LAS VEGAS - The key to creating a learning health system is to establish a technological framework for clinical study that engages patients at a more direct level, according to Thomas Carton, MD, director of health services research and principal investigator at REACHnet.

Presenting with Harshal Shah, senior director of Healthcare Persistent Systems, at the HIMSS16 conference in Las Vegas on Tuesday, Carton reviewed some of the tablet-based approaches to data sharing that has facilitated better research and more streamlined learning systems.

The goal, he said, is to foster pragmatic research.

“You’re comparing A to B,” he said. “It could be a behavioral intervention. It could be comparing two doses of aspirin. You’re comparing outcomes and effectiveness, the risks and harms, and the benefits of two or more treatments or services.”

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In REACHnet’s model, clinical research is embedded in healthcare delivery settings. This is accomplished primarily through tablet and laptop applications, helping to streamline data linkages, patient recruitment for clinical studies, and trial management.

“We face a lot of important, unanswered questions in healthcare today,” said Carton. “We needed a different system where we engaged clinicians … as partners in the process, to harness the data and ask the right questions, which are meaningful to each of those stakeholders – as opposed to a scientist at a university who’s interested in his or her own query … and translate those answers back into the care setting to change the way care is delivered.”

Global Patient Identifiers, or GIPDs, allow for the data matching of patients who move from one site to another, without people at the data center holding onto information such as social security numbers, he said.

Carton said that tablets are changing the way data is managed.

“We’re putting tablet computers in examination rooms and allowing them to sync with patients through the common data model,” he said. “It allows us to push targeted content through tablets at the point of care. So we’re working with the electronic medical record, but not through it. And that’s important. That’s the sync app through the tablet.”

More efficiencies and improvements to the model are in the works.

“We’re matching across clinical and claims data,” said Carton. “The Medicaid office will hash out their patient records, send bundles to us, we’ll create those linkages and create a cross table with them. So as a study comes up, they can decide whether or not to share their data. We’re approaching this incrementally.”

Twitter: @JELagasse

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