02985nas a2200169   4500000000100000008004100001260001000042653003400052653005700086653002300143100001200166700001100178245009600189856006400285520244100349022002502790       2022                            d  bWiley10aHealth Information Management10aPublic Health, Environmental and Occupational Health10aHealth Informatics1 aFoley T1 aVale L00aA framework for understanding, designing, developing and evaluating learning health systems  uhttps://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.103153 a<h3 id="lrh210315-sec-0001-title">Introduction</h3>

<p>A Learning Health System is not a technical project. It is the evolution of an existing health system into one capable of learning from every patient. This paper outlines a recently published framework intended to aid the understanding, design, development and evaluation of Learning Health Systems.</p>

<h3 id="lrh210315-sec-0002-title">Methods</h3>

<p>This work extended an existing repository of Learning Health System evidence, adding five more workshops. The total was subjected to thematic analysis, yielding a framework of elements important to understanding, designing, developing and evaluating Learning Health Systems. Purposeful literature reviews were conducted on each element. The findings were revised following a review by a group of international experts.</p>

<h3 id="lrh210315-sec-0003-title">Results</h3>

<p>The resulting framework was arranged around four questions:</p>

<ol start="1">
	<li>
	<p>What is our rationale for developing a Learning Health System?</p>

	<p>There can be many reasons for developing a Learning Health System. Understanding these will guide its development.</p>
	</li>
	<li>
	<p>What sources of complexity exist at the system and the intervention level?</p>

	<p>An understanding of complexity is central to making Learning Health Systems work. The non-adoption, abandonment, scale-up, spread and sustainability framework was utilised to help understand and manage it.</p>
	</li>
	<li>
	<p>What strategic approaches to change do we need to consider?</p>

	<p>A range of strategic issues must be addressed to enable successful change in a Learning Health System. These include, strategy, organisational structure, culture, workforce, implementation science, behaviour change, co-design and evaluation.</p>
	</li>
	<li>
	<p>What technical building blocks will we need?</p>

	<p>A Learning Health System must capture data from practice, turn it into knowledge and apply it back into practice. There are many methods to achieve this and a range of platforms to help.</p>
	</li>
</ol>

<h3 id="lrh210315-sec-0004-title">Discussion</h3>

<p>The results form a framework for understanding, designing, developing and evaluating Learning Health Systems at any scale.</p>

<h3 id="lrh210315-sec-0005-title">Conclusion</h3>

<p>It is hoped that this framework will evolve with use and feedback.</p>
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