Cargando…

A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization

INTRODUCTION: Foundational to a learning health system (LHS) is the presence of a data infrastructure that can support continuous learning and improve patient outcomes. To advance their capacity to drive patient‐centered care, health systems are increasingly looking to expand the electronic capture...

Descripción completa

Detalles Bibliográficos
Autores principales: Austin, Elizabeth J., LeRouge, Cynthia, Lee, Jenney R., Segal, Courtney, Sangameswaran, Savitha, Heim, Joseph, Lober, William B., Hartzler, Andrea L., Lavallee, Danielle C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8512814/
https://www.ncbi.nlm.nih.gov/pubmed/34667879
http://dx.doi.org/10.1002/lrh2.10263
_version_ 1784583086901559296
author Austin, Elizabeth J.
LeRouge, Cynthia
Lee, Jenney R.
Segal, Courtney
Sangameswaran, Savitha
Heim, Joseph
Lober, William B.
Hartzler, Andrea L.
Lavallee, Danielle C.
author_facet Austin, Elizabeth J.
LeRouge, Cynthia
Lee, Jenney R.
Segal, Courtney
Sangameswaran, Savitha
Heim, Joseph
Lober, William B.
Hartzler, Andrea L.
Lavallee, Danielle C.
author_sort Austin, Elizabeth J.
collection PubMed
description INTRODUCTION: Foundational to a learning health system (LHS) is the presence of a data infrastructure that can support continuous learning and improve patient outcomes. To advance their capacity to drive patient‐centered care, health systems are increasingly looking to expand the electronic capture of patient data, such as electronic patient‐reported outcome (ePRO) measures. Yet ePROs bring unique considerations around workflow, measurement, and technology that health systems may not be poised to navigate. We report on our effort to develop generalizable learnings that can support the integration of ePROs into clinical practice within an LHS framework. METHODS: Guided by action research methodology, we engaged in iterative cycles of planning, acting, observing, and reflecting around ePRO use with two primary goals: (1) mobilize an ePRO community of practice to facilitate knowledge sharing, and (2) establish guidelines for ePRO use in the context of LHS practice. Multiple, emergent data collection activities generated generalizable guidelines that document the tangible best practices for ePRO use in clinical care. We organized guidelines around thematic areas that reflect LHS structures and stakeholders. RESULTS: Three core thematic areas (and 24 guidelines) emerged. The theme of governance reflects the importance of leadership, knowledge management, and facilitating organizational learning around best practice models for ePRO use. The theme of integration considers the intersection of workflow, technology, and human factors for ePROs across areas of care delivery. Lastly, the theme of reporting reflects critical considerations for curating data and information, designing system functions and interactions, and presentation of ePRO data to support the translation of knowledge to action. CONCLUSIONS: The guidelines produced from this work highlight the complex, multidisciplinary nature of implementing change within LHS contexts, and the value of action research approaches to enable rapid, iterative learning that leverages the knowledge and experience of communities of practice.
format Online
Article
Text
id pubmed-8512814
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-85128142021-10-18 A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization Austin, Elizabeth J. LeRouge, Cynthia Lee, Jenney R. Segal, Courtney Sangameswaran, Savitha Heim, Joseph Lober, William B. Hartzler, Andrea L. Lavallee, Danielle C. Learn Health Syst Experience Reports INTRODUCTION: Foundational to a learning health system (LHS) is the presence of a data infrastructure that can support continuous learning and improve patient outcomes. To advance their capacity to drive patient‐centered care, health systems are increasingly looking to expand the electronic capture of patient data, such as electronic patient‐reported outcome (ePRO) measures. Yet ePROs bring unique considerations around workflow, measurement, and technology that health systems may not be poised to navigate. We report on our effort to develop generalizable learnings that can support the integration of ePROs into clinical practice within an LHS framework. METHODS: Guided by action research methodology, we engaged in iterative cycles of planning, acting, observing, and reflecting around ePRO use with two primary goals: (1) mobilize an ePRO community of practice to facilitate knowledge sharing, and (2) establish guidelines for ePRO use in the context of LHS practice. Multiple, emergent data collection activities generated generalizable guidelines that document the tangible best practices for ePRO use in clinical care. We organized guidelines around thematic areas that reflect LHS structures and stakeholders. RESULTS: Three core thematic areas (and 24 guidelines) emerged. The theme of governance reflects the importance of leadership, knowledge management, and facilitating organizational learning around best practice models for ePRO use. The theme of integration considers the intersection of workflow, technology, and human factors for ePROs across areas of care delivery. Lastly, the theme of reporting reflects critical considerations for curating data and information, designing system functions and interactions, and presentation of ePRO data to support the translation of knowledge to action. CONCLUSIONS: The guidelines produced from this work highlight the complex, multidisciplinary nature of implementing change within LHS contexts, and the value of action research approaches to enable rapid, iterative learning that leverages the knowledge and experience of communities of practice. John Wiley and Sons Inc. 2021-03-01 /pmc/articles/PMC8512814/ /pubmed/34667879 http://dx.doi.org/10.1002/lrh2.10263 Text en © 2021 The Authors. Learning Health Systems published by Wiley Periodicals LLC on behalf of University of Michigan. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Experience Reports
Austin, Elizabeth J.
LeRouge, Cynthia
Lee, Jenney R.
Segal, Courtney
Sangameswaran, Savitha
Heim, Joseph
Lober, William B.
Hartzler, Andrea L.
Lavallee, Danielle C.
A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization
title A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization
title_full A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization
title_fullStr A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization
title_full_unstemmed A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization
title_short A learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization
title_sort learning health systems approach to integrating electronic patient‐reported outcomes across the health care organization
topic Experience Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8512814/
https://www.ncbi.nlm.nih.gov/pubmed/34667879
http://dx.doi.org/10.1002/lrh2.10263
work_keys_str_mv AT austinelizabethj alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT lerougecynthia alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT leejenneyr alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT segalcourtney alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT sangameswaransavitha alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT heimjoseph alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT loberwilliamb alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT hartzlerandreal alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT lavalleedaniellec alearninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT austinelizabethj learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT lerougecynthia learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT leejenneyr learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT segalcourtney learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT sangameswaransavitha learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT heimjoseph learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT loberwilliamb learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT hartzlerandreal learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization
AT lavalleedaniellec learninghealthsystemsapproachtointegratingelectronicpatientreportedoutcomesacrossthehealthcareorganization