Embracing the learning health system in primary care

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As knowledge and research of health systems grows, it is imperative that this evidence base is translated into clinicians’ practice and overall service delivery. However, this is often an arduous and complex process, especially if research and empirical methodology sits outside the bounds of the healthcare provider’s frameworks and governance.

The learning health system model is designed to overcome these challenges in research translation and is a framework where research and data are aligned and regularly used within clinical practice to facilitate system improvement and high-quality care. A paper by the PCHSS Observatory team including Genevieve Dammery, Dr Louise Ellis, and Professor Jeffrey Braithwaite, examines an Australian university-affiliated general practice to uncover how a learning health system has been established, and what opportunities there are for further embracing the model.

Uniquely, the study also used an embedded researcher model, which involves a researcher placed within the practice on a part-time basis to observe the system in play, and to also help bridge the gap between researchers and clinicians in care delivery. Persevering through COVID-19 lockdowns and virtual communication, this embedded researcher model proved to be highly successful, with researchers being added to existing clinician projects, and clinicians also taking on research roles themselves.

Through interviews with practice staff, it was clear that the general practice excelled on the aspects of the learning health system that focus on a continuous learning culture, sustained partnership between clinicians and patients, and transparency between healthcare providers in their practice network. Although uncommon within most general practices in Australia, partnering with a university also allowed the practice staff to have better access to science and informatics, and fostered implicit value on learning and collaboration.

As the first research to present a case study of a learning health system within an Australian primary care setting, this paper is a key stepping stone towards understanding how learning health systems can address the quadruple aim of healthcare: sustainable cost, improved provider satisfaction, patient experience of care, and quality and population health.

Demonstrated in this case study, the learning health system model is full of potential. Further embracing of this framework and its core values can help strengthen ties between researchers and clinicians, and overall contribute to a more effective, evidence-based healthcare system.




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