusetts Department of Public Health

[Lunch 12:00–12:30]

Appendix B

Biographical Sketches of

Workshop Participants

David Blumenthal, M.D., M.P.P., formerly served as the National Coordinator for Health Information Technology under President Barack Obama. In this role he was charged with building an interoperable, private and secure­ nationwide health information system and supporting the widespread, meaningful use of health information technology (IT). Dr. Blumenthal received his undergraduate, medical, and public policy degrees from Harvard University and completed his residency in internal medicine at Massachusetts General Hospital. Prior to his appointment to the administration, Dr. Blumenthal was a practicing primary care physician; Director, Institute for Health Policy; and the Samuel O. Thier Professor of Medicine and Professor of Health Policy at the Massachusetts General Hospital/Partners HealthCare System and Harvard Medical School. Dr. Blumenthal is a renowned health services researcher and national authority on health IT adoption. With his colleagues from Harvard Medical School, he authored the seminal studies on the adoption and use of health IT in the United States. He is the author of more than 200 scholarly publications, including most recently, “Heart of Power: Health and Politics in the Oval Office,” which tells the history of U.S. presidents’ involvement in health reform, from Franklin D. Roosevelt through George W. Bush. A member of the Institute of Medicine and a former board member and national correspondent for the New England Journal of Medicine, Dr. Blumenthal has held several leadership positions in medicine, government, and academia including Senior Vice President at Boston’s Brigham and Women’s Hospital; Executive Director of the Center for Health Policy and Management and Lecturer on Public Policy at the Kennedy School of Government; and as a professional staff

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