1) The document discusses a briefing on learning health systems presented at an AMIA symposium. 2) It outlines the challenges of realizing a learning health system that can continuously learn from all patient data and experiences to rapidly improve practices. 3) The briefing describes efforts by the Learning Health Community coalition of 91 organizations to develop standards and governance to enable learning health systems, and proposes that realizing these systems may require a new field of "cyber-social learning systems."

1. Learning Health System Briefing
Chuck Friedman
Josh Rubin
AMIA Symposium
November 17, 2015

2. Disclosure
Josh and I are wearing two hats tonight:
1) University of Michigan
2) Learning Health Community
We will try to be a clear as possible as to
when we are wearing each one.
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3. Not a “Pep Rally” This Year
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4. Today’s Briefing
• The LHS Challenge
• The Role of Community in Realizing
an LHS
• A Science of Cyber-Social Learning
Systems
• The New Journal: “Learning Health
Systems”
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5. Properties of a Health System That
Can Learn
Every consenting patient’s characteristics
and experience are available to learn from
Best practice knowledge is immediately
available to support decisions
Improvement is rapid and continuous through
ongoing study
An infrastructure enables this happen
routinely and with economies of scale.
All of this is part of the culture 5

6. The LHS is Bigger than BD2K:
It Must Do This
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Assemble
Relevant Data
Take Action to Change
Practice
Interpret
Results
Analyze
Data
Deliver Tailored
Message
A Problem of
Interest
Decision to Study

7. Not This
7
Assemble
Relevant Data
Take Action to Change
Practice
Interpret
Results
Analyze
Data
Deliver Tailored
Message
A Problem of
Interest
Decision to Study
Journals?

8. LHS Infrastructure
A Single Socio-Technical Platform Supports
Multiple Simultaneous Learning Cycles
Different
Problems
Rapid Cycle
Slower Cycle
SUPPORTING PLATFORM
People
ProcessTechnology
Policy

9. The Learning Health
Community
• Evolved from the 2012 LHS Summit
• Consensus Core Values Endorsed by
91 Organizations
• Two Initiatives:
– Essential Standards to Enable Learning
(ESTEL)
– Governance
• Vision of a “Second Summit”
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10. 10

11. New Science?
• National workshop explored the
research challenges inherent in
realizing a high functioning LHS
• April, 2013: 45 invited attendees
• At the end, it was suggested that
these challenges may equate to a
new science
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12. Cyber-Social Learning
Systems
As formulated by Kevin Sullivan:
• Ability to gather, integrate, and analyze
information at scale to produce new
insights, and use such insights to
continuously improve complex socio-
technical system structure, function, and
performance to meet demanding and
evolving requirements
• Is this the future of informatics?
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13. Features of Cyber-Social
Learning Systems
• People, institutions, legal frameworks, etc.
are parts of computational architecture
• At ecosystem scales, traditional
engineering methods are no longer
adequate
• Systems must be self-aware, continuously
evolving, and self-governing
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14. Bill Stead’s Formulation…
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15. Next Steps
• The Computing Community
Consortium, NSF’s program planning
arm for computing, has given us a
“soft” green light to plan a series of
visioning workshops
• Three workshops addressing cyber-
social learning systems applied to
health and three other domains
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16. A New International Journal
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17. LHS Journal
• Editorial office in Ann Arbor
• Three Associate Editors
– Brendan Delaney
– Jonathan Silverstein
– Kevin Sullivan
• 46-member Editorial Board (nine
countries)
• Article types
– Research reports
– Experience reports
– Briefs
– Commentaries
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