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. 2015 Mar 10;3(1):1122.
doi: 10.13063/2327-9214.1122. eCollection 2015.

Operationalizing the learning health care system in an integrated delivery system

Affiliations

Operationalizing the learning health care system in an integrated delivery system

Wayne A Psek et al. EGEMS (Wash DC). .

Abstract

Introduction: The Learning Health Care System (LHCS) model seeks to utilize sophisticated technologies and competencies to integrate clinical operations, research and patient participation in order to continuously generate knowledge, improve care, and deliver value. Transitioning from concept to practical application of an LHCS presents many challenges but can yield opportunities for continuous improvement. There is limited literature and practical experience available in operationalizing the LHCS in the context of an integrated health system. At Geisinger Health System (GHS) a multi-stakeholder group is undertaking to enhance organizational learning and develop a plan for operationalizing the LHCS system-wide. We present a framework for operationalizing continuous learning across an integrated delivery system and lessons learned through the ongoing planning process.

Framework: The framework focuses attention on nine key LHCS operational components: Data and Analytics; People and Partnerships; Patient and Family Engagement; Ethics and Oversight; Evaluation and Methodology; Funding; Organization; Prioritization; and Deliverables. Definitions, key elements and examples for each are presented. The framework is purposefully broad for application across different organizational contexts.

Conclusion: A realistic assessment of the culture, resources and capabilities of the organization related to learning is critical to defining the scope of operationalization. Engaging patients in clinical care and discovery, including quality improvement and comparative effectiveness research, requires a defensible ethical framework that undergirds a system of strong but flexible oversight. Leadership support is imperative for advancement of the LHCS model. Findings from our ongoing work within the proposed framework may inform other organizations considering a transition to an LHCS.

Keywords: 2014 EDM Forum Symposium; Context; Delivery System; Ethics; Health Information Technology; Learning Health System; Patient Involvement.

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Figures

Figure 1.
Figure 1.
Overview of Geisinger Health System (GHS)

References

    1. Institute of Medicine, IOM Roundtable on Evidence-Based Medicine. Olsen L, Aisner D, McGinnis Je. The Learning Health Care System: Workshop Summary. 2007
    1. Etheredge LM. A rapid-learning health system. Health Aff (Millwood) 2007 Mar-Apr;26(2):w107–18. - PubMed
    1. Institute of Medicine, Committee on the Learning Health Care System in America Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: National Academies Press; 2013. - PubMed
    1. Friedman CP, Wong AK, Blumenthal D. Achieving a nationwide learning health system. Science Translational Medicine. 2010;2(57):57cm29–57cm29. - PubMed
    1. Sledge GW, Hudis CA, Swain SM, Peter MY, Mann JT, Hauser RS, Lichter AS. ASCO’s approach to a learning health care system in oncology. Journal of Oncology Practice. 2013;9(3):145–148. - PMC - PubMed

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