Learning Health Care System

An overarching theme for Wake Forest Baptist Medical Center’s strategic plan is the goal of becoming a continuously learning health care system (Institute of Medicine Roundtable on Evidence-Based Medicine, 2007). Fundamental to this vision is recognizing that faculty and health care providers, staff, residents, fellows and students, as well as our patients and families serve as both learners and educators. 
A learning health care system generates discoveries and creates partnerships with patients, providers, and communities that apply evidence-based innovations to improve health, patient care, health care education, quality, safety, experience and value. Such approaches drive continuous improvement by translating what we learn into what we do. 

Six Focus Areas

Central to this goal is the identification of a strategic plan for research that takes advantages of our strengths while also addressing health issues of major importance to our community, nation, and Medical Center. To this end, we have highlighted six research areas in order to focus our efforts and thereby provide successful environments for research and discovery.  
These focus areas were identified because they represent an intersection of significant institutional strength with major regional and national public health issues. The focus areas also reflect domains wherein health care expenditures are increasing rapidly and, therefore, where savings generated by research on better prevention and treatment strategies could have substantial positive impact on the financial health of the Medical Center. 
The same areas are potential targets for “destination” clinical programs that could attract new patients while at the same time fueling new research into better healthcare delivery. Significant strengths exist in both faculty and programs which, with further investment, can optimize the impact on discovery.   Finally, there is potential to synergize across scientific areas, leading to novel insights (e.g., shared risk factors for diabetes, cancer, and Alzheimer’s Disease). 

The six areas of focus are the following: 

  1. Cancer      
    • Lung cancer
    • Precision oncology
    • Tobacco control
  2. Neurosciences/Brain
    • Substance abuse and addiction
    •  Pain
  3. Regenerative Medicine
    • Micro-nano fabrication
    • Body on a chip
    • In situ regeneration
    • Manufacturing innovation
  4. Aging/Alzheimer’s Disease
    • Healthy aging
    • Effect of brain aging on peripheral metabolism and physical function
    • Role of energy metabolism in the pathogenesis of Alzheimer’s disease and dementia
  5. Diabetes/Obesity/Metabolism
    • Translational programs in the precision medicine of diabetes and obesity
    • Brain and metabolism
    • Diabetes and heart disease
  6. Cardiovascular Disease
    • Cardiovascular disease prevention
    • Prediction and prevention of heart failure  

Three Primary Activities and Services

Supporting these scientific focus areas are three primary activities and services that function to maximize the impact of our research, and particularly in our efforts to become a continuously learning health care system. These activities and services include Implementation Science; Clinical Informatics; and Population Health. 

The integration of our research findings into clinical practice will occur through approaches developed by our implementation science team. We will maximize the use of our clinical data for the purpose of research and education, with a goal of improving population health. Approaches will include risk stratification, quality improvement programs and comparative effectiveness research. Continual investments in these areas are necessary to realize the goals and thereby maximize our impact on healthcare. 

Business of Improving Health

As a learning healthcare system, we have the unique opportunity of translating the knowledge that we gain in our research environment into our business of improving health. This is the value that an academic medical center brings to its community, and broadly to the region and nation. 
Health care systems are increasingly operating in an environment that demands continuous improvement in quality and outcomes, with fewer resources. It is here that research and discovery can positively impact the financial health of the clinical enterprise, as well as the health of the community.