Learning health system, positive deviance analysis, and electronic health records: Synergy for a learning health system.

Abstract

Over the past decade, numerous efforts have encouraged the realization of the learning health system (LHS) in the United States. Despite these efforts, and promising aims of the LHS, the full potential and value of research conducted within LHSs have yet to be realized. New technology coupled with a catalyzing global pandemic have spurred momentum. In addition, the LHS has lacked a consistent framework within which "best evidence" can be identified. Positive deviance analysis, itself reinvigorated by recent advances in health information technology (IT) and ubiquitous adoption of electronic health records (EHRs), may finally provide a framework through which LHSs can be operationalized and optimized. We describe the synergy between positive deviance and the LHS and how they may be integrated to achieve a continuous cycle of health system improvement. As we describe below, the positive deviance approach focuses on learning from high-performing teams and organizations. Such learning can be enabled by EHRs and health IT, providing a lens into how digital clinical interventions are successfully developed and deployed.