A ‘learning system’ in behavioral health can help in sharing best practices, innovations
While the U.S. healthcare system’s embrace of different health information technologies is still a work in progress, new models of capturing and sharing health data have already begun to transform the way healthcare providers practice medicine in this country.
One such initiative is the so-called “learning” healthcare system, a symbiotic relationship, in which practice informs research and research informs practice.
Historically, the conversation about learning healthcare systems has mainly been focused on the realm of physical healthcare. But the same budding promise of a learning healthcare system exists in behavioral health, and the tools necessary to make it happen are increasingly available.
Better capturing and sharing of the vast amounts of health data generated each year through behavioral health research and clinical practice can lead to the creation of a behavioral healthcare system that continuously improves—or, in other words, that “learns” from both its successes and failures—and that is able to harness technologies to improve care in ways never before possible.
When providers use new electronic technologies to log observations, treatment decisions or lessons learned from routine clinical care, at the same time they can be adding to and improving the knowledge base. Likewise, providers can now have immediate access to the knowledge base—made more robust by their own clinical contributions in real time—while they are caring for patients.
The thinking behind this concept (first called for in a 2012 Institute of Medicine report) was that leveraging technological advances to make better use of the best available data would help rein in costs and improve both quality and safety. This makes sense whether the healthcare being delivered is physical or behavioral.
Imagine a behavioral healthcare system in which every patient’s experience can contribute to the overall knowledge of how best to treat behavioral health disorders; in which local innovations are documented and shared; and in which evidence gathered from both practice and research will continually improve the understanding of the pros and cons of different approaches to diagnosing, treating and preventing behavioral health problems.
Imagine a behavioral healthcare system in which providers can at once contribute to the evidence base and benefit from it at the point of care. This is the potential of a learning behavioral healthcare system.
A transformation to such a system is within reach. A road map exists for how to proceed, and the technolo- gies needed to improve care are increasingly accessible. Federal health reforms, such as the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, have paved the way for the delivery of behavioral health services on par with general medical services. And the 21st Century Cures Act, enacted late last year, also includes several provisions that hold promise to advance learning in behavioral health.
Building a learning behavioral health system will require the buyin of researchers, providers and health systems. A successful transformation will depend on a number of critical next steps: building consensus around common metrics for high-quality care, relevant outcomes and contextual factors; fostering partnerships between researchers, providers and clinical and community settings; creating a “data commons” to pool information; and designing and evaluating decision-support tools that allow for real-time feedback.
Expanding the discussion to focus on behavioral, as well as physical, healthcare is a worthy goal—one that has the potential to enhance the delivery of behavioral health, and ultimately improve outcomes for millions of Americans.
Bradley D. Stein is a senior natural scientist at the not-for-profit, nonpartisan RAND Corp. and an adjunct associate professor of psychiatry at the University of Pittsburgh.