Columbia-Cornell-Einstein EQUIP+ Center for Learning Health System Science

With persistent healthcare disparities experienced by US minority groups, there is an urgent need to prioritize health equity and reorient healthcare systems around this issue. This is especially apparent in quality and safety, an area of national attention for over two decades, yet progress has been limited. In response, quality experts, including AHRQ, urge healthcare systems to embed equity into all quality and safety efforts, ensure resources and infrastructure, engage patients and communities as partners, expand diversity in the workforce, and equip quality and safety leaders within healthcare systems to reduce health disparities. Our proposal is directly responsive to this call to action, as the Columbia-Cornell-Einstein EQUIP+ Center for Learning Health System (LHS) Science is laser focused on the intersection of health equity and quality through a comprehensive embedded LHS Scientist training and research program. Our purpose is to address Equity and Health Disparities, and Quality and Safety, through utilization of Implementation Science and Informatics approaches to conduct Patient-Centered Outcomes Research (PCOR) and Comparative Effectiveness Research (CER). The EQUIP+ Center in New York City, a novel LHS training and research program, is a collaboration of 3 world-class academic institutions, Columbia University, Weill Cornell Medicine, and Albert Einstein College of Medicine, their affiliated healthcare delivery systems, NewYork-Presbyterian and Montefiore Health System, and a 20-strong community stakeholder group. The EQUIP+ Center will train, mentor, fund, and support embedded LHS Scientists in conducting LHS research projects focused on AHRQ priorities, and will leverage the complementary strengths of each institution within our leadership, structure, and activities of the Administrative, Research Education, and Research and Data Analysis Cores. Our innovative project promotes multiple infrastructure enhancements, or “+” components: Submission+ guides LHS Scientists to develop robust research project proposals; Project+ provides tailored mentoring and consulting support and resources to conduct LHS projects; and Dissemination+ gives practical support to widely share research findings and lessons learned. To achieve our vision of embedded LHS Scientists who generate evidence for improving operations, equity, quality, safety, and outcomes, the EQUIP+ Center will pursue the following aims: Aim 1–Build and coordinate a robust LHS infrastructure, through the EQUIP+ Center, that provides vital research resources to embedded LHS Scientists and meets their individual training and research project needs; Aim 2–Develop and deliver a high-caliber, multidisciplinary LHS research didactics and mentorship program for a diverse group of embedded LHS Scientists to equip them with the knowledge and practical skills to conduct PCOR/CER and to launch their independent careers in LHS research; Aim 3–Support LHS Scientists in applying rigorous research methods to conduct PCOR/CER projects focused on the intersection of equity and quality, in collaboration with LHS partners and stakeholders.