with their clinicians; and, with the help of their caregivers, directly applying evidence to their self-care and self-management on an ongoing basis.

Partnering with patients are the health care professionals who deliver care. Physicians, nurses, pharmacists, and other health professionals represent the front lines of health care delivery and the primary interface for patients and consumers. Expanding the supply of clinical information, promoting the use of evidence, and better involving patients in their care are all contingent upon the engagement and teaming of health professionals.

By convening their constituent professionals and providing a forum for action, professional societies have important roles in achieving the vision of a learning health care system. Through guidelines, performance measures, quality improvement initiatives, and data infrastructures for assessing performance with respect to specific procedures or conditions, these societies can take a leadership role in improving quality, safety, and efficiency.

Health care delivery organizations, because of their size and care capacities, have several levers by which they can steward progress toward a continuously improving system, such as using new practice methods, setting standards, and sharing resources and information with other care delivery organizations. Furthermore, through investments in health information technology, these organizations can build their capacity to perform near-real-time research, speeding the generation of practical evidence and its translation to the bedside.

Those who finance care also have opportunities to leverage their unique position to improve the quality and efficiency of care. As organizations that interact directly with patients, public and private payers can support patients as they seek to maintain healthy behaviors and access quality health care services, while their payment and contracting policies have a strong influence on how clinicians practice. Similarly, employers can support efforts to improve quality and value by using their purchasing power to drive improvement efforts through contracts with providers and insurers, the design of benefit plans, and the provision of incentives and information for employees.

Digital technology developers, health product innovators, and regulators are additional stakeholders that need to be engaged in achieving the vision of a learning health care system. Digital technology developers create the products and infrastructure necessary to meet the growing demand for capturing, storing, retrieving, and sharing information in virtually every aspect of health care. Continuous improvement in diagnostic and treatment options is contingent on a safe and innovative product development enterprise. Health product innovators, by conducting clinical research and devising new treatments and interventions, can develop novel products for diagnosis and treatment. Essential partners in this arena are regulators, including the Food and Drug Administration, who can work to develop



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