Beyond Meaningful Use: Listening Session Looks Ahead to The Learning Health System
The April 6, 2010 listening session (audio link below) for the draft framework for the Health IT Strategic Plan pointed to a concept more far reaching than meaningful use: the Learning Health System. One of the four themes proposed by the Health IT Committee Strategic Plan Workgroup, the  Learning Health System, is based on the charter of  the Institute of Medicine’s Roundtable on Evidence-Based Medicine, since renamed the Roundtable on Value & Science-Driven Health Care.

One of the transformational concepts underlying the learning system moves the physician beyond reliance on their solo expertise toward working in collaboration with the patient, other clinicians, and continuously updated  data resources and scientific evidence to improve patient care.

“A learning health system” according to a slide from the listening session citing the Institute of Medicine, ”is a system that is designed to generate and apply the best evidence for the collaborative health care choices of each patient and provider; to drive the process of new discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in health care.”

The prior week, the Roundtable sponsored its latest Workshop,  April 1-2, 2010, in Washington, DC, which was  titled “The Learning Healthcare System in 2010 and Beyond: Understanding, engaging, and communicating the possibilities.” The Roundtable, in describing its work, says it develops meetings and projects with leaders from a range of healthcare sectors to achieve “its goal that by 2020, ninety percent of clinical decisions will be supported by accurate timely, and up-to-date clinical information, and will reflect the best available evidence.”

ONC’s Health IT Strategic Framework:
The Learning Health System 
The following section on the Learning Health System, one of four themes, is excerpted from the pre-decisional draft of the ONC’s Health IT Strategic Framework that was discussed at the April 6 listening session of the HIT Policy Committee Strategic Plan Workgroup.
PDF version of draft Framework

a. Goal:
Transform the current health care delivery system into a high performance learning system by leveraging health information and technology. 

 b. Principles |
          1. Health information should be used to facilitate rapid learning and innovation in diagnosis, treatment, and decision making to improve health outcomes and to enhance health system value. 

          2. HIT should help engage patients and providers to take active roles in creation and application of evidence-based care.  

c. Objectives 
          1. Use HIT methodologies, policies and standards to foster creation of knowledge across a large network of distributed data sources, while protecting privacy and confidentiality. 

          2. Engage public and private sectors stakeholders at the national, regional, and local levels to effectively leverage data and human resources to advance care delivery, alignment of payment with outcomes, research (e.g., clinical research, comparative effectiveness research), public health (e.g., drug safety monitoring, outbreak surveillance), education (e.g., K-12, colleges, professional schools, professional lifelong learning) and social services to promote and maintain community health. 

           3. Support individuals decision on making their data be used for society (e.g., research and public health), while protecting their privacy. 

          4. Leverage data from populations to expand knowledge and promote scientific discoveries that advance the understanding of health, disease, and treatments. 

d. Strategies 
          1. Continuously evaluate successes and lessons learned through HIT adoption, and actively incorporate best practices into the HIT programs and services. 

                              Provide mechanisms to assess and continuously improve EHR safety. Explore and develop EHR safety measures and reporting mechanisms as learning processes to improve the safety of EHRs. 

           2. Reward, showcase, and leverage industry best practices and innovative uses of HIT to create an active community learning system that supports advances in health promotion and treatment of diseases in the US. Make knowledge and technology accessible to health care professionals and consumers. 

          3. Engage all levels of the public and private sectors, along with the international community, in coordinated activities to advance population health (public health, biomedical research, quality improvement, and emergency preparedness) by using common policies, standards, protocols, legal agreements, specifications, and services for data sharing and building knowledge. 

          4. Stimulate and support innovations in care delivery, performance measurements, genomics, and comparative effectiveness through HIT. 

                             Support research and development activities to overcome obstacles that impede creation of learning systems.  

           5. Incorporate the global health dimension into the interoperability requirements of the learning system infrastructure.  

           6. Harmonize the meaningful-use requirements with the dual needs of population health (clinical research, comparative effectiveness, public health) and a learning system. 

          7. Through a comprehensive education and communications campaign, promote a shared vision of a learning health system and the role of HIT in helping to create it. 

                         Develop and implement educational material and tools to improve consumers’ health and HIT literacy and to promote self management and self efficacy using HIT. 

                        Communicate with professional societies and boards to identify opportunities for meaningful use activities to contribute to professional education programs. 
END OF EXCERPT

Additional Resources:
See earlier post from e-Healthcare Marketing on Listening Session on Strategic Framework.

Materials and audio from April 6, 2010 Listening Session.

IOM April 1-2, 2010 Roundtable: “The Learning Healthcare System in 2010 and Beyond: Understanding, engaging, and communicating the possibilities”

Use the tool below to view free online published version of 2006 IOM Workshop on the Learning Health System.