BD²: A roadmap for learning health networks driving care improvement in bipolar disorder

Background: The bipolar disorder field suffers from underinvestment of clinical and research resources, missing links between validated measures and individual biology, poorly understood practice variation, and gaps in clinical practice. These challenges underscore the need for systems-level approaches to improve care delivery. Learning Health Networks (LHNs) are a growing approach driving advances in care delivery by leveraging data and experiences to identify best practices. Key features of LHNs include diverse stakeholder engagement, standardized data collection, measurement-based care, shared governance, information technology infrastructure, and evidence generation. LHNs enable rapid dissemination of shared learnings to drive improvement in bipolar disorder care. Methods: A case study of the Breakthrough Discoveries for thriving with Bipolar Disorder (BD²) Integrated Network. Results: The BD² Integrated Network is composed of a longitudinal cohort study embedded within an LHN. A novel data platform to integrate new vectors of association in bipolar disorder that include electronic health record, smartphone, and wearable device data will produce actionable evidence to guide care delivery improvements. Feedback from individuals with lived experience of bipolar disorder prompted changes in the measurement strategy including: 1) reframing goals to increase positive outcomes instead of decreasing disease measures; and, 2) considering wellness factors that extend beyond the medical system. Limitations: The BD² Integrated Network is currently enrolling, and actionable insights are forthcoming. Conclusions: Lessons learned include the value of lived experience stakeholder input to shape the LHN and the need to navigate challenges in identifying common measures. This work provides a roadmap for advancing bipolar disorder treatment.