ArticleBMC primary care2023
The journey to a learning health system in primary care: a qualitative case study utilising an embedded research approach.
Article in BMC primary care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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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.
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Who cites it
13 citing papers in PubMed.
- Learning Health System Implementation: Building a Hub-and-Spoke Model for Hypertension Management Through the QI Hub.Journal of general internal medicine · 2026Article
- Article
- Clinical quality registries: Establishing the socio-technical infrastructure for learning health systems.Learning health systems · 2025Article
- Bridging research and practice in a learning health system: Developing and refining an embedded scholars program through insights from scholars and clinical mentors.Learning health systems · 2025Article
- Organizational characteristics associated with sustained participation in internal quality improvement: Findings from two waves of a national sample of physician practices in the United States.Social science & medicine (1982) · 2025Article
- Evaluation of an Interdisciplinary Educational Program to Foster Learning Health Systems: Education Evaluation.JMIR medical education · 2025Article
- The embedded research model: an answer to the research and evaluation needs of community service organizations?Health research policy and systems · 2024Article
- The Nursing Theory of Complex Adaptive Systems: A New Paradigm for Nursing.Healthcare (Basel, Switzerland) · 2024Article
- Learning health systems on the front lines to strengthen care against future pandemics and climate change: a rapid review.BMC health services research · 2024Review
- Barriers and facilitators to learning health systems in primary care: a framework analysis.BMJ health & care informatics · 2024Article
- Learning together for better health using an evidence-based Learning Health System framework: a case study in stroke.BMC medicine · 2024Article
- Data to knowledge to improvement: creating the learning health system.BMJ (Clinical research ed.) · 2024Article
- High-performing primary care: reinvigorating general practice as a learning health system.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundHealthcare systems may be resilient and adaptive, but they are not fit for purpose in their current state. Increasing threats to health system sustainability have underscored the need to move towards a learning health system in which research and data are used routinely in clinical practice to facilitate system improvement. This study aimed to establish which elements of the learning health system were being realised within a university-based general practice and determine acceptability from staff to embrace further the transition towards a learning health system.
methodsSemi-structured interviews were conducted with practice staff, including clinical and administrative staff, to determine the current state of the learning health system in the practice. An embedded researcher was placed within the general practice on a part-time basis to investigate the learning health system model. Interviews were transcribed and thematically analysed based on the National Academy of Medicine's framework of learning health systems.
resultsIn total, 32 (91%) practice staff were interviewed, comprising general practitioners (n = 15), nurses (n = 3), administrative staff (n = 13), and a psychologist (n = 1). Participants indicated that the practice was operating with several characteristics of a learning health system (e.g., emphasising science and informatics; focusing on patient-clinician partnerships; applying incentives; supporting a continuous learning culture; and establishing structures and governance for learning). These measures were supported by the university-based setting, and resultant culture of learning. Nevertheless, there were areas of the practice where the learning health system could be strengthened, specifically relating to the use of patient data and informatics. Staff generally expressed willingness to engage with the process of strengthening the learning health system within their practice.
conclusionAlthough the idea of a learning health system has been gaining traction in recent years, there are comparatively few empirical studies presented in the literature. This research presents a case study of a general practice that is operating as a learning health system and highlights the utility of using the learning health system framework.
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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.