Five dimensions to explore a learning system that promotes continuous innovation in medical care

For decades, modern medicine has made remarkable progress, people's understanding of the disease has become more in-depth, and various new treatment methods have emerged in an endless stream, bringing new hope to patients. However, in a wide range of medical fields, experimental studies, such as randomized controlled trials (RCTs) using strict exclusion criteria, are expensive and often not applicable due to the complexity of health conditions and the heterogeneity of patient characteristics. Patients found in the clinic.

In this case, changes in the medical industry are imminent. In view of this, various research institutions around the world are actively conducting research on a new thing, the “learning medical system”. The Institute of Health and Society (IHS) at the University of Newcastle, UK is an academic research institution with extensive expertise in medical services, public health, epidemiology, professional practice and medical technology research.

Recently, the agency announced its research results funded by The Health Foundation: The Learning Medical System Potential Report. The contents of the Report focus on the development and potential of the learning-based medical system, and the system is explained in detail in terms of background, component modules, use cases, industry influence and future development.

Five dimensions to explore a learning system that promotes continuous innovation in medical care

Background

With the proliferation of information on therapeutic methods and clinical research data in the medical field, today's medical practitioners often barely keep up with the latest developments in his narrow branch. Because of the sheer volume and complexity of research, even the application of evidence-based medicine methods, such as the development of systematic reviews, can only partially solve this problem. This has led to many medical practices still relying on the intuition and prejudice of the researchers.

In addition to the rapid expansion of the evidence base, the medical industry faces challenges such as population growth and aging, rising chronic disease levels, limited budgets, unfair medical care, and high-cost interventions and technological surges, resulting in a gradual reduction in returns from health improvements. In addition, various unreasonable changes in medical practice are becoming less and less accepted.

At the same time, in other industries, the Internet and big data analytics have begun to bring about earth-shaking changes. When this technology is combined with prognostic improvement measurement and system behavior change technology, a "learning medical system" can be obtained. According to the definition of the Institute of Medicine (IoM), the learning-based medical system is a system that harmonizes science, informatics, incentives, and culture to promote continuous improvement and innovation in medical care. Seamlessly embedded into the delivery of medical services and making new knowledge a complete by-product of delivery experience."

Learning medical systems can take many forms, but all forms follow a similar ecological chain, including compiling, analyzing, and interpreting data, and feeding it back into practice and creating changes.

Component module

The data collected regularly within the medical system is the driving force behind the movement of the learning medical system, but how to collect this data in an electronically readable form is a major challenge today. In general, data recorded by clinicians is often incomplete or of poor quality, and the way data is encoded often varies from medical organization to organization, making interoperability difficult between systems. In addition, people need to pay attention to issues related to technology and information management related to data storage methods and locations.

In addition to the data in the medical system, there are more and more data from outside the medical system: the emergence of new wearable technologies and network platforms allows patients to have more control over their health data. Of course, the importance of such technologies remains to be verified.

Prognostic improvement measurement techniques will demonstrate the role of learning medical systems. This measurement is not only reflected in the patient mortality rate, but also includes various levels that have a significant impact on the patient's prognosis. New automated collection methods will reduce the cost of collating such information.

Finally, behavioral change is an important indicator of the success of a learning-based medical system, because everything really makes sense when the behavior of the clinician and patient changes. The advances in current behavioral change research provide the soil for finding comprehensive and evidence-based approaches to systematic behavioral change, and allow people to embed this approach into the implementation of learning-based medical systems.

The public's concern and anxiety about medical data sharing provides an early warning of the controversy that may accompany the implementation of a learning medical system. Under the current ethical framework, clinical practice and research are clearly defined, and it is difficult to adapt to the learning medical system. To this end, a new framework that empowers patients, clinicians, and researchers has emerged.

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