Overview:

Dr. A. John Rush and Dr. Tony Tramontin have co-authored a peer-reviewed editorial in The Journal of Clinical Psychiatry entitled “Learning by doing: Can our collective experiences as clinicians improve mental health care?” In this editorial, Dr. Rush and Dr. Tramontin explore the challenges that impede the development of a “learning health system” for mental health care, where outcomes are systematically obtained, compiled, and analyzed to inform and revise clinical and administrative decisions. These challenges are represented by three key gaps, consisting of a gap in information (data collection), a gap in knowledge (evidence), and a gap in learning. Dr. Rush and Tramontin also examine how these gaps could be bridged, through technology such as natural language processing, expert consensus, and collective action. Evidence-based care begins with access to aggregated and analyzable data that is representative of real-world settings and rich with outcome measures. Real-world data, or data derived from sources such as electronic health records or administrative claims, equips providers to better assess treatment effectiveness, care patterns and gaps, and disorder progression. “Without outcomes, the collective learning potential from clinician’s day-to-day experiences remains unrealized,” says Dr. Rush and Dr. Tramontin. “We need real-world evidence to address questions that trial data do not.”

‍

Executive Summary:

Currently, stakeholders in the delivery of mental health care including clinicians, program heads, administrators, and payors often make clinical and programmatic decisions that are based on day-to-day interactions with patients or published studies of patients who do not align with patients seen in real-world clinical practice. In this editorial, Dr. Rush and Dr. Tramontin discuss how evidence-based decision making by these stakeholders can help to develop a “learning health care system” in the field of mental health care. They identify and discuss three critical gaps related to data collection, evidence generation, and learning that impose challenges to building learning healthcare systems and propose ways in which these gaps can be bridged to facilitate stronger evidence-based decision making.

‍

To read the full editorial, visit the journal online.