The National Academy of Medicine (NAM) has announced the launch of its Shared Commitments initiative, a national effort to align all health stakeholders—patients and those supporting them—in ensuring that every person and community throughout the nation can expect health and health care that is effective, efficient, fair, and continuously learning and improving.
“This year marks the 20th anniversary of the NAM’s launch of the Learning Health System program.” said Michael McGinnis, Executive Officer of the NAM. “The LHS Shared Commitments represent the practical and meaningful embodiment of what we have learned, the growth in availability of health data, development of AI and other new technologies, and the deeper understanding of how the system can be refocused to deliver what matters most to people.”
The initiative provides a unifying framework to bring together clinicians, researchers, payers, policymakers, patients, and families to improve quality, safety, fairness, and affordability across the U.S. health system.
“A learning health system changes what’s possible,” said Peter Margolis, Adjunct Professor of Pediatrics at Stanford University School of Medicine and co-chair of the NAM Learning Health System Strategy Group. “Imagine a health system in which every part works seamlessly toward one shared goal: better health for every person. Care that is accessible, personalized, and guided by the outcomes that matter most. Care that learns from each patient experience and turns those insights into better practice everywhere.”
A Trust Framework to Align Action
At the center of the initiative is the Shared Commitments framework, a set of principles that define what patients, providers, and communities should expect from a health system built for continuous improvement. They call for health and health care that is:
- Engaged – Understanding and acting on people’s goals
- Safe – Using validated safeguards to prevent harm
- Effective – Applying continuously updated evidence
- Efficient – Delivering optimal outcomes for resources available
- Fair – Advancing parity in people’s opportunities to reach full health potential
- Accessible – Offering timely, convenient, interoperable, and affordable services
- Accountable – Measuring what matters, with clear responsibility and feedback
- Transparent – Open sharing of activities, decision-making processes, and results
- Secure – Using protected data sharing and digital/AI responsibly to speed progress
- Adaptive – Centering continuous learning and improvement in organizational priorities
Together, these commitments provide a common trust framework for health care delivery and transformation, offering a practical foundation for aligning people, processes, technology, and incentives around better outcomes for all.
Scientific breakthroughs—from next-generation metabolic therapies to AI-enhanced diagnostics—can only improve lives when integrated into care models that are affordable, accessible, and validated in real-world settings. A learning health system ensures this translation happens effectively and fairly by uniting science, data, incentives, culture, and patient partnership.
The Shared Commitments will help organizations across the health ecosystem strengthen patient and community engagement as full partners in learning, integrate LHS principles into workforce development, and define the technical and structural requirements for real-time learning. Together, these efforts can help organizations build a shared, outcomes-oriented vision.
Chaired by Margolis, Nakela Cook, Executive Director of the Patient-Centered Outcomes Research Institute, and Sean Dowdy, Chief Value Officer, Associate Dean for Practice Transformation and Professor of Gynecologic Oncology at Mayo Clinic, the NAM initiative will host cross-sector dialogue, catalyze partnerships, and accelerate coordinated action to create a health system that learns at scale. Implementation is guided and informed by the LHS Strategy Group, comprised of leaders from stakeholder organizations across health, health care, and the learning health ecosystem. View the Strategy Group roster.
Through three working groups, the initiative will define what organizations need to put a learning health system into practice, including the routine measurement of outcomes, support for practice change, technology, and strong data practices. It will also convey the benefits for both public and private investors, support the integration of the Shared Commitments and learning health system principles into professional training and accreditation, and create clear communication strategies that help people understand the vision and real-world value of a learning health system.
This initiative announcement is the first activity within a larger movement toward cross-sector learning and system-wide resolve to continuously improve and learn.
“Transformation of this magnitude isn’t simple, but it is achievable and already underway,” said Dowdy. “Early adopters are showing that when organizations act with shared purpose, trust strengthens, outcomes improve, and innovation spreads faster.”
The direction is clear: a future where every person benefits from care and services that continuously learn and improve—for everyone, everywhere. The NAM invites organizations across the health ecosystem to join this initiative and help build a stronger and more resilient health system.
For more information about the Shared Commitments initiative and to get involved, visit nam.edu/shared-commitments.
