Abstract

BackgroundThe transition to electronic health records offers the potential for big data to drive the next frontier in healthcare improvement. Yet there are multiple barriers to harnessing the power of data. The Learning Health System (LHS) has emerged as a model to overcome these barriers, yet there remains limited evidence of impact on delivery or outcomes of healthcare.ObjectiveTo gather evidence on the effects of LHS data hubs or aligned models that use data to deliver healthcare improvement and impact. Any reported impact on the process, delivery or outcomes of healthcare was captured.MethodsSystematic review from CINAHL, EMBASE, MEDLINE, Medline in-process and Web of Science PubMed databases, using learning health system, data hub, data-driven, ehealth, informatics, collaborations, partnerships, and translation terms. English-language, peer-reviewed literature published between January 2014 and Sept 2019 was captured, supplemented by a grey literature search. Eligibility criteria included studies of LHS data hubs that reported research translation leading to health impact.ResultsOverall, 1076 titles were identified, with 43 eligible studies, across 23 LHS environments. Most LHS environments were in the United States (n = 18) with others in Canada, UK, Sweden and Australia/NZ. Five (21.7%) produced medium-high level of evidence, which were peer-reviewed publications.ConclusionsLHS environments are producing impact across multiple continents and settings.

Highlights

  • Most Learning Health System (LHS) environments were in the United States (n = 18) with others in Canada, UK, Sweden and Australia/NZ

  • The transition to digital health including electronic medical records (EMR) is creating the opportunity and expectation that big data will drive the frontier of healthcare improvement and transformation

  • LHS impact categories were determined by authorship panel of experts and were based on the healthcare improvement and impact reported in the study

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Summary

Methods

Systematic review from CINAHL, EMBASE, MEDLINE, Medline in-process and Web of Science PubMed databases, using learning health system, data hub, data-driven, ehealth, informatics, collaborations, partnerships, and translation terms. English-language, peer-reviewed literature published between January 2014 and Sept 2019 was captured, supplemented by a grey literature search. Eligibility criteria included studies of LHS data hubs that reported research translation leading to health impact

Results
Introduction
ImproveCareNow Chronic United
University of Alabama at United
Community Health
18 Cystic Fibrosis Foundation United
19 Kaiser Permanente
22 Learn From Every Patient United
10 KPNC 30 primary care practices at 13
Discussion
Limitations
Conclusion
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