The role of co-production in Learning Health Systems

Area of Science:

• Health Services Research
• Implementation Science
• Sociotechnical Systems

Background:

• Co-production of health involves interdependent work between users and professionals to improve health outcomes.
• Learning Health Systems (LHSs) aim for continuous improvement by integrating diverse knowledge domains.
• While LHS definitions include user engagement, many emphasize technology over interpersonal interactions in healthcare design.

Purpose of the Study:

• To clarify the role and contributions of co-production within Learning Health System (LHS) conceptualizations and applications.
• To analyze how LHS models incorporate value co-creation principles.

Main Methods:

• Conducted a scoping review of LHS conceptualizations.
• Compared identified LHS models against established characteristics.
• Assessed LHS conceptualizations for their integration of co-production, co-design, co-construction, and co-innovation.

Main Results:

• Identified 17 LHS conceptualizations, with three models (Cincinnati Collaborative, Dartmouth Coproduction, Michigan Learning Cycle) being most comprehensive.
• These comprehensive models demonstrate all four types of value co-creation.
• Identified seven principles for enhancing value co-creation in LHSs, including shared aims, user-centered feedback, distributed leadership, and facilitated interactions.

Conclusions:

• LHS conceptualizations share common features and leverage co-production to create value for patients and health systems.
• LHSs integrate technology within sociotechnical systems to foster learning and improvement.
• Further real-world research is needed to understand how co-production and value co-creation drive LHS development.