BOX 9-1
Strategic Elements

TECHNICAL PROGRESS…activities that advance:

  • Ultra-large-scale system perspective
  • Functionality focus
  • System specifications/interoperability
  • Workflow and usability
  • Security and privacy safeguards
  • System innovation

KNOWLEDGE GENERATION AND USE…activities that advance:

  • Shared learning environment
  • Point of decision support and guidance
  • Research-ready records for data reuse
  • Patient-generated data
  • Integration and use of data across sources
  • Distributed data repositories
  • Sentinel indicators
  • Query capacity
  • Analytic tools and methods innovation


  • Value proposition and patient confidence
  • Shared learning culture
  • Patient-clinician outcomes partnerships
  • Person-centric, lay-oriented health information access
  • Closing the disparity gap
  • Continuous evaluation

GOVERNANCE…activities that advance:

  • The vision
  • Guiding principles
  • Participant roles and responsibilities
  • Process and protocol stewardship
  • Implementation phasing
  • Continuous evaluation

Attention to the technical aspects of security and privacy concerns were highlighted as major contributors to the building of trust among system stakeholders. Finally, the need to drive continuous innovation of technical approaches through constant testing and refinement and the creation of a supporting multidisciplinary research ecosystem were suggested.

Discussion of the strategic elements needing attention for the creation of a robust knowledge generation and use engine for the learning health

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