Momentum Is Building for Health Systems That "Learn"

As part of AHRQ's mission to improve the quality and safety of health care, the Agency is actively exploring how its work can help transform health care organizations into learning health care systems. Utilizing one of the principles of a learning health care system, we are looking both within and outside of AHRQ as we design our activities.

Recently, we invited Dr. Michael McGinnis, National Academy of Medicine (NAM) senior scholar and Executive Director of the NAM Leadership Consortium for a Value & Science-Driven Health System, to visit with us.

NAM has been working in the learning health care system space for the past decade. Under Dr. McGinnis's leadership, NAM launched the Learning Health System Initiative, a program that aligns science, informatics, incentives and culture for continuous improvement and innovation in health.

During his time with us, Dr. McGinnis provided a compelling update on learning health care systems and their potential to tackle some of the most urgent challenges facing today's hospital and health system leaders, clinicians, policymakers, administrators and researchers.

In his discussion with AHRQ leaders and researchers, Dr. McGinnis offered several reasons why the time is right for accelerating the learning health care system:

• The trend toward evidence-based medicine continues. But the need to efficiently harness data to support this trend has never been greater. Since 1970, the number of medical journal articles published per year has effectively quadrupled, severely challenging clinicians' efforts to keep pace with the cascade of new evidence.
• The consequences of suboptimal care are staggering. The delivery of unnecessary tests and treatments results in enormous amounts of unnecessary spending—by one estimate more than $200 billion per year.
• Better use of data could reduce missed opportunities, such as preventing harms that befall up to one-third of hospital patients, or increasing the recommended amount of care that is currently delivered only about half of the time.

As he shared with us valuable insights on what role AHRQ can play moving forward, Dr. McGinnis emphasized that AHRQ is uniquely equipped to advance learning health care systems. There's a great deal of overlap between the opportunities for progress that he sees—with respect to informatics, science, incentives, and culture—and AHRQ's activities, particularly related to the use of data to support changes in care, and measuring and improving a culture of safety.

Dr. McGinnis's presentation to AHRQ was a timely complement to responses received by the Agency to a recent Federal Register Notice requesting information about how organizations select and apply evidence to everyday practice. Those responses helped to identify areas for future work, including:

• Developing measures of system improvement
• Producing tools to help health systems use their own data
• Investing in training that provides a bridge between researchers and health care systems

In the coming months, AHRQ will continue to develop plans for catalyzing the development of data analytics and advancing the implementation of evidence into the practice of medicine. Thanks, Mike, for helping us along this journey!

Dr. Arnold is deputy director of AHRQ.