streamlined methods for ensuring that safe, effective products are brought to market without delay.

A learning health care system depends on evidence to promote improvements in care delivery processes and patient care and overall system improvement. Consequently, health researchers are critical partners in generating knowledge on the effectiveness and value of interventions and care protocols. A commitment to practical and efficient research methods across the spectrum of the research enterprise—the design and operation of clinical trials, the development of clinical registries and clinical databases, the creation of standards and metrics, modeling and simulation studies, studies of health services and care delivery processes, and the aggregation of study results into systematic reviews and clinical guidelines—is foundational for a learning system. Through their programmatic and funding activities, private philanthropies, as well as agencies and organizations such as the Agency for Healthcare Research and Quality, the National Institutes of Health, and the Patient-Centered Outcomes Research Institute have a central role to play in the stewardship and strategic direction of these activities.

Missed opportunities for better health care have real human and economic impacts. If the care in every state was at the quality delivered by the highest performing state, there would have been an estimated 75,000 fewer deaths across the country in 2005 (McCarthy et al., 2009; Schoenbaum et al., 2011). Current waste diverts resources from productive use—an estimated $750 billion lost (IOM, 2010). It is only through shared commitments, in alignment with a supportive policy environment, that the opportunities offered by science and information technology can be captured to address the health care system’s growing challenges and to ensure that it reaches its full potential to provide the best care for each patient. The nation’s health and economic futures—best care at lower cost—depend on the ability to steward the evolution of a continuously learning health care system.


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