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Becoming a Learning Healthcare System

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Presentation at the annual Birnbaum Lecture by Greg Simon, MD, MPH, senior investigator with Group Health Research Institute.

Presentation at the annual Birnbaum Lecture by Greg Simon, MD, MPH, senior investigator with Group Health Research Institute.


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  • 1. BIRNBAUMLECTURE 2013Prologue: Becoming a learninghealthcare systemUnlocking the power of research @GHResearch #Birnbaum13
  • 2. What is a learning healthcare system?“Each patient care experience naturally reflectsthe best available evidence, and, in turn, addsseamlessly to learning what works best in differentcircumstances.”IOM Roundtable on Evidence-Based Medicine, 2008Unlocking the power of research @GHResearch #Birnbaum13
  • 3. With the accent on:“Each patient care experience naturally reflectsthe best available evidence, and, in turn, addsseamlessly to learning what works best in differentcircumstances.”IOM Roundtable on Evidence-Based Medicine, 2008Unlocking the power of research @GHResearch #Birnbaum13
  • 4. Seamless integration means:• No boundary between practice and research.• Patients and providers are both creators andconsumers of the latest information.• All experience contributes to evidence.Unlocking the power of research @GHResearch #Birnbaum13
  • 5. An example:Unlocking the power of research @GHResearch #Birnbaum13
  • 6. An example:I want information that is:• Up to the minute• Unbiased• Personalized to me• When & where I wantUnlocking the power of research @GHResearch #Birnbaum13
  • 7. An example:I want information that is:• Up to the minute• Unbiased• Personalized to me• When & where I wantClinical trials won’t get there,so we should stop waiting.Unlocking the power of research @GHResearch #Birnbaum13
  • 8. The pieces are coming into place• Systematic assessment of outcomes• Well-organized data resources• Sophisticated analytic methods• Effective health communicationBut…technology changes faster than culture.Unlocking the power of research @GHResearch #Birnbaum13
  • 9. Two cultural challenges:• Acting under uncertainty• Transparency & trustUnlocking the power of research @GHResearch #Birnbaum13
  • 10. Two cultural challenges:• Acting under uncertaintyo Quickly commit to action – knowing we might be wrongo Change direction – immediately and with no regretsUnlocking the power of research @GHResearch #Birnbaum13
  • 11. Two cultural challenges:• Acting under uncertaintyo Quickly commit to action – knowing we might be wrongo Change direction – immediately and with no regretso Or – learn to play like MauroUnlocking the power of research @GHResearch #Birnbaum13
  • 12. Two cultural challenges• Acting under uncertaintyo Quickly commit to action – knowing we might be wrongo Change direction – immediately and with no regrets• Transparency & trustUnlocking the power of research @GHResearch #Birnbaum13
  • 13. Two cultural challenges• Acting under uncertaintyo Quickly commit to action – knowing we might be wrongo Change direction – immediately and with no regrets• Transparency & trustIt’s not really about patient privacy. It’s about our own issues:o Providers’ fear of scrutinyo Health systems’ “reputational risk”o The business model of traditional researchUnlocking the power of research @GHResearch #Birnbaum13
  • 14. Why Group Health?• We are an integrated systemUnlocking the power of research @GHResearch #Birnbaum13
  • 15. Why Group Health?• We are an integrated systemo So the financial incentives are alignedUnlocking the power of research @GHResearch #Birnbaum13
  • 16. Why Group Health?• We are an integrated systemo So the financial incentives are aligned• We are a cooperativeUnlocking the power of research @GHResearch #Birnbaum13
  • 17. Why Group Health?• We are an integrated systemo So the financial incentives are aligned• We are a cooperativeo So we know that it’s our members’ data, ourmembers’ money, and our members’ healthUnlocking the power of research @GHResearch #Birnbaum13
  • 18. THANK YOU@GHResearch #Birnbaum13