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.

Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.

Advances in digital and information technology have meant that medical informatics and its associated fields are of ever-increasing importance in the modern healthcare environment. This book presents selected papers from the 63rd annual conference of the German Society of Medical Information Sciences, Biometry, and Epidemiology, GMDS 2018, held in Osnabrück, Germany, in September 2018. The society encompasses not only medical informatics, biometry and epidemiology, but also medical bioinformatics, systems biology and health data management. The title of this year’s conference is “The Learning Health System: Research Based, Innovative, Connecting”, and 38 full papers of the 164 oral presentations and 65 posters delivered at the conference are included here. A wide variety of scientific topics are covered, including standards to enable the interoperable interchange of information; metadata management; record linkage; IT issues for health care networks; interprofessional teaching and training; eHealth legislation; analysis of miRNAs and RNA-Seq data, among others. The contributors are all specialists in their field, and this book disseminates some of the innovative ideas which are urgently needed to meet the challenges facing a constantly developing digital healthcare environment.

This volume reports on discussions among multiple stakeholders about ways they might help transform health care in the United States. The U.S. healthcare system consists of a complex network of decentralized and loosely associated organizations, services, relationships, and participants. Each of the healthcare system's component sectors-patients, healthcare professionals, healthcare delivery organizations, healthcare product developers, clinical investigators and evaluators, regulators, insurers, employers and employees, and individuals involved in information technology-conducts activities that support a common goal: to improve patient health and wellbeing. Implicit in this goal is the commitment of each stakeholder group to contribute to the evidence base for health care, that is, to assist with the development and application of information about the efficacy, safety, effectiveness, value, and appropriateness of the health care delivered.

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

Genomic and Precision Medicine: Foundations, Translation, and Implementation highlights the various points along the continuum from health to disease where genomic information is impacting clinical decision-making and leading to more personalization of health care. The book pinpoints the challenges, barriers, and solutions that have been, or are being, brought forward to enable translation of genome based technologies into health care. A variety of infrastructure (data systems and EMRs), policy (regulatory, reimbursement, privacy), and research (comparative effectiveness research, learning health system approaches) strategies are also discussed. Readers will find this volume to be an invaluable resource for the translational genomics and implementation science that is required to fully realize personalized health care. - Provides a comprehensive volume on the translation and implementation of biology into health care provision - Presents succinct commentary and key learning points that will assist readers with their local needs for translation and implementation - Includes an up-to-date overview on major 'translational events' in genomic and personalized medicine, along with lessons learned

"Public health is concerned with the process of mobilizing local, state/provincial, national, and international resources to assure the conditions in which all people can be healthy (Detels and Breslow 2002). To successfully implement this process and to make health for all achievable, public health must perform the functions listed in Box 1.1.1"--

The Manual of Clinical Oncology, Ninth Edition, published with the International Union Against Cancer (UICC), provides a concise, accessible and feasible reference covering state of art multidisciplinary clinical oncology in order to meet the needs of clinicians caring for cancer patients throughout the world. Edited by world-renowned practising oncologists and written by key opinion leaders, this book contains authoritative and up-to-date information on cancer detection, diagnosis and treatment alongside topics such as survivorship, special populations and palliative care. Remodelled and revised for the ninth edition to provide practical information to oncology workers, the UICC Manual of Clinical Oncology is structured in two parts. Part 1 covers general principles of cancer diagnosis and management with additional attention to special settings in oncology, including supportive care and survivorship, and Part 2 covers site-specific multidisciplinary cancer management. The edition includes up-to-date summaries of all treatment modalities (medical, surgical and radiation) for all tumour sites. It also contains the latest TNM classifications outlined in the TNM Classification of Malignant Tumours. The ninth edition includes: Practical presentation with bullet points, tables, and flow charts intended to facilitate quick reference for day-to-day clinical practice in busy oncology environments, Representation of multidisciplinary care for site specific management, Evidence-based approaches to management, including specific treatment recommendations and investigations guided by clinical practice guidelines, State of art evidence-based recommendations that take into consideration the lack of availability of certain medications or resources, as well as practice variations, in different and remote regions of the world, and Contemporary topics on cancer treatment, such as cancer informatics, evidence levels, principles of prognostication, survivorship and cancer in pregnancy. Oncologists, oncologists-in-training, nurses working with cancer patients and other health professionals responsible for treating and caring for those with cancers will find the UICC Manual of Clinical Oncology an indispensable and comprehensive resource.

Recent scientific and technological advances have accelerated our understanding of the causes of disease development and progression, and resulted in innovative treatments and therapies. Ongoing work to elucidate the effects of individual genetic variation on patient outcomes suggests the rapid pace of discovery in the biomedical sciences will only accelerate. However, these advances belie an important and increasing shortfall between the expansion in therapy and treatment options and knowledge about how these interventions might be applied appropriately to individual patients. The impressive gains made in Americans' health over the past decades provide only a preview of what might be possible when data on treatment effects and patient outcomes are systematically captured and used to evaluate their effectiveness. Needed for progress are advances as dramatic as those experienced in biomedicine in our approach to assessing clinical effectiveness. In the emerging era of tailored treatments and rapidly evolving practice, ensuring the translation of scientific discovery into improved health outcomes requires a new approach to clinical evaluation. A paradigm that supports a continual learning process about what works best for individual patients will not only take advantage of the rigor of trials, but also incorporate other methods that might bring insights relevant to clinical care and endeavor to match the right method to the question at hand. The Institute of Medicine Roundtable on Value & Science-Driven Health Care's vision for a learning healthcare system, in which evidence is applied and generated as a natural course of care, is premised on the development of a research capacity that is structured to provide timely and accurate evidence relevant to the clinical decisions faced by patients and providers. As part of the Roundtable's Learning Healthcare System series of workshops, clinical researchers, academics, and policy makers gathered for the workshop Redesigning the Clinical Effectiveness Research Paradigm: Innovation and Practice-Based Approaches. Participants explored cutting-edge research designs and methods and discussed strategies for development of a research paradigm to better accommodate the diverse array of emerging data resources, study designs, tools, and techniques. Presentations and discussions are summarized in this volume.

Science-fiction author William Gibson is famously quoted as saying, “The future is already here – it's just not very evenly distributed.” During the Covid pandemic, telehealth and remote monitoring were elevated from interesting innovations to essential tools in many healthcare systems, but not all countries had the infrastructure necessary to pivot quickly, amply demonstrating the negative consequences of the digital divide. This book presents the proceedings of MedInfo 2023, the 19th World Congress on Medical and Health Informatics, held from 8 – 12 July 2023 in Sydney, Australia. This series of biennial conferences provides a platform for the discussion of applied approaches to data, information, knowledge, and wisdom in health and wellness. The theme and title of MedInfo 2023 was The Future is Accessible, but the digital divide is a major concern for health and care-informatics professionals, whether because of global economic disparities, digital literacy gaps, or limited access to reliable information about health. A total of 935 submissions were received for the conference, of which 228 full papers, 43 student papers and 117 posters were accepted following a thorough peer-review process involving 279 reviewers. Topics covered include: information and knowledge management; quality, safety and outcomes; health data science; human, organizational and social aspects; and global health informatics. Significant advances in artificial intelligence, machine learning, augmented reality, virtual reality, and genomics hold great hope for future healthcare planning, delivery, management, education, evaluation, and research, and this book will be of interest to all those working to not only exploit the benefits of these technologies, but also to identify ways to overcome their associated challenges.