National Academy of Medicine

Generating Knowledge from Best Care: Advancing the Continuously Learning Health System

By Edward Abraham, Carlos Blanco, Celeste Castillo Lee, Jennifer B. Christian, Nancy Kass, Eric B. Larson, Madhu Mazumdar, Stephanie Morain, Katherine M. Newton, Alexander Ommaya, Bray Patrick-Lake, Richard Platt, John Steiner, Maryan Zirkle, Marianne Hamilton Lopez
September 06, 2016 | Discussion Paper

In this discussion paper, the authors aim to facilitate the growth of learning health environments by highlighting strategies and examples of operational and research collaborations within delivery system settings in the United States. Informed by empirical data, conceptual literature, and authors’ experiences, the paper explores barriers to successful research and operational collaborations within the current health care context, as well as strategies that various health systems have used to move further toward the goal of continuous learning.

Specifically, the authors highlight activities by the National Academy of Medicine (NAM) and the Patient-Centered Outcomes Research Institute (PCORI) to engage various stakeholders, specifically health executives, in the evidence-generation process; present an overview of collaborative activities that have resulted from these initiatives, including the findings from two research projects designed explicitly to explore the priorities, decisions, and analytic needs facing health executives at the delivery-system level as they consider further transitioning to a learning health system; and finally offer a series of priorities for actions and corresponding case examples, to demonstrate strategies for generating knowledge from care. While all types of research are essential to continuous learning, this Perspective focuses on those evidence-generating activities that are designed explicitly to be conducted within the care delivery system, embedded within the practice of routine care, and whose findings are used to impact the clinical enterprise.

It is the authors’ intention that this paper will add to the emerging body of knowledge around learning health systems while also serving as an actionable blueprint for institutions interested in transforming to a continuously learning system.



Suggested Citation

Abraham, E., C. Blanco, C. Castillo Lee, J. B. Christian, N. Kass, E. B. Larson, M. Mazumdar, S. Morain, K. M. Newton, A. Ommaya, B. Patrick-Lake, R. Platt, J. Steiner, M. Zirkle, and M. Hamilton Lopez. 2016. Generating Knowledge from Best Care: Advancing the Continuously Learning Health System. NAM Perspectives. Discussion Paper, National Academy of Medicine, Washington, DC. doi: 10.31478/201609b


Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.