2023-09-28 14:46:10 +00:00
|
|
|
abstract: 'Purpose - The purpose of this paper is to describe how clinical
|
|
|
|
|
|
|
|
|
|
registers were designed and used to serve multiple purposes in three
|
|
|
|
|
|
|
|
|
|
health systems, in order to contribute practical experience for building
|
|
|
|
|
|
|
|
|
|
learning healthcare systems.
|
|
|
|
|
|
|
|
|
|
Design/methodology/approach - Case description and comparison of the
|
|
|
|
|
|
|
|
|
|
development and use of clinical registries, drawing on participants''
|
|
|
|
|
|
|
|
|
|
experience and published and unpublished research.
|
|
|
|
|
|
|
|
|
|
Findings - Clinical registers and new software systems enable fact-based
|
|
|
|
|
|
|
|
|
|
decisions by patients, clinicians, and managers about better care, as
|
|
|
|
|
|
|
|
|
|
well as new and more economical research. Designing systems to present
|
|
|
|
|
|
|
|
|
|
the data for users'' daily work appears to be the key to effective use of
|
|
|
|
|
|
|
|
|
|
the potential afforded by digital data.
|
|
|
|
|
|
|
|
|
|
Research limitations/implications - The case descriptions draw on the
|
|
|
|
|
|
|
|
|
|
experience of the authors who were involved in the development of the
|
|
|
|
|
|
|
|
|
|
registers, as well as on published and unpublished research. There is
|
|
|
|
|
|
|
|
|
|
limited data about outcomes for patients or cost-effectiveness.
|
|
|
|
|
|
|
|
|
|
Practical implications - The cases show the significant investments
|
|
|
|
|
|
|
|
|
|
which are needed to make effective use of clinical register data. There
|
|
|
|
|
|
|
|
|
|
are limited skills to design and apply the digital systems to make the
|
|
|
|
|
|
|
|
|
|
best use of the systems and to reduce their disadvantages. More use can
|
|
|
|
|
|
|
|
|
|
be made of digital data for quality improvement, patient empowerment and
|
|
|
|
|
|
|
|
|
|
support, and for research.
|
|
|
|
|
|
|
|
|
|
Social implications - Patients can use their data combined with other
|
|
|
|
|
|
|
|
|
|
data to self-manage their chronic conditions. There are challenges in
|
|
|
|
|
|
|
|
|
|
designing and using systems so that those with lower health and computer
|
|
|
|
|
|
|
|
|
|
literacy and incomes also benefit from these systems, otherwise the
|
|
|
|
|
|
|
|
|
|
digital revolution may increase health inequalities.
|
|
|
|
|
|
|
|
|
|
Originality/value - The paper shows three real examples of clinical
|
|
|
|
|
|
|
|
|
|
registers which have been developed as part of their host health
|
|
|
|
|
|
|
|
|
|
systems'' strategies to develop learning healthcare systems. The paper
|
|
|
|
|
|
|
|
|
|
gives a simple non-technical introduction and overview for clinicians,
|
|
|
|
|
|
|
|
|
|
managers, policy-advisors and improvers of what is possible and the
|
|
|
|
|
|
|
|
|
|
challenges, and highlights the need to shape the design and
|
|
|
|
|
|
|
|
|
|
implementation of digital infrastructures in healthcare services to
|
|
|
|
|
|
|
|
|
|
serve users.'
|
|
|
|
|
affiliation: 'Ovretveit, J (Corresponding Author), Karolinska Inst, LIME MMC, Stockholm,
|
|
|
|
|
Sweden.
|
|
|
|
|
|
|
|
|
|
Ovretveit, John, Karolinska Inst, LIME MMC, Stockholm, Sweden.
|
|
|
|
|
|
|
|
|
|
Nelson, Eugene, Dartmouth Coll, Dartmouth Inst, Hanover, NH USA.
|
|
|
|
|
|
|
|
|
|
James, Brent, Intermt Healthcare, Inst Healthcare Delivery Res, Salt Lake City,
|
|
|
|
|
UT USA.'
|
|
|
|
|
author: Ovretveit, John and Nelson, Eugene and James, Brent
|
|
|
|
|
author-email: jovretbis@aol.com
|
|
|
|
|
author_list:
|
|
|
|
|
- family: Ovretveit
|
|
|
|
|
given: John
|
|
|
|
|
- family: Nelson
|
|
|
|
|
given: Eugene
|
|
|
|
|
- family: James
|
|
|
|
|
given: Brent
|
|
|
|
|
da: '2023-09-28'
|
|
|
|
|
doi: 10.1108/JHOM-06-2016-0110
|
|
|
|
|
eissn: 1758-7247
|
|
|
|
|
files: []
|
|
|
|
|
issn: 1477-7266
|
|
|
|
|
journal: JOURNAL OF HEALTH ORGANIZATION AND MANAGEMENT
|
|
|
|
|
keywords: 'Information technology; Quality improvement; Safety; Healthcare; Health
|
|
|
|
|
|
|
|
|
|
information technology; Learning health system; Clinical registers'
|
|
|
|
|
keywords-plus: 'INFORMATION EXCHANGE; PATIENT-CARE; QUALITY; TECHNOLOGY; IMPROVE;
|
|
|
|
|
|
|
|
|
|
REGISTRIES'
|
|
|
|
|
language: English
|
|
|
|
|
number: '7'
|
|
|
|
|
number-of-cited-references: '45'
|
|
|
|
|
orcid-numbers: ovretveit, john/0000-0002-5177-6613
|
|
|
|
|
pages: 1105-1118
|
|
|
|
|
papis_id: ed3b9cd9507496d3502d8ac6c44b9e5c
|
|
|
|
|
ref: Ovretveit2016buildinglearning
|
|
|
|
|
times-cited: '25'
|
|
|
|
|
title: 'Building a learning health system using clinical registers: a non-technical
|
|
|
|
|
introduction'
|
2023-10-01 08:15:07 +00:00
|
|
|
type: article
|
2023-09-28 14:46:10 +00:00
|
|
|
unique-id: WOS:000387176300005
|
|
|
|
|
usage-count-last-180-days: '0'
|
|
|
|
|
usage-count-since-2013: '10'
|
|
|
|
|
volume: '30'
|
|
|
|
|
web-of-science-categories: Health Policy \& Services
|
|
|
|
|
year: '2016'
|
