Learning Health System Shared Commitments
The National Academy of Medicine’s Learning Health System Shared Commitments are the product of the Learning Health System initiative stewarded since 2006 by the NAM Leadership Consortium. The Shared Commitments build upon landmark publications To Err is Human and Crossing the Quality Chasm, which identified quality health care as that which is: safe, effective, patient-centered, timely, efficient, and equitable. They have been expanded through the NAM’s leadership and reported in the NAM Learning Health System Series of publications to focus on both health and health care improvement, and to add the critical elements of transparency, accountability, security, and adaptability. These Shared Commitments are integral to continuous learning and improvement.
In addition to establishing common ground in a fragmented ecosystem, implementation of the Shared Commitments will accelerate discovery, health and medical care effectiveness, improved system and organizational performance, and identification of policy opportunities and priorities. They can also serve as a framework for increasing system trust and enhancing organizational culture and synergy. The Shared Commitments are adaptable as foundation stones of any health sector stakeholder seeking to be a learning health organization and reflect the commitment of all learning health organizations to effectiveness, efficiency, equity, and continuous learning.
Shared Commitments: A Trust Framework
Health and health care that is…
| ENGAGED | Gives primacy to understanding, caring, and acting on people’s goals |
| SAFE | Deploys verified protocols to safeguard against risk from unintended harm |
| EFFECTIVE | Applies continuously updated evidence to target goal achievement |
| EQUITABLE | Advances parity in individual opportunity to reach full health potential |
| EFFICIENT | Delivers optimal outcomes and affordability for accessible resources |
| ACCESSIBLE | Provides timely, convenient, interoperable, and affordable services |
| ACCOUNTABLE | Identifies clear responsibilities, measures that matter, and reliable feedback |
| TRANSPARENT | Displays full clarity and sharing in activities, processes, results, and reports |
| SECURE | Embeds safeguards in access, sharing, and use of data and digital/AI tools |
| ADAPTIVE | Centers continuous learning and improvement in organizational practices |
In 2006, the National Academy of Medicine (then the IOM/Institute of Medicine) advanced the notion of the Learning Health System, defined as “one in which science, informatics, incentives, and culture are aligned for continuous improvement, innovation, and equity—with best practices and discovery seamlessly embedded in the delivery process, individuals and families active participants in all elements, and new knowledge generated as an integral by-product of the delivery experience.”
Extraordinary advances in digital health capacity, along with the development of new research approaches and a growing appreciation of the need to identify and adopt much more rapidly lessons learned about effective interventions, offers the nation both an opportunity and pressing imperative to implement the Shared Commitments of the LHS as a means of providing common ground for systematic, sustained, and focused improvements.
