Actioning the Learning Health System: An applied framework for integrating research into health systems

Health systems across the world experience pervasive gaps in the speed with which high quality evidence is generated, implemented and refined. A Learning Health System (LHS) approach that blends research with health care operations is to eliminate or reduce delays. This paper builds on existing LHS frameworks to deepen our practical understanding of the research-health systems operations interface and to provide actionable insights on how to realize a LHS in practice. We present a LHS action framework that describes how research and health care operations are linked and enacted in a comprehensive LHS approach to advance population health and health equity. Health systems seeking to implement a LHS approach can use this framework to identify capabilities necessary to enact the learning elements, including key questions and methods, to ensure a systematic approach to learning and achieving equity-centered quadruple aim metrics.