AHRQ and the National Academy of Medicine: A Shared Enthusiasm for Learning Health Systems

When I became AHRQ’s director in May, I was thrilled to join the Agency’s efforts to support the development and spread of learning health care systems. What could be more important than helping organizations increase their use of evidence to improve patient safety and quality of care?

After attending a recent meeting convened by the National Academy of Medicine (NAM), my enthusiasm has grown even more.

The June 29 meeting—"Moving Forward with the Vision of a Continuously Learning Health System"—was supported partly by AHRQ. Along with NAM’s Michael McGinnis, M.D., and AHRQ Deputy Director Sharon B. Arnold, Ph.D., I was pleased to welcome more than 50 thought leaders from health systems, academia, public health organizations, the health insurance sector, and Federal agencies.

And these experts wasted no time addressing core questions: What constitutes a learning health care system? How might learning health care systems be implemented? What strategies exist for spreading the vision of continuous learning?

As part of its contributions since 2006, NAM has provided a valuable working definition:

A learning health care system is one in which science, informatics, incentives and culture are aligned for continuous improvement and innovation, with best practices seamlessly embedded in the care process, patients and families active in all elements, and new knowledge captured as an integral by-product of the care experience.

AHRQ, meanwhile, has worked to further the dialogue. Earlier this year, we issued an invitation to health care delivery organizations to share what they’re learning about the challenges and solutions of becoming learning health care systems. The exercise yielded a thoughtful menu of possible future activities for AHRQ, building upon our ongoing work on quality and safety, including the development of measures for system improvements, tools for increased use of data, and training programs for systems’ researchers.

At the NAM meeting, the mood was upbeat and the theme was clear: A health care organization that systematically collects, adopts, and applies evidence has strong potential to improve patient safety and quality of care.

In particular, participants discussed how organizations might be motivated to embrace the principles of a learning health care system, and we heard many ideas about how AHRQ might catalyze these efforts. Also addressed was the need to support systems that seek wider use of evidence after early successes within a limited clinical area.

Participants also emphasized that efforts to advance learning health care systems should prioritize the interests of physicians and patients.

I’m extremely optimistic about the prospects for making progress in this critical area of health care. In September, AHRQ will sponsor a research summit to gather more ideas aimed at guiding the Agency’s future work. It won’t answer all of our questions about how to inspire and support learning health care systems. But it will certainly be another important step forward.

Exciting times ahead!

Gopal Khanna is Director of AHRQ.