The National Academy of Medicine’s Leadership Consortium: Collaboration for a Learning Health System provides a trusted venue for national leaders in health and health care to work cooperatively toward their common commitment to effective, innovative care that consistently adds value to patients and society. Consortium Members are leaders from core stakeholder communities brought together by their common commitment to steward the advances in science, value and culture necessary for a health system that continuously learns and improves in fostering healthier people.
"A learning health care system is 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."
NAM Leadership Consortium Charter
To address the growing threat to the nation’s health status, productivity, and competitiveness—the acute shortfall in health system effectiveness, efficiency, and equity—the Leadership Consortium announced the formation of the Emerging Fairer & Stronger from COVID-19: the National Commission on Investment Imperatives for a Healthy Nation (the Commission). The Commission aims to advance transformative improvements in the U.S. health system, motivated by and based on lessons learned from deadly shortfalls experienced during the COVID-19 pandemic. Learn more about this new initiative.
Catalyzing Innovative Health System Transformation: An Opportunity Agenda for the Center for Medicare & Medicaid Innovation
Since its founding, the Center for Medicare & Medicaid Innovation (CMMI) has tested more than 50 alternative payment models reaching more than 28 million patients across 528,000 health care providers and plans, yielding invaluable insights on the implementation of models to achieve better care, better health, and lower costs. On the other hand, many basic lessons learned are lessons unapplied. U.S. population health outcomes lag behind its highly economically developed peers and our health system is still firmly entrenched in the fee-for-service payment system that rewards service volume.
This Special Publication suggests six key priority actions for CMMI centered on signaling, mapping, measuring, modeling, partnering, and demonstrating. These priority actions, coupled with implementation considerations that focus on meaningful and continuous engagement, intersectionality and diversity, and expanding CMMI activities and impact, are intended to assist in aligning, supporting, and informing the implementation of CMMI’s Strategic Refresh.
Guided by a committee of national and community leaders that reflect diverse backgrounds and perspectives, the Assessing Community Engagement project aims to provide community-engaged, effective, and evidence-based tools to those who want to measure engagement to ensure that it is meaningful and impactful, with a special emphasis on ensuring equity as a critical input and outcome.
Advancing health and health care through cooperative projects
Action Collaboratives engage key stakeholders with similar interests and field responsibilities in cooperative activities to advance science and value in health and health care. These ad hoc convening activities aim to foster sector information sharing and cooperation in accelerating the evolution of a continuously learning health system, and progress on findings highlighted in prior Academies reports of mutual priority. Action Collaboratives currently support activities in four overlapping and complementary areas:
Supporting the conditions necessary for transforming real world experiences into valuable data that are routinely used to improve population and patient-level health.
Fostering improvements and innovation in digital infrastructure so that health technology is developed and applied in ways that consistently lead to better population and patient-level health.
Supporting payment systems that incentivize value and population health.
Advancing a culture of health equity and engagement that places the needs of people and communities at its core.
Employing an inclusive, “collaborative without walls” approach—balanced with practicality around individual projects—these convening activities bring together stakeholders with mutual interests to harness their substantial talent and expertise in the identification and development of cooperative efforts most practical and strategic to field advancement.
Projects of the Action Collaboratives are participant identified, driven, and supported, with facilitation by Consortium staff. They vary in structure and content to meet the needs of specific issues and challenges. Some focus on identifying issues of common interest and marshaling needed leadership, expertise and resources; others aim at cooperative development of tools needed for progress; and others seek to highlight strategies, through individually authored literature summaries, technical discussions, and cooperative issue reviews. Certain activities lead to proposals for formal workshops and studies for consideration by the NAM and the Academies.
Consortium activities are both informational and project focused. Projects are participant generated and supported, NAM-staff facilitated, and participant executed and “owned.” Products are ascribed to the engaged individuals. They are not products of the NAM or the Academies. Endorsement and use is at the discretion of individual organizations.
Emerging Stronger After COVID-19: Priorities for Health System Transformation
For decades, the U.S. health system has fallen far short of its potential to support and improve individual and population health. The COVID-19 pandemic has presented death and devastation—but also an unprecedented opportunity to truly transform U.S. health, health care, and health delivery.
To capitalize on this opportunity, the National Academy of Medicine gathered field leaders from across all of the major health system sectors to assess how each sector has responded to the pandemic and the opportunities that exist for health system transformation. The opportunity is now to capitalize on the hard-won lessons of COVID-19 and build a health care system that centers patients, families, and communities; cares for clinicians; supports care systems, public health, and biomedical research to perform at the best of their abilities; applies innovations from digital health and quality, safety, and standards organizations; and encourages health care payers and health product manufacturers and innovators to produce products that benefit all.
Sharing Health Data: The Why, the Will, and the Way Forward
Sharing health data and information across stakeholder groups is the bedrock of a learning health system. As data and information are increasingly combined across various sources, their generative value to transform health, health care, and health equity increases significantly. Health data has proven its centrality in guiding action to change the course of individual and population health, if properly stewarded and used.
This Special Publication features some of these novel data sharing collaborations, and has been developed to provide practical context and implementation guidance that is critical to advancing the lessons learned identified in its parent NAM Special Publication, Health Data Sharing: Building a Foundation of Stakeholder Trust. The focus of this publication is to identify and describe exemplar groups to dispel the myth that sharing health data more broadly is impossible and illuminate the innovative approaches that are being taken to make progress in the current environment.
Priorities on the Health Horizon: Informing PCORI’s Strategic Plan
To inform the next steps in their organizational strategy, the Patient-Centered Outcomes Research Institute (PCORI) enlisted the NAM to leverage its deep experience in convening experts on matters of significant national importance, including its longstanding thought leadership role in the realization of a learning health system.
This Special Publication outlines high-priority emerging issues in health, health care, and biomedical science and technology and offers cross-cutting opportunities to inform and shape PCORI’s strategic planning process to improve the effectiveness, efficiency, and equity of the U.S. health care system. Moving forward, building the capacity to continuously improve learning and sharing throughout the system will entail stakeholders working together as seamlessly as possible. The NAM and PCORI worked together to facilitate an expansive dialogue with key stakeholders ad engender trust through a focus on shared commitments to progress on improving health for all Americans in the decade ahead.
Health Data Sharing to Support Better Outcomes: Building a Foundation of Stakeholder Trust
The effective use of data is foundational to the concept of a learning health system—one that leverages and shares data to learn from every patient experience, and feeds the results back to clinicians, patients and families, and health care executives to transform health, health care, and health equity. More than ever, the American health care system is in a position to harness new technologies and new data sources to improve individual and population health.
We can improve together by sharing and using data in ways that produce trust and respect. Patients and families deserve nothing less.
Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril
The emergence of artificial intelligence (AI) in health care offers unprecedented opportunities to improve patient and clinical team outcomes, reduce costs, and impact population health. While there have been a number of promising examples of AI applications in health care, it is imperative to proceed with caution or risk the potential of user disillusionment, another AI winter, or futher exacerbation of existing health- and technology-driven disparities.
This Special Publication synthesizes current knowledge to offer a reference document for relevant health care stakeholders. It outlines the current and near-term AI solutions; highlights the challenges, limitations, and best practices for AI development, adoption, and maintenance; offers an overview of the legal and regulatory landscape for AI tools designed for health care application; prioritizes the need for equity, inclusion, and a human rights lens for this work; and outlines key considerations for moving forward.
AI is poised to make transformative and disruptive advances in health care, but it is prudent to balance the need for thoughtful, inclusive health care AI that plans for and actively manages and reduces potential unintended consequences, while not yielding to marketing hype and profit motives.
Caring for the Individual Patient: Understanding Heterogeneous Treatment Effects
Evidence-based medicine arose from a clear need and represents a major advance in the science of clinical decision-making. Despite broad acceptance of evidence-based medicine, however, a fundamental issue remains unresolved: evidence is derived from groups of people, yet medical decisions are made by and for individuals. Despite persistent assertions from clinicians that determining the best therapy for each patient is a more complicated endeavor than just picking the best treatment on average, traditional approaches have been overly reliant on the average effects estimated from the outcomes of clinical trials.
For evidence to be more applicable to individual patients, we need to combine methods for strong causal inference (first and foremost, randomization) with methods for prediction that permit inferences about which particular patients are likely to benefit and which are not. Better population-based outcomes will only be realized when we understand more completely how to treat patients as the unique individuals they are.
Leadership Consortium Staff
J. Michael McGinnis, Executive Director | Bio and CV
Laura Adams, Senior Counsel | LAdams@nas.edu
Ayodola Anise, Deputy Director | AAnise@nas.edu
Elaine Fontaine, Consultant | EFontaine@nas.edu
Sarah Greene, Senior Counsel | SGreene@nas.edu
Amanda Hunt, Senior Program Officer | AHunt@nas.edu
Annie Murff, Senior Program Assistant | AMurff@nas.edu
Asia Williams, Research Associate | AsWilliams@nas.edu