New Program Allows Clinicians to Learn from Every Patient

William Smoyer

At Nationwide Children’s Hospital, what started as a pilot test of a new way of doing things that challenged both the clinical and IT culture ended up being so popular that at least 12 other units want to give it a try.

The program is called Learning From Every Patient, explained William Smoyer, holder of the C. Robert Kidder Chair and director of the Center for Clinical and Translational Research in the hospital’s research institute.

The program grew from the widespread desire to integrate medical research information into clinical care, especially in the age of the electronic medical record. Under the program, organizers decided that rather than incrementally adding research information, they would reboot the clinical program altogether to fully embed research collection into the provision of care.

Under the program model, a patient receives standardized care as a starting point. Along the way, at every visit, information that could improve the quality of care is collected and entered as part of the EMR. The promise is that patients who follow will benefit from this endeavor.

The model was first adopted in a pilot program in the cerebral palsy clinic. Before it could be launched, organizers identified stakeholders across clinical care and IT teams and set expectations for all of them. “There was definitely a sense that the way we were doing business was going to change,” Smoyer said.

Doctors were asked to commit to a standard of care, but they also were required to determine three research questions that would advance their field and help design the database components that could properly collect data to address those questions.

Though leaders are still figuring out how to extract data in medically meaningful ways, he said that a preliminary analysis suggests that program implementation alone – and its enforcement – is showing positive trends, including reduced ER utilizations and hospitalizations among children with CP.

The program proved to be popular: As word got out, leaders in other disciplines expressed interest in implementing Learning From Every Patient in their areas, as well.

According to Smoyer, the opportunity exists to develop a standardized approach to learning from every patient and adapt it to any kind of care setting, not only in a pediatric hospital.

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