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Next Steps


LHS Phase 1 Plan

This draft proposal is a stakeholder-driven plan for how ACTS Collaborative participants and other stakeholders can take specific actions to build on the ACTS LHS Concept Demonstration and drive progress toward a shared learning health system (LHS) future vision. The proposed plan is under review and advisement by AHRQ.

The proposal outlines a three-year Phase 1 effort to create a series of concept demonstrations around specific use cases. The goal is to demonstrate a strong digital knowledge ecosystem where information flows seamlessly around the LHS cycle in ways that improve care processes – and ultimately outcomes – for selected high priority clinical targets.

Proposed Concept Demonstration Use Cases

To prove the value of the ACTS framework for real-world scenarios, the proposal focuses on creating four initial use cases with broad value to the extended healthcare community. These use cases share specific traits, including:

  • Care Improvements Use cases represent significant opportunities to improve public health and reduce morbidity and mortality
  • Leverage Federal Initiatives Activities and deliverables build on pertinent Federal programs, guidance, and tools for the use cases
  • Stakeholder Participation Use cases are based on improvement targets prioritized by stakeholders and work to address them will be driven by their strategic initiatives

Proposed Use Cases

  1. Pandemic Response
  2. Preventative Care
  3. Hypertension Control
  4. Pain Management / Opioid Use

ACTS Stakeholder-Based Approach to Success

The public and private sectors are already investing massive resources into improving information flow to build a true health knowledge ecosystem. But current investments and activities are fraught with waste and redundancy, and valuable health information and evidence is not used nearly to its true potential. This is occurring in a large part because most of the work underway is happening in siloes.

Numerous organizations play a role in delivering on the vision of a tightly integrated, interactive learning health system. The ACTS Phase 1 proposal aims to drive collaboration and consensus. Continuous improvement within learning health systems is driven by smooth flow of information - within and between many different sources – throughout the cycle (see figure below).

The ACTS Phase 1 proposal calls on AHRQ and other participants to work together to identify projects currently underway, leverage existing efforts and tools, and when needed, enhance or create new solutions. Participating organizations will identify tasks and deliverables they can work on (based on their business drivers) to contribute to a broader, federated LHS whole. The viability of this approach is reinforced by the 41 ACTS support letters indicating interest from key stakeholder organizations in aligning their efforts and investments in this way.

The proposal recommends conducting scalable pilots for the initial four use cases that successfully:

Use best available tools and strategies (including existing resources from AHRQ/HHS/federal agencies) to develop living, evidence-based guidance

Implement guidance through care process reengineering for several care delivery organizations (CDOs)

Evaluate results from care, learning, and progress toward Quintuple Aim outcomes

Apply the results from this analysis to build working concept demonstrations for four use cases and promote scaling to more CDOs and targets

The “How” and the “Who”

The image below depicts how the various elements of the learning health cycle should interoperate. We’re not there yet, but initiatives such as ACTS are driving real progress.

The ACTS Phase 1 proposal focuses on convening the individuals and organizations (the who) already working independently and in small groups to address discrete parts of the larger challenge. By promoting understanding of who is doing what to enable the knowledge ecosystem, the ACTS initiative can help organizations share ideas, best practices, and even resources and tools on a broader scale.

ACTS participants are beginning to fill out a "Phase 1 LHS Project Stakeholder Organization Activities Template" to document their LHS-related efforts pertinent to the Phase 1 proposal. Once completed and shared on via this Proposal page, stakeholders will be able to see others doing similar work, get ideas about promising practices and collaborations, and cultivate synergies.

The ACTS initiative has been a valuable forum to understand and begin addressing gaps in technology, standards, and processes that hind progress. We have the opportunity to further advance collaborations and coordination around disjointed projects to more quickly make progress toward an effective learning health system cycle that fully realizes stakeholder goals


Elements of an Effective Learning Health System Cycle

Phase 1 Activities

Information under the the following five tabs detail specific activities AHRQ and others could undertake to transform independent, separate activities, into an integrated learning health system cycle. The proposed activities address the broad spectrum of requirements needed to create and sustain an effective learning health system cycle, initially focusing on the four identified use cases and expanding over time to additional targets.

This work will focus on accessing and using the best of available tools and information, as well as designing and piloting better future approaches (view the University of Minnesota LHS case study as an example). Proposed activities will build on the experiences/insights derived from such previous work as illustrated in the LHS Concept Demo that lays a strong foundation for each of the proposed tasks.

The proposed timeline for activities is located following the list of proposed activities. Click on one of the five buttons below to see the corresponding activities/tasks.

Proposed Phase 1 Deliverables