ArticleCurrent oncology (Toronto, Ont.)2018
Regional process redesign of lung cancer care: a learning health system pilot project.
Article in Current oncology (Toronto, Ont.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Building a learning health care community in rural and remote areas: a systematic review.BMC health services research · 2024Pooled it
- Implementation strategies and outcome measures for advancing learning health systems: a mixed methods systematic review.Health research policy and systems · 2023Pooled it
- Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review.BMC health services research · 2022Pooled it
- Learning health systems using data to drive healthcare improvement and impact: a systematic review.BMC health services research · 2021Pooled it
- Evaluating health organization readiness for implementing a learning health system: a scoping review.Health research policy and systems · 2025Article
- Leveraging intermediaries' skillsets to build implementation research and practice infrastructure: a qualitative case study.Implementation science communications · 2025Article
- Learning Care Pathways Framework: A New Method to Implement, Learn, Replicate, and Scale up Care Pathways for and With the Patient.International journal of health policy and management · 2025Article
- Digital Information Ecosystems in Modern Care Coordination and Patient Care Pathways and the Challenges and Opportunities for AI Solutions.Journal of medical Internet research · 2024Article
- The California collaborative network to promote data driven care and improve outcomes in early psychosis (EPI-CAL) project: rationale, background, design and methodology.BMC psychiatry · 2024Article
- Diversity in Combating Complex, Chronic, and Costly Conditions Using a Learning Health System Approach: A Scoping Review.The Permanente journal · 2024Article
- Tools and frameworks for evaluating the implementation of learning health systems: a scoping review.Health research policy and systems · 2024Article
- How to use communities of practice to support change in learning health systems: A landscape of roles and guidance for management.Learning health systems · 2024Article
- Implementation and evaluation of a national quality improvement initiative in cancer surgery.BMJ open quality · 2024Article
- Understanding needs and expectations to start effective communities of practice.BMC health services research · 2023Article
- Exploring the impact of evaluation on learning and health innovation sustainability: protocol for a realist synthesis.Systematic reviews · 2023Article
- Review
- Exploring Patient Journey Mapping and the Learning Health System: Scoping Review.JMIR human factors · 2023Article
- Optimization of Care Pathways Through Technological, Clinical, Organizational and Social Innovations: A Qualitative Study.Health services insights · 2023Article
- Cancer Clinic Redesign: Opportunities for Resource Optimization.Current oncology (Toronto, Ont.) · 2022Article
- Benefits and limitations of business process model notation in modelling patient healthcare trajectory: a scoping review protocol.BMJ open · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Ottawa Hospital (toh) defined delay to timely lung cancer care as a system design problem. Recognizing the patient need for an integrated journey and the need for dynamic alignment of providers, toh used a learning health system (lhs) vision to redesign regional diagnostic processes. A lhs is driven by feedback utilizing operational and clinical information to drive system optimization and innovation. An essential component of a lhs is a collaborative platform that provides connectivity across silos, organizations, and professions.
methodsTo operationalize a lhs, we developed the Ottawa Health Transformation Model (ohtm) as a consensus approach that addresses process barriers, resistance to change, and conflicting priorities. A regional Community of Practice (cop) was established to engage stakeholders, and a dedicated transformation team supported process improvements and implementation.
resultsThe project operationalized the lung cancer diagnostic pathway and optimized patient flow from referral to initiation of treatment. Twelve major processes in referral, review, diagnostics, assessment, triage, and consult were redesigned. The Ottawa Hospital now provides a diagnosis to 80% of referrals within the provincial target of 28 days. The median patient journey from referral to initial treatment decreased by 48% from 92 to 47 days.
conclusionsThe initiative optimized regional integration from referral to initial treatment. Use of a lhs lens enabled the creation of a system that is standardized to best practice and open to ongoing innovation. Continued transformation initiatives across the continuum of care are needed to incorporate best practice and optimize delivery systems for regional populations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.