A framework for value-creating learning health systems

Context

In Canada and internationally, there is a growing interest in value-based healthcare. Learning health systems have been proposed as a key strategy for improving value and enabling evidence-driven health system transformations. However, it remains unclear how to implement learning health systems and how they contribute to value improvement.

Objective

The purpose of this project was to develop a conceptual framework to support the implementation of value-creating learning health systems in Canada.

Methodology

The conceptual framework was developed by an interdisciplinary team at the Institut national d’excellence en santé et en services sociaux (INESSS). It was informed by a scoping review of the scientific and grey literature on learning health systems, regular team discussions over a 14-month period, and consultations with Canadian and international experts.

Results

The framework describes four elements that characterise LHSs, namely (1) core values, (2) pillars and accelerators, (3) processes and (4) outcomes. LHS pillars are the infrastructure and resources supporting the LHS, whereas accelerators are those specific structures that enable more rapid learning and improvement. These pillars support the execution and routinisation of learning cycles, which are the fundamental processes of LHSs. The main outcome sought by learning systems is the creation of value, defined as the achievement of a more optimal balance of impacts on patient and provider experience, population health and health system costs.

Conclusion

This framework illustrates how the distinctive structures, processes and outcomes of learning health systems tie together with the aim of optimising health system performance and delivering greater value to the population.