April 8, 2013

By Charles P. Friedman, PhD; and Joshua C. Rubin, JD, MBA, MPH, MPP
April 2013, HIMSS Clinical Informatics Insights

As the nation’s health system goes digital, a clear consensus is emerging: Our historic investment of over $150 billion in health IT will yield the anticipated benefits only if we harmonize efforts nationwide into a national-scale Learning Healthcare System (LHS). Just as the internet had transformative impacts on numerous and diverse stakeholders’ ways of working, communicating and interacting, the LHS promises to have broad and far-reaching impacts on health.

What is the Learning Healthcare System?
The IOM defines an LHS as “... one in which progress in science, informatics, and care culture align to generate new knowledge as an ongoing, natural by‐product of the care experience, and seamlessly refine and deliver best practices for continuous improvement in health and healthcare.”

The LHS is one infrastructure, serving multiple purposes, being built collaboratively atop a foundation of meaningful use and other health IT investments. The LHS allows the increasing amount of health data that is captured digitally – about 30 percent now, expected to be 80 percent by 2019 – to be aggregated, analyzed and converted to actionable knowledge.

This knowledge is then shared with stakeholders who can benefit and learn from it. The LHS holds the potential to transform care delivery by shortening the 17-year gap between knowledge generation and its application, to empower clinicians and patients with knowledge to inform their decisions, and to create a more robust public health and biomedical research infrastructure for the nation.

What is the Learning Healthcare Community Movement?
At the same time, this imperative is spawning a national movement: a grassroots Learning Healthcare Community mobilizing multiple and diverse stakeholders to realize a shared vision for the LHS. This vision was articulated in a set of Core Values developed collaboratively at a multi-stakeholder meeting last May. Noting their alignment with HIMSS’ mission,HIMSS was an early endorser of the LHS Core Values.

The LHS is being realized by initiatives growing out of the Learning Health Community, and, like any grassroots endeavor, it will become what the members of this community make it into. To help give shape to the LHS, we encourage your active participation and invite you to contact the authors to become engaged.

Evidence of support for the Learning Healthcare System
The LHS imperative is supported by a series of reports by the Institute of Medicine (IOM), the Federal Health IT Strategic Plan: 2011-2015, an issue of Health Affairs dedicated to rapid learning, and a recent New England Journal of Medicine commentary.

About the Contributors
Charles P. Friedman, PhD, is the Professor of Information and Public Health at the University of Michigan. Joshua C. Rubin, JD, MBA, MPH, MPP, is Executive Director of the Joseph H. Kanter Family Foundation.