Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change
Abstract Background Pandemics and climate change each challenge health systems through increasing numbers and new types of patients. To adapt to these challenges, leading health systems have embraced a Learning Health System (LHS) approach, aiming to increase the efficiency with which data is transl...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12916-024-03345-8 |
| _version_ | 1797247217471324160 |
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| author | Carolynn L. Smith Georgia Fisher Putu Novi Arfirsta Dharmayani Shalini Wijekulasuriya Louise A. Ellis Samantha Spanos Genevieve Dammery Yvonne Zurynski Jeffrey Braithwaite |
| author_facet | Carolynn L. Smith Georgia Fisher Putu Novi Arfirsta Dharmayani Shalini Wijekulasuriya Louise A. Ellis Samantha Spanos Genevieve Dammery Yvonne Zurynski Jeffrey Braithwaite |
| author_sort | Carolynn L. Smith |
| collection | DOAJ |
| description | Abstract Background Pandemics and climate change each challenge health systems through increasing numbers and new types of patients. To adapt to these challenges, leading health systems have embraced a Learning Health System (LHS) approach, aiming to increase the efficiency with which data is translated into actionable knowledge. This rapid review sought to determine how these health systems have used LHS frameworks to both address the challenges posed by the COVID-19 pandemic and climate change, and to prepare for future disturbances, and thus transition towards the LHS2.0. Methods Three databases (Embase, Scopus, and PubMed) were searched for peer-reviewed literature published in English in the five years to March 2023. Publications were included if they described a real-world LHS’s response to one or more of the following: the COVID-19 pandemic, future pandemics, current climate events, future climate change events. Data were extracted and thematically analyzed using the five dimensions of the Institute of Medicine/Zurynski-Braithwaite’s LHS framework: Science and Informatics, Patient-Clinician Partnerships, Continuous Learning Culture, Incentives, and Structure and Governance. Results The search yielded 182 unique publications, four of which reported on LHSs and climate change. Backward citation tracking yielded 13 additional pandemic-related publications. None of the climate change-related papers met the inclusion criteria. Thirty-two publications were included after full-text review. Most were case studies (n = 12, 38%), narrative descriptions (n = 9, 28%) or empirical studies (n = 9, 28%). Science and Informatics (n = 31, 97%), Continuous Learning Culture (n = 26, 81%), Structure and Governance (n = 23, 72%) were the most frequently discussed LHS dimensions. Incentives (n = 21, 66%) and Patient-Clinician Partnerships (n = 18, 56%) received less attention. Twenty-nine papers (91%) discussed benefits or opportunities created by pandemics to furthering the development of an LHS, compared to 22 papers (69%) that discussed challenges. Conclusions An LHS 2.0 approach appears well-suited to responding to the rapidly changing and uncertain conditions of a pandemic, and, by extension, to preparing health systems for the effects of climate change. LHSs that embrace a continuous learning culture can inform patient care, public policy, and public messaging, and those that wisely use IT systems for decision-making can more readily enact surveillance systems for future pandemics and climate change-related events. Trial registration PROSPERO pre-registration: CRD42023408896. |
| first_indexed | 2024-04-24T19:55:11Z |
| format | Article |
| id | doaj.art-a1f0875b80024c7883780a991ea3f5be |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-04-24T19:55:11Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj.art-a1f0875b80024c7883780a991ea3f5be2024-03-24T12:23:12ZengBMCBMC Medicine1741-70152024-03-0122111810.1186/s12916-024-03345-8Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate changeCarolynn L. Smith0Georgia Fisher1Putu Novi Arfirsta Dharmayani2Shalini Wijekulasuriya3Louise A. Ellis4Samantha Spanos5Genevieve Dammery6Yvonne Zurynski7Jeffrey Braithwaite8Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityCentre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityCentre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityCentre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityCentre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityCentre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityCentre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityCentre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityCentre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie UniversityAbstract Background Pandemics and climate change each challenge health systems through increasing numbers and new types of patients. To adapt to these challenges, leading health systems have embraced a Learning Health System (LHS) approach, aiming to increase the efficiency with which data is translated into actionable knowledge. This rapid review sought to determine how these health systems have used LHS frameworks to both address the challenges posed by the COVID-19 pandemic and climate change, and to prepare for future disturbances, and thus transition towards the LHS2.0. Methods Three databases (Embase, Scopus, and PubMed) were searched for peer-reviewed literature published in English in the five years to March 2023. Publications were included if they described a real-world LHS’s response to one or more of the following: the COVID-19 pandemic, future pandemics, current climate events, future climate change events. Data were extracted and thematically analyzed using the five dimensions of the Institute of Medicine/Zurynski-Braithwaite’s LHS framework: Science and Informatics, Patient-Clinician Partnerships, Continuous Learning Culture, Incentives, and Structure and Governance. Results The search yielded 182 unique publications, four of which reported on LHSs and climate change. Backward citation tracking yielded 13 additional pandemic-related publications. None of the climate change-related papers met the inclusion criteria. Thirty-two publications were included after full-text review. Most were case studies (n = 12, 38%), narrative descriptions (n = 9, 28%) or empirical studies (n = 9, 28%). Science and Informatics (n = 31, 97%), Continuous Learning Culture (n = 26, 81%), Structure and Governance (n = 23, 72%) were the most frequently discussed LHS dimensions. Incentives (n = 21, 66%) and Patient-Clinician Partnerships (n = 18, 56%) received less attention. Twenty-nine papers (91%) discussed benefits or opportunities created by pandemics to furthering the development of an LHS, compared to 22 papers (69%) that discussed challenges. Conclusions An LHS 2.0 approach appears well-suited to responding to the rapidly changing and uncertain conditions of a pandemic, and, by extension, to preparing health systems for the effects of climate change. LHSs that embrace a continuous learning culture can inform patient care, public policy, and public messaging, and those that wisely use IT systems for decision-making can more readily enact surveillance systems for future pandemics and climate change-related events. Trial registration PROSPERO pre-registration: CRD42023408896.https://doi.org/10.1186/s12916-024-03345-8Learning Health SystemsClimate changePandemicsCOVID-19 |
| spellingShingle | Carolynn L. Smith Georgia Fisher Putu Novi Arfirsta Dharmayani Shalini Wijekulasuriya Louise A. Ellis Samantha Spanos Genevieve Dammery Yvonne Zurynski Jeffrey Braithwaite Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change BMC Medicine Learning Health Systems Climate change Pandemics COVID-19 |
| title | Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change |
| title_full | Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change |
| title_fullStr | Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change |
| title_full_unstemmed | Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change |
| title_short | Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change |
| title_sort | progress with the learning health system 2 0 a rapid review of learning health systems responses to pandemics and climate change |
| topic | Learning Health Systems Climate change Pandemics COVID-19 |
| url | https://doi.org/10.1186/s12916-024-03345-8 |
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