Farr Institute & (University College London)
Dr Amitava Banerjee, Senior Lecturer in Clinical Data Science and Honorary Consultant in Cardiology at the Farr Institute of Health Informatics
Head of Education at Royal College of Physicians Informatics Unit
Learning Health Systems have had fluid definitions, but within the Farr, the emphasis has been more on the importance of continuous data.
The Farr has been focused on training and building capacity within the Learning Health System community. They have been building a cohort of individuals who have taken, short courses, placements and PhDs within the Institute, on topics related to LHSs. They have also supported, advised and collaborated on other projects, rather than launch stand-alone LHS implementation projects. Several such projects will be featured at the Farr Informatics for Health Conference in April 17 (http://informaticsforhealth.org). There is potential for The Health Foundation also to achieve more by supporting existing projects, rather than launching de novo projects.
They see the potential of LHSs to bridge the clinical – research divide and to enable much larger scale change than has previously been possible.
Evidence Based Medicine has been criticised for not being practical enough, while QI has been criticised for being academic-lite. There is some fatigue regarding these two lenses, within healthcare. LHS are an opportunity to bring together Evidence Based Medicine and QI.
To date, there have been a relatively small number of clinicians involved in work on LHS. It is important that this work is not seen as being owned by academia or informatics.
There is an opportunity for The Health Foundation to take this further, by making LHSs more practical and accessible to frontline clinicians and QI practitioners.
There has been a lot of hype in this area, particularly around wearables and machine learning. This has, to some extent been fuelled by funders and researchers. At the same time, there has been a lack of robust evaluation – this is a gap that The Health Foundation could help to fill. Without this evidence, it will be difficult to sell LHS initiatives to frontline clinicians who have already been disappointed by Connecting for Health and Care.Data.
Work at the RCP and RCGP, to create a Faculty of Health Informatics, will go some way towards training the next batch of Chief Clinical Information Officers. The NHS England programme, to establish a virtual Digital Academy will also contribute. This will be helpful, but there is also a need to develop a broader cohort, throughout healthcare, who can help to realise the benefits of LHSs. This may be an area to which The Health Foundation can contribute.
In training and in thinking about IT implementation more broadly, there has been a tendency to look to the US and to US experts for inspiration. While this can be helpful, it is also important to look at innovations in other countries and to encourage bottom up development within the UK.