Imagining the Social in a Learning Health System

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

Abstract

Learning Health Systems (LHS) offer a new way of organizing healthcare systems to promote patient engagement, evidence-based practice, and continuous improvement. This new structure promises to make use of patient- and practitioner-generate data sources to balance the often-competing priorities of high quality care and cost control. Since 2006, the National Academy of Medicine has brought together the Leadership Consortium for a Value and Science-Driven Health System, which has released a series of reports envisioning the structure and organization of the LHS. Along with the recently established journal Learning Health Systems, these reports serve as an archive for examining the socio-technical imaginaries of LHSs. In designing new systems is it important to ask: what aspects of healthcare as an everyday, social activity are articulated during system-oriented planning? Drawing on these archival sources, I focus on two stated goals of the LHS: to change the culture of a healthcare system so that it supports a continuously learning health system, and to shape patient and practitioner work to support this culture change.
I draw on inhabited institutions theory and the STS concept ‘configuring the user’ to examine the conceptions of culture and work that are built into healthcare systems during the design phase. The goal of the analysis is to examine the status of the social in socio-technical imaginaries of the LHS as conveyed by planning documents, reports, and accounts of system change. In so doing, I will also advance a methodological point about how LHSs should be studied by systems researchers.

Author

• Alexandra Vinson, University of Michigan