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Introduction: Implementation of research findings in clinical practice often is not realized or only partially achieved, and if so, with a significant delay. Learning health systems (LHSs) hold promise to overcome this problem by embedding clinical research and evidence‐based best practices into care delivery, enabling innovation and continuous improvement. Implementing an LHS is a complex process that requires participation and resources of a wide range of stakeholders, including healthcare leaders, clinical providers, patients and families, payers, and researchers. Engaging these stakeholders requires communicating clear, tangible value propositions. Existing models identify broad categories of benefits but do not explicate the full range of benefits or ways they can manifest in different organizations. Methods: To develop such a framework, a working group with representatives from six Clinical and Translational Science Award (CTSA) hubs reviewed existing literature on LHS characteristics, models, and goals; solicited expert input; and applied the framework to their local LHS experiences. Results: The Framework of LHS Benefits includes six categories of benefits (quality, safety, equity, patient satisfaction, reputation, and value) relevant for a range of stakeholders and defines key concepts within each benefit. Applying the framework to five LHS case examples indicated preliminary face validity across varied LHS approaches and revealed three dimensions in which the framework is relevant: defining goals of individual LHS projects, facilitating collaboration based on shared values, and establishing guiding tenets of an LHS program or mission. Conclusion: The framework can be used to communicate the value of an LHS to different stakeholders across varied contexts and purposes, and to identify future organizational priorities. Further validation will contribute to the framework's evolution and support its potential to inform the development of tools to evaluate LHS impact. [ABSTRACT FROM AUTHOR]

The T1D Exchange QI Collaborative was formed in 2016 to accelerate quality improvement (QI) at clinics serving people with type 1 diabetes (T1D). Through an evidence-based review and idealized design process, the collaborative chose seven process and outcome measures to be the focus of improvement activities directed at high-risk T1D patients (2 or more A1c values >9% in the preceding year) aged 12-26 years. We report monthly aggregate statistics from seven Collaborative clinics for the measures and show the statistics for May and August 2018. A substantial percent of patients meet high risk criteria across all centers, and there is wide variation in performance measures. No center has the capacity to report on all measures, but there are incremental improvements in data availability. Outcomes remain suboptimal, particularly in this high-risk population. These measures will be continuously tracked to define network progress and to design QI interventions to improve glycemic outcomes. The work of the Collaborative and the creation of a technology platform will improve reporting capacity and drive QI activities. Disclosure: A.B. Cabrera: None. G.T. Alonso: None. S. Corathers: None. J.M. Lee: Consultant; Self; Taiho Oncology, Inc. P. Prahalad: None. N. Rioles: None. Funding: The Leona M. and Harry B. Helmsley Charitable Trust [ABSTRACT FROM AUTHOR]

Less than 20% of pediatric patients with type 1 diabetes (T1D) in the U.S. achieve target A1c values, with rising A1c trends between age 6 to 17 years. The International Society of Pediatric and Adolescent Diabetes recommends outpatient clinic visits at least every 3 months, while the American Diabetes Association recommends every 3-6 months. The T1D Exchange Quality Improvement Collaborative aims to improve the quality of T1D care in the U.S. by identifying variations in care and sharing best practices. Six pediatric diabetes clinics in the Collaborative reported the mean number of days between outpatient diabetes clinic visits for patients with T1D aged 0-6, 7-12, 13-17, and 17-26 years for each month from 11/2017-10/2018. Patients with new onset T1D were excluded, as were those with visit interval >13 months. Analysis included 31,358 patients. Age group and clinic site (both p<.001) were associated with interval between clinic visits (Figure 1), but month was not (p=.87). Mean number of days was >90 for each age group. The majority of patients attended clinic less often than required to meet 4 encounters per year. Older age was associated with longer interval between visits. Improving outcomes will require a combination of increasing the perceived value of clinic attendance, increasing access to outpatient encounters, and innovative methods of care delivery outside regular clinic attendance. Disclosure: G.T. Alonso: None. S. Thomas: None. C. Garey: None. D.A. Buckingham: None. A.B. Cabrera: None. M.A. Clements: Advisory Panel; Self; Glooko, Inc. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Medtronic. S. Corathers: None. D.J. DeSalvo: Consultant; Self; Dexcom, Inc., Insulet Corporation. A. Garrity: None. J.M. Lee: Consultant; Self; Taiho Oncology, Inc. R. McDonough: None. F. Mostajabi: None. C. Yee: None. M.K. Kamboj: None. Funding: The Leona M. and Harry B. Helmsley Charitable Trust [ABSTRACT FROM AUTHOR]

Introduction: Implementation of research findings in clinical practice often is not realized or only partially achieved, and if so, with a significant delay. Learning health systems (LHSs) hold promise to overcome this problem by embedding clinical research and evidence-based best practices into care delivery, enabling innovation and continuous improvement. Implementing an LHS is a complex process that requires participation and resources of a wide range of stakeholders, including healthcare leaders, clinical providers, patients and families, payers, and researchers. Engaging these stakeholders requires communicating clear, tangible value propositions. Existing models identify broad categories of benefits but do not explicate the full range of benefits or ways they can manifest in different organizations., Methods: To develop such a framework, a working group with representatives from six Clinical and Translational Science Award (CTSA) hubs reviewed existing literature on LHS characteristics, models, and goals; solicited expert input; and applied the framework to their local LHS experiences., Results: The Framework of LHS Benefits includes six categories of benefits (quality, safety, equity, patient satisfaction, reputation, and value) relevant for a range of stakeholders and defines key concepts within each benefit. Applying the framework to five LHS case examples indicated preliminary face validity across varied LHS approaches and revealed three dimensions in which the framework is relevant: defining goals of individual LHS projects, facilitating collaboration based on shared values, and establishing guiding tenets of an LHS program or mission., Conclusion: The framework can be used to communicate the value of an LHS to different stakeholders across varied contexts and purposes, and to identify future organizational priorities. Further validation will contribute to the framework's evolution and support its potential to inform the development of tools to evaluate LHS impact., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Authors. Learning Health Systems published by Wiley Periodicals LLC on behalf of University of Michigan.)