Moving from crisis response to a learning health system: Experiences from an Australian regional primary care network.

Introduction: The COVID-19 pandemic challenged primary care to rapidly innovate. In response, the Western Victorian Primary Health Network (WVPHN) developed a COVID-19 online Community of Practice comprising general practitioners (GPs), practice nurses, pharmacists, aged care and disability workers, health administrators, public health experts, medical specialists, and consumers. This Experience Report describes our progress toward a durable organizational learning health system (LHS) model through the COVID-19 pandemic crisis and beyond. Methods: In March 2020, we commenced weekly Community of Practice sessions, adopting the Project ECHO (Extension of Community Health Outcomes) model for a virtual information-sharing network that aims to bring clinicians together to develop collective knowledge. Our work was underpinned by the LHS framework proposed by Menear et al. and aligned with Kotter's eight-step change model. Results: There were four key phases in the development of our LHS: build a Community of Practice; facilitate iterative change; develop supportive organizational infrastructure; and establish a sustainable, ongoing LHS. In total, the Community of Practice supported 83 unique COVID-19 ECHO sessions involving 3192 h of clinician participation and over 10 000 h of organizational commitment. Six larger sessions were run between March 2020 and September 2022 with 3192 attendances. New models of care and care pathways were codeveloped in sessions and network leaders contributed to the development of guidelines and policy advice. These innovations enabled WVPHN to lead the Australian state of Victoria on rates of COVID vaccine uptake and GP antiviral prescribing. Conclusion: The COVID-19 pandemic created a sense of urgency that helped stimulate a regional primary care-based Community of Practice and LHS. A robust theoretical framework and established change management theory supported the purposeful implementation of our LHS. Reflection on challenges and successes may provide insights to support the implementation of LHS models in other primary care settings.