Learning Health System
The Learning Health System presents an evidence-based framework to support a sustainable Learning Health System in the Translation Centre context and encourage a Learning Health Systems network in Australia.
The vision of the Monash Partners Learning Health System is ‘learning together for better health’. In line with the findings
of our systematic review and qualitative research, and co-design processes, four principles underpin all aspects of the
Learning Health System: People, Culture, Standards, and Resources/Infrastructure.
It contains the necessary elements to enable routine health practice data, from service delivery and patient care, to contribute to iterative cycles of knowledge generation and improvement in healthcare, whereby the whole Learning Health System is enabled by partnerships across multidisciplinary stakeholders (academic, clinician, community and industry stakeholders).
“It‘s a system where routine health practice data can lead to iterative cycles of knowledge generation and improvement”
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HEALTHCARE IMPROVEMENT
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ENGAGEMENT OF PEOPLE
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IDENTIFYING PRIORITIES
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EVIDENCE SYNTHESIS AND GUIDELINES
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EVIDENCE BASED INFORMATION
Four principles underpin all aspects of the Learning Health System:
People
All those who contribute to a healthy LHS
Culture
Trust, transparency, partnership and co-design
Standards
Guides to processes and governance frameworks
Resources/
Infrastructure
Access, linkage, storage, analysis and application
The evidence quadrants - four different sources of evidence are vital
The Learning Health System encompasses four different sources of evidence, with each represented diagrammatically in a quadrant of the wheel. Each is essential to capture, identify and address health service and community priorities and emergent challenges and need to be integrated to create the systems-level intervention needed for a Learning Health System to deliver health impact.
Stakeholder's evidence
Stakeholder‘s evidence is generated through engagement with end users, understanding of front-line health problems and identification of priorities.
- End-user engagement, partnership and transparent governance
- Genuine and ongoing engagement of all stakeholders at all stages
- Stakeholder engagement from the very beginning to understand the problem/issue from all perspectives, including front-line clinicians, patients and consumers with lived experience of the health condition and system
- Robust priority setting in partnership with all stakeholders, including policymakers, so that research and healthcare improvement efforts address what is most important.
Research evidence
In the Learning Health System, research evidence
includes:
• Randomised clinical trials, systematic reviews and meta analyses
• Evidence-based guidelines
• Data and relevant information from research/ academic sources, reports and grey literature
• Economic and policy data
• Standards and policies as sources of best practice
Data evidence
In the Learning Health System, research evidence
includes:
• Randomised clinical trials, systematic reviews and meta analyses
• Evidence-based guidelines
• Data and relevant information from research/ academic sources, reports and grey literature
• Economic and policy data
• Standards and policies as sources of best practice
Implementation evidence
In a Learning Health System, data generated knowledge must then be translated into clinical practice and healthcare improvement to improve patient outcomes. Implementation evidence around how to create change is generated through implementation research and sustainable change through health care improvement.
Key considerations include:
• Effective leadership to support and drive implementation
• Building rigour and capacity for improvement programs through theory-driven, methodological, rigorous and economically sound approaches
• Taking into account system-level (external) and organisational (internal) perspectives
• Identifying and addressing barriers and enablers to implementation
• Ensuring the change is relevant across stakeholders and settings
• Capturing learnings on effective implementation and improvement practices
• Monitoring, audit and feedback, assessment of impact, and refinement
Key themes for a Learning Health System
- Learning Health System environments are system-level initiatives with effective examples demonstrating translation from practice data to data analysis and new knowledge back to clinical practice
- An integrated multidisciplinary team of frontline clinicians, researchers and community members embedded in healthcare settings is key to success
- To have a direct health impact, a Learning Health System must provide timely access to data, as well as analysis of that data with feedback
- Effective Learning Health Systems require people with a broad range of workforce capabilities to make sense of the data arising from complex healthcare environments.