title: Setting the vision: applied patient-reported outcomes and smart, connected digital healthcare systems to improve patient-centered outcomes prediction in critical illness.
abstract: OBJECTIVE
  Prediction models in critical illness are generally limited to short-term mortality and uncommonly include patient-centered outcomes. Current outcome prediction tools are also insensitive to individual context or evolution in healthcare practice, potentially limiting their value over time. Improved prognostication of patient-centered outcomes in critical illness could enhance decision-making quality in the ICU.
  
  
  RESULTS
  Patient-reported outcomes have emerged as precise methodological measures of patient-centered variables and have been successfully employed using diverse platforms and technologies, enhancing the value of research in critical illness survivorship and in direct patient care. The learning health system is an emerging ideal characterized by integration of multiple data sources into a smart and interconnected health information technology infrastructure with the goal of rapidly optimizing patient care. We propose a vision of a smart, interconnected learning health system with integrated electronic patient-reported outcomes to optimize patient-centered care, including critical care outcome prediction.
  
  
  CONCLUSIONS
  A learning health system infrastructure integrating electronic patient-reported outcomes may aid in the management of critical illness-associated conditions and yield tools to improve prognostication of patient-centered outcomes in critical illness.
authors.affiliation: aDivision of Pulmonary and Critical Care Medicine, Department of Medicine bCenter for Learning Healthcare cDivision of Medical Oncology, Department of Medicine dProgram to Support People and Enhance Recovery, Duke University, Durham, North Carolina, USA.
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Wysham
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Cox
mesh_terms: D003422:Critical Care / Q000458:organization & administration / Q000592:standards / Q000639:trends; D016638:Critical Illness; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000639:trends; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D006801:Humans; D007256:Information Systems / Q000639:trends*; D063868:Patient Outcome Assessment; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000639:trends; D011379:Prognosis; D011787:Quality of Health Care