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greenbutton [2015/05/20 09:22]
nigam [Steps in building a Green Button]
greenbutton [2020/06/24 21:29] (current)
nigam [Informatics Consultation Service at Stanford]
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-====== ​The green button idea ====== +====== ​Informatics Consultation Service at Stanford ​======
-By Christopher Longhurst, Robert Harrington and Nigam Shah. Described in [[http://​​content/​33/​7/​1229.abstract | A ‘Green Button’ For Using Aggregate Patient Data At The Point Of Care]].+
-{{:green-button.png?nolink|}}+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”. 
 +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. 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://​​watch?​v=zRwKm-Uhkiw | 3 minute animation]] summarizes the workflow of the service we offered during the study. 
 +===== Learn More ===== 
 +Learn about the [[http://​​ACE|Advanced Cohort Engine]] (ACE) that enabled the service. For setting up such a service at your institution,​ write to us at [[|]],​ read our {{ :ics_how_to_guide.pdf |handbook}},​ and check out our [[https://​​som-shahlab/​green_button_public | GitHub repository]]. 
 +Know the [[https://​​2016winter/​on-the-button.html | story]] of how the [[https://​​news/​all-news/​2015/​10/​the-promise-of-personalizing-medical-practice-guidelines-in-real-time.html | Green Button idea]] crystalized into the [[https://​​2019summer/​millions-ehr-harnessed-ultimate-consult-each-patient.html| Informatics Consultation Service]]. Read about our [[https://​​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://​​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://​​watch?​v=h-d7LPCxtHo&​t=2220 | Congressional testimony]]. 
 +{{youtube>​fuyVriaq5Vk?​small | One minute video on the Informatics Consult Service}} 
 +One minute video on the Informatics Consult Service.
-''​ ''​ 
 ---- ----
-''​ ''​ 
-====== ​Usage model ======+{{vimeo>​375462436?​small | NIH Collaboratory}} 
 +Grand Rounds at the NIH Collaboratory on Nov 22, 2019 
 +===== Example Consultations ​===== 
 +  - In a young patient presenting with mononeuritis multiplex what is their ultimate diagnosis? [[https://​​file/​d/​12hXIH1T7IoAN2SR0lAVIpN5tOiPeZXeo/​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://​​file/​d/​1Mr8sB8DA7I9jXoOq7uSWYXefZYEIvKoq/​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://​​file/​d/​1UEsKDuaSj226EZJrDjIYxZyZs_ZJ2Nb8/​view?​usp=sharing|See report]]. 
 +===== The Team =====
 +  * [[https://​​profiles/​166781|Saurabh Gombar MD, PhD]]
 +  * [[https://​​profiles/​alison-callahan|Alison Callahan, PhD]]
 +  * Vladimir Polony
 +  * Ken Jung, PhD
 +  * Ethan Steinberg
 +  * Keith Morse, MD
 +  * [[https://​​robert-tibshirani|Robert Tibshirani, PhD]]
 +  * [[https://​​trevor-hastie|Trevor Hastie, PhD]]
 +  * [[https://​​profiles/​nigam-shah|Nigam Shah MBBS, PhD]] (Principal Investigator)
 +  * [[https://​​robert-harrington|Robert Harrington, MD]] (Executive Sponsor)
-{{:​green-button-model.png?​nolink|}} ​ 
-====== Steps in building a Green Button ====== 
-Gallego et al, [[http://​​doi/​full/​10.2217/​cer.15.12 | Bringing cohort studies to the bedside: framework for a 'green button'​ to support clinical decision-making]] 
greenbutton.1432138948.txt.gz · Last modified: 2015/05/20 09:22 by nigam