Review and Special ArticlesEnsuring Public Health’s Future in a National-Scale Learning Health System
Introduction
Data and information are fundamental to every function of public health and crucial to public health agencies, from outbreak investigations to environmental surveillance. Information allows for timely, relevant, and high-quality decision making by public health agencies. Evidence-based practice is an important, grounding principle within public health practice, but resources to handle and analyze public health data in a meaningful way are limited. The Learning Health System (LHS) is a platform that seeks to leverage health data to allow evidence-based real-time analysis of data for a broad range of uses, including primary care decision making, public health activities, consumer education, and academic research.
The concept of an LHS has emerged over the past decade and is gaining widespread support throughout the U.S. health sector, especially among primary care. Public health should be a key stakeholder in the development of a single, comprehensive national-scale LHS. Participation presents many potential benefits, including increased workforce capacity, enhanced resources, and greater opportunities to use health information for the improvement of the public’s health. The LHS is an important opportunity for collaboration between primary care and public health, with public health playing a crucial role by providing unique health information to other LHS stakeholders.
The Learning Health Community (LHC) is a self-organizing, multi-stakeholder group that has been working to develop standards and governance models and identify solutions to LHS implementations challenges.1 Greater engagement by public health in the LHC will ensure that a public health perspective is integrated into the development of a national-scale LHS, public health concerns are adequately addressed, and public health agencies can benefit fully from participation. Once the LHS is established, the LHC will continue to oversee the operation of the LHS. This article describes the framework and progression of a national-scale LHS, considers the advantages of and challenges to public health involvement in the LHS, including the public health workforce, gives examples of small-scale LHS projects involving public health, and discusses how public health practitioners can better engage in the LHC.
Section snippets
Background of the Learning Health System
Through advances in technology such as automated disease reporting, electronic health records (EHRs), and syndromic surveillance systems, public health’s ability to generate data has increased dramatically in recent years. The sheer volume of digital information now available vastly outweighs public health’s ability to store, process, and analyze it in a meaningful way that results in actionable information.2 Technologic innovations have allowed the business sector to analyze supply chain and
Benefits and Challenges for Public Health in a Learning Health System
We believe the potential benefits to state and local public health agencies, as well as the public health workforce, from participation in a national-scale LHS are diverse. The public health workforce will have greater access to technology to conduct and analyze the results of disease outbreak tracking, epidemic tracking, studies of population health status, disease notification, evaluation of interventions, and other essential public health activities can be transformed by the capabilities of
Examples of Small-Scale Learning Health Systems for Public Health
Although no national-scale LHS currently exists, there are several small-scale LHS initiatives that have been developed specifically for public health activities. These initiatives are aimed to effectively and efficiently utilize public health information to improve population health, including timely analysis of public health data, increased surveillance capability, and greater integration with primary care. The experiences from these initiatives serve as examples of the potential role of
Next Steps
To ensure that public health is a key stakeholder in the collaborative development of a national-scale LHS, we propose the development of a Public Health LHC (PHLHC). The PHLHC would continue the work initiated at the Public Health and the Learning Health System Workshop held in March 2013. The community should include representation from a wide range of public health agencies from across the country at the local, state, and federal levels. The PHLHC also should include individuals across the
Acknowledgments
No financial disclosures were reported by the authors of this paper.
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