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Reports

The Potential of Learning Healthcare Systems

Author Dr Tom Foley, Dr Fergus Fairmichael16th Nov, 2015

This is our first major report, examining the potential of Learning Healthcare Systems. 
It examines the major challenges facing healthcare, defines a Learning Healthcare System, outlines the building blocks that must be in place to realise it, provided use cases that are already in operation and discusses the longer term implications.
The report is based on a literature review as well

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Journal Articles

What role for learning health systems in quality improvement within healthcare providers?

Author Foley, Vale31st May, 2017

AbstractIntroductionRecent decades have seen a focus on quality in healthcare. Quality has been viewed across 6 dimensions—safe, effective, patient-centred, timely, efficient and equitable. As IT has enabled the transformation of other industries, there has been an increasing interest in the potential for learning health systems (LHS) to improve quality in healthcare. We are not aware of any syste

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Is IT the end for doctors?

Author Tom Foley11th Jul, 2016

A BMJ Careers article, that appeared in the print edition of the British Medical Journal in July 2016.
This article explores the potential implications of Learning Health Systems, for doctors.

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Blogs

Learning Healthcare Systems: Emerging developments and their implications

Author Dr Tom Foley12th Nov, 2015

A blog summarising the background to our project and some of the findings.

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Presentations
Learning Health Systems: The Implications for patients and professionals. A presentation and panel session.

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Presentation on what mental health can take from the experience of Learning Health Systems in other specialties.

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Introductory lecture on the definitions, scale and scope of Learning Health Systems, along with examples in practice and foundational elements that are still required.

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Tom delivered one of four phases of the conference, around analysing the data and disseminating results. This included discussion of using behaviour change models to overcome barriers to dissemination.

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Interviews

East London Patient Record

Author Tom Foley5th Apr, 2017

Luke Readman, Chief Information Officer, Learning Health System The use of data to drive improvement is central to the Learning Health System (LHS) approach in ea

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NHS England - Global Digital Exemplars

Author Tom Foley5th Apr, 2017

Ann Slee, ePrescribing Lead, Strategic Systems & Technology, Patients & Information, NHS England As well as her work with NHS England, Ann has recently b

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Children and Young People’s Health Partnership (CYPHP)

Author Tom Foley5th Apr, 2017

Dr Ingrid Wolfe, Consultant in children's public health medicine and Programme Director of Children and Young People’s Health Partnership (CYPHP) Background t

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Farr Institute & (University College London)

Author Tom Foley5th Apr, 2017

Dr Amitava Banerjee, Senior Lecturer in Clinical Data Science and Honorary Consultant in Cardiology at the Farr Institute of Health Informatics Head of Education

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School of Health and Related Research (ScHARR)(Unversity of Sheffield)

Author Tom Foley5th Apr, 2017

Dr Clare Relton, Senior Research Fellow, University of Sheffield   How do you define a Learning Health System? One that learns from the healthcare it p

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Cambridge University Hospitals NHS Foundation Trust (CUH)

Author Tom Foley5th Apr, 2017

Dr Afzal Chaudhry, Consultant Nephrologist, Chief Clinical Information Officer and Associate Lecturer, Cambridge University Hospitals In 2014, CUH became the first UK healthcare provider to implement

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Professor Hiroshi Tanaka

Author Dr Tom Foley16th Nov, 2016

Professor Tanaka is Professor Emeritus in the School of Medicine at Tokyo Medical and Dental University. He is also Special Advisor to the Executive Director of the

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Dr Caroline Wood Interview

Author Dr Tom Foley29th May, 2015

BackgroundDr Caroline Wood is Assistant Director at the UCL Centre for Behaviour Change,
Dr Wood has kindly reviewed the behaviour change chapter of our report and offered many helpful additions.

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Mr John Loder Interview

Author Dr Tom Foley20th May, 2015

BackgroundJohn Loder is a senior programme manager at Nesta in the Health and Ageing team within the Innovation Lab. He works on the Centre for Social Action Innovation Fund that aims to use the skill

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Dr Gerry Morrow Interview

Author Dr Tom Foley20th May, 2015

BackgroundDr Gerry Morrow is Medical Director of Clarity Informatics, who aim to improve patient care and outcomes using data and analytics.  Clarity offer a Quality Improvement Service (QIS) in

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Professor Faden and Professor Kass Interview

Author Dr Tom Foley, Dr Fergus Fairmichael20th May, 2015

Background Professor Faden is the Philip Franklin Wagley Professor of Biomedical Ethics and Andreas Dracopoulos Director of the Berman Institute of Bioethics.Professor Kass is the Phoebe R Berman Prof

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Dr Shaun O’Hanlon Interview

Author Dr Fergus Fairmichael19th Mar, 2015

Background
Dr O’Hanlon is EMIS Group's Chief Medical Officer. He started with EMIS in 2006 as Clinical Design Director and was responsible for the clinical architecture of EMIS's flagship p

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Dr James Munro Interview

Author Dr Fergus Fairmichael11th Mar, 2015

BackgroundDr James Munro is chief executive and chief technology officer of Patient Opinion. He has a background in clinical medicine, public health and health services research.Patient Opinion was fo

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Mr Kingsley Manning interview

Author Dr Tom Foley11th Mar, 2015

BackgroundKingsley Manning is Chair of the Health and Social Care Information Centre.  He was previously Founder and Managing Director of Newchurch Limited, Executive Chairman of Tribal Group’s h

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Translation into Practice Focus Group

Author Dr Tom Foley, Dr Fergus Fairmichael5th Mar, 2015

ParticipantsDr Gregory Maniatopoulos, Senior Research Associate, Institute of Health and Society, Newcastle University
Mr John Fellows, Analyst Centre for Workforce Intelligence
Professor John F

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Workforce and Training Focus Group

Author Dr Tom Foley, Dr Fergus Fairmichael5th Mar, 2015

ParticipantsDr Graham Willis, Head of Research and Development, Centre for Workforce Intelligence
Dr Wai Keong Wong, Consultant Haematologist UCL
Professor Alan Cribb, Professor of Bioethics and

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Technical Feasibility Focus Group

Author Dr Tom Foley, Dr Fergus Fairmichael5th Mar, 2015

ParticipantsDr Wai Keong Wong, Consultant Haematologist UCL
Prof Brendan Delaney, Professor of Primary Care Research Kings College London, Project Coordinator and Scientific Director TRANSFoRm proj

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Improving the Underlying Data Focus Group

Author Dr Tom Foley, Dr Fergus Fairmichael5th Mar, 2015

ParticipantsProfessor Brendan Delaney, Professor of Primary Care Research Kings College London, Project Coordinator and Scientific Director TRANSFoRm project
Mr Seref Arikan, Software developer at

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Ethics and Information Governance Focus Group

Author Dr Tom Foley, Dr Fergus Fairmichael5th Mar, 2015

ParticipantsDr Gregory Maniatopoulos, Senior Research Associate, Institute of Health and Society
Dr Graham Willis, Head of Research and Development, Centre for Workforce Intelligence
Dr Jonathan

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Dr Rupert Dunbar-Rees Interview

Author Dr Tom Foley, Dr Fergus Fairmichael4th Mar, 2015

BackgroundDr Rupert Dunbar-Rees is a GP by background, and Founder of Outcomes Based Healthcare. He trained in Medicine at Imperial College, gaining a degree in Orthopaedics from University College Lo

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Mr Lynn Etheredge Interview

Author Dr Tom Foley, Dr Fergus Fairmichael13th Feb, 2015

BackgroundLynn Etheredge heads the Rapid Learning Project, a Washington DC area policy research center.. His career started at the White House Office of Management and Budget (OMB), where he was OMB’s

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Dr Lisa Simpson Interview

Author Dr Tom Foley, Dr Fergus Fairmichael13th Feb, 2015

BackgroundDr. Simpson is the President and Chief Executive officer of AcademyHealth. Before joining AcademyHealth, Dr. Simpson was director of the Child Policy Research Center at Cincinnati Children&#

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Dr Michael McGinnis Interview

Author Dr Tom Foley, Dr Fergus Fairmichael12th Feb, 2015

BackgroundDr Michael McGinnis is a physician, epidemiologist, and long-time contributor to national and international health programs and policy. An elected Member of the Institute of Medicine (IOM),

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Dr Caleb Stowell Interview

Author Dr Tom Foley, Dr Fergus Fairmichael12th Feb, 2015

BackgroundCaleb Stowell is Vice President, Research and Development, at the International Consortium for Health Outcomes Measurement (ICHOM); and Senior Researcher at Harvard Business School. His role

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Dr Christina Åkerman Interview

Author Dr Tom Foley9th Feb, 2015

BackgroundDr Christina R. Åkerman is President of ICHOM. Between 2008 and 2014, she served as Director General for the Medical Products Agency (MPA) in Sweden, a national agency employing approximatel

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Professor Richard Platt Interview

Author Dr Tom Foley, Dr Fergus Fairmichael9th Feb, 2015

BackgroundProfessor Platt is Chair of the Harvard Medical School Department of Population Medicine at the Harvard Pilgrim Health Care Institute.  He has extensive experience in developing systems

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Dr Jeff Brown Interview

Author Dr Tom Foley, Dr Fergus Fairmichael9th Feb, 2015

BackgroundDr Brown is an Associate Professor in the Department of Population Medicine (DPM) at Harvard Medical School and the Harvard Pilgrim Health Care Institute.  He is Associate Director and

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Dr David W Bates Interview

Author Dr Tom Foley, Dr Fergus Fairmichael6th Feb, 2015

BackgroundDavid W. Bates, MD, MSc, is Senior Vice President and Chief Innovation Officer for Brigham and Women’s Hospital. He is a practicing general internist and maintains his positions as Chief of

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Dr Paul Wallace Interview

Author Dr Tom Foley, Dr Fergus Fairmichael6th Feb, 2015

BackgroundPaul Wallace, MD, is Chief Medical Officer and Senior Vice President for Clinical Translation at Optum Labs. Before joining Optum Labs, Dr. Wallace was senior vice president and Director of

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Mr Joshua Rubin Interview

Author Dr Tom Foley, Dr Fergus Fairmichael6th Feb, 2015

BackgroundMr Joshua Rubin is the Program Officer for Learning Health System Initiatives at the Department of Learning Health Sciences, University of Michigan Medical School.  Mr. Rubin is a forme

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Professor Charles Friedman Interview

Author Dr Tom Foley, Dr Fergus Fairmichael30th Nov, -0001

BackgroundProfessor Charles Friedman is Chair of the Department of Learning Health Sciences at the University of Michigan Medical School. He is the former Deputy National Coordinator and Chief Scienti

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Please watch the video of Professor John Fox discussing OpenClinical at out workshop in London on 5 March 2015 by clicking on the thumbnail.OpenClinical was established in 2001 to support clinical kno

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Please watch Professor Brendan Delaney discussing the TRANSFoRm Project and the challenges it has encountered by clicking on the thumbnail.The TRANSFoRm project aims to develop the technology to enabl

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Site Visits

IBM Watson Site Visit

Author Dr Tom Foley, Dr Fergus Fairmichael11th Feb, 2015

BackgroundDr Eric BrownDr Eric Brown is Director of Watson Technologies at the IBM T.J. Watson Research Center, NY. Eric is currently working on the DeepQA project, advancing the state-of-the-art in automatic, open domain question answering technology. The DeepQA team is applying this technology to build Watson, a computer system that famously beat the best human players of Jeopardy! Eric has been

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Site visit to Geisinger Health System

Author Dr Tom Foley, Dr Fergus Fairmichael3rd Feb, 2015

BackgroundGeisinger Health System (GHS) is an integrated health services organization. GHS serves more than 2.6 million residents throughout 44 counties in central and northeast Pennsylvania. GHS is considered to be at the forefront of innovative care, with products and services aimed at improving quality, efficiency and value.  Population health strategies such as ProvenHealth Navigator, whi

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External Project Links

Connected Health Cities (University of Bradford) – Empowering independence in older people

Author Tom Foley5th Apr, 2017

Linking routinely collected primary, secondary, social care data with that from a large cohort study, to evaluate the comparative effectiveness of different interventions.

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Connected Health Cities (Public Health England) – Using data to tackle antibiotic resistance

Author Tom Foley5th Apr, 2017

Anonymised GP, A&E and out of hours clinic records across Greater Manchester will be extracted, analysed and visualised so that GPs can compare their prescribing behaviour with others across the c

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Model Hospital (Department of Health)

Author Tom Foley5th Apr, 2017

The Carter Review1 identified unwarranted variation in running costs, sickness absence, infection rates and prices paid for supplies and services between providers. As part of the review, a ‘model hos

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Connected Health Cities (Durham University) – Forecasting emergency unplanned care

Author Tom Foley5th Apr, 2017

A collaboration to produce statistical models, powered by linked health, local authority and other data, that can be routinely used to produce daily forecasts, up to 6 months in advance, of variations

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Connected Health Cities – (Newcastle University) Learning Health System for vulnerable families

Author Tom Foley5th Apr, 2017

Building a platform to link data between health, social care and other agencies, relating to families, across North East England, that have multiple risk factors, such as poverty, chronic illness or u

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Connected Health Cities (Greater Manchester) – Using data to improve diagnosis and treatment of stroke in Greater Manchester

Author Tom Foley5th Apr, 2017

A collaboration between Manchester University, AHSN, local trusts, local authorities and the Greater Manchester Stroke Operational Delivery Network. Linking data from GP, providers, the ambulance serv

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QSurveillance

Author Tom Foley5th Apr, 2017

QSurveillance® is a clinical surveillance system based on data from 3,400 EMIS general practices spread throughout the UK. It is run as a collaboration between the University of Nottingham, EMIS (GP E

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Connected Health Cities – (University of Sheffield) Supporting community care and reducing demand on A&E

Author Tom Foley5th Apr, 2017

Linked de-identified data from the ambulance service, 111, hospital trusts and out of hours services across the Yorkshire and Humber region, is to be used to monitor patterns of service use and outcom

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Connected Health Cities – (University of Liverpool) Learning system for alcohol related conditions

Author Tom Foley5th Apr, 2017

Using routinely collected health data, linked with social care and other data, to analyse alcohol care pathways in the North West. Making linked data available at the point of care and ultimately, aim

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Connected Health Cities – (Bradford University) Promoting Healthier Child Growth

Author Tom Foley5th Apr, 2017

Combining health visitor and primary care records with schools based national child measurement service data and the “Born in Bradford dataset”, to gain insights into the aetiology of obesity and to c

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NHS Digital

Author Tom Foley5th Apr, 2017

In England, HES (Hospital Episode Statistics) data, collected by providers and collated by NHS Digital provides, demographic, diagnostic and intervention data for all inpatient episodes, along with ve

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Clinical Practice Research Datalink (CPRD)

Author Tom Foley5th Apr, 2017

The Clinical Practice Research Datalink (CPRD) is a governmental, not-for-profit research service, jointly funded by the NHS National Institute for Health Research (NIHR) and the Medicines and Healthc

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QRESEARCH

Author Tom Foley5th Apr, 2017

QRESEARCH is a large consolidated database derived from the pseudonymised health records of over 24 million patients. The data currently come from approximately 1500 general practices using the EMIS c

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Manchester Data Well

Author Tom Foley5th Apr, 2017

Datawell is an informatics platform designed to enable health data to be shared and Linked across Greater Manchester. In time, it is expected to become a genuine shared care record and a health data e

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Great North Care Record (GNCR)

Author Tom Foley5th Apr, 2017

A regional shared record system for the North East of England and Cumbria. This currently consists of an implementation of the Medical Interoperability Gateway (MIG), a system that allows secondary ca

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Lancashire Patient Record Exchange

Author Tom Foley5th Apr, 2017

A patient record exchange that appears to be focused on enabling records to be viewed across different providers within the region. Only very limited technical specifications available online.

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Hampshire Health Record

Author Tom Foley5th Apr, 2017

Supported and run by South Central and West Commissioning Support Unit, this system has been operational for over 10 years. It allows patient data to be viewed between hospital, general practice, comm

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Doncaster Integrated Digital Care Record

Author Tom Foley5th Apr, 2017

Doncaster CCG plans to launch this system in Summer 2017. It will allow sharing of records across community, acute, mental health, and social care systems, however, the project is described as proof o

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Institute for Health and Society (Newcastle University)

Author Tom Foley5th Apr, 2017

IHS is a health improvement institute that has traditionally been underpinned by, Health Economics, Health Psychology, Medical Sociology and Health Technology Evaluation and which is now developing a

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Centre for Health Informatics (CHI) (Manchester University)

Author Tom Foley5th Apr, 2017

The CHI hosts the MRC Health eResearch Centre and leads research across a number of methodological disciplines, particularly health informatics, bioinformatics, biostatistics, computer science and sof

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Centre for Patient Safety and Service Quality (CPSSQ) & NIHR Patient Safety Translational Research Centre (Imperial College London)

Author Tom Foley5th Apr, 2017

Researchers within the centres have expertise including surgery, medicine, pharmacy, infection prevention, psychology, economic evaluation, technological innovation, organisational development and pat

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Biomedical Informatics Group (King’s College London)

Author Tom Foley5th Apr, 2017

The KCL Biomedical Informatics Group is a multidisciplinary group of informaticians, clinicians, psychologists and computer scientists, researching the role of data and knowledge in medical research a

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Farr Institute – Centre for Improvement in Population Health through E-records Research (CIPHER) (Swansea University)

Author Tom Foley5th Apr, 2017

CIPHER undertakes research that covers both observational and interventional research across all disease areas with an emphasis on methodological innovation and development in e-records research, incl

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Farr Institute (Edinburgh University)

Author Tom Foley5th Apr, 2017

The Farr Institute at Edinburgh is collaborating with Asthma UK to build a LHS for Asthma. There is currently limited information available on this initiative.

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GDE Learning Network

Author Tom Foley5th Apr, 2017

NHS England is establishing a Learning Network to encourage GDEs to share learning but also to collaborate on developing common solutions, so that they do not each have to reinvent wheels unnecessaril

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Connected Health Cities Citizen Juries

Author Tom Foley5th Apr, 2017

Data sharing within Connected Health Cities will require the building of public trust, so that the population understand and consent to the use of data. This will have to be built on openness, transpa

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AHSNs

Author Tom Foley5th Apr, 2017

There are 15 Academic Health Science Networks (AHSNs) across England, established by NHS England in 2013 to spread innovation at pace and scale – improving health and generating economic growth. They

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NHS Digital Academy

Author Tom Foley5th Apr, 2017

Plans are underway to create a virtual organisation that will provide a unique training and development opportunity for Chief Clinical Information Officers (CCIOs), Chief Information Officers (CIOs) a

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Faculty of Medical Informatics (FMI)

Author Tom Foley5th Apr, 2017

Work is underway to establish the FMI, this aims to overcome problems currently faced by doctors with an interest in informatics: no career structure, inconsistent remuneration, isolation, lack of sys

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Farr Institute

Author Tom Foley5th Apr, 2017

The Farr Institute is a UK-wide research collaboration involving 21 academic institutions and health partners in England, Scotland and Wales. Publically funded by a consortium of ten organisations led

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Medical Research Council (MRC)

Author Tom Foley5th Apr, 2017

MRC will invest £37.5m over 5 years to establish an independent UK Institute for Health and Biomedical Informatics Research (Farr 2). Additional funds will be contributed by the health research depart

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National Institute for Health Research (NIHR)

Author Tom Foley5th Apr, 2017

NIHR is funded by DH, to drive research from bench to bedside for the benefit of patients. It supports a wide range of translational and applied research. So far, it has shown limited direct interest

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Engineering and Physical Sciences Research Council (EPSRC)

Author Tom Foley5th Apr, 2017

EPSRC is the main UK government agency for funding research and training in engineering and the physical sciences. Health is a significant strand of its work. Research funded projects include: CONSULT

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Wellcome Trust

Author Tom Foley5th Apr, 2017

The Wellcome Trust is a global charitable foundation that supports scientists and researchers to take on big questions in population health, medical innovation, the humanities and social sciences and

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The Health Foundation (THF)

Author Tom Foley5th Apr, 2017

THF is an independent charity committed to bringing about better health for people in the UK. It aims to improve health service delivery and policy making by testing innovations, sharing evidence on w

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Innovate UK

Author Tom Foley5th Apr, 2017

Innovate UK is an executive non-departmental public body, sponsored by the Department for Business, Energy & Industrial Strategy. They work with people, companies and partner organisations to find

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Disease Specific Charities

Author Tom Foley5th Apr, 2017

Charities such as Cancer Research UK, MQ Mental Health and Asthma UK have significant disease specific research funding programmes and are collaborators on other broad based projects such as the Farr

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EU Commission

Author Tom Foley5th Apr, 2017

The EU Commission has funded LHS research projects of varying scales. The TRANSFoRm project outlined above received over €7.5m from the EU Seventh Framework Programme, while other research collaborati

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NHS England - Global Digital Exemplars

Author Tom Foley5th Apr, 2017

Ann Slee, ePrescribing Lead, Strategic Systems & Technology, Patients & Information, NHS England As well as her work with NHS England, Ann has recently b

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Connected Health Cities (University of Liverpool) – Learning system for unplanned care

Author Tom Foley4th Apr, 2017

Linking routinely collected health and eventually social care data to compare the care pathways of those who attended Emergency Departments with exacerbations of COPD in different locations. This will

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ICHOM has been set up to define global Standard Sets of outcome measures for all medical conditions and to drive adoption, reporting and benchmarking of these measures worldwide23. Essentially, these standard sets populate Porter’s hierarchy24 for each condition. They are created through international collaborations among patients, clinicians and outcome

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