GP-HD: Using Genetic Programming to Generate Dynamical Systems Models for Health Care

The huge wealth of data in the health domain can be exploited to create models that predict development of health states over time. Temporal learning algorithms are well suited to learn relationships between health states and make predictions about their future developments. However, these algorithms: (1) either focus on learning one generic model for all patients, providing general insights but often with limited predictive performance, or (2) learn individualized models from which it is hard to derive generic concepts. In this paper, we present a middle ground, namely parameterized dynamical systems models that are generated from data using a Genetic Programming (GP) framework. A fitness function suitable for the health domain is exploited. An evaluation of the approach in the mental health domain shows that performance of the model generated by the GP is on par with a dynamical systems model developed based on domain knowledge, significantly outperforms a generic Long Term Short Term Memory (LSTM) model and in some cases also outperforms an individualized LSTM model

Participatory Common Learning in Groups of Dairy Farmers in Uganda (FFS approach) and Danish Stable Schools

Farmer Field Schools (FFS) is a well-known concept, which is widely used in many types of farming systems in the Global South. In this report different approaches to FFS adjusted to Ugandan smallholder dairy systems and to Danish organic dairy systems are explored and discussed. The report is based on a Master Thesis in Health Anthropology and a mini manual to the so-called Stable Schools. Improvements of farming practices should be based on the context of the individual farm and include the goals of the farmer and the farming system. This should be the case in all types of farming systems. Viewing learning as a social phenomenon and process, as well as an interaction between the learner and the learning environment (including other farmers) may give opportunities for context based innovations and developments towards a common goal in a group of farmers. It is also seen as a result of common transformative learning and legitimate peripheral participation in a social learning environment

Medical education and the pursuit of excellence : the quest for the Holy Grail?

Medical education in Europe is currently facing enormous challenges brought about by the number and the diversity of medical schools that are now within the fold. This diversity is amplified by different educational systems, cultural and socioeconomic issues, health care delivery systems and the ever increasing burden of communicable and non-communicable disease. There is also a movement away from traditional taught curricula to curricula that emphasise self-directed learning and thererby promote lifelong learning. The ultimate goal of undergraduate medical curricula should be to produce a medical doctor with certain core competances and the right basis for further specialisation and adaptability to different roles in health care. Furthermore, increasing professional mobility has highlighted the need for the establishment and maintenance of standards for quality assurance common to all EU countries.peer-reviewe

Integrating Behavioral Health & Primary Care in New Hampshire: A Path Forward to Sustainable Practice & Payment Transformation

New Hampshire residents face challenges with behavioral and physical health conditions and the interplay between them. National studies show the costs and the burden of illness from behavioral health conditions and co-occurring chronic health conditions that are not adequately treated in either primary care or behavioral health settings. Bringing primary health and behavioral health care together in integrated care settings can improve outcomes for both behavioral and physical health conditions. Primary care integrated behavioral health works in conjunction with specialty behavioral health providers, expanding capacity, improving access, and jointly managing the care of patients with higher levels of acuity In its work to improve the health of NH residents and create effective and cost-effective systems of care, the NH Citizens Health Initiative (Initiative) created the NH Behavioral Health Integration Learning Collaborative (BHI Learning Collaborative) in November of 2015, as a project of its Accountable Care Learning Network (NHACLN). Bringing together more than 60 organizations, including providers of all types and sizes, all of the state’s community mental health centers, all of the major private and public insurers, and government and other stakeholders, the BHI Learning Collaborative built on earlier work of a NHACLN Workgroup focused on improving care for depression and co-occurring chronic illness. The BHI Learning Collaborative design is based on the core NHACLN philosophy of “shared data and shared learning” and the importance of transparency and open conversation across all stakeholder groups. The first year of the BHI Learning Collaborative programming included shared learning on evidence-based practice for integrated behavioral health in primary care, shared data from the NH Comprehensive Healthcare Information System (NHCHIS), and work to develop sustainable payment models to replace inadequate Fee-for-Service (FFS) revenues. Provider members joined either a Project Implementation Track working on quality improvement projects to improve their levels of integration or a Listen and Learn Track for those just learning about Behavioral Health Integration (BHI). Providers in the Project Implementation Track completed a self-assessment of levels of BHI in their practice settings and committed to submit EHR-based clinical process and outcomes data to track performance on specified measures. All providers received access to unblinded NHACLN Primary Care and Behavioral Health attributed claims data from the NHCHIS for provider organizations in the NH BHI Learning Collaborative. Following up on prior work focused on developing a sustainable model for integrating care for depression and co-occurring chronic illness in primary care settings, the BHI Learning Collaborative engaged consulting experts and participants in understanding challenges in Health Information Technology and Exchange (HIT/HIE), privacy and confidentiality, and workforce adequacy. The BHI Learning Collaborative identified a sustainable payment model for integrated care of depression in primary care. In the process of vetting the payment model, the BHI Learning Collaborative also identified and explored challenges in payment for Substance Use Disorder Screening, Brief Intervention and Referral to Treatment (SBIRT). New Hampshire’s residents will benefit from a health care system where primary care and behavioral health are integrated to support the care of the whole person. New Hampshire’s current opiate epidemic accentuates the need for better screening for behavioral health issues, prevention, and treatment referral integrated into primary care. New Hampshire providers and payers are poised to move towards greater integration of behavioral health and primary care and the Initiative looks forward to continuing to support progress in supporting a path to sustainable integrated behavioral and primary care

Improving Personalized Consumer Health Search

CLEF 2018 eHealth Consumer Health Search task aims to investigate the effectiveness of the information retrieval systems in providing health information to common health consumers. Compared to previous years, this year’s task includes five subtasks and adopts new data corpus and set of queries. This paper presents the work of University of Evora participating in two subtasks: IRtask-1 and IRtask-2. It explores the use of learning to rank techniques as well as query expan- sion approaches. A number of field based features are used for training a learning to rank model and a medical concept model proposed in previous work is re-employed for this year’s new task. Word vectors and UMLS are used as query expansion sources. Four runs were submitted to each task accordingly