Evidence map›Paper›PMID 40999263›Full record

ArticleJournal of general internal medicine2026

Leading Learning Health Systems: Strategies Used to Establish and Conduct a Learning Health System.

Dawn M Bravata, Cathy C Schubert, Amy M Kilbourne, Scotte R Hartronft, Ashley L Schwartzkopf, Jennifer L Myers, Mindy E Flanagan, Claire E Donnelly, Stanley E Taylor, Mathew J Reeves and 10 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Dawn M BravataDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA. Dawn.Bravata2@va.gov.ORCID http://orcid.org/0000-0002-3048-2536
Cathy C SchubertDivision of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Amy M KilbourneOffice of Research and Development, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, DC, USA.
Scotte R HartronftDepartment of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
Ashley L SchwartzkopfDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Jennifer L MyersDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Mindy E FlanaganDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Claire E DonnellyDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Stanley E TaylorDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Mathew J ReevesDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Anthony J PerkinsDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Laura E MyersDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Indrakshi RoyDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Robert E BurkeVA HSR Center for Healthcare Evaluation, Research, and Promotion (CHERP), Crescenz VA Medical Center, Philadelphia, PA, USA.
Rachael A BeardOffice of Nursing Services, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, DC, USA.
Marcos MontagniniVA Geriatric Research Education and Clinical Center (GRECC), Ann Arbor, MI, USA.
Shivani K JindalOffice of Geriatrics & Extended Care, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, DC, USA.
Greg ArlingDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Caroline MadrigalDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.
Nicholas A RattrayDepartment of Veterans Affairs (VA) Health Systems Research (HSR) Expanding Expertise Through E-Health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLearning health systems (LHS) improve patient and provider experiences, population health, and health system performance. LHS leaders develop LHS' social and scientific infrastructures and align the LHS with host organization's priorities. Although researchers have examined data infrastructure and Learning Community configurations, few studies have evaluated discrete strategies leaders deploy to construct a LHS.

objectivesWe described methods used to establish the Department of Veterans Affairs (VA) Geriatric LHS (GLHS) supporting older Veterans transitioning from hospital to home and examined strategies GLHS leaders used to conduct LHS activities.

designQualitative methods were employed to review notes from all meetings and post-meeting debriefs from encounters with operational partners, Learning Community members, and Quantitative and Qualitative Data Core subcommittees. Member checking with Learning Community and Data Core representatives led to iterative refinement of findings. A seven-question survey examined Learning Community member satisfaction with the GLHS.

resultsTen of 16 Learning Community members (62.5%) completed surveys, indicating that the GLHS met Learning Community members' needs. The four key GLHS structural elements were (1) the imperative of maintaining an Idea Repository, (2) the value of notetaking and formal debriefs, (3) the cadence of meetings, and (4) the role of the newsletter to promote engagement. Five themes described core activities/perspectives GLHS operational leaders used: (1) listening to the Learning Community; (2) modifying analyses in response to Learning Community input; (3) including diverse perspectives; (4) managing organizational complexity; and (5) serving the healthcare system.

conclusionsThe GLHS illustrates the importance of active listening, collaborative engagement, and responsive adaptation to advance LHS objectives. LHS leadership strategies such as an Idea Repository and iterative feedback mechanisms fostered stakeholder participation and informed data-driven improvements.

Indexed as

LeadershipLearning Health SystemUnited States Department of Veterans AffairsHumansUnited StatesCommunities of practiceImplementation scienceLearning Health SystemsQuality improvementTranslational science

Identifiers

What OpenQuestion holds

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Registered trials

None linked

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.