Teams and the Learning Healthcare System King C. Li, MD, FRCP(C), MBA Senior Associate Dean, Clinical and Translational Research Isadore Meschan Distinguished Professor and Chair of Radiology

Macro-level: Teams of teams. How can we leverage teams of teams to deal with issues at the population level?

“… American health care is falling short on basic dimensions of quality, outcomes, costs, and equity. Available knowledge is too rarely applied to improve the care experience, and information generated by the care experience is too rarely gathered to improve the knowledge available. The traditional systems for transmitting new knowledge—the ways clinicians are educated, deployed, rewarded, and updated—can no longer keep pace with scientific advances.” (IOM, 2012)

Page 4 Wake Forest Baptist Medical Center Problem Statement We are not leveraging our scientific base well enough to benefit our patients. We are not training our students and providers well enough to provide value based care. We are not deriving our knowledge well enough from our patient care experience. We are not engaging our patients, their family, other care givers and other community members well enough in the care and learning cycle.

“…achieving a learning health care system—one in which science and informatics, patient-clinician partnerships, incentives, and culture are aligned to promote and enable continuous and real-time improvement in both the effectiveness and efficiency of care— is both necessary and possible for the nation.” (IOM, 2012)

GOAL 5: ENHANCE THE CLINICAL, RESEARCH AND EDUCATION MISSIONS BY FURTHER INTEGRATING PATIENT CARE AND RESEARCH. Objective 3: Use our clinical observations to inform/develop research hypotheses with testing in pilot studies to be supported in Strategy 1: Include clinical faculty as members of research centers and create opportunities for interaction. Strategy 2: Create translational research groups that align Integrated Practice Unit (IPU) leaders with basic/public health science researchers.

Page 11 Wake Forest Baptist Medical Center Questions for consideration… How can we best integrate our three missions – clinical, research and education to benefit patients? What funds flow and compensation models should we adopt to stimulate team science? How would we demonstrate and measure our progress year over year?