Insights

Insights February 2024

The Learning Health System Is for Everyone and It Is the Way Forward

Amie Archibald-Varley, Laura Desveaux, Keddone Dias, Robert Reid and Hayley Wickenheiser

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Has a graph ever kept you up at night? It may sound strange, but for those of us who work in healthcare, that is often the case. A graph can tell you a lot about what is happening and where action needs to be taken. 

At the recent Hazel McCallion Annual Lecture in Shaping Healthier Communities, hosted by Trillium Health Partners’ (THP) Institute for Better Health, THP’s President and Chief Executive Officer Karli Farrow presented one such graph. It showed that despite unprecedented investment in health infrastructure in the Peel Region, the demand for health services is growing exponentially and will soon outpace available resources. 

Innovation in healthcare has rapidly shifted from an opportunity to an imperative. Hospital leaders know that they will need to provide care differently to meet the present and future health needs of our communities, and the approach requires system partners coming together to ensure health inequities are addressed, especially among structurally marginalized populations.

The problems facing our healthcare system are deep and pervasive, necessitating rapid, deliberate change. We do not have the luxury of time – we need to learn as we go, tapping into the research and evidence produced within a learning health system. 

So what is a learning health system? It is a bold initiative that takes research and rapidly implements findings into operations to improve patient care and health outcomes in real time – not years from now. Outside of healthcare, most industries embed research and development into daily practices to allow for constant and consistent evolution. In healthcare, we play it safer, maintaining the status quo while tinkering around with innovations through local pilot projects. We are designed to rely on the same fragmented systems and solutions that we have had for decades.

As a result, Canada ranks second to last in health equity, healthcare outcomes and overall health system performance compared to other Organization for Economic Cooperation and Development (OECD) countries. As Canadians, we should demand differentfrom our health system leaders. This is the conversation we started at the Hazel McCallion Annual Lecture in Shaping Healthier Communities, alongside health leaders, patients, community partners, researchers and policy makers and it is the conversation that we owe to Canadians to keep having. We need to drive transformational change in the health system by doing things differently.

Here is how we can start:

  • Include the voices of those frequently left out. Patients, caregivers and community members add crucial context to ideas and it is integral that healthcare leaders, researchers, policy makers and advocates work and learn with patients and communities to make meaningful impact. The frustration of a patient waiting for a surgery date, someone disappointed with the lack of access to a specialized service for a loved one, or a newcomer confused about how to navigate the health system – these are all key inputs driving us forward and act as essential fuel for learning health systems.
  • Push for progress over perfection. We need to understand the nature of challenges in our healthcare system from the perspective of everyone, and then co-design and implement solutions with iterative learning cycles. We need to address these challenges head-on, applying solutions to patients at the right time, at the right place and in the right way, rather than developing myriad workaround solutions.
  • Be open and willing to change. Curiosity and continuous learning are the backbone of learning health systems. To borrow a term coined by psychologist Carol Dweck, it is about having a “growth mindset,” where our abilities and skills are not fixed but constantly improving and evolving, and are fundamentally tied to continual learning. In the healthcare context, this means trying and doing things differently, working collaboratively, learning from mistakes and challenging the status quo. We need to be willing to be guided by evidence and evaluation, creating a culture where everyone is engaged in research, innovation and quality improvement with a collective mission of improving healthcare for all.
  • Understand the power of conversation. A culture of innovation is fueled by diverse skillsets and perspectives coming together to challenge the status quo. Ask yourself and those around you: How can we do things differently? What are we willing to give up?

With the learning health system approach as an anchor, transformational change is at our fingertips. Maintaining the status quo is a choice and it could cost lives and livelihoods. A learning health system is for everyone, and should be wholeheartedly embraced by all health and social care organizations who are focused on the health of our communities if we want to do better for our patients, our families, our communities and our futures.

About the Author(s)

Amie Archibald-Varley is a registered nurse, health equity specialist, freelance journalist and one of the authors of The Wisdom of Nurses (published by Harper Collins, 2024).

Laura Desveaux is the scientific director and Learning Health Systems Program lead at Trillium Health Partners’ Institute for Better Health.

Keddone Dias is the executive director of LAMP Community Health Centre.

Robert Reid is the Hazel McCallion Research Chair in Learning Health Systems and chief scientist at Trillium Health Partners’ Institute for Better Health.

Hayley Wickenheiser is a four-time Olympic gold medalist, resident physician and assistant general manager at Toronto Maple Leafs.

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