In addition to evaluating an outcome, it can also be helpful to assess the maturity of the processes within a Learning Health System. Maturity refers to the degree to which a process is able to achieve a specific objective in a predictable way [181].
The maturity of the underlaying technical infrastructure within a healthcare provider can be assessed using a maturity model, such as those developed by Healthcare Information and Management Systems Society (HIMSS) [182]:
- EMRAM: The Electronic Medical Record Adoption Model
- AMAM: The Analytics Maturity Adoption Model
- CCMM: The Continuity of Care Model
- INFRAM: The Infrastructure Adoption Model
These can provide a baseline assessment of an organisation’s infrastructure, a roadmap for prioritising improvements, a measure of improvement and a community of peers. While these are all necessary, they are not enough to determine the maturity of a Learning Health System. It is not just a piece of technology, whose speed or capacity can be easily quantified. It is a complex, constantly changing, sociotechnical system, intended to meet a unique and evolving set of needs. It is therefore important to consider how well a Learning Health System is aligned with the needs and resources of the stakeholders implementing it.
Lannon et al. [181] propose a process maturity assessment tool aimed specifically at Learning Health Systems. The tool takes the form of a capability maturity grid covering six domains:
- Systems of Leadership: Purpose, understanding the system, measuring the system, planning for improvement etc
- Governance and Management: Policies, processes, controls, oversight, norms etc
- Quality Improvement: Systematic and continuous actions towards measurable improvements in outcomes
- Community Building and Engagement: Structures and processes to enable all stakeholders to become involved
- Data and Analytics: Collecting, validating, organising and standardising data relevant to the system’s purpose
Research: Generating knowledge through a range of research methods.