Chapters Transcript Video The Learning Health Systems Rehabilitation Network: Opportunities for Johns Hopkins Medicine Janet Freburger, P.T., Ph.D., F.A.P.T.A., presents at the Johns Hopkins Department of PM&R’s Grand Rounds on April 28, 2021. I'm happy to be here to talk about learn because I am very excited about the opportunities with this rehabilitation research network and I'm very interested and um on behalf of the executive committee to try to um engage rehabilitation researchers you know across the continuum and not just physical therapists. I mean costar was focused on physical therapy and this is trying to kind of go beyond that and um hoping that we can get some involvement of um non pt folks. We're still a little bit peaty heavy starting out. But I think as folks get to learn more about this, hopefully we can expand the the you know people that are engaging in this work. So here are my financial disclosures, this um grant and contract support from NIH H. R. Q. And pick Corey. So what I'd like to do today is to provide to provide an overview of learn and discuss some of the activities and opportunities and then um hopefully engage in the discussion of um Lauren's resources and future opportunities with um with you all uh if you answer any questions and um you know get feedback. So learn is supported by NIH specifically the National Center for Medical rehabilitation Research under N. I. C. H. D. And the National Institute of Nursing Research. And this is what's referred to as a P. Two C. Funding mechanism which is designed to support multi component projects and centers that will enhance the capability of research resources to serve the biomedical research community. And this p. two C funding mechanism is geared towards rehabilitation researchers. We're closing in on our first year of um funding and um you know, we've been pleased with with the activities that were done, were looking forward to growing and and doing more as we go through the next four years. So Lauren is just one of um six P two C centers that are funded by um N. I C. H. D. And the group of these P two C centers are referred to as the medical rehabilitation resource Network and perhaps some of you have interacted with some of these these P two C centers currently or in the past they've been and I see HD has been funding these P two C centers I think this is I believe the 3rd, 55 year round or maybe the fourth. So why learn um we feel like there's an urgent need to improve rehabilitation care by timelier implementation of evidence based practice and the implementation of some suboptimal low value practice. So, Lauren's mission is really to to try to improve the quality and outcomes and value of rehabilitation care um through stakeholder partner research, both within and across learning health systems. Um as Mike said, it's a collaboration of Brown Boston University and the University of Pittsburgh and eight Healthcare Systems um with one of which is johns Hopkins, I'll talk a little bit more about these systems um in a few slides um some of them look, I'm sure look familiar to you and um you know you you recognize them as health systems. We have some unique partners also that I'll get into more details shortly. So the objectives of learn is to create a learning health system innovation hub that's kind of what we're calling a group of health system partners and basically you know where that's kind of at the foundation of of this um this network really trying to do work where we engage patients, providers, administrators and um you know all the stakeholders and um doing this work in real world settings or real real world care. Um Our second objective is to provide funding and methodological and technical technical support for um style scholars and pilot awardees. And then um our third objective is to develop a knowledge repository um where we have learning health system resources that are tailored to um the rehabilitation community with the goal of trying to advance best practices and um rehabilitation. Learning health systems research. So um just briefly what is a learning health system, there's as we know in science and academia there's always several definitions of terms. Um I like this one. It's simple, it's health system that combines internal data and experiences with external evidence to produce knowledge that is put into practice. Um you know, some key aspects of learning health system is that it harnesses data and analytics to learn what works best and it feeds that knowledge back to create a continuous quality improvement cycle. This is um again one of several ways that learning health systems are depicted, but um I like this because it kind of talks about the three components of the of the learning health systems cycle basically data to knowledge where you're kind of collecting data to understand your problem and then knowledge to practice, where you're trying to apply that knowledge um into practice and and affect change and then practice to data where you kind of look at, okay, we've we've used this um knowledge, we've made change. Let's look at how um how we're doing by looking at data again and you kind of start the cycle again. Um This is another way to to um look at it. I I like this slide just because it really um um it illustrates the goal of learning is really which is really to to partner healthcare partners and researchers to um you know, participate in this learning health system cycle. Um As far as um Learning health systems researchers and learning health systems competencies, Agency for Healthcare Research and Quality actually convened a group of experts and came up with learning health systems research competencies um and define what uh you know, learning health system researcher was um They saw the need for for um kind of articulating these competencies. Um you know, as far as health services research, they just looked and they saw that it was something that was becoming more and more common implementation science was becoming more comments that they wanted to um you know capitalize on that and and guide folks. Um So learning health system researchers are are embedded within the health system and collaborate with its stakeholders to produce novel insights and evidence that can be rapidly implemented to improve the outcomes of individuals and populations. Um they came up with seven broad research competencies um which are listed here on the right side of the of the slide and we'll talk about that information a little bit more detail as I go through through the presentation. But these competencies are really at the core of our training and um research activities that were that we're trying to promote through learn um This is the kind of administer the the organization of learned. Lynda Resnick is the overall P. I. Of of learned, she's at Brown University and she was actually the overall P. I. Of Costar which mike talked about at the beginning of um of this presentation. Um We've got an executive committee and um the executive committee members direct different components of learn. And there are seven components to learn. There's um the administrative over administrative oversight component and then we've got um these components here, promotion of center expertise, didactic interactions, mentor collaborations which is the learning health system scholar program that we talked about pilot studies and techniques developments and then at the bottom collaborative opportunities which is basically our health systems innovation hub and we have that down kind of at the bottom and as the foundation of this because it really is a partnership and we rely a lot on the health systems to to um participate in the activities and inform the activities. We also have an independent advisory board. Then I'll talk about um folks that are on that in just a second. So here's the executive committee. Um it's from its folks from Brown Pit and uh boston University. Okay. We also have four project managers or staff um that that helps support learn um and they do a lot of the work and we're very appreciative of them. Um there's kristen wrestles at pit with me and then Brown has a couple of folks and then boston University has hysteria. Um This is our independent advisory board which we're thrilled to have um these folks that have a lot of experience and and prestige tim Carey, who's at the University of north Carolina. Um He directed the chef center for health services research there for a long time. We have Charles Friedman who is an expert in learning health systems Brent James from stanford, um Tracy liu cannot bugger and shoshana. So for so we've had 11 meeting with our advisory board. We we planned to meet with them once to twice per year to get input. Um Again, Lynda Resnick oversees the administrative component of learned as the p i of the overall um learn and um I don't need to really read that that's just kind of um the administrative stuff mary slavin overseas promoting um center expertise component and this is the component that develops and implements um kind of learning activities and training activities um to to help um you know get engaged rehabilitation researchers and and help them become better um Learning health systems researchers. Mm hmm. Um the Learning Health Systems Innovation hub as we refer to it um is our eight partners um UPMC Hopkins Medicine, Intermountain Healthcare, Cleveland clinic boston Medical Center. There are there are all large um integrated um somewhat integrated healthcare system, some more so than others. Um but we also have the yada who is the largest um not for profit home health provider in the nation. And um we have aka N. C. A. L. Which is um the American Health Care Association and National Center for assisted living. They represent skilled nursing facilities and assisted living facilities around the country. They do a lot of advocacy work for their members but they also have access to um you know to to the members to to participate in in Learning Health System activities. And then Nava Health is a company that was started um with the bundle payment initiatives that came out and they were um a service for post acute care providers to try to help them deliver higher quality um you know more more value based care. Um There uh their customers have actually kind of changed now to more Medicare um advantage plans and they're working more with payers. But again with the goal of trying to improve the quality and value of post acute care and specifically in skilled nursing facilities and inpatient rehab facilities but they're starting to move into the home health arena also. So um we're thrilled to have this kind of diverse group of health systems. They represent diverse settings. Um They provide care across the life span um across different you know rehabilitation settings, there's um geographic diversity um serving urban and rural communities and and boston medical center as a safety net hospital. So um we were you know we're trying to um or you know we have some access to a really diverse group up there. Um The didactic interactions component is led by mary slavin and and Teresa Shireman and and this is um you know the the component that creates all the webinars and um grand rounds and activities that that um you know that that learn has has been sponsoring this year and will continue over the four years. Um They've got a planning committee of folks um from from brown and uh pitt and boston in boston um that that you know help inform their activities. So outside of the executive committee and this is kind of a summary of some of the work that has been done in this first year with the didactic activities um As I said earlier our work is guided by the learning health systems core competencies and sub competencies. And so just giving an example up here at the top the core competency of informatics um their sub competencies under that of demonstrating the ability to use the HR data and clinical information systems and then knowledge of how to link data sources to um to clinical data. So what the didactic activities community does is they try to find experts that can talk about these um competencies and they put on a webinar um where these experts come and then they followed up with a grand rounds where there's more kind of discussion of applications um by you know perhaps a researcher or a health system representative. So we've we've been through um three webinars um and two of them had grand rounds after them. We've um started with just kind of Learning health systems introduction and then went into stakeholder engagement which is one of the competencies of learning health systems researchers. And we're starting into system science um brian minutemen will be presenting next week I believe. And then um Pamela Duncan will be following up with a discussion of the compass trial after that. So these are are are are archived act um events that are available on our website which I'll give you the the hyperlink to that at the end of this presentation. So um these are all available for for anyone to view. Mhm. And then as I said we've got brian minutemen and pam Duncan coming up with um with the system science um that area and then we've got laura dot john Schroeder pub coming in the fall to talk about um the role of contacts or contextual factors in learning health systems. We just wrapped up our tele rehabilitation institute, hopefully some of you may have been there in attendance um that was just last week, it was co sponsored by Learn and costar um and we also had some support from Navajo Health and um that was a great a great two day um event. Again this is archived for for folks to um to listen to if if they're interested and we will have an institute like this once a year. May that may or may not be co sponsored but the goal is once a year will have an institute um that that addresses some timely topic. Um learn is going to be participating in the pre precision rehabilitation um annual scientific retreat. Um 1st 1 for the I guess this new cycle of funding um and I know that precision rehabilitation is is a is a big focus at Hopkins so um presumably uh you guys will be there or know of this um if not um you know again it's open open to um rehabilitation researchers and there's no cost. Um the men the pilot component is another component of learning and these are really kind of the funding opportunities um that we have with the pilot component and the scholars um component. So these are mentored pilot studies um of that are $40,000 inclusive of indirect costs. Um We put out a call for pilot applications each year, so we've already put out our call for for this first year but a new call will be coming out I would say in the late fall. Um we also actually um had had worked with mike and and um others at Hopkins to put out a special call looking at um Hopkins implementing the activity and mobility program um within the boston Medical Center and we actually have identified a scholar for that um for that activity and and hopefully it will follow up with the with pilot work and then we've got our mentor collaborations component. This is where we find Learning health system scholars. Um these are year long programs um where the scholar develops a relationship with the health care system kind of learns about the the ins and outs of the data, um understands kind of the context of the system and formulates a plan, a plan to address a system identified um high priority problems. So both the pilot studies and the Learning health Systems Scholar um awards are really focused on health systems priorities that the health system has has identified. So if you go to our website, um each of our health systems partners are listed and they've got a list of priorities that um that are important to them. We spend some time um talking with our health systems providers and and coming up with some kind of some common common priorities. And then the health systems often have specific priorities that are kind of at the top of their list. Um you know that we try to to work with and match with scholars. So the scholars um funding is $15,000 total funds. So it's direct and indirect costs. So it's a modest amount of money. But the idea is that we found that when you work with Learning health systems or Health Systems, you're trying to get a researcher in there. It really takes a lot of time just to kind of deal with all the issues around access to data and just for the researcher to kind of understand what's going on with the health system. So the idea is that these scholar opportunities are hopefully going to lead to um to pilot opportunities or some other activity at the end of the year. Um We funded four scholars in our first year and um we're in the process of funding um nine more um in this um you know in the beginning of the year to so here here are the scholars that we funded in year one and we these were actually individuals that were written up in our application for learn. Um so these were people that we had kind of um we had some relationships with through Costar and so um dr Coyle is looking at transitions of care following stroke with UPMC um Dr johnson's working at Cleveland clinic and looking at the value of PT and acute care setting. Um Dr Mengele's working with UPMC looking at um decision making, data driven decision making for patients with low back pain and then Tracy um facing Roz is an OT who's working with Intermountain Health and um looking at home home health care. We have funded three scholars for year two. We've got um actually we we've funded um dr galore who is working with um BMC and Hopkins. This is the activity and mobility promotion promotion, Scholar pilot opportunity that I referred to in the pilot um component. And then we've got um Rick black working with Akka and C. A. L. Looking at um using the G. G. Codes or data to analyze functional outcomes. And then dr khoja who's working with inner mountain to look at um knee osteoarthritis and telehealth. But if you look down here at the bottom we're working with Hopkins to to to pair them with the scholar. We're still in the process of that. Um And that's going to be focusing I believe on some kind of cognitive impairment and delirium um for patients in the acute care setting and then we're trying to match scholars with our other health system partners. Mm hmm. We funded two pilot studies in our first year um dr stevens who um is Okay, well that's actually um that's actually incorrect. Dr stevens is working with um skilled nursing facilities to um and and looking at the use of E. HRS and skilled nursing facilities. And then DR Young is um working with Intermountain Healthcare and looking at an activity mobility promotion program. We're in the process of um selecting pilot studies for year two. So we've had applications and and are are still in the process of reviewing them. Um The final component is that that um learn has is called the techniques component. And this is really trying to translate um learning health systems techniques and resources to the rehabilitation context. So we are um using a survey right now to the rehabilitation research community and perhaps you've received it over email where we're looking at needs and interests of the community in regard to learning health systems research. And the reason we're doing this is that um we want to kind of target areas that are of most interest to the um to the research community. So we want this survey to kind of guide how well do the didactic activities and training activities in year two. Um the information that we get from the survey will help us customize resources and um also we wanted to include the priorities of the innovation hub, stakeholders in in our resources and how we're customizing things for the rehabilitation research community. So this is a um a copy of the um one page of the survey. Um you can access this here if if you guys get the pdf, I was gonna give the pdf um to to mike or to um to Jack to um you know make available if you're interested in these slides. Um but you can also access it on the website, which I will show you how to get to that. Um But basically what we're doing is asking about the different learning health systems competencies, asking researchers what is your knowledge about these competencies and what is your interest in learning more? And so we're hoping that that, you know, the results of the survey will help inform what we've tried to focus on for for a year or two. And and going forward we're distributing this through professional organizations and um We actually had our project manager look at R1 level universities and and get emails from um you know from different universities at that focused on um rehab or that had rehab training programs and then using our internal email list. So this is kind of a summary of the learn activities I know kind of going through the organizational structures probably a little bit um you know a little bit harder kind kind of comprehend. But basically we've got funding opportunities through mentored collaborations are learning health systems scholar program and mentored pilot studies and these are, you know, all of these funded activities are partnering researchers with health systems and addressing a health system driven priority. Um and then we've got educational activities, we're aiming to have four webinars and four grand rounds per year. Um having an annual institute, we're going to be actually having an annual stakeholder summit where we're going to be getting together our health Systems Partners too. Talk about how the first year went and how we can help them advance Learning health systems Research and in the next year, Um we're proposing 2-3 symposia, our national conferences. Um we didn't really do that this year, but I think as we kind of get more settled um we'll probably be trying to do do some other things besides the institute and then um we are going to be providing consultations. Again, I think this is something that we haven't really tried to um to advertise a lot, but we do want to um serve consultative services for um you know, individuals that are interested in and you know, trying to to improve their skills is learning health systems researchers. And then the techniques development component is really just trying to um you know, maximize how we um match the how, you know maximize the training resources that were um you know, creating so that we're really addressing the needs of the of the research community and really trying to um you know, to advance learning health systems research and again our stakeholder engagement is key in working with our health systems partners um to, you know to inform all this work is extremely important. So here is our website um week you can access the survey here if you haven't already done it. Um you can find out about training activities um that are upcoming and um archived events. We actually also have a resource page where um we're starting to collate um you know uh journal articles and websites on Learning health systems. So um it might be something that that is abuse use for you if you're pursuing this kind of work, you can connect with us in various ways. Um you can join our email list. We have we're on twitter um the web site and then facebook and then this is just kind of a one page infographic that kind of summarizes um learn its purpose and um and you know just kind of an overview of of what what I discussed um during this presentation, so that concludes the kind of overview of learn. I'm um open to answering questions. Um folks have comments, thoughts um you know, we did appreciate at all. So thank you Janet, thank you so much for joining us and attending uh just open to the floor for any questions or comments. Mm hmm. I mean I do want I do really want to emphasize our desire to get people outside of physical therapy um engaged in the pilot funding and the scholars um again I think we, you know, we kind of have been funding the, you know, the people that we know and the connections that we've had um and you know through co star, but we're really interested in trying to get um other types of rehabilitation researchers with or without clinical backgrounds and involved in this um in in our activities and this type of work I did want to mention just so everyone's aware and then pretty I think you have your camera and probably gonna ask questions, but I believe Megan Beyer did submit something so and from Hopkins we are very committed to um it being team folks and you can see everything I think started jan it's fair to say through PT because it was like that pipeline that was developed by post are right and trying to extend and so that's why from Hopkins steve Wagner Nicole Schechter Annette Lovisa, there are a number of different disciplines who are a part of the groups and I think one of the pilots put forth was cog and delirium for that purpose, but uh thank you, got the camera on there, so go ahead. Okay, hi dr free burger, thank you for the wonderful overview. Um I'm my name is pretty ragged and I'm the Vice chair for research um here in our department. Um so I'd love to understand exactly how it sounds like the scope is very broad and you do want to expand beyond physical therapy interventions um I'd love to learn about, you know, the many ways in which we could potentially work with you. So what you know when you think when you're talking about expanding the purview uh could you give me a give us a little bit of sense of would it mean different areas, office search or exactly how do you envision it? Right. So um I mean it definitely needs to stay within the realm of rehabilitation. So I think you know, we are committed to advancing rehabilitation research but that that can include so many things outside of um you know, I guess what you know a lot of people think of when they think of rehab, you know pT and Ot So um so that's one thing. So you know the various professions, I mean when we um when we uh pilot sent out the survey we sent it out to like nursing rehabilitation, nursing prosthetics and orthotics folks, um speech therapy, occupational therapy, um uh um psychologists um so you know anyone in the healthcare team that that um you know in the rehabilitation healthcare team which is you know very multidisciplinary so in that regard um you know trying to reach all types of providers and researchers kind of addressing all areas of rehabilitation. Um I mean how how you could become more engaged is participating in the activities we're always looking for people to um for to help on planning committees to offer input on um you know what types of topics we should cover. Um So so that's one way to be engaged and then just the health system generally the health system priorities. Um you know, I think again, when we did this kind of for the application, we were focused on our costar group to kind of come up with priorities. But each year that will be working with the health system to kind of find out what their priorities are, how their priorities may have changed. And that would be an opportunity to to potentially engage different different people. Because if you've got a priority that, you know, focuses on a certain patient population, certain types of providers, whatever, you know, whatever is is kind of at the top of the list for for for you. Um but anything, you know, any engagement that anyone at your university could have with us to kind of help, let us let us understand what, you know, what you need and what, you know, you think is the is the best way to try to advance the science because it's so dependent on in the health system to be a success. So we really really umm appreciate that and value that. And I and I think part of having this um this presentation was, you know, and I reached out to mike and steve and said, you know, I, you know, when you want to, you know, we want to figure out ways to engage or you know, health system um folks more so pretty. I just want to follow up on the priorities and I see Pablo's where you go. But um, we're given a survey at the beginning and so the priorities are huge and we come at things like I wouldn't be caught up on the discipline, but the prior, so let me just read off what they are. So the team knows implementation of mobility programs in acute care. So that could be a stroke. I see you like it could be anything right. Um, transitions of care across the continuum effectiveness of pre debilitation and surgical care, unintended consequences of the coronavirus, pandemic and team based models of care and care accord. I mean those are huge topics with all types of leeway to bring in things, you know, all over from a team perspective. So, um, I just wanted you to have an idea. It's pretty broad um, which is usually something we don't always get. So and it could, but it can and it can be focused too if need be because I know like with um with the skull opportunity we're trying to work with with Hopkins and some of the other ones are health system partners have said, well, you know, we were doing this quality improvement project right now and it's um, you know, we really could, you know, use some help or you know, get some boost with this with the scholar. So again, I mean it's really, it's really what, you know, what you need and um and you know how we can help you and you know, hopefully it's a win win situation because the researchers are learning what it's like um to you know to to work with the health system and understand kind of how the research is different than, you know, doing, you know, R 01 in the ivory tower where you know, you're controlling everything. Um but you know, we think it's so valuable and and you know, we feel like this is really how we might be able to move the needle and and um kind of elevate rehab and its value. I just want to say, I think it's really terrific to that you have this program um and we'd be, you know, I personally would be delighted to talk with you more and find a way to collaborate um in terms of the pilot funding opportunities. Is that mostly for junior faculty, what level are you what level of faculty are appropriate for that kind of funding? Good question. It's it's for any level faculty so um and um and you know, I mean what we're finding is there's there's really not a lot of people in rehab that are well versed in Learning Health systems research and implementation science, I mean I think we're, you know, we're growing but you know, as in really all of medicine, I mean I think this is something that, you know, providers across um you know, all the disciplines are, are are trying to develop and improve with, so there's no there's no criteria um as far as that, it's really just someone who's willing um to, to work with the health system and um you know, and understand that they're not driving the research agenda. The health system is, so, I mean, I think that's kind of hard for someone like with the scholars of, you know, it was when they their applications, so I think we need to be a little bit clear about about that, but you know, we're learning as we go along how to do this because it's a new model um but the idea is if, you know, scholar has an interest in a particular area, general area, you know, it can be valuable for them to work with the health system and um you know, address the problem from the health system's perspective. So Janet here, I'm the director of the department, thank you again for the presentation, this is great and I am very much aware of, although maybe we haven't talked directly, I'm very much aware of a lot of activities that we have been doing in collaboration, focusing if I wouldn't have been doing, which is great and I love that you're presenting this year because I think they're supported to even expand that to two more um so so I really appreciate the conversation um maybe following a little bit the lines of what pretty was asking, can you speak a little bit about, so you told us that it doesn't matter if you're a junior or a senior but can you speak to us a little about how onerous is the application if you want to apply for the pilot or for the other one that with mentoring and have and then how much you need to have things well put together. For instance I want to work with my organization um to test these ideas, let's say acute therapy somewhere in some location. Do I need to have a letter from the big hospital boss or you know what kind of level of degree of engagement and support your this expectation to have with these applications. So the the scholar applications are um less onerous um but you know the pilot, the pilot study applications aren't um extremely um you know um hard but the the scholar applications really are pretty easy in my opinion because you're basically just kind of talking about kind of the area of interest that you have um that that seems to align with the health system and then your experience, you know what you bring to the table but also you know what things you would like to learn or um you know improve upon with um with the scholar experience the pilot studies and there is a review of the pilot studies and I think that um you know it has to have some some substance but we recognize that you know, even what's proposed might not really turn out, you know, as as it's proposed, but if there's, you know, a logical um flow to it, you know, the aims are clearly stated and the, you know, the approach is consistent with the aims. Um we're not really, you know, looking for the, I I guess like the, you know, the scientific rigor rigor of um you know like an R. 03 through NIH or something. So if you don't have, you know, all the statistics and and stuff like that um worked out that's not that's not as much of an issue, it's more, it's more really um proposing something that is consistent with the health system that seems um and that, you know, the person seems like that they could complete it and um and you know, it has some cohesion as far as an idea, so I don't know if that that was a good answer or not, but we can try to, I think we have, you know, with this first year we've kind of learned that we need to maybe be a little bit more um uh specific and prescriptive about what, you know, what we're expecting with these applications, but um they aren't they aren't expected to be um you know to to um demanding because again, I mean, learning health systems research is a little bit sloppy I think, you know, we we recognize that, So thank you. Thank you jan can I ask one more little question along those lines. Um so you know, for many grant applications you need a track record. So you submit your bio sketch and you need to have a track record of research. But I realize here you're really looking at the translational piece, you know how you know implementation science. So are you looking for a track record of NIH funded research, you know that kind or are you looking for a passionate clinician who can implement? You know, some of the there are so many gaps between what has been recommended in research and what is actually done in the clinic. Are you looking to bridge that gap? You know, click through a passionate clinician? Um Yes. Yes. So um yeah, I mean I think we are probably x. We are looking at me because it's um you know, NIH and and and and I C. H. D. I mean I think they really are focused on kind of the rehabilitation researcher but we can partner a researcher with a clinician and then I think it could work. So we're open to we're open to those kinds of arrangements. I think it would just have to be um we'd have to feel comfortable that that that it would, you know, it seems like it would be successful but we have a situation kind of like that already with one of our learning health systems scholars um at the Cleveland clinic. So I mean, I think it, you know, the clinician that's very, that's interested in research and has the passion, could definitely be um you know, in the mix, I think those are the kinds of things that would be good too to reach out to us if you know, once a call comes out to discuss it, I mean, were there to, to kind of work with you and and as I said, both of the scholars and the pilot studies are mentored in the, in the sense that, you know, just trying to help keep focus on target and focused and um you know, to ensure that there's success. Um so I don't know if that answered it, but I did want to pretty to your point though, I think what makes us unique at Hopkins and, and probably Janet what you're mentioning at Cleveland Clinic and I would argue UPMC is we're on both sides of the coin, so on one side we have people that are trained researchers looking for funding, but we also have clinical passionate people invested that can totally benefit from the education components of this, but also they have the frontline questions of implementing evidence in the practice and so, you know, hey, great, if that's a Hopkins person who applies for a pilot at Hopkins, but if not if it's a Hopkins person implementing it somewhere else or someone from somewhere else implementing it at Hopkins is bringing those skills together, but I would argue that we have a lot of people that would benefit from the education training and concepts being put forth um even if they don't necessarily qualify and Janet you'd have to speak to this to the actual funding. Oh right. Yeah. I mean the all the training activities and the webinars are open to, you know, the entire research um community and the entire health system community and you know, we we and some of the webinars that we've done, we've had our health Systems partners um commentate at the end um you know, be the be discussed since um So yes, I mean the training activities and um you know, webinars and the resources really are for everyone. The funding opportunities I you know, I think they, you know, you can we can have a situations where you could have a researcher and um you know a clinical person and and potentially support some of the clinical person's time. Um The scholar money can be used for for you know, anything. So we do have some scholars that are using um some of the money to support a clinical person um or to support a data person at the health system. Likewise, with the pilot's pilot funding um you know, the team, the pilot funding could be used to support clinical people on the team. So we're we're open to um you know to there's not a lot a lot of restrictions on, on how the money is, is used. So we're, we're open to um, you know, two models that would work. I mean really what we want to do is try to advance the science so that the success, we feel like successful scholar years would lead to a project at the end of the year, lead to, you know, kind of taking the work to the next step either through pilot funding or um, you know, maybe the health system is interested in it enough to try to support the work. But I really wanna, you know, try to to advance the advance the research and elevated to some degree. I mean, um, you know, we know that health systems often want to, you know the answer yesterday and they want to do, do the work quickly to get the answer and, and um, we appreciate that. We, we also want to try to kind of um elevate the work a little bit. Um, so that its more impactful. Hey Janet there's a question in the chat. Um, it just says it's a scholar program opened the fellows as well. Um, yeah. Yes. Um, and I see one other one. Can we get, I would imagine the slides you said would be available by pdf. Yeah, yeah, I have a pdf and yeah, please take the survey, the links in the pdf or you can go to the website but we would, we would love to, you know, love to hear from all of you um you know, if you haven't, you know, obviously if you have an interest in learning health systems research, um you know, if you don't then um you know, you'll get kicked out of the survey right away, but if you, you know, if you're interested in this field and we would love to have your input on, you know, what you think are important things to learn. So I just want to be mindful of time Janet, I want to thank you so much for presenting um everyone on the call and beyond will get these out and then we'll do a good job myself, steve Wagner will, will push out information from the learned group that are, we get these things for free, free seminars, freeway. So we just gotta, you know, I think make it louder and it's just not going to people's fam and I appreciate all the emails and webinars you all get, so we'll try to get loud um pretty maybe we'll work with you a little bit when those things happen like what, you know, maybe their key people we should have attend and um beyond that, if you all have questions and I appreciate you can reach out directly to learn but feel free to reach out to myself and steve Wagner and we can try to direct the question and and make sure you get answered, but Janet again, thank you so much uh for attending. And yeah, thanks, thanks everyone for your attention and yeah, the pretty and um and Pablo, Yeah, I mean, I think with the Health System Summit, the um the summit that were coming up, that's coming up in the fall with the Health System Leaders, we would love to have you participate in that and so will um reach out maybe to try to um you know, see if you would be available and um you know anyone else that that summit is for kind of our Health System Partners. So, um there'll be more information about that coming up. Absolutely. Happy to the moment. Absolutely. Thank you. Thanks everyone. Thanks everyone. Thank you. Bye bye. Created by
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