Got Skills? What it Takes to be a Learning Health System Researcher

Don’t let those crisp, white lab coats fool you. While researchers share the ultimate goal of reaching new findings that can advance the best possible medical care, they aren’t all the same. Each investigator has a highly specialized knowledge base that is constantly changing as they apply new things that they’ve discovered, whether in the lab, at the bedside, or within an emerging field called the learning health system.

A learning health system engages patients, physicians, and researchers who together explore the wealth of health information available in large, shared data-sets that can be aggregated, analyzed, and quickly disseminated to inform individualized patient care decisions. A new article from the Agency for Healthcare Research and Quality (AHRQ) describes the unique skills that learning health system researchers need to be successful, and it identifies core competencies to guide their future training requirements and curricula.

The authors define a learning system researcher as: “An individual who is embedded within a health system and collaborates with its stakeholders to produce novel insights and evidence that can be rapidly implemented to improve the outcomes of individuals and populations and health system performance.”

Christopher Forrest, MD, PhD, a professor of Pediatrics at Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, co-authored the article that appeared this week in Health Services Research. He explained that “embeddedness” is a distinguishing feature of a learning health system researcher.

“A learning health system researcher must be part of the system that he or she is studying, either as an employee or invited guest,” Dr. Forrest said. “This embeddedness allows the researcher to execute scientific investigations in real-world settings in ways that do not disrupt day-to-day operations, and it ensures that the researcher understands the context within which the work is being done.”

The AHRQ article was developed based on a literature review, interviews and surveys, and input from three expert panels that included researchers, practicing clinicians, patients, and health system leaders. It provides a list of 33 core competencies divided into seven domains of expertise as a framework for health systems to design, implement, and evaluate training programs for learning health system researchers:

• Systems science
• Research questions and standards of scientific evidence
• Research methods
• Informatics
• Ethics of research and implementation in health systems
• Improvement and implementation science
• Engagement, leadership, and research management

These core competencies could improve outcomes for children because pediatric research often requires multiple disciplines to work together to tackle healthcare delivery challenges. No single pediatric institution usually has enough patients to generate large numbers of study participants, so a national, pediatric-specific learning health system called PEDSnet provides access to diverse, nationally representative health information from millions of children. Dr. Forrest is the principal investigator of the research network that combines clinical data from eight children’s hospitals, including CHOP, plus several specialty disease networks.

“PEDSnet was formed by leading children’s hospitals in the U.S. to advance the learning health system model nationally in pediatrics,” Dr. Forrest said. “The leaders of PEDSnet believe that one of the best ways to improve the outcomes of children and their families is to forge a national learning health system by collaborating across organizational boundaries on research and implementation of evidence. This is the vision that has been part of the DNA of PEDSnet since it was formed.”

Find out more about AHRQ’s development of a learning health system here, and about PEDsnet here.