Measuring engagement in a collaborative learning health system: The case ofImproveCareNow

Background: Collaborative learning health systems have demonstrated improved outcomes for a range of different chronic conditions. Patient and healthcare provider engagement in these systems is thought to be associated with improved outcomes. We have adapted an observational framework to measure, and track over time, engagement in ImproveCareNow, a collaborative learning health system for children with inflammatory bowel disease. Introduction: We developed a categorical classification scheme for engagement in ImproveCareNow. Each tier is defined in terms of observable individual behaviors. When an individual completes one or more qualifying behavior, s/he is classified as engaged at that tier. Individuals are entered into a database, which is accessible to care centers throughout the ImproveCareNow network. Database records include fields for individual name, behavior type, time, place, and level of engagement. Results: The resulting system is employed at 79 ImproveCareNow care centers in the United States. The system recognizes four levels of engagement. Behaviors are recorded in a managed vocabulary and recorded in an online database. The database is queried weekly for individual engagement behaviors, which are tracked longitudinally. Center- and network-level statistics are generated and disseminated to stakeholders. Conclusion: It is possible to monitor longitudinal engagement in a collaborative learning health system, thereby charting progress toward engagement goals and enabling quantitative evaluation of interventions aimed at increasing engagement.

Automated summary

A study has adapted an observational framework to measure engagement in ImproveCareNow, a collaborative learning health system for children with inflammatory bowel disease. The system recognizes four levels of engagement and records behaviors in an online database, which is queried weekly to track individual engagement behaviors longitudinally. Statistics are generated and disseminated to stakeholders for evaluation of interventions aimed at increasing engagement.