Learning Health Systems最新文献

{"title":"Data Fit for Health Equity: Learning Health Systems, AI, and the STANDING Together Recommendations","authors":"Elinor Laws,&nbsp;Neil Cockburn","doi":"10.1002/lrh2.70053","DOIUrl":"10.1002/lrh2.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Artificial Intelligence (AI) tools may deliver significant improvements in healthcare and Learning Health Systems are well positioned to benefit. However, during the adoption of AI, Learning Health Systems should consider the potential for AI to exacerbate health inequity and perpetuate biases that exist in healthcare and its associated data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The STANDING Together recommendations provide a method to identify and report potential bias during the curation of datasets for AI and the development of AI from those datasets. The recommendations could form a key learning cycle within a Learning Health System ensuring transparent reporting of healthcare data use and the implementation of AI healthcare technologies that promote health equity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results and Conclusions</h3>\u0000 \u0000 <p>Learning Health Systems are well placed to adopt the STANDING Together best practice recommendations for using healthcare data as they are likely to have both the capabilities to implement the recommendations and the strategic goals that will realize the value of health data and AI that promotes health equity. The STANDING Together recommendations are available from www.datadiversity.org.</p>\u0000 </section>\u0000 </div>","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"10 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embedding Systems Engineering Leadership in Learning Health Systems: The Case for a Chief Systems Engineer in Every Hospital","authors":"Md Doulotuzzaman Xames","doi":"10.1002/lrh2.70054","DOIUrl":"https://doi.org/10.1002/lrh2.70054","url":null,"abstract":"<p>As healthcare systems transition toward Learning Health Systems (LHS), the need for executive-level leadership in systems thinking becomes urgent. This commentary advocates for the institutionalization of a Chief Systems Engineer (CSE) role in hospitals to embed systems engineering (SE) principles within leadership structures, navigate complexity, integrate technology with clinical workflows, and drive continuous organizational learning. Drawing on lessons from high-reliability industries and existing healthcare initiatives, this commentary argues that establishing dedicated SE leadership is essential for achieving both horizontal and vertical integration across clinical, operational, and strategic domains. It outlines the responsibilities of the CSE, aligns them with LHS goals, and offers recommendations for sustained and scalable implementation across healthcare organizations.</p>","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"10 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145983590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Informatics Education to Advance Learning Health Systems: A Scoping Review","authors":"Alexandra Zingg,&nbsp;L. Ida Tovar,&nbsp;Laura Witte,&nbsp;Kelsey L. Koym,&nbsp;Kyler Godwin","doi":"10.1002/lrh2.70050","DOIUrl":"https://doi.org/10.1002/lrh2.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Learning health systems leverage clinical data and knowledge to advance healthcare quality. Effective training in informatics concepts and tools is essential for medical trainees to become health system experts and contributors to positive organizational change. The objective of this study is to summarize characteristics of existing clinical informatics training programs and map these to recommended Learning Health System informatics competencies. We aim to answer the following research questions: (1) How are academic medical institutions implementing informatics education initiatives for medical trainees? (2) Are these initiatives implementing recommended informatics competencies? and (3) How effective are these initiatives according to established health professions education evaluation frameworks?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched for literature in the databases Embase, Ovid Medline, and Web of Science. Three researchers independently screened study titles and abstracts. Inclusion criteria were (a) studies with medical students and/or postgraduate medical professionals in the study sample, (b) in an academic medical setting, and (c) describing a clinical informatics curriculum initiative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included a total of 27 studies for analysis. Most curricula (<i>n</i> = 16) had the objective of basic informatics knowledge acquisition. Instruction delivery for most (<i>n</i> = 17) included a combination of didactic and practical components. The most common evaluation tool was student self-reported confidence and self-efficacy. All but three of the studies integrated the recommended informatics competency of demonstrating knowledge of clinical information systems such as Electronic Health Records. Most studies (<i>n</i> = 12) reported outcomes related to the Kirkpatrick Level II of Learning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gaps remain in the context of leveraging education to pursue Learning Health System endeavors of clinical research, quality improvement, and achieving organizational-level results. Further research on recent education initiatives targeting undergraduate and graduate medical trainees is needed to elevate the rate of clinical informatics education implementation, while simultaneously advocating for standardization in the design and evaluation of these initiatives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"10 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Factors That Impact Genetic Counseling Referral and Uptake Using Learning Health Approaches","authors":"Samantha Greenberg,&nbsp;Bob Wong,&nbsp;Katherine A. Sward,&nbsp;Kathleen A. Cooney,&nbsp;Jonathan Tward,&nbsp;Andrew Post,&nbsp;Mollie R. Cummins","doi":"10.1002/lrh2.70049","DOIUrl":"https://doi.org/10.1002/lrh2.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Germline testing and pretest genetic counseling are advised for many cancer patients, yet not all receive these services. Electronic Health Records (EHRs) offer a valuable resource to measure referral to genetic counseling (referral receipt) and uptake (completion of counseling). This study uses EHR data to assess demographic factors influencing genetic counseling referral and uptake among prostate cancer patients, serving as a learning health system model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included prostate cancer patients who met germline testing and counseling criteria at an NCI-designated cancer center from January 1, 2018, to June 30, 2022. Demographic factors—age at diagnosis, race, employment, insurance, and geographic region—were assessed for associations with genetic counseling referral and uptake. Analyses involved descriptive statistics, two-group comparisons, and regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 356 prostate cancer patients, only 34.2% received genetic counseling referrals, and of these, 73% completed a counseling visit. Older patients were less likely to receive referrals (OR = 0.93, 95% CI [0.89–0.97]) and complete visits (OR = 0.92, 95% CI [0.87–0.96]). Patients employed full-time were more likely to receive referrals (39.2% vs. 23.1%; <i>p</i> = 0.01), while White (93% vs. 81%; <i>p</i> = 0.047) and rural patients (42.7% vs. 6.1%; <i>p</i> = 0.02) had higher uptake. Insurance status did not significantly affect referral or uptake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates the potential of EHRs to identify demographic disparities in genetic counseling services. Using a learning health system approach, healthcare institutions can leverage EHR data to design targeted interventions aimed at improving access and reducing disparities in genetic services, ultimately enhancing patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"10 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium","authors":"Amytis Towfighi,&nbsp;Allison Z. Orechwa","doi":"10.1002/lrh2.70042","DOIUrl":"https://doi.org/10.1002/lrh2.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Southern California Healthcare Delivery Science Center organizes an annual symposium for a broad audience interested in health innovation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The 2024 symposium convened healthcare professionals, researchers, policymakers, and advocates to explore innovative strategies for advancing health equity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials &amp; Methods</h3>\u0000 \u0000 <p>Organizers assembled panels of patients, health system leaders, and researchers to present their perspectives on four primary themes: (1) conceptual frameworks for social determinants of health, (2) community-engaged healthcare delivery interventions, (3) healthcare system-based strategies and innovations, and (4) the ethical use of emerging technologies. The agenda also included poster presentations and interactive break-out sessions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty presenters and facilitators engaged attendees in discussions throughout the day-long symposium. A common theme was understanding social determinants as fundamental, intermediate, and proximate drivers of health inequities. Strategies to bridge these gaps included interdisciplinary collaboration, engaging individuals with lived experience, healthcare system-based and community-centered interventions, ethical use of artificial intelligence, and policy reform.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Presentations emphasized the importance of interdisciplinary collaboration, innovation, and policy reform in addressing social determinants of health and achieving equity. They also highlighted the significance of lived experience, community involvement, and data-driven strategies in advancing healthcare delivery science.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 2024 Healthcare Delivery Science Symposium successfully convened broad stakeholders to exchange ideas and proven strategies for advancing health equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"10 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145983464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patient Engaged Research Center's Sustainable Funding Framework: A Path Towards Sustainable Patient Engagement in Care and Research Within a Health System","authors":"Paige Coyne,&nbsp;Leah Copeland,&nbsp;Dana Murphy,&nbsp;Ashley Redding,&nbsp;Christine C. Johnson,&nbsp;Karen E. Kippen,&nbsp;Sara Santarossa","doi":"10.1002/lrh2.70047","DOIUrl":"https://doi.org/10.1002/lrh2.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite growing acknowledgement that patient engagement (PE) in research, quality improvement, and clinical care is important, models showcasing how learning health systems (LHSs) can sustain long-term PE across endeavors remain scant. Henry Ford Health's (HFH) Patient Engaged Research Center (PERC) provides a replicable example by which other LHSs can feasibly sustain/grow PE across research, quality improvement, and clinical care in a more efficient and cohesive manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To support its current infrastructure, PERC obtains financial support from an array of sources, including internal health system funding, external grant funding, and philanthropic support. In addition, PERC has created a Sustainable Funding Framework (SFF) and offers à la carte patient-centered services to further diversify its funding and ensure the sustainability of PE throughout the system. PERC utilizes a four-step SFF to offer expertise in conducting patient-centered research, as well as operational and programming support for PE-related initiatives at HFH and within the broader community. The steps are as follows: awareness/need recognition, intake process (intake form, intake meeting, and invoice), project status (approval or not), and project details/start date. Example services include, but are not limited to, instrument development (surveys, moderator guides for interviews/focus groups), facilitation/transcription (surveys/interviews/focus groups), data analysis and reporting (mixed methods and qualitative), Patient Advisor recruitment and training, development/maintenance of Patient and Family Advisory Councils, placement of patient advisors on committees/councils/projects, and grant writing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>PE in research, quality improvement, and clinical care within most health systems is often siloed and disjointed, lacking a sustainable financial or work process model. PERC's SFF provides a promising and replicable example by which LHSs can feasibly sustain and grow PE across research, quality improvement, and clinical care delivery, as well as incorporate this data in a feedback loop to improve all three.</p>\u0000 </section>\u0000 </div>","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"10 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thanks to our peer reviewers","authors":"","doi":"10.1002/lrh2.70046","DOIUrl":"https://doi.org/10.1002/lrh2.70046","url":null,"abstract":"&lt;p&gt;The publication of Issue 4 marks the completion of Volume 9 of &lt;i&gt;Learning Health Systems&lt;/i&gt;. An international, trans-disciplinary, open access publication, the journal has advanced research and scholarship on learning health systems in partnership with our reviewers. With indexing in multiple major sources and an Impact Factor of 2.6, we have achieved a publication milestone that signals a sustainable, positive trajectory. Articles from the journal had more than 142,000 full-text views in 2024. We continue to diversify the offerings of the journal through special issues and special collections, and through the supplemental issue published each year in collaboration with Academy Health.&lt;/p&gt;&lt;p&gt;We are keenly aware that these achievements would not have happened without the dedicated efforts and insightful comments of all those individuals who accepted invitations to review submitted articles. With busy schedules and full commitments, these individuals found the time and energy to contribute their expertise to our authors to help ensure that their papers met (and often exceeded) the journal's high standards for publication.&lt;/p&gt;&lt;p&gt;Please accept our sincere gratitude for your outstanding efforts!&lt;/p&gt;&lt;p&gt;Charles P. Friedman, Editor in Chief&lt;/p&gt;&lt;p&gt;Nancy Allee, Senior Associate Editor&lt;/p&gt;&lt;p&gt;Linda Novak, Managing Editor&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;&lt;i&gt;Learning Health Systems&lt;/i&gt; Peer Reviewers&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;Note: These are the reviewers for articles published in all four issues of Volume 9 and for all articles currently published and posted online in Early View through September 30, 2025. Reviewers of manuscripts that were not ultimately published are also included in this list.&lt;/p&gt;&lt;p&gt;Julia Adler-Milstein (United States)&lt;/p&gt;&lt;p&gt;Aneel Advani (United States)&lt;/p&gt;&lt;p&gt;Holt Anderson (United States)&lt;/p&gt;&lt;p&gt;Nate Apathy (United States)&lt;/p&gt;&lt;p&gt;Cristina Ardura-Garcia (Cambodia)&lt;/p&gt;&lt;p&gt;Amir Reza Azizian (United States)&lt;/p&gt;&lt;p&gt;Ross Bailie (Australia)&lt;/p&gt;&lt;p&gt;Rebecca Baker (United States)&lt;/p&gt;&lt;p&gt;Timothy Beebe (United States)&lt;/p&gt;&lt;p&gt;Peter Bower (United Kingdom of Great Britain and Northern Ireland)&lt;/p&gt;&lt;p&gt;Jeffrey Brown (United States)&lt;/p&gt;&lt;p&gt;Michael Bushey (United States)&lt;/p&gt;&lt;p&gt;Michael Cantor (United States)&lt;/p&gt;&lt;p&gt;Yidan Cao (United States)&lt;/p&gt;&lt;p&gt;Harold Collard (United States)&lt;/p&gt;&lt;p&gt;Marisa Conte (United States)&lt;/p&gt;&lt;p&gt;Theresa Cullen (United States)&lt;/p&gt;&lt;p&gt;Jennie David (United States)&lt;/p&gt;&lt;p&gt;Josie Dickerson (United Kingdom of Great Britain and Northern Ireland)&lt;/p&gt;&lt;p&gt;Anne Douglass (United States)&lt;/p&gt;&lt;p&gt;Douglas Easterling (United States)&lt;/p&gt;&lt;p&gt;Davide Ferrari (United Kingdom of Great Britain and Northern Ireland)&lt;/p&gt;&lt;p&gt;Stephan Fihn (United States)&lt;/p&gt;&lt;p&gt;Karen Fisher (Australia)&lt;/p&gt;&lt;p&gt;Allen Flynn (United States)&lt;/p&gt;&lt;p&gt;Tom Foley (United Kingdom of Great Britain and Northern Ireland)&lt;/p&gt;&lt;p&gt;Kelly Foltz-Ramos (United States)&lt;/p&gt;&lt;p&gt;Rachel Forcino (United States)&lt;/p&gt;&lt;p&gt;Patricia Franklin (United States)&lt;/p&gt;&lt;p&gt;Nicholas Fusco (United States)&lt;/p&gt;&lt;p&gt;Melissa Garrido (United States)&lt;/p&gt;&lt;p&gt;Cheryl G","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"9 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten Reasons Why Learning Health Systems Will Have a Transformational Effect on Health and Health Care","authors":"Charles P. Friedman,&nbsp;Sarah M. Greene,&nbsp;Joshua C. Rubin","doi":"10.1002/lrh2.70044","DOIUrl":"https://doi.org/10.1002/lrh2.70044","url":null,"abstract":"&lt;p&gt;The description of each feature, to follow, is accompanied by at least one citation, out of multitudes that are eligible to be referenced. A fully referenced paper goes beyond the scope of this commentary; but in almost every case, the works referenced below point to a more complete set of citations supporting the assertions offered here.&lt;/p&gt;&lt;p&gt;There are many reasons why innovations are adopted, but the process typically begins when the idea behind the innovation attracts the attention of potential adopters [&lt;span&gt;2&lt;/span&gt;]. Beginning with the 2007 seminal workshop report from the (then) Institute of Medicine [&lt;span&gt;3&lt;/span&gt;] with 574 citations and later with the Friedman et al. 2010 article cited 622 times [&lt;span&gt;4&lt;/span&gt;] and Greene et al. cited 430 times [&lt;span&gt;5&lt;/span&gt;], the concepts and methods associated with Learning Health Systems have garnered significant attention. Gro wth of the LHS, both as a concept and set of methods, is difficult to quantify, but the two indices presented in Figure 1 offer evidence of steadily increasing attention. The first is the number of retrievals through a PubMed search for articles with the title or abstract containing “Learning Health Systems” or “Learning Healthcare Systems.” (The actual number of relevant publications is likely much higher since the search as conducted retrieved only 52% of the articles published in this journal.) The second is the number of full-text downloads of articles published in &lt;i&gt;Learning Health Systems&lt;/i&gt;, which is fully online.&lt;/p&gt;&lt;p&gt;In the authors' own subjective experience with LHS, dating back to 2009, no one has said that LHS is a bad idea. One conjecture about the appeal of the idea goes to its name: very few people oppose “learning” and almost no one opposes “health.” While “system” is a somewhat more controversial concept, when combined with the other two terms, “system” takes on a more positive connotation. Indeed, the challenge and the corresponding opportunity associated with realizing learning and transformation at the system level can attract diverse thinkers who recognize that system problems demand system solutions.&lt;/p&gt;&lt;p&gt;There are many descriptions of “improvement cycles” in LHS; but, to a reasonable approximation, all such models include transitional elements of practice to data, data to knowledge (evidence), and knowledge (evidence) back to practice. While cyclical activity to drive improvement is hardly a new concept, the LHS brings inclusion and co-creation—similarly referred to as co-production—to the level of imperatives. An extensive literature describes the hyper-collaborative nature of Learning Health Systems [&lt;span&gt;11&lt;/span&gt;], and a scoping review [&lt;span&gt;12&lt;/span&gt;] offers examples of how LHS models incorporate the related concept of co-production. The imperative for inclusion, however, derives primarily from common sense. It is intuitively obvious that including everyone with a stake in a health problem in learning communities that are dedicated to ","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"9 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging Health Equity, Quality Improvement, and Patient Safety: A Framework for Medical Student Education","authors":"Joyce R. Javier,&nbsp;Anne T. Vo,&nbsp;Gery W. Ryan,&nbsp;Craig W. Robbins,&nbsp;Heidi D. Nelson,&nbsp;Ashwini Lakshmanan","doi":"10.1002/lrh2.70045","DOIUrl":"https://doi.org/10.1002/lrh2.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ensuring patient safety (PS) and implementing quality improvement (QI) are well-recognized functions of healthcare delivery systems and fall within physicians' scope of practice. How to effectively introduce equity-centered PS and QI concepts into an already overloaded undergraduate medical education curriculum is a challenge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This report describes our experiences at the Kaiser Permanente Bernard J. Tyson School of Medicine (KPSOM), a new medical school, and how we have developed our Quality Improvement and Patient Safety curriculum within a larger institutional environment where equity and social justice are highly valued.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Integrating health systems science into undergraduate medical education and concepts related to health equity requires intentional curricular design and ongoing adaptation. Lessons learned include: (1) importance of using the Basic Improvement Framework as an educational anchor; (2) understanding the value of integration across curricular phases; and (3) creating a dedicated space for curricular refinement over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Medical schools and health systems aiming to strengthen their health systems science curricula may find value in implementing structured approaches—such as the Basic Improvement Framework utilized at KPSOM—to promote early and meaningful engagement with systems-based concepts, especially health equity, throughout learners’ training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"10 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145983751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data-Driven Implementation Trials: Realizing Their Full Potential in Achieving the Promise of Learning Health Systems","authors":"Charis X. Xie,&nbsp;Patricia D. Franklin,&nbsp;Theresa L. Walunas,&nbsp;Rinad S. Beidas","doi":"10.1002/lrh2.70043","DOIUrl":"https://doi.org/10.1002/lrh2.70043","url":null,"abstract":"<p>The digital transformation of healthcare has generated unprecedented volumes of routine clinical data, enabling health system leaders, including quality improvement (QI) efforts, to optimize care using real-time analytics. However, health system QI typically focuses on changes within localized environments; it is often limited in its ability to address systemic barriers or scale evidence-based strategies across diverse settings. Thoughtful integration of implementation science (IS) approaches addresses this gap by systematically integrating interventions into diverse practice settings and defining generalizable implementation strategies. These attributes position IS as a cornerstone of learning health systems (LHS), which strive for population-wide improvements through continuous, data-driven learning. Within this paradigm, randomized implementation trials provide the gold standard for comparing and optimizing implementation strategies. By leveraging routine data, these trials generate causal evidence on the effectiveness of different approaches and offer rigorous insights for health system decision-makers. In this viewpoint, we highlight data-driven implementation trials as catalysts for rigorous and scalable health system transformation. Specifically, we articulate the value proposition of data-driven implementation trials, examine their transformative potential toward learning health systems, and outline persistent challenges. Drawing on experiences from the UK and the US in large health systems, we propose actionable recommendations to optimize infrastructure, foster collaboration, secure health system-level commitments, and cultivate a culture that is grounded in IS while augmenting the impact of QI—critical steps toward realizing scalable, equitable healthcare innovation.</p>","PeriodicalId":43916,"journal":{"name":"Learning Health Systems","volume":"10 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lrh2.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145983890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}