2018 | The System Awakens

Building Learning Health Systems in Canada

30th Annual Health Policy Conference | March 8-9, 2018

CHSPR’s 30th annual health policy conference, March 8-9, 2018, at the Pinnacle Hotel Vancouver Harbourfront, addressed the question of how BC can become a learning health system. In a learning health system, every patient interaction is treated as a learning activity, and the ethos of the system overall is improvement. Speakers shared the latest thinking on learning health systems and facilitated conversations on how BC can adopt the principles and actions that define such systems.

The key objective of the conference was to bring together researchers, policy-makers, decision-makers, clinicians, students, patient partners, and interested public who would be involved in creating, implementing, and being part of a learning health system. Speakers included Charles Friedman of the University of Michigan, an international leader in learning health systems and our opening keynote; Nancy Kass, a Johns Hopkins bioethicist who has written extensively about learning health systems; Lucy Savitz of Kaiser Permanente as our closing keynote; and Jean-François Ethier (Université de Sherbrooke), David Ford (College of Medicine in Swansea University, Wales), and Walter Wodchis (University of Toronto) as a panel showcasing learning health system exemplars from outside of BC from which we can learn.

The program also featured panels taking inventory of nascent learning health systems (and precursors) in BC, and anticipating issues in transforming to learning health systems, such as ethical concerns, policy barriers, informatics challenges, and gaps in leadership. Immediately post-conference, meetings of collaborative groups seeded with conference speakers were organized, intended to help create concrete action plans for moving learning health system ideas into practice in BC. We expect that many conference delegates will bring ideas back to their organizations and act as learning health system ‘champions’ to facilitate transformation in BC.


Download a pdf version of the full program

Pre-conference: Wednesday, March 7

10:00 am | Pre-conference workshop: Using an Upstream Approach to Frailty in Seniors
This workshop was designed to enhance understanding of frailty and the importance of collecting data on frailty, and identify next steps for research and quality improvement. Participants learned how artificial intelligence methods (e.g. machine learning) can be used to identify frailty from electronic medical records; and examined tools for assessing older adults’ frailty, how these assessments can fit into clinic flow, and how assessment findings can be used to connect frail older adults to appropriate community resources using a team-based care approach, showcasing work undertaken by Fraser Health Authority through the CARES (Community Actions and Resources Empowering Seniors) initiative.

Day 1: Thursday, March 8

8:45 am | Welcome remarks

Speaker: Heather Davidson, BC Ministry of Health
Speaker: Sabrina Wong, CHSPR
Indigenous welcome and blessing: Coast Salish Elder Roberta Price, Snuneymuxw and Cowichan First Nations
Speaker: Kim McGrail, Conference co-chair, CHSPR

9:20 am | Opening keynote | Envisioning the learning health system

What defines learning health systems, and what benefits can they offer?
Chair: Kim McGrail, CHSPR
Speaker: Charles Friedman, University of Michigan Medical School [Slides]

10:45 am | Panel I | A New Hope: Building blocks for a BC learning health system

Where are existing learning health systems or components of such systems in BC? How can we build on these and other successes?
Chair: Robyn Tamblyn, Institute of Health Services and Policy Research
Speaker: Jim Christenson, BC Emergency Medicine Network [Slides]
Speaker: Doris Barwich, BC Centre for Palliative Care [Slides]
Speaker: Lillian Parsons, Providence Health Care [Slides]

11:30 am | Breakout | Clones and Fractals: Your turn to identify other building blocks

Tables will work individually and together to identify examples of precursors and starting points for our own learning health system, to enrich our understanding of where we are in BC and the rest of the Canada about what we have and what we still need in order to move forward. There will be a facilitator at each table.

12:00 pm | Return of the Jedi: Q&A with morning speakers

What have we heard? Where are we now?

1:30 pm | Concurrent sessions

Session I: Conceptual frameworks for learning health systems
Session II: The learning cycle
Session III: Community and culture in learning health systems

3:00 pm | Panel II | Galaxies not so far, far away: Perspectives from outside BC

Where are existing learning health systems or components of those systems outside BC? What have they achieved?
What can they teach us about the best approach in BC?

Chair: Zena Sharman, Michael Smith Foundation for Health Research
Speaker: David Ford, Swansea University, Wales [Slides]
Speaker: Walter Wodchis, University of Toronto [Slides]
Speaker: Jean-François Ethier, Université de Sherbrooke [Slides]

4:30 pm | Questions to ponder

Speaker: Steven Lewis, Access Consulting
Speaker: Kim McGrail, CHSPR

4:45 pm | Interactive poster session and reception

Day 2: Friday, March 9

8:45 am | Welcome and reflections on Day 1

Speakers: Tom Noseworthy, Steven Lewis and friends

9:20 am | Keynote | Advice from the Jedi: Ethical considerations in blurring the lines between research and practice

How do we accelerate learning without causing harm?
Chair: Charlyn Black, CHSPR
Speaker: Nancy Kass, Johns Hopkins University [Slides]

10:45 am | Keynote | May the force be with you: What do we need to change to awaken the system?

What are the keys to change at the individual, practice, and system levels? How do we make the changes needed?
Chair: Marc Pelletier, Institute for Health Systems Transformation and Sustainability
Speaker: Lucy Savitz, Kaiser Permanente Center for Health Research [Slides]

11:25 am | Awakening the system: What have we learned?

Final Q&A with speakers and respondents

12:00 pm | Closing remarks

Speaker: Steven Lewis, Access Consulting
Speaker: Kim McGrail, CHSPR

12:30 pm | Invited post-conference session: Putting learning health system ideas into practice in BC

This three-hour facilitated session provided a chance for participants to work together to start applying what was learned during the conference in BC.

1:00 pm | Post-conference workshop: The Evolving Ethics of Research with Indigenous People in Canada
This workshop took a case-study approach to learning how research in partnership with Indigenous communities can be done in a meaningful and ethical way.