Paula M Lozano1, Meghan Lane-Fall2,3, Patricia D Franklin4, Russell L Rothman5, Ralph Gonzales6,7, Michael K Ong8,9,10, Michael K Gould11, Timothy J Beebe12, Christianne L Roumie13, Jeanne-Marie Guise14,15,16, Felicity T Enders17, Christopher B Forrest18, Eneida A Mendonca19,20,21, Joanna L Starrels22, Urmimala Sarkar23, Lucy A Savitz24, JeanHee Moon18, Mark Linzer25, James D Ralston1, Francis D Chesley26. 1. Kaiser Permanente Washington Health Research Institute Seattle Washington USA. 2. Department of Anesthesiology and Critical Care University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA. 3. Department of Biostatistics, Epidemiology, and Informatics University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA. 4. Department of Medical Social Science Northwestern University Feinberg School of Medicine Chicago Illinois USA. 5. Institute for Medicine and Public Health Vanderbilt University Medical Center Nashville Tennessee USA. 6. Department of Medicine, Division of General Internal Medicine UCSF San Francisco California USA. 7. Continuous Improvement Department UCSF Health San Francisco California USA. 8. Department of Medicine UCLA Los Angeles California USA. 9. Department of Health Policy and Management UCLA Los Angeles California USA. 10. VA Greater Los Angeles Healthcare System Los Angeles California USA. 11. Department of Health System Science Kaiser Permanente Bernard J. Tyson School of Medicine Pasadena California USA. 12. School of Public Health University of Minnesota Minneapolis Minnesota USA. 13. Division of General Internal Medicine and Public Health Vanderbilt University Medical Center Nashville Tennessee USA. 14. Department of Obstetrics and Gynecology OHSU-PSU School of Public Health Portland Oregon USA. 15. Department of Medical Informatics and Clinical Epidemiology OHSU-PSU School of Public Health Portland Oregon USA. 16. Department of Emergency Medicine OHSU-PSU School of Public Health Portland Oregon USA. 17. Department of Quantitative Health Science Mayo Clinic College of Medicine and Science Rochester Minnesota USA. 18. Applied Clinical Research Center Children's Hospital of Philadelphia Philadelphia Pennsylvania USA. 19. Center for Biomedical Informatics Regenstrief Institute, Inc. Indianapolis Indiana USA. 20. Department of Pediatrics Indiana University School of Medicine Indianapolis Indiana USA. 21. Department of Biostatistics Indiana University School of Medicine Indianapolis Indiana USA. 22. Department of Medicine Albert Einstein College of Medicine Bronx New York USA. 23. UCSF Department of Medicine, Division of General Internal Medicine UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital San Francisco California USA. 24. Kaiser Permanente Center for Health Research Portland Oregon USA. 25. Department of Medicine and the Institute for Professional Worklife Hennepin Healthcare and University of Minnesota Medical School Minneapolis Minnesota USA. 26. Agency for Healthcare Research and Quality Rockville Maryland USA.
Abstract
Introduction: The learning health system (LHS) aligns science, informatics, incentives, stakeholders, and culture for continuous improvement and innovation. The Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute designed a K12 initiative to grow the number of LHS scientists. We describe approaches developed by 11 funded centers of excellence (COEs) to promote partnerships between scholars and health system leaders and to provide mentored research training. Methods: Since 2018, the COEs have enlisted faculty, secured institutional resources, partnered with health systems, developed and implemented curricula, recruited scholars, and provided mentored training. Program directors for each COE provided descriptive data on program context, scholar characteristics, stakeholder engagement, scholar experiences with health system partnerships, roles following program completion, and key training challenges. Results: To date, the 11 COEs have partnered with health systems to train 110 scholars. Nine (82%) programs partner with a Veterans Affairs health system and 9 (82%) partner with safety net providers. Clinically trained scholars (n = 87; 79%) include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians (n = 29; 26%) represent diverse fields, dominated by population health sciences. Stakeholder engagement helps scholars understand health system and patient/family needs and priorities, enabling opportunities to conduct embedded research, improve outcomes, and grow skills in translating research methods and findings into practice. Challenges include supporting scholars through roadblocks that threaten to derail projects during their limited program time, ranging from delays in access to data to COVID-19-related impediments and shifts in organizational priorities. Conclusions: Four years into this novel training program, there is evidence of scholars' accomplishments, both in traditional academic terms and in terms of moving along career trajectories that hold the potential to lead and accelerate transformational health system change. Future LHS training efforts should focus on sustainability, including organizational support for scholar activities.
Introduction: The learning health system (LHS) aligns science, informatics, incentives, stakeholders, and culture for continuous improvement and innovation. The Agency for Healthcare Research and Quality and the Patient-Centered Outcomes Research Institute designed a K12 initiative to grow the number of LHS scientists. We describe approaches developed by 11 funded centers of excellence (COEs) to promote partnerships between scholars and health system leaders and to provide mentored research training. Methods: Since 2018, the COEs have enlisted faculty, secured institutional resources, partnered with health systems, developed and implemented curricula, recruited scholars, and provided mentored training. Program directors for each COE provided descriptive data on program context, scholar characteristics, stakeholder engagement, scholar experiences with health system partnerships, roles following program completion, and key training challenges. Results: To date, the 11 COEs have partnered with health systems to train 110 scholars. Nine (82%) programs partner with a Veterans Affairs health system and 9 (82%) partner with safety net providers. Clinically trained scholars (n = 87; 79%) include 70 physicians and 17 scholars in other clinical disciplines. Non-clinicians (n = 29; 26%) represent diverse fields, dominated by population health sciences. Stakeholder engagement helps scholars understand health system and patient/family needs and priorities, enabling opportunities to conduct embedded research, improve outcomes, and grow skills in translating research methods and findings into practice. Challenges include supporting scholars through roadblocks that threaten to derail projects during their limited program time, ranging from delays in access to data to COVID-19-related impediments and shifts in organizational priorities. Conclusions: Four years into this novel training program, there is evidence of scholars' accomplishments, both in traditional academic terms and in terms of moving along career trajectories that hold the potential to lead and accelerate transformational health system change. Future LHS training efforts should focus on sustainability, including organizational support for scholar activities.
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