Learning Health System initiative weaves research into care delivery at KP Washington

With priorities aligned, our researchers and practitioners can make bold progress on behalf of members and patients, writes Dr. Eric B. Larson.

by Eric B. Larson, MD, MPH, Kaiser Permanente Washington Health Research Institute (KPWHRI) executive director, and Kaiser Foundation Health Plan of Washington vice president for research and health care innovation

The past few weeks have been an exciting time for those interested in leveraging the power of learning health systems to continually advance patient care at Kaiser Permanente Washington and beyond.

It started on May 24 with a workshop that KPWHRI Research Associate Leah Tuzzio, Project Manager James Fraser, and I organized at the National Institutes of Health (NIH) in Bethesda, Maryland on behalf of the NIH Health Care Systems Research Collaboratory. The focus: Nine pragmatic clinical trials that the Collaboratory has been sponsoring nationwide within large health systems like Kaiser Permanente, including one study led by KPWHRI senior investigator and Kaiser Permanente Washington psychiatrist Dr. Greg Simon, which focuses on suicide prevention. Greg was on hand to present this work. And Kaiser Permanente Washington President Susan Mullaney was among three health system leaders who presented their perspectives on ways to better translate findings into practice.

Pragmatic clinical trials differ from traditional clinical trials, which are typically conducted in experimental settings with specialized populations. The traditional approach can work well for conducting “gold standard” randomized controlled trials. But many experts in recent years have questioned the wisdom of studying health care in isolated academic settings, away from the community-based hospitals, clinics, and homes where most Americans get their care. They note that many highly touted medical discoveries seem to lose their power once they cross the threshold from research to everyday care. And they point to a documented 17-year average delay between publication of scientific findings and the time those discoveries benefit everyday patient care.

Finding practical solutions in real-world settings

But what if we embedded the work of designing, evaluating, and implementing health care innovations into the very systems where most people get their care? And what if those health system leaders and scientists aligned research priorities to better serve their members and patients?

Rather than wait until an experimental trial is complete before taking research findings into the “real-world,” researchers and practitioners would work shoulder-to-shoulder in clinical settings. They would learn as they go, adapting approaches to solve challenges that arise as new ideas are tried out. They would be in a position to find immediate and practical solutions to the most pressing issues before them.

“The alignment piece is critical,” Susan Mullaney told the 200 researchers and health system leaders who attended the NIH workshop. “Research needs to be woven into the fabric of our work, so we can understand the issues, move quickly to address them, and continue to deliver on an exceptional care experience for our members and patients.”

Supporting our clinical teams’ highest aspirations

That’s the ideal behind the NIH-funded pragmatic trials — and the work KPWHRI researchers are doing with our clinical partners within Kaiser Permanente Washington. So it was great to see this week’s announcement from Susan and Dr. Steve Tarnoff, president and executive medical director of Washington Permanente Medical Group (WPMG), that Kaiser Permanente Washington has launched a newly funded initiative to further develop our organization as a learning health system. As Susan and Steve wrote in their memo to our organization’s leaders on Monday, “This work, which began June 1, will support the establishment of a Learning Health System Program that uses the Institute’s expertise and methodology to support Kaiser Permanente Washington clinical teams’ highest aspirations to achieve health care’s quadruple aim — better patient experience, improved population health, affordability, and improved experience of providing care.”

The new Learning Health System Program will be co-led by Dr. Paula Lozano and Katie Coleman. Paula is WPMG’s associate medical director for research and translation and a senior investigator at KPWHRI, and Katie is a KPWHRI research associate with extensive experience studying and disseminating findings about best practices in primary care through the Institute’s MacColl Center for Health Care Innovation. Their team’s work over the next seven months will include the creation of a new blueprint for a fully funded program within Kaiser Permanente Washington that will foster partnerships between clinical care and research that promote innovation, quality, safety, and value.

As Susan Mullaney stated at last month’s NIH workshop, alignment between research and the health care system is critical. With her recent approval for this program — and with the support we’ve heard expressed by Steve Tarnoff and other medical staff leaders — we see that alignment happening. The organization’s priorities are in sync and Kaiser Permanente Washington is making bold progress to advance the care of our members and patients everywhere.

This article originally appeared in LinkedIn.

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