A Learning Behavioral Health Care System

Opportunities to Enhance Research

Published in: Psychiatric Services, 2016

Posted on RAND.org on May 09, 2016

by Bradley D. Stein, Alyce S. Adams, David A. Chambers

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This article was published outside of RAND. The full text of the article can be found at the link above.

Research Questions

  1. How can a learning behavioral health system help address service delivery challenges?
  2. What are the opportunities and challenges in establishing such a system?

Sweeping changes in health care financing combined with the increased use of technology across health care systems are making it possible to address long-standing challenges to the behavioral health services delivery system. This Open Forum outlines opportunities and challenges facing health services researchers in this rapidly changing landscape. Inspired by a 2012 report by the Institute of Medicine, the authors discuss innovative research endeavors, promising study designs, and challenges involved in integrating high-impact behavioral health services research within a learning behavioral health care framework. The Open Forum concludes with a discussion of the critical next steps in this process: building consensus around common metrics for high-quality care, relevant outcomes, and contextual factors; connecting researchers to community and clinical settings; creating a data commons to pool information across sites; and designing and evaluating evidence-based decision support tools to drive improved care and outcomes.

Key Findings

  • Advances in technology and changes to the organization, delivery, and financing of health care could present opportunities to improve behavioral health care.
  • A learning health system would use technologies that can collect and help clinicians interpret data and embedded tools to support patient management.
  • Both care experiences and research studies would feed into a continuously updated system to help clinicians understand the utility of different approaches to diagnosis, treatment, and prevention.
  • Researchers, providers, patients, and health system leaders would need to collaborate on the design, development, and appraisal of a learning health system to ensure cross-system comparisons and relevance to population segments.
  • Goals and priorities of researchers and clinicians can create tension between the desire for rigorous methods versus the urgent need for real-world solutions.
  • Tools that support clinical decisionmaking can help improve care by translating research findings into clinical information.

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