Core Skills Specified for “Embedded” Health Systems Researchers

Researchers who work in what’s called a “learning health system” such as Children’s Hospital of Philadelphia (CHOP) may have a special relationship to their investigation — not just adding to the sum of human knowledge, but applying that new knowledge to patients at the point of care. At the same time, under this research model, patients are more than research subjects; they’re active participants in helping design a study to address questions that are meaningful to them.

“The fact that a researcher is embedded in a health organization can make this type of health systems research distinctive,” says CHOP pediatrician Christopher Forrest, MD, PhD, who recently co-authored a study in Health Services Research that described core competencies for learning health systems (LHS) researchers. Forrest’s co-authors were from the study’s sponsors, the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services.

The end goal of this research, added Forrest, is to increase a health system’s capacity to improve patient outcomes, while making the system’s operations more efficient and less costly. Being embedded in the health system, he stressed, means the researcher is involved in real-world experience of day-to-day healthcare. Researchers are also involved in implementing new findings at the point of care, unlike other researchers whose findings may take 10 or 15 years to disseminate into practice.

Another key element, said Forrest, is that LHS researchers engage with stakeholders — patients, clinicians and hospital officials — “to produce novel insights and evidence” to be implemented.

The current study identified 33 core competencies for LHS researchers, within seven domains of expertise to be developed into training programs. The competencies include skills in systems science, statistics, epidemiology, study design, informatics, and ethical and legal considerations. One domain focuses on how to best implement findings into routine practice.

The current study, added Forrest, dovetails with his involvement in PEDSnet, the national clinical research network of eight children’s hospitals (including CHOP), which is funded by many sponsors, including the Patient-Centered Outcomes Research Institute (PCORI). As principal investigator of PEDSnet, Forrest directs a program that combines “big data” with family engagement — partnering with parents in research design to address concerns that are important to families.

Forrest et al, “Development of the Learning Health System Researcher Core Competencies,” Health Services Research, online Aug. 4, 2017.