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The Duke University Learning Health System Training Program

Project Description: The Duke University Hospital Learning Health System Training Program (LHSTP) will develop and pilot a systemic change in the provision of graduate medical education to better meet the needs of an LHS, preparing them to be practitioners of “evidence based medicine version 2.0 (EBM 2.0)”. We will train resident physicians in the skills needed to become physician data scientists who are able to understand and obtain individual patient and clinician practice level data from the LHS, analyze the data to inform current clinical questions and processes, integrate findings with published research evidence to practically solve clinical problems, use local data to support iterative organizational practical improvement, and ultimately transform individual and system-wide clinical practice patterns to realize the goal of providing high value care. 

Our goal in the initial pilot is to design and implement a novel educational program that will train high-level users of the LHS. These individuals, referred to as “Trailblazers,” will be equipped with the skills necessary to build evidence and advance LHS-based initiatives across their disciplines and the Duke Health System. We plan intensive training in clinical data structure, informatics, data visualization, and statistics, allowing trainees to better understand existing patterns of care, and to alter clinical practice to improve quality, and patient outcomes. Lessons learned will be incorporated into a practical curriculum for wider dissemination at Duke and beyond, and into a second phase in the LHSTP development that focuses on equipping the more entry-level user of practice-based data with core basic LHS skills. With support from this award we will: 1) develop of core LHS curriculum 2) lead 5-10 physicians-in-training through the LHS curriculum 3) have each learner develop and implement a LHS-based project, with the initial PDSA cycles completed in AY2014-15.

2014 UPDATE: Our trainees have a high level of interest in learning the skills necessary to practice in a learning health environment.  Most trainees selected to participate are at a relatively advanced level of data manipulation from the electronic health record, but need continued instruction in statistics.  Importantly, engagement of the health system in our projects has helped the trainees access information and discuss projects with high-level health system representatives.  This input is key to gaining access to the individuals who are most skilled at extracting data from the electronic health record.  Allowing trainees to choose projects of interest from a list of projects put forth by health system leadership has maintained a high degree of trainee interest.  Our first cohort of six trainees began in January 2014 and are scheduled to complete their training and projects in May 2015.  Our second cohort, consisting of nine trainees, began in July 2014 and will complete training and projects in May 2015.  We anticipate recruiting an additional cohort to begin in July 2015.

Primary contact: Aimee K. Zaas M.D., M.H.S.; Program Director, Internal Medicine Residency; Associate Professor of Medicine
Institution: Duke University Medical Center

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