ISQua's 39th International Conference 2023

Learning health systems in primary care: Identifying barriers and enablers to implementation and evaluation

Background

•Learning health systems (LHSs) have been gaining traction over the past decade.

•Primary care, including general practice, is a common first point of contact with the healthcare system and is thus an opportune setting to develop a LHS.

•While many existing LHSs have been described in the literature, few have a focus on primary care1-2.

•Previously, we identified the elements of the LHS that were realised within a university-based general practice2. Here, we build on that study and identify key barriers and enablers to successful implementation and evaluation of an LHS in this primary care setting.

Methods

•Study co-designed with administrative and clinical staff at the MQ Health General Practice, and researchers at the Australian Institute of Health Innovation.

•MQ Health General Practice operates across two sites and is a department of MQ Health, a university-owned not-for-profit health enterprise.

•Interviews (n=32) conducted with practice staff, including clinical and administrative staff.

•Interviews transcribed and thematically analysed using a framework approach to identify barriers and enablers to implementation of an LHS.

•Data coding according to the Theoretical Domains Framework (TDF), and then the adapted IoM LHS framework (Table 1) to describe barriers and enablers to practice alignment with specific elements of the LHS.

Results

A total of 32 out of 35 (91%) practice staff were interviewed, comprising general practitioners, practice nurses, administrative staff, and a psychologist. Participants reported that the practice alignment with LHS principles was influenced by many behavioural determinants, some applicable to healthcare in general, but many specific to the general practice environment.

Conclusion

Although the idea of an LHS has been gaining traction in recent years, challenges remain for its implementation and evaluation. This study presents key barriers and enablers to initiating and sustaining LHS concepts in primary care, that can be applied to future, successful primary care LHSs.

ISQua's 39th International Conference 2023

LEARNING HEALTH SYSTEMS IN PRIMARY CARE: IDENTIFYING BARRIERS AND ENABLERS TO IMPLEMENTATION AND EVALUATION

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