Seid Michael, Dellal George, Peterson Laura E, Provost Lloyd, Gloor Peter A, Fore David Livingstone, Margolis Peter A
Pulmonary Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
James M Anderson Center for Health Systems Excellence, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
JMIR Hum Factors. 2018 Feb 22;5(1):e8. doi: 10.2196/humanfactors.8083.
Our health care system fails to deliver necessary results, and incremental system improvements will not deliver needed change. Learning health systems (LHSs) are seen as a means to accelerate outcomes, improve care delivery, and further clinical research; yet, few such systems exist. We describe the process of codesigning, with all relevant stakeholders, an approach for creating a collaborative chronic care network (C3N), a peer-produced networked LHS.
The objective of this study was to report the methods used, with a diverse group of stakeholders, to translate the idea of a C3N to a set of actionable next steps.
The setting was ImproveCareNow, an improvement network for pediatric inflammatory bowel disease. In collaboration with patients and families, clinicians, researchers, social scientists, technologists, and designers, C3N leaders used a modified idealized design process to develop a design for a C3N.
Over 100 people participated in the design process that resulted in (1) an overall concept design for the ImproveCareNow C3N, (2) a logic model for bringing about this system, and (3) 13 potential innovations likely to increase awareness and agency, make it easier to collect and share information, and to enhance collaboration that could be tested collectively to bring about the C3N.
We demonstrate methods that resulted in a design that has the potential to transform the chronic care system into an LHS.
我们的医疗保健系统未能取得必要的成果，而渐进式的系统改进也无法带来所需的变革。学习型健康系统（LHS）被视为加速成果、改善护理服务和推进临床研究的一种手段；然而，这样的系统却很少存在。我们描述了与所有相关利益攸关方共同设计一种创建协作式慢性病护理网络（C3N）的方法的过程，C3N是一个由同行创建的网络化LHS。
本研究的目的是报告与不同利益攸关方群体一起使用的方法，以将C3N的理念转化为一系列可采取行动的后续步骤。
研究背景是“改善现在护理”（ImproveCareNow），这是一个针对儿童炎症性肠病的改进网络。C3N的领导者与患者及其家属、临床医生、研究人员、社会科学家、技术专家和设计师合作，采用了一种经过修改的理想化设计流程来开发C3N的设计方案。
超过100人参与了设计过程，产生了（1）“改善现在护理”C3N的总体概念设计，（2）实现该系统的逻辑模型，以及（3）13项可能提高认识和能动性、使信息收集和共享更容易并加强协作的潜在创新，这些创新可以共同进行测试以实现C3N。
我们展示了一些方法，这些方法产生了一种有可能将慢性病护理系统转变为学习型健康系统的设计。
