Dr. Charles Friedman and Joshua Rubin's 2015 AMIA Symposium presentation.

1. Learning Health System Briefing
Chuck Friedman
Josh Rubin
AMIA Symposium
November 17, 2015

2. Disclosure
Josh and I are wearing two hats tonight:
1) University of Michigan
2) Learning Health Community
We will try to be a clear as possible as to
when we are wearing each one.
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3. Not a “Pep Rally” This Year
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4. Today’s Briefing
• The LHS Challenge
• The Role of Community in Realizing
an LHS
• A Science of Cyber-Social Learning
Systems
• The New Journal: “Learning Health
Systems”
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5. Properties of a Health System That
Can Learn
Every consenting patient’s characteristics
and experience are available to learn from
Best practice knowledge is immediately
available to support decisions
Improvement is rapid and continuous through
ongoing study
An infrastructure enables this happen
routinely and with economies of scale.
All of this is part of the culture 5

6. The LHS is Bigger than BD2K:
It Must Do This
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Assemble
Relevant Data
Take Action to Change
Practice
Interpret
Results
Analyze
Data
Deliver Tailored
Message
A Problem of
Interest
Decision to Study

7. Not This
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Assemble
Relevant Data
Take Action to Change
Practice
Interpret
Results
Analyze
Data
Deliver Tailored
Message
A Problem of
Interest
Decision to Study
Journals?

8. LHS Infrastructure
A Single Socio-Technical Platform Supports
Multiple Simultaneous Learning Cycles
Different
Problems
Rapid Cycle
Slower Cycle
SUPPORTING PLATFORM
People
ProcessTechnology
Policy

9. The Learning Health
Community
• Evolved from the 2012 LHS Summit
• Consensus Core Values Endorsed by
91 Organizations
• Two Initiatives:
– Essential Standards to Enable Learning
(ESTEL)
– Governance
• Vision of a “Second Summit”
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10. 10

11. New Science?
• National workshop explored the
research challenges inherent in
realizing a high functioning LHS
• April, 2013: 45 invited attendees
• At the end, it was suggested that
these challenges may equate to a
new science
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12. Cyber-Social Learning
Systems
As formulated by Kevin Sullivan:
• Ability to gather, integrate, and analyze
information at scale to produce new
insights, and use such insights to
continuously improve complex socio-
technical system structure, function, and
performance to meet demanding and
evolving requirements
• Is this the future of informatics?
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13. Features of Cyber-Social
Learning Systems
• People, institutions, legal frameworks, etc.
are parts of computational architecture
• At ecosystem scales, traditional
engineering methods are no longer
adequate
• Systems must be self-aware, continuously
evolving, and self-governing
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14. Bill Stead’s Formulation…
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15. Next Steps
• The Computing Community
Consortium, NSF’s program planning
arm for computing, has given us a
“soft” green light to plan a series of
visioning workshops
• Three workshops addressing cyber-
social learning systems applied to
health and three other domains
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16. A New International Journal
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17. LHS Journal
• Editorial office in Ann Arbor
• Three Associate Editors
– Brendan Delaney
– Jonathan Silverstein
– Kevin Sullivan
• 46-member Editorial Board (nine
countries)
• Article types
– Research reports
– Experience reports
– Briefs
– Commentaries
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