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.

The service embodied the Green Button Idea outlined in a 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 3 minute animation summarizes the workflow of the service we offered during the study and the results are described in a NEJM Catalyst article.

To scale the concept nationally, we launched Atropos Health and lay out the journey ahead in a Harvard Business Review article.

• If you are a stanford physician, please see the quick start guide on our intranet.
• For setting up such a service at your institution, reach out to Atropos Health.

Know the story of how the Green Button idea crystalized into the Informatics Consultation Service. Read about our step-by-step progress towards launching the IRB approved study. Check out how we fit into the larger vision of being Digitally Driven at Stanford Health Care as well as listen to the NLM Director Dr. Patricia Brennan's Congressional testimony. Learn about the Advanced Cohort Engine (ACE) that enabled the service.

One minute video on the Informatics Consult Service. Read about harnessing millions of de-identified patient records for the ultimate consult.

Grand Rounds at the NIH Collaboratory on Nov 22, 2019. Read about the impact of Using Aggregate Patient Data at the Bedside via an On-Demand Consultation Service in the NEJM Catalyst.

1. In a young patient presenting with mononeuritis multiplex what is their ultimate diagnosis? See report.
2. Is there a relationship between HSV or VZV infection in patients treated with PD-1/PD-L1 inhibitor immunotherapy? See report.
3. 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?See report.