2018 Annual Meeting

Applying Epidemiology Across the Lifespan to Improve Health Care,
Inform Health Policy and Enhance Population Health




Concurrent Session 2a

Location: University of Cincinnati, Medical Sciences Building (MSB), Kresge Auditorium

Epidemiology for the Learning Health System

Chair: Maurizio Macaluso, MD, DrPH, FACE, Professor of Pediatrics, University of Cincinnati College of Medicine, Director, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center

Brief Biography:

Maurizio Macaluso, MD, DrPH, FACE, is Professor of Pediatrics at the University of Cincinnati (UC) College of Medicine, Director of the Division of Biostatistics and Epidemiology at Cincinnati Children’s Hospital and Associate Director of the Center for Clinical and Translational Science and Training of UC.  He has over 35 years of research experience in methods; cancer; occupational health and safety; reproductive health; infectious diseases; surveillance systems; and has authored over 200 publications. He is a Fellow of the American College of Epidemiology and serves on the Board of Directors of ACE and as Associate Editor of the Annals of Epidemiology. He is the Program Chair and Local Host of the 2018 meeting.



Peter Margolis, MD, PhD, Co-Director, James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, “Learning from the Healthcare System to improve population health”

Description: This talk will describe how networked Learning Health Systems can eliminate the boundaries between clinical care, research and improvement to produces better individual and population health outcomes and experience for patients and families, faster research, and lower costs.

Abstract: The predominant organization of health care systems today relies on management and organizational approaches developed during the industrial age.  Responding to this challenge, the National Academy of Sciences has called for the development of a ‘learning healthcare system,’ in which patients and clinicians work together to choose care, based on best evidence, and to drive discovery as a natural outgrowth of every clinical encounter to ensure innovation, quality and value at the point of care. This vision of a learning health system has remained aspirational - until now. Over the last 15 years, the Anderson Center has designed and tested a networked learning health system model that demonstrated success in changing clinical outcomes - cutting serious safety events by 50%, decreasing mortalityfrom hypoplastic left heart syndrome by 40% during the inter-surgery period, reducing elective preterm delivery by 75%, and increasing the proportion of children with inflammatory bowel disease in remission by 26%. Networks unleash the motivation of diverse participants (parents, families, clinicians, clinical staff and researchers) to contribute ideas, know-how, tools, resources, and innovations aimed at making children healthier. Networked Learning Health Systems overcome the artificial barriers between clinical care, improvement, and research.  They leverage technology and ‘big data’ to improve the health and well being of individuals and populations of patients by enabling patients, clinicians, researchers and health systems to collaborate in ways that have not been possible before.

Brief Biography:

Peter Margolis, MD, PhD, is Cincinnati Children’s Professor of Pediatrics and Co-Director of the James M. Anderson Center for Health System Excellence at Cincinnati Children’s Hospital. His work encompasses the application and study of systems improvement methods across a broad range of areas including primary and sub-specialty care, communities and public health settings to improve the health outcomes of children, families and communities.  Over the last 20 years, he and his research team have developed innovative approaches that engage patients, their families, clinicians, scientists and communities in developing network-based learning health systems that simultaneously improve care, spawn innovation and accelerate research. This work has repeatedly demonstrated significant impact on the process and outcomes of care. 


John H. Holmes, PhD, FACE, FACMI, Professor of Medical Informatics in Epidemiology, Department of Biostatistics, Epidemiology, and informatics, Associate Director for Medical Informatics, Institute for Biomedical Informatics, University of Pennsylvania Perelman School of Medicine, “The Learning Health System as an Information Ecosystem”

Description: This talk focuses on the synergistic roles that epidemiology and biomedical informatics play in clinical research and improving care in the context of the learning health system. The emergence of new learning health systems and contexts, such as PCORnet and other distributed research networks will be discussed, as well as the changing role of epidemiologists and biomedical informaticians as they work within these systems.

Abstract: The Learning Health System (LHS) can be envisioned as an architecture that enables an iterative cycle of generating data from patients, learning from those data as they embody past experience, and then applying what has been learned from those data in the service of improving patient care. At its core, the LHS is data-centric, and its definition is steeped in the availability of clinical data primarily from electronic health record systems. With the advent of nearly ubiquitous clinical data collection and management, we are witnessing a burgeoning of new and extraordinary data resources that are available to epidemiologists. These data resources include not only the electronic health record and its subsidiary systems in ancillary services, such as laboratory, radiology, and anesthesiology systems, but increasingly from patient portals, wearable technology, and geographic information systems, to name a few. All of these resources exist in what can best be described as an “Information Ecosystem”, characterized as a potentially volatile yet diverse and valuable environment- a “sandbox”, to be blunt- in which the epidemiologist can perform her craft in new ways, and answer research questions that have hitherto been difficult or impossible to address. One could validly posit that the role of the epidemiologist is changing to include data science and even informatics. And just as validly, one could say that the clinical research informatician- the information scientist charged with such tasks as data harmonization and integration, curation of large datasets, and development and application of knowledge discovery and analytic algorithms- needs to be competent in the principles and execution of epidemiologic research. Thus, the lines are blurring between informaticians and epidemiologists, with due thanks to the Learning Health System.

Brief Biography:

John H. Holmes, PhD, FACE, FACMI, is Professor of Medical Informatics in Epidemiology at the University of Pennsylvania Perelman School of Medicine. He is the Associate Director of the Penn Institute for Biomedical Informatics and is Past-Chair of the Graduate Group in Epidemiology and Biostatistics. He has mentored or co-mentored eighteen pre- and post-doctoral students in informatics or epidemiology, and has developed curricula for graduate training in epidemiology and biomedical informatics as well as short courses in these disciplines. Dr. Holmes has been recognized nationally and internationally for his work on developing and applying new approaches to mining epidemiologic surveillance data, as well as his efforts at furthering educational initiatives in clinical research.  Dr. Holmes’ research interests are focused on the intersection of medical informatics and clinical research, specifically evolutionary computation and machine learning approaches to knowledge discovery in clinical databases, deep electronic phenotyping, interoperable information systems infrastructures for epidemiologic surveillance, and their application to a broad array of clinical domains, including cardiology and pulmonary medicine. He has collaborated as the informatics lead on an Agency for Healthcare Research and Quality-funded project at Harvard Medical School to establish a scalable distributed research network, and he has served as the co-lead of the Governance Core for the SPAN project, a scalable distributed research network; he participates in the FDA Sentinel Initiative. Dr. Holmes has served as the evaluator for the PCORNet Obesity Initiative studies, where he is responsible for developing and implementing the evaluation plan and metrics for the initiative. Dr. Holmes is a principal or co-investigator on projects funded by the National Cancer Institute, the National Library of Medicine, and the Agency for Healthcare Research and Quality, and he was the Penn principal Investigator of the NIH-funded Penn Center of Excellence in Prostate Cancer Disparities. Dr. Holmes is engaged with the Botswana-UPenn Partnership, assisting in building informatics education and epidemiologic research capacity in Botswana. Dr. Holmes is an elected Fellow of the American College of Medical Informatics (ACMI) and the American College of Epidemiology (ACE), and an elected Fellow of the International Academy of Health Sciences Informatics (IAHSI).


Amanda Latimer, PhD, Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Faculty, Bloomberg American Health Initiative, Public Sector Lead “Using academic – public sector partnerships to facilitate high impact change in policy and practice”

Description: The collaboration of academia and the public sector provides an opportunity for mutually beneficial learning and contextualize, translation-ready research. Examples are shared on how providing technical assistance to local and state governmental agencies across the US can positively impact policy and practice.

Abstract: The collaboration of academia and the public sector provides an opportunity for mutually beneficial learning and contextualize, translation-ready research. Examples are shared on how providing technical assistance to local and state governmental agencies across the US - sharing best practices, translating research and facilitating informed conversations while leveraging local expertise – can significantly contributed to public welfare. Emphasis on evidence-based programming across governmental sectors and increased value placed on public health practice within academic institutions can bridge the divide between the ivory tower and the boots on the ground, paving the way for greater impact.

Brief Biography:

Amanda Latimore, PhD, is a social epidemiologist with a focus on practice-based activities. She previously served as the Director of Social Epidemiology and Evaluation at the Baltimore City Health Department as well as Behavioral Health System Baltimore, which oversees publicly-funded behavioral health services in Baltimore. During this time, she spearheaded several projects that supported evidence-driven decision-making internally and externally, such as using Medicaid claims data to identify gaps and efficiencies in the City’s behavioral health service system and conducting daily overdose hot-spotting for the City’s rapid response teams. Amanda led research and evaluation projects at BHSB to provide policy and practice insights into topics such as the barriers to service utilization among overdose survivors and experiences of overdose bystanders in the context of the Good Samaritan Law, and the impact of a state pilot program for individuals under civil commitment. In partnership with the Baltimore City Health Department, Amanda mentored a Baltimore-based technology team, Code in the Schools, to develop a text-based service called Bad Batch (badbatchalert.com), a harm reduction tool which has received national recognition. Currently faculty in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, Dr. Latimore continues to focus on the community-informed applications of social epidemiology in and out of the classroom. As the Public Sector Initiatives Lead for the Bloomberg American Health Initiative, Dr. Latimore’s role is to work directly with public officials on collaborative projects and create and facilitate opportunities for public sector engagement.

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