Message from the Chair
 The Department of Learning Health Sciences is developing at a rapid pace. Occupying a unique niche in higher education we are focused on learning across levels of scale - individuals, groups, organizations, and ultra-large systems - to improve human health. Because we bring a new concept to the academic marketplace, we call ourselves an "academic startup" and have developed a culture consistent with that theme.
Data to Knowledge-Knowledge to Practice captures our uniqueness. While we share the data to knowledge process with all sciences, our difference stems from the co-equal attention paid to development of implementation methods that bring knowledge to practice. This enables cycles of continuous learning and improvement exemplified in our newsletter’s title, The Loop. Additionally, we focus on building infrastructure to facilitate learning with economies of scale. We strive metaphorically to build bridges, not rowboats.
I am extremely proud of our faculty, staff, and students whose energy, creativity, and commitment shapes our work. As you peruse this first issue of The Loop, you will see evidence of our "startup" spirit, our fixation on improving human health, our passion for the transcendent concept of learning, our focus on implementation, and our penchant for building infrastructure.
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DLHS Debuts New PhD Program
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 There’s a new graduate program in town, the HILS program. That’s short for the Health Infrastructures and Learning Systems program now offering PhD and MS courses as part of the growing stable of educational programs from the Department of Learning Health Sciences (DLHS).
In its inaugural year, HILS has attracted students with a variety of experience from the social sciences and applied health research, to those with strong backgrounds in Informatics and Information Science. Their transformational mission in this first of its kind program is to research and develop ways to help health systems become “learning systems,” where continuous improvement is built right into an infrastructure that encompasses technology, policy and human behavior.
Because of the program’s interdisciplinary emphasis, HILS students enjoy the benefit of faculty mentors culled from diverse fields including Public Health, Information, Nursing, Nephrology, and Obstetrics and Gynecology. As the program grows in size – goals for a future cohort are 10 to 15 PhD students and 30 MS students – the diversity of faculty will increase as well.
HILS Program Director Anne Sales, PhD, RN, describes how HILS research and practice can have a big impact on health care quality saying, “We can make the cycles of improvement much faster than they currently are.” Sales also brings that spirit of continuous improvement to her other role as the new Associate Chair for Education Programs and Health System Innovation in DLHS.
Take a closer look at HILS, and other DLHS education programs, by clicking here.
Inaugural HILS Class Photo
Back row, left to right: Nik Koscielniak; Kyle Kerbawy; HILS Director Anne Sales, PhD; Oliver Jintha Gadabu; Gracie Trinidad. Front row, left to right: Jeffrey Vlasic; Mike Roth
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Phasing In: CSC Opens iSim Lab and Plans for Second Location
 The Clinical Simulation Center (CSC) in the Towsley Continuing Education Building is a popular spot. So popular that a planned expansion, which will nearly double the current 5,000 square feet of simulation space, is already underway.
Situated in the heart of the Health System, a steady stream of medical students, residents, fellows, nurses, faculty and staff cycle through the CSC on a daily basis to perform a wide range of surgical simulations, computer based simulation assessments or work together in a mock operating room. The resulting 10,000 learner visits a year has the center bursting at the seams.
As simulation has grown to become essential to health professional training and patient safety initiatives, the CSC is responding to the demand in two phases. Phase one saw the October opening of a 24-hour Independent Simulation Center (iSim) in Towsley. iSim makes seven state of the art self-directed learning stations available to busy learners anytime they need to practice a skill or take an assessment.
Phase two is a bigger undertaking. The former Furstenberg Student Study Center Lounge in Medical Science Building II will be renovated to provide a second full service simulation center. “You can’t beat the location,” said Dr. James Cooke, CSC Executive Director, noting that Furstenberg is well positioned near the School of Nursing and the Medical School, both of which supply the lion’s share of CSC users.
Cooke and his team are already meeting with U-M facilities and architects to maximize the CSC Furstenberg expansion. Look for the new location to open in early 2018.
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The Knowledge Grid: Putting Biomedical Knowledge to Work
 The time lag between new biomedical discoveries and their widespread application to practice is more than 10 years. This means that today’s treatments employ the knowledge of the past decade, and the latest knowledge is virtually locked away in journal articles that are hard to find and even harder to apply directly to practice. Better health requires that we close this gap. Enter The Knowledge Grid.
Brainchild of Department of Learning Health Sciences (DLHS) Chair Charles Friedman, PhD and Allen Flynn, PharmD, Technology Lead and DLHS Research Analyst, the Knowledge Grid aims to accelerate local, regional and global health advancement with a new paradigm in biomedical knowledge representation, management and dissemination. The idea is to explode current limitations in written scholarly reports by representing research findings (a formula, a predictive model, a best practice protocol) as actionable Knowledge Objects in computer code. Knowledge Objects can compute advice to clinicians, and when best practice knowledge changes, Knowledge Objects can be rapidly revised.
A real world example can be found in the developing partnership between DLHS and Peter Tsai, MD, PhD of the National Research Institutes of Taiwan. Because Hepatitis B is an ongoing health issue on the island nation, healthcare providers need a way to identify who among the large population of Hepatitis B carriers could develop liver cancer. The Taiwanese continuously refine their prediction formula based on new data. Flynn’s team has engineered Knowledge Objects that can predict liver cancer risk, always using the most recent version of the formula, and suggest preventative measures for those individuals.
Closer to home Timothy Pletcher, DHA, DLHS Adjunct Research Investigator and Executive Director of the Michigan Health Information Network Shared Services, describes another developing application, “For opioid abuse prevention and treatment we can build Knowledge Objects that look for a pattern of concern, recognize that pattern as a predictive model and suggest a best practice for care.”
The Knowledge Grid concept points the way to an entirely new ecosystem for biomedical knowledge. Via the Grid, collections of coded Knowledge Objects can be held in new-generation digital libraries, just as books and journals are contained in traditional libraries today. The Knowledge Grid will enable clinicians and patients to have instant access to the latest best-practice knowledge—and, equally important, advice readily computed from that knowledge—to inform decisions that improve health.
For more information, contact Allen Flynn at ajflynn@med.umich.edu.
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DLHS Profile: Kyriaki Marti Takes Teaching Seriously
 Kyriaki (Kiki) Marti, DMD, MD, PhD, FEBOMS would be the first to tell you how her three-year stint in the Masters of Health Professions Education (MHPE) program has kicked her teaching skills up a few notches. The native of Greece comes by her dental education cred honestly; her mother was an educator, her father was an academic oral surgeon and she taught at the University of Athens for 20 years.
It was 2011 when Marti arrived to carve out a new niche in the U-M School of Dentistry. Two years later she dove headfirst into the MHPE program. Meeting with mentor Martha Funnell, interacting with co-learners and working to master the 12 program competencies inspired Marti to develop initiatives like the simulation courses she now teaches.
Not one to sit still, Marti is part of U-M Dentistry's Global Initiatives in Oral and Craniofacial Health program to empower the local dental community to serve special needs patients on the Greek island of Corfu. An accomplished pianist, Marti also has recently taken up sailing with the U-M Sailing Club. Next on her list? She and her husband hope to volunteer at next year’s Iditarod.
Kyriaki C. Marti, DMD, MD, PhD, FEBOMS is a Clinical Assistant Professor in the U-M Department of Oral and Maxillofacial Surgery and Hospital Dentistry, Department of Periodontics and Oral Medicine, Department of Cariology, Restorative Sciences and Endodontics
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DLHS Profile: Gretchen Piatt Designs Diabetes Interventions
 Gretchen Piatt, MPH, PhD spends a lot of time in church, but the questions she’s asking aren’t religious in nature. She and a U-M research team are there to survey, and check the health markers of, study participants who want help managing their Type 2 diabetes.
Recognizing the vital role churches play in African American communities, the self-described Pittsburgher’s work includes enlisting the aid of parish nurses and select peer leaders to provide ongoing support to diabetes patients. A recent NIH grant will keep Piatt’s work going at 21 churches in Detroit, Flint and Toledo for the next five years, a boon to her work designing effective interventions for chronic illness care. “There’s no other disease besides diabetes I would rather work on,” says Piatt, “because it impacts those who have it every day for the rest of their lives.”
In her down time Gretchen loves DIY projects, interior decorating or taking her bike for a spin. On a Saturday you may see her and partner, Elizabeth, walking their dachshunds or cheering at the Big House like true Ann Arborites.
Gretchen A. Piatt, MPH PhD is an Assistant Professor of Learning Health Sciences in the U-M Department of Learning Health Sciences and an Assistant Professor of Health Behavior and Health Education in the U-M School of Public Health.
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