Utilizing the learning health system approach for prevention and control of cardiovascular disease in primary care: An initiative from Thailand

The burden of noncommunicable diseases (NCDs), including cardiovascular disease (CVD), is rapidly increasing in Thailand; 74% of deaths are caused by NCDs. Healthcare systems are required to adapt to respond to this disease shift, particularly in primary care, where most NCDs are managed. The concept of learning health systems (LHS) is one approach to driving quality improvement (QI) in NCD management and control. Championed by the World Health Organization, the LHS approach supports dynamic learning being embedded into routine clinical care. One example of an LHS study aims to trial and evaluate the LHS approach for the management of hypertension, diabetes mellitus, and chronic kidney disease in primary care in Chiang Mai and Lamphun provinces (Reg No: NCT06873243). Electronic health record (EHR) data will be used in digital software to help primary care staff prioritise patients for CVD management. Staff will receive support and training from facilitators, staff experienced in the use of EHRs to drive QI. Eventually, peer learning networks will be developed for continued learning across primary care units. There are challenges and opportunities associated with this approach. Although it can offer solutions developed from existing resources, existing challenges in providing care may be exacerbated if the LHS is not supported properly. The future of using the LHS approach for the control of CVD in primary care will require transparent knowledge exchange, an open approach to sharing challenges, and continued feedback cycles to embed iterative learning in routine care.