The first CCOS-coordinated Collaborative Workshop was held May 22, 2024, in Charlotte, North Carolina. The event, co-sponsored by the Wake Forest CTSI and the Wake Forest University School of Medicine, was focused on explaining what learning health systems (LHS) are and exploring how the CTSA program can leverage learning health systems as a mechanism of translational science to turn science discoveries into solutions with clinical benefits.
The Collaborative Workshop was attended by 89 people, 80 of which were CTSA members representing 33 CTSA Program institutions. The attendees had varying levels of familiarity with LHS; some came from institutions with established LHS’ and others attended to learn how to implement an LHS at their own institution. After opening remarks from Dr. Michael Kurilla, Director of NCATS Division of Clinical Innovation, and workshop co-leads Dr. Doug Easterling, Wake Forest CTSI, and Dr. Martin Zand, CCOS Team Science, the Collaborative Workshop began with a morning of introductory presentations. Speakers introduced key concepts of LHS and discussed how their specific LHS operates, highlighting the wide variety of possibilities and potential implementation strategies for LHS. The panelists demonstrated how an LHS can be simple, by implementing A/B testing protocols to improve clinical practices or more complex involving more robust implementation oversight. Panel discussions were held after the presentations, giving the audience the opportunity to ask clarifying questions about the speakers’ experiences with LHS.
After laying the groundwork with these introductory panels, attendees were invited to suggest topics for breakout room discussions in the afternoon. Two rounds of topic identification resulted in nine breakout topics:
- Learning Health System maturity models
- Pragmatic clinical trials
- Evaluation impact of learning health systems
- Building a learning health system team
- Intersection of learning health systems and quality improvement
- Data infrastructure
- Learning health systems in large health systems
- Integration and role of the CTSAs in learning health systems, and
- Community role in learning health systems
Workshop attendees selected which topics most interested them and were empowered to switch breakout discussions if they chose. During these small group discussions, resources, challenges, and next steps for each topic were identified and shared with the whole audience at the end of the day.
Several themes emerged during the Collaborative Workshop; in particular, challenges to implementation and successful organization of LHS’ were discussed extensively. Funding was an often-cited challenge, but strategies to overcome this challenge were shared, such as aligning the incentives of different stakeholders or demonstrating the value of a LHS to organization executives by identifying case studies or proofs-of-concepts. Another theme that emerged during the panels and breakout sessions was that no two learning health systems are identical, and how they operate is often dictated by the source of funding; however, regardless of the size or arrangement, the focus of LHS should be patient-centered, and equity should be at the forefront by engaging the community.
The learning health system workshop was a day of networking with CTSA peers and learning that highlighted the complexity and collaborative nature of the CTSA Program. Discussions of how the CTSAs could align their efforts in learning health systems were held in multiple breakout sessions, highlighting the potential of the CTSA program to advance this type of work. Dr. Easterling hoped that attendees took away a “fuller appreciation of the challenges of [learning health systems]”, noting that LHS is “the paradigm for translational science”. Many attendees expressed their hope that these types of discussions will continue so that different CTSA hubs can learn from each other how to best implement a learning health system at their institutions.
CCOS is already planning its next Collaborative Workshop and encourages CTSA members to attend – details to come soon!
