Implementing the learning health system paradigm within academic health centers

Introduction The learning health system (LHS) concept represents a bold innovation that combines organizational learning, strategic analysis of patient data, stakeholder engagement and the systematic translation research into practice – all in service improving quality care delivered across organization. This has been diffused widely adopted by healthcare organizations over past 15 years, but academic centers (AHCs) have slower on uptake. irony is AHCs resources (e.g., trained researchers, sophisticated clinical data systems, informatics infrastructure) are necessary to do highest-quality most impactful LHS work. Methods Based review publications describing how implemented work, as well authors' direct experience promoting adoption paradigm at Atrium Health Wake Forest Baptist (AHWFB), we:identify set factors inhibited broader among AHCs; distinguish between forms work consistent inconsistent with mission offer recommendations for fuller implementation paradigm. Results an expansion scientific which serves foundation enterprise within AHCs. Both paradigms value rigorous studies new treatments practices, including pragmatic trials. also places high improvement studies, findings improved operations local system. two differ origin question, i.e., pressing patient-care issue facing versus investigator's own interests. Academic researchers disincentivized from pursuing least some research. However, growing number finding ways integrate their enterprise, either providing faculty institutional funding cover effort address system's priority issues, or establishing institute dedicated Conclusions disruptive intervention AHCs, one was initially resisted increasingly being embraced. developing strategies conducting research, typically parallel more traditional biomedical science core medicine. Full will require further alignment science, shift criteria promotion tenure support those who choose focus issues