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For researchers to contribute meaningfully to the creation of learning health systems, practical tools are required to operationalize existing conceptual frameworks. We describe a model currently in use by the University of Wisconsin Health Innovation Program (HIP). The HIP model consolidates and enhances existing learning health system frameworks by defining specific steps needed to create sustainable change based on research conducted within the health system. As an example of the model's application, we describe its use to improve patient identification for the University of Wisconsin health system's case management program. Our case study shows the importance of culture, infrastructure, and strong leadership support in realizing a learning health systems research project and creating sustainable change within the health system. By articulating the foundational elements and steps to conduct research with learning health systems, our model supports researchers in achieving the challenge of moving learning health systems from concept to action., Competing Interests: Declaration of competing interest None., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: Case management programs for high-need high-cost patients are spreading rapidly among health systems. PCORNet has substantial potential to support learning health systems in rapidly evaluating these programs, but access to complete patient data on health care utilization is limited as PCORNet is based on electronic health records not health insurance claims data. Because matching cases to comparison patients on baseline utilization is often a critical component of high-quality observational comparative effectiveness research for high-need high-cost patients, limited access to claims may negatively affect the quality of the matching process. We sought to determine whether the evaluation of programs for high-need high-cost patients required claims data to match cases to comparison patients., Materials and Methods: A retrospective cohort study design with multiple measures of before-and-after health care utilization for 1935 case management patients and 3833 matched comparison patients aged 18 years and older from 2011 to 2015. EHR and claims data were extracted from 3 health systems participating in PCORNet., Results: Without matching on claims-based health care utilization, the case management programs at 2 of 3 health systems were associated with fewer hospital admissions and emergency visits over the subsequent 12 months. With matching on claims-based health care utilization, case management was no longer associated with admissions and emergency visits at those 2 programs., Discussion: The results of a PCORNet-facilitated evaluation of 3 programs for high-need high-cost patients differed substantially depending on whether claims data were available for matching cases to comparison patients., Conclusions: Partnering with learning health systems to rapidly evaluate programs for high-need high-cost patients will require that PCORNet facilitates comprehensive and timely access to both electronic health records and health insurance claims data., (© The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: The majority of health care utilization decisions in the United States are made by persons with multiple chronic conditions. Existing public reports of health system quality do not distinguish care for these persons and are often not used by the consumers they aim to reach., Objective: Our goal was to determine if tailoring quality reports to persons with diabetes mellitus and co-occurring chronic conditions would increase user engagement with a website that publicly reports the quality of diabetes care., Methods: We adapted an existing consumer-focused public reporting website using adult learning theory to display diabetes quality reports tailored to the user's chronic condition profile. We conducted in-depth cognitive interviews with 20 individuals who either had diabetes and/or cared for someone with diabetes to assess the website. Interviews were audiotaped and transcribed, then analyzed using thematic content analysis., Results: Three themes emerged that suggested increased engagement from tailoring the site to a user's chronic conditions: ability to interact, relevance, and feeling empowered to act., Conclusions: We conclude that tailoring can be used to improve public reporting sites for individuals with chronic conditions, ultimately allowing consumers to make more informed health care decisions., Competing Interests: Conflicts of Interest: None declared., (©Maureen A Smith, Lauren Bednarz, Peter A Nordby, Jennifer Fink, Robert T Greenlee, Daniel Bolt, Elizabeth M Magnan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.12.2016.)