STS Enters the Imaginary of the Learning Health System: A Discourse Analysis of the Learning Health System in its First Decade

• In Event: The Learning Health System as a Socio-Technical System of Translation

Abstract

New technological and information infrastructures are facilitating the collection, aggregation, and storage of clinical and research data within the healthcare system. The Learning Health System (LHS) concept emerged about ten years ago and encapsulates a new vision for the use of these data, shared across national and international networks, in efforts to improve quality, safety, and value in healthcare.
Our paper traces the expansion of this sociotechnical vision in the peer-reviewed literature (2007-2016) to analyze the discourses around the LHS, and to identify trends and themes that shape its imaginary and frame efforts to bring it to reality. Several papers recognize the LHS as a “sociotechnical” system thus suggesting a bridge between STS and LHS implementation and an opportunity for STS research to inform evaluation and practice. For example, our analysis aims to identify what count as “successes” of the LHS to date, and which are the articulated priorities for realization of the LHS to inform system builders and policy makers.
We have identified the need for leadership, an organizational culture of collaboration, and renewed meanings for valid research and care methodologies as key priorities in the extant literature on LHS. Since its early conceptualization, LHS discourse seems to be shifting from a vision and advocacy on behalf of the LHS concept to empirical reports of implementation and evaluation. A small number of papers have addressed the ethical and moral dimensions of the LHS citing the model as a moral imperative in need of renegotiating existing bioethical frameworks.

Authors

• Minakshi Raj, University of Michigan

• Jodyn Platt, University of Michigan Medical School

• Matthias Wienroth, Policy, Ethics & Life Sciences Research Centre, Newcastle University