scholarly journals An Analysis of the Learning Health System in Its First Decade in Practice: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Jodyn E Platt ◽  
Minakshi Raj ◽  
Matthias Wienroth
Keyword(s):  
Health Care ◽  
Health System ◽  
Thematic Analysis ◽  
Scoping Review ◽  
Rapid Learning ◽  
The Past ◽  
Learning From Data ◽  
Learning Health System ◽  
Over Time ◽  
Value Of Health

BACKGROUND In the past decade, Lynn Etheredge presented a vision for the Learning Health System (LHS) as an opportunity for increasing the value of health care via rapid learning from data and immediate translation to practice and policy. An LHS is defined in the literature as a system that seeks to continuously generate and apply evidence, innovation, quality, and value in health care. OBJECTIVE This review aimed to examine themes in the literature and rhetoric on the LHS in the past decade to understand efforts to realize the LHS in practice and to identify gaps and opportunities to continue to take the LHS forward. METHODS We conducted a thematic analysis in 2018 to analyze progress and opportunities over time as compared with the initial <i>Knowledge Gaps and Uncertainties</i> proposed in 2007. RESULTS We found that the literature on the LHS has increased over the past decade, with most articles focused on theory and implementation; articles have been increasingly concerned with policy. CONCLUSIONS There is a need for attention to understanding the ethical and social implications of the LHS and for exploring opportunities to ensure that these implications are salient in implementation, practice, and policy efforts.

scholarly journals An Analysis of the Learning Health System in Its First Decade in Practice: Scoping Review

10.2196/17026 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e17026 ◽  
Author(s):  
Jodyn E Platt ◽  
Minakshi Raj ◽  
Matthias Wienroth
Keyword(s):  
Health Care ◽  
Health System ◽  
Thematic Analysis ◽  
Rapid Learning ◽  
The Past ◽  
Learning From Data ◽  
Learning Health System ◽  
Initial Knowledge ◽  
Over Time ◽  
Value Of Health

Background In the past decade, Lynn Etheredge presented a vision for the Learning Health System (LHS) as an opportunity for increasing the value of health care via rapid learning from data and immediate translation to practice and policy. An LHS is defined in the literature as a system that seeks to continuously generate and apply evidence, innovation, quality, and value in health care. Objective This review aimed to examine themes in the literature and rhetoric on the LHS in the past decade to understand efforts to realize the LHS in practice and to identify gaps and opportunities to continue to take the LHS forward. Methods We conducted a thematic analysis in 2018 to analyze progress and opportunities over time as compared with the initial Knowledge Gaps and Uncertainties proposed in 2007. Results We found that the literature on the LHS has increased over the past decade, with most articles focused on theory and implementation; articles have been increasingly concerned with policy. Conclusions There is a need for attention to understanding the ethical and social implications of the LHS and for exploring opportunities to ensure that these implications are salient in implementation, practice, and policy efforts.

scholarly journals Designing for Accelerated Translation (DART) of emerging innovations in health

2019 ◽  
Vol 3 (2-3) ◽  
pp. 53-58 ◽  
Author(s):  
Alex T. Ramsey ◽  
Enola K. Proctor ◽  
David A. Chambers ◽  
Jane M. Garbutt ◽  
Sara Malone ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Dynamic Process ◽  
Evidence Base ◽  
Dynamic Decision Making ◽  
Dissemination And Implementation ◽  
The Past ◽  
Learning Health System ◽  
Stakeholder Partnerships ◽  
Over Time

AbstractAccelerating innovation translation is a priority for improving healthcare and health. Although dissemination and implementation (D&I) research has made significant advances over the past decade, it has attended primarily to the implementation of long-standing, well-established practices and policies. We present a conceptual architecture for speeding translation of promising innovations as candidates for iterative testing in practice. Our framework to Design for Accelerated Translation (DART) aims to clarify whether, when, and how to act on evolving evidence to improve healthcare. We view translation of evidence to practice as a dynamic process and argue that much evidence can be acted upon even when uncertainty is moderately high, recognizing that this evidence is evolving and subject to frequent reevaluation. The DART framework proposes that additional factors – demand, risk, and cost, in addition to the evolving evidence base – should influence the pace of translation over time. Attention to these underemphasized factors may lead to more dynamic decision-making about whether or not to adopt an emerging innovation or de-implement a suboptimal intervention. Finally, the DART framework outlines key actions that will speed movement from evidence to practice, including forming meaningful stakeholder partnerships, designing innovations for D&I, and engaging in a learning health system.

Interventions for Improving Health Care Workers’ Retention in Epidemics – a Scoping Review

2021 ◽  
Author(s):  
Zahra Zarei Jelyani ◽  
Sadra Valiee ◽  
Mohammad Kia ◽  
Ali jajarmizadeh ◽  
Sajad Delavari
Keyword(s):  
Health Care ◽  
Human Resources ◽  
Health System ◽  
Human Health ◽  
Scoping Review ◽  
Health Care Workers ◽  
Health Resources ◽  
The United States ◽  
Human Beings ◽  
Care Workers

Abstract Introduction: Generally, in Epidemics, such as COVID-19, health care workers (HCWs) faces many problems which lead to a shortage and weakening of human resources in the health system. Therefore, using effective strategies to retain human resources is one of the most important issues during outbreaks. This study aims to collect and classify the proposed interventions to strengthen human health resources and their sustainability during epidemics through scoping review.Methods: In this scoping review study, 2300 studies were retrieved through searching international databases –PubMed, Embase, Scopus and Web of Science. The retrieved studies were screened, and finally, 50 studies were included for analysis. The strategies were classified using inductive qualitative content analysis.Results: Most of the studies were conducted in the United States and the United Kingdom. The target population in 39 studies was all health workers; five studies were on physicians, five studies on nurses, and only one study on dentists. The proposed interventions were classified into five categories: preparation, protection, support, treatment, and feedback. Discussion: Most studies focused on providing interventions in one or two dimensions of human resources, but these interventions were summarized and categorized in this review. Therefore, this study has a holistic view of various dimensions of strengthening and maintaining human health resources during epidemics by providing a thematic map. Considering that human beings are multidimensional, policymakers and managers of the health system should use a set of interventions that simultaneously cover different aspects of their needs to strengthen and maintain HCWs.

scholarly journals Value-Based Health Care Supported by Data Science

2018 ◽  
pp. 193-212 ◽  
Author(s):  
Tiffany I. Leung ◽  
G. G. van Merode
Keyword(s):  
Health Care ◽  
Service Delivery ◽  
Health System ◽  
Healthcare System ◽  
Patient Outcomes ◽  
Data Science ◽  
Costs Of Care ◽  
Learning Health System ◽  
Measuring Outcomes ◽  
Cost Measurement

AbstractThe value agenda involves measuring outcomes that matter and costs of care to optimize patient outcomes per dollar spent. Outcome and cost measurement in the value-based health care framework, centered around a patient condition or segment of the population, depends on data in every step towards healthcare system redesign. Technological and service delivery innovations are key components of driving transformation towards high-value health care. The learning health system and network-based thinking are complementary frameworks to the value agenda. Health care and medicine exist in a data-rich environment, and learning about how data can be used to measure and improve value of care for patients is and increasingly essential skill for current and future clinicians.

A Rapid-Learning Health System

2007 ◽  
Vol 26 (Suppl1) ◽  
pp. w107-w118 ◽  
Author(s):  
Lynn M. Etheredge
Keyword(s):  
Health System ◽  
Rapid Learning ◽  
Learning Health System

Advancing health care quality and safety through action learning

2017 ◽  
Vol 30 (2) ◽  
pp. 148-158 ◽  
Author(s):  
Simon Mathews ◽  
Sherita Golden ◽  
Renee Demski ◽  
Peter Pronovost ◽  
Lisa Ishii
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Quality ◽  
Design Methodology ◽  
Action Learning ◽  
Care Quality ◽  
Quality And Safety ◽  
Content Type ◽  
Learning Health System ◽  
Academic Medical

Purpose The purpose of this study is to demonstrate how action learning can be practically applied to quality and safety challenges at a large academic medical health system and become fundamentally integrated with an institution’s broader approach to quality and safety. Design/methodology/approach The authors describe how the fundamental principles of action learning have been applied to advancing quality and safety in health care at a large academic medical institution. The authors provide an academic contextualization of action learning in health care and then transition to how this concept can be practically applied to quality and safety by providing detailing examples at the unit, cross-functional and executive levels. Findings The authors describe three unique approaches to applying action learning in the comprehensive unit-based safety program, clinical communities and the quality management infrastructure. These examples, individually, provide discrete ways to integrate action learning in the advancement of quality and safety. However, more importantly when combined, they represent how action learning can form the basis of a learning health system around quality and safety. Originality/value This study represents the broadest description of action learning applied to the quality and safety literature in health care and provides detailed examples of its use in a real-world context.

Mental Health System Historians: Adults with Schizophrenia Describe Changes in Community Mental Health Care Over Time

2014 ◽  
Vol 86 (1) ◽  
pp. 33-48 ◽  
Author(s):  
Catherine H. Stein ◽  
Jaclyn E. Leith ◽  
Lawrence A. Osborn ◽  
Sarah Greenberg ◽  
Catherine E. Petrowski ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Mental Health Care ◽  
Health System ◽  
Mental Health System ◽  
Community Mental Health Care ◽  
Over Time

scholarly journals Understanding the use of patient-reported data by health care insurers: A scoping review

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244546
Author(s):  
Anne Neubert ◽  
Óscar Brito Fernandes ◽  
Armin Lucevic ◽  
Milena Pavlova ◽  
László Gulácsi ◽  
...  
Keyword(s):  
Health Care ◽  
Health System ◽  
Scoping Review ◽  
Business Models ◽  
Grey Literature ◽  
Process Indicators ◽  
Patient Reported ◽  
Reported Data ◽  
And Function ◽  
Health Insurers

Background Patient-reported data are widely used for many purposes by different actors within a health system. However, little is known about the use of such data by health insurers. Our study aims to map the evidence on the use of patient-reported data by health insurers; to explore how collected patient-reported data are utilized; and to elucidate the motives of why patient-reported data are collected by health insurers. Methods The study design is that of a scoping review. In total, 11 databases were searched on. Relevant grey literature was identified through online searches, reference mining and recommendations from experts. Forty-two documents were included. We synthesized the evidence on the uses of patient-reported data by insurers following a structure-process-outcome approach; we also mapped the use and function of those data by a health insurer. Results Health insurers use patient-reported data for assurance and improvement of quality of care and value-based health care. The patient-reported data most often collected are those of outcomes, experiences and satisfaction measures; structure indicators are used to a lesser extent and often combined with process indicators. These data are mainly used for the purposes of procurement and purchasing of services, quality assurance, improvement and reporting, and strengthening the involvement of insured people. Conclusions The breadth to which insurers use patient-reported data in their business models varies greatly. Some hindering factors to the uptake of such data are the varying and overlapping terminology in use in the field and the limited involvement of insured people in a health insurer’s business. Health insurers are advised to be more explicit in regard to the role they want to play within the health system and society at large, and accommodate implications for the use of patient-reported data accordingly.

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