Creating a nationwide Learning Health System
“Building a Learning Health System to improve care for kids”
How can we create a healthcare system that learns and improves?
The Learning Health System Initiative is a funding partnership between Sydney Children’s Hospitals Foundation and the University of Sydney. Professor Tom Snelling is developing a blueprint for a collaborative learning healthcare environment by turning health data into health information. He’s proposed a national response to help fast-track the best treatment outcomes for patients with COVID-19, and paediatric care within Sydney Children’s Hospitals Network.
Current approaches to establishing and implementing evidence-based medicine remain inefficient, costly and fragmented.
It's estimated that less than 10% of modern clinical practice is supported by high quality evidence from clinical trials. When using traditional research approaches, most trials are inadequate for deciphering exactly which aspects work, which don’t, and who does it work for in a timely way.
The opportunity lies with digitised patient data. Electronic health records (eHRs) used by the majority of Australia’s hospitals are designed for managing clinical care or billing purposes. But current systems are not fit for the research that can actively optimise clinical care and deliver enhanced health outcomes.
The challenge remains for hospitals to convert their vast and rapidly accumulating health data into health information – data which is organised, analysed and actioned in a way that improves care.
A transformative approach is possible thanks to developments in health information, analytics, clinical trials, and decision theory, together with the growing digitisation of health data. Collectively, these can deliver more efficient capture, assimilation and acting on evidence to achieve a healthcare system that learns, and one which is ethical and sustainable.
To establish a national Learning Health System Initiative (LHSI) – a blueprint for a collaborative learning healthcare environment. The LHSI will develop the scalable infrastructure needed to use clinical and administrative data to drive significant improvements in care.
Central to this infrastructure will be an engine for real time clinical decision support, powered by Bayesian networks - an advanced statistical methodology. This technology will enable individual-level clinical decision-making at the point-of-care, informed by the collective knowledge of experts, integrated with accumulating data.
The platform will also support the implementation of Bayesian adaptive platform trials to quickly and efficiently learn about patient-specific treatments by ‘learning in real time’, shrinking timelines for data collection, improvements and recommendations from years to months or even weeks. We believe the LHSI will achieve demonstrable improvements in health outcomes within five years - and will be recognised as world-leading within a decade with a predicted 15% reduction in hospital bed stays across the Sydney Children’s Hospitals Network (SCHN).
COVID 19 has now provided an opportunity to test this approach across our health systems by applying a model based on Bayesian reasoning and building a framework for adaptive clinical trials for COVID-19. While we wait for a vaccine, we need to understand what works and does not work for a variety of COVID-19 patients across Australia. Collaborating with medical and research teams in New South Wales, Queensland and Victoria, Prof Tom Snelling is working on a national response to help fast-track the best treatment outcomes for patients with COVID-19.
The modelling of this project will use three disease areas of focus to research the learning health system approach on children with cystic fibrosis, children with serious bacterial infections and children with lower respiratory tract infections.
The pressing need for safer, more effective and efficient care presents a unique opportunity for Australia to lead in the discovery and implementation of better ways to evaluate existing and new health technologies and innovating service delivery through automated technology platforms, such as SMS text messaging. The LHSI will not only support large-scale analyses across Australian hospitals, it also plans to facilitate participation and the initiation of collaborative projects with major treatment centres in North America and Europe.
Your commitment will transform the model of care
Sydney Children’s Hospitals Foundation is seeking funding to support the SCHN node of this project, including clinical leaders, research staff and data scientists. Funding for this program will lay the groundwork for building a transformative, Learning Health System that is evidence driven and visionary, supporting millions of patients in accessing close to real-time health information to inform the best healthcare choices.
About Professor Tom Snelling
Tom Snelling is a paediatric infectious diseases physician at the Children’s Hospital at Westmead, a professor in the School of Public Health at the University of Sydney and lead researcher behind the LHSI. Prof Snelling leads a team of researchers aiming to improve healthcare by implementing learning health systems approaches in children and adults. His team is working in the application of new approaches in the design, implementation and analysis of public interest studies, and is leading a number of multi-institutional collaborative learning health projects across Australia. Prof Snelling is the clinical lead of the Clinical Data Analytics Platform (CDAP) a national initiative aiming to assist frontline healthcare workers to provide evidence-based care for COVID-19 disease.
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