Tools and frameworks for evaluating the implementation of learning health systems: a scoping review

Area of Science:

• Health Services Research
• Implementation Science
• Systems Science

Background:

• Learning Health Systems (LHS) are gaining traction, yet practical guidance for evaluating their implementation is scarce.
• Existing literature lacks comprehensive tools and frameworks for assessing LHS initiatives.

Purpose of the Study:

• To conduct a scoping review of existing tools and evaluate exemplars of LHS implementation.
• To identify and analyze frameworks and tools used for evaluating LHS implementation.

Main Methods:

• A systematic scoping review of four major databases (Scopus, EMBASE, MEDLINE, MEDLINE in-process) was performed.
• Studies published from 2018 onwards, focusing on LHS implementation evaluation or tool development, were included.
• Exclusion criteria included non-English articles, abstracts, and basic research.

Main Results:

• Only four studies met the eligibility criteria, yielding three distinct evaluation tools: Network Maturity Grid (NMG), Kaiser Permanente Washington (KPWA) LHS Logic Model, and LADDERS.
• Commonly evaluated constructs included Stakeholders, Data, Research Evidence, Implementation, and Sociotechnical Infrastructure.
• The NMG showed the highest maturity in adaptation and adoption; two tools conceptualized LHS as processes linking constructs.

Conclusions:

• The evaluation of LHS implementation is an under-researched area, with only three tools identified.
• There is emerging consensus on key constructs for LHS evaluation.
• Further empirical research is needed to develop and validate robust LHS implementation evaluation tools.