Defining the Learning Health Care System: An International Health System Leadership Perspective

Over the past 2 decades, many academic health centers (AHCs) have implemented learning health systems (LHSs). However, the LHS has been defined with limited input from AHC leaders. This has implications because these individuals play a critical role in LHS implementation and sustainability. This study aims to demonstrate how an international group of AHC leaders defines the LHS, and to identify key considerations they would pose to their leadership teams to implement and sustain the LHS.

A semistructured survey was developed and administered in 2022 to members of the Association of Academic Health Centers President's Council on the Learning Health System to explore how AHC leaders define the LHS in relation to their leadership roles. The authors then conducted a focus group, informed by the survey, with these leaders. The focus group was structured using the nominal group technique to facilitate consensus on an LHS definition and key considerations. The authors mapped the findings to an existing LHS framework, which includes 7 components: organizational, performance, ethics and security, scientific, information technology, data, and patient outcomes.

Thirteen AHC leaders (100%) completed the survey and 10 participated in the focus group. The AHC leaders developed the following LHS definition: "A learning health system is a health care system in which clinical and care-related data are systematically integrated to catalyze discovery and implementation of new knowledge that benefits patients, the community, and the organization through improved outcomes." The key considerations mapped to all LHS framework components, but participants also described as important the ability to communicate the LHS concept and be able to rapidly adjust to unforeseen circumstances.

The LHS definition and considerations developed in this study provide a shared foundation and road map for future discussions among leaders of AHCs interested in implementing and sustaining an LHS.