The Learning Loop - UW Health's Learning Health System News

In this podcast, we invite Dr. Gabrielle Rude, President and Executive Director of the Wisconsin Collaboarative for Healthcare Quality, for a conversation about what it takes to design and build a state-wide learning health system.  For over 20 years the WCHQ has collected and analyzed outcome data from a variety of health care institutions across Wisconsin. The Collaborative established local metrics for these institutions, as wells educated clinicians and coached leaders, and created reports that permitted clinics and hospitals to develop data-driven quality improvement (QI) programs. By investing in the infrastructure to provide data, education and facilitation to health care organizations that did not have adequate resources to do their own QI, WCHQ empowered small- to mid-size health systems not only to compete but collaborate with one another. (and were under pressure from CMS to develop it). We explore how the WCHA has moved Wisconsin over time toward something that looks like a head start on realizing a regional LHS, and discuss what it would mean to potentially connect the WCHQ's infrastructure and network with larger partners such as UW Health--and to harness the organization's work to support a large-scale statewide LHS enterprise.  The WCHQ continues to build on its groundbreaking work by facilitating cross-industry as well as institution data sharing. They also facilitate conversations with and convene those resource partners that can help healthcare systems meet their needs, aligning stakeholder efforts to take on the thorniest health issues we face in the US. One outcome of this is that Wisconsin boasts one of the highest patient performance rates on quality measures across the country. Join us to learn more about what it has taken – and will take- to put together the missing pieces of the needed partnership puzzle to continue ramping up not just Wisconsin's but the Midwest's capacity to meet the challenges of access to health care and health equity via a regional learning health system.

In this episode, we meet with Dr. Joel Gordon, UW Health's Chief Medical Informatics Officer, to talk about the purpose and promise of adopting an LHS approach to using artificial intelligence (AI) to improve health care. We focus specifically on UW Health's recent LHS project and study, an evaluation of an Ambient Listening tool to lessen clinical documentation burden and enhance provider well-being in an outpatient setting. In this lively conversation, we discuss the extensive planning and ongoing adaptations for improvement that the project involved--from establishing a governance structure that could effectively drive the project--to ensuring all regulatory requirements were met.  Dr. Afshar explains how using a pragmatic clinical trial design yielded a novel Pramatic Trial Operations (PTOps) playbook for health systems interested in exploring this use case for AI in clinical practice. The PTOps Playbook is publicly available for researchers to use should they wish to replicate the study and implementation within their health system. Dr. Gordon details some the extraordinary opportunties the AI ambient listening project presented for UW Health, even as we recall the challenges of aligning the Institute's research and UW Hospital's operational timelines, as well as developing strategies and tools for ongoing monitoring of real-time data. 

What exactly is a Learning Health System? Definitions are highly variable and differ from one health organization and system to the next. At the University of Wisconsin-Madison's LHS program, the most common characterization of an LHS approach is that "we learn from what we do, and do what we learn." In part one of this two-part episode, Program Director Majid Afshar and Associate Program Director Anne Gravel Sullivan talk with Dr. Jeff Pothof, Chief Quality Officer at UW Health, about the hallmarks of a Learning Health System and how they differ from the quality improvement process. They discuss the benefits of the LHS approach to healthcare improvement and the role the Institute for Clinical and Translational Reasarch (ICTR) plays in creating the architecture to support the LHS as both a research and system improvement enterprise. They delve into the variables that help facilitate change --or generate obstacles--with an LHS approach, as well as the potential for Artificial Intelligence to help accelerate positive change in the UW Health learning health system.