On September 15th
2017 the Agency for Healthcare Research and Quality
or AHRQ brought together key stakeholders,
representatives of health delivery systems, small- and medium-sized practices,
researchers, and AHRQ staff, to convene the agency's
first research summit on learning health systems
AHRQ Director, Gopal Khanna:
I believe we are sitting on on
opportunities that are usually huge, and that's the reason
why I thought it will be a very good idea to have our
stakeholders come to us and we can work with them,
and learn from them.
The summit focused on achieving three goals
First,
identifying the aspects of learning health systems
needed to improve organizational performance and
quality and safety of care, as well as important
characteristics of the healthcare workforce.
Second,
recognizing attendees roles in helping to create a Learning Health System and
third,
exploring how AHRQ can act as a catalyst for the advancement
of learning health organizations and practices.
Throughout the summit, attendees participate in interactive panel discussions,
moderated group exercises, and a variety of fast-paced brainstorming activities.
They shared stories about challenges unique to
their organizations and many they had in common.
During the session, Learning Healthcare Delivery
Systems in Practice, Lucy Savitz, Karen Feinstein and
Peter Pronovost
delved into issues like these and many others.
As moderator, Karen Feinstein of the Jewish Health Care Foundation
probed on questions about improvements, harm, and organizational culture.
Dr. Peter Pronovost of the Johns Hopkins School of Medicine shares his perspective
Healthcare has a number of improvements to do.
We harm too often. We cost too much,
we often disrespect patients. The way we improve
that is through being a learning health system
by making sure we're constantly seeking to get better,
to find that new knowledge that allows us to get better and most
importantly, make sure we apply that in the care of our patients
Lucy Savitz from Kaiser Permanente Northwest offers further insight
There has to be commitment from senior leadership
But they truly want to be a learning healthcare
system and that requires not just in words
Making that attestation it also includes really
Investing in the capacity and the resources
necessary to make that happen whether they do that
Internally or they collaborate with external partners to make that happen.
And the other thing that I think is really critical that
gets really short-shrifted it in all of this, is creating
the culture. There's a National Academy of Medicine paper out -Rich
Platts is the lead author right now- where they're talking about
creating a culture of inquiry, you know so that people begin to ask the questions.
Mary Naylor of the University of Pennsylvania's school of medicine
and Dr. J. Michael McGinnis of the National Academy of Medicine
offered perspectives on their vision for Learning Health Systems
I see in the last couple of years
one really solid example of where
advances have been made and that is in the partnerships that now exist.
I'm sure they always existed
but in the alignment of the goals and agendas of the National
Academy of Medicine and AHRQ and all of the other organizations
really converging, coalescing around a common shared
agenda to get to better health, better health care, and
better outcomes
for people in our society. So it's been
tremendously exciting for me to have a chance to sit in
many of these spots to hear about the work of so many.
Well, I agree with your observation about the
importance of stakeholder synergy and what we see now
We see
New partnerships being developed we see a new appreciation for the opportunities
And we see a commitment to work together to try to capture those opportunities
Which is a reflection of a couple of things so many things but
one is the urgency of the issues involved when we see missed opportunities
to improve the health of people who are most vulnerable
when we see
the costs of care
continuing to rise and at the expense of many of the
social services that are necessary to make a difference,
when we see a
clinician community, that because it's working in a culture that at this point
hasn't been able to take advantage of the appreciation about teen care and about
engagement with patients and families, we are in a in a circumstance
of
deep societal obligation to make these changes.
That's why I think you see a different spirit about the importance
of working together, to capture what we know is possible in
developing a continuously learning health system.
For attendees, presenters, and staff
honing in on the opportunities, and capturing the possibilities
to achieve the transformative for learning health systems
now and into the future
aligned with each of the three goals AHRQ set out to accomplish.
And as discussions among agency stakeholders and staff
continued into the afternoon, new ideas began to emerge
resulting in clearer and more unified concepts,
like ones noted by AHRQ Chief Medical Officer,
Dr. David Myers.
The learning healthcare system has in my mind three components
And we really heard focus on two of them today
jumping out. At least that's what I heard,
So one, is taking the evidence that's coming from
the academic health centers, from health services
researchers from outside of healthcare and
bringing it in. That's what we've done for years,
but what was new about today's discussion, two parts One was how
healthcare systems who are caring for patients everyday can learn to
care for tomorrow's patients because of what happened today.
Karen Feinstein summarizes what
she and others agreed as essential in building a successful learning healthcare system
Well, I was very
reassured at this meeting. We took a vote on what is the most important factor in
having a successful
Learning organization, and far and away the most popular
criteria it was of the criteria, were leadership, a champion in every unit
That means training is ongoing so I think that people named
all the key components you've got to have real-time data
Credible real-time data drill down to the unit and practice level.
Such sentiments resonated with many participants
Having heard the thoughts and ideas of panelists and attendees
Agency leaders reflect on how AHRQ might serve as a catalyst for
the advancement of learning healthcare organizations and practices
I think there is a need for AHRQ to leverage its
competencies which are really very significant and
provide greater value for the community at large physicians,
clinicians and ultimately the patients and the American people
I think when it comes to tools and resources
they want to understand a lot more about how to spread and scale new
findings new investments
You know how do they know what to replicate and
how to replicate it and how to evaluate success
success so I think that's something we can certainly focus on.
Using all the information they're generating all the experience they're gaining
their own, and what we call data and turning that data into knowledge
to improve healthcare in the future. That was never before possible.
The agency was able to achieve the goals outlined for the summit
thanks to the valuable input from all who participated
As a result, AHRQ is putting in place plans to support learning
health systems to further embrace the power of their own data
and people. So I think we've got a lot of great
ideas and I think one of the the most important
concepts was how AHRQ could be a convener of other public agencies and private agencies
other government agencies that
have some work in
this space and private entity so I look forward to working with lots of others
Yes, we do have a lot of structural issues at play
However, the opportunity is that we can create a tipping point by design,
because when these forces are at play can we do something transformative?
And I believe so. We can.