From Learning Healthcare Systems to Learning Health Systems

There is growing national and international interest in creating learning healthcare systems; this drive is stimulated by the (then) Institute of Medicine's (now National Academy of Medicine) 2007 seminal report on the Learning Healthcare System.1 In this report, the Institute of Medicine urged for the creation of a model of care “…that is designed to generate and apply the best evidence for the collaborative healthcare choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and to ensure innovation, quality, safety, and value in healthcare.” Over the ensuing 12 years, this bold idea has catalyzed considerable scientific, clinical, and policy interest in finding ways to converge the processes of knowledge generation and practice improvement and through doing so, simultaneously improving healthcare delivery and personalization of care2 whilst also containing healthcare expenditure.3 Whilst this expanding interest is welcome in many respects, I believe the emphasis on Learning Healthcare Systems is misplaced. My contention is that we need to focus on the creation of Learning Health Systems. There are two key reasons why I believe we need to shift our focus, which I summarize below.

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