Implementing the Learning Health System: From Concept to Action
Implementing the Learning Health System: From Concept to Action
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DOI：
10.7326/0003-4819-157-3-201208070-00012
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发表时间：
2012-08-07
影响因子：
39.2
通讯作者：
Larson, Eric B.
中科院分区：
文献类型：
--
作者：
Greene, Sarah M.;Reid, Robert J.;Larson, Eric B.
临床医生和卫生系统正面临着广泛的挑战，包括医疗服务的变化，不断上升的医疗保健成本，以及跟上快速科学发现的需要。重组美国的医疗保健并改变其做法，以提供更好、更负担得起的医疗保健，需要改变卫生系统如何产生和应用知识。“快速学习卫生系统”--作为一种促进这种转变的概念性战略--利用卫生信息技术的最新发展和不断发展的卫生数据基础设施，在真实的时间内访问和应用证据，同时从现实世界的护理提供过程中汲取知识，以促进创新和卫生系统的变革。本文介绍了一个不断发展的学习健康系统在团体健康合作社，6个阶段的特点，其方法，并在组织范围内的应用程序的例子。这种实用的模式促进了双向发现和系统层面的开放心态，从而使人们愿意根据科学合理和基于实践的证据进行变革。快速学习必须作为卫生系统的一项财产加以重视，以充分发挥其产生和应用知识的潜力。
Clinicians and health systems are facing widespread challenges, including changes in care delivery, escalating health care costs, and the need to keep up with rapid scientific discovery. Reorganizing U.S. health care and changing its practices to render better, more affordable care requires transformation in how health systems generate and apply knowledge. The "rapid-learning health system"-posited as a conceptual strategy to spur such transformation-leverages recent developments in health information technology and a growing health data infrastructure to access and apply evidence in real time, while simultaneously drawing knowledge from real-world care-delivery processes to promote innovation and health system change on the basis of rigorous research. This article describes an evolving learning health system at Group Health Cooperative, the 6 phases characterizing its approach, and examples of organization-wide applications. This practical model promotes bidirectional discovery and an open mind at the system level, resulting in willingness to make changes on the basis of evidence that is both scientifically sound and practice-based. Rapid learning must be valued as a health system property to realize its full potential for knowledge generation and application.