|Type of paper:
|Learning Education Health and Social Care Healthcare
The learning health system (LHS) is an approach implemented to improve the outcomes of populations, individuals, and healthcare organizations. The method combines research, quality improvement, and data science to get knowledgeable about patient-physician interaction. The engagement of families, patients, and clients in its research studies, governance, and development of projects is the distinguishing and essential attribute of the LHS. Just like any other approach, there exists emerging characteristics and trends related to the emergence context of the LHS. There has been a concern to create and integrate a national-scale LHS to achieve the vision of the approach by aligning academic medical research centers. The national-scale LHS would enable the development of specialty-specific infrastructure to promote LHS. Core competency domains within the system refer to the main areas in which the current research on the healthcare system will be embedded to provide a comprehensive health system research. Therefore, the paper focuses on investigating LSH based on the critical primary competencies with an effort to increase the overall performance of a healthcare system.
- How does the health system operations and how does the healthcare operation affect implementation and research?
- What is the impact of scientific insights and scientific insights essential to evaluate while carrying out scientific evidence and research areas?
- How are the outcomes of the stakeholders within a healthcare system affected by LSH research?
- How does the LSH informatics competency domain affect the overall system and patient outcome?
The first step would be to develop the definition of an LHS researcher and a domain framework. It is the first phase of organizing competencies. Conducting semi-structured interviews, literature review alongside letting the expert panel to handle a consensus development meeting is also incorporated in the first phase (Mullins et al., 2018). The second phase would encompass a second consensus development meeting. The second phase would entail the drafting of specific competencies (Scobie & CastleClarke, 2020). Delphi survey would be the final stage where the expert panel would hold the final consensus development meeting.
To improve the outcomes of populations and individuals and the performance of the health system at large, individuals should be required to collaborate with the stakeholders. Also, they should be embedded in the health system. The embedded characteristic of every LHS researcher acts as a notable and distinguishing feature. A researcher should be embedded in the system as an invited partner or an employee-oriented towards the development, analysis, implementation, dissemination, and conduct of research design to capture the questions of interest to clinicians and stakeholders in the healthcare system.
LHS researcher should be keen while executing research to deviate from disrupting day-to-day operations. It is the embeddedness that enables this to occur and ensure that an investigator appreciates the perspectives of the ones operating the systems and the patients receiving health care (Scobie & CastleClarke, 2020). A researcher who collects data within health systems and does not form a part of the system should not be termed as LHS researchers. It is because they are no embedded.
Expert Panel Meetings. The expert panel would be made up of 19 members to define who an LHS researcher is. It is the first phase where specific competencies in the competency domain framework are developed.
Development of Individual Competencies. The 19 members in the expert panel would form writing teams to tackles ten initial domains. Due to the existence of drafting competencies that exist as relevant to their domain, 90 of them would be chosen to be handled (McLachlan et al., 2019).
Modified Delphi. A survey where panel members actively participate in rating how essential each chosen 67 competencies are. The scale to be used is from 1 (low) to 9 (high) (McLachlan et al., 2019). He survey would be conducted twice; in the 2nd and 3rd meetings held by the expert panel. The challenge involved is that everything depends solely on the expert panel. There might exist bias. An example is in the modified Delphi survey, where some members in the expert panel rate the competencies while exaggerating.
The domain structure and core competencies to be identified generated from the study would provide a framework to be used while designing the training programs (McLachlan et al., 2019). It is research that would prepare a cadre of LHS researchers who would consistently address and tackle real-world challenges that exist in healthcare delivery and drive improvements.
From the core competencies and the domain structure, outcomes from the population, individuals, and system would be promoted. It would be considered as the first attempt in defining the scope and how the LHS researchers would be trained (Foley & Vale, 2017). The individual competencies emphasize on specific assets required to apply and generate new knowledge in the context of health systems.
The embeddedness of the researcher, the real-world context, and participation of stakeholder’s within the health system in most aspects of research are identifiable features of LHS research (Foley & Vale, 2017). The improvement of these aspects is distinguishing characteristics in the study of the approach. The role of the core competencies is to guide the expansion and development of the already existing training programs.
The core competencies do not prescribe the experiential or pedagogical methods through which knowledge and skills are either acquired or evaluated (Scobie & CastleClarke, 2020). Specific learning activities such as curricula, teaching strategies, and participation in LHS research would be determined by individual training programs. They would also be determined by areas where the specific emphasis is implemented or through the approaches implemented to assess the competency achievement.
LHS research needs multiple disciplines to integrate and work jointly to produce science and translate its results. As a result, no one is expected to be an expert in all domains of competency (Mullins et al., 2018). However, the LHS researcher should lead and assemble multidisciplinary expert teams who would associate their expertise in every domain involved in the competency framework to achieve the broader objectives and goals of the LHS.
There exist various attributes of LHS research. Each has implications on how the researchers should be trained. LHS research results are concerned with generalization to the context and aspect of the individual system. The research evidence in health systems may not require to achieve all the standards allocated to be met by medical evidence while making clinical decisions (Stucki & Bickenbach, 2017). However, LHS researchers should depend on health systems while investing in their research.
The framework is entailing the core competencies and domains that are adopted by the LHS researcher act as the starting point for further discussion and work. The core competencies should evolve together with LHS research and science. Future iterations would be well informed if there is a greater understanding of how the core competencies are conducted regarding teaching and curricula strategies. The core competencies should be used and refined in health systems that use and emphasize the LHS approach while seeking to train individuals to use the knowledge, models, and new methods to improve the system and patient outcomes. Therefore, researchers need additional skills to enable the implementation of LHS.
Mullins, C. D., Wingate, L. M. T., Edwards, H. A., Tofade, T., & Wutoh, A. (2018). Transitioning from learning healthcare systems to learning health care communities. Journal of comparative effectiveness research, 7(6), 603-614. https://www.futuremedicine.com/doi/abs/10.2217/cer-2017-0105
Scobie, S., & CastleClarke, S. (2020). Implementing learning health systems in the UK NHS: policy actions to improve collaboration and transparency and support innovation and better use of analytics. Learning Health Systems, 4(1), e10209. https://onlinelibrary.wiley.com/doi/abs/10.1002/lrh2.10209
Stucki, G., & Bickenbach, J. (2017). The implementation challenge and the learning health system for the SCI initiative. American journal of physical medicine & rehabilitation, 96(2), S55-S60. https://journals.lww.com/ajpmr/Fulltext/2017/02001/The_Implementation_Challenge_and_the_Learning.8.aspx
Foley, T. J., & Vale, L. (2017). What role for learning health systems in quality improvement within healthcare providers?. Learning Health Systems, 1(4), e10025. https://onlinelibrary.wiley.com/doi/abs/10.1002/lrh2.10025
McLachlan, S., Dube, K., Johnson, O., Buchanan, D., Potts, H. W., Gallagher, T., & Fenton, N. (2019). A framework for analyzing learning health systems: Are we removing the most impactful barriers?. Learning health systems, 3(4), e10189. https://onlinelibrary.wiley.com/doi/abs/10.1002/lrh2.10189
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