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Using a Knowledge Grid to Enhance Messages in Michigan
Allen Flynn, Pharm.D Jim Edwards, Director of Development Copyright Michigan Health Information Network Shared Services
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Agenda Statewide Health Directory services
Active Care Relationship services Current medication reconciliation workflow Learning Health for Michigan infrastructure Enhanced medication reconciliation workflow Persona stories Enhanced medication reconciliation demonstration
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Statewide Health Directory
Manages organizations, providers and the multiple relationships between them Contains electronic addresses used to route information to providers Health Directory Name Specialty Practice unit Practice organizations Related organizations Delivery oreferences …additional attributes Insert HD picture Copyright Michigan Health Information Network Shared Services
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Active Care Relationships
Declared active care relationships between patients and providers Primary Care Provider Linkage Patient Active Care Relationships: Providers: 13,535,374 16,466 In Michigan: Copyright Michigan Health Information Network Shared Services
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Medication Reconciliation Current Workflow
Health Plan Trusted Data Sharing Organization (TDSO) Trusted Data Sharing Organization (TDSO) Specialist Patient to Provider Attribution Health Directory Patient Primary Care 1) Patient discharged from hospital, message sent to TDSO, MiHIN Pharmacist 2) MiHIN checks patient-provider attribution and identifies recipients 3) MiHIN retrieves contact and delivery preference for each recipient from directory 4) Notifications routed to recipients based on electronic address and preferences Copyright Michigan Health Information Network Shared Services
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Can We Make the Workflow Smarter?
Copyright Michigan Health Information Network Shared Services 6
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Learning Health for Michigan Infrastructure
Connecting Health for Michigan 2017 Learning Health for Michigan Infrastructure kgrid.org Slides: Allen J. Flynn, Charles P. Friedman, 2016, 2017
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The Knowledge Grid Infrastructure Approach
Need: Computable Knowledge ‘FAIRness’ Why? State-wide Learning Depends on Effective Computable Knowledge Sharing How? Knowledge Grid and Its Components kgrid.org Learning Health Sciences
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LH4M & Knowledge FAIRness
To Make Computable Knowledge a Statewide Resource It Has to Be “FAIR” Findable Accessible Interoperable Reusable Learning Health Sciences
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Rapid, Transparent Statewide Knowledge Sharing
Digital Library Digital Library Digital Library • Knowledge Grid Learning Health Sciences
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Why? Speeding Up Knowledge to Practice
Objects 1. Computable Knowledge 2. Knowledge Management Digital Library Corroboratory Mechanisms 3. Maintain Trust ✔ Object Shelf 4. Connect Knowledge to Practice Duplicae and move to beginning EHRs/eHealth Learning Health Sciences
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Analytic Results of Interest
What is Knowledge Grid, by Components? or Analytic Results of Interest 1. Knowledge Objects 2. Digital Library Digital Library Knowledge Grid 3. FAIRness Mechanisms 4. Activator 5. RESTful services EHRs/eHealth Existing Health IT Learning Health Sciences
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1. Computer-Processable Knowledge Objects
Description Guidelines Interface Computer-Processable Knowledge “Payload” Articles Knowledge Objects Results of Interest Learning Health Sciences
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Example Knowledge Object Source from Oncology
Learning Health Sciences
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Here Is the Written Knowledge
Learning Health Sciences
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Types of Knowledge Objects
Input Service Output Calculation Individual Features “Do the Math” Numeric Result e.g., predictive models or dosage calculator Interpretation Facts of the Case Apply Best Practice Health Knowledge Written or Verbal Instruction e.g., computable guideline Presentation Image Parameters Apply Communication Best Practice Knowledge Visual Display or Image e.g., iconarray Tailoring Facts & Features About the Output Recipient Apply Psychological and Communication Best Practice Knowledge Individualized, Evidence-Based Multimedia Message e.g., motivational messages of encouragement for an individual who is more likely to respond to them Learning Health Sciences
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2. Digital Library to Manage and Share Knowledge
Capability to Curate and Manage Online Collections of Knowledge Objects Learning Health Sciences
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3. Mechanisms to support Knowledge FAIRness
✔ Links to Knowledge Sources ✔ Records of Knowledge Object Use ✔ Technical Safeguards to Protect Knowledge Objects FAIR means: Findable Accessible Interoperable Reusable Learning Health Sciences
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EHRs & Apps Activator Engine Shelf
4. & 5. Connect Linked Knowledge to Practice Shelf Engine Activator Knowledge Objects Payloads People Wanting to Know Best Practices ”Request” eHealth Applications EHRs & Apps ”Response” RESTful Services Learning Health Sciences
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Analytic Results of Interest
Knowledge Grid by Components or Analytic Results of Interest 1. Knowledge Objects More Info 2. Digital Library Digital Library kgrid.org 3. FAIRness Mechanisms 4. Activator 5. RESTful services EHRs/eHealth Existing Health IT Learning Health Sciences
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Enhanced Medication Reconciliation Workflow
Health Plan Trusted Data Sharing Organization (TDSO) Trusted Data Sharing Organization Specialist Patient to Provider Attribution Health Directory Patient Primary Care 1) Patient discharged from hospital, message sent to TDSO, MiHIN Pharmacist 2) MiHIN checks Knowledge Grid, enhances message as appropriate 3) MiHIN checks patient-provider attribution and identifies recipients 4) MiHIN retrieves contact and delivery preference for each recipient from directory 5) Notifications routed to recipients based on electronic address and preferences Copyright Michigan Health Information Network Shared Services
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Persona Stories Christy Munson gets a new opioid prescription which may put her at risk for dependence Alice Vargas gets a new prescription that puts her at risk of respiratory depression Copyright Michigan Health Information Network Shared Services
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Enhanced Medication Reconciliation Demonstration
Copyright Michigan Health Information Network Shared Services
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Copyright 2017 - Michigan Health Information Network Shared Services
Thank You Allen Flynn, Pharm. D Department of Learning Health Sciences, University of Michigan Jim Edwards Director of Development Copyright Michigan Health Information Network Shared Services
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