A learning health systems approach to integrating electronic <scp>patient‐reported</scp> outcomes across the health care organization

Austin, Elizabeth; LeRouge, Cynthia; Lee, Jenney R; Segal, Courtney; Sangameswaran, Savitha; Heim, Joseph A.; Lober, William B.; Hartzler, Andrea L.; Lavallee, Danielle C.

doi:10.1002/lrh2.10263

Cited by 18 publications

(17 citation statements)

References 24 publications

(56 reference statements)

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“…Functionality for automatic sampling and storage of data about the health problem, the care that is provided and the care outcomes [3], [20], [21].…”

Section: Learning Health System Feature or Functionality Possible Ind...mentioning

confidence: 99%

Does your EHR support a Learning Healthcare System? An exploration of possible indicators

Golburean¹,

Lintvedt²,

Nordheim³

et al. 2022

Linköping Electronic Conference Proceedings

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“…Functionality for automatic sampling and storage of data about the health problem, the care that is provided and the care outcomes [3], [20], [21].…”

Section: Learning Health System Feature or Functionality Possible Ind...mentioning

confidence: 99%

Does your EHR support a Learning Healthcare System? An exploration of possible indicators

Golburean¹,

Lintvedt²,

Nordheim³

et al. 2022

Linköping Electronic Conference Proceedings

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“…Despite the value of PROMs within a health system, their successful implementation into routine clinical care is complex (17,18). It requires a signi cant investment of time and resources, as well as the development of a supportive information technology infrastructure (17,19). Commonly cited challenges to their implementation include nding appropriate PROMs (i.e., relevant to patients' needs, feasible to use, and adding value to the clinical encounter), designing PROMs data collection processes around clinical work ows, getting buy-in from clinical staff, and creating a culture that is supportive of learning and quality improvement (17).…”

Section: Introductionmentioning

confidence: 99%

A protocol for the formative evaluation of the implementation of patient-reported outcome measures in child and adolescent mental health services as part of a learning health system

McCabe

Dyson

McNeil

et al. 2023

Preprint

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Background: Mental health conditions affect one in seven young people and research suggests that current mental health services are not meeting the needs of most children and youth. Learning health systems are an approach to enhancing through rapid, routinized cycles of continuous learning and improvement. Patient-reported outcome measures provide a key data source for learning health systems. They have also been shown to improve outcomes for patients when integrated into routine clinical care. However, implementing these measures into health systems is a challenging process. This paper describes a protocol for a formative evaluation of the implementation of patient-reported measures in a newly operational child and adolescent mental health centre in Calgary, Canada. The purpose is to optimize the collection and use of patient-reported outcome measures. Our specific objectives are to assess the implementation progress, identify barriers and facilitators to implementation, and explore patient, caregivers and clinician experiences of using these measures in routine clinical care. Methods: This study is a mixed-methods, formative evaluation using the Consolidated Framework for Implementation Research. Participants include patients and caregivers who have used the centre’s services, as well as leadership, clinical and support staff at the centre. Focus groups and semi-structured interviews will be conducted to assess barriers and facilitators to the implementation and sustainability of the use of patient-reported outcome measures, as well as individuals’ experiences with using these measures within clinical care. The data generated by the patient-reported measures over the first five months of the centre’s operation will be analyzed to understand implementation progress, as well as validity of the chosen measures for the centres’ population. Discussion: The findings of this evaluation will help to identify and address the factors that are affecting the successful implementation of patient-reported measures at the centre. They will inform the co-design of strategies to improve implementation with key stakeholders, which include patients, clinical staff, and leadership at the centre. To our knowledge, this is the first study of the implementation of patient-reported outcome measures in child and adolescent mental health services and our findings can be used to enhance future implementation efforts in similar settings.

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“…Systematically analyzing and translating health system data in the dynamic knowledge generation and exchange ecosystem of a learning health system (LHS) 1 , 2 , 3 can optimize health system productivity and improve patient outcomes. 4 , 5 , 6 , 7 After the Institute of Medicine first introduced the idea of an LHS in 2007 as applying available evidence to increase system effectiveness and efficiency, 2 various conceptual frameworks have been described in the literature. 1 , 6 , 8 , 9 Since then, the LHS concept has become widely accepted and acknowledged globally.…”

Section: Introductionmentioning

confidence: 99%

“… 11 , 13 However, those who have evaluated the process, outcomes, and impacts of LHS programs have demonstrated that an LHS can improve program development, patient outcomes, as well as time and cost‐effectiveness. 1 , 6 , 7 , 11 , 14 , 15 Evaluating an LHS encourages continuous system improvement and collaboration within the healthcare system.…”

Section: Introductionmentioning

confidence: 99%

“… 17 To address this, regional, national, and international COVID‐19 initiatives were established around the world to answer pressing health‐system COVID‐19 questions. 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 LHS models have shown to bridge gaps in understanding, support clinical practice, improve health system efficiency, and reduce costs. 8 , 11 , 14 , 18 Scientific evidence may result in clinical practice changes during the pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating a learning health system initiative: Lessons learned during COVID‐19 in Saskatchewan, Canada

Groot

Witham

Badea

et al. 2022

Learning Health Systems

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Introduction Evaluating a learning health system (LHS) encourages continuous system improvement and collaboration within the healthcare system. Although LHS is a widely accepted concept, there is little knowledge about evaluating an LHS. To explore the outputs and outcomes of an LHS model, we evaluated the COVID‐19 Evidence Support Team (CEST) in Saskatchewan, Canada, an initiative to rapidly review scientific evidence about COVID‐19 for decision‐making. By evaluating this program during its formation, we explored how and to what extent the CEST initiative was used by stakeholders. An additional study aim was to understand how CEST could be applied as a functional LHS and the value of similar knowledge‐to‐action cycles. Methods Using a formative evaluation design, we conducted qualitative interviews with key informants (KIs) who were involved with COVID‐19 response strategies in Saskatchewan. Transcripts were analyzed using reflexive thematic analysis to identify key themes. A program logic model was created to represent the inputs, activities, outputs, and outcomes of the CEST initiative. Results Interview data from 11 KIs were collated under three overarching categories: (1) outputs, (2) short‐term outcomes, and (3) long‐term outcomes from the CEST initiative. Overall, participants found the CEST initiative improved speed and access to reliable information, supported and influenced decision‐making and public health strategies, leveraged partnerships, increased confidence and reassurance, and challenged misinformation. Themes relating to the long‐term outcomes of the initiative included improving coordination, awareness, and using good judgment and planning to integrate CEST sustainably into the health system. Conclusion This formative evaluation demonstrated that CEST was a valued program and a promising LHS model for Saskatchewan. The future direction involves addressing program recommendations to implement this model as a functional LHS in Saskatchewan.

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A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization

Cited by 18 publications

References 24 publications

Does your EHR support a Learning Healthcare System? An exploration of possible indicators

Does your EHR support a Learning Healthcare System? An exploration of possible indicators

A protocol for the formative evaluation of the implementation of patient-reported outcome measures in child and adolescent mental health services as part of a learning health system

Evaluating a learning health system initiative: Lessons learned during COVID‐19 in Saskatchewan, Canada

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