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A framework for analysing learning health systems: Are we removing the most impactful barriers?

McLachlan, S; Dube, K; Johnson, O; Buchanan, D; Potts, H; Gallagher, T; Fenton, N; (2019) A framework for analysing learning health systems: Are we removing the most impactful barriers? Learning Health Systems , Article e10189. 10.1002/lrh2.10189. (In press). Green open access

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Abstract

Introduction Learning health systems (LHS) are one of the major computing advances in health care. However, no prior research has systematically analysed barriers and facilitators for LHS. This paper presents an investigation into the barriers, benefits, and facilitating factors for LHS in order to create a basis for their successful implementation and adoption. Methods First, the ITPOSMO‐BBF framework was developed based on the established ITPOSMO (information, technology, processes, objectives, staffing, management, and other factors) framework, extending it for analysing barriers, benefits, and facilitators. Second, the new framework was applied to LHS. Results We found that LHS shares similar barriers and facilitators with electronic health records (EHR); in particular, most facilitator effort in implementing EHR and LHS goes towards barriers categorised as human factors, even though they were seen to carry fewer benefits. Barriers whose resolution would bring significant benefits in safety, quality, and health outcomes remain. LHS envisage constant generation of new clinical knowledge and practice based on the central role of collections of EHR. Once LHS are constructed and operational, they trigger new data streams into the EHR. So LHS and EHR have a symbiotic relationship. The implementation and adoption of EHRs have proved and continues to prove challenging, and there are many lessons for LHS arising from these challenges. Conclusions Successful adoption of LHS should take account of the framework proposed in this paper, especially with respect to its focus on removing barriers that have the most impact.

Type: Article
Title: A framework for analysing learning health systems: Are we removing the most impactful barriers?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/lrh2.10189
Publisher version: https://doi.org/10.1002/lrh2.10189
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Electronic health records, learning health systems, learning health care systems
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > CHIME
URI: https://discovery.ucl.ac.uk/id/eprint/10070823
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