Closing the Loop by Operationalizing Systems Engineering and Design (CLOSED)
Motivation:
Specific Aims :
Aim 1:​Use systems engineering and patient engagement to design, develop, and refine a highly reliable “closed loop” system for diagnostic tests and referrals that ensures diagnostic orders and follow-up occur reliably within clinically- and patient-important time-frames.
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Aim 2: Use systems engineering and patient engagement to design, develop, and refine a highly reliable “closed loop” system for symptoms that ensures clinicians receive and act on feedback about evolving symptoms and physical findings of concern to patients or clinicians.
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Aim 3: Design for generalizability across health systems more broadly so that the processes created in Aims 1 and 2 are effective in (1) a practice in an underserved community, (2) a large tele-medicine system, and (3) a representative range of simulated other health system settings and populations.
Partners:
Sunday, June 2, 2019
Sunday, June 2, 2019
Approach:
Sunday, June 2, 2019
Results to Date:
Center for Healthcare
Engineering Research
How CHER Works
Three keys to running a vibrant impactful collaborative research center are to keep logistics simple, ensure member voice and value in research projects, and allow flexibility to meet evolving needs. Members join on an annual rolling basis, co-define research projects of mutual interest, participate in whatever and how many project they would like, benefit in the application of results in their systems, and participate in dissemination, evaluation, and grant-seeking based on results.
Further information on membership, logistics, project selection and overall operations of the Center for Healthcare Engineering Research (CHER) are described below and in the provided links, modeld on our prior National Science Foundation Industry/University Collaborative Research Center
CHER Membership
Organizations join CHER for an annual fee at one of three membership levels (full member, associate member, affiliate member) based on their interest, size, budget, and other considerations. Members can join at any time during the year (with pro-rated dues accordingly) and can change between membership levels as needs and circumstances change. Members can be health systems, healthcare technology companies, payers, or otherwise.
Project Selection
Projects are reviewed on an ongoing basis at CHER-wide quarterly meetings (attended virtually or in-person) with summary materials distributed in advance. The purpose of these meetings is to review the overall portfolio of current CHER projects, discuss new potential projects, and address any center management issues. All projects are chartered in one-year cycles, on a rolling basis, so that any given quarterly meeting consists of reviewing completed projects, med-progress projects, and potential new projects to launch (based on member priorities). To maximize the benefit of collaborative research and to achieve budget efficiencies, the typical number of active projects is roughly 30-50% of the number of CHER members, with each member participation in (on average) 2-5 projects most relevant to their needs (although there is no limit on number of projects a member can participate in)
Center Operations
Each project itself is conducted by an identified research team consisting of, depending on the project, one or more HSyE research students, an HSyE staff or faculty lead, project management support, and individuals within the participating member health systems. Typical roles for the health system participants are to attend bi-weekly or monthly project meetings, provide health system feedback on results, assist with project data or implementation, and serve as a liaison to the health system. Overall center operations and coordination is handled by a day-to-day center manager, and Dr. Benneyan (or his designee) serves as overall CHER director. Internally, at HSyE we also review all projects as part of our weekly project management meetings in order to ensure focus, timeline management, team staffing, and so on.
Time and Resource Commitment
Health systems can put in as much or as little time as their needs and circumstances permit. While every project is different, the bulk of the “hands on” work of any given project tends to be conducted by the HSyE students (developing models, conducting analysis, mapping processes, running scenarios, analyzing data, conducting interviews, etc), working with the larger project team. Typically, each project has an identified person or persons within each participating health system to serve as project “point” to the system (attend meetings provide feedback, help obtain data, open doors, etc), spending anywhere from 1 to 4 hours per month on each project. More senior sponsors typically attend the quarterly review meetings to provide direction, feedback, insights on new potential projects, and so on – perhaps spending 1 to 4 hours per quarter (1-2 days per year) on CHER activities (although more engagement certainly is welcome). The more working weekly project work meetings to work on each specific project attended by healthcare staff, HSyE research students, and project managers. Typical project needs from a health system, again depending on their interest, might range from helping to define a problem, providing access to input data to run a developed model, testing a developed solution, giving access to student teams to observe and analyze a workflow, helping with manuscript preparation, and so on.
Health System Confidentiality
All CHER projects follow customary norms for confidentiality including data protections, review and approval periods for any external publications, and non-disclosure agreements. These are detailed in the CHER membership agreement in customary language, including all standard HIPAA, data use, mutual non-disclosure, co-authorship, and shared intellectual property agreements. All shared data is protected beyond minimal norms, and even generic project results are not disseminated without mutual agreement (and authorship if desired). While lawyers tend to like to spend disproportionate time on these things, it’s pretty simple; respect each other’s business and professional growth needs, work to ensure all ships rise, and collaborative research relationships tend to flourish.
One-on-One Projects
In addition to collaborative CHER projects, members also are able to receive assistance with one-on-one research and applied projects in a variety of manners. Please contact us to discuss any specific project needs.
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One-on-one Research Projects. Most directly, we have a standardized process for rapid approval of industry sponsored research projects, using a simple template for defining a statement of work and research budget. For example, this might focus on some research problem of interest to only one CHER member but that they still want to conduct.
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Senior Capstone Projects. CHER members also can participate in two-semester senior capstone projects that may have less time urgency, conducted by teams of 4-5 industrial engineering students over their senior year.
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Summer Internship Projects. CHER members also can participate in smaller projects conducted through our HSyE summer research internship program, working with some of the best industrial engineering students from across the U.S who spend a summer in our institute to learn more about healthcare and research as potential career paths.