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greenbutton [2020/06/14 13:24]
nigam [Informatics Consultation Service at Stanford] |
greenbutton [2023/07/12 09:54] (current)
nigam [Learn More] |
| ====== Informatics Consultation Service at Stanford ====== | ====== Informatics Consultation Service at Stanford ====== |
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| 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. |
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| 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 workflow of 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]]. |
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| The study concluded in August 2019. Learn about the [[http://shahlab.stanford.edu/ACE|Advanced Cohort Engine]] (ACE) that enabled the service. For setting up such a service at your institution, write to us at [[greenbutton@stanford.edu|]], read our {{ :ics_how_to_guide.pdf |handbook}}, and check out the [[https://github.com/som-shahlab/green_button_public | GitHub repository]]. | 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]]. |
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| | ===== How to use ===== |
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| | * 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]]. |
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| ===== Learn More ===== | ===== Learn More ===== |
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| 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]]. | [[https://stanmed.stanford.edu/2016winter/on-the-button.html|Read the 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, [[https://shahlab.stanford.edu/doku.php?id=service_details| step-by-step]] became the [[https://stanmed.stanford.edu/2019summer/millions-ehr-harnessed-ultimate-consult-each-patient.html| Informatics Consultation Service]], as an IRB approved study. This work is part of 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]]. Learn about the [[http://shahlab.stanford.edu/ACE|Advanced Cohort Engine]] (ACE) that enabled the service. |
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| {{youtube>fuyVriaq5Vk?small | One minute video on the Informatics Consult Service}} | {{youtube>fuyVriaq5Vk?small | One minute video on the Informatics Consult Service}} |
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| 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]]. |
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| | {{youtube>w9Jm04ZxPLw?small | Three minute video on the Service featured by the National Library of Medicine}} |
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| | Three minute video on the Service featured by the National Library of Medicine. Including congressional testimony by Dr. Patricia Brennan. |
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| ---- | ---- |
| {{vimeo>375462436?small | NIH Collaboratory}} | {{vimeo>375462436?small | NIH Collaboratory}} |
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| 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. |
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| ---- | ---- |
| - 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]]. | - 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]]. |
| - 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]]. | - 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]]. |
| ===== The Team ===== | |
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| * [[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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