1. Operationalizing the Learning Health System in an Integrated Delivery System Wayne Psek MBChB, MBA, PhD AcademyHealth Delivery System Science Fellow Geisinger Health System EDM Forum 4th Annual Stakeholder Symposium San Diego, CA 7th June 2014

2. Acknowledgements | 2 Geisinger Learning Health System Committee: Jonathan Darer MD, MPH; Becky Stametz, Ded, MPH; Lisa Bailey-Davis Ded, RD; F. Daniel Davis PhD; Dorothy Sellers; Deb Henninger ; Cathy Betz; W. Andy Faucett MS,CGC; Gloria Gerrity MBA Earl Steinberg MD, MPP – EVP Innovation & Dissemination GHS AcademyHealth - Delivery System Science Fellowship

3. Introduction Geisinger Health System: Not-for-profit integrated health care delivery system Approx. 20,000 employees EMR since 1996 Health Plan Rural Teaching programs | 3 | 3 | 3

4. | 4 | 4 Geisinger Learning Health Care System Project Purpose of the project: 1.Develop a strategic plan for system-wide LHS 2.Operationalize the plan 3.Develop funding sources for LHS transformation Rationale: Strategic focus on value-based care | 4

5. | 5 | 5 Geisinger Learning Health Care System Project Committee: Chief Innovation Officer Physicians VP Operations Research Bioethics and Research Oversight Quality and Safety Who else? | 5

6. Key Issues Resources, infrastructure and organization Patient and community engagement Ethics and oversight of clinical activity, research and QI | 6

7. Geisinger Learning Health Care System Framework | 7 Evaluation & Methodology Prioritization Ethics & Oversight Data & Analytics People & Partnerships Funding Strategies Organization Deliverables Patient & Family Engagement

8. Lessons Learned Realistic assessment of : Capacity and capabilities Data and analytic infrastructure Setting expectations Alignment of goals and resources Patient engagement requires multi-level strategy | 8

9. Challenges Cultural differences Leadership support (Low tolerance for BWF) Integrating medical education Funding infrastructure Ethical oversight of learning activities Appropriate involvement of patients | 9

10. Next Steps Ongoing, long-term project Leadership support Expand committee representation Socializing the organization Secure funding | 10

11. Thank you Questions Comments | 11 Contact Information: Telephone: 570-214-5259 E-mail: wpsek@geisinger.edu