A tale of two cities: Developing health information platforms for a learning health system in Austin and in New Orleans

Abstract

AbstractIntroductionNew Orleans and Austin are two cities that are quite different in many ways. While one is known for its poverty, disparity, and crime, the other is famous for its young, vibrant, and fun environment. While one is proud of its past, the other is excited about its future. However, the history of these two cities in terms of developing a learning health system information infrastructure does not follow the same narrative.MethodsOne important aspect of any learning health system is availability of information to allow for the learning to be systematic, ongoing, and data‐driven. This requires the capability to share data across the usually fragmented health systems. This paper uses a comparative case study approach based on personal experiences and key informant interviews to trace the development of information sharing infrastructure in the two cities. The study uses examples to demonstrate learning health system activities facilitated by these information infrastructure capabilities.ResultsThe analysis identified some key factors that may explain the differences in approach and outcomes in the two cities. New Orleans adopted a more comprehensive approach than Austin in envisioning the needs of the community. The study finds that development of a learning health system infrastructure is assisted by working with champions in the community, by not being constrained by legacy systems, and by considering data sharing as a health systems transformation effort rather than simply a technology solution. Other unique factors that particularly helped New Orleans to build a more forward‐looking infrastructure were the role of a backbone organization in the community and a broader collaboration among medical, social, behavioral, and public health service providers.ConclusionsBoth Austin and New Orleans have many health systems innovations underway. However, like many other communities in the United States, they have a long way to go to become learning health systems, a goal that cannot be achieved without a robust, shared information infrastructure.