Ideally, a learning health system would take data and findings from U.S. health systems’ combined experience in responding to the COVID-19 pandemic to craft an evidence-based response to the next wave of the pandemic as well as future epidemics. AcademyHealth has taken steps to do just that by identifying priority questions health system leaders and care providers will have over the next six to nine months to fuel rapid-cycle research projects.
AcademyHealth is a national nonprofit organization for health services researchers, policymakers, and health care practitioners and stakeholders. It sought to identify topics of potential interest involving COVID-19 and the impact (both intended and unintended) on health system policies, processes, providers and patient care.
The project is looking to identify research that can be conducted within three to nine months and support learning within a health system as well as broad dissemination of results and learnings to other health systems.
The co-chairs of AcademyHealth’s Learning Health System Interest Group reached out to 56 experts to identify questions that should be addressed and then grouped those questions into six categories. Here are the six categories and examples of questions.
• Patient and community experience, engagement, and outcomes: Evaluate the unintended consequences on non-COVID-19 patient outcomes (impacts of missed/delayed care on guideline- concordant care quality, hospitalization rates, complications, risk-adjusted mortality).
• Care delivery, management, decision-making, and operations: Did past pressures to increase health system efficiency lead to a lack of resilience and lack of surge capacity? What policies and incentives would be necessary to increase health system resiliency and surge capacity in the future?
• Workforce needs, training, and policies: Assess impact of COVID-19 on the existing and future health care workforce, including ripple effects of COVID-19 deaths of health care workers and variable trust in health systems (e.g., media reports of systems not allowing providers or other staff to wear masks).
• Technology, data, and telehealth: What are we learning as a result of the rapid change in the use of virtual monitoring and telecommunications that is actionable for equity and effectiveness of telehealth (e.g., lack of minutes, data and text for many Americans as a barrier to effective telehealth utilization—potentially an FCC policy issue to lift caps on minutes, text, and data)?
• Policies, including payment policy: Assess barriers and enabling policies to effective local system data flow up to community, regional, and federal levels to enhance planning and response. How were data shared (and not shared) with researchers to increase learning?
• Collaboration and coordination: Assess health system approaches to working collaboratively with public health to address immediate needs and sharing of workforce, facilities, PPE, medicines and testing capabilities.
The outcome is a report intended to inform decision-making of federal and foundation funders of health services research, and specifically healthcare delivery science, to guide rapidly launched investments in responsive research. Both the Veteran’s Administration’s Health Services Research and Development service and the Agency for Healthcare Research and Quality have released calls for this types of research.
