Learning healthcare systems: a perspective from the US

Changes under way in the healthcare environment have the potential to accelerate the pace at which evidence is incorporated into practice. Motivated by new payment models that hold clinicians accountable for cost and quality, healthcare organisations in the US are developing their capacity to become learning healthcare systems that are able to generate, adopt and apply evidence to support quality improvement and high-value care. The pace at which healthcare organisations will make progress will depend on whether they perceive a return on their investments, the availability of internal and external resources to help them make this transformation, and the external pressures on them to be accountable for managing the cost and quality of their patient care.