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Research initiative uses Big Data to improve patient care

Researchers at the University of Colorado College of Nursing are participating in an initiative to improve health care outcomes and efficiencies by using large clinical and administrative data in a pediatric acute care setting. The project was funded by a grant received from Data Science to Patient Value (D2V) from the CU School of Medicine.

D2V is a multidisciplinary research initiative that funds projects focusing on using technology and Big Data and their applications to health care through collaborations with multiple stakeholders, including providers, patients, health systems, payers and policy makers. Also playing key roles in the initiative are the CU College of Nursing and the Colorado School of Public Health (ColoradoSPH).

Using Big Data

The use of Big Data to improve health-care delivery is being studied by Principal Investigator John Welton, PhD, RN, FAAN, and Co-Investigators Marcelo Coca Perraillon, PhD, an assistant professor in the Department of Health, Systems, Management & Policy in the ColoradoSPH and Peggy Jenkins, PhD, RN, assistant professor in the College of Nursing. Their study focuses on developing a database warehouse called the Nursing Value Research Data Warehouse (NVRDW) that collects data for each nurse caring for each patient during hospitalization.

The PI for the study, Welton, states, “This is the largest database of its kind to date detailing the overall care delivered by individual nurses and provides exciting potential to better understand the factors leading to better hospital outcomes of care.”

‘This is the largest database of its kind to date detailing the overall care delivered by individual nurses.’ – John Welton, PhD, RN, FAAN

The NVRDW is a large “pool” of data collected from various sources within multiple organizations that can be used to improve patient outcomes or transform health-care systems and deliver quality care to patients. Additionally, it can be used by researchers as a resource to create innovative strategies that improve patient outcomes.

One of the products from the D2V study is the creation of a consortium of three schools of nursing including the University of Kansas and University of Minnesota to share expertise to collect Big Data across multiple institutions in the future and leverage the expertise developed from the D2V project to improve the quality of care and optimizing nursing care to lower health care costs.

“There is a distinct purpose for data stored in the warehouse, such as research or reporting to improve patient outcomes or transform health-care systems,” said Jenkins. “Because so much data are collected in health-care settings, it is important to resource teams working to standardize the data so it can be compared and used to inform innovation.”

Providing Quality Care

Playing a huge role in the future of health care, Big Data is becoming more important to measure the quality of care provided to patients. Jenkins believes that nurses are just one of many individual interprofessional providers of patient care who can help in improving the quality of health care.

Big Data’s impact on health care

With technology becoming more present in the delivery of health-care services, more data is being collected than ever before. From tracking vital signs to discover trends, charting patient care histories through electronic health records, or using multiple patients’ health histories to predict health conditions and create treatment plans, Big Data is being used to reduce costs, create innovative treatments and provide effective care in a timely manner.

“Interprofessional collaboration of data scientists, informaticians, nurse scientists, nurse leaders, academia, clinical practice sites, and industry is necessary to construct data warehouses,” she said.

Although not all hospitals and health-care settings have large database warehouses, the multidisciplinary work at the CU Anschutz Medical Campus is a step in the right direction. Problems such as incompatible data systems could make it hard to import data to use to improve quality of care. Patient confidentiality can also become an issue. With large amounts of data such as electronic health records being housed in one database, it can make patients’ information vulnerable to a security breech, so it is important to have clear protocols in place to make the data secure.

Additionally, Big Data can create higher-value care that is more efficient, effective, higher quality and more cost effective, which can improve the care patients receive from providers in all sectors of the health field. This is particularly essential to nursing care, Jenkins notes.

“Using new methods, nurses are viewed as unique providers of patient care, and the value of quality nursing care provided divided by costs can be measured,” she said. “There is much to be learned about nurse characteristics and processes contributing to quality patient outcomes.”

Welton adds, “We are at the start of our journey to better understand the inner workings of health care by examining the care of each provider. We know a lot about physician care, but we are just beginning to collect data at the individual nurse-patient unit of analysis.”

The foundational D2V project has started a national dialogue on how to use this work to collect increasingly larger datasets to complement the many efforts to improve future health-care systems.

Guest contributor: This story was written by freelance contributor Katherine Phillips

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Data Science to Patient Value initiative strives to maximize big data

Jean Kutner, MD
Jean Kutner, MD, is one of the leaders of the Data Science to Patient Value initiative

When Jean Kutner, MD, MSPH, provides care for patients, she wishes she could spend more time talking with patients about their health and the care they want to receive—and not spending her time on a computer, trying to sort through volumes of health records.

“That’s probably not a good use of our valuable and limited time together,” said Kutner, a general internist and palliative care specialist, chief medical officer of University of Colorado Hospital and associate dean for clinical affairs at the University of Colorado School of Medicine (SOM).

Despite her occasional frustration, Kutner is not against technology—far from it. She wants to unlock its potential to create effective care personalized for each patient.

Kutner co-leads the Data Science to Patient Value (D2V) initiative, a new multidisciplinary program at the University of Colorado Anschutz Medical Campus. The initiative, supported with a $20 million grant from the SOM’s Transformational Research Funding program, has big ambitions.

“Our work could revolutionize how we think about how health care is provided, the patient experience, and how we make decisions,” Kutner said. “Our goal is to make CU Anschutz a leader in the intersection between data and value and the application of cutting-edge data science to the value equation.”

Personalizing big data

Right now, the volume of clinically relevant data in health records and from other sources can be overwhelming. Initiatives like D2V could fix that and develop technologies that create a new era in health care. Kutner thinks in the future supercomputers will help diagnose and treat patients, and that will lead to real improvements in their health and maximize the doctor-patient relationship.

“This is personalized medicine focused on a patient’s goals and values, and not necessarily on their genome,” Kutner said.

She gives the hypothetical example of a patient just discharged from the hospital. In a few years, a doctor could use an activity tracker like a Fitbit to see if the patient exercises and gets out of the house. The doctor would look for signs the patient is not recovering or has developed other health problems.

Kutner said the clinical team could see the data and reach out to the patient, checking on their status and, if necessary, asking the patient to come in to be evaluated. Before the visit, a supercomputer could analyze the patient’s data and compare it to data collected from tens of millions of other people. The analysis could create a personalized risk profile with suggestions for a custom treatment plan based on proven therapies. At the start of the next appointment, a doctor could see that information in single user-friendly dashboard.

“With all that data already synthesized, I could get the most value out of face-to-face time with a patient and help them make decisions about their treatment,” Kutner said. “That would be my ideal world.”

Physicians would still have important roles, Kutner said. The doctor and patient would use their time together to talk about what problems are arising and focus on their patients’ priorities. They would work together to get back on track.

Value from the patient’s perspective

While D2V is working on technological innovation in fields such as medical informatics, biostatistics and data visualization, Kutner said it also will address the more philosophical question of how to define value. It is not a simple question.

“If I’m a patient, I might define value differently than an insurer or a health care provider,” Kutner said. Patients can have unsatisfactory experiences despite being what doctors might consider success stories.

D2V will address that disconnect by including stakeholders such as patient advocates and experts in public health and the insurance industry. Kutner believes that will keep the project focused on the ultimate goal, which is improving care.

Building technology and a team

D2V started work in 2016 by recruiting experts from across CU Anschutz. Kutner wants to take advantage of CU Anschutz’s collaborative environment and current faculty members, researchers and staff.

“We have unique expertise here. We have outstanding data scientists. We have people who do world-leading work in care decision making and understanding stakeholder perspectives,” Kutner said. “We need to connect them behind a common goal.”

D2V also recruits researchers from around the world, with more people hired each month. Guest speakers from other leading institutions have given seminars to spark ideas.

Eight pilot projects are underway. They include a team trying to improve the databases that track children who have severe asthma attacks. That project’s goal is to test whether risk profiles can help create personalized predictions of when children might suffer attacks.

D2V will fund an additional six pilot projects in 2017 and is accepting project proposals through March 15.

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Center for Global Health receives Gates Foundation grant for groundbreaking research

CU Anschutz announced today that it is a Grand Challenges Explorations winner, an initiative funded by the Bill & Melinda Gates Foundation. Kathryn Colborn, PhD, assistant research professor at the CU School of Medicine and senior investigator with the Center for Global Health at the Colorado School of Public Health, will pursue an innovative global health and development research project titled “Development of an automated early warning system for malaria transmission using machine learning.”

Kathrun Colborn
Kathryn Colborn

Grand Challenges Explorations (GCE) supports innovative thinkers worldwide to explore ideas that can break the mold in how we solve persistent global health and development challenges. Colborn’s project is one of more than 55 Grand Challenges Explorations Round 17 grants announced today by the Bill & Melinda Gates Foundation.

To receive funding, Colborn and other Grand Challenges Explorations winners demonstrated in a two-page online application a bold idea in one of six critical global heath and development topic areas.  The foundation will be accepting applications for the next GCE round in February 2017.

Using data from Mozambique, Colborn, in collaboration with her husband, James, seeks to show how novel statistical models and online tools can change the way people are surveying, predicting and responding to areas of high malaria transmission. It focuses on innovations in malaria elimination analytics, specifically the training of algorithms using supervised learning, an advanced computing task, on demographic health surveys and satellite data. The methods will be disseminated through GitHub, a code repository and version control system, and can be made available for free to anyone in the world.

“Ideally, the malaria analytics tools we develop would be used by Mozambique’s Ministry of Health to predict future monthly case rates and to help in their prevention planning,” Colborn said.

At CU Anschutz, scientists engage in high-profile studies that contribute new information about the nature and treatment of disease to the rest of the world.

mosquito
Malaria is transmitted among humans by female mosquitoes of the genus Anopheles.

Grand Challenges Explorations is a US$100 million initiative funded by the Bill & Melinda Gates Foundation.  Launched in 2008, over 1228 projects in more than 65 countries have received Grand Challenges Explorations grants.  The grant program is open to anyone from any discipline and from any organization.  The initiative uses an agile, accelerated grant-making process with short two-page online applications and no preliminary data required.  Initial grants of US$100,000 are awarded two times a year. Successful projects have the opportunity to receive a follow-on grant of up to US$1 million.

 

 

 

 

 

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