{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T05:27:21Z","timestamp":1787203641651,"version":"build-2736575974"},"reference-count":51,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Learning health system (LHS) frameworks have been presented in multiple forms, but there is no standardized representation that captures both their core concepts and the relationships among them. This limits their practical use by health services seeking to design, implement, and evaluate LHS capabilities in changing sociotechnical environments. This study developed the Smart Learning Health System ontology (SMARTLHS), a formal semantic framework that synthesizes concepts and relationships from published LHS frameworks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Relevant literature was identified through a systematic database search. SMARTLHS was developed using an iterative system mapping and ontology engineering approach, comprising five steps: (1) ontology requirements specification, (2) iterative ontology conceptualization, (3) concept and relationship comparison and formalization, (4) ontology evaluation and refinement, and (5) ontology alignment with foundational ontology, to ensure semantic consistency and interoperability. The SMARTLHS ontology was implemented using the Web Ontology Language (OWL) and developed in Prot\u00e9g\u00e9.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      SMARTLHS contains 447 classes and 134 object properties. Its structure is organized around four high\u2010level groupings:\n                      <jats:italic>LHSs, supporting pillars, cross\u2010cutting themes,<\/jats:italic>\n                      and\n                      <jats:italic>common reference LHS frameworks<\/jats:italic>\n                      . The supporting pillars comprise seven domains:\n                      <jats:italic>Care delivery and organizational strategies<\/jats:italic>\n                      ,\n                      <jats:italic>community and patient engagement, culture and change management, data and technology infrastructure, governance and leadership, research and education,<\/jats:italic>\n                      and\n                      <jats:italic>workforce and capacity building<\/jats:italic>\n                      . The cross\u2010cutting themes include\n                      <jats:italic>ethics and oversight, evaluation and methodology<\/jats:italic>\n                      , and\n                      <jats:italic>value creation and benefits<\/jats:italic>\n                      . Together, these classes and relationships provide a computable semantic representation of LHS implementation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SMARTLHS addresses key limitations of existing LHS frameworks by transforming narrative framework concepts into a formal, extensible semantic knowledge model. By explicitly representing both concepts and relationships, it provides a foundation for organizational assessment, semantic interoperability, and future AI\u2010enabled applications, including ontology\u2010guided retrieval and Retrieval\u2010Augmented Generation (RAG).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.70117","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:14:25Z","timestamp":1787148865000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Toward a Smart Learning Health System: An Ontology\u2010Based Framework"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6287-8781","authenticated-orcid":false,"given":"Meg","family":"Ma","sequence":"first","affiliation":[{"name":"Digital Health, South Easten Sydney Local Health District  Randwick New South Wales Australia"},{"name":"Centre for Digital Transformation, School of Computing and Information Technology University of Wollongong  Wollongong New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7910-9396","authenticated-orcid":false,"given":"Ping","family":"Yu","sequence":"additional","affiliation":[{"name":"Centre for Digital Transformation, School of Computing and Information Technology University of Wollongong  Wollongong New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise D.","family":"Hickman","sequence":"additional","affiliation":[{"name":"Faculty Medicine and Health University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50039"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3001456"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.15265\/IYS-2016-s006"},{"key":"e_1_2_11_5_1","volume-title":"Digital Infrastructure for the Learning Health System: The Foundation for Continuous Improvement in Health and Health Care: Workshop Series Summary. 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