The Center of Excellence in Promoting LHS Operations and Research at Einstein/Montefiore (EXPLORE)

“学习健康系统”（LHS）模式代表了一个相对较新的，非常有前途的，和范式转变 提供保健的方法。LHS的特点是它能够不断地研究每一个 医疗保健互动，以产生客观证据和可操作的知识，吸引利益相关者， 制定有针对性的流程，以改善成果。LHS要求发展基础设施， 科学、信息学、激励措施和文化是一致的，卫生信息技术（HIT）的进步 促进产生新的证据，作为提供护理的一个不可或缺的副产品。实现这一愿景， 需要对许多现有的医疗保健提供和学术追求的驱动因素进行巨大的转变， 特别是建立一支训练有素、多样化的调查人员队伍， LHS研究和运营的领导者。我们建议的促进LHS运营的卓越中心 和研究在爱因斯坦/蒙蒂菲奥里（EXPLORE）是一个合作之间的阿尔伯特爱因斯坦学院， 医学和蒙蒂菲奥里卫生系统（MHS），一个大型的，综合的，以责任为导向的学术 为布朗克斯和纽约的下哈德逊河谷地区提供服务的医疗中心。我们将努力 MHS为主要是少数民族的社会经济弱势群体提供高质量的服务， 与此同时，对责任制护理的财政和服务提供要求作出反应。我们 拟议的计划将参与并建立在爱因斯坦和一个强大的教育和培训基础设施， 创新的信息学和价值为基础的护理提供基础设施在MHS。我们将利用教育 爱因斯坦临床和转化研究所（ICTR）的研究支持资源， 我们的临床和转化科学奖（CTSA），包括其临床硕士的教学部分 研究及其AHRQ/PCARI赞助的R25以患者为中心的结果研究课程， 健康数据创新中心的信息学基础设施，以及Montefiore的资源 网络绩效小组（负责护理质量、卓越运营和患者安全 MHS），在LHS研究中创建一个新颖的职业发展计划。我们将选出最有才华， 积极的，多学科的临床医生和其他教师注册，使他们具备知识和技能 进行，实施和传播高质量和可操作的LHS研究，并为他们提供 作为LHS研究领导者的可持续职业道路。我们的学者和导师将有助于国家LHS 研究合作，爱因斯坦-蒙蒂菲奥里的贡献由内部的专业知识和经验驱动 从我们独特的机构计划和资源中收集。这将通过课程来实现。 分享和跨机构教育;机构间PI/PD和学者导师互动，包括 在可行和适当的情况下进行跨机构指导;研究合作，包括传播 研究成果和多中心研究举措;以及分享变革和组织振兴方案/核证的排减量方法方面的进展。 !

The “learning health system” (LHS) model represents a relatively new, highly promising, and paradigm-shifting approach to the delivery of health care. A LHS is characterized by its capacity to continuously study every health care interaction to generate objective evidence and actionable knowledge, engage stakeholders, and develop targeted processes to improve outcomes. The LHS requires development of infrastructure where science, informatics, incentives and culture are aligned, and advances in Health Information Technology (HIT) facilitate the generation of new evidence as an integral byproduct of care delivery. Realizing this vision also requires dramatic transformation of many existing drivers of healthcare delivery and scholarly pursuit, in particular the creation of an appropriate workforce of well trained, diverse investigators who will become leaders in LHS research and operations. Our proposed Center of Excellence in Promoting LHS Operations and Research at Einstein/Montefiore (EXPLORE) is a collaboration between the Albert Einstein College of Medicine and Montefiore Health System (MHS), a large, integrated, accountable-care-oriented academic medical center that serves the Bronx and New York's Lower Hudson Valley region. We will leverage the efforts of MHS to deliver high quality services to a largely minority, socioeconomically disadvantaged community, while at the same time responding to the financial and service delivery imperatives of accountable care. Our proposed program will engage and build upon a strong education and training infrastructure at Einstein and an innovative informatics and value-based care delivery infrastructure at MHS. We will leverage the educational and research support resources of Einstein's Institute for Clinical and Translational Research (ICTR), the home our Clinical and Translational Science Award (CTSA), including didactic components of its Masters in Clinical Research and its AHRQ/PCORI- sponsored R25 patient-centered outcomes research coursework, the informatics infrastructure of the Center for Health Data Innovations, and the resources of Montefiore's Network Performance Group (responsible for quality of care, operational excellence, and patient safety at MHS), to create a novel career development program in LHS research. We will identify the most talented, motivated, and multidisciplinary clinicians and other faculty to enroll, equip them with the knowledge and skills to conduct, implement, and disseminate high quality and actionable LHS research, and provide them a sustainable career path as LHS research leaders. Our Scholars and mentors will contribute to a national LHS Research Collaborative, with Einstein-Montefiore's contribution driven by the expertise within and experience gleaned from our unique institutional program and resources. This will be accomplished through curriculum sharing and cross-institutional education; inter-institutional PI/PD and Scholar-Mentor interactions, including cross-institutional mentoring when feasible and appropriate; research cooperation, including dissemination of research findings and multi-center research initiatives; and sharing PCOR/CER methodological advances. !