Learning Health System Briefing

Chuck FriedmanJosh Rubin

AMIA SymposiumNovember 17, 2015

DisclosureJosh and I are wearing two hats tonight:

1) University of Michigan2) Learning Health Community

We will try to be a clear as possible as to when we are wearing each one.

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Not a “Pep Rally” This Year

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Today’s Briefing

• The LHS Challenge• The Role of Community in Realizing

an LHS• A Science of Cyber-Social Learning

Systems• The New Journal: “Learning Health

Systems”

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Properties of a Health System That Can Learn

Every consenting patient’s characteristics and experience are available to learn from

Best practice knowledge is immediately available to support decisions

Improvement is rapid and continuous through ongoing study

An infrastructure enables this happen routinely and with economies of scale.

All of this is part of the culture 5

The LHS is Bigger than BD2K:It Must Do This

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AssembleRelevant Data

Take Action to Change Practice

InterpretResults

AnalyzeData

Deliver Tailored Message

A Problem of Interest

Decision to Study

Not This

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AssembleRelevant Data

Take Action to Change Practice

InterpretResults

AnalyzeData

Deliver Tailored Message

A Problem of Interest

Decision to Study

Journals?

LHS Infrastructure A Single Socio-Technical Platform Supports

Multiple Simultaneous Learning CyclesDifferentProblems

Rapid Cycle

Slower Cycle

SUPPORTING PLATFORM

People

ProcessTechnology

Policy

The Learning Health Community

• Evolved from the 2012 LHS Summit• Consensus Core Values Endorsed by

91 Organizations• Two Initiatives:

– Essential Standards to Enable Learning (ESTEL)

– Governance• Vision of a “Second Summit”

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New Science?• National workshop explored the

research challenges inherent in realizing a high functioning LHS

• April, 2013: 45 invited attendees• At the end, it was suggested that

these challenges may equate to a new science

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Cyber-Social Learning Systems

As formulated by Kevin Sullivan:• Ability to gather, integrate, and analyze

information at scale to produce new insights, and use such insights to continuously improve complex socio-technical system structure, function, and performance to meet demanding and evolving requirements

• Is this the future of informatics?

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Features of Cyber-Social Learning Systems

• People, institutions, legal frameworks, etc. are parts of computational architecture

• At ecosystem scales, traditional engineering methods are no longer adequate

• Systems must be self-aware, continuously evolving, and self-governing

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Bill Stead’s Formulation…

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Next Steps

• The Computing Community Consortium, NSF’s program planning arm for computing, has given us a “soft” green light to plan a series of visioning workshops

• Three workshops addressing cyber-social learning systems applied to health and three other domains

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A New International Journal

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LHS Journal• Editorial office in Ann Arbor• Three Associate Editors

– Brendan Delaney– Jonathan Silverstein– Kevin Sullivan

• 46-member Editorial Board (nine countries)

• Article types– Research reports– Experience reports– Briefs– Commentaries

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