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. 2021 Apr;96(4):849-855.
doi: 10.1016/j.mayocp.2021.02.006. Epub 2021 Feb 16.

Rapid, Bottom-Up Design of a Regional Learning Health System in Response to COVID-19

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Rapid, Bottom-Up Design of a Regional Learning Health System in Response to COVID-19

Andrew F Beck et al. Mayo Clin Proc. 2021 Apr.
No abstract available

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Figures

Figure 1
Figure 1
Simplified early iteration of system-level key driver diagram showing the aim and theory for action for the regional response to coronavirus disease 2019 (COVID-19). Our global and SMART aims are listed on the left. Primary and secondary drivers extend on the middle and right side of the figure, respectively. Reff, effective reproductive ratio; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SMART, specific, measurable, achievable, realistic, timebound; SNF, skilled nursing facility.
Figure 2
Figure 2
Schematic pathway from disconnected sectors to an integrated regional population health situational awareness and action system, using Greater Cincinnati’s coronavirus disease 2019 (COVID-19) Multi-Agency Coalition (MAC) as an example. The left side shows the oft-separate, siloed sectors. To connect these related but disconnected sectors for a region such as Greater Cincinnati (map in the center), there are a series of challenges (middle-top) that can be met through the identified solutions (middle-bottom). For the current pandemic, this resulted in the MAC depicted on the right. The MAC is co-chaired by the chief executive officer (CEO) of a large adult health care system and the CEO of the organization serving as both the convener of the regional disaster preparedness coalition and the Regional Health Information Organization. The MAC includes appointed representatives of regional health care systems, two public health commissioners representing regional public health jurisdictions, and a leader of the Council on Aging and CEO of a long-term care facility representing congregate care facilities (including skilled nursing facilities, jails, halfway houses, shelters, etc). Support teams include representation of infectious disease specialists, a chair of pathology representing laboratory operations, communications (linked to the Chamber of Commerce and business community), and our situational awareness and strategy team. Since the formation of the MAC, additional sectors and their representatives have been added, including those from schools and universities. Together, the MAC and teams that support the MAC focus on aims relating to disease containment, testing and tracing, nonpharmaceutical interventions, communications across sectors and with the public, and supply chain (eg, hospital beds, ventilators, and personal protective equipment). Such a structure could have lasting ramifications as we seek population health situational awareness and action to outlast COVID-19.
Figure 3
Figure 3
Annotated chart depicting daily case incidence, measured per 100,000 population, with a 7-day moving average. Each line indicates an event or change expanded upon with the list on the right side. Light blue lines indicate mitigation-oriented interventions. Dark blue lines indicate background changes likely influencing viral transmission.

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References

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