The University of Wisconsin–Madison’s Institute for Clinical and Translational Research (ICTR) and UW Health are transforming health care delivery by implementing a Learning Health System (LHS) approach. This innovative strategy is set to change the way health care is provided.
Organizations or networks implement a learning health system to continuously self-study and adapt using data and analytics to generate knowledge, engage stakeholders, and implement behavior change to transform practice.
An LHS supports goals based on health care’s Quintuple Aims, such as making patient care more effective, improving clinician well-being, and reducing costs. It aims to create a dynamic and responsive health care environment that evolves based on real-world evidence and collaborative efforts.
Dr. Joel Gordon, Chief Medical Information Officer at UW Health, describes LHS as both a mindset and a system. “LHS can be an informal mindset where data is transformed into processes, processes into practice, and practices back into data. When systematized, you have different branches of people collaborating around a process of iterative growth. The trust that you build across different sectors of the partnership is what allows LHS to advance.”
Dr. Joel Gordon (left) and Dr. Majid Afshar (right).
LHS activities began at UW–Madison in 2013, building on UW Health’s evidence-based quality improvement and evaluation framework. In 2022, UW Health and ICTR expanded their partnership to advance LHS work as a new component of ICTR’s Clinical and Translational Science Award (CTSA). The CTSA Program, part of the National Center for Advancing Translational Sciences within the National Institutes of Health, provides financial support for ICTR.
Led by a small but dedicated team, ICTR’s LHS initiative is driven by a collaborative process. The program brings together experts from various fields, including data scientists, implementation scientists, human factors engineers, and pragmatic clinical trialists. This multidisciplinary approach ensures that health care initiatives are not only effectively implemented, but also rigorously evaluated.
Dr. Majid Afshar, Director for the ICTR Learning Health System, reflected on the program’s origins: “The momentum came from ICTR, but we started with dyad buy-in and partnership from the beginning. We received support from UW Health operations leadership and UW School of Medicine and Public Health leadership, aligning research and operations without claiming ownership from one side or the other. Here we are several years later, and we can speak to the success of this approach.”
A key aspect of the LHS approach is scalability. Unlike traditional quality improvement projects that may focus on specific processes or units, LHS projects are designed to be scalable across the entire organization. This allows for the development of best practices that can be implemented system-wide, enhancing the overall quality of care. Dr. Jeff Pothof, Chief Quality Officer at UW Health, notes that “The best health systems will have to figure out what the next best practice is. That’s where the LHS can be very impactful.”
One notable example is the ambient listening project, an initiative developed and implemented by the ICTR LHS Program and UW Health. The project evaluated the effectiveness of using Ambient AI software during outpatient visits to help make documentation easier, enhance physician-patient encounters, and reduce provider burden through clinical note generation.
Dr. Majid Afshar (left) and Dr. Jeff Pothof (right).
Looking ahead, Pothof believes LHS can be scaled up to either a statewide or national level. However, he cautions, “It would be hard to say what a health system would actually need to do to scale up because there’s so much variability between health systems. There won’t be a one-size-fits-all approach, and local adoption to what you learn is needed.”
The commitment of ICTR and UW Health to a multidisciplinary approach and collaborative ownership of LHS projects positions them as leaders in health care innovation. By empowering clinicians, leveraging advanced technologies, and involving patients in the process, a new standard for health care excellence is being set.
For more information on this conversation and to learn more about ICTR’s Learning Health System, visit the program page and listen to the new LHS podcast. Be sure to stay up to date on the latest news from ICTR LHS by subscribing to its quarterly newsletter.
The project described was supported by the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR002373. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.