LN Transformation Study

The LN Transformation Study is in its final stages, and I am beginning to publish the findings. Please see below for a project description and hyperlinks to each paper. 

Culture as Infrastructure in Learning Health Systems describes sociological research on culture, linking these concepts to characteristics of Learning Health Networks. The goal of this commentary paper is to promote the use of a precise vocabulary for describing the actions of social groups and group members, as part of a broader process of investigating how Learning Health Networks operate as social groups. This paper is open access (not paywalled and free to read). Additionally, this paper is part of a special issue of Learning Health Systems Journal on the Science of Collaborative Learning Health Systems.

Putting the network to work: Learning networks in rapid response situations is a study that examines how one Learning Network transformed its operations to help network members cope with the operational and patient care changes brought by COVID-19. This paper is open access (not paywalled and free to read).

Project Overview
Healthcare delivery reform is a pressing issue in the United States. Some of the most urgent needs include increasing transparency in healthcare costs, improving care quality and access, and accelerating the pace of quality improvement research and point-of-care implementation of research findings. One novel approach to addressing these challenges is the establishment of Learning Networks as a mechanism of achieving Learning Health Systems. In a Learning Network, providers, patients, families, health system administrators and researchers work together to improve outcomes by collaborating on quality improvement and clinical research projects. The results of clinical research can lead to targeted, effective treatments, lowering long-term cost and improving health outcomes. Preliminary research[i] has demonstrated that Learning Networks are an example of successful healthcare delivery reform.

However, not much is yet known about the process of taking existing healthcare systems and changing them into Learning Networks. Existing research[ii] points to the complexity of this process, but without greater understanding of the organizational, cultural and structural transformations of healthcare systems into Learning Networks, our ability to scale this process will be hindered.

I am conducting a 2-year descriptive evaluation study of four condition-specific networks as they transform into Learning Networks. This research study is supported by funding from the Patient-Centered Outcomes Research Institute (PCORI) and will run from November 2018 until April 2021.

A deeper understanding of how healthcare systems make the transition to become Learning Networks is the first step in support of the long-term goal of replicating and scaling this model to the national level. In service of this aim, this study attends to organizational change, information technology infrastructures, and how the transition to a Learning Network impacts the daily work and health of those embedded in it.

[i] Crandall, W., M.D. Kappelman, R.B. Colletti, I. Leibowitz, J.E. Grunow, S. Ali, H.I. Baron, J.H. Berman, B. Boyle, S. Cohen, F. del Rosario, L.A. Denson, L. Duffy, M.J. Integlia, S.C. Kim, D. Milov, A.S. Patel, B.T. Schoen, D. Walkiewicz, P. Margolis (2011). “ImproveCareNow: The development of a pediatric inflammatory bowel disease improvement network.” Inflammatory Bowel Diseases, 17(1):450-7.

[ii] Kraft, S., W. Caplan, E. Trowbridge, S. Davis, S. Berkson, S. Kamnetz, N. Pandhi (2016). “Building the learning health system: Describing an organizational infrastructure to support continuous learning.” Learning Health Systems. DOI: 10.1002/lrh2/10034

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