Regenstrief authors: Dawn M. Bravata, M.D. and Nicholas A. Rattray, PhD
Published in the Journal of General Internal Medicine. Here is a link to the article.
This article describes the strategies used to develop and conduct the U.S. Department of Veterans Affairs (VA) Geriatric Learning Health System (GLHS) to support older veterans as they transition from hospital to home.
The Problem
Despite global momentum behind the Learning Health System model, there is a need for insight into how leaders actually build and drive these systems forward.
Key Findings and Impacts
The authors identified four structures and five activities that supported key GLHS functions such as stakeholder engagement and collaborative knowledge management to inform operational and policy decisions. In the GLHS, the multi-disciplinary stakeholder group included operational leaders with policy-making authority—individuals who are in a position to take action or influence policy based on lessons learned. An example of a key structure was the Idea Repository, which provided a mechanism for collecting, organizing and prioritizing suggestions from team members and stakeholders to guide future learning cycles, research projects or quality improvement. VA research leaders used the Idea Repository to inform calls for proposals and investigators developed research and implementation projects based on innovative project ideas.
Target Population
While the VA GLHS strategic project portfolio supports older veterans—a population at high risk during care transitions—this article focuses on the strategies employed by GLHS leaders to carry out this work.
Implications for Future Research
The GLHS model offers a roadmap for other healthcare systems seeking to launch or strengthen their own learning health systems emphasizing responsive leadership and collaborative engagement.
Funding
This work was supported by the US Department of Veterans Affairs (VA), Health Systems Research (HSR), Expanding Expertise Through E-health Network Development Quality Enhancement Research Initiative (QUERI; QUE HX0003205-01).
Authors
Dawn M Bravata 1 2 3 4, Cathy C Schubert 5 6, Amy M Kilbourne 7 8, Scotte R Hartronft 9, Ashley L Schwartzkopf 10 11, Jennifer L Myers 10 11, Mindy E Flanagan 10, Claire E Donnelly 10 11, Stanley E Taylor 10 11, Mathew J Reeves 10 9, Anthony J Perkins 10 12, Laura E Myers 10 11 5 13, Indrakshi Roy 10 14, Robert E Burke 15 16, Rachael A Beard 17 18, Marcos Montagnini 19 20 21, Shivani K Jindal 22 23 24, Greg Arling 10 25, Caroline Madrigal 10 26, Nicholas A Rattray 10 11 5 13
Affiliations
1Department of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
2VA HSR Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
3Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
4Regenstrief Institute, Indianapolis, IN, USA.
5Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
6Community, Home, and Geriatrics Service, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
7Office of Research and Development, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, DC, USA.
8Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA.
9Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
10Department of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
11VA HSR Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
12Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.
13Regenstrief Institute, Indianapolis, IN, USA.
14Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA.
15VA HSR Center for Healthcare Evaluation, Research, and Promotion (CHERP), Crescenz VA Medical Center, Philadelphia, PA, USA.
16Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
17Office of Nursing Services, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, DC, USA.
18Nursing Service, St. Louis VA Healthcare System, St. Louis, MO, USA.
19VA Geriatric Research Education and Clinical Center (GRECC), Ann Arbor, MI, USA.
20Veterans Integrated Service Network (VISN 10) Geriatrics, Ann Arbor, MI, USA.
21Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
22Office of Geriatrics & Extended Care, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, DC, USA.
23Medical Service, Cincinnati VA Medical Center, Cincinnati, OH, USA.
24Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
25School of Nursing, Purdue University, West Lafayette, IN, USA.
26VA Boston Healthcare System, Boston, MA, USA.
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