No two Learning Health Systems are the same, but there is much to be learned by studying examples and considering what succeeded, and in what circumstances.
A recent review of the literature identified 68 Learning Health System case studies across 20 countries [19]. A previous Learning Healthcare Project report and associated website described many other examples [1]. This report is illuminated by several additional examples that have been identified from the literature and our workshops. They are referenced throughout the report and summarised below. Most relate to components of a Learning Health System, though some are full Learning Health Systems in their own right.
| Learning Health System | Details |
|---|---|
| Better Care Programme (HDR UK) [20] | A UK-wide hub and spoke funding and collaboration network designed to support the development of Learning Health Systems that integrate clinical practice, large-scale data and advanced analytics in a cycle of continuous improvement. |
| Evelina London Children and Young People’s Health Partnership [21, 22] | An interagency model to provide coordinated and tailored care for children and young people in South London. Anticipatory care is enabled using a population health model supported by primary and secondary care data systems. |
| Geisinger Health System [23] | Geisinger is an integrated health system in Pennsylvania, USA, that has embraced the Learning Health System concept to drive continuous care improvement. |
| HealthTracker [24] | A well-evaluated Australian clinical decision support tool that incorporates ten different clinical practice guidelines into a single on-screen algorithm on the clinician’s desktop. It provides estimates of cardiovascular risk and suggests further investigations and lifestyle changes. |
| Learning Networks [25] | The Learning Network approach has been pioneered by Cincinnati Children’s Hospital. In 2007 it started with ImproveCareNow, a Learning Health System for Inflammatory Bowel Disease, and now covers many other conditions. It has scaled up and spread the concept by sharing its common framework, methods and processes with other institutions. |
| Local Health and Care Records [21] | A group of regional interagency information-sharing initiatives across England, based on the Learning Health System concept. |
| Mayo Clinic Platform [26] | A ten-year strategic initiative aiming to transform healthcare by delivering data, care, diagnostics and management platforms that could support a Learning Health System. |
| Mobilizing Computable Biomedical Knowledge [27] | An international community led by the Department of Learning Health Sciences at the University of Michigan. Their goal is to ensure that biomedical knowledge in computable form is Findable, Accessible, Interoperable and Reusable (FAIR). |
| Nightingale Learning System [28] | In response to the Covid-19 pandemic, the NHS in England converted a London convention centre into the first of the country’s Nightingale Hospitals, expanding treatment capacity. A learning system was built into the organisational architecture of the facility. |
| Open Lab Newcastle [29] | Open Lab is a research group that works on advanced Human-Computer Interaction (HCI), digital citizenship, sustainability, design futures, social innovations and machine learning. The group essentially creates sociotechnical learning systems in health and beyond. |
| Rapid cycle randomized testing at NYU Langone Health [30] | A Learning Health System was developed by embedding randomised tests of quality-improvement interventions within an existing healthcare system, using routinely collected data. |
| National Institute for Health and Care Excellence (NICE) [31] | NICE produces national guidelines across health and social care. It aims to support a Learning Health System by broadening its scope from single condition, narrative guidelines, to structured recommendations encompassing multi-morbidity, polypharmacy, and wider health system considerations. |
| NHS Digital [32] | The English health system’s data hub aims to enable a national Learning Health System, using cradle-to-grave longitudinal health data on the entire population. |
| OpenClinical [33] | A collaboration between University College London, Oxford University and Deontics Ltd., created to maintain an open access and open-source repository of medical knowledge in a machine-readable format. |
| Optum Labs [1] | A US research partnership with access to the health records of over 100 million patients, Optum Labs has used structured data and Natural Language Processing to enable a research-based Learning Health System. |
| PatientsLikeMe [29, 34] | A US-based web platform that allows patients around the world to share their health-related experiences and outcomes in a highly structured format. The data can be used by individual patients or researchers to learn from the experience of each patient. This information has also been linked to biological data and used to train AI algorithms. |
| Scottish National Decision Support Programme [35, 36] | A development programme aligned to the broader national health strategy that focuses on improving outcomes in key areas. Each decision support tool is developed through a participatory co-design process, engaging all stakeholders. |
| TRANSfoRm [37] | An EU-wide programme to enable a Learning Health System, this could improve patient care by speeding up translational research, enabling more cost-effective Randomised Control Trials and by deploying diagnostic decision support. |