Program will train the next generation of researchers to work with clinicians, administrators, and patients in health care settings.
A new collaboration among three of Minnesota’s most important health research, education, and care delivery organizations — University of Minnesota School of Public Health, Mayo Clinic, and Hennepin Healthcare — will train experts in a game-changing, modern approach to health care. Called learning health systems (LHS), the approach embeds researchers in a health care system, creating a nimble feedback loop among researchers and clinicians so they can more quickly, and together, improve the quality of patient care.
The Learning Health System Mentored Career Development Program (MN-LHS) was chosen as 1 of 11 programs nationwide to receive $4 million over five years from the Agency for Healthcare Research and Quality (AHRQ) and the Patient-Centered Outcomes Research Institute (PCORI). MN-LHS stood out among competitors because of the collaboration history among the three Minnesota partners and their ability to design a first-class training program.
“These awards will help to grow the number of researchers with the knowledge and skill to learn from the real-world practice going on within their delivery systems and the real-world data being generated in ever-increasing quantity,” says PCORI Executive Director Joe Selby.
It’s estimated that by 2020, medical knowledge will double every 73 days. The traditional research process is not flexible enough to meet this changing landscape and the needs of patients and health care systems.
“Advances and shifts in health care policy, payment reform efforts, and health IT and data are forcing clinical practices to constantly adapt,” says Tim Beebe, MN-LHS co-director, School of Public Health professor, and head of the Health Policy and Management division. “Busy practices can’t wait for five months to gear up to do a randomized clinical trial. They want and need information fast and without sacrificing scientific rigor.”
Using learning health systems to reduce opioid prescriptions
At the Mayo Clinic, there were major variations in how opioids were prescribed for surgical procedures, even for patients with similar opioid use history undergoing the same procedures. But over the last two years, specialty-specific multidisciplinary teams, using a health learning systems approach, developed prescribing guidelines for each surgical procedure. In orthopedic surgery, this resulted in a decrease of opioids prescribed by 50 percent, with no observed increase in refills. It’s estimated that this work could reduce the number of excess opioids in Minnesota communities by up to 1 million pills per year.
Though the concept of learning health systems has existed for a decade, embedded researchers remain rare, in part due to the limitations of traditional research training programs. This is where the Minnesota collaboration comes in.
“This grant gives us the opportunity to train future researchers to bring research to health care delivery faster, while working with the delivery system to identify and solve the problems of greatest importance,” says MN-LHS co-director Nilay Shah, chair of the Mayo Clinic Division of Health Care Policy & Research.
MN-LHS will work on a cohort model with two to five researcher scholars per year embedded in an active health care system for an intensive, mentored research experience. At the heart of their training is a weekly “Design Shop,” where scholars, mentors, and affiliated faculty from across the state will gather with others to solve problems, role play situations, and get expert input. MN-LHS issued the call for applicants on October 1 and chosen participants will join the program in January 2019.
“We are thrilled at Hennepin Healthcare to have the chance to participate in the MN-LHS training program,” says co-director Mark Linzer, vice chief for Education, Mentorship and Scholarship and director of the Center for Patient and Provider Experience at Hennepin Healthcare. “We are also looking forward to working with our patients on this project, and answering questions that are meaningful to and driven by them.”
Fairview Health Services, Minneapolis VA Health Care System, Children’s Minnesota, Ebenezer, Essentia Health, and HealthPartners will join with MN-LHS in training the scholars, offering diverse patient populations and dynamic learning laboratories.