Learning Health Systems学习型医疗系统
Learning Health Systems(英文缩写 LEARN HEALTH SYST),ISSN 2379-6146,eISSN 2379-6146,中文译名:学习型医疗系统 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 未收录 | N/A |
| 2022 | 3.100 | N/A |
| 2023 | 2.600 | Q2 |
| 2024 | 2.600 | Q2 |
| 2025 | 2.300 | Q2 |
Learning Health Systems 最新收录文献
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1. Moving Person-Centered Care Planning From Theory Into Practice: Patient Perspectives.
PMID:日期:2026-10-01Persons with multiple chronic conditions often receive care from a complicated network of multiple providers across multiple health systems unique to their conditions, needs, available resources, and insurance. Patients must navigate this healthcare system, which is a difficult and complicated process with just one provider or system, let alone multiple. Developing new solutions to overcome the systemic challenges within healthcare systems to provide high-quality, comprehensive, person-centered care for persons living with, or at risk for, multiple chronic conditions is critical. Person-centered care is needed, not only because it is the right and just approach to supporting patients, but because of the profound implications of the increasing prevalence of multiple chronic conditions on healthcare costs, caregiver burden, workforce productivity, and the broader social fabric. In this commentary, we present patient perspectives on a project that brought together diverse groups to identify potential solutions to challenges in implementation of person-centered care. Patients, families, and family caregivers are essential to the design and implementation of person-centered care planning for people with multiple chronic conditions. The Agency for Healthcare Research and Quality (AHRQ) funded a project aimed at compiling best practices and discussing barriers. The project used a learning system approach to engage policy experts, clinicians, researchers, and persons with multiple chronic conditions, their families, and family caregivers. Four main activities included a technical expert panel, an environmental scan, a partner roundtable, and a learning collaborative. An in-person/hybrid summit held in March 2025 summarized activities and provided a forum for presentations to share activities of the project and conduct small group discussions on select topics. We present patient narratives to complement content provided by the partner roundtables and other AHRQ-funded activities that provided foundational knowledge and diverse perspectives to promote person-centered care planning as standard practice for persons with multiple chronic conditions. Although many challenges to implementation of person-centered care were identified and discussed, learning from successful models and customization of models using components as appropriate may help overcome barriers. In particular, the need for culture change, use of meaningful measures, scalability, and other concepts must be addressed. Alignment of payment structures and policy support will be essential to ensuring that person-centered care can be advanced as an integral component of routine care. Multiple challenges to adoption of person-centered care planning have been identified. Future work by multidisciplinary teams (that must include patients, caregivers, policymakers, and clinicians) is needed to develop evidence-based feasible solutions to overcome these barriers in ways that respect the values and preferences of patients, families, and caregivers.
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2. Harnessing Potential: A Systematic Investigation of How and Why Learning Happens in a Health System.
PMID:日期:2026-09-25The ability to learn is central to innovation and performance across industries, and it is the hallmark feature of the rapidly growing movement toward Learning Health Systems. While learning drivers-such as experimentation, risk-taking, participative decision-making, dialogue, and interaction with the external environment-are well defined, they have received little attention in healthcare contexts. This study explored the nature of organizational learning within Trillium Health Partners (THP), one of Canada's largest community-based teaching hospital systems. Formal leaders at THP completed the Organizational Learning Capability instrument. A latent profile analysis identified the number and nature of distinct learning profiles. Semi-structured interviews were conducted to develop an empirically grounded explanation of how organizational learning drivers interact to enable-or constrain-learning within the organization. Of 334 eligible leaders, 231 responded to the survey, and 141 provided sufficient data for inclusion in the analyses. Latent Profile Analysis identified two distinct learning profiles: one with relatively higher perceived learning capability and another with relatively lower perceived capability. Interviews with leaders ( = 12) from both groups described how theoretical factors that influence organizational learning manifest to drive (or derail) learning in practice. Our systematic investigation into how and why learning occurs within a large community hospital system may support other healthcare systems in developing programs that foster the learning necessary to develop and implement innovative delivery models at scale.
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3. Leveraging a Locally Anchored Learning Health Care System Toward Equitable Telehealth: Assessing Broadband Access and Supporting Use of Federal Internet Subsidies in a Safety-Net Setting.
PMID:日期:2026-09-21To understand patients' access to telehealth and broadband and interest in the Connectivity Program (ACP) in an urban, safety-net setting, using community-engaged iterative learning cycles to improve patient-centered care. Roots Community Health, a health center focused on uplifting those impacted by systemic inequities, functions as a community-anchored learning health system (LHS). Community was engaged in data collection and intervention development through Roots' Telehealth Patient Advisory Council. A cross-sectional survey was administered to adult patients. Roots designed and implemented an intervention to connect patients to digital access resources, including a 66-item questionnaire capturing patients' telehealth experience and barriers, device and broadband access, and awareness of ACP-a federal benefit providing up to $30 monthly toward internet for low-income households. Patients interested in ACP were offered enrollment support. Patients were screened for ACP interest and eligibility and offered survey participation, in-person or by phone by trained clinic staff and volunteers. One hundred nine patients were screened for ACP eligibility and interest; 99 completed the survey. Two-thirds (65/99) had experience with telehealth and 53% (52/99) were interested in future telehealth appointments. Patients reported several notable barriers: slow internet (46/98), no Internet access (40/99), mobile data plan issues (31/98), and downloading/using the telehealth software (31/98). Surveyed patients frequently reported utilizing the Internet for resources categorizable as Social Drivers of Health (SDOH). Most screened patients (65/109) had not heard of ACP, but over half (60/109) reported interest in applying. Using a community-embedded LHS approach, we found that broadband connectivity is crucial for equitable telehealth access, an essential part of healthcare in clinics that aim to remedy persistent health inequities affecting people of African descent. Policy and advocacy should prioritize this SDOH, while healthcare organizations evaluate their role in broadband policy to improve equity.
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4. Promising Patient-Engagement Practices Used by National Research Networks at the US Veterans Health Administration: Perspectives of Veterans, Staff, and Research Leaders.
PMID:日期:2026-09-16Active involvement of patients is an essential feature of learning health systems and patient-centered research. Research networks and healthcare organizations lack guidance on best practices for developing and sustaining patient engagement infrastructure. We sought to examine perspectives on promising Veteran-engagement infrastructure and practices used by US Veterans Affairs (VA) research networks. We solicited expert opinion from three separate panels of Veterans, VA engagement staff, and VA research leaders using a modified Delphi process comprising two rounds of online surveys and a set of virtual group meetings or individual interviews. In a prior study, we identified promising engagement practices in use by VA national research networks. We analyzed survey data with predefined rating categories to determine which practices the three expert panels consistently endorsed. We used thematic analysis to compare experts' perspectives across panels and to identify emergent cross-cutting themes. Veterans, VA engagement staff, and VA research leaders consistently endorsed 66% (29/44) of the research networks' promising Veteran-engagement practices. Summarized, these practices formed five recommended engagement-related responsibilities for VA research networks. Some network engagement practices were inconsistently endorsed (13/44, 30%), and two practices (4%) received overall ratings of neutral or unsure by at least one expert panel. Network practices not consistently endorsed varied by expert panel, but panelists' comments reflected three overarching themes: constraint of resource availability, commitment to respectful and meaningful engagement processes, and concern for potential burden on partners. Panelists' perspectives highlight challenges regarding how to best invest limited patient-engagement resources within research and learning health system organizations. Research network engagement infrastructure can help expand the capacity and culture of patient-centered research and care. Organizations seeking to function as learning health systems need to devote planning time, skilled staff, and funds to develop and sustain patient-engagement infrastructure tailored to their context.
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5. Beyond Blind Trust in Hospital Data Warehouses: Evaluating Real-World Data Accountability.
PMID:日期:2026-09-06The reliability of real-world evidence (RWE) depends on data accuracy and secondary users' ability to evaluate how data are generated and transformed. Although recent frameworks emphasize provenance, transparency, and auditability, their practical assessment in routine hospital settings remains unclear. This study examines the practical evaluability of real-world data (RWD) and explores operational boundaries limiting data quality assessment within learning health systems. An empirical case study was conducted at a tertiary-care university hospital in Japan. Data extracted from electronic health records and a clinical data warehouse were compared using 15 quality indicators derived from the of the Digital Agency of Japan (based on ISO/IEC 25012). Evaluability was assessed using a two-step framework comprising empirical verification and contextual explanation from the perspective of research support personnel operating under routine institutional access permissions. Evaluability varied substantially across clinical domains. Diagnosis records were generally verifiable and explainable, whereas medication-related domains contained observations that could be verified but not fully explained by secondary users. Indicators including currentness and efficiency faced additional operational constraints, revealing boundaries between observable data characteristics and available explanatory information. Practical RWD use depends not only on observable data characteristics but also on the accessibility of information needed to interpret them. Evaluability boundaries reflect operational constraints rather than poor data quality. Rendering these boundaries visible may support more transparent and accountable RWD governance and inform future improvements through system design and data governance practices.
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6. Evaluation of a Real-Time Knowledge Exchange Network Supporting Syphilis Rapid Testing and Immediate Treatment in Seven Public Health Units in Ontario, Canada.
PMID:日期:2026-09-01The Syphilis Point of care Rapid testing and Immediate Treatment Evaluation (SPRITE) is a collaborative, community-based initiative that strengthens syphilis prevention and control in Ontario, Canada through flexible outreach nursing and point-of-care testing (POCT) and immediate treatment. Seven public health units (PHUs) partnered with 86 community-based organizations (CBOs) to deliver syphilis/HIV POCTs in underserved settings. This study evaluated a real-time knowledge exchange network that supported syphilis POCT implementation and capacity-building across PHUs and CBOs in Ontario. The evaluation was a mixed-methods case study using surveys and interviews focusing on the community of practice (CoP), community engagement, and knowledge mobilization. It considers SPRITE CoP activities from beginning of implementation (mid 2023) to the Fall of 2025. The CoP, consisting of public health nurses, researchers, and knowledge specialists, supported engagement, co-development, and peer learning. Members shared lessons learned, built partnerships, and supported each other in navigating challenges. Flexibility in funding allowed innovation by CoP members in their CBO engagement efforts but also created some uncertainty and possible confusion. CoP members were overall satisfied with CoP functioning, and CBOs surveyed appeared knowledgeable and engaged in SPRITE. The CoP model, while distinct from traditional public health CoPs, proved effective in fostering engagement, resource development, and knowledge mobilization. Lessons learned and tools developed provide guidance for future POCT efforts. Improvements should include clearer goals, stronger facilitation, and structured engagement strategies. Addressing funding stability, particularly for POCT services and CoP management roles, is essential. Strengthening CBO partnerships through incentives and bi-directional information sharing will further enhance POCT and syphilis prevention. This evaluation underscores the importance of flexible yet accountable approaches to knowledge mobilization and POCT implementation in diverse public health contexts. Continued investment in collaborative networks like SPRITE remains critical to advancing syphilis elimination efforts across Ontario.
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7. Toward a Smart Learning Health System: An Ontology-Based Framework.
PMID:日期:2026-08-19Learning health system (LHS) frameworks have been presented in multiple forms, but there is no standardized representation that captures both their core concepts and the relationships among them. This limits their practical use by health services seeking to design, implement, and evaluate LHS capabilities in changing sociotechnical environments. This study developed the Smart Learning Health System ontology (SMARTLHS), a formal semantic framework that synthesizes concepts and relationships from published LHS frameworks. Relevant literature was identified through a systematic database search. SMARTLHS was developed using an iterative system mapping and ontology engineering approach, comprising five steps: (1) ontology requirements specification, (2) iterative ontology conceptualization, (3) concept and relationship comparison and formalization, (4) ontology evaluation and refinement, and (5) ontology alignment with foundational ontology, to ensure semantic consistency and interoperability. The SMARTLHS ontology was implemented using the Web Ontology Language (OWL) and developed in Protégé. SMARTLHS contains 447 classes and 134 object properties. Its structure is organized around four high-level groupings: and . The supporting pillars comprise seven domains: , and . The cross-cutting themes include , and . Together, these classes and relationships provide a computable semantic representation of LHS implementation. SMARTLHS addresses key limitations of existing LHS frameworks by transforming narrative framework concepts into a formal, extensible semantic knowledge model. By explicitly representing both concepts and relationships, it provides a foundation for organizational assessment, semantic interoperability, and future AI-enabled applications, including ontology-guided retrieval and Retrieval-Augmented Generation (RAG).
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8. Long-Term, Low-Maintenance, and Impactful: Lessons Learned From Sustaining the NOHARM Pragmatic Clinical Trial.
8. 长期、低维护和有效：从维持NOHARM实用临床试验中吸取的经验教训PMID:日期:2026-08-17Sustaining interventions implemented as part of pragmatic clinical trials requires proactive planning, but how to approach this process remains understudied. The Non-pharmacological Options in Hospital-based and Rehabilitation pain Management stepped-wedge cluster-randomized pragmatic trial tested an electronic health record-based educational bundle (known as the Healing After Surgery [HAS] initiative) that encouraged the incorporation of non-pharmacological pain care in perioperative pain management. The HAS initiative was implemented in multiple surgical practices and hospital sites. One year prior to trial completion, a sustainment committee was established to support the transition of intervention components to clinical ownership and to support posttrial sustainment of the HAS initiative. We reviewed meeting minutes from biweekly sustainment committee meetings and conducted debriefing sessions with committee members (informed by the Clinical Sustainability Assessment Tool) to identify sustainment strategies and challenges, which were then organized into meaningful themes. The following six themes emerged from meeting minutes and debriefings: (1) automation of low-touch components, (2) reliance on internal champions, (3) intentional handoff communication, (4) institutional attention, (5) relaxed fidelity, and (6) continuous evaluation. Together, they highlight the importance of early, structured planning and adaptable implementation strategies. Sustainment of the HAS initiative required extensive communication, adaptation, and stakeholder engagement across diverse institutional contexts. Proactive sustainment planning during trial design may help ensure interventions are successfully integrated into routine clinical practice posttrial.
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9. Operationalizing Patient Experience Data as a System Feedback Asset in Learning Health Systems: Learnings From Model of Care Redesign at Trillium Health Partners.
PMID:日期:2026-08-17Learning Health Systems (LHS) offer a pathway to continuously improve care by integrating data and lived experience, yet few practical examples demonstrate how LHS can be operationalized in hospital settings in ways that embed the voices of patients and families. This manuscript describes how patient experience (PX) data are integrated into the design of a new model of care (MoC) that responds to both system demands and the realities of patients and families. Researchers partnered with clinical leaders to integrate patient and family voices into the design of a new MoC using PX survey data, interviews with patients and families admitted to medicine units, and naturalistic walk-throughs of each medicine unit. Data collection explored care priorities, interactions with staff, physical environments, and reflections on positive and challenging aspects of care. Analysis followed a three-step iterative process: unit-level synthesis, cross-unit thematic comparison, and data integration. In total, 390 patients participated in the PX survey and 19 patients/families participated in interviews. Patients situated their experiences within a health care system under strain, highlighting both strengths and gaps. Many expressed appreciation for nurses' compassion, but emotional support for fears, anxieties, and worries was inconsistent, particularly when staff were overstretched or transient. Long wait times for transport, procedures, or basic care needs were reported as sources of anxiety and diminished dignity. Naturalistic walk-throughs documented how crowding, noise, lighting, and wayfinding shaped patients' comfort and privacy. This work provides a practical example of how an LHS approach can be operationalized by embedding the voices of patients and families into care redesign. Findings from the PX survey and interviews are directly shaping a new MoC at Trillium Health Partners (THP) that is evidence-informed and co-designed with patients and families, providing a practical example of how PX data can drive continuous, system-level learning.
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10. Development of the Learning Health Systems Toolkit: A Collaborative Effort to Bridge Concept and Practice.
PMID:日期:2026-08-14Learning communities need access to resources to support efforts in building and sustaining learning health systems. This experience report details our development and initial assessments of the Learning Health System (LHS) Toolkit, a menu of resources purpose-designed to support users to build more proactive, responsive, and equitable systems of care by developing, implementing and sustaining LHSs. Toolkit development began in 2022, and the current version was completed in 2025. To optimize knowledge translation, we structured our methods to align with the phases of the Knowledge to Action (KTA) Model, including (1) Knowledge Inquiry; (2) Synthesis and Creation; (3) Knowledge Selection; (4) Adapting Knowledge to Local Context; (5) Assessing Barriers and Facilitators to Knowledge Use; (6) Selecting, Tailoring, and Implementing the Intervention, and (7) Monitoring Knowledge Use. Development of the web-based toolkit and vetting of its contents were achieved over several phases. Feedback from toolkit users was positive overall and was integral to its development and refinement. Users from 72 countries have accessed the toolkit, although most engagement has occurred in high-income countries, chiefly the US, UK, Türkiye, Australia, Canada, The Netherlands, and New Zealand. The toolkit is uniquely situated to support learning communities. It includes a dynamic design, is regularly updated, and is accessible free of cost. Additionally, unlike a literature search, the toolkit is developed with usability in mind and includes tools beyond peer-reviewed literature, curated by LHS experts. The next steps are to develop and action a dissemination plan based on implementation science principles to increase the reach and adoption of the toolkit.