4.6 Article

Learning From What We Do, and Doing What We Learn: A Learning Health Care System in Action

Journal

ACADEMIC MEDICINE
Volume 96, Issue 9, Pages 1291-1299

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ACM.0000000000004021

Keywords

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Funding

  1. Clinical and Translational Science Award from the National Center for Advancing Translational Sciences [UL1 TR002243]

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Different models of learning health systems are emerging, with Vanderbilt University Medical Center establishing a Learning Health Care System (LHS) Platform focused on creating generalizable knowledge through pragmatic trials. The LHS Platform provides infrastructure and governance to leverage translational, transdisciplinary team science, and emphasizes stakeholder engagement.
Different models of learning health systems are emerging. At Vanderbilt University Medical Center, the Learning Health Care System (LHS) Platform was established with the goal of creating generalizable knowledge. This differentiates the LHS Platform from other efforts that have adopted a quality improvement paradigm. By supporting pragmatic trials at the intersection of research, operations, and clinical care, the LHS Platform was designed to yield evidence for advancing content and processes of care through carefully designed, rigorous study. The LHS Platform provides the necessary infrastructure and governance to leverage translational, transdisciplinary team science to inform clinical and operational decision making across the health system. The process transforms a clinical or operational question into a research question amenable to a pragmatic trial. Scientific, technical, procedural, and human infrastructure is maintained for the design and execution of individual LHS projects. This includes experienced pragmatic trialists, project management, data science inclusive of biostatistics and clinical informatics, and regulatory support. Careful attention is paid to stakeholder engagement, including health care providers and the community. Capturing lessons from each new study, the LHS Platform continues to mature with plans to integrate implementation science and to complement clinical and process outcomes with cost and value considerations. The Vanderbilt University Medical Center LHS Platform is now a pillar of the health care system and leads the evolving culture of learning from what we do and doing what we learn.

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