1. Omaha System Partnership Research Overview Madeleine Kerr, PhD, RN

2. Background

3. Purpose Describe completed and in-progress studies of the partnership research teams (41 to date) Studies are listed and available through links at omahasystempartnership.orgomahasystempartnership.org

4. Investigators and co-investigators Multidisciplinary teams (n=27) International teams (n=8) Students (n=25) Community partners (n=22)

5. Subjects High risk families served by public health nurses (n=22) Elders receiving home care services (n=12) Mothers with intellectual disabilities Children with special health care needs Diabetics Firefighters

6. Settings Public health Home health Community advocacy organizations Community coalitions Nurse-managed wellness centers Workforce studies

7. Electronic health record data

8. Study Methods Descriptive (n=37) Inferential (n=26) Text mining (n=3) Machine learning (n=2) Data visualization (n=1)

9. Machine learning example Data Management for Intervention Effectiveness Research: Comparing Deductive and Inductive Approaches Purpose: To use data mining techniques to create meaningful intervention clusters from structured Omaha System intervention data Monsen, K.A., et al. (2009). Research in Nursing and Health, 32 (6),647- 656

10. Method: Intervention data from 2,862 clients from 15 home care agencies managed using 3 deductive approaches and 1 inductive (data mining) method. Results: The data mining approach generated more intervention groups (24) compared to action category, theoretical and clinical expert consensus approaches. Intervention Scheme

11. Text mining example Informing Standard Development and Understanding User Needs with Omaha System Signs and Symptoms Text Entries in Community- Based Care Settings Purpose: To study free text with Omaha System data, to improve use in computerized platforms, identify gaps, and propose improvements. Melton, G. B., et al. (2010). Proceedings of the 2010 American Medical Informatics Association Symposium, 512-516.

12. Method: Free text data for ‘other’ signs and symptoms from 2 years of client records analyzed by content experts into categories. Results: Five categories: 1) duplicate entries, 2) multiple concepts, 3) medical diagnoses, 4)interventions and 5) comments. Signs and Symptoms

13. Descriptive inferential example Benchmark Attainment by Maternal and Child Health Clients Across Public Health Nursing Agencies Purpose: To demonstrate benchmarking of public health nursing outcomes Monsen, K.A., et al. (2011). Public Health Nursing, 29(1), 11-18.

14. Method: MCH data from from 6 counties using a benchmark of 4 (1=lowest, 5=highest) Results: All counties showed significant increases in client knowledge benchmark attainment; 4 of 6 counties showed increases for behavior & status. Knowledge Behavior Status

15. Studies in progress Using Visualization Methods to Discover Tailoring in PHN Intervention Data Evaluating Effects of PHN Home Visiting on Health Literacy (NI2012 AMIA-0421) Occupational Health Nursing Informatics: Mapping Hearing Health Outcomes to the Omaha System (NI2012 AMIA-0413)

16. Questions? Omaha System Partnership omahasystempartnership.org omahasystempartnership.org Madeleine Kerr kerrx010@umn.edukerrx010@umn.edu