CHALLENGES OF BUILDING A LEARNING HEALTH SYSTEM FOR EARLY PSYCHOSIS CARE

The Early Psychosis Intervention Network (EPINET) is a national initiative designed to advance coordinated specialty care (CSC) for individuals experiencing first-episode psychosis by establishing a learning health system (LHS) infrastructure across diverse clinical sites. EPINET integrates harmonized data collection, stakeholder input, and continuous quality improvement to accelerate the translation of research into practice, thereby improving outcomes for service users. ONTrackNY, a statewide CSC program and EPINET regional hub, delivers evidence-based, multidisciplinary care—including psychopharmacology, cognitive-behavioral interventions, family support, supported employment and education, and peer services—to individuals aged 16–30 with recent-onset nonaffective psychosis. ONTrackNY emphasizes recovery-oriented, person-centered care and utilizes a centralized data infrastructure to monitor fidelity, inform practice-based research, and support ongoing adaptation of services. Both EPINET and ONTrackNY exemplify the integration of LHS principles in early psychosis care, fostering collaborative learning, standardized outcome measurement, and participatory governance. These approaches have demonstrated significant improvements in treatment engagement, functional recovery, and reduction in hospitalization rates, while also addressing disparities in access and outcomes. The ongoing development of EPINET and ONTrackNY continues to inform best practices and drive innovation in early intervention for psychosis. Challenges have included disrupted funding, high staff turnover, variable agency-level support, gaps in follow-up care, and implementing the model at rural sites.

References

Basaraba CN, Scodes JM, Dambreville R, et al: Prediction tool for individual outcome trajectories across the next year in first-episode psychosis in coordinated specialty care. JAMA Psychiatry. 2023;, 80(1):49-56. van der Ven E, Jones N, Bareis N, et al.: An intersectional approach to ethnoracial disparities in pathways to care among individuals with psychosis in coordinated specialty care. JAMA Psychiatry. 2022, 79(8):790-798.