Notes from the Chair.
Charles Friedman, PhD
DLHS Broadens Its Research Agenda
with Amazing New Grants
To introduce this edition of The Loop, I want to celebrate some novel directions of our research programs, with funding from the Food and Drug Administration (FDA) and the National Science Foundation (NSF).
Rachel Richesson won a spirited competition for FDA funding of “Multi-Stakeholder Consensus Approach to Problem Consolidation and Strategic Use of Electronic Health Record (EHR) Data Standards for Clinical Research and Regulatory Reporting.” She and her colleagues will be studying the use of EHR systems as a source of “real-world data” which has great potential to improve research. Her project will develop consensus recommendations for leveraging real-world data for FDA-regulated research.
Vitaliy Popov received a highly competitive NSF grant for “Project mTEAM: Advancing Emergency Medicine Trainee Skills using Multimodal Debriefing System in Simulation-based Training.” He and his colleagues will study how to use simulation methods to better prepare teams for work in fast-paced, acute care settings. Through a highly innovative system that Vitaliy will develop, instructors will be able to provide personalized feedback to clinicians during post-simulation debriefing sessions to enable rapid development of these vital skills.
These are two examples of the increasing volume, relevance and ingenuity of the research ongoing in DLHS. I am extremely proud of Rachel, Vitaliy, and all of the DLHS faculty, staff, and students who are working so hard and so well to achieve better health of individuals and populations.
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The LHSCollaboratory kicked off the school year with a poster session highlighting the departments and programs within Michigan Medicine that are using a Learning Health System approach to address health problems, improve treatment in those areas and implement research.
From concussions to cardiac arrest, radiation oncology to medical rehabilitation and beyond, poster presenters laid out how LHS methods can work for health challenges on a variety of scales.
We partner with the U-M Office of Research, the Institute for Healthcare Policy & Innovation (IHPI), and the Michigan Institute for Clinical and Health Research (MICHR) to make the LHSCollaboratory a hub for advancing interdisciplinary research and development of learning health systems at the University of Michigan.
Each month faculty, staff and students from across the university convene around a new topic to exchange ideas and research.
Join us for the next #LHSCollaboratory.
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Bipolar Disorder Learning Community Takes Shape
A collaboration with the Department of Psychiatry is in the works to improve treatment for those living with bipolar disorder by adopting learning health system (LHS) principles and practices.
Last fall Melvin McInnis, MD, FRCPsych director of the Heinz C. Prechter Bipolar Research Program at Michigan Medicine, began conversations with DLHS Chair, Charles Friedman, PhD, as well as other DLHS faculty and staff about how to create a Bipolar Learning Community (BPLC) within their LHS.
Amy Kilbourne, PhD, MPH, DLHS’ associate chair for research, was part of those early conversations and sees the pressing need for an LHS approach to this mental health diagnosis that effects 2.8% of the U.S. population.
“Bipolar disorder (BPD) is ideal for LHS implementation,” says Kilbourne. “Despite the availability of effective treatments, few with bipolar disorder receive adequate quality of care.” That care deficit can increase functional impairment in patients and lead to premature mortality especially from suicide and cardiovascular disease.
To better understand how an LC can come together to around a particular health challenge, members of the BPLC turned to DLHS staff Michelle Williams, MHI, Lisa Ferguson, MSI, and Jane Ferraro, BSN, MPP, RN, who have been on the ground floor for LCs such as GI Prep and Out-of-Hospital-Cardiac Arrest.
Claudia Diaz-Byrd, BPLC program manager, said meeting with DLHS has been a great help, “They walked us through examples, literature, and the philosophy of a Learning Health System.” This primer helped set the foundation for the creation of an LC focused on adults newly diagnosed with BPD.
In this consulting role DLHS supplied strategies to improve practice while simultaneously getting help to those who need it. Often it takes 10 years to correctly diagnose someone with bipolar disorder, so speeding up community access is primary goal of the BPLC. A tandem goal is creating a successful feedback loop, where the patients are partners in their own care.
For instance, Medicaid patients in the Prechter Program will be able to use the Life Goals app created by Kilbourne to not only help manage their symptoms but also provide data to inform research and improve the lives of persons with bipolar disorder.
As the collaboration progresses, DLHS faculty member Alexandra Vinson, PhD, will get involved developing a scientific agenda that runs alongside the Department of Psychiatry’s LHS.
In the meantime, the BPLC is identifying a specialty clinic to implement the LHS model and engaging stakeholders to make up the community; patients, caregivers, family members, and healthcare providers joined by U-M leadership in psychiatry, the Prechter Program and DLHS.
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Kudos to the Learning Health Systems (LHS) Journal which recently passed 100,000  downloads! Don't miss this LHS Journal Special Issue specifically curated to build understanding of LHS workforce development across a range of initiatives in academic and real-world clinical settings.
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This position is part of a new faculty cluster at the U-M focused on “Racial Justice in Healthcare: Informatics and Data-Driven Approaches.”
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LHS at work in Physical Medicine and Rehabilitation
When Michigan Medicine departments like Physical Medicine and Rehabilitation (PM&R) want to explore the benefits of becoming a learning health system (LHS), DLHS is happy to be a resource for latest best practices.
PM&R is embracing the LHS philosophy as part of their strategic goals to rapidly improve care and training while simultaneously generating research. To advance this effort they consulted with Charles Friedman, PhD, DLHS chair and Amy Kilbourne, PhD, DLHS associate chair for research, who have been delivering the message throughout Michigan Medicine that LHS is a growing opportunity for translational research.
In conversation with PM&R, Friedman and Kilbourne described the ways in which LHS methods can be effective in the clinic space while also supporting research that then is applied back into practice.
 The Loop talked with Edward Hurvitz, MD, chair of PM&R, to find out how his department’s LHS journey is developing.
LOOP: How is PM&R employing learning health system methods to improve patient care?
Dr. Hurvitz: PM&R is working toward a goal of learning from every clinical experience. Our goal is to be able to inform ourselves, our patients and our trainees about best outcomes from interventions for their rehabilitation care. This may include treatments for spasticity in individuals with cerebral palsy or stroke, various interventions to help back pain, or an improved understanding of the results of neuropsychological tests.
One of the great benefits of moving toward a learning health system model is that it has brought practitioners together to discuss their practice and introduced standardization into how they collect clinical information during a patient encounter.
LOOP: What areas in particular are involved in incorporating LHS?
Dr. Hurvitz: Our LHS lead is Dr. Claire Kalpakjian, a rehabilitation psychologist who works with our teams on developing their clinical questions and starts them on their path. We have a new project manager who assists the teams, and a data analyst to help with that aspect of the project. We have several teams including concussion, spine, multiple sclerosis, orthotics/prosthetics, neuropsychology, and many more.
LOOP: Is there a specific example you can share of LHS in action?
Dr. Hurvitz: Our concussion team has a NeuroSport LHS database that has more than 8000 patients that will be moving into the analysis phase to look at interventions to decrease symptoms of concussion and the application of back-to-play protocols.
Our Spine team has engaged all of its providers to develop intake questionnaires for patients that will provide discrete data that can be used for clinical decision-making, and then analyzed for outcomes. They have included community stakeholders in their project.
Our “Long-Covid’ clinic team is working out what variables are of most interest for this new syndrome.
LOOP: What do you consider the most valuable aspect of your collaboration with DLHS?
Dr. Hurvitz: The DLHS has been invaluable in its guidance in this project. Dr. Friedman has been a tremendous resource and advisor for us, we are working with him on building the LHS in our department and spreading it in the medical center. Dr. Kilbourne has been a valuable resource as well.
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 Staying Alive Video Contest
Winners Announced
As part of the HeartSafeHome.org campaign to promote the three easy steps that can save a life when sudden cardiac arrest occurs, the Michigan Resuscitation Innovation and Science Enterprise (M-RISE) research program conducted the Staying Alive Video Contest this month.
Members of the public were asked to make and submit a short video showing how they were practicing their HeartSafe Home plan. The M-RISE team, which partners with the Out-of-Hospital Cardiac Arrest Learning Community (OHCA LC), recently reviewed submissions and is pleased to announce the winners and their prizes:
- 1st place: Adrian Dantzer - $1000
- 2nd place: Caroline D’Agostino - $500
- 3rd place: Katie Farrell - $300
The contest took place in October to coincide with Sudden Cardiac Arrest Awareness month. A staggering 74% of sudden cardiac arrests occur in the home, so being prepared is vital. See the videos and learn how your household can create a plan by visiting heartsafehome.org today.
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DLHS is Growing Our Faculty
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 We are very pleased to welcome Debra F. Weinstein, MD, the new U-M Medical School Executive Vice Dean for Academic Affairs, as a professor of Learning Health Sciences.
Additionally, DLHS is excited that longtime DLHS collaborator Akbar Karim Waljee, MD, MSc, will be joining us as professor. Lisa M. Meeks, PhD, MA, will also be joining DLHS as a clinical associate professor and our own HILS graduate, Rama Musalia Mwenesi, PhD, MSE, comes aboard soon as an assistant professor.
Did you know we're hiring? DLHS is currently seeking a tenure track Data Science faculty in the area of anti-racism as part of a new U-M hiring initiative focused on "Racial Justice in Healthcare: Informatics and Data-Driven Approaches."
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MESP Symposium and Roland "Red" Hiss Lecture
For the past 20 plus years the Medical Education Scholars Program (MESP) has been teaching U-M junior faculty and fellows the leadership tools and skills to become medical education leaders.
This summer attendees gathered at the Michigan Union for the MESP symposium. This opportunity to showcase learners’ final projects is held in conjunction with the Roland “Red” Hiss Lecture which celebrates the life and career of Dr. Hiss, former chair of the department of medical education.
U-M alum Louito C. Edje, MD, MHPE, FAAFP, whose current role is associate dean of graduate medical education at University of Cincinnati College of Medicine, delivered this year’s lecture on the topic of advocacy. Her talk was followed up with reflections from new Michigan Medicine Chief Academic Officer and Medical School Executive Vice Dean for Academic Affairs, Debra F. Weinstein, MD who also holds a professorship in DLHS.
Save the date for next year June 6, 2023
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Congratulations are in Order
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DLHS students getting noticed...
- Rising 2nd year PhD student Azia Harris-Martin received funding from the Rackham's Dean's Strategic Initiative (DSI) Programmatic Support Fund to support a workshop she organized titled "Racialized Slavery & the Paternalism of Care: Racialized Medicine, Science, & Statistics."
- Rackham Travel Grant recipients: Elliott Brannon, Roshan Paudel, and Anthony Provenzano who also received a HILS Travel Grant
- Rackham Debt Management Award: Elliott Brannon
- Rising 2nd year John O'Malley was admitted into the PhD Program in Scientific Computing, in addition to his HILS PhD program. John also was recognized with the 2022 Association of State & Territorial Dental Director's President's Award
- Rising 4th year PhD candidate Hyeon Joo is a participant in the 2022 Aikens Innovation Academy sponsored by the Frankel Cardiovascular Center
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Looking for way to support those struggling in the U-M family?
Our Liz Rodriguiz is helping to bring awareness to the U-M Emergency Hardship Fund. Learn more at:
emergency hardship.umich.edu
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Ambrielle Stoltz-Bango
