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--- greenbutton [2020/06/12 13:17]
acallaha [Example Consultations]
+++ greenbutton [2023/07/12 09:47]
nigam [How to use]
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 ====== Informatics Consultation Service at Stanford ======
-The **Informatics Consultation service** was an IRB approved project to study the use of routinely collected data on millions of individuals to provide on-demand evidence in those situations where good evidence is lacking. We used demographics, diagnoses, procedures, medications, laboratory values, clinical notes, mortality, and length of stay information for millions of patients to inform clinical care decisions by summarizing “what happened to patients like mine”.
+The **Informatics Consultation service** was an IRB approved project to study the use of routinely collected data on millions of individuals to provide on-demand evidence in those situations where good evidence is lacking. We informed clinical care decisions by summarizing “what happened to patients like mine” in the form a report with a descriptive summary of similar patients in Stanford’s clinical data warehouse, treatment choices made, and observed outcomes.
-Given a specific clinical question, we provided a report with a descriptive summary of similar patients in Stanford’s clinical data warehouse, treatment choices made, and observed outcomes. This [[https://www.youtube.com/watch?v=zRwKm-Uhkiw | 3 minute animation]] summarizes the service we offered.
+The service embodied the [[https://shahlab.stanford.edu/greenbutton_idea | Green Button Idea]] outlined in a [[https://www.healthaffairs.org/doi/10.1377/hlthaff.2014.0099 | Health Affairs article]] in 2014. The study concluded in August 2019. We responded to 100 consultation requests by 53 users from multiple specialties. Of the 83 requests we fulfilled, 52 consultations guided further research, 17 led to follow up investigations and 10 directly informed patient care. This [[https://www.youtube.com/watch?v=zRwKm-Uhkiw|3 minute animation]] summarizes the workflow of the service we offered during the study and the results are described in [[https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0224 | a NEJM Catalyst article]].
-The study concluded in August 2019. Learn about [[http://shahlab.stanford.edu/ACE|search engine]] that enabled the service. For setting up such a service at your institution, write to us at **[[greenbutton@stanford.edu|]]** or read our {{ :ics_how_to_guide.pdf |handbook}}.
+To scale the concept nationally, we launched [[https://www.atroposhealth.com/ | Atropos Health]] and lay out the journey ahead in a [[https://hbr.org/2023/05/how-medical-records-can-close-the-information-gap-in-patient-care | Harvard Business Review article]].
+===== How to use =====
+  * If you are a stanford physician, please see the [[https://stanfordhc.service-now.com/esm?id=kb_article_view&sysparm_article=KB0578398 | quick start guide]] on our intranet.
+  * For setting up such a service at your institution, reach out to [[https://www.atroposhealth.com/contact | Atropos Health]].
 ===== Learn More =====
-[[https://stanmed.stanford.edu/2019summer/millions-ehr-harnessed-ultimate-consult-each-patient.html|Read our story]], [[:service_details| learn how we got started]], check out our [[https://stanfordhealthcare.org/stanford-health-now/ceo-report/biomedical-insights-putting-data-science-to-work-for-patients.html| CEO's annual report]] and {{:shc_data_science_for_patients.pdf| brochure}}, or NLM Director Dr. Patricia Brennan's [[https://www.youtube.com/watch?v=h-d7LPCxtHo&t=2220 | Congressional testimony]] on Investments in Medical Research at Five Institutes & Centers of the NIH.
+Know the [[https://stanmed.stanford.edu/2016winter/on-the-button.html|story]] of how the [[https://med.stanford.edu/news/all-news/2015/10/the-promise-of-personalizing-medical-practice-guidelines-in-real-time.html| Green Button idea]] crystalized into the [[https://stanmed.stanford.edu/2019summer/millions-ehr-harnessed-ultimate-consult-each-patient.html| Informatics Consultation Service]]. Read about our [[https://shahlab.stanford.edu/doku.php?id=service_details| step-by-step]] progress towards launching the IRB approved study. Check out how we fit into the larger vision of being Digitally Driven at [[https://stanfordhealthcare.org/stanford-health-now/ceo-report/biomedical-insights-putting-data-science-to-work-for-patients.html| Stanford Health Care]] as well as listen to the NLM Director Dr. Patricia Brennan's [[https://www.youtube.com/watch?v=h-d7LPCxtHo&t=2220| Congressional testimony]]. Learn about the [[http://shahlab.stanford.edu/ACE|Advanced Cohort Engine]] (ACE) that enabled the service.
 {{youtube>fuyVriaq5Vk?small | One minute video on the Informatics Consult Service}}
-One minute video on the Informatics Consult Service.
+One minute video on the Informatics Consult Service. Read about [[https://stanmed.stanford.edu/millions-ehr-harnessed-ultimate-consult-each-patient/ |harnessing millions of de-identified patient records for the ultimate consult]].
 ----
@@ Line 20: / Line 25: @@
 {{vimeo>375462436?small | NIH Collaboratory}}
-Grand Rounds at the NIH Collaboratory on Nov 22, 2019
+Grand Rounds at the NIH Collaboratory on Nov 22, 2019. Read about the impact of [[https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0224 | Using Aggregate Patient Data at the Bedside via an On-Demand Consultation Service]] in the NEJM Catalyst.
 ----
@@ Line 28: / Line 33: @@
   - In a young patient presenting with mononeuritis multiplex what is their ultimate diagnosis? [[https://drive.google.com/file/d/12hXIH1T7IoAN2SR0lAVIpN5tOiPeZXeo/view?usp=sharing|See report]].
-  - Of patients administered opioids as inpatients or prescribed opioids as an outpatient and discharged with adequate, inadequate, or no bowel regimen, how many suffer constipation, bowel perforation, or colitis within the 30-day post-discharge period? [[https://drive.google.com/file/d/1--fXMkiW2_cmp3jZCIcKMcg0dLkTjjXe/view?usp=sharing|See report]].
+  - Is there a relationship between HSV or VZV infection in patients treated with PD-1/PD-L1 inhibitor immunotherapy? [[https://drive.google.com/file/d/1Mr8sB8DA7I9jXoOq7uSWYXefZYEIvKoq/view?usp=sharing|See report]].
-  - In female patients at least 18 years old and diagnosed with a urinary tract infection, and prescribed a sulfonamide antibiotic, is there any difference in peak blood glucose after treatment compared to patients prescribed a cephalosporin antibiotic or penicillin derivative antibiotic? [[https://drive.google.com/file/d/1jg0jwH9MivsIneOQ1SKWa65WEBzgONh1/view?usp=sharing|See report]].
+  - Between 2013 and 2017, in women, men, adults ≤ 45 years old and adults > 45 years old, how frequently was a positive procalcitonin (defined as a result > 0.5) associated with a positive blood culture?[[https://drive.google.com/file/d/1UEsKDuaSj226EZJrDjIYxZyZs_ZJ2Nb8/view?usp=sharing|See report]].
-  - What is the population of admitted children (age 1 year - 17 years inclusive) who have acute kidney injury (AKI; defined as > 1.5x their baseline creatinine value) within the first 7 days of admission? [[https://drive.google.com/file/d/1_3_CugtlEpwMKxzJkYjanZ6VUV-NOOZq/view?usp=sharing|See report]].
-  - How many patients aged 0 to 17 years received a new diagnosis of fever of unknown origin (FUO), Kawasaki disease, apparent life-threatening event or brief resolved unexplained event (ALTE/BRUE), or seizure (febrile, simple partial, complex partial, generalized idiopathic epilepsy) in the year 2016? [[https://drive.google.com/file/d/1ttu3CKyZKa2VS8u2jvUFJxLapoTuQ5YS/view?usp=sharing|See report]].
-===== The Team =====
-  * [[https://med.stanford.edu/profiles/166781|Saurabh Gombar MD, PhD]]
-  * [[https://med.stanford.edu/profiles/alison-callahan|Alison Callahan, PhD]]
-  * Vladimir Polony
-  * Ken Jung, PhD
-  * Ethan Steinberg
-  * Keith Morse, MD
-  * [[https://profiles.stanford.edu/robert-tibshirani|Robert Tibshirani, PhD]]
-  * [[https://profiles.stanford.edu/trevor-hastie|Trevor Hastie, PhD]]
-  * [[https://med.stanford.edu/profiles/nigam-shah|Nigam Shah MBBS, PhD]] (Principal Investigator)
-  * [[https://profiles.stanford.edu/robert-harrington|Robert Harrington, MD]] (Executive Sponsor)

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