Over the past two decades, biomedical research has made extraordinary progress, at amazing speeds and with astounding computational capabilities. Even in very agile organizations, these fast-paced advances represent significant barriers to nimble and successful implementation, scaling, integration, cultural shaping, and ongoing education. Learning at individual, team, organization or system levels is paramount to the good functioning of all health systems. Academic health institutions are uniquely positioned to drive innovation, improve patient outcomes, and cultivate future leaders by integrating well-managed clinical operations, breakthrough research, and outstanding education. The Learning Health System (LHS) framework provides a powerful model of integration, leveraging iterative cycles of discovery, learning and improvement by employing robust operational management, analytical capabilities, implementation and dissemination capacity and functionalities. Central to this model are three interconnected phases: Practice to Data, Data to Knowledge, and Knowledge to Practice, which form the ‘implementation arc’ or the LHS cycle. At each junction between these phases, the incorporation of external evidence and the active engagement of community members or stakeholders serve as critical pillars, ensuring that learning is both rigorous and relevant. First, we offer a modified design and conceptualization of LHS as a four-cycle, mission-based model centered by its community, and strengthened by external evidence and data as distinct inputs, at multiple points of the cycle. Second, we propose that the Clinical and Translational Science Award (CTSA) hubs’ structures and functions can represent the strong operational engine of the LHS plant, while community represents the central axle and transmission of movement in the central mechanism of the LHS. As such, the CTSA hubs can serve as a robust machinery for the clinical, research, and educational cycles in learning health systems. Not applicable. • Learning is an activity that encapsulates systematic data collection, thorough analysis to create useful insights, and robust feedback loops that incorporate those insights into the daily praxis or activities for improved outcomes. • A Learning Health System (LHS) is a complex ecosystem in which science, informatics, incentives, and culture are aligned for innovation and continuous improvement, with best practices seamlessly embedded in the delivery processes. • Clinical and Translational Science Award (CTSA) hubs have complex structures, cores and functions, and aim to facilitate learning and continuous improvement at individual, institutional, and system levels. What roles can a CTSA hub have in designing, building and consolidating a LHS? • We offer a modified design and conceptualization of LHS as a four-cycle, mission-based model centered by its community, and strengthened by external evidence and data as distinct inputs, at multiple points of the cycle. • We propose that the CTSA hubs become strong operational engines of learning that operate simultaneously at all levels by integrating clinical practice, education, research, and governance activities. • In this model, the community represents the main axle and the variable transmission of movement in the central mechanism of future LHS plants.
Octavian C. Ioachimescu (Tue,) studied this question.