Becoming a Learning Health System
As payers begin to shift towards alternative payment models in response to the rising cost of care, particularly for chronic diseases like diabetes, some healthcare systems are beginning to embrace models of care that incorporate the principles of a learning health system.
A learning health system has four main features:
(1) Uses health information technology to capture and analyze real-time data from patient care
(2) Real-time generation and application of clinical knowledge
(3) Includes patients as vital members of care teams
(4) Leadership-instilled cultures of learning in order to turn clinical research knowledge into practice.
In April 2017, a project team was formed between clinicians and administrators from Penn State Health and researchers from Penn State University to discuss the possibility of offering chronic disease care management to Penn State employees and their spouses. With support of an internal strategic grant, the Penn State team designed, implemented, and conducted an evaluation of a targeted intervention. Penn State Health ultimately chose an intervention based on the Diabetes Prevention Program and researchers collaborated to evaluate the process of implementation.
This paper describes Penn State Health's experience in the early stages of becoming a learning health system and highlights the challenging and iterative process by which a healthcare system must make critical decisions and incorporate important stakeholder needs throughout the intervention design.
The primary focus of this paper is to describe the project team’s design and implementation process as well as the challenges of embracing new clinical and administrative approaches to care as part of becoming a learning health system, which may be beneficial for others to better understand how a healthcare system transforms, in practice, into a learning health system.
The project team’s main lessons learned emphasize the need for healthcare systems to:
(1) Just get started
(2) Be aware of and work towards navigating organizational constraints on staff and space
(3) Provide leaders with appropriate authority and autonomy to independently carry out necessary activities while being aware of organizational needs in terms of revenue and the business model generally
(4) Have team members or partners who can navigate the entire research process to identify and design an intervention with the best chance of success among the target population.
Authors
Joel Segel, PhD, Assistant Professor of Health Policy and Administration, Penn State University
Selena Ortiz, PhD, Assistant Professor of Health Policy and Administration, Penn State University
Bethany Shaw, MHA, Research Analyst, Center for Health Care and Policy Research, Penn State University
Mark Stephens, MD, MS, FAAFP, Professor of Family and Community Medicine at The Pennsylvania State University College of Medicine
Dennis Scanlon, PhD, Distinguished Professor of Health Policy and Administration and Director of the Center for Health Care and Policy Research
Support for this paper was provided by The Pennsylvania State University through a University Strategic Initiative Seed Grant through the Office of the Executive Vice President and Provost.
