Policy Capacity in the Learning Healthcare System Comment on "Health Reform Requires Policy Capacity"

Gardner, William

doi:10.15171/ijhpm.2015.147

Cited by 4 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 928 articles identified (719 from the primary search and 209 from the supplemental search), 879 were excluded after abstract screening and duplicate removal, leaving a total of 49 articles that met inclusion criteria and were retained for full-text review (Figure 1). 4–6,8–11,20–23,25–62 A summary of each of the included articles is available in Supplemental Digital Appendix 2 at http://links.lww.com/ACADMED/B262.…”

Section: Resultsmentioning

confidence: 99%

“…In all, 34 of the 49 (69.4%) articles provided a definition for an LHS, 4,6,8–11,20,21,23,25–30,32–35,37,40–43,47,48,50–52,54,55,60–62 2 articles provided a definition for embedded research, 8,25 and 2 articles provided a definition for collaborative or coordinated research networks. 11,26 Articles commonly referenced the LHS definition provided by the IOM 18 or briefly listed LHS attributes.…”

Section: Resultsmentioning

confidence: 99%

“…The scientific component, which identifies questions and IT structures posited to the LHS framework, was identified in 11 included studies. 6,10,36,38,40,41,46,54,55,56,57 Stoto et al (2017) stated that “addressing these questions requires a scientific approach to quality improvement that is characterized by a basis in theory.” 6 These questions are content- and context-specific since the capabilities of answering them are determined by the organizational capacity to support and absorb research endeavors. Academic health centers embedded within research universities are particularly well suited to address the scientific component of the LHS because they maintain the capacity to support research and translate that research into evidence-based practice.…”

Section: Resultsmentioning

confidence: 99%

“…For 13 articles included in this review, data were derived from clinical records, patient participation, data networks, existing literature, and meta-analyses. 5,9,20,21,30,32,33,36,39,54–57 According to Verheij et al (2018), “data flow from their initial point of generation through one or more systems for processing, ultimately generating information for a desired purpose.” 55 These data are acquired from single institutions or larger multi-institution collaborations building health-data networks that share standardized data among collaborators. 20,21,30,36…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Adapting an Interdisciplinary Learning Health System Framework for Academic Health Centers: A Scoping Review

et al. 2022

View full text Add to dashboard Cite

PurposeLearning health systems (LHSs), defined as a systematic process for aligning science, informatics, and clinical practice to integrate providers, researchers, and patients as active participants in an evidence-based care continuum, can provide an ideal environment for academic health centers to rapidly adopt evidence-based guidelines and translate research into practice. However, few LHS frameworks are specifically adapted for academic health centers. The authors wanted to identify the definitions, components, and other features of LHSs to develop an interdisciplinary LHS framework for use within academic health centers. MethodThe authors conducted a scoping review of the literature to identify definitions, components, and other features of LHSs that are useful to academic health centers. In January 2021, they searched PubMed, Academic Search Premier, and Scopus databases and identified English-language, peer-reviewed articles pertaining to LHS, LHS frameworks, organization, components, and models. Since the phrase learning health system is relatively new terminology, they conducted a supplemental review with alternative phrases, including embedded research and coordinated or collaborative research network. They used the Knowledge to Action (KTA) Framework to integrate the generation and flow of research into practice.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Adapting an Interdisciplinary Learning Health System Framework for Academic Health Centers: A Scoping Review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…During that coding process, the coders determined that 30 of the publications did not meet the eligibility criteria. Thus, the final corpus comprised of 79 publications 4,9,12‐88 …”

Section: Methodsmentioning

confidence: 99%

Clarifying the concept of a learning health system for healthcare delivery organizations: Implications from a qualitative analysis of the scientific literature

Easterling

Perry

Woodside

et al. 2021

Learning Health Systems

View full text Add to dashboard Cite

The "learning health system" (LHS) concept has been defined in broad terms, which makes it challenging for health system leaders to determine exactly what is required to transform their organization into an LHS. This study provides a conceptual map of the LHS landscape by identifying the activities, principles, tools, and conditions that LHS researchers have associated with the concept. Through a multi-step screening process, two researchers identified 79 publications from PubMed (published before January 2020) that contained information relevant to the question, "What work is required of a healthcare organization that is operating as an LHS?" Those publications were coded as to whether or not they referenced each of 94 LHS elements in the taxonomy developed by the study team. This taxonomy, named the Learning Health Systems Consolidated Framework (LHS-CF), organizes the elements into five "bodies of work" (organizational learning, translation of evidence into practice, building knowledge, analyzing clinical data, and engaging stakeholders) and four "enabling conditions" (workforce skilled for LHS work, data systems and informatics technology in place, organization invests resources in LHS work, and supportive organizational culture). We report the frequency that each of the 94 elements was referenced across the 79 publications. The four most referenced elements were: "organization builds knowledge or evidence," "quality improvement practices are standard practice," "patients and family members are actively engaged," and "organizational culture emphasizes and supports learning." By dissecting the LHS construct into its component elements, the LHS-CF taxonomy can serve as a useful tool for LHS researchers and practitioners in defining the aspects of LHS they are addressing. By assessing how often each element is referenced in the literature, the study provides guidance to health system leaders as to how their organization needs to evolve in order to become an LHS -while also recognizing that each organization should emphasize elements that are most aligned with their mission and goals.

show abstract

A framework for analysing learning health systems: Are we removing the most impactful barriers?

McLachlan

Dube

Johnson

et al. 2019

Learning Health Systems

View full text Add to dashboard Cite

IntroductionLearning health systems (LHS) are one of the major computing advances in health care. However, no prior research has systematically analysed barriers and facilitators for LHS. This paper presents an investigation into the barriers, benefits, and facilitating factors for LHS in order to create a basis for their successful implementation and adoption.MethodsFirst, the ITPOSMO‐BBF framework was developed based on the established ITPOSMO (information, technology, processes, objectives, staffing, management, and other factors) framework, extending it for analysing barriers, benefits, and facilitators. Second, the new framework was applied to LHS.ResultsWe found that LHS shares similar barriers and facilitators with electronic health records (EHR); in particular, most facilitator effort in implementing EHR and LHS goes towards barriers categorised as human factors, even though they were seen to carry fewer benefits. Barriers whose resolution would bring significant benefits in safety, quality, and health outcomes remain.LHS envisage constant generation of new clinical knowledge and practice based on the central role of collections of EHR. Once LHS are constructed and operational, they trigger new data streams into the EHR. So LHS and EHR have a symbiotic relationship. The implementation and adoption of EHRs have proved and continues to prove challenging, and there are many lessons for LHS arising from these challenges.ConclusionsSuccessful adoption of LHS should take account of the framework proposed in this paper, especially with respect to its focus on removing barriers that have the most impact.

show abstract

Policy Capacity in the Learning Healthcare System Comment on "Health Reform Requires Policy Capacity"

Cited by 4 publications

References 14 publications

Adapting an Interdisciplinary Learning Health System Framework for Academic Health Centers: A Scoping Review

Adapting an Interdisciplinary Learning Health System Framework for Academic Health Centers: A Scoping Review

Clarifying the concept of a learning health system for healthcare delivery organizations: Implications from a qualitative analysis of the scientific literature

A framework for analysing learning health systems: Are we removing the most impactful barriers?

Contact Info

Product

Resources

About