The Learning Healthcare System


Note: Proceedings contain the opinion of the presenters, but do NOT reflect the conclusions of the Health and Medicine Division or the National Academies. Learn more about the differences between Reports and Proceedings.

A summary of an Institute of Medicine workshop, The Learning Healthcare System, is the first  publication of the IOM Roundtable on Evidence-Based Medicine, and the first in a series that will focus on issues important to improving the development and application of evidence in healthcare decision making. The Roundtable serves as a neutral venue for cooperative work among key stakeholders on several dimensions: to help transform the availability and use of the best evidence for the collaborative health care choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and, ultimately, to ensure innovation, quality, safety, and value in health care.

As our nation enters a new era of medical science that offers the real prospect of personalized health care, we will be confronted by an increasingly complex array of healthcare options and decisions.  This workshop  considered how health care is structured to develop and to apply evidence—from health professions training and infrastructure development to advances in research methodology, patient engagement, payment schemes, and measurement—and highlighted opportunities for the creation of a sustainable, learning healthcare system that gets the right care to people when they need it and then captures the results for improvement.

The most pressing needs for change identified in The Learning Healthcare System are those related to:

  • Adaptation to the pace of change
  • Stronger synchrony of efforts 
  • New clinical research paradigm
  • Clinical decision support systems
  • Tools for database linkage, mining, and use
  • Notion of clinical data as a public good
  • Incentives aligned for practice-based evidence
  • Public engagement
  • Trusted scientific broker
  • Leadership