Conceptualizing learning health systems: A mapping review

Area of Science:

• Health Services Research
• Organizational Learning
• Public Health Policy

Background:

• Regional cross-sectoral partnerships are crucial for integrating health, public health, and social care services.
• Understanding learning mechanisms within these complex partnerships is essential for improving population health and managing costs.
• The concept of a Learning Health System (LHS) offers a framework for this understanding.

Purpose of the Study:

• To map the concept of a Learning Health System (LHS).
• To understand how learning occurs within regional cross-sectoral partnerships for health.
• To identify the aims, design elements, and processes of learning within LHS.

Main Methods:

• A qualitative text analysis approach was employed.
• A literature search was conducted in Embase (2015-2020), yielding 155 articles.
• Deductive and inductive coding were used to disentangle the LHS concept into aims, design elements, and learning processes.

Main Results:

• The Institute of Medicine's LHS definition was used, but interpretations varied widely.
• Twenty-five interconnected aims and nine design elements of LHS were identified, with some variation in stakeholder, data infrastructure, and data interpretation.
• Three types of learning were identified: practice-research interaction, data-to-knowledge-to-performance cycles, and recurrent stakeholder interaction; however, the third type was underrepresented and rarely occurred simultaneously with others.

Conclusions:

• To enhance learning in regional partnerships, specify LHS aims and operationalize design elements.
• Deliberately choose and integrate appropriate learning types for effective implementation.
• Further research should explore the underrepresentation of stakeholder-driven learning and simultaneous learning types.