Transformed (transforming) Health Care System

1. Transformed (transforming) Health Care System Big Data Invitational 2013 Connie White Delaney, PhD, RN, FAAN, FACMISchool of Nursing Professor & DeanAcademic Health Center     Director, Biomedical Health Informatics (BMHI)     Associate Dir. CTSI-BMI Nursing Knowledge: Big Data Research for Transforming Healthcare

2. Current State of Health Care System • Challenges of healthcare access, quality, safety, efficiency, and effectiveness • Recent financial crisis within the context of an annual cost of medical errors • Influx of patients in 2014 of ~32 million Americans Big Data Invitational 2013

3. Vision for the Future Health Care System • Health IT & Patient Safety http://www.iom.edu/Reports/2011/Health-IT-and-Patient-Safety-Building-Safer-Systems-for-Better-Care.aspx • Computational Technology for Effective Health Carehttp://www.nap.edu/catalog.php?record_id=12572 • Digital Infrastructure for the Learning Health System http://www.iom.edu/Reports/2011/Digital-Infrastructure-for-a-Learning-Health-System.aspx • Best Care at Lower Cost: The Path to Continuously Learning Health Care in Americahttp://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx Big Data Invitational 2013

4. Continuously Learning Health System Vision 4 Big Data Invitational 2013 Generate and apply the best evidence for the collaborative health care choices of each patient and provider; Drive the process of new discovery as a natural outgrowth of patient care Ensure innovation, quality, safety, and value in health care. (Charter of the Institute of Medicine Roundtable on Value & Science-Driven Health Care)

5. HealthIT.gov Federal Health IT Strategic Plan 2011 - 2015 Big Data Invitational 2013 5

6. Clinical and Translational Science Awards (CTSAs) • Program creates a definable academic home for clinical and translational research. • CTSA institutions work to transform the local, regional, and national environment to increase the efficiency and speed of clinical and translational research across the country http://www.ncats.nih.gov/research/cts/cts.html; https://www.ctsacentral.org/

7. Health & Nursing Knowledge Discovery & Dissemination Community Practice Bench Big Data Invitational 2013 Bedside

8. CONNECT WITH CTSI http://www.ctsi.umn.edu/index.htm • CONNECT WITH CTSA NURSE SCIENTIST SPECIAL INTEREST GROUP https://www.ctsacentral.org/committee/ctsa-nurse-scientist Big Data Invitational 2013

9. NINR Strategic Plan:Innovation NINR will invest in research that: • Develops new technologies and informatics-based solutions that promote health, including comprehensive high-throughput technologies • Develops and creatively applies new and existing knowledge to the implementation of health information technology, including electronic health records • Expands knowledge and application of health care technologies to facilitate decision support, self-management, and access to health care • Uses genetic and genomic technologies to advance knowledge of the “symptome,” including the biological underpinnings of symptoms associated with chronic illness • Encourages risk-taking, innovation, re-invention, and creativity, including high-risk/high-return concepts Big Data Invitational 2013

10. Nursing Research • Nursing informatics agenda for 2008–18 must expand users of interest to: Include interdisciplinary researchers Build upon the knowledge gained in nursing concept representation to address genomic and environmental data Guide the reengineering of nursing practice Harness new technologies to empower patients and their caregivers for collaborative knowledge development Develop user configurable software approaches that support complex data visualization, analysis, and predictive modeling Facilitate the development of middle-range nursing informatics theories Encourage innovative evaluation methodologies that attend to human-computer interface factors and organizational context Big Data Invitational 2013 Bakken et al In McDaniel, A. & Delaney, C. (Guest Editors). 2008. Informatics: Science and Practice.  Nursing Outlook, 56(5), 195-279.

11. BioMedical Health Informatics microscopic macroscopic Clinical Research Informatics UMN Profiles Consumer Health Informatics Human Health & Disease [translational bioinformatics] Public health informatics Bioinformatics Imaging informatics Clinical informatics Big Data Invitational 2013 REDCap (Research Electronic Data Capture) tissues & organs individual patients molecular and cellular processes populations EBP – Clinical Guidelines

12. UMN AHC IE PlatformClinical Data Repository (CDR) Big Data Invitational 2013

13. UMN AHC IE PlatformClinical Data Repository (CDR) • Extended Clinical Data • Other Clinical Partners • Research Data Marts Big Data Invitational 2013

14. Vision for Nursing Data in a Clinical Data Warehouse Big Data Invitational 2013 Continuum of Care 14

15. NIH BIG Data Centershttp://www.nih.gov/news/health/jul2013/nih-22.htm Big Data Invitational 2013

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17. Nursing Minimum Data Set (NMDS) Big Data Invitational 2013 Werley, HH & Divine, E., & Zorn, C. (1988). Nursing Minimum Data Set Data Collection Manual. University of Wisconsin, Milwaukee, WI

18. Nursing Management Minimum Data Set (NMMDS) Huber D, Schumacher L, Delaney C. Nursing management minimum data set (NMMDS). J Nurs Adm. 1997;27(4):42-48.

19. Call to action – Roadmap • Standardized representation of nursing knowledge • Integration within broader essential spectrum of clinical care data into clinical data warehouses • Engage in big data science for discovery of new knowledge that enables evidence-based practice. Big Data Invitational 2013