Implementation of a "real-world" learning health system: Results from the evaluation of the Connected Health Cities programme.

Stephanie Steels,Tjeerd P Van Staa,John Ainsworth

doi:10.1002/lrh2.10224

Abstract

BackgroundThe “learning health system” has been proposed to deliver better outcomes for patients and communities by analyzing routinely captured health information and feeding back results to clinical staff. This approach has been piloted in the Connected Health Cities (CHC) programme in four regions in the North of England. This paper presents the results of the evaluation of this program conducted between February and December 2018.MethodsFifty nine semistructured interviews were completed with a mix of CHC programme staff and external partners who had contributed to the delivery of the CHC programme. Interviews were audio recorded and transcribed verbatim. This also included the review of project documentation including project reports and minutes of project group meetings, in addition to a short online survey that was completed by 31 members of CHC programme staff. Data were analyzed thematically.ResultsTwo overarching themes emerged through the thematic analysis of participant interview: (a) challenges in the implementation of learning health system pathways, and (b) benefits to the CHC approach for both staff and patients. In particular, time constraints in delivering an ambitious program of work, data quality, and accessibility, as well as the long‐term sustainability of the CHC programme were noted as key challenges in implementing a LHS at scale.ConclusionsThe findings from this evaluation provide valuable insight into creating learning health system at scale, including the potential benefits and likely challenges.

Highlights

Two overarching themes emerged through the thematic analysis of participant interview: (a) challenges in the implementation of learning health system pathways, and (b) benefits to the Connected Health Cities (CHC) approach for both staff and patients
Two overarching themes emerged through the thematic analysis of participant interviews, online survey, and documentary analysis: (a) Challenges in the implementation of learning health system pathways, and (b) benefits to the CHC approach for both staff and patients
The majority of participants stated that the program as a whole had underestimated the scale of the challenge in getting National Health Service (NHS) Trusts and Higher Education Institute (HEI) with very different set-ups, approaches, resources, and starting points to all get the degree of harmonization and staffing necessary to implement all that they wanted to do and this had led to delays in delivering outputs

Summary

Introduction

The “learning health system” has been proposed to deliver better outcomes for patients and communities by analyzing routinely captured health information and feeding back results to clinical staff. This approach has been piloted in the Connected Health Cities (CHC) programme in four regions in the North of England. Interviews were audio recorded and transcribed verbatim This included the review of project documentation including project reports and minutes of project group meetings, in addition to a short online survey that was completed by 31 members of CHC programme staff. Results: Two overarching themes emerged through the thematic analysis of participant interview: (a) challenges in the implementation of learning health system pathways, and (b) benefits to the CHC approach for both staff and patients. Conclusions: The findings from this evaluation provide valuable insight into creating learning health system at scale, including the potential benefits and likely challenges

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