Swiss Learning Health System: A national initiative to establish learning cycles for continuous health system improvement

Stefan Boes, Sarah Mantwill, Cornel Kaufmann, Mirjam Brach, Jerome Bickenbach, Sara Rubinelli, Gerold Stucki, Stefan Boes, Sarah Mantwill, Cornel Kaufmann, Mirjam Brach, Jerome Bickenbach, Sara Rubinelli, Gerold Stucki

Abstract

The health system in Switzerland is considered as one of the best in the world. Nevertheless, to effectively and efficiently meet current and future challenges, an infrastructure and culture are needed where the best evidence is systematically made available and used, and the system evolves on the basis of a constant exchange between research, policy, and practice. The Swiss Learning Health System institutionalizes this idea as a multistakeholder national initiative to ensure continuous improvement through ongoing research and implementation. This article presents the objectives and mechanisms of the Swiss Learning Health System in the context of international initiatives to strengthen health systems and improve population health through learning cycles.

Keywords: LHS infrastructure; evidence‐informed decision‐making; management of health information; scientific capacity building; stakeholder dialogue.

Figures

Figure 1
Figure 1
Bridging mechanism in the Swiss Learning Health System (SLHS)—the SLHS cycle

References

    1. Federal Office of Public Health . Forschungskonzept Gesundheit 2013‐2016. Bern: Federal Office of Public Health (FOPH), Bundeamt für Gesundheit (BAG); 2012. Januar 2012.
    1. Federal Office of Public Health . Health2020. The Federal Council's health‐policy priorities. Bern: Federal Office of Public Health (FOPH) Bundesamt für Gesundheit (BAG); 2013. Januar 2013.
    1. Federal Office of Public Health . Forschungskonzept Gesundheit 2017‐2020. Bern: Federal Office of Public Health (FOPH), Bundeamt für Gesundheit (BAG); 2015. December 2015.
    1. Röthlisberger M, Amstad H. Förderprogramm «Versorgungsforschung im Gesundheitswesen». Schweiz Ärzteztg. 2017;98(3):59‐61.
    1. National Research Programme “Smarter Health Care” (NRP74) .
    1. Schweizerische Akademie der Medizinischen Wissenschaften . Stärkung der Versorgungsforschung in der Schweiz. 2014;Swiss Academies Reports 9(1).
    1. Institute of Medicine . The Learning Healthcare System: Workshop Summary. Washington, DC: The National Academies Press; 2007.
    1. Institute of Medicine . Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press; 2013.
    1. National Academy of Medicine (NAM) . Learning health system series. See [last accessed Feb 12, 2018]
    1. Institute of Medicine . Table of characteristics of a continuously learning health care system. 2012. See [last accessed Feb 12, 2018]
    1. Friedman CP, Wong AK, Blumenthal D. Achieving a nationwide learning health system. Sci Transl Med. 2010;2(57):57cm29.
    1. Friedman CP, Rubin JC, Sullivan KJ. Toward an information infrastructure for global health improvement. Yearb Med Inform 2017. 2017;26:16‐17.
    1. Friedman CP, Rubin JC, Brown JS, et al. Toward a science of learning systems: a research agenda for the high‐functioning learning health system. J Am Med Inform Assoc. 2015;22(1):43‐50.
    1. National Science Foundation (NSF) . Toward a science of learning systems: the research challenges underlying a national‐scale learning health system: findings from a multi‐disciplinary workshop supported by the national science foundation. Washington, DC; 2013. Nov11. See [last accessed Feb 12, 2018]
    1. CancerLinQ LLC, a subsidiary of the American Society of Clinical Oncology.
    1. Collins FS, Hudson KL, Briggs JP, Lauer MS. PCORnet: turning a dream into reality. J Am Med Inform Assoc. 21(4):576‐577.
    1. Fleurence RL, Curtis LH, Califf RM, Platt R, Selby JV, Brown JS. Launching PCORnet, a national patient‐centered clinical research network. J Am Med Inform Assoc. 2014;21(4):578‐582.
    1. FDA's Sentinel Initiative, US Food and Drug Administration .
    1. Health Care Systems Research Network .
    1. Delaney BC, Curcin V, Andreasson A, et al. Translational medicine and patient safety in Europe: TRANSFoRm—architecture for the learning health system in Europe. Biomed Res Int. 2015;2015. Article ID 961526
    1. Kalra D, Stroetmann V, Sundgren M, et al. The European institute for innovation through health data. Learn Health Syst. 2017;1(1):e10008.
    1. Foley T. Background: need for LHS. The Learning Healthcare Project UK. Newcastle University UK. 2015. [last accessed Feb 12, 2018]
    1. Asia Pacific Network for Health Systems Strengthening . .
    1. World Health Organization (WHO) . Everybody's Business: Strengthening Health Systems to Improve Health Outcomes: Who's Framework for Action. Geneva: WHO; 2007.
    1. De Savigny D, Adam T. (Eds). Systems Thinking for Health Systems Strengthening. Geneva: Alliance for Health Policy and Systems Research, WHO; 2009.
    1. van Olmen J, Marchal B, van Damme W, Kegels G, Hill PS. Health systems frameworks in their political context: framing divergent agendas. BMC Public Health. 2012;12(1):774.
    1. Swiss Learning Health System .
    1. McMaster Health Forum .
    1. Lavis JN, Oxman AD, Lewin S, Fretheim A. SUPPORT tools for evidence‐informed health policymaking (STP). Health Res Policy Syst. 2009;7(Suppl 1):I1.
    1. Lavis JN, Permanand G, Oxman AD, Lewin S, Fretheim A. SUPPORT tools for evidence‐informed health policymaking (STP). 13. Preparing and using policy briefs to support evidence‐informed policymaking. Health Res Policy Syst. 7(Suppl 1):S13.
    1. Lavis JN, Boyko JA, Oxman AD, Lewin TJ, Fretheim A. SUPPORT tools for evidence‐informed health policymaking (STP). 14. Organising and using policy dialogues to support evidence‐informed policymaking. Health Res Policy Syst. 2009;7(Suppl 1):S14.
    1. Fretheim A, Oxman AD, Lavis JN, Lewin S. SUPPORT tools for evidence‐informed health policymaking (STP). 18. Planning monitoring and evaluation of policies. Health Res Policy Syst. 7(Suppl 1):S18.
    1. van Eemeren FH, Grootendorst R. A Systematic Theory of Argumentation: The Pragma‐Dialectical Approach. Cambridge: Cambridge University Press; 2004.
    1. Rubinelli S, von Groote PM. Stakeholder dialogue as deliberation for decision making in health policy and systems: the approach from argumentation theory. Am J Phys Med Rehabil. 2017;96(2):S17‐S22.
    1. Public Health Switzerland . Bessere Gesundheitsdaten für ein effizienteres Gesundheitswesen. Manifest presented during the Swiss Public Health Conference 2013 in Zurich. 2013. [last accessed Feb 12, 2018].
    1. Flynn AJ, Shi W, Fischer R, Friedman CP. Digital knowledge objects and digital knowledge object clusters: unit Holdings in a Learning Health System Knowledge Repository. In: 49th Hawaii International Conference on System Sciences (HICSS) Conference on 2016 Jan 5, (Pp 3308‐3317). IEEE. 2016.
    1. Flynn AJ, Bahulekar N, Boisvert P, et al. Architecture and initial development of a digital library platform for computable knowledge objects for health. Stud Health Technol Inform. 2017;235:496‐500.
    1. Learning Health Community . Mission, Vision and Values of the LHC. Core Values Underlying a National‐Scale Person‐Centered Continuous Learning Health System.

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