Replicability in the Learning Health System Knowledge Ecosystem
Learning Health Systems (LHS) embed knowledge generation processes for uninterrupted self-study so they can adapt and innovate. LHS use public knowledge from published literature to monitor the general state of the science for a given topic. The public knowledge is augmented by private knowledge gained from LHS analysis of internal medical and administrative data for internal decision-making regarding care improvements. Ideally, this private knowledge becomes public through later publications, which are then incorporated into the larger knowledge ecosystem and updated state of the science. Practically, the LHS internal analyses are rarely subjected to replication, and the publications are often crafted to serve communications purposes rather than science goals of developing public knowledge. Further, LHS care improvements and innovations are often complex interventions on complex systems, and complexity is itself a difficulty to overcome in replication. This session will examine replication issues across the LHS cycle, and their implications for grading strength of evidence.
Dr. Butler trained in health services research, with special emphasis on outcomes research and health behaviors in alternative medicine. Her areas of interest include scientific evidence standards, research design and systematic review methodology, evidence-based or evidence-informed healthcare, and complexity science in health and healthcare. Dr. Butler is PI and Co-Director of the AHRQ-funded Minnesota Evidence-based Practice Center (EPC) and has led or overseen evidence synthesis projects on a wide range of topics, specializing in complex patients and complex interventions. Prior to her academic career, Dr. Butler worked as an investment professional for a financial services firm, managing a $45 million portfolio. She brought to the University corporate experience managing multiple organizationally diverse collaborative teams tasked to meet financial and investment objectives, and created portfolio benchmarks to track performance.