Our expert answers 3 Questions
My work is dedicated to realizing the vision of the Learning Health System (LHS), which means transforming our health system into one that can continuously study and improve itself by harnessing the power of modern data and analytics. Since it was first described by the Institute of Medicine in 2007, the LHS concept has achieved significant traction, and is now being adopted across the U.S. and around the world. The Office of the National Coordinator for Health IT within the U.S. Department of Health and Human Services, where I previously served as the Deputy National Coordinator and Chief Scientific Officer, signaled the achievement of the LHS as a pinnacle goal for 2024. The LHS allows communities of interest to form around specific health problems, then collect relevant data and interpret the findings, setting in motion continuous learning cycles to address these problems. The LHS process of generating and exchanging transformative knowledge shares many characteristics with health services research, as both are driven by data analytics and are highly interdisciplinary. The LHS concept complements health services research through an explicit focus on creating an infrastructure that supports cycles driving continuous improvement and change.
The LHS, in order to be high-functioning and work at large scale, requires an infrastructure that supports these learning activities. The platform enables and supports the data collection, the analyses, the interpretations, the curation of the knowledge that's created, the feedback, and the resulting change processes – in much the same way that a bridge carries large numbers of people across a river without each of them having to build a boat. Also, it’s important to recognize that policy is a key element of that platform. A lot of people think about the LHS as a big technology endeavor, but it's as much about people and policy as it is about technology. The core of the LHS concept involves instilling the capacity and commitment to learn at all levels of the health system, looking at every stakeholder interaction as a learning opportunity that contributes to continuously improving the system.
I believe the LHS should be the ultimate goal toward which not only the government, but the nation’s entire health eco-system should be devoting its resources. Through the HITECH Act, the federal government has invested more than $30 billion to promote “meaningful use” of health information technology. I always believed that we should set our sights higher, and that Meaningful Use should be seen as an enabler toward the ultimate goal of achieving a Learning Health System. The challenge in implementing a successful LHS is not really so much about the technology, much of which we have in place, but the policies and the governance and the processes and procedures that allow this to happen with fluidity and economy of scale. Healthcare’s Triple Aim is to improve the patient experience, improve population health, and reduce cost. With time, I believe that a mature, high-functioning LHS has the capacity to realize the Triple Aim in its purest form, as well as support research, advance public health, and empower consumers/patients.