• Bmc Med · May 2024

    Learning together for better health using an evidence-based Learning Health System framework: a case study in stroke.

    • Helena Teede, Dominique A Cadilhac, Tara Purvis, Monique F Kilkenny, CampbellBruce C VBCVStroke Theme, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia.Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Parkville, VIC, Australia.Department o, Coralie English, Alison Johnson, Emily Callander, Rohan S Grimley, Christopher Levi, Sandy Middleton, Kelvin Hill, and Joanne Enticott.
    • Monash Centre for Health Research and Implementation, 43-51 Kanooka Grove, Clayton, VIC, Australia. helena.teede@monash.edu.
    • Bmc Med. 2024 May 15; 22 (1): 198198.

    BackgroundIn the context of expanding digital health tools, the health system is ready for Learning Health System (LHS) models. These models, with proper governance and stakeholder engagement, enable the integration of digital infrastructure to provide feedback to all relevant parties including clinicians and consumers on performance against best practice standards, as well as fostering innovation and aligning healthcare with patient needs. The LHS literature primarily includes opinion or consensus-based frameworks and lacks validation or evidence of benefit. Our aim was to outline a rigorously codesigned, evidence-based LHS framework and present a national case study of an LHS-aligned national stroke program that has delivered clinical benefit.Main TextCurrent core components of a LHS involve capturing evidence from communities and stakeholders (quadrant 1), integrating evidence from research findings (quadrant 2), leveraging evidence from data and practice (quadrant 3), and generating evidence from implementation (quadrant 4) for iterative system-level improvement. The Australian Stroke program was selected as the case study as it provides an exemplar of how an iterative LHS works in practice at a national level encompassing and integrating evidence from all four LHS quadrants. Using this case study, we demonstrate how to apply evidence-based processes to healthcare improvement and embed real-world research for optimising healthcare improvement. We emphasize the transition from research as an endpoint, to research as an enabler and a solution for impact in healthcare improvement.ConclusionsThe Australian Stroke program has nationally improved stroke care since 2007, showcasing the value of integrated LHS-aligned approaches for tangible impact on outcomes. This LHS case study is a practical example for other health conditions and settings to follow suit.© 2024. The Author(s).

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