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Objectives Predictive models for critical events in the intensive care unit (ICU) might help providers anticipate patient deterioration. At the heart of predictive model development lies the ability to accurately label significant events, thereby facilitating the use of machine learning and similar strategies. We conducted this study to establish the validity of an automated system for tagging respiratory and hemodynamic deterioration by comparing automatic tags to tagging by expert reviewers. Methods This retrospective cohort study included 72,650 unique patient stays collected from Electronic Medical Records of the University of Massachusetts’ eICU. An enriched subgroup of stays was manually tagged by expert reviewers. The tags generated by the reviewers were compared to those generated by an automated system. Results The automated system was able to rapidly and efficiently tag the complete database utilizing available clinical data. The overall agreement rate between the automated system and the clinicians for respiratory and hemodynamic deterioration tags was 89.4% and 87.1%, respectively. The automatic system did not add substantial variability beyond that seen among the reviewers. Conclusions We demonstrated that a simple rule-based tagging system could provide a rapid and accurate tool for mass tagging of a compound database. These types of tagging systems may replace human reviewers and save considerable resources when trying to create a validated, labeled database used to train artificial intelligence algorithms. The ability to harness the power of artificial intelligence depends on efficient clinical validation of targeted conditions; hence, these systems and the methodology used to validate them are crucial.

Overcoming Integration Failure Through Negotiation – A Workshop for Doers and Planners . "CONNECARE; A Bridge Over Troubled Waters" How to resolve conflicts of interest that prevent integrated care – an interactive workshop to generate solutions for shared dilemmas, based on real-life experience. Background: Learnings from a real life integrated healthcare venture: a new general hospital (Samson Assuta Ashdod, Israel) with an integrated care vision, in partnership with a healthcare insurer and provider of community healthcare services (Maccabi) and social services, supported by an H2020 project – CONNECARE - aimed to create and implement a digitally supported integrated care model. Why is moving from vision to reality so difficult? What are the main obstacles and challenges? How can we overcome the diverse and conflicting interests and perspectives of the major stakeholders? Aims and Objective of the workshop: To identify the different and sometimes conflicting interests of the major stakeholders – the Payer(s) (State, Region, Municipality, social insurer), the providers ( clinicians, provider organizations), the patient and his caregivers To set up consensus groups with "representatives" of all stakeholders To challenge the participants in the consensus groups to negotiate a workable integrated care model that takes into account the interests of all stakeholders To share learnings among the groups To briefly share 4 patient- centered innovative integrated care solutions that have been implemented in Ashdod with preliminary results Format: Introduction to the workshop (10 minutes) a. Setting the Scene – Dr Rachelle Kaye (4 minutes) b. Barriers to Integration – Hospital Perspective – Dr. Ofer Chen (3 minutes) c. Barriers to integration – Payer/Community Services Perspective –Keren Schecter Azoulay ( 3 minutes) Divide participants into small groups – their task to negotiate an integrated care model that takes into account the needs and interests of each stakeholder group (20 minutes) Presentation of small group findings and discussion - Dr. Rachelle Kaye, moderator (10 minutes) Presentation of integrated care solutions in Ashdod (15 minutes) a. Home Hospitalization and Home Rehabilitation – Dr Ofer Chen (5minutes) b. Community integrated care units in the hospital – Keren SchechterAzulay (5 minutes) c. CONNECARE – patient empowerment through digitally supported coordinated care – Reut Ron (5 minutes) Summary of learnings and comments from participants (5 minutes) Target audience: Health care managers, Clinicians, Researchers Learnings/Take away: Analysis of practical challenges and barriers in Implementing Integrated Care Building New models for implementing integrated care in practice that overcome the barriers Implications of Learnings for other environments

Adoption of Maker programs entails deep cultural and structural changes within schools. In this case study, we interviewed a principal and seven faculty members in a high school in the United States, after the first year of implementing making-centered curricula. We report how faculty members responded to the reform, their motivations and beliefs, and the concomitant shifts in power and status. We found that educators are required to make non-trivial adaptations to their skills, instructional approaches, and pedagogical beliefs, and that successful adaptation may lead them to gain status, resources, and support within the school. Those are gained on account of technical expertise and educators' efforts to promote the vision of the reform. The extent to which faculty members adapt to a reform, accommodate and support others in their process of adapting, or resist it, may determine whether the reform is successful or not. As such, school leaders face the challenge of encouraging faculty to buy into such reforms. The case study provides a unique perspective on Maker-centered reforms and outlines important implications for administrators seeking to implement similar programs.