Table 1.

Essential Characteristics of a Learning Public Health System (LPHS)

Science and Informatics	Essential Characteristics of Learning Public Health System	Data Sources and Measures
In-time access to knowledge	The LPHS reliably captures and delivers the best available evidence to guide and support decision-making to improve population health through assessment, policy development, and assurance.	American Community Survey provides social, economic, and housing characteristics data on the population annually; 10 states have systems for merging claims data from all health insurers to monitor cost and use of services. PHA relevant including measures include use of preventive services, continuity of medication treatment for chronic conditions, and rates of preventable hospitalizations.
Digital capture of data	The capture of data on population health indicators and the changing characteristics of communities and contextual changes provide the basis for in-time generation and application of knowledge.	Health Information Exchanges can access electronic health record data and have the potential to aggregate key indicators of health-illness in populations and to identify trends.
Community-PHA Relationships
Engaged and empowered communities	The LPHS is anchored on community needs and promotes community inclusion as members of the LPHS team.	Assess community health needs through surveys, analysis of health and health services data, and document disparities and high need groups.
Incentives
Incentives aligned for value	Incentives structured to encourage continuous improvement, minimize waste, and promote value (ratio of population health improvement divided by cost).	Collect data on incentives, changes in incentives and individuals/groups targeted for incentives. Examine the relationship of incentives to disparities, use of services, and health status indicators.
Full transparency	The LPHS monitors context, community characteristics, quality processes, cost, and population health outcomes and makes information available to communities, policymakers and PHA staff.	Identify the range of methods used to share information with communities, policymakers, and PHA staff and assess their effectiveness.
Culture
Leadership instilled culture of learning	“Leadership commitment to a culture of teamwork, collaboration, and adaptability in support of continuously learning as a core aim.”3	Survey PHA leadership and staff to assess organizational culture including teamwork, collaboration, and adaptability.
Supportive system competencies	“Complex community intervention operations and support processes are “constantly being refined through team training and skill building, systems analysis and information development, and creation of the feedback loops for continuous learning and system improvement.”4	LPHS constantly refines its data sources and analyses of community needs and services provided by the PHA; measures quality, efficiency, and population outcomes; and provides feedback to communities, policymakers and PHA staff.