Leveraging Learning Health Systems to Address Racial and Ethnic Disparities in Veteran Patient Experience

Learning health systems (LHS) use continuous data-driven learning cycles to improve care delivery, but seldom apply this approach to advance health equity. This perspective describes how the Veterans Health Administration (VA) applied LHS principles through a research-operations partnership between the Office of Health Equity (OHE) and the VA Health Equity-Quality Enhancement Research Initiative (QUERI) National Partnered Evaluation Center (PEC) to address racial and ethnic disparities in patient experience among VA users. The PEC analyzed the Survey of Healthcare Experience of Patients data to identify disparities in patient experience within VA regions (Veterans Integrated Service Networks [VISNs]). To address these disparities, OHE and PEC developed a "VISN equity toolkit" that communicates VISN-specific equity gaps by population group and patient experience metrics and offers tailored equity-guided quality improvement resources for distinct patient experience domains. For instance, in one VISN, Black veterans reported lower satisfaction with office staff helpfulness and respect versus White veterans, prompting focused strategies for staff training and service recovery programs. This research-operations partnership leverages LHS principles, aligns research and healthcare priorities, maps to existing frameworks for pursuing health equity through the LHS, and tailor interventions to regional needs to improve equity in VA patient care experience.