Meet Michigan Medicine: Department of Learning Health Sciences

November 6, 2018  //  FOUND IN: Our Employees,

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Every year, thousands of newly published articles describe advances made across a range of sciences pertinent to health and health care. Similarly, new unpublished discoveries are made daily both at Michigan Medicine and around the globe.

But how do faculty, students and staff within the organization — and beyond — take full advantage of these new findings? How can they put them into practice to promote better health for patients and families?

The Department of Learning Health Sciences (DLHS) is working on just this problem from a variety of perspectives.

Here’s what you may not know about the department that is changing how the organization thinks about learning in order to transform health.

Learning as a continuous process

In 2014, the Department of Medical Education became DLHS, a change that brought a new focus as well as a new name.

“We are now a basic science department,” said Charles Friedman, Ph.D., chair of the department. “We approach learning and improvement as a science, realizing that the effective health system of the future must employ a continuous process of study and change that leads to continuous improvement.”

To carry out this work, the department conducts research on learning at all levels of scale, from the individual, to groups, to organizations, to state, national and even global levels.

“We can use data — big and small — to improve health across these scales via learning health systems,” Friedman said. “Learning systems employ continuous cycles as part of their daily operation where data becomes useable knowledge, that knowledge is integrated into practice, and then the experience from these changed practices become the foundation for the next cycle of improvement.”

It’s also essential to support these processes with appropriate infrastructure so that these learning cycles draw on a set of shared services.

One example of this learning cycle is the collaboration between DLHS and Gastroenterology (GI) to achieve ongoing improvement in the way patients are instructed to prep for an outpatient colonoscopy.

The data showed that 10 to 12 percent of patients were showing up at appointments insufficiently prepped for the test. The GI group revamped the bowel prep instructions and will continue to use feedback from patients and staff to modify them in order to ensure more patients arrive ready for their procedure. Similar collaborations are forming with the Department of Obstetrics and Gynecology and the Department of Emergency Medicine.

Learning how to learn

Naturally, it is vital for a department that studies learning to offer a variety of educational programs to support those engaged in their medical training, as well as professionals intent on expanding their skills.

DLHS offers the Health Infrastructures and Learning Systems (HILS) M.S. and Ph.D. program, that is currently being pursued by its third cohort. HILS trains students in the sciences of learning health systems and equips researchers and health leaders with tools to solve some of the most complex health problems in the U.S. and abroad.

The Master of Health Professions Education (MHPE) degree, started in 2013, focuses on the knowledge and skills of an effective educator. MHPE is a competency-based program in which students learn on the job under guidance of a mentor, and complete competencies rather than traditional courses.

DLHS also supports state-of-the-art simulation training through the Clinical Simulation Center (CSC). In January, the CSC opened a second location in Medical Science Building II to better accommodate all Michigan Medicine students, faculty and staff.

Finally, the department hosts professional development opportunities — such as the annual Health Professions Education Day every April and the Medical Education Scholars Program. DLHS faculty also lead two paths of excellence within the U-M Medical School.

Promoting access to knowledge

Finally, DLHS has taken the lead on a number of initiatives designed to improve health far beyond the walls of Michigan Medicine.

One of these, the Knowledge Grid, is an open software platform to make the latest biomedical knowledge and best practices more accessible and actionable.

“The many-year lag between when a new medical discovery is made and when it is put into practice in a clinic is unacceptable,” Friedman said. “For the 21st century, we need a completely new publishing paradigm so new discoveries don’t just appear as journal articles but are available in ways that allow the discoveries to translate much more directly into advice about specific health decisions.”

To ensure that the Knowledge Grid — and innovations like it — meet their full potential, DLHS is spearheading a national movement to mobilize computable biomedical knowledge. A meeting on the NIH campus, co-sponsored by DLHS and the National Library of Medicine this past July, brought together 150 experts who shared this interest.

In the end, the initiative will bring about fundamental changes in how best practice knowledge is applied to improve health care. And that’s at the core of what DLHS attempts to do every day.

“We have created a unique culture in DLHS.” Friedman said. “We’re focused on the future. We are both students of change and implementers of change. We are doing things no one else is doing, and that is helping us gain recognition as pioneers.”

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