Are Communities Willing to Transition Into Learning Health Care Communities? A Community-Based Participatory Evaluation of Stakeholders’ Receptivity

Abstract

This article aims to determine receptivity for advancing the Learning Healthcare System (LHS) model to a novel evidence-based health care delivery framework—Learning Health Care Community (LHCC)—in Baltimore, as a model for a national initiative. Using community-based participatory, qualitative approach, we conducted 16 in-depth interviews and 15 focus groups with 94 participants. Two independent coders thematically analyzed the transcripts. Participants included community members (38%), health care professionals (29%), patients (26%), and other stakeholders (7%). The majority considered LHCC to be a viable model for improving the health care experience, outlining certain parameters for success such as the inclusion of home visits, presentation of research evidence, and incorporation of social determinants and patients’ input. Lessons learned and challenges discussed by participants can help health systems and communities explore the LHCC aspiration to align health care delivery with an engaged, empowered, and informed community.

Similar values, different expectations: How do patients and providers view ‘health’ and perceive the healthcare experience?

“…A two‐step coding process was followed to analyse the data in concordance with similar qualitative approaches. 23 , 25 , 26 The first step was inductive, where two coders independently read each transcript to identify emerging themes, followed by a group meeting to discuss extracted themes, identify broad categories and refine them into headings that matched the original concepts outlined in the interview guides. 27 , 28 Under each category, major themes and sub‐themes were identified and presented in a codebook that was used for the second step.…”

“…The LHS model works by ‘systematically capturing and translating information generated by clinical research and health care delivery’ to close open‐ended learning loops 21 . The LHCC model builds on the LHS framework by bringing the LHS's core components into the community by continuously engaging residents, patients, providers and other community stakeholders in the learning process 22,23 …”

“…21 The LHCC model builds on the LHS framework by bringing the LHS's core components into the community by continuously engaging residents, patients, providers and other community stakeholders in the learning process. 22 , 23 …”

Wonderings to research questions: Engaging patients in long COVID research prioritization within a learning health system

“…The systematic gathering and generating of data to drive change and improve care within Learning Health Systems (LHS) still face barriers to implementation to ensure continuous patient‐centered, evidence‐based care, particularly in low‐resource settings 1,2 . Although the LHS model advocates for patient‐centered care, there is limited evidence of health systems effectively and genuinely involving patients and community partners in the “learning” process 3 . To meaningfully advance the health and quality of care for patients, address health disparities, and truly provide “patient‐centered” care experiences, patients must be engaged in the research and innovation process as much as in the care delivery process.…”

“… 1 , 2 Although the LHS model advocates for patient‐centered care, there is limited evidence of health systems effectively and genuinely involving patients and community partners in the “learning” process. 3 To meaningfully advance the health and quality of care for patients, address health disparities, and truly provide “patient‐centered” care experiences, patients must be engaged in the research and innovation process as much as in the care delivery process. Patient engagement increases the research's relevance to patient needs, improves the quality of a project, and impacts healthcare policy and practice.…”