Seven practices for pursuing equity through learning health systems: Notes from the field

Despite learning health systems' focus on improvement in health outcomes, inequities in outcomes remain deep and persistent. To achieve and sustain health equity, it is critical that learning health systems (LHS) adapt and function in ways that directly prioritize equity.

We present guidance, including seven core practices, borne from theory, evidence, and experience, for actors within LHS pursuing equity.

We provide a foundational definition of equity. We then offer seven core practices for how LHS may effectively pursue equity in health: establish principle, measure for equity, lead from lived experience, co-produce, redistribute power, practice a growth mindset, and engage beyond the healthcare system. We include three use cases that illustrate ways in which we have begun to center equity in the work of our own LHS.

The achievement of equity requires real transformation at individual, institutional, and structural levels and requires sustained and persistent effort.