Genomics-Enabled Learning Health Care Systems

Genomics-Enabled Learning Health Care Systems

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2015-07-08

Total Pages: 105

ISBN-13: 0309371155

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The inclusion of genomic data in a knowledge-generating health care system infrastructure is one promising way to harness the full potential of that information to provide better patient care. In such a system, clinical practice and research influence each other with the goal of improving the efficiency and effectiveness of disease prevention, diagnosis, and treatment. To examine pragmatic approaches to incorporating genomics in learning health care systems, the Institute of Medicine Roundtable on Translating Genomic-Based Research for Health hosted a workshop which convened a variety of stakeholder groups, including commercial developers, health information technology professionals, clinical providers, academic researchers, patient groups, and government and health system representatives, to present their perspectives and participate in discussions on maximizing the value that can be obtained from genomic information. The workshop examined how a variety of systems are capturing and making use of genomic data to generate knowledge for advancing health care in the 21st century. It also sought to evaluate the challenges, opportunities, and best practices for capturing or using genomic information in knowledge-generating health care systems. Genomics-Enabled Learning Health Care Systems summarizes the presentations and discussion of the workshop.


Implementing and Evaluating Genomic Screening Programs in Health Care Systems

Implementing and Evaluating Genomic Screening Programs in Health Care Systems

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2018-06-16

Total Pages: 151

ISBN-13: 0309473411

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Genomic applications are being integrated into a broad range of clinical and research activities at health care systems across the United States. This trend can be attributed to a variety of factors, including the declining cost of genome sequencing and the potential for improving health outcomes and cutting the costs of care. The goals of these genomics-based programs may be to identify individuals with clinically actionable variants as a way of preventing disease, providing diagnoses for patients with rare diseases, and advancing research on genetic contributions to health and disease. Of particular interest are genomics- based screening programs, which will, in this publication, be clinical screening programs that examine genes or variants in unselected populations in order to identify individuals who are at an increased risk for a particular health concern (e.g., diseases, adverse drug outcomes) and who might benefit from clinical interventions. On November 1, 2017, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop to explore the challenges and opportunities associated with integrating genomics-based screening programs into health care systems. This workshop was developed as a way to explore the challenges and opportunities associated with integrating genomics-based programs in health care systems in the areas of evidence collection, sustainability, data sharing, infrastructure, and equity of access. This publication summarizes the presentations and discussions from the workshop.


The Learning Healthcare System

The Learning Healthcare System

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2007-06-01

Total Pages: 374

ISBN-13: 0309133939

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As our nation enters a new era of medical science that offers the real prospect of personalized health care, we will be confronted by an increasingly complex array of health care options and decisions. The Learning Healthcare System considers how health care is structured to develop and to apply evidence-from health profession training and infrastructure development to advances in research methodology, patient engagement, payment schemes, and measurement-and highlights opportunities for the creation of a sustainable learning health care system that gets the right care to people when they need it and then captures the results for improvement. This book will be of primary interest to hospital and insurance industry administrators, health care providers, those who train and educate health workers, researchers, and policymakers. The Learning Healthcare System is the first in a series that will focus on issues important to improving the development and application of evidence in health care decision making. The Roundtable on Evidence-Based Medicine serves as a neutral venue for cooperative work among key stakeholders on several dimensions: to help transform the availability and use of the best evidence for the collaborative health care choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and, ultimately, to ensure innovation, quality, safety, and value in health care.


Genomics

Genomics

Author: Hans C. Andersson, MD

Publisher: Millbrook Press

Published: 2020-09-01

Total Pages: 139

ISBN-13: 1728411580

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Over the past 50 years, scientists have made incredible progress in the application of genetic research to human health care and disease treatment. Innovative tools and techniques, including gene therapy and CRISPR-Cas9 editing, can treat inherited disorders that were previously untreatable, or prevent them from happening in the first place. You can take a DNA test to learn where your ancestors are from. Police officers can use genetic evidence to identify criminals—or innocents. And some doctors are using new medical techniques for unprecedented procedures. Genomics: A Revolution in Health and Disease Discovery delves into the history, science, and ethics behind recent breakthroughs in genetic research. Authors Whitney Stewart and Hans Andersson, MD, present fascinating case studies that show how real people have benefitted from genetic research. Though the genome remains full of mysteries, researchers and doctors are working hard to uncover its secrets and find the best ways to treat patients and cure diseases. The discoveries to come will inform how we target disease treatment, how we understand our health, and how we define our very identities.


Best Care at Lower Cost

Best Care at Lower Cost

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2013-05-10

Total Pages: 437

ISBN-13: 0309282810

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America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.


Clinical Decision Support and Beyond

Clinical Decision Support and Beyond

Author: Robert Greenes

Publisher: Academic Press

Published: 2023-02-10

Total Pages: 880

ISBN-13: 0323995772

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Clinical Decision Support and Beyond: Progress and Opportunities in Knowledge-Enhanced Health and Healthcare, now in its third edition, discusses the underpinnings of effective, reliable, and easy-to-use clinical decision support systems at the point of care as a productive way of managing the flood of data, knowledge, and misinformation when providing patient care. Incorporating CDS into electronic health record systems has been underway for decades; however its complexities, costs, and user resistance have lagged its potential. Thus it is of utmost importance to understand the process in detail, to take full advantage of its capabilities. The book expands and updates the content of the previous edition, and discusses topics such as integration of CDS into workflow, context-driven anticipation of needs for CDS, new forms of CDS derived from data analytics, precision medicine, population health, integration of personal monitoring, and patient-facing CDS. In addition, it discusses population health management, public health CDS and CDS to help reduce health disparities. It is a valuable resource for clinicians, practitioners, students and members of medical and biomedical fields who are interested to learn more about the potential of clinical decision support to improve health and wellness and the quality of health care. Presents an overview and details of the current state of the art and usefulness of clinical decision support, and how to utilize these capabilities Explores the technological underpinnings for developing, managing, and sharing knowledge resources and deploying them as CDS or for other uses Discusses the current drivers and opportunities that are expanding the prospects for use of knowledge to enhance health and healthcare


The Thinking Healthcare System

The Thinking Healthcare System

Author: Dominique J Monlezun

Publisher: Elsevier

Published: 2023-02-17

Total Pages: 324

ISBN-13: 0443189072

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The Thinking Healthcare System: Artificial Intelligence and Human Equity is the first comprehensive book detailing the historical, global, and technical trends shaping the evolution of the modern healthcare system into its final form—an AI-driven thinking healthcare system, structured and functioning as a global digital health ecosystem. Written by the world's first triple doctorate trained physician-data scientist and ethicist, and author of three AI textbooks and over 350 scientific and ethics papers, this indispensable resource makes sense of how technology, economics, and ethics are already producing the future's health system—and how to ensure it works for every patient, community, and culture in our globalized, digitalized, and divided world. Providing clear descriptions and concrete examples, this book brings together AI-accelerated digital health ecosystems, data architecture, cloud and edge computing, precision medicine, public health, telemedicine, patient safety, health political economics, multicultural global ethics, blockchain, and quantum health computing, among other topics. Healthcare and business executives, clinicians, researchers, government leaders, policymakers, and students in the fields of healthcare management, data science, medicine, public health, informatics, health and public policy, political economics, and bioethics will find this book to be a groundbreaking resource on how to create, nourish, and lead AI-driven health systems for the future that can think, adapt, and so care in a manner worthy of the world's patients. - Details the first comprehensive, global, and multidisciplinary analysis of the AI-driven transformation of modern healthcare systems into their definitive digitalized form that will dominate the future - Provides clear descriptions and concrete examples of AI-informed value-based healthcare, digital health ecosystems, data architecture, cloud and edge computing, precision medicine, public health, telemedicine, patient safety, health political economics, multicultural and embedded global ethics, blockchain, AI security, health security, digital twins, and quantum health computing - Serves as a practical blueprint, roadmap, and system DNA for creating the future's healthcare system that integrates efficiency and equity to accelerate the treatment (and in some cases even cures) for some of our world's most urgent, immediate, and impending global health challenges and crises


Biomarker Tests for Molecularly Targeted Therapies

Biomarker Tests for Molecularly Targeted Therapies

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2016-07-30

Total Pages: 293

ISBN-13: 0309381347

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Every patient is unique, and the evolving field of precision medicine aims to ensure the delivery of the right treatment to the right patient at the right time. In an era of rapid advances in biomedicine and enhanced understanding of the genetic basis of disease, health care providers increasingly have access to advanced technologies that may identify molecular variations specific to an individual patient, which subsequently can be targeted for treatment. Known as biomarker tests for molecularly targeted therapies, these complex tests have the potential to enable the selection of the most beneficial treatment (and also to identify treatments that may be harmful or ineffective) for the molecular underpinnings of an individual patient's disease. Such tests are key to unlocking the promise of precision medicine. Biomarker tests for molecularly targeted therapies represent a crucial area of focus for developing methods that could later be applicable to other areas of precision medicine. The appropriate regulatory oversight of these tests is required to ensure that they are accurate, reliable, properly validated, and appropriately implemented in clinical practice. Moreover, common evidentiary standards for assessing the beneficial impact of biomarker-guided therapy selection on patient outcomes, as well as the effective collection and sharing of information related to those outcomes, are urgently needed to better inform clinical decision making. Biomarker Tests of Molecularly Targeted Therapies examines opportunities for and challenges to the use of biomarker tests to select optimal therapy and offers recommendations to accelerate progress in this field. This report explores regulatory issues, reimbursement issues, and clinical practice issues related to the clinical development and use of biomarker tests for targeting therapies to patients. Properly validated, appropriately implemented biomarker tests hold the potential to enhance patient care and improve outcomes, and therefore addressing the challenges facing such tests is critical.


Capturing Value in Digital Health Eco-Systems

Capturing Value in Digital Health Eco-Systems

Author: Felix Lena Stephanie

Publisher: CRC Press

Published: 2021-11-10

Total Pages: 260

ISBN-13: 1000476391

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The United Nation's Sustainable Development Goals call for the establishment of Good Health and Well-being and target a universal digital healthcare ecosystem by 2030. However, existing technology infrastructure is ineffectual in achieving the envisioned target and requires massive reconfiguration to achieve its intended outcome. This book suggests a way forward with fair and efficient digital health networks that provide resource efficiencies and inclusive access to those who are currently under-served. Specifically, a fair and efficient digital health network that provides a common platform to its key stakeholders to facilitate sharing of information with a view to promote cooperation and maximise benefits. A promising platform for this critical application is ‘cloud technology’ with its offer of computing as a utility and resource sharing. This is an area that has attracted much scholarly attention as it is well-suited to foster such a network and bring together diverse players who would otherwise remain fragmented and be unable to reap the benefits that accrue from cooperation. The fundamental premise is that the notion of value in a digital-health ecosystem is brought about by the sharing and exchange of digital information. However, notwithstanding the potential of information and communication technology to transform the healthcare industry for the better, there are several barriers to its adoption, the most significant one being misaligned incentives for some stakeholders. This book suggests among other findings, that e-health in its true sense can become fair and efficient if and only if a regulatory body concerned assumes responsibility as the custodian of its citizens’ health information so that ‘collaboration for value’ will replace ‘competition for revenue’ as the new axiom in delivering the public good of healthcare through digital networks.


Intelligent IoT Systems in Personalized Health Care

Intelligent IoT Systems in Personalized Health Care

Author: Arun Kumar Sangaiah

Publisher: Academic Press

Published: 2020-11-06

Total Pages: 362

ISBN-13: 0128232048

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Intelligent IoT Systems in Personalized Health Care delivers a significant forum for the technical advancement of IoMT learning in parallel computing environments across biomedical engineering diversified domains and its applications. Pursuing an interdisciplinary approach, the book focuses on methods used to identify and acquire valid, potentially useful knowledge sources. The book presents novel, in-depth, fundamental research contributions from a methodological/application perspective to help readers understand the fusion of AI with IoT and its capabilities in solving a diverse range of problems for biomedical engineering and its real-world personalized health care applications. The book is well suited for researchers exploring the significance of IoT based architecture to perform predictive analytics of user activities in sustainable health. - Presents novel, in-depth, fundamental research contributions from a methodological/application perspective to help readers understand the fusion of AI with IoT - Illustrates state-of-the-art developments in new theories and applications of IoMT techniques as applied to parallel computing environments in biomedical engineering systems - Presents concepts and technologies successfully used in the implementation of today's intelligent data-centric IoT systems and Edge-Cloud-Big data