An article published online this month in the Journal of the American Medical Informatics Association (JAMIA) outlines research challenges that must be addressed to achieve a high-functioning learning health system (LHS) that uses data to generate knowledge and improve care in continuous cycles. The article, titled “Toward a Science of Learning Systems: A Research Agenda for the High-Functioning Learning Health System,” is the product of an international workshop sponsored by the National Science Foundation. The workshop involved 45 prominent interdisciplinary researchers, who examined use cases for a national-scale LHS to determine a path toward this goal.
“…the LHS can succeed only by creating novel combinations of role, process and technology. This must occur by working back from the future, not by figuring out how to fix the various problems with a current system that fails to learn rapidly, routinely, and at scale.”
The group synthesized a research agenda in the form of key questions targeted at four system-level requirements for a high-functioning LHS. The authors further propose that addressing these questions will involve evolution to a new interdisciplinary science of “cyber-social ecosystems” in which diverse stakeholders collaborate to drive innovation.
Additional information from the workshop, including participants, slides, and use cases, is available online.
Article authors include NIH Collaboratory Coordinating Center Co-Principal Investigator Richard Platt, MD, MSc, and Co-Chair of the NIH Collaboratory Electronic Health Records Core, Jeffrey Brown, PhD.
A new Living Textbook topic chapter, “Learning Healthcare Systems,” has just been published. The topic includes background information on the creation and evolution of the concept of the learning healthcare system and the key attributes that define such systems, as described by the Institute of Medicine:
A learning healthcare system is [one that] is designed to generate and apply the best evidence for the collaborative healthcare choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in health care .
Also included in the topic chapter are ethical and regulatory implications for learning healthcare systems, patient and public engagement, the application of electronic heatlh records and other information technology, logistical and organizational challenges to bulding learning healthcare systems, and early examples of such systems in practice.
1. Institute of Medicine. The Learning Healthcare System: Workshop Summary. Olsen L, Aisner D, McGinnis JM, eds. Washington, DC: National Academies Press; 2007. Available at: http://www.iom.edu/Reports/2007/The-Learning-Healthcare-System-Workshop-Summary.aspx. Accessed April 4, 2014.
Slides and a workshop summary are now available from the Institute of Medicine website.
On April 23-24, 2014, the Institute of Medicine held a Roundtable on Value & Science-Driven Health Care workshop titled “Health System Leaders Working Towards High Value Care Through Integration of Care and Research” in Washington, DC. The workshop, sponsored by the Patient-Centered Outcomes Research Institute (PCORI), brought together stakeholders from across research networks, health systems, industry, and the patient community to engage on barriers and opportunities in building a continuously learning health system, where routinely collected health data informs improvements in evidence-based care. Eric Larson, MD, MPH, of the Group Health Research Institute chaired the workshop Planning Committee.
Workshop goals included:
- Fostering the development of a shared commitment, vision, and strategy among health system leaders building a national clinical research network
- Broadening and deepening health systems’ leadership awareness of the prospects for and from a continuously learning health system
- Learning from models and examples of productive integration of research with care delivery programs
- Identifying common issues compelling to health systems leaders related to science, technology, ethics, regulatory oversight, business, and governance
- Exploring strategic opportunities for executive, clinical, and research leaders to forge working partnerships for progress
- Considering the approach and desirable outcomes of a meeting of CEO leaders vital to building and sustaining a functional, real-time national clinical research network
One particular focus of the meeting was the recently launched National Patient-Centered Clinical Research Network (PCORnet). Workshop participants included representatives from PCORnet’s Clinical Data Research Networks and Patient-Powered Research Networks. Speakers provided real-world examples of learning health systems and urged leaders to make a business case for the learning health system model. Speed and dissemination of research were discussed as important considerations for patients.
The meeting was open to the public via webcast. Archived meeting presentations will be made available; a link will be provided in an update to this post. Workshop-related tweets can be found with the hashtag #IOMPCORI.
View the workshop agenda and briefing materials.